KTC De Marke: twee decennia innovaties voor duurzame melkveehouderij

De Marke, Proefbedrijf voor Melkveehouderij en Milieu bestaat dit jaar 20 jaar. Met militaire precisie is destijds de strategie, opzet en ontwikkeling van dit melkveeproefbedrijf door Frans Aarts, Edo Biewinga en Richard Donker vastgelegd in De Marke-rapport nr. 1: 'Melkveehouderij bij stringente milieunormen'. Nu, 20 jaar later, is er mede door hun aanzet meer bereikt dan we voor mogelijk hielden. Koeien melken met minimale belasting van de omgeving: de melkveehouderij is en blijft een gewaardeerde voedselproducent die schoon werkt in een fraai landschap. Alle reden om hier in 2012 uitgebreid bij stil te staan

Degenerative inter-vertebral disc disease osteochondrosis intervertebralis in Europe: prevalence, geographic variation and radiological correlates in men and women aged 50 and over.

Objectives.: To assess the prevalences across Europe of radiological indices of degenerative inter-vertebral disc disease (DDD); and to quantify their associations with, age, sex, physical anthropometry, areal BMD (aBMD) and change in aBMD with time. Methods.: In the population-based European Prospective Osteoporosis Study, 27 age-stratified samples of men and women from across the continent aged 50+ years had standardized lateral radiographs of the lumbar and thoracic spine to evaluate the severity of DDD, using the Kellgren-Lawrence (KL) scale. Measurements of anterior, mid-body and posterior vertebral heights on all assessed vertebrae from T4 to L4 were used to generate indices of end-plate curvature. Results.: Images from 10 132 participants (56% female, mean age 63.9 years) passed quality checks. Overall, 47% of men and women had DDD grade 3 or more in the lumbar spine and 36% in both thoracic and lumbar spine. Risk ratios for DDD grades 3 and 4, adjusted for age and anthropometric determinants, varied across a three-fold range between centres, yet prevalences were highly correlated in men and women. DDD was associated with flattened, non-ovoid inter-vertebral disc spaces. KL grade 4 and loss of inter-vertebral disc space were associated with higher spine aBMD. Conclusion.: KL grades 3 and 4 are often used clinically to categorize radiological DDD. Highly variable European prevalences of radiologically defined DDD grades 3+ along with the large effects of age may have growing and geographically unequal health and economic impacts as the population ages. These data encourage further studies of potential genetic and environmental causes

Neuroform Stent Assisted Aneurysm Treatment: Evolving Treatment Strategies Complications and Results of Long Term Follow-Up

Introduction: This report details experience with the Neuroform stent, with an emphasis on evolving treatment strategies, complication rates and treatment durability. Methods: All patients undergoing Neuroform stent assisted aneurysm treatment were registered in prospectively maintained endovascular databases at two institutions. Results: 284 patients with 302 aneurysms underwent aneurysm treatment with Neuroform during a 42-month study period. Imaging follow-up was available for 166 of 286 saccular aneurysms which were treated with stents and coils (average interval 12.9 months). 80 demonstrated progressive thrombosis (48.2%), 40 were unchanged (24.1%) and 46 (27.7%) demonstrated re-canalization, 25 (15.1%) of which were major recanalizations requiring retreatment. The vast majority of recanalizations and retreatments were observed in large or giant aneurysms. A cumulative total of 25 ischemic strokes (8.8%) and eight neurovascular deaths (2.8%) were recorded in these patients. Ten of these strokes were associated with transient deficits which went on to complete resolution by the time of discharge or at the initial clinical follow-up, yielding a significant stroke rate of 5.3%. Delayed (\u3e48 h) complications, including four deaths - related to stroke (n = 2, 6 days and 8 weeks post-procedure) and spontaneous parenchymal hemorrhages (n = 2) - represent events which are a direct consequence of stenting and likely would not have been encountered in the context of standard non-stent supported embolization techniques. Conclusion: Neuroform facilitates the endovascular treatment of complex and wide necked cerebral aneurysms. However, complete occlusion at angiographic follow-up remains uncommon and is observed in only one-third of patients. Delayed complications (\u3e48 h) represent an important component of the overall complications associated with Neuroform assisted aneurysm embolization