| 1. |
- Valassi, E., et al.
(author)
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High mortality within 90 days of diagnosis in patients with Cushing's syndrome: results from the ERCUSYN registry
- 2019
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In: European Journal of Endocrinology. - : Oxford University Press (OUP). - 0804-4643 .- 1479-683X. ; 181:5, s. 461-472
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Journal article (peer-reviewed)abstract
- Objective: Patients with Cushing's syndrome (CS) have increased mortality. The aim of this study was to evaluate the causes and time of death in a large cohort of patients with CS and to establish factors associated with increased mortality. Methods: In this cohort study, we analyzed 1564 patients included in the European Registry on CS (ERCUSYN); 1045 (67%) had pituitary-dependent CS, 385 (25%) adrenal-dependent CS, 89 (5%) had an ectopic source and 45 (3%) other causes. The median (IQR) overall follow-up time in ERCUSYN was 2.7 (1.2-5.5) years. Results: Forty-nine patients had died at the time of the analysis; 23 (47%) with pituitary-dependent CS, 6 (12%) with adrenal-dependent CS, 18 (37%) with ectopic CS and two (4%) with CS due to other causes. Of 42 patients whose cause of death was known, 15 (36%) died due to progression of the underlying disease, 13 (31%) due to infections, 7 (17%) due to cardiovascular or cerebrovascular disease and 2 due to pulmonary embolism. The commonest cause of death in patients with pituitary-dependent CS and adrenal-dependent CS were infectious diseases (n = 8) and progression of the underlying tumor (n = 10) in patients with ectopic CS. Patients who had died were older and more often males, and had more frequently muscle weakness, diabetes mellitus and ectopic CS, compared to survivors. Of 49 deceased patients, 22 (45%) died within 90 days from start of treatment and 5 (10%) before any treatment was given. The commonest cause of deaths in these 27 patients were infections (n = 10; 37%). In a regression analysis, age, ectopic CS and active disease were independently associated with overall death before and within 90 days from the start of treatment. Conclusion: Mortality rate was highest in patients with ectopic CS. Infectious diseases the commonest cause of death soon after diagnosis, emphasizing the need for careful vigilance at that time, especially in patients presenting with concomitant diabetes mellitus.
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| 2. |
- Cherenko, M., et al.
(author)
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Venous thromboembolism in Cushing syndrome: results from an EuRRECa and Endo-ERN survey
- 2024
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In: Endocrine Connections. - 2049-3614. ; 13:6
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Journal article (peer-reviewed)abstract
- Background: Patients with Cushing syndrome (CS) are at increased risk of venous thromboembolism (VTE). Objective: The aim was to evaluate the current management of new cases of CS with a focus on VTE and thromboprophylaxis. Design and methods: A survey was conducted within those that report in the electronic reporting tool (e-REC) of the European Registries for Rare Endocrine Conditions (EuRRECa) and the involved main thematic groups (MTG’s) of the European Reference Networks for Rare Endocrine Disorders (Endo-ERN) on new patients with CS from January 2021 to July 2022. Results: Of 222 patients (mean age 44 years, 165 females), 141 patients had Cushing disease (64%), 69 adrenal CS (31%), and 12 patients with ectopic CS (5.4%). The mean follow-up period post-CS diagnosis was 15 months (range 3–30). Cortisol-lowering medications were initiated in 38% of patients. One hundred fifty-four patients (69%) received thromboprophylaxis (including patients on chronic anticoagulant treatment), of which low-molecular-weight heparins were used in 96% of cases. VTE was reported in six patients (2.7%), of which one was fatal: two long before CS diagnosis, two between diagnosis and surgery, and two postoperatively. Three patients were using thromboprophylaxis at time of the VTE diagnosis. The incidence rate of VTE in patients after Cushing syndrome diagnosis in our study cohort was 14.6 (95% CI 5.5; 38.6) per 1000 person-years. Conclusion: Thirty percent of patients with CS did not receive preoperative thromboprophylaxis during their active disease stage, and half of the VTE cases even occurred during this stage despite thromboprophylaxis. Prospective trials to establish the optimal thromboprophylaxis strategy in CS patients are highly needed. Significance statement The incidence rate of venous thromboembolism in our study cohort was 14.6 (95% CI 5.5; 38.6) per 1000 person-years. Notably, this survey showed that there is great heterogeneity regarding time of initiation and duration of thromboprophylaxis in expert centers throughout Europe.
