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  • Jokumsen Chapman heeft een update geplaatst 1 dag, 8 uren geleden

    The high morbidity and poor survival rates associated with chronic heart failure still represent a big challenge, despite improvements in treatments and the development of new therapeutic opportunities. The prediction of outcome in heart failure is gradually moving towards a multiparametric approach in order to obtain more accurate models and to tailor the prognostic evaluation to the individual characteristics of a single subject. The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score was developed 10 years ago from 2715 patients and subsequently validated in a different population. The score allows an accurate evaluation of the risk of heart failure patients using only six variables that include the evaluation of the exercise capacity (peak oxygen uptake and ventilation/CO2 production slope), blood samples (haemoglobin, Na+, Modification of Diet in Renal Disease) and echocardiography (left ventricular ejection fraction). Over the following years, the MECKI score was tested taking into account therapies and specific markers of heart failure, and it proved to be a simple, useful tool for risk stratification and for therapeutic strategies in heart failure patients. The close connection between the centres involved and the continuous updating of the data allow the participating sites to propose substudies on specific subpopulations based on a common dataset and to put together and develop new ideas and perspectives.Background Calprotectin is present in the cytosol of neutrophil granulocytes and released upon activation. Fecal calprotectin is applied in the clinical management of inflammatory bowel disease whereas serum calprotectin has been discussed as a biomarker in inflammatory disorders. However, its long-term prognostic relevance in critical illness remains unclear. Our aim was to investigate serum calprotectin concentrations as a prognostic biomarker in critically ill and septic patients. Methods Serum calprotectin concentrations were analyzed in 165 critically ill patients (108 with sepsis, 57 without sepsis) included in our observational study. Patients were enrolled upon admission to the medical intensive care unit (ICU) of the RWTH Aachen University Hospital. Calprotectin concentrations were compared to 24 healthy controls and correlated with clinical parameters, therapeutic interventions, and survival. Results Serum calprotectin concentrations were significantly increased in ICU patients as well as in septic e long-term outcome.We introduce SodSAR, a fully polarimetric tower-based wide frequency (1-10 GHz) range Synthetic Aperture Radar (SAR) aimed at snow, soil and vegetation studies. The instrument is located in the Arctic Space Centre of the Finnish Meteorological Institute in Sodankylä, Finland. The system is based on a Vector Network Analyzer (VNA)-operated scatterometer mounted on a rail allowing the formation of SAR images, including interferometric pairs separated by a temporal baseline. We present the description of the radar, the applied SAR focusing technique, the radar calibration and measurement stability analysis. Measured stability of the backscattering intensity over a three-month period was observed to be better than 0.5 dB, when measuring a target with a known radar cross section. Deviations of the estimated target range were in the order of a few cm over the same period, indicating also good stability of the measured phase. Interforometric SAR (InSAR) capabilities are also discussed, and as a example, the coherence of subsequent SAR acquisitions over the observed boreal forest stand are analyzed over increasing temporal baselines. The analysis shows good conservation of coherence in particular at L-band, while higher frequencies are susceptible to loss of coherence in particular for dense vegetation. The potential of the instrument for satellite calibration and validation activities is also discussed.Studies in recent years have shown increased interest in developing new methods of evaluation, but also in limiting post infarction ventricular remodeling, hoping to improve ventricular function and the further evolution of the patient. This is the point where biomarkers have proven effective in early detection of remodeling phenomena. There are six main processes that promote the remodeling and each of them has specific biomarkers that can be used in predicting the evolution (myocardial necrosis, neurohormonal activation, inflammatory reaction, hypertrophy and fibrosis, apoptosis, mixed processes). Some of the biomarkers such as creatine kinase-myocardial band (CK-MB), troponin, and N-terminal-pro type B natriuretic peptide (NT-proBNP) were so convincing that they immediately found their place in the post infarction patient evaluation protocol. Others that are related to more complex processes such as inflammatory biomarkers, atheroma plaque destabilization biomarkers, and microRNA are still being studied, but the results so far are promising. This article aims to review the markers used so far, but also the existing data on new markers that could be considered, taking into consideration the most important studies that have been conducted so far.Corner mouth lift is in increasing demand among young patients in East Asia. NST-628 Although various surgical methods exist for corner mouth lift, many patients are reluctant to undergo surgery due to fears of postsurgical scarring. We present a new technique aimed at reducing postoperative scarring. The technique involves triangular excision of the corner of the mouth and incision of the commissure with transposition of a lateral vermilion flap to lift the corner of the mouth. The muscle around the corner of the mouth is dissected to release tension. The corner mouth lift was successfully performed in all patients. It can be effectively used even in patients, such as young Asian women, who are susceptible to hypertrophic scars.

    Ulnar humeral condyle fractures are rare paediatric elbow fractures, classified as Salter-Harris IV paediatric elbow injuries. Due to constant radiological changes in the elbow with varying manifestation of ossification centres as well as late ossification of the trochlea, diagnosis of these injuries is challenging. To avoid long-term complications, the treating surgeon should be familiar with the rare injury picture, diagnostics and adequate therapeutic measures.

    The present retrospective study includes data on all paediatric cases from 2002 to 2019 with primary or secondary treatment at a paediatric traumatology centre for ulnar condyle fracture with a minimum follow-up of 12 months. Range of motion, joint stability under valgus and varus stress as well as axial ratios of the injured and uninjured side were evaluated in a clinical follow-up examination. The Mayo Elbow Performance Score was used to objectify functional results.

    20 children, average age 8.6 years (4 - 13) and average follow-up time 25 months, were included.

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