Factors that trigger emergency physicians to contact a poison centre: findings from a Swiss study.

OBJECTIVE Poison centres offer rapid and comprehensive support for emergency physicians managing poisoned patients. This study investigates institutional, case-specific and poisoning-specific factors which influence the decision of emergency physicians to contact a poison centre. METHODS Retrospective, consecutive review of all poisoning-related admissions to the emergency departments (EDs) of a primary care hospital and a university hospital-based tertiary referral centre during 2007. Corresponding poison centre consultations were extracted from the poison centre database. Data were matched and analysed by logistic regression and generalised linear mixed models. RESULTS 545 poisonings were treated in the participating EDs (350 (64.2%) in the tertiary care centre, 195 (35.8%) in the primary care hospital). The poison centre was consulted in 62 (11.4%) cases (38 (61.3%) by the tertiary care centre and 24 (38.7%) by the primary care hospital). Factors significantly associated with poison centre consultation included gender (female vs male) (OR 2.99; 95% CI 1.69 to 5.29; p<0.001), number of ingested substances (>1 vs 1) (OR 2.84; 95% CI 1.65 to 4.9; p<0.001) and situation (accidental vs intentional) (OR 2.76; 95% CI 1.05 to 7.25; p=0.039). In contrast, age, medical history and hospital size did not influence poison centre consultation. Poison centre consultation was significantly higher during the week, and significantly less during night shifts. The poison centre was consulted significantly more when patients were admitted to intensive care units (OR 5.81; 95% CI 3.25 to 10.37; p<0.001). Asymptomatic and severe versus mild cases were associated with more frequent consultation (OR 4.48; 95% CI 1.78 to 11.26; p=0.001 and OR 2.76; 95% CI 1.42 to 5.38; p=0.003). CONCLUSIONS We found low rates of poison centre consultation by emergency physicians. It appears that intensive care unit admission and other factors reflecting either complexity or uncertainty of the clinical situation are the strongest predictors for poison centre consultation. Hospital size did not influence referral behaviour.

Jubelklänge : zur allerhöchsten Vermählungsfeier Seiner Majestät Ludwig des Zweiten König von Bayern mit Ihrer kgl. Hoheit der Prinzessin Sofie Charlotte Auguste Herzogin von Bayern

Text u. Musik von Maximilian G. Loewenstamm

Prognostic factors and outcomes in primary urethral cancer: results from the international collaboration on primary urethral carcinoma.

PURPOSE To evaluate risk factors for survival in a large international cohort of patients with primary urethral cancer (PUC). METHODS A series of 154 patients (109 men, 45 women) were diagnosed with PUC in ten referral centers between 1993 and 2012. Kaplan-Meier analysis with log-rank test was used to investigate various potential prognostic factors for recurrence-free (RFS) and overall survival (OS). Multivariate models were constructed to evaluate independent risk factors for recurrence and death. RESULTS Median age at definitive treatment was 66 years (IQR 58-76). Histology was urothelial carcinoma in 72 (47 %), squamous cell carcinoma in 46 (30 %), adenocarcinoma in 17 (11 %), and mixed and other histology in 11 (7 %) and nine (6 %), respectively. A high degree of concordance between clinical and pathologic nodal staging (cN+/cN0 vs. pN+/pN0; p < 0.001) was noted. For clinical nodal staging, the corresponding sensitivity, specificity, and overall accuracy for predicting pathologic nodal stage were 92.8, 92.3, and 92.4 %, respectively. In multivariable Cox-regression analysis for patients staged cM0 at initial diagnosis, RFS was significantly associated with clinical nodal stage (p < 0.001), tumor location (p < 0.001), and age (p = 0.001), whereas clinical nodal stage was the only independent predictor for OS (p = 0.026). CONCLUSIONS These data suggest that clinical nodal stage is a critical parameter for outcomes in PUC.

VEGFR2 Signaling Prevents Colorectal Cancer Cell Senescence to Promote Tumorigenesis in Mice With Colitis.

