[Length of hospital stay of patients with ischemic brain infarction: trends over 10 years and analysis of influencing factors]. / Liegezeit von Patienten mit ischämischem Hirninfarkt: 10-Jahres-Trends und Analyse der Einflussfaktoren.

BACKGROUND: The length of the acute hospital stay (LOS) is an indicator of efficiency in the treatment of ischemic brain infarctions (ICD I63). The aim of this study was to describe the development of the LOS over 10 years and to analyze influencing factors with a focus on the structural level of hospitals. METHODS: Routine treatment data for the years 2000 to 2009 generated within the quality assurance project "Stroke Register Northwest Germany" formed the basis of our analyses (n = 175,149). Additionally, the infrastructure and equipment of the hospitals were documented. Information regarding the bed density on county level was provided by the statistical offices of the federal German states. The median LOS was calculated for each year. Moreover, a linear multilevel analysis of the influencing factors stratified by hospital specialty was performed. RESULTS: The LOS after an ischemic brain infarction decreased by several days over the years 2000 to 2009. The difference between the specialties neurology vs. internal and geriatric medicine diminished. A small part of variation in LOS was explained by the factors measured on the three levels patient, hospital and county. The biggest proportion of variance was explained by socio-demographic and clinical factors measured on patient level. Hospital equipment contributed somewhat additionally to the explanation of variance for hospitals specializing in internal and geriatric medicine. There were differences between the medical specialties both with regard to the associations observed and the distribution of variance on the three levels. CONCLUSION: There was a reduction of the LOS in patients with ischemic brain infarction. A stratified analysis according to medical specialty seems necessary. Single features of the hospital infrastructure are associated with the LOS. However, the interpretation of these associations is in part difficult.

[Secondary prevention of coronary heart disease. Results from EuroASPIRE I and II in the region of Münster, Germany]. / Sekundärprävention der koronaren Herzkrankheit - Ergebnisse der EuroASPIRE I- und II-Studien in der Region Münster, Germany.

BACKGROUND: EuroASPIRE (European Action on Secondary Prevention through Intervention to Reduce Events) is a European multicenter study on secondary prevention in patients with coronary heart disease (CHD). The first cross-sectional survey was undertaken in 1995/96 among 3569 patients from nine countries. A second cross-sectional survey (EuroASPIRE II) was conducted in 1999/2000 among 5556 patients from 15 countries to evaluate among others whether coronary prevention had improved since the first. METHODS: The present study was conducted in the region of Münster, Germany, as part of the EuroASPIRE study. Consecutive patients, men and women up to 70 years of age with established CHD, were identified retrospectively. A total of 392 (EuroASPIRE I) and 402 (EuroASPIRE II) patients participated. Information on cardiovascular risk factors, lifestyle and medication were obtained through medical records, interviews and examinations. RESULTS: Both studies demonstrate a high prevalence of risk factors among CHD patients. At the time of the interview more than 60% of the patients in both surveys had two or more risk factors. The comparison of EuroASPIRE I and II reveals a substantial decrease of 20% in the prevalence of hypercholesterolemia, but an increase in the prevalence of hypertension and obesity. ACE-inhibitors, betablockers and lipid lowering drugs, especially statins, were used more frequently in EuroASPIRE II. CONCLUSIONS: We conclude that secondary prevention of CHD in the region of Münster like in the other European study regions is less than optimal and has not substantially improved between 1996 and 2000. Potential reasons are discussed.

Assignment of overlapping (1)H NