Clinical Outcome of Intra-Arterial Embolization for Treatment of Patients with Pelvic Trauma

Purpose. To analyse the technical success of pelvic embolization in our institution and to assess periprocedural hemodynamic status and morbidity/mortality of all pelvic trauma patients who underwent pelvic embolization. Methods. A retrospective analysis of patients with a pelvic fracture due to trauma who underwent arterial embolization was performed. Clinical data, pelvic radiographs, contrast-enhanced CT-scans, and angiographic findings were reviewed. Subsequently, the technical success and peri-procedural hemodynamic status were evaluated and described. Results. 19 trauma patients with fractures of the pelvis underwent arterial embolization. Initially, 10/19 patients (53%) were hemodynamically unstable prior to embolization. Technical success of embolization was 100%. 14/19 patients (74%) were stable after embolization, and treatment success was high as 74%. Conclusion. Angiography with subsequent embolization should be performed in patients with a pelvic fracture due to trauma and hemodynamic instability, after surgical intervention or with a persistent arterial blush indicative of an active bleeding on CT

A recalibrated prediction model can identify level-1 trauma patients at risk of nosocomial pneumonia

Introduction: Nosocomial pneumonia has poor prognosis in hospitalized trauma patients. Croce et al. published a model to predict post-traumatic ventilator-associated pneumonia, which achieved high discrimination and reasonable sensitivity. We aimed to externally validate Croce’s model to predict nosocomial pneumonia in patients admitted to a Dutch level-1 trauma center. Materials and methods: This retrospective study included all trauma patients (≥ 16y) admitted for &gt; 24 h to our level-1 trauma center in 2017. Exclusion criteria were pneumonia or antibiotic treatment upon hospital admission, treatment elsewhere &gt; 24 h, or death &lt; 48 h. Croce’s model used eight clinical variables—on trauma severity and treatment, available in the emergency department—to predict nosocomial pneumonia risk. The model’s predictive performance was assessed through discrimination and calibration before and after re-estimating the model’s coefficients. In sensitivity analysis, the model was updated using Ridge regression. Results: 809 Patients were included (median age 51y, 67% male, 97% blunt trauma), of whom 86 (11%) developed nosocomial pneumonia. Pneumonia patients were older, more severely injured, and underwent more emergent interventions. Croce’s model showed good discrimination (AUC 0.83, 95% CI 0.79–0.87), yet predicted probabilities were too low (mean predicted risk 6.4%), and calibration was suboptimal (calibration slope 0.63). After full model recalibration, discrimination (AUC 0.84, 95% CI 0.80–0.88) and calibration improved. Adding age to the model increased the AUC to 0.87 (95% CI 0.84–0.91). Prediction parameters were similar after the models were updated using Ridge regression. Conclusion: The externally validated and intercept-recalibrated models show good discrimination and have the potential to predict nosocomial pneumonia. At this time, clinicians could apply these models to identify high-risk patients, increase patient monitoring, and initiate preventative measures. Recalibration of Croce’s model improved the predictive performance (discrimination and calibration). The recalibrated model provides a further basis for nosocomial pneumonia prediction in level-1 trauma patients. Several models are accessible via an online tool. Level of evidence: Level III, Prognostic/Epidemiological Study.</p

Lässt sich pflanzenverfügbares Phosphat mittels Infrarot-Spektroskopie bestimmen?

