The temperature variations of a BGO crystal ball were monitored with a set of 177 platinum probes and followed in their evolution with time. This allowed the control of the temperature dependence of the calibration parameters of the calorimeter and the evaluation of its contribution to the energy resolution

Abstract Disintegration of 12 C nuclei by tagged photons of 700–1500 MeV energy at the GRAAL facility has been studied by means of the LAGRAN γ E detector with a wide angular acceptance. The energy and momentum distributions of produced neutrons and protons as well as their multiplicity distributions were measured and compared with corresponding distributions calculated with the RELDIS model based on the intranuclear cascade and Fermi break-up models. It was found that eight fragments are created on average once per about 100 disintegration events, while a complete fragmentation of 12 C into 12 nucleons is observed typically only once per 2000 events. Measured multiplicity distributions of produced fragments are well described by the model. The measured total photoabsorption cross section on 12 C in the same energy range is also reported.

Background Although the early diagnosis of an anastomotic leak is a key point in reducing its clinical consequences, in daily practice this diagnosis appears later than it should. Faecal calprotectin is a protein that binds calcium and zinc, and belongs to the S100 family expressed mainly by neutrophils, and has important extracellular activity. Faecal calprotectin is used to assess active inflammation in patients with inflammatory bowel disease and colorectal cancer. Colorectal cancer is associated with a local acute inflammatory reaction of variable intensity. Several studies have assessed the role of C-reactive protein (CRP) as an early marker of anastomotic leakage, but studies into the role of faecal calprotectin to predict anastomotic failure have never been described in scientific literature. We aimed to determine whether faecal calprotectin is a predictor of anastomotic leak in colorectal surgery. Methods The study was performed on 100 consecutive patients with diagnosed colorectal cancer admitted to hospital for an operation. Data were collected on: demographical, surgical, ASA class, and morbidity. During the first four postoperative days, faecal calprotectin, C-reactive protein, leucocytes, haemoglobin, platelets, and vital signs were evaluated. Findings Nine (9%) patients developed a major anastomotic leak (needing reoperation) and two patients needed abdominal drainage. 4 days after surgery faecal calprotectin was significantly higher (>300 μg/g; normal value <90 μg/g) in patients who developed anastomotic leakage than those who did not develop any complications. The association between faecal calprotectin value and a CRP cutoff value of 12 mg/dL yielded a sensitivity of 85%, a specificity of 95%, and a negative predictive value of 95% for the detection of anastomotic leakage. Interpretation Faecal calprotectin is a predictor of major anastomotic leak after colorectal resection. If raised faecal calprotectin is reported on the fourth day after surgery a careful evaluation of the patient is necessary before discharge. The increasing association between faecal calprotectin and CRP may provide a more effective way to detect an anastomotic leak.

Background Anastomotic leakage represents a serious complication after colorectal surgery for cancer. The early diagnosis of anastomotic leakage is a key point in reducing its clinical consequences. Currently there are no post-surgical markers for early detection of this complication before it becomes clinically apparent. C-reactive protein (CRP) is a biomarker used to help sepsis diagnosing and monitoring antibiotic therapy. The predictive value of CRP as a marker of infective postoperative complications has been widely investigated with promising results. The aim of our study is to evaluate the predictive value of CRP in predicting anastomotic leakage. Methods A series of 99 consecutive patients, 56 (56.56%) men and 43 (43.43%) women, who underwent elective colorectal surgery for cancer (both laparoscopic and laparotomic with primary anastomosis) were prospectively recruited. Mean age was 68 years. The following data were collected: demographical, surgical, ASA class, and morbidity. 24 h after surgical procedure was completed, the C-reactive protein, leucocytes, and vital signs were evaluated. Findings 11 (11.11%) patients developed a major anastomotic leak (need for drainage or reoperation). CRP was significantly higher (>12 mg/dL) 24 h after surgery in patients who developed anastomotic leakage, whereas the white blood cell count was not. A CRP cutoff value of 12 mg/dL 24 h after surgery yielded a sensitivity of 80%, a specificity of 95%, and a negative predictive value of 95% for the detection of anastomotic leakage. Interpretation This is a preliminary study and requires larger sample of patients; however, our results show that increased CRP levels 24 h after colorectal surgery may provide an effective marker to detect anastomotic leakage, before clinical symptoms appear. Moreover, normal CRP values might be also a useful marker to facilitate a safe and early discharge of selected patients after colorectal surgery. CRP is an early, sensitive, and reliable marker of anastomotic leakage.