Diastolic exercise stress testing in heart failure with preserved ejection fraction: The DEST-HF study.

Aims: Pulmonary capillary wedge pressure (PAWP) ≥25 mmHg during bicycle ergometry is recommended to uncover occult heart failure with preserved ejection fraction. We hypothesized that PAWP increase would differ in available diastolic stress tests and that the margin of PAWP ≥25 mmHg would only be reliably achieved through ergometry.

Methods And Results: We conducted a prospective, single-arm study in patients with an intermediate risk for heart failure with preserved ejection fraction according to the ESC HFA-PEFF score.

Palliative Care Consultation and Cost of Stay in out of Hospital Cardiac Arrest.

: Cardiac arrest is a critical condition with high clinical, economic, and emotional burden. The role of palliative medicine in the management of critical patients has grown and, in some areas, has shown reduced cost of stay. This study set out to examine the association of palliative care involvement in out of hospital post cardiac arrest patients and cost of stay.

Selection and Amplification of Fungicide Resistance in in Relation to DMI Fungicide Use in Agronomic Settings: Hotspots versus Coldspots.

is a ubiquitous saprophytic fungus. Inhalation of spores can lead to Invasive Aspergillosis (IA) in people with weakened immune systems. The use of triazole antifungals with the demethylation inhibitor (DMI) mode of action to treat IA is being hampered by the spread of DMI-resistant "ARAf" (azole-resistant ) genotypes.

Development of a finite element biomechanical whole spine model for analyzing lumbar spine loads under caudocephalad acceleration.

Spine injury risk due to military conflict is an ongoing concern among defense organizations throughout the world. A better understanding of spine biomechanics could assist in developing protection devices to reduce injuries caused by caudocephalad acceleration (+Gz) in under-body blasts (UBB). Although some finite element (FE) human models have demonstrated reasonable lumbar spine biofidelity, they were either partial spine models or not validated for UBB-type loading modes at the lumbar functional spinal unit (FSU) level, thus limiting their ability to analyze UBB-associated occupant kinematics.

Unrecognized pulmonary arterial hypertension in hospitalized patients.

Pulmonary hypertension (PH) is an underdiagnosed and potentially fatal condition. The utility of screening for PH in hospitalized patients undergoing echocardiography is unknown. The goal of this study was to determine the prevalence of undiagnosed pulmonary hypertension (PH) and probable pulmonary arterial hypertension (PAH) in hospitalized patients undergoing echocardiography for any indication.

HNF1B nephropathy has a slow-progressive phenotype in childhood-with the exception of very early onset cases: results of the German Multicenter HNF1B Childhood Registry.

Background: HNF1B gene mutations are an important cause of bilateral (cystic) dysplasia in children, complicated by chronic renal insufficiency. The clinical variability, the absence of genotype-phenotype correlations, and limited long-term data render counseling of affected families difficult.

Methods: Longitudinal data of 62 children probands with genetically proven HNF1B nephropathy was obtained in a multicenter approach.

Review of the impact of presbyopia on quality of life in the developing and developed world.

Purpose: To examine the public health impact of presbyopia regarding its effect on quality of life (QoL) and society in both the developed and developing worlds.

Methods: A database was created from articles found on PubMed, the Cochrane Library and Science Direct using the following search terms: presbyopia, QoL, accommodation, impact, cost, prevention, treatment and public health. Articles were accepted into the database if they addressed presbyopia and public health.

[Pegfilgrastim vs filgrastim in primary prophylaxis of febrile neutropenia in patients with breast cancer after chemotherapy: a cost-effectiveness analysis for Germany].

Objective: Febrile neutropenia (FN) is a common toxic side effect of myelosuppressive chemotherapy. The cost-effectiveness of primary prophylaxis (PP) of FN with granulocyte colony stimulating growth factor (G-CSF) filgrastim for six or eleven days was compared to single dose pegfilgrastim in patients with early breast cancer receiving chemotherapy (>or= 20 % FN risk) as simulated in a model.

Methods: Based on a decision-analytical model we conducted a cost-effectiveness analysis (CEA) and a cost-utility analysis (CUA) from the perspective of the Statutory Health Insurance (SHI) in Germany.

Clinical effectiveness of attentional bias modification training in abstinent alcoholic patients.

A new training to decrease attentional bias (attentional bias modification training, ABM) was tested in a randomized controlled experimental study with alcohol-dependent patients as an addition to cognitive behavioral therapy. In alcohol dependence, attentional bias has been associated with severity of alcoholism, craving, treatment outcome, and relapse. Forty-three patients with DSM-IV diagnosis of alcohol dependence were randomly assigned to an ABM intervention or control training.

Maladaptive coping strategies in patients with bruxism compared to non-bruxing controls.

Background: Sleep bruxism is the non-functional grinding or clenching of teeth during sleep. It may lead to tooth damage and myofascial pain. Although stress is discussed as a main causal agent, there is a lack of studies concerning coping strategies in patients with sleep bruxism.

Cost-effectiveness of rosiglitazone oral combination for the treatment of type 2 diabetes in Germany.

Aims/hypothesis: To assess the cost-effectiveness of rosiglitazone in combination with other oral agents for the treatment of overweight and obese patients with type 2 diabetes in Germany.