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| 3. |
- Riley, M A, et al.
(author)
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Beyond band termination in Er-157 and the search for wobbling excitations in strongly deformed Hf-174
- 2005
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In: Journal of Physics G: Nuclear and Particle Physics. - : IOP Publishing. - 0954-3899 .- 1361-6471. ; 31:10, s. 1735-1740
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Journal article (peer-reviewed)abstract
- High-spin terminating bands in heavy nuclei were first identified in nuclei around Er-158(90). While examples of special terminating states have been identified in a number of erbium isotopes, almost nothing is known about the states lying beyond band termination. In the present work the high-spin structure of Er-157 has been studied using the Gammasphere spectrometer. The subject of triaxial superdeformation and 'wobbling' modes in Lu nuclei has rightly attracted a great deal of attention. Very recently, four strongly or superdeformed (SD) sequences have been observed in Hf-174 and ultimate cranker calculations predict, such structures may have significant triaxial deformation. We have performed two experiments in an attempt to verify the possible triaxial nature of these bands. A lifetime measurement was performed to confirm the large (and similar) deformation of the bands. In addition, a high-statistics, thin-target experiment was run to search for linking transitions between the SD bands and possible wobbling modes.
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| 4. |
- Riley, M. A., et al.
(author)
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Observation of states beyond band termination in Er-156,Er-157,Er-158 and strongly deformed structures in Hf-173,Hf-174,Hf-175
- 2006
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In: Physica Scripta. - 0031-8949. ; T125, s. 123-126
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Journal article (peer-reviewed)abstract
- High-spin terminating bands in heavy nuclei were first identified in nuclei around Er-158(90). While examples of terminating states have been identified in a number of erbium isotopes, almost nothing is known about the states lying beyond band termination. In the present work, the high-spin structure of Er-156,Er-157,Er-158 has been studied using the Gammasphere spectrometer. The subject of triaxial superdeformation and 'wobbling' modes in Lu nuclei has rightly attracted a great deal of attention. Very recently four strongly or superdeformed (SD) sequences have been observed in Hf-174, and cranking calculations using the Ultimate Cranker code predict that such structures may have significant triaxial deformation. We have performed two experiments in an attempt to verify the possible triaxial nature of these bands. A lifetime measurement was performed to confirm the large (and similar) deformation of the bands. In addition, a high-statistics, thin-target experiment took place to search for linking transitions between the SD bands, possible wobbling modes, and new SD band structures.
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| 5. |
- Simpson, J., et al.
(author)
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Evolution of structure and shapes in Er 158 to ultrahigh spin
- 2023
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In: Physical Review C. - 2469-9985. ; 107:5
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Journal article (peer-reviewed)abstract
- The level structure of Er158 has been studied using the Gammasphere spectrometer via the Cd114(Ca48,4n) reaction at 215 MeV with both thin (self-supporting) and thick (backed) targets. The level scheme has been considerably extended with more than 200 new transitions and six new rotational structures, including two strongly coupled high-K bands. Configuration assignments for the new structures are based on their observed alignments, B(M1)/B(E2) ratios of reduced transition probabilities, excitation energies, and comparisons with neighboring nuclei and theoretical calculations. With increasing angular momentum, this nucleus exhibits Coriolis-induced alignments of both neutrons and protons before it then undergoes a rotation-induced transition from near-prolate collective rotation to a noncollective oblate configuration. This transition occurs via the mechanism of band termination around spin 45ħ in three rotational structures. Two distinct lifetime branches, consistent with the crossing of a collective "fast"rotational structure by an energetically favored "slow"terminating sequence, are confirmed for the positive-parity states, and similar behavior is established in the negative-parity states. Weak-intensity, high-energy transitions are observed to feed into the terminating states. At the highest spins, three collective bands with high dynamic moments of inertia and large quadrupole moments were identified. These bands are interpreted as triaxial strongly deformed structures and mark a return to collectivity at ultrahigh spin.
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| 6. |
- Bhowal, S., et al.
