Long-term functional follow-up after kidney injury in children: Retrospective review of 33 cases

Introduction Renal injuries accounts for 8-12% of all pediatric abdominal trauma, of which >90% are blunt and treated conservatively. Questions remain regarding the most adequate follow-up and whether there is a correlation between grade of injury and long-term renal function. The purposes of this study were to assess the treatment of renal injuries in our institution, evaluate the complications and analyse late functional outcome. Method Retrospective review of renal injuries over 22 years in one institution. Patient's demographics, mechanism and grade of injury, associated injuries, management and complications were collected. Consecutive follow-up 123-I-hippuran dynamic renographies (RG) were reviewed and statistical analysis of renal function evolution was assessed. Results 33 children were identified, consisting of 22 males and 11 females. The mean age was 11.5 years (median 10.6; range 1.5-15.8). All injuries were blunt. There were 2 (6%) grade I, 3 (9%) grade II, 11 (33%) grade III, 9 (27%) grade IV and 8 (25%) grade V. Associated injuries occurred in 24 children. Treatment was surgical in 8, minimal invasive in 15, and non- operative in 13. Complications included 3 urinary infections, 2 hydronephrosis, 14 urinomas, 1 pseudoaneurysm, 1 renal artery thrombosis, 2 calculus and 2 cysts. Chronic hypertension occurred in 3 and chronic renal insufficiency in 2children. Long-term follow-up of renal function consisted of 1 to 8 dynamic renographies (2.9±1.9) over a follow-up period of 1.8 to 16 years (4.6±3.9). Overall long-term function correlated with grade of injury and a trend towards functional loss was observed over time. Detailed renal function analysis will be presented Conclusion In our population, the proportion of grade III and above injuries was high when compared to the literature. The majority of children were treated non-operatively or with minimal invasive procedures. Late occurring clinically significant complications were numerous and warrant long-term clinical and functional follow-up in most cases

Elastic behaviour of the carotid artery in intact spontaneously hypertensive rats

Intact spontaneously hypertensive rats (SHR) were studied to assess the effect of prolonged antihypertensive treatment on the elastic behaviour of the external carotid artery. Thirty-week-old SHR received the ACE inhibitor captopril, the ateriolar dilator hydralazine or their vehicle for 6 weeks. These rats were compared to normotensive, vehicle treated WKY rats. The internal diameter of the carotid artery was measured continuously in halothane-anaesthetized rats using an echo-tracking device, and intra-arterial pressure was also monitored continuously, on the controlateral side. Captopril- and hydralazinetreated SHR as well as normotensive controls had similar blood pressure values. No significant shift in the distensibility-pressure curves was observed among vehicle-treated SHR and WKY rats or the SHR which had received captopril or hydralazine. Histological examination of the carotid artery fixed ex vivo with paraformaldehyde showed a significant increase in cross-sectional area in vehicle-treated SHR as compared to their normotensive counterparts. These results therefore suggest that the elastic behaviour of elastic arteries is not necessarily altered by the structural changes developing in response to hypertensio

Vascular risk factors in the Swiss population

Background and Purpose : Identification of the population at risk of stroke remains the best approach to assess the burden of cardiovascular morbidity and mortality. Methods : The prevalence of hypertension (HT), hypercholesterolemia (HCh), diabetes mellitus (DM), overweight (OW), obesity (OB), tobacco use (SM), and their combinations was examined in 4458 Swiss persons (1741 men and 2717 women, mean age 57.8 ± 15 years), who volunteered for the present survey. Results : OW was the most prevalent risk factor (50 %), followed by HT (47%), HCh (33%), SM (13 %) and DM (1.6 %). The proportion of persons without risk factors (RF) was 19.9%, with 1 RF 41.5%, 2 RF 33.8%, 3 RF 4%, and 4 RF 0.9%. OW was more prevalent in men than in women (53% vs. 41%, P=0.02). More men than women aged 41-50 years and 51-60 years had HT (49 % vs. 36%, P=0.01, and 52 % vs. 42%, P=0.02). The prevalence of HCh and DM did not show any sex-related differences. HT, OW and HCh were not only the most common single risk factors, but were also most likely to aggregate with each other. Conclusions : The majority of Swiss people have one or two vascular risk factors. OW and HT are by far most common and are likely to aggregate with each other. A small modification of these two factors would reduce the incidence of stroke and myocardial infarction significantl

Comparison of Melphalan Combined with Treosulfan or Busulfan as High-Dose Chemotherapy before Autologous Stem Cell Transplantation in AML.

