Search

Precipitation is considered one of the most important triggering factors of landslides. In addition to precipitation as the actual triggering event, the antecedent precipitation may be of great importance, as this can lead to an increase of the soil water content and the pore water pressure and, thus, to a decisive slope instability. In the present study, 236 landslide events and daily precipitation records of 55 precipitation stations in the Central Uplands in Germany are used to analyze the relationship between the occurrence of landslides and the antecedent precipitation for the first time. In addition, the precipitation on the day of the landslide event was used to determine the degree of influence of the two parameters on the occurrence. To ensure a good representation, the nearest station was assigned to each landslide. The analyses show that the antecedent precipitation is generally of great importance for the occurrence of landslides all year round. Especially in the winter months, the antecedent precipitation, as the predisposing factor, has a major impact on the occurrence of landslides which is expressed by the decrease of the slope stability by an increasing soil water content. This influence of the antecedent precipitation is also of great importance in the summer months in order to create the conditions for the possible occurrence of landslides. The precipitation on the day of the landslide, i.e. short-term heavy precipitation events, is not so decisive for the triggering in winter, which is why the antecedent precipitation is also regarded as the trigger here. In summer, on the other hand, the precipitation on the day of the landslide is necessary as a trigger to an increasing degree. The results of this study could be useful for further interdisciplinary analyses in the future, taking into account the specific geological, geomorphological and climatological conditions of the landslide sites, in order to investigate the complex relationship between landslide occurrences and influencing and triggering factors even more comprehensively.

A dataset with information about 394 landslide events between 1901 and 2016 is used for the analysis of the long-term relationship between landslides and precipitation in southern Lower Saxony, northern Hesse and the surroundings. The present study investigates the relationship between landslides and annual precipitation as well as selected monthly landslide distributions and their connection with weather anomalies. Landslide distributions are correlated with precipitation records of a synthetic precipitation series as a representative for the study area. The annual landslide distribution shows an overall increasing number of events with alternating periods of low and high landslide activity. Correlation with the annual precipitation predominantly reveals a more frequent occurrence of landslides in humid years. The monthly landslide distribution between 1901 and 2016 shows a first accumulation of events in winter months (January–March: 31%) and a second one in summer months (June–August: 32%). In general, this monthly landslide distribution follows the annual course of precipitation. Particular monthly landslide distributions are apparent for periods of increased landslide activity which coincide with exceptional long-term winter and summer precipitation trends. In these periods the monthly distributions widely follow the annual precipitation courses. Overall, the results show that the precipitation is basically suitable for an explanation for the occurrence of landslide events. Whereas the annual precipitation is only partially meaningful for the annual landslide activity, the influence of exceptional seasonal precipitation is reflected in the monthly landslide distributions. The results provide a promising basis for more detailed analyses of the relationship between landslides and the precipitation in the study area.

AbstractObjectiveDilated cardiomyopathy is a leading cause of cardiac death in children. Approximately 30% of children die or need cardiac transplantation in the first year after establishing the diagnosis. New strategies are needed to improve the outcome in this high-risk patient population.Method and resultsWe present our experience in 38 patients below the age of three years, who were diagnosed with dilated cardiomyopathy and who were treated at our institution between 2006 and 2012. The treatment strategy involved institution of β-blockers and angiotensin-converting enzyme inhibitors as soon as feasible. In selected cases, pulmonary artery banding or intracoronary autologous bone marrow-derived cell therapy was performed. The median age at presentation was six months (range 1–26 months). The median follow-up age was 16 months (range 2–80 months). Kaplan–Meier analysis of survival after dilated cardiomyopathy diagnosis revealed a one-year survival of 97% and a five-year survival of 86%. The rate of freedom from death or heart transplantation was 82% at one year and 69% at five years. Surviving patients who were free of transplantation, at the follow-up at 25 months (3–80 months), showed a significant improvement in left ventricular ejection fraction (from 19±11 to 46±16%) and left ventricular end-diastolic diameter (z-score from 4.6±2.4 to 1.4±1.6). In addition, the levels of B-type natriuretic peptide improved significantly (from 3330±3840 to 171±825 pg/ml).ConclusionOur data suggest that the clinical approach described here may result in a markedly improved medium-term outcome in young children with dilated cardiomyopathy. Further studies are required to evaluate whether these approaches reduce end-points such as transplantation or death.

