[New health care delivery model in cardiology -- Myocardial Infarction Network Essen].

Current guidelines favor primary percutaneous coronary intervention (PCI) as the strategy of choice for the treatment of acute ST segment elevation myocardial infarction (STEMI). Already in its 1st year, the myocardial infarction network "Herzinfarktverbund Essen" demonstrates with 489 patients the feasibility of an exhaustive urban STEMI network with preference to patient transfer to high-volume PCI centers. Furthermore, integrated health care as an optional part of the "Herzinfarktverbund" offers reimbursement for modern and innovative diagnostic procedures, therapies, and rehabilitation.

Long-term results of a three-week intensive cardiac out-patient rehabilitation program in motivated patients with low social status.

Unlabelled: The short-term benefits of cardiac rehabilitation (CR) are well established. In contrast, well-documented long-term results are rare. The objective of this longitudinal multi-centre observational study was to examine the effects of intensive out-patient CR in a larger patient cohort, especially for patients with low social status.

[Effects of a phase II cardiac rehabilitation program performed on an outpatient basis].

Background And Objective: In Germany, phase II cardiac rehabilitation has always been carried out on an inpatient basis. Meanwhile, the governmental health authorities are demanding more flexible solutions for cardiac rehabilitation. The objective of this study is to examine the effects of phase II cardiac rehabilitation performed on an outpatient basis (OCR) in a larger patient cohort.

[Lipid intervention and coronary heart disease in men less than 56 years of age. The Coronary Intervention Study: CIS].

Unlabelled: The CIS was undertaken with the aim to evaluate the effects of lipid modifications on angiographic progression and regression of CAD in patients with CAD and hypercholesterolemia. The design included a multicenter randomized, double-blind, parallel, placebo-controlled comparison, with target and safety limits for adjusting the trial medication depending on the LDL cholesterol level (LDL-C) achieved, i.e.

[Ambulatory vs. inpatient rehabilitation after established myocardial infarct--contra ambulatory rehabilitation].

Outpatient cardiac rehabilitation, as compared to inpatient rehabilitation, has substantial disadvantages for several patient groups. These drawbacks may lead to insufficient results in long term secondary prevention and to inadequate quality of life in patients with chronic heart disease. As outpatients, they remain in life circumstances which were, at least in part, causative for their heart diseases.

The effect of simvastatin on progression of coronary artery disease. The Multicenter coronary Intervention Study (CIS).

Background: In several angiographic trials, HMG-CoA reductase inhibitors have shown a beneficial effect on the progression of coronary artery disease. Using 20 mg simvastatin, day-1, a treatment period of up to 4 years was necessary to show a significant reduction in coronary artery disease progression. The question remains however whether higher dosages of simvastatin would be more advantageous in respect to the magnitude of the effect and the required time interval to demonstrate treatment efficacy.

[Comprehensive life style changes by coronary patients--an intervention study].

In an intervention trial 31 coronary patients participated in a comprehensive lifestyle change program and 43 control patients received the usual care of the conventional cardiac rehabilitation system. First preliminary findings show that the patients in the intervention group not only improved their health related lifestyle but also increased their exercise capacity and reduced depression, while there was no substantial improvement in the control group. Up to the present, the existing data indicate that German heart patients are able to make comprehensive lifestyle changes and that these changes have positive effects on biomedical and psychosocial variables.

Reaction of glutathione with the electrophilic metabolites of 1,1-dichloroethylene.

1,1-Dichloroethylene (DCE) requires cytochrome P450-catalyzed bioactivation to electrophilic metabolites (1,1-dichloroethylene oxide, 2-chloroacetyl chloride and 2,2-dichloroacetaldehyde) to exert its cytotoxic effects. In this investigation, we examined the reactions of these metabolites with glutathione by spectroscopic and chromatographic techniques. In view of the extreme reactivity of 2-chloroacetyl chloride, primary reactions are likely to include alkylation of cytochrome P450, conjugation with GSH to give S-(2-chloroacetyl)-glutathione, or hydrolysis to give 2-chloroacetic acid.

[Reliable Quick value management by self determination].

Because of the considerably increased risk of thrombembolic complications after implantation of mechanical heart valves, lifelong anticoagulation is required. In the face of frequently unsteady prothrombin-time (PT)-values, a stable anticoagulation is one of the most difficult tasks in attending patients with heart-valve-prosthesis. If PT is out of the therapeutic range, the risk of bleeding or of thrombembolism increases disproportionately.

[Coronary angiographic findings in 308 patients with the clinical diagnosis of intramural myocardial infarction (author's transl)].

308 patients with the clinical diagnosis of intramural myocardial infarction made elsewhere were re-investigated more than eight weeks after the acute event. ECGs and pulmonary "wedge" pressures were recorded at rest and during exercise and coronary angiography performed (Sones' or Judkin's technique). In the first group (1973/74) of 77 patients, 35 (45.

Pharmacokinetic and clinical studies with carfecillin.

The pharmacokinetics of carfecillin (Carbenicillin-phenyl-ester) were studied in 10 healthy subjects, in 5 patients with hepatic cirrhosis and in 5 cases of renal insufficiency. In healthy subjects maximal carbenicillin serum levels attained by therapeutic doses were about 20 microgram/ml; concentrations in the urine surpassed 1000 mu/ml. The phenol moiety was detectable as free phenol in sera (less than 1 microgram/ml) and urine (less than 3 microgram/ml), but its major part was transformed to glucuronide and sulphate conjugates.

[Experimental investigation of cardiac lymph vascular system (author's transl)].

Ligatures of the supracardiac lymph vessels and the cardiac lymph nodes have been performed in fifty mongrel dogs. Comparative electrocardiographical, light microscopical, scanning and transmission electron microscopical investigations were done one day to three months after surgery. The demonstrated findings confirmed former results concerning the topography and the microstructure of the cardiac lymph vascular drainage system.