First results from the MONICA stroke register in Heidelberg.

The Stroke Register was established in 1984 in Heidelberg, as a part of the MONICA Project, covering the same population (approximately 601,000) as the Acute Myocardial Infarction Register. In the present analysis, the data for men and women (aged 25-64) for 1985 and 1986 are presented. During the two years, 303 men and 143 women were registered. The overall age-standardized attack rate was 127.2/100,000 for men and 52.8/100,000 for women, and the age-standardized incidence was 97.4/100,000 in men and 42.9/100,000 in women. The proportion of first stroke was 76.5% in men and 81% in women. The 28-days mortality was 12% for men and 19% for women. Hypertension, diabetes mellitus, smoking and heart disease (coronary heart disease, rhythm disturbances) were identified as risk factors for stroke. Among the registered victims of stroke, 61% of the men and 67% of the women had a history of hypertension. In men, a high prevalence of smokers, 54% was found (33.9% in the total population in the same age range). In women, the prevalence of smokers is nearly the same as in the total population. Diabetes mellitus was present in 23% of men and in 40% of women, and hyperlipidaemia in 30% of men and in 18% of women.

Diagnosis of exocrine pancreatic insufficiency from stool fat and weight.

Diagnostic workup was performed in 118 patients with a chronic malassimilation syndrome. 45 patients had exocrine pancreatic insufficiency, 23 patients jejunal mucosal atrophy (mainly celiac disease), 36 patients increased enteral deconjugation of bile acids and as shown by the 14C-glycocholate breath test and in 14 patients with chronic diarrhea and steatorrhea the cause could not be determined. Eleven patients with irritable bowel syndrome served as controls. Stool fat and weight were determined in all patients. Classification function coefficient were calculated on the basis of a discriminant analysis, leading to a correct classification in 82.2% of the patients with pancreatic insufficiency, 67.8% in the patients with jejunal mucosal atrophy and 83.3% in the patients with increased enteral deconjugation of bile acids. Calculation of sensitivity, specificity and predictive value in the total group and in two randomized subgroups and the correct diagnosis of exocrine pancreatic insufficiency in 78.5% of the patients of an independent verification group suggest clinical usefulness of this approach mainly in the diagnosis of exocrine pancreatic insufficiency.

[Coronary risk factors and extent of angiographically proven coronary artery stenoses (author's transl)]. / Beziehungen von "Risikofaktoren" der Arterioskelrose zum Schweregrad der angiographisch nachweisbaren Koronarsklerose.

In 196 patients with angina pectoris selective coronary angiography was performed, and the extent of angiographically proven coronary artery stenoses was described by means of a coronary score. A significant correlation between the degree of atherosclerotic lesions on the one hand and hypertriglyceridemia, hypercholesterolemia as well as smoking habits on the other hand was detected. No correlation between other risk factors, such as hypertension, diabetes mellitus, hyperuricemia and obesity, and the coronary score was observed.

[Visual EEG analysis in controlling intravenous anesthesia using propofol]. / Visuelle EEG-Analyse zur Steuerung intravenöser Narkosen mit Propofol.

Since the discovery of brain waves by Berger, repeated efforts have been made to use the electroencephalogram EEG for monitoring and controlling anesthesia. Owing to its susceptibility to failure and the high expenditure regarding technology and personnel, the technique has not yet been adopted in routine anesthesia, however. In the study now reported an attempt was made to apply the positive experience with the recording and interpretation of EEG in the development of new anesthetic agents in the experimental laboratory, during routine clinical operations. The anesthetic used in the study was Propofol, an induction hypnotic that has only recently been introduced, together with nitrous oxide and repeated doses of fentanyl. Propofol is distinguished by its fast onset of action and short inactivation time; it is therefore suitable for induction and maintenance of anesthesia. The aim of the study was to maintain predetermined stages of sleep during anesthesia with the aid of visual on-line analysis of the EEG and to establish the dose of Propofol required for this purpose. The operations-general and orthopedic surgery-lasted 70-190 min (average duration: 120 min). In accordance with the randomization plan, the maintenance dose of Propofol was controlled in such a way that in ten patients light sleep levels (C0 to D1) and in the other ten deep sleep levels were maintained. The EEG was recorded via five active scalp electrodes (FP2, F4, C4, P4, O2) with reference to a joint electrode (A2). The stages of sleep were classified according to Kugler.(ABSTRACT TRUNCATED AT 250 WORDS)

The Eberbach/Wiesloch Study: lipoprotein profiles of 35- to 49-year-old men and women.

Plasma lipid- and lipoprotein profiles of a representative sample of men and women aged 35 to 49 years in the Federal Republik of Germany were investigated. Mean plasma cholesterol levels, triglyceride levels, and phospholipid levels were significantly higher in men than in women. An extensive investigation of plasma lipoproteins, including measurement of all major apolipoproteins and lipids in each density class revealed profound sex differences in the distribution and composition of lipoproteins. In men mean plasma levels of VLDL-cholesterol (33.20 mg/dl) and of VLDL-triglycerides (155 mg/dl) were three times as high as in women (11.38 mg/dl and 50.08 mg/dl, respectively). The relative amount of triglyceride was 15% higher in VLDL of men, due to decreased relative amounts of VLDL-phospholipids. Intermediate-density lipoproteins (IDL) were significantly higher in men. Men had also higher levels of Apo B in low-density lipoproteins (LDL). Interestingly, LDL-cholesterol levels of men and women were not significantly different. Women had more high-density lipoproteins (HDL), and the absolute and relative amounts of HDL2-cholesterol were significantly higher in women. In summary, besides well-known sex differences in plasma lipid levels, sex-specific differences in the levels of certain plasma lipoproteins were observed. The most important finding was that the composition of the lipoproteins showed profound differences between men and women. With regard to risk for atherosclerotic cardiovascular disease, women have more favorable lipoprotein profiles than men. These data may provide a basis for further investigations on alterations in plasma lipid and lipoprotein profiles in respect to risk for atherosclerotic cardiovascular disease.