This review summarizes what is now known about the left ventricul

This review summarizes what is now known about the left ventricular ejection fraction and left ventricular volumes, discusses the importance of measurement units in image analysis, and describes the different imaging techniques available. Finally, there is a discussion of how to select the best imaging technique for specific clinical applications.”
“Psoriasis of childhood shows an annual prevalence of 0.71 % and accordingly has to be regarded as a frequent chronic

inflammatory skin disorder of this age. The impact on the quality of life as well as development of the afflicted children and their parents is evident. On the other side, therapy is demanding with regard to the specific juvenile metabolism, physical development and skin p53 inhibitor penetration of topical drugs. Long-term treatment at an early age has to be critically judged regarding the chronicity of the disease. Topical corticosteroids, alternatively Nepicastat Metabolism inhibitor dithranol

may be used first-line, followed by vitamin D derivatives. A combination with UV-light, preferably UV-B, has to be decided on an individual basis. Systemic treatment may be initiated in recalcitrant disease with methotrexate and cyclosporine where long-term experience is available from juvenile rheumatology and transplantation medicine. Alternatively fumaric acid esters or retinoids are available. Rehabilitation procedures will help the children and their parents to cope with the disease and its treatment. The different treatment options are presented here as a German expert consensus, as clinical studies are hardly available and only a few therapeutics are licensed for this age. In any case the therapy has to be individually planned and decided together with the patients and their parents to gain maximal safety, comfort and success.”
“While potent anti-inflammatory medications have reduced the symptoms of Crohn’s disease, more than 60% of patients eventually require surgery due to the development of fibrosis. Even after the introduction of biologic drugs, the

population-based rate of surgery for Crohn’s disease has not decreased. We suspect this is due to late initiation of these therapies, after the fibrosis cascade is unstoppable. We review the evidence that suggests early aggressive therapy is beneficial, especially in patients diagnosed before age 40, and with ileal or perianal disease. Patients with symptomatic strictures may benefit from early surgery (before penetrating complications) followed by initiation of biologics. With increased early use of biologics and better control of inflammation, we hope to see a global reduction in intestinal fibrosis and related complications of Crohn’s disease. (C) 2013 Published by Elsevier B.V. on behalf of European Crohn’s and Colitis Organisation.

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