Die Analyse von Bodeneigenschaften mittels Infrarot-Spektroskopie (IR) im sichtbaren und Nahinfrarot (VisNIRS) bzw. im mittleren Infrarot (MIRS) hat in den letzten Jahren große Fortschritte gemacht. Ein wesentlicher Vorteil der IR-Spektroskopie ist, dass ohne bzw. mit minimaler Probenaufbereitung sehr schnell viele Proben analysiert werden können. Das macht diese Technologie für das Precision Farming sehr interessant, weil für Anwendungen wie eine teilflächenspezifische Düngung viele Daten (hohe räumliche Auflösung) in kürzester Zeit benötigt werden. Verschiedene Parameter wie Textur, Humusgehalt und Carbonatgehalt können nach Literaturangaben und eigenen Vorarbeiten mit der IR-Spektroskopie bereits sehr gut abgeschätzt werden. Zur Qualität der Bestimmung mobiler Anteile von (Nähr-) Elementen gibt es jedoch z.T. widersprüchliche Ergebnisse. Das Poster soll den derzeitigen Stand der eigenen Untersuchungen zur Bestimmung von pflanzenverfügbarem (CAL-löslichen) Phosphat darstellen. Da Phosphat selber nicht IR-aktiv ist, kann eine Vorhersage mobiler P-Anteile nur indirekt über die bestimmenden Einflussgrößen erfolgen. Erfolg oder Misserfolg bzw. die Qualität der Vorhersage von CAL-P hängt daher stark von der Zusammenstellung der Proben ab, die zur Kalibration von Vorhersagemodellen verwendet werden. Die bereits vorliegenden Ergebnisse zur VisNIR-Spektroskopie zeigen, dass das bodenbildende Substrat, aber auch die Bewirtschaftungsgeschichte (z.B. Düngungsmaßnahmen, angebaute Kulturen) großen Einfluss haben. Im Rahmen unseres Teilprojektes im BonaRes-Verbund „I4S“ laufen derzeit entsprechende Untersuchungen mittels MIRS, deren Ergebnisse ebenfalls in dem Beitrag gezeigt werden sollen

Журнал кримських караїмів “Бизым йол” (“Наш шлях”) у світлі традицій караїмської преси і національної політики Кримської АРСР

В статье содержится описание караимских периодических изданий начала ХХ века, их целей и задачи, объема, основных отделов, исследуется отражение в караимской периодике процессов национального культурного ренессанса, изучается связь этнических изданий караимов с общественно-политической жизнью караимской общины.Стаття містить опис караїмських видань початку ХХ століття, з'ясовує їхні цілі і завдан-ня, обсяг, основні розділи; досліджує відбиття у караїмській періодиці процесів національного культурного ренесансу; вивчає зв'язок етнічних видань караїмів із суспільно-політичним життям караїмської громади.The article researches the Karaite mass media of the beginning of the XX century: its matters and tasks, volume, main sections, the reflection of the cultural renaissance in it and its connection with life of the Karaite community

Genetic testing for Lynch syndrome: family communication and motivation

Current genetic counselling practice for Lynch syndrome (LS) relies on diagnosed index patients to inform their biological family about LS, referred to as the family-mediated approach. The objective of this study was to evaluate this approach and to identify factors influencing the uptake of genetic testing for LS. In 59 mutation carriers, 70 non carriers and 16 non-tested relatives socio-demographic characteristics, family communication regarding LS, experiences and attitudes towards the family-mediated approach and motivations for genetic testing, were assessed. The majority of all respondents (73 %) were satisfied with the family-mediated approach. Nevertheless, 59 % of the respondents experienced informing a family member and 57 % being informed by a family member as burdensome. Non-tested differed from tested respondents, in that they were younger, less closely related to the index patient and a lower proportion had children. The most important reasons for declining genetic testing were (1) anticipating problems with life insurance and mortgage, (

Metabolic syndrome in adults with autistic traits:associated psychological, behavioral, and biological factors in females and males - a PharmLines initiative

Background: While cardiovascular diseases is highly prevalent and an important cause of mortality in autistic adults, knowledge on their increased cardiovascular risk is limited. Hence, this study aimed to investigate psychological, behavioral, and physical factors associated with metabolic syndrome (MetS) in adults with autistic traits. Methods: In total, 17,705 adults from the Lifelines Cohort were included and categorized using Autism Spectrum Quotient-10 sum-scores. The quartiles with highest (HQ-traits-group females: n = 2,635; males: n = 1803) and lowest levels of autistic traits (LQ-traits-group, n = idem) were analyzed. Using multivariable logistic regression, the associations between MetS and (self-reported and interviewed) psychological, behavioral, and physically measured factors in these stratified groups were investigated. Results: Among females, MetS was more common in the HQ-traits-group than in the LQ-traits-group (10.0% versus 7.5%, p &lt; 0.01), while this was not the case among males (HQ-traits-group 13.8% versus LQ-traits-group 13.1%, p = 0.52). In both the female and male HQ-traits-group, the presence of MetS was associated with poorer self-reported health, less daily physical activity, and altered leukocyte counts. Conclusion: These findings underline the relevance of adequate cardiovascular prevention in adults with higher levels of autistic traits. Future research could gain more insight into the relationship between cardiovascular risk and autistic traits in females, and into tailored cardiovascular prevention.</p