(author)
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Development of collective structures over noncollective excitations in Nd-139
- 2011
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In: Physical Review C (Nuclear Physics). - 0556-2813. ; 84:2
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Journal article (peer-reviewed)abstract
- High-spin states in Nd-139 were investigated using the reaction Zr-96(Ca-48,5n) at a beam energy of 195 MeV and gamma-ray coincidences were acquired with the Euroball spectrometer. Apart from several dipole bands at medium excitation energy, three quadrupole bands have been observed at high spin. Linking transitions connecting two of the high-spin bands to low-energy states have been observed. Calculations based on the cranked-Nilsson-Strutinsky formalism have been used to assign configurations for the high-spin quadrupole bands.
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| 7. |
- Forsberg, Ulrika, et al.
(author)
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Spectroscopic Tools Applied to Element Z = 115 Decay Chains
- 2014
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In: EPJ Web of Conferences. - : EDP Sciences. - 2100-014X .- 2101-6275. - 9782759811755 - 9782759811762 ; 66, s. 02036-02036
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Conference paper (peer-reviewed)abstract
- Nuclides that are considered to be isotopes of element Z = 115 were produced in the reaction 48Ca + 243Am at the GSI Helmholtzzentrum für Schwerionenforschung Darmstadt. The detector setup TASISpec was used. It was mounted behind the gas-filled separator TASCA. Thirty correlated α-decay chains were found, and the energies of the particles were determined with high precision. Two important spectroscopic aspects of the offline data analysis are discussed in detail: the handling of digitized preamplified signals from the silicon strip detectors, and the energy reconstruction of particles escaping to upstream detectors relying on pixel-by-pixel dead-layer thicknesses.
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| 8. |
- Leguillon, R., et al.
(author)
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High-spin spectroscopy of Nd-140
- 2013
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In: Physical Review C (Nuclear Physics). - 0556-2813. ; 88:1
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Journal article (peer-reviewed)abstract
- The population of the high-spin states in Nd-140 was investigated using the reaction Zr-96(Ca-48,4n). The results from two experiments, one with the EUROBALL array and one with the JUROGAM II + RITU + GREAT setup employing the recoil decay tagging technique, have been combined to develop a very detailed level scheme for Nd-140. Twelve bands of quadrupole transitions and eleven bands of dipole transitions were identified and their connections to low-lying states were established. Calculations using the cranked Nilsson-Strutinsky and the tilted axis cranking models were used to interpret the observed structures. The overall good agreement between the experimental results and the calculations assuming a triaxial shape of the nucleus strongly support the existence of a stable triaxial shape at high spins in this mass region.
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| 9. |
- Petrache, C. M., et al.
(author)
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Triaxiality at high spins in Nd nuclei
- 2006
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In: Physica Scripta. - 0031-8949. ; T125, s. 212-213
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Journal article (peer-reviewed)abstract
- The level structure of Nd-140(80) has been established up to spin 48 by in-beam gamma-ray spectroscopy using the Zr-96(Ca-48, 4n) reaction. High-fold gamma-ray coincidences were measured with the EUROBALL spectrometer. Twelve new rotational bands have been discovered at high spins, showing the change from a spherical single-particle behaviour at low spins to a deformed regime with stable triaxiality at high spins. Possible configurations are assigned to the observed bands on the basis of configuration-dependent cranked Nilsson-Strutinsky calculations.
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| 10. |
- Zerrouki, T., et al.
(author)
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Shape evolution and magnetic rotation in Nd-141
- 2015
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In: European Physical Journal A. Hadrons and Nuclei. - : Springer Science and Business Media LLC. - 1434-6001. ; 51:4
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Journal article (peer-reviewed)abstract
- The high-spin states in Nd-141 were investigated using the Zr-96(Ca-48, 3n) reaction and the EU-ROBALL array. The level scheme has been extended up to an excitation energy of around 16MeV and spin 81/2. Two new bands of dipole transitions and three bands presumably of quadrupole transitions were identified and their connections to low-lying states were established. Cranked Nilsson-Strutinsky and tilted axis cranking calculations are combined in the interpretation of the observed dipole bands. The high-spin bands with assigned quadrupole transitions are interpreted as triaxial bands, while the dipole bands appear in the calculations to exhibit a shape evolution from low-deformation triaxial to spherical shape. They can be classified as magnetic rotation, with transition probabilities that show the characteristic decrease with angular momentum caused by the shears mechanism.
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