Development of an electronic Poor Outcome Screening (ePOS) Score to identify critically ill patients with potential palliative care needs.

Purpose: To develop and validate an electronic poor outcome screening (ePOS) score to identify critically ill patients with potentially unmet palliative care (PC) needs at 48 hours after ICU admission.

Materials And Methods: Retrospective single-centre cohort study of 1'772 critically ill adult patients admitted to a tertiary academic ICU in Switzerland between 2017 and 2018. We used data available from electronic health records (EHR) in the first 48 hours and least absolute shrinkage and selection operator (LASSO) logistic regression to develop a prediction model and generate a score to predict the risk of all cause 6-month mortality.

[Compassionate Cities: Strengthening Social Resources in Communities for Mutual Support at the End of Life].

Compassionate Cities: Strengthening Social Resources in Communities for Mutual Support at the End of Life People at the end of life often wish to remain at home for as long as possible. To make this possible to a greater extent, not only health professionals who accompany those affected and their relatives are needed, but also educational programmes to strengthen health literacy at the end of life. Within the framework of the project "Compassionate City Lab of the Bernese People", experiences in dealing with the end of life were collected and published, and a course on advance care planning for elderly people was developed.

The paradoxical role of urinary macromolecules in the aggregation of calcium oxalate: a further plea to increase diuresis in stone metaphylaxis.

This study was designed to get information on aggregation (AGN) of urinary calcium oxalate crystals (CaOx) which seems to occur in stone formation despite a protecting coat of urinary macromolecules (UMs). CaOx crystallization was directly produced in urine, control and albumin solution by Ox titration and was spectrophotometrically followed. A rapid decrease of optical density indicating AGN was absent in 14 of 15 freshly voided urines of 5 healthy controls.

From crystalluria to kidney stones, some physicochemical aspects of calcium nephrolithiasis.

Nephrolithiasis seems to be the result of crystal formation, aggregation and retention in the kidney during crystalluria. These processes have to occur within the short urinary transit time through the kidney being in the order of few minutes. Recently much work was done on rather qualitative aspects of nephrolithiasis like genetics, metabolism and morphology.

Alteration of urinary macromolecules by adsorption on surfaces, probably an important factor in urolithiasis.

To get information on the consequences of adsorption of urinary macromolecules (UMs) on crystals, Ca phosphate (CaP) precipitation was performed in urine of 15 stone patients and 15 controls. In solutions of dissolved precipitates (DPU), Ca oxalate (CaOx) crystallization and aggregation (AGN) of latex beads were spectrophotometrically studied and compared to results obtained in urine and in UMs isolated by hemofilter dialysis (HD). Tests were repeated with a 20 μg/mL albumin solution (AS).

New pathophysiological aspects of growth and prevention of kidney stones.

Kidney stones probably grow during crystalluria by crystal sedimentation and aggregation (AGN) on stone surfaces. This process has to occur within urinary transit time (UT) through the kidney before crystals are washed out by diuresis. To get more information, we studied by spectrophotometry the formation and AGN of Ca oxalate (Ca Ox) crystals which were directly produced in urine of 30 stone patients and 30 controls by an oxalate (Ox) titration.

Aggregation of freshly precipitated calcium oxalate crystals in urine of calcium stone patients and controls.

Aggregation (AGN) of freshly precipitated calcium oxalate crystals was photometrically studied in urine of 30 calcium stone patients and 30 controls, in solutions containing urinary macromolecules (UMS) and in an inhibitor free control solution (CS). Crystals were produced by oxalate titration and crystallization was monitored measuring optical density (OD). Tests were repeated adding hydroxyapatite (HAP) to urine and UMS and adding citrate and pyrophosphate (PPi) to UMS of the controls.

Serum procalcitonin, C-reactive protein and white blood cell levels following hypothermia after cardiac arrest: a retrospective cohort study.

Introduction: The aim of this study was to investigate time course of procalcitonin (PCT), C-reactive protein (CRP) and white blood cell (WBC) levels in patients with therapeutic hypothermia after cardiac arrest.

Methods: We retrospectively assessed laboratory and clinical data in a consecutive cohort of patients admitted to the medical intensive-care-unit of the University Hospital in Basel, Switzerland, in whom therapeutic hypothermia was induced because of cardiac arrest between December 2007 and January 2009. Infection was considered based on microbiological evidence (restricted definition) and/or clinical evidence of infection with prescription of antibiotics (extended definition).

Crystal sedimentation and stone formation.

Mechanisms of crystal collision being the first step of aggregation (AGN) were analyzed for calcium oxalate monohydrate (COM) directly produced in urine. COM was produced by oxalate titration in urine of seven healthy men, in solutions of urinary macromolecules and in buffered distilled water (control). Crystal formation and sedimentation were followed by a spectrophotometer and analyzed by scanning electron microscopy.

Role of calcium in the aggregation of particles coated by urinary macromolecules.

Objectives: In urine, aggregation (AGN) of crystal occurs although they are coated by negatively charged urinary macromolecules (UM) and isolated at a distance from each other, where attraction forces become extremely weak. Calcium (Ca) bridges or viscous binding by UM could explain this AGN.

Methods: Suspensions of Ca oxalate monohydrate (COM) and carboxylated latex (CL) were prepared in buffered water and UM solutions which were obtained from the urine of 6 healthy men.

