Clinical research for patient empowerment--a qualitative approach on the improvement of heart health promotion in chronic illness.

Background: Concepts of health management and improved quality of health care are of growing importance. In this context, the concept of empowerment is widely accepted in health-related disciplines. The aim of the present study was to investigate whether theory-based empowerment, using motivational interviewing, can be facilitated within clinical research in patients with severe chronic diseases.

[Particulate matter and cardiovascular health in the European Union: time for prevention?].

With reference to the EU-Council Directive (1999/30/EC) a discussion in the European Union between basic science, epidemiologic knowledge, and regulatory policies has become of growing public interest. The consequences following particulate matter (PM) exposure on the cardiovascular system, are actually not fully understood. This work reviews latest developments as regards the realization of the mentioned Council Directive and emphasizes the cardiovascular health impairment in this context.

Development of Healthy Cities networks in Europe.

The Healthy Cities network in Europe was inspired by the Ottawa Charter for Health Promotion when it was launched in 1987. The networking process was initiated by the WHO Regional Office for Europe, but developed its own dynamics in different European countries during a time marked by fundamental political transformations in many of the countries of Eastern Europe. The networks then connected with the 'Local Agenda 21' and the 'Sustainable Cities and Towns Campaign' to create a new and broader programmatic agenda at the local level.

The effect of oxytocin, prostaglandin E2 and acetylsalicylic acid on flow distribution and on the transfer of alanine, glucose and water in isolated perfused guinea pig placentae.

The influence of oxytocin (OXY), sulproston (SUL) and acetylsalicylic acid (ASA) on L-alanine- (ALA), D-glucose- (GLU) or water- (H(2)O) uptake (maternal side) in the isolated perfused guinea pig placenta was investigated. Uptake was measured with a single injection, paired tracer dilution method. 'T50' values were derived from venous concentration curves (extracellular marker) as the distance (sec) between two concentration values at 50 per cent of peak concentration.

[Non-puerperal mastitis: a disease without end? (Results of a long-term study)].

Recently, the symptomatology and therapy of non-puerperal mastitis (N.P.M.

[Special clinical and follow-up aspects of invasive lobular breast cancer].

We examined 121 invasive lobular breast carcinomas (ILCs) with regard to certain standardised prognosis parameters, such as tumour size, receptor status, histological grading, the presence of lymphangiosis carcinomatosa, and the histological nodal status of the axillae and correlated these findings with follow-up data obtained over a mean period of 65 months. The parameters, tumour size, presence of lymphangiosis carcinomatosa, and nodal status, were found to be correlated and to have a significant influence on the patients' overall survival time, but not on relapse-free survival. Receptor status appeared to have no significant influence on patient survival.

[Managing a high risk pregnancy after liver transplantation from the obstetrician's point of view. A case report].

We report about a pregnancy and obstetrical management of a patient who had undergone a liver transplantation. Following a normal pregnancy, the newborn was born spontaneously in the 39th week of pregnancy. During the pregnancy the CSA blood levels were controlled frequently as well as the fetal development.

[The need for cooperation between the gynecologist and dentist in pregnancy. A study of dental health education in pregnancy].

The causes of tooth and gum disorders during pregnancy and possible prevention measures are discussed. The evaluation of a nation-wide survey comprising 700 pregnant women reflects the women's respective scope of knowledge in respect of mouth and tooth hygiene, 357 of the 700 women included in the investigation had no dental treatment in the course of their pregnancy. 57.

[Successful therapy of nonpuerperal mastitis--already routine or still a rarity?].

The data from 102 patients with an average age of 36 +/- 14.4 years, who underwent treatment for nonpuerperal mastitis (NPM) were examined. After a definite diagnosis had been made, the patients were treated with a prolactin inhibitor either on its own, or in combination with antibiotics.

[Pregnancy following organ transplantation].