Methods: The Diabetes Decision Analysis of Cost--type 2 model was adapted for clinical practice and healthcare financing rules in Germany. The model was calibrated using Cost of Diabetes in Europe Type 2 study data and national statistics.

Validation of health economic models: the example of EVITA.

Objectives: The credibility of models rests on their validity. An age-structured decision analytic model, Economic Varicella Vaccination Tool for Analysis (EVITA), has been developed to examine the epidemiologic and economic effects of universal varicella (chicken pox) vaccination in Germany. EVITA combines a varicella transmission module describing the spread of infection in a population over time with a second module describing the course of disease in case of an infection.

[Catabolic stress response during and after abdominal surgery. Comparison between two anaesthesia procedures].

Background: The purpose of the study was to investigate the effect of modified neuroleptanesthesia (NLA) with fentanyl/midazolam on the catabolic responses during and after abdominal surgery.

Methods: A total of 13 patients undergoing cystoprostatectomy received either modified NLA ( n=7) or inhaled anesthesia with isoflurane (ISO, n=6). Glucose and urea production rates were assessed before, during and 1 day after the operation.

Integrated analysis of glucose, lipid, and urea metabolism in patients with bladder cancer. Impact of tumor stage.

Objective: The aim of the study was to characterize the metabolic changes in non-weight-losing patients with cancer of the bladder and to investigate the effect of tumor stage. The kinetics of glucose, glycerol, and urea metabolism were assessed in 22 weight-stable patients with non-metastatic bladder cancer (tumor stage p T2, n = 14) and 10 patients with benign uterine myoma (controls).

Methods: The kinetics of glucose, glycerol, and urea metabolism were assessed by [6,6-(2)H(2)]glucose, [1,1,2,3,3-(2)H(5)]glycerol, and [(15)N(2)]urea.

The cost-effectiveness of routine childhood varicella vaccination in Germany.

This study explores the economic value of a routine varicella vaccination program for Germany. An age-structured decision analytic model was used to assess the benefits, costs and cost-effectiveness of an immunization program for a period of 30 years. Three interventions were compared with no vaccination: universal vaccination of around 15 months old healthy children, vaccination of susceptible adolescents (11-12 years of age), and the combined strategy.

Can varicella be eliminated by vaccination? Potential clinical and economic effects of universal childhood varicella immunisation in Germany.

Varicella is a potentially serious infection not only in immunocompromised individuals but also in otherwise healthy adults and children. Vaccination plays an important role in preventing the disease and its sequelae. A universal vaccination in childhood is expected to reduce substantially the number of uncomplicated cases of varicella and decrease the number of complicated cases requiring hospitalisation.

Bootstrap confidence intervals for costs-of-illness of type 2 diabetes mellitus in Germany.

Objective: The Costs of Diabetes in Europe-Type 2 study (CODE-2, SmithKline Beecham plc) measures costs of managing patients with type 2 diabetes mellitus in Germany. The aim of this analysis was to assess the uncertainty of these estimates.

Design And Setting: The German study arm was based on a sample of 809 patients with type 2 diabetes registered in general practices.

[Using epidural anesthesia in patients with acute pancreatitis--prospective study of 121 patients].

According to a previous study, an excellent level of analgesia can be expected when using epidural anaesthesia in patients with acute pancreatitis. In the present investigation, the effectiveness and safety of epidural anaesthesia is demonstrated in a large group of patients with severe acute pancreatitis, who were admitted to an intensive care unit. Epidural anaesthesia alone produced excellent analgesia on 1,083 of 1,496 observation days (72%) without the systemic use of other analgesic substances.

Complications, co-morbidity, and blood glucose control in type 2 diabetes mellitus patients in Germany--results from the CODE-2 study.

In this study, prevalence and incidence of complications as well as co-morbidity in type 2 diabetes patients in Germany were evaluated as part of a cost-of-illness study (CODE-2(TM), Costs of Diabetes in Europe - Type 2)In a pre-study, 197 general practitioners and diabetes specialists all over Germany provided data on the complication status of 2701 randomly selected patients with type 2 diabetes. The patients were grouped into five mutually exclusive strata. This pre-study was performed to generate a general overview on complication status to select proper patients for the main study.

Intraoperative epidural blockade prevents the increase in protein breakdown after abdominal surgery.

Background: The aim of this study was to investigate the effect of epidural blockade with bupivacaine, restricted to the intraoperative period, on protein catabolism after major abdominal surgery.

Methods: Fourteen patients undergoing cystoprostatectomy were randomly assigned to receive either general anaesthesia with isoflurane (control group, n=7) or a combination of general anaesthesia and epidural blockade with bupivacaine from segment T4 to S5 (epidural group, n=7). Rates of urea (Ra urea) and glucose production (Ra glucose) were measured three days before and three days after the operation using stable isotope tracers ([15N2]urea, [6,6-2H2]glucose).

Understanding the mechanisms by which isoflurane modifies the hyperglycemic response to surgery.

Unlabelled: We studied the effect of anesthesia on the kinetics of perioperative glucose metabolism by using stable isotope tracers. Twenty-three patients undergoing cystoprostatectomy were randomly assigned to receive epidural analgesia combined with general anesthesia (n = 8), fentanyl and midazolam anesthesia (n = 8), or inhaled anesthesia with isoflurane (n = 7). Whole-body glucose production and glucose clearance were measured before and during surgery.