Stabilization of calcium oxalate suspension by urinary macromolecules, probably an efficient protection from stone formation.

Introduction: Crystal aggregation (AGN) destabilizes crystal suspensions and during crystalluria probably favors crystal apposition to kidney calcifications and preexisting stones. We analyzed inhibition of AGN and stabilization of calcium oxalate suspensions by urinary macromolecules (UM), urine and solutions with urinary citrate concentration.

Materials And Methods: Solutions of UM (UMS) were obtained by a hemofiltration procedure from urine of 6 healthy men.

Increased intraarticular pressure reduces blood flow to the femoral head.

Hemarthrosis leading to increased intracapsular pressure after an undisplaced femoral neck fracture is suspected to impair blood flow to the femoral head and may lead to osteonecrosis. We hypothesized that an increase of intraarticular pressure would reversibly decrease the blood flow to the femoral head. Eleven patients having surgical dislocations for treatment of femoroacetabular impingement were included in this study.

Calcium oxalate aggregation in whole urine, new aspects of calcium stone formation and metaphylaxis.

Objectives: To assess the influence of pH, Ca(2+)-concentration, hydroxyapatite (HAP) and preformed calcium oxalate (CaOx) aggregates on the aggregation (AGN) of CaOx crystals directly produced in unpretreated whole urine (U) by oxalate loads (OL).

Methods: After OL at pH 5.0 and pH 6.

Hydroxyapatite induction and secondary aggregation of calcium oxalate, two important processes in calcium stone formation.

Stone formation has often been ascribed to crystal aggregation and fixed particle growth on kidney calcifications. In this paper, the influence of hydroxyapatite (HAP) and of preformed calcium oxalate (CaOx) aggregates on CaOx crystallization was studied in freshly voided urine. Crystallization was induced by different oxalate loads and precipitates were analyzed by the spectrophotometric measurement of sedimentation time (ST), which decreases with increasing particle size.

Nucleation and aggregation of calcium oxalate in whole urine; spectrophotometric sedimentation analysis: a new approach to study the aggregation of calcium oxalate dihydrate.

Spectrophotometric and scanning electron microscopic (SEM) studies of oxalate-induced crystallization have been performed in whole urine with and without continuous magnetic stirring and before and after millipore filtration of urine. With continuous stirring, preferential nucleation was observed and this followed second order kinetics. Important crystal aggregation only occurred after an oxalate load above 1 mmol/l and without stirring.

Measurement of metastability, growth and aggregation of calcium oxalate in native urine. A new approach for clinical and experimental stone research.

Nucleation, growth and aggregation are thought to be the most important crystallization processes in stone formation. Since crystallization properties change with urinary dilution, centrifugation and filtration, crystallization should always be studied in freshly voided and not pretreated urine. Recently we developed an automated method where calcium oxalate crystallization is induced in native urine by an exogenous oxalate load and nucleation and growth are monitored by an ion-selective calcium electrode.

New variant of type II von Willebrand's disease with structural abnormality of plasma von Willebrand factor in a patient with very mild bleeding history.

A new variant of von Willebrand's disease has been discovered in 2 members of a Macedonian family of 6. The proband, an 8-year-old boy, showed a prolonged bleeding episode on 1 occasion. Ristocetin-induced platelet aggregation and bleeding time were normal.

Automated and computer-controlled method for the measurement of the crystallization of calcium oxalate monohydrate in urine.

Monitoring of crystallization of calcium salts with ion-selective electrodes has turned out to be a very sensitive method. The difficulties of handling these electrodes in native whole urine and other biological fluids have been eliminated by new calcium analyzers, which clean and calibrate the electrodes after each measurement. To study crystallization kinetics, repeated calcium ion measurements have to be performed at regular intervals.

Multimeric analysis of von Willebrand factor by vertical sodium dodecyl sulphate agarose gel electrophoresis, vacuum blotting technology and sensitive visualization by alkaline phosphatase anti-alkaline phosphatase complex.

To detect von Willebrand factor multimers in plasma samples and factor VIII concentrates, a vertical discontinuous SDS electrophoresis was developed. A vacuum blotting system allowed to improve the transfer to the nitrocellulose membrane. The visualization of the separated multimers was sensitized by applying an alkaline phosphatase anti-alkaline phosphatase staining technique.

Rapid method of measuring the inhibition of calcium-oxalate monohydrate growth in urine.

In order to have a rapid method of measuring the inhibition of calcium-oxalate monohydrate growth in freshly voided whole urine, a test system by Meyer and Smith that has originally been developed for diluted urine was modified. The crystallization processes were monitored by an ion-selective calcium electrode, which allowed determination of the half-life value of the decrease in calcium within 25 min. Even given the high inhibitory activity of whole urine, the test gave reliable results when a high seed concentration was used.

The influence of hydroxyapatite and pyrophosphate on the formation product of calcium oxalate at different pHs.

The nucleating effect of hydroxyapatite (HAP) and the inhibitory effect of pyrophosphate (PPi) on calcium oxalate crystallization have been studied at different pH's in solution metastabely supersaturated with respect to calcium oxalate but saturated with respect to HAP. Crystallization was monitored by a decrease of calcium in the supernatant and formation products were calculated. At a pH above 6.