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BACKGOUND: The number of patients with chronic gastrointestinal (GI) symptoms after cancer therapies which have a moderate or severe impact on quality of life is similar to the number diagnosed with inflammatory bowel disease annually. However, in contrast to patients with inflammatory bowel disease, most of these patients are not referred for gastroenterological assessment. Clinicians who do see these patients are often unaware of the benefits of targeted investigation (which differ from those required to exclude recurrent cancer), the range of available treatments and how the pathological processes underlying side effects of cancer treatment differ from those in benign GI disorders. This paper aims to help clinicians become aware of the problem and suggests ways in which the panoply of syndromes can be managed. METHODS: A multidisciplinary literature review was performed to develop guidance to facilitate clinical management of GI side effects of cancer treatments. RESULTS: Different pathological processes within the GI tract may produce identical symptoms. Optimal management requires appropriate investigations and coordinated multidisciplinary working. Lactose intolerance, small bowel bacterial overgrowth and bile acid malabsorption frequently develop during or after chemotherapy. Toxin-negative Clostridium difficile and cytomegalovirus infection may be fulminant in immunosuppressed patients and require rapid diagnosis and treatment. Hepatic side effects include reactivation of viral hepatitis, sinusoidal obstruction syndrome, steatosis and steatohepatitis. Anticancer biological agents have multiple interactions with conventional drugs. Colonoscopy is contraindicated in neutropenic enterocolitis but endoscopy may be life-saving in other patients with GI bleeding. After cancer treatment, simple questions can identify patients who need referral for specialist management of GI symptoms. Other troublesome pelvic problems (eg, urinary, sexual, nutritional) are frequent and may also require specialist input. The largest group of patients affected by chronic GI symptoms are those who have been treated with pelvic radiotherapy. Their complex symptoms, often caused by more than one diagnosis, need systematic investigation by gastroenterologists when empirical treatments fail. All endoscopic and surgical interventions after radiotherapy are potentially hazardous as radiotherapy may induce significant local ischaemia. The best current evidence for effective treatment of radiation-induced GI bleeding is with sucralfate enemas and hyperbaric oxygen therapy. CONCLUSIONS: All cancer units must develop simple methods to identify the many patients who need help and establish routine referral pathways to specialist gastroenterologists where patients can receive safe and effective treatment. Early contact with oncologists and/or specialist surgeons with input from the patient''s family and friends often helps the gastroenterologist to refine management strategies. Increased training in the late effects of cancer treatment is required. [ABSTRACT FROM AUTHOR]

In the last two decades, through technological, experimental and theoretical advances, the situation in experimental fission studies has changed dramatically. With the use of advanced production and detection techniques both much more detailed and precise information can now be obtained for the traditional regions of fission research and, crucially, new regions of nuclei have become routinely accessible for fission studies. This work first of all reviews the recent developments in experimental fission techniques, in particular the resurgence of transfer-induced fission reactions with light and heavy ions, the emerging use of inverse-kinematic approaches, both at Coulomb and relativistic energies, and of fission studies with radioactive beams. The emphasis on the fission-fragment mass and charge distributions will be made in this work, though some of the other fission observables, such as prompt neutron and γ-ray emission will also be reviewed. A particular attention will be given to the low-energy fission in the so far scarcely explored nuclei in the very neutron-deficient lead region. They recently became the focus for several complementary experimental studies, such as β-delayed fission with radioactive beams at ISOLDE(CERN), Coulex-induced fission of relativistic secondary beams at FRS(GSI), and several prompt fusion–fission studies. The synergy of these approaches allows a unique insight in the new region of asymmetric fission around Hg, recently discovered at ISOLDE. Recent extensive theoretical efforts in this region will also be outlined. The unprecedented high-quality data for fission fragments, completely identified in Z and A, by means of reactions in inverse kinematics at FRS(GSI) and VAMOS(GANIL) will be also reviewed. These experiments explored an extended range of mercury-to-californium elements, spanning from the neutron-deficient to neutron-rich nuclides, and covering both asymmetric, symmetric and transitional fission regions. Some aspects of heavy-ion induced fusion–fission and quasifission reactions will be also discussed, which reveal their dynamical features, such as the fission time scale. The crucial role of the multi-chance fission, probed by means of multinucleon-transfer induced fission reactions, will be highlighted. The review will conclude with the discussion of the new experimental fission facilities which are presently being brought into operation, along with promising ‘next-generation’ fission approaches, which might become available within the next decade. [ABSTRACT FROM AUTHOR]

The /EC decay of Tl to excited states in the daughter nuclei Hg has been investigated at the CERN on-line isotope mass separator facility. In both Tl nuclei two β-decaying states were observed. In the case of 184Tl, narrow-band laser spectroscopy could be used to disentangle the decay of both isomers. In 182Hg a precise energy of 335 (1) keV for the state was measured together with its feeding from a tentatively proposed state at 973 keV. Large conversion coefficients for the transition in Hg were measured to be 7.2 (13) and 14.2 (36), respectively, evidencing a strong E0 component. [ABSTRACT FROM AUTHOR]

α-decay spectroscopy of Tl has been performed at the CERN isotope separator on-line (ISOLDE) facility. New fine-structure α decays have been observed for both isotopes. α-decay branching ratios of 0.089(19)%, 0.047(6)% and 1.22(30)% have been deduced for the (10−), (7+) and (2−) states respectively in 184Tl and a lower limit of 0.49% for the α-decay branching ratio of 182Tl. A new half-life of 9.5(2) s for the (2−) state in 184Tl and 1.9(1) s for the low-spin state in 182Tl has been deduced. Using α–γ coincidence analysis, multiple γ rays were observed de-exciting levels in Au fed by Tl α decays. The γ transitions connecting these low-lying states in Au are essential to sort the data and possibly identify bands from in-beam studies in these isotopes. Owing to the complex fine-structure α decays and limited knowledge about the structure of the daughter nuclei, only partial level schemes could be constructed for both gold isotopes in the present work. Reduced α-decay widths have been calculated and are compared with values obtained in neighboring odd-A and even-A thallium isotopes. Except for the allowed α decay of the 184Tl (10−) state, the other fine-structure α decays observed in this study are hindered. This points to strong structural changes between parent thallium and daughter gold isotopes. [ABSTRACT FROM AUTHOR]

The new isotope 179Pb has been produced in the complete fusion reaction 40Ca + 144Sm - 179Pb+5n at the velocity filter SHIP (GSI). Its a-decay energy of 7350(20) keV and half-life value of 3.5+1.4[?] 0.8 ms were deduced based on the recoil-a-a correlation technique. A spin parity of Ip = (9/2[?]) was tentatively assigned to the ground state of 179Pb; thus, it is based on the 1h9/2 orbital. Improved measurements of the a-decay properties of 179Tlm and 175Aum are also presented. [ABSTRACT FROM AUTHOR]