On pulsed fusion experiments, the neutron time of flight (nToF) diagnostic provides critical information on the fusion neutron energy spectrum. This work presents an analysis technique that uses two collinear nToF detectors, potentially to measure nuclear bang time and directional flow velocities. Two collinear detectors may be sufficient to disambiguate the contributions of nuclear bang time and directional flow velocities to the first moment of the neutron energy spectrum, providing an independent measurement of nuclear bang time.
View Article and Find Full Text PDFJ Hepatobiliary Pancreat Sci
January 2018
Management bundles that define items or procedures strongly recommended in clinical practice have been used in many guidelines in recent years. Application of these bundles facilitates the adaptation of guidelines and helps improve the prognosis of target diseases. In Tokyo Guidelines 2013 (TG13), we proposed management bundles for acute cholangitis and cholecystitis.
View Article and Find Full Text PDFJ Hepatobiliary Pancreat Sci
January 2018
Antimicrobial therapy is a mainstay of the management for patients with acute cholangitis and/or cholecystitis. The Tokyo Guidelines 2018 (TG18) provides recommendations for the appropriate use of antimicrobials for community-acquired and healthcare-associated infections. The listed agents are for empirical therapy provided before the infecting isolates are identified.
View Article and Find Full Text PDFThe initial management of patients with suspected acute biliary infection starts with the measurement of vital signs to assess whether or not the situation is urgent. If the case is judged to be urgent, initial medical treatment should be started immediately including respiratory/circulatory management if required, without waiting for a definitive diagnosis. The patient's medical history is then taken; an abdominal examination is performed; blood tests, urinalysis, and diagnostic imaging are carried out; and a diagnosis is made using the diagnostic criteria for cholangitis/cholecystitis.
View Article and Find Full Text PDFTuberculosis (TB) affects the production and life span of all hematologic cellular components. In addition, plasma coagulation factors may be affected, resulting in sometimes life-threatening complications. Iron, folate, and vitamin B12 metabolism is derailed.
View Article and Find Full Text PDFThe diagnosis of latent and active tuberculosis in the HIV-positive population is challenged by diminished sensitivity of conventional tests, atypical presentations, and the lack of culture methods in the developing world, where the burden of co-infection is greatest. In response to these challenges, a variety of new diagnostics have emerged. These include interferon-gamma release assays for the diagnosis of latent tuberculosis (TB) infection and novel culture methods and molecular assays for the diagnosis of active tuberculosis.
View Article and Find Full Text PDFBoth primary and reactivation tuberculosis may present as an acute process and mimic community-acquired pneumonia. Tuberculosis should always be included in the initial differential diagnosis, and suspicion should be heightened by a variety of clinical and epidemiologic clues, as well as by multiple underlying conditions. This article reviews the pathophysiology, risk factors, and clinical manifestations of acute presentations of tuberculosis.
View Article and Find Full Text PDFTuberculosis is an important cause of fever of unknown origin. Travel, age, dialysis, diabetes, birth in a country with a high prevalence of tuberculosis, and immunoincompetence are among the most salient risks. Associated physical findings, radiologic evaluation, and hematologic and endocrinologic abnormalities may provide clues to the diagnosis.
View Article and Find Full Text PDFTuberculosis (TB) is an enormous global public health problem. Cases of extensively drug-resistant TB (XDR-TB) are being reported in increasing numbers across the globe. A large outbreak of XDR-TB associated with rapid and nearly universal mortality has been reported among patients with human immunodeficiency virus infection or acquired immunodeficiency disease in South Africa who have been receiving standard TB therapy and antiretrovirals.
View Article and Find Full Text PDFA systematic approach is presented for the patient with antibiotic failure. Noninfectious mimics of infection and nontreatable infections must first be excluded. Then, the clinician must identify those patients who have responded but have a surgical component of their infection or have complications separate from their initial infection.
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