AbstractIntroductionIn spite of tremendous progress in the medical and surgical treatment of children with congenital heart disease and dilated cardiomyopathy achieved during the past few decades, for some children a heart transplant remains the only option. Clinically relevant benefits of intracoronary injection of autologous stem cells on cardiac function and remodelling have been demonstrated in adult patients with acute myocardial infarction. Experience with autologous stem cell therapy in children with severe congenital or acquired pump failure is limited to a small number of case reports.Method and resultsBetween 2006 and 2010, nine severely ill children were treated with intracoronary infusion of autologous bone marrow-derived mononuclear cells as part of a compassionate therapy in our centre. No procedure-related unexpected adverse events occurred. There was one patient on extracorporeal membrane oxygenation who died of haemorrhage unrelated to the procedure; three patients proceeded to heart transplantation once a donor heart became available. The other five patients showed an improvement with respect to New York Heart Association classification (greater than or equal to 1), brain natriuretic peptide serum levels, and ejection fraction.ConclusionSimilar to adults, intracoronary injection of autologous bone marrow cell is technically feasible and safe for children. On the basis of our data, we propose to perform a pilot study for children with congestive heart failure, to formally assess the efficacy of intracoronary autologous bone marrow cell therapy.

Background: Intervertebral disc extrusions in the thoracolumbar region are a common spinal neurologic disorder in dogs and usually considered a neurological emergency. Several factors, like timing of surgery, have previously been analysed in order to determine the effect on outcome and time of recovery. Most studies have investigated one defined population of dogs and the influence of a single factor on the overall outcome. In this retrospective study, a large cohort of dogs and the influence of one or combinations of several factors on outcome and time of recovery were analysed. Results: The bivariate analysis demonstrated a significant association between the following variables and the time of recovery: the time span between the onset of clinical signs and surgery (Cramers Phi ${\phi }^{\prime }$\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\varphi^{\prime}$$\end{document}= 0.14; P = 0.003), the grade of severity (${\phi }^{\prime }$\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\varphi^{\prime}$$\end{document}= 0.23; P < 0.001) and the implementation of physical rehabilitation (${\phi }^{\prime }$\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\varphi^{\prime}$$\end{document}= 0.2; P < 0.001). However, the analysis of a multivariable regression model demonstrated that a significant correlation only exists between the time span between the onset of clinical signs and surgery and the overall outcome (P = 0.007), as well as between the grade of severity and the time of recovery (P < 0.001). The percentage of dogs with lacking deep pain perception (DPP) that had to be euthanised due to their neurological condition, decreased from 20.0 to 2.9% when physical rehabilitation was implemented. Additionally, the proportion of dogs (same group) that improved to reach an ambulatory status increased from 80.0 to 91.4%. Conclusion: The results of the bivariate analysis demonstrated several correlations between some variables and overall outcome or time of recovery, whereas the multivariable regression model demonstrated only two associations. The time span between the onset of clinical signs and surgery was significantly associated with the overall outcome. We therefore suggest that a surgical intervention should be performed without unreasonable delay. Due to the correlation between the grade of severity and time of recovery, owners of dogs with more severe neurological deficits prior to surgery should be informed about the presumably prolonged time of recovery.

Pharmacologic support of the failing neonatal heart to maintain cardiac output, which is vital for sufficient end organ perfusion, is a challenging task for the pediatric intensivist, especially since strategies which have been proven to be effective in adults cannot necessarily be extrapolated to neonates. The unique biochemical properties and structure of the neonatal heart, including the increased non-contractile tissue mass, a lower responsiveness to beta adrenergic agents and the heart rate dependent cardiac output with a limited ability toincrease stroke volume, favor some of the new inotropes of the Ca+ sensitizer family. Focusing on the after loadreduction, inodilators as phosphodiesterase inhibitors and human brain natriuretic peptide offer treatment optionsfor the neonatal myocardium. Additionally, thyroxine and steroids have been investigated in neonates with lowcardiac output after surgery for congenital heart disease. Gene therapy, in particular cardiac-selective gene transfer,might offe r perspectives for future support for the neonatal heart. This text reviews some of the most recentpharmacologic strategies targeting the failing myocardium in the critically ill newborn and infant

The aim of this study was to compare the effect of extracorporeal shockwave therapy (ESWT) in patients with chronically painful proximal plantar fasciitis with a conventional conservative treatment consisting of nonsteroidal anti-inflammatory drugs, heel cup, orthoses and/or shoe modifications, local steroid injections and electrotherapy. Forty-seven patients (49 feet) with a previously unsuccessful conservative treatment of at least six months were randomized to two groups. Treatment of Group 1 (25 heels) started immediately with three sessions of ESWT (3000 shockwaves/session of 0.2 mJ/mm2) at weekly intervals. In the patients of Group 2 (24 heels) treatment was continued for 12 weeks. After this period they were treated using the protocol of Group 1. No significant difference of pain and walking time after further non-ESWT treatment (three months) was seen. Six months after ESWT pain decreased by 64% to 88% on the visual analog scale (VAS) and the comfortable walking time had increased significantly in both groups.

A retrospective study was performed of 182 revisions on failed back surgery syndrome from the years 1965 to 1990.