(1) Background: High-dose chemotherapy (HDCT) before autologous stem cell transplantation (ASCT) in acute myeloid leukemia (AML) patients predominantly combines busulfan with cyclophosphamide or melphalan. Treosulfan compares favorably regarding lower inter-individual bioavailability and neurotoxicity, but so far, had not been studied before ASCT in AML. (2) Methods: This single-center study investigated AML patients undergoing ASCT in CR1 between November 2017 and September 2020. The first 16 patients received busulfan 16 mg/kg b.w. (days -5 to -2) and melphalan 140 mg/m2 (day -1) (BuMel). In a subsequent (TreoMel) cohort, 20 patients received treosulfan 14 g/m2 (days -4 to -2) and melphalan. Plasma concentrations of busulfan and treosulfan were determined by mass spectrometry. (3) Results: Neutrophil engraftment and platelet recovery were similar, and PFS and OS were comparable. In only the BuMel cohort, patients reported central nervous toxicities, including seizures (6%) and encephalopathy (12%). The mean AUC for busulfan was 1471.32 μM*min, and for treosulfan it was 836.79 mg/L*h, with ranges of 804.1-2082 μM*min and 454.2-1402 mg/L*h. The peak values for busulfan ranged between 880.19-1734 μg/L and for treosulfan between 194.3-489.25 mg/L. (4) Conclusions: TreoMel appears to be safe and effective for pre-ASCT treatment in AML patients. Due to considerable interindividual biovariability, pharmacologic monitoring may also be warranted for the use of treosulfan

Efficacy and Safety of High-Dose Chemotherapy with Treosulfan and Melphalan in Multiple Myeloma.

(1) Background: Upfront treatment consolidation with high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) has relevantly contributed to achieving durable remissions following induction treatment in multiple myeloma (MM) patients. The optimization of HDCT regimens can, therefore, essentially contribute to improving the depth and duration of tumor remissions. To date, melphalan at 200 mg/m2 is the standard HDCT regimen for fit MM patients. In our previous work, we showed promising efficacy and safety results for treosulfan (14 g/m2) and melphalan (200 mg/m2) (TreoMel) in acute myeloid leukemia (AML) patients receiving ASCT. Based on these data, TreoMel became the standard of care for fit MM patients at our institution. (2) Methods: We identified 115 consecutive MM patients who underwent consolidation with TreoMel between 01/2020 and 08/2022 at the University Hospital of Bern. We analyzed the safety and efficacy data, as well as the treosulfan pharmacokinetics, correlating them with tumor responses. (3) Results: A complete response (CR) rate of 84% was achieved, which is comparable to the CR rate reported for the quadruplet combination. The median PFS was 30 months (95% CI: 20.4-not reached), and the 31-month OS rate was 83%. The median area under the curve (AUC) for treosulfan was 952.5 mg*h/L (range: 527.4-1781.4), and the median peak level was 332.3 mg/L (range: 168-554). The treosulfan pharmacokinetics showed no significant correlation with MM responses after HDCT and ASCT. However, female patients had a significantly higher AUC (p = 0.007) and peak value (p = 0.001), and the higher values were associated with longer hospitalizations. (4) Conclusions: Treatment consolidation with TreoMel HDCT demonstrated a promising efficacy and safety profile in our cohort of MM patients and deserves further investigation in prospective studies

Neue Lerntechnologien für Umweltwissenschaften

Umweltwissenschaften/Ökologie sind durch ihren hohen Grad an Vernetzung, Inter- und Transdisziplinarität dazu prädestiniert, um umweltrelevantes Wissen mit "neuen Lerntechnologien" (E-Learning; internet-based learning; Multimedia-Unterricht) zu vermitteln. Dieser Beitrag stellt eine Auswahl von solchen Aktivitäten an den Universitäten Basel, Bern und Zürich sowie der ETH Zürich vor

Angle-scanned photoemission: Fermi surface mapping and structural determination

A brief survey of the angle-scanned photoemission technique is given. It incorporates two complementary methods in one:http://www.sciencedirect.com/science/article/B6TVX-3X82696-4F/1/e2ffd4efc660238ad8d4ad8f685991b

Remnant Fermi surface in the presence of an underlying instability in layered 1T-TaS_2

We report high resolution angle-scanned photoemission and Fermi surface (FS) mapping experiments on the layered transition-metal dichalcogenide 1T-TaS_2 in the quasi commensurate (QC) and the commensurate (C) charge-density-wave (CDW) phase. Instead of a nesting induced partially removed FS in the CDW phase we find a pseudogap over large portions of the FS. This remnant FS exhibits the symmetry of the one-particle normal state FS even when passing from the QC-phase to the C-phase. Possibly, this Mott localization induced transition represents the underlying instability responsible for the pseudogapped FS

Angle-scanned photoemission: Fermi surface mapping and structural determination

A brief survey of the angle-scanned photoemission technique is given. It incorporates two complementary methods in one:http://www.sciencedirect.com/science/article/B6TVX-3X82696-4F/1/e2ffd4efc660238ad8d4ad8f685991b