Mortality in polytrauma patients with moderate to severe TBI on par with isolated TBI patients: TBI as last frontier in polytrauma patients

Background: Mortality caused by Traumatic Brain Injury (TBI) remains high, despite improvements in trauma and critical care. Polytrauma is naturally associated with high mortality. This study compared mortality rates between isolated TBI ( ITBI) patients and polytrauma patients with TBI ( PTBI) admitted to ICU to investigate if concomitant injuries lead to higher mortality amongst TBI patients. Methods: A 3-year cohort study compared polytrauma patients with TBI ( PTBI) with AIS head ≥3 (and AIS of other body regions ≥3) from a prospective collected database to isolated TBI ( ITBI) patients from a retrospective collected database with AIS head ≥3 (AIS of other body regions ≤2), both admitted to a single level-I trauma center ICU. Patients <16 years of age, injury caused by asphyxiation, drowning, burns and ICU transfers from and to other hospitals were excluded. Patient demographics, shock and resuscitation parameters, multiple organ dysfunction syndrome (MODS), acute respiratory distress syndrome (ARDS), and mortality data were collected and analyzed for group differences. Results: 259 patients were included; 111 PTBI and 148 ITBI patients. The median age was 54 [33-67] years, 177 (68%) patients were male, median ISS was 26 [20-33]. Seventy-nine (31%) patients died. Patients with PTBI developed more ARDS (7% vs. 1%, p = 0.041) but had similar MODS rates (18% vs. 10%, p = 0.066). They also stayed longer on the ventilator (7 vs. 3 days, p=<0.001), longer in ICU (9 vs. 4 days, p=<0.001) and longer in hospital (24 vs. 11 days, p=<0.001). TBI was the most prevalent cause of death in polytrauma patients. Patients with PTBI showed no higher in-hospital mortality rate. Moreover, mortality rates were skewed towards ITBI patients (24% vs. 35%, p = 0.06). Discussion: There was no difference in mortality rates between PTBI and ITBI patients, suggesting TBI-severity as the predominant factor for ICU mortality in an era of ever improving acute trauma care

Metabolic syndrome in adults with autistic traits:associated psychological, behavioral, and biological factors in females and males - a PharmLines initiative

Background: While cardiovascular diseases is highly prevalent and an important cause of mortality in autistic adults, knowledge on their increased cardiovascular risk is limited. Hence, this study aimed to investigate psychological, behavioral, and physical factors associated with metabolic syndrome (MetS) in adults with autistic traits. Methods: In total, 17,705 adults from the Lifelines Cohort were included and categorized using Autism Spectrum Quotient-10 sum-scores. The quartiles with highest (HQ-traits-group females: n = 2,635; males: n = 1803) and lowest levels of autistic traits (LQ-traits-group, n = idem) were analyzed. Using multivariable logistic regression, the associations between MetS and (self-reported and interviewed) psychological, behavioral, and physically measured factors in these stratified groups were investigated. Results: Among females, MetS was more common in the HQ-traits-group than in the LQ-traits-group (10.0% versus 7.5%, p &lt; 0.01), while this was not the case among males (HQ-traits-group 13.8% versus LQ-traits-group 13.1%, p = 0.52). In both the female and male HQ-traits-group, the presence of MetS was associated with poorer self-reported health, less daily physical activity, and altered leukocyte counts. Conclusion: These findings underline the relevance of adequate cardiovascular prevention in adults with higher levels of autistic traits. Future research could gain more insight into the relationship between cardiovascular risk and autistic traits in females, and into tailored cardiovascular prevention.</p