BACKGROUND & AIMS Senescence prevents cellular transformation. We investigated whether vascular endothelial growth factor (VEGF) signaling via its receptor, VEGFR2, regulates senescence and proliferation of tumor cells in mice with colitis-associated cancer (CAC). METHODS CAC was induced in VEGFR2(ΔIEC) mice, which do not express VEGFR2 in the intestinal epithelium, and VEGFR2(fl/fl) mice (controls) by administration of azoxymethane followed by dextran sodium sulfate. Tumor development and inflammation were determined by endoscopy. Colorectal tissues were collected for immunoblot, immunohistochemical, and quantitative polymerase chain reaction analyses. Findings from mouse tissues were confirmed in human HCT116 colorectal cancer cells. We analyzed colorectal tumor samples from patients before and after treatment with bevacizumab. RESULTS After colitis induction, VEGFR2(ΔIEC) mice developed significantly fewer tumors than control mice. A greater number of intestinal tumor cells from VEGFR2(ΔIEC) mice were in senescence than tumor cells from control mice. We found VEGFR2 to activate phosphatidylinositol-4,5-bisphosphate-3-kinase and AKT, resulting in inactivation of p21 in HCT116 cells. Inhibitors of VEGFR2 and AKT induced senescence in HCT116 cells. Tumor cell senescence promoted an anti-tumor immune response by CD8(+) T cells in mice. Patients whose tumor samples showed an increase in the proportion of senescent cells after treatment with bevacizumab had longer progression-free survival than patients in which the proportion of senescent tumor cells did not change before and after treatment. CONCLUSIONS Inhibition of VEGFR2 signaling leads to senescence of human and mouse colorectal cancer cells. VEGFR2 interacts with phosphatidylinositol-4,5-bisphosphate-3-kinase and AKT to inactivate p21. Colorectal tumor senescence and p21 level correlate with patient survival during treatment with bevacizumab.

Trajectory mapping of middle atmospheric water vapor by a mini network of NDACC instruments

The important task to observe the global coverage of middle atmospheric trace gases like water vapor or ozone usually is accomplished by satellites. Climate and atmospheric studies rely upon the knowledge of trace gas distributions throughout the stratosphere and mesosphere. Many of these gases are currently measured from satellites, but it is not clear whether this capability will be maintained in the future. This could lead to a significant knowledge gap of the state of the atmosphere. We explore the possibilities of mapping middle atmospheric water vapor in the Northern Hemisphere by using Lagrangian trajectory calculations and water vapor profile data from a small network of five ground-based microwave radiometers. Four of them are operated within the frame of NDACC (Network for the Detection of Atmospheric Composition Change). Keeping in mind that the instruments are based on different hardware and calibration setups, a height-dependent bias of the retrieved water vapor profiles has to be expected among the microwave radiometers. In order to correct and harmonize the different data sets, the Microwave Limb Sounder (MLS) on the Aura satellite is used to serve as a kind of traveling standard. A domain-averaging TM (trajectory mapping) method is applied which simplifies the subsequent validation of the quality of the trajectory-mapped water vapor distribution towards direct satellite observations. Trajectories are calculated forwards and backwards in time for up to 10 days using 6 hourly meteorological wind analysis fields. Overall, a total of four case studies of trajectory mapping in different meteorological regimes are discussed. One of the case studies takes place during a major sudden stratospheric warming (SSW) accompanied by the polar vortex breakdown; a second takes place after the reformation of stable circulation system. TM cases close to the fall equinox and June solstice event from the year 2012 complete the study, showing the high potential of a network of ground-based remote sensing instruments to synthesize hemispheric maps of water vapor.

Ms. germ. oct. 31 (Ausst. 38) - Leben und Leiden Christi. Gebete

Vorbesitzer: Johann Maximilian zum Jungen

Das Laufburschen-Lied

Boberach: Angegriffen werden der Prinz von Preußen, Metternich und die Minister Bodelschwingh und Uhden

Mein Glaubensbekenntniß, angehend den politischen Zustand Deutschlands

Boberach: Der Präsident des Reichsministeriums [des Innern] entwickelt als Programm: Vorrang des Vereinbarungsprinzips, Bundesstaat, Beschränkung der Aufgaben der Nationalversammlung, die praktisch erloschen ist, während die Provisorische Zentralgewalt weiter besteht. Die vieldeutigen Fremdwörter "Revolution" und "Volkssouveränität" sollen durch "Umwälzung" und "Hoheit" ersetzt werden.. - Wentzke: Verfaßt für den Reichsverweser bei Übernahme des Ministeriums am 13. Mai: Die Berechtigung der Nationalversammlung ist durch ihren Auftrag umschrieben: 1. nur konstituierend (=abfassend); 2. Zustimmung der Regierungen vorbehalten; 3. Grundlage der Bundesstaat. Ihre Befugnis, die Reichsminister zur Verantwortung zu ziehen, ist durch Erledigung ihrer Aufgabe (durch Vollbringung oder durch Erkenntnis des Unvermögens) erloschen, während die Zentralgewalt auf Grund des Gesetzes vom 28. Juni [1848 bestehen] bleibt. - Welsch (Projektbearbeiter): Samt dem Abdruck eines Schreibens des Constitutionellen Vereins des Kreises Rothenburg () an Grävell

