50 research outputs found
Characteristics, Treatment Strategies and Outcome in Cardiogenic Shock Complicating Acute Myocardial Infarction:A Contemporary Dutch Cohort
Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) is associated with high morbidity and mortality. Our study aimed to gain insights into patient characteristics, outcomes and treatment strategies in CS patients. Patients with CS who underwent percutaneous coronary intervention (PCI) between 2017 and 2021 were identified in a nationwide registry. Data on medical history, laboratory values, angiographic features and outcomes were retrospectively assessed. A total of 2328 patients with a mean age of 66 years and of whom 73% were male, were included. Mortality at 30 days was 39% for the entire cohort. Non-survivors presented with a lower mean blood pressure and increased heart rate, blood lactate and blood glucose levels (p-value for all <0.001). Also, an increased prevalence of diabetes, multivessel coronary artery disease and a prior coronary event were found. Of all patients, 24% received mechanical circulatory support, of which the majority was via intra-aortic balloon pumps (IABPs). Furthermore, 79% of patients were treated with at least one vasoactive agent, and multivessel PCI was performed in 28%. In conclusion, a large set of hemodynamic, biochemical and patient-related characteristics was identified to be associated with mortality. Interestingly, multivessel PCI and IABPs were frequently applied despite a lack of evidence.</p
Secreted production of an elastin-like polypeptide by Pichia pastoris
Elastin-like polypeptides (ELPs) are biocompatible designer polypeptides with inverse temperature transition behavior in solution. They have a wide variety of possible applications and a potential medical importance. Currently, production of ELPs is done at lab scale in Escherichia coli shake flask cultures. With a view to future large scale production, we demonstrate secreted production of ELPs in methanol-induced fed-batch cultures of Pichia pastoris and purification directly from the culture medium. The production of ELPs by P. pastoris proved to be pH dependent within the experimental pH range of pH 3 to 7, as an increasing yield was found in cultures grown at higher pH. Because ELP produced at pH 7 was partly degraded, a pH optimum for production of ELP was found at pH 6 with a yield of 255Â mg of purified intact ELP per liter of cell-free medium
“Fast track” rehabilitation after gastric cancer resection: experience with 80 consecutive cases
[Review of: A. Boele (2013) Leden van Ă©Ă©n lichaam. Denkbeelden over armen, armenzorg en liefdadigheid in de Noordelijke Nederlanden 1300-1650]
' "Vande groote swaricheyt der armen deser Stadt". De reorganisatie van de armenzorg in Utrecht, 1580-1674'
The Stability of Voluntarism. Financing Social Care in Early Modern Dutch Towns Compared with the English Poor Law, c. 1600-1800
Keeping Up the Good Works: Voluntary Giving and the Financial Maintenance of Charitable Institutions in Dutch Towns, c. 1600-1800
Historians generally acknowledge that institutions shaping the political economy of the Dutch Republic were very efficient, thus contributing to its economic boom in the early modern period.1 One of the Dutch organizations often mentioned, but seldom systematically analyzed by economic historians,2 are welfare institutions. Nevertheless, charitable organizations formed an important part of the institutional framework of the early modern urban political economy. An abundance of historical literature has commented on their numerous functions, such as upholding social order, securing a reservoir of unskilled labourers, or even for settling feuds between local elites.3 Rather than focusing on the relationship between the poor and the elites, more recently some historians have come to stress the role of welfare provisions in (urban as well as religious) community building by a larger segment of the population, including the bourgeois middle groups.4 Most probably, financial management of charitable funds played a vital role in the sustainability of early modern poor relief.5 The purpose of this paper is to uncover how charitable institutions, especially those assisting the local outdoor poor, were financially maintained in the highly urbanized Dutch Republic. Which sources of income to charity were available, what were the financial possibilities and difficulties the almoners and deacons encountered, and what choices did they make in times of financial difficulties? In this paper, five towns are investigated in great detail: Delft and Leiden, two industrial towns in the core province of Holland, Utrecht, in the center of the Republic, which attracted many rentiers especially in the eighteenth century, Zwolle, in the more peripheral and agrarian Eastern part of the Northern Netherlands, and ’s-Hertogenbosch, which was at the frontier of the Generality Lands in the south (see Figure 1). We will establish trends over time, as well as similarities and differences between these towns, and try to explain these developments. The most important sources used for this analysis will be the financial records of several urban charities, which contain detailed information on the income structure as well as on the expenses of charitable organizations. Moreover, this paper aims to further the discussion on the proverbial generosity of Dutch citizens in the early modern period. Estimates by Peter Lindert suggest that per capita spending on poor relief was relatively high in the Dutch Republic, at least until the end of the eighteenth century,6 but his claims have not been substantiated by solid empirical evidence. Lindert’s assertion will be tested for mid-eighteenth century Delft and Leiden, for which total charitable expenditure as well as total annual revenues of the city-dwellers can be estimated. Furthermore, by giving detailed information on sources of income as well as expenses of local poor relief institutions, we hope to expose how generous Dutch people actually were, and how this relates to the financial strategies of charitable organizations in the early modern era. For this we will combine information from the poor relief administrations with other sources, such as tax records and wills. 2 The paper is structured as follows. First, we will briefly go into the organization of poor relief in the Dutch Republic, focusing on the case studies under investigation. Then, we will turn to an elaborate discussion of the different types of income of institutions that assisted the outdoor poor. Our main focus will be on the institutions managed by the civic administrators, but as in every town poor relief was organized in a different manner, we will, as far as the data allow us to, also discuss other institutions providing monetary assistance, for instance the Reformed diaconates. The subsequent section will deal with the cash flow management of the charities. The sources of income will be compared to the yearly expenses of charitable institutions, in order to address issues of financial management and durability. In the last paragraph, we will analyse to what extent the provisions under scrutiny contributed to the redistribution of means within Dutch towns. In the conclusion, we will analyse trends over time, and compare the financial management of poor relief institutions between towns and offer explanations
The Stability of Voluntarism. Financing social care in early modern Dutch towns compared with the English Poor Law, c. 1600-1800
This article aims to compare the financing of two apparently entirely different systems of pre-industrial welfare: urban institutional welfare in the federal Dutch Republic and the national Elizabethan Poor Law in Britain. By analysing a new dataset on the income and expenditure of five Dutch towns, we conclude that, despite the absence of uniform legislation, Dutch poor relief was viable at least up until the 1790s, even in times of severe crises and declining real wages. This was obtained by the – in monetary terms – remarkably stable donations by Dutch citizens, mostly through regular collections, as well as careful financial management of the charitable funds