In 17 of 74 patients, in the 20-40 years of age group, who had undergone an organ transplantation (kidney or liver), the course and outcome of pregnancy were evaluated. In three cases, the pregnancies ended in premature miscarriage and in five cases they were terminated for medical reasons. Nine infants were born alive between the 32nd to the 40th week of gestation, six of them spontaneously, three of them by abdominal Caesarean section.

High-risk pregnancies and amniotic fluid isoamylase activity.

A kinetic test (Phadebas) was employed to determine the isoamylase activity in 77 amniotic fluid samples taken from a total of 60 high-risk pregnancies at different gestational ages. It was ascertained that in high-risk pregnancies the s-type isoamylase level frequently deviates from the common scatter range of the respective week of gestation. The measured activity of the s-type isoamylase is subsequently set in relation to the pre- and postnatal state of the newborn.

Endocrine profiles and luteal function during GnRH-analogue/HMG therapy.

We have found a significant improvement of pregnancy rates after pretreatment with an agonist of gonadotrophin releasing hormone (GnRH-a). The pregnancy rate in patients treated with HMG/HCG was 17% per patient and 5.5% per cycle, in patients treated with buserelin, 25% per patient and 15% per cycle and in the triptorelin group 25% per patient and 22% per cycle.

[Prognostic factors in medullary breast cancer].

In 55 patients with medullary carcinoma of the breast follow-up data over an average period of 68.1 +/- 35.3 months were recorded.

Amniotic fluid isoamylase activity in uneventful pregnancies.

A kinetic test (Phadebas) was used to determine the isoamylase activity in 50 serum specimens and 159 samples of amniotic fluid. A highly significant difference between the isoamylase patterns of serum and amniotic fluid was ascertained which strongly supports the view that amylase activity in amniotic fluid is not of maternal origin. During the whole course of gestation the activity of pancreatic isoamylase was constantly low whereas there was an increase of nonpancreatic activity (S-type amylase) from 44 +/- 10 U/l in the 18th week of gestation to 445 +/- 170 U/l in week 39/40.

Anemia, ferritin and preterm labor.

The results of this study suggest that the additional determination of serum ferritin in pregnancy is necessary for a more reliable classification of iron deficiency. In 300 pregnant women the hematological values (Hb, MCH and serum ferritin) were determined toward the end of gestation. In 36 per cent of the women both Hb values greater than 11 g/dl and MCH values less than 28 pg fail to give evidence of an existing iron deficiency, indicated by serum ferritin values below 20 micrograms/l.

Premature labor contractions and the value of serum ferritin during pregnancy.

In general, the diagnosis of pregnancy-related anemia relies on the estimation of the hemoglobin level. The findings of this study suggest that the additional estimation of serum ferritin - a reliable index of the iron stores - can improve the diagnosis of anemia. Hematological data of 150 pregnant women were retrospectively related to the courses of pregnancy, in particular to the incidence of premature labor contractions.

[Locoregional breast cancer recurrence. Treatment following exclusively local therapy].

In 58 out of 515 patients with a primary carcinoma of the breast there was local-regional recurrence. Treatment consisted in generous excision and local radiation (50-60 Gy). After a mean observation period of 65.

[Is amniotic fluid prolactin an osmoregulatory hormone of clinical importance?].

The present paper reports on the amniotic fluid prolactin concentrations in 61 pregnancies with undisturbed amniotic fluid volume from the 17th to the 41st week of pregnancy. The amniotic fluid prolactin concentrations reach a peak in the 19th week of pregnancy with a slight decrease to the 21st week. After a plateau from the 23rd to the 31st week of pregnancy, prolactin concentrations decrease to very low levels in late gestation.

[Importance of clinically prognostic factors in the treatment of advanced ovarian carcinoma].

25 patients with stage III and IV ovarian carcinoma were treated with radical surgery and postoperative chemotherapy. Analysis of the disease-free intervals and the survival rates indicated significant differences related to the stage of the disease. Furthermore patients with minimal residual disease (tumor mass less than 2 cm in diameter) had a far better prognosis than patients with extensive residual disease (greater than 3 cm).