Der Deutsche Reichsadler oder Geschichtlicher Beweis, daß der von Karl d. G. als Reichsabzeichen angenommene Römische Adler seit 1519 mit einem zweiten Kopfe stetig verunstaltet worden sei : nebst einem die staatliche Umgestaltung Deutschlands betreffenden Vorworte und 26 erläuternden Abbildungen von Siegeln und Münzen

Boberach: Statt des Doppeladlers soll der ursprüngliche einfache Adler, der auch auf den abgebildeten Siegeln und Münzen der Kaiser von Ludwig dem Frommen bis Maximilian I. erscheint, Hoheitszeichen sein. Die Umgestaltung Deutschlands bietet die Gelegenheit der Besinnung auf das Werk der Hohenstaufen. Der Reichstag soll von der besitzenden und der nichtbesitzenden Klasse paritätisch gewählt werden und auf Vorschlag der Fürsten das mit suspensivem Veto ausgestattete Reichsoberhaupt auf fünf Jahre wählen. - Wentzke: Reichsoberhaupt von der Volksvertretung, dem Reichstag, auf Vorschlag der Fürsten auf 5 Jahre zu wählen, mit suspensivem Veto. Zum Reichstag wählen die besitzende und die nichtbesitzende Klasse je eine gleiche Anzahl von Abgeordneten

Der Schutz der Eisen-Industrie vor der verfassunggebenden deutschen Nationalversammlung

Boberach: Die Nationalversammlung soll die Notwendigkeit von Schutzzöllen für die Eisenindustrie anerkennen, die durch statistische Angaben über die inländische Produktion und den Import von Roheisen, Stahl und Kleineisen begründet werden soll. - Welsch (Projektbearbeiter): Der Verfasser, ein führender nassauischer Eisenindustrieller, war Gegner des Freihandels

Trajectory mapping of middle atmospheric water vapor by a mini network of NDACC instruments

The important task to observe the global coverage of middle atmospheric trace gases like water vapor or ozone usually is accomplished by satellites. Climate and atmospheric studies rely upon the knowledge of trace gas distributions throughout the stratosphere and mesosphere. Many of these gases are currently measured from satellites, but it is not clear whether this capability will be maintained in the future. This could lead to a significant knowledge gap of the state of the atmosphere. We explore the possibilities of mapping middle atmospheric water vapor in the Northern Hemisphere by using Lagrangian trajectory calculations and water vapor profile data from a small network of five ground-based microwave radiometers. Four of them are operated within the frame of NDACC (Network for the Detection of Atmospheric Composition Change). Keeping in mind that the instruments are based on different hardware and calibration setups, a height-dependent bias of the retrieved water vapor profiles has to be expected among the microwave radiometers. In order to correct and harmonize the different data sets, the Microwave Limb Sounder (MLS) on the Aura satellite is used to serve as a kind of traveling standard. A domain-averaging TM (trajectory mapping) method is applied which simplifies the subsequent validation of the quality of the trajectory-mapped water vapor distribution towards direct satellite observations. Trajectories are calculated forwards and backwards in time for up to 10 days using 6 hourly meteorological wind analysis fields. Overall, a total of four case studies of trajectory mapping in different meteorological regimes are discussed. One of the case studies takes place during a major sudden stratospheric warming (SSW) accompanied by the polar vortex breakdown; a second takes place after the reformation of stable circulation system. TM cases close to the fall equinox and June solstice event from the year 2012 complete the study, showing the high potential of a network of ground-based remote sensing instruments to synthesize hemispheric maps of water vapor.

An meine Wahlmänner in den nassauischen Aemtern Hadamar, Montabauer, Selters und Wallmerod: Liebe Mitbürger! Ihr habt mich zu Eurem Volksvertreter für die nahe große Nationalversammlung zu Frankfurt gewählt ...

Welsch (Projektbearbeiter): Biographische Selbstdarstellung Max von Gagerns nach seiner Wahl zum Volksvertreter der Frankfurter Nationalversammlung

Tagsbefehl am 18. Mai 1848: Da mir der Minister-Rath nach geäußerten Wünschen der Nationalgarde ...

Welsch (Projektbearbeiter): Tagesbefehl des Feldmarschall-Lieutenants Auersperg anläßlich der Übernahme des Oberkommandos über die Nationalgarde

Mitbürger! Das Central-Comité der Nationalgarde und akademischen Legion hat den Antrag ...

Welsch (Projektbearbeiter): Bekanntmachung: Unterstellung der Nationalgarde, der akademischen Legion sowie der Bürgergarde unter das Kommando des Feldmarschall-Lieutenants Maximilian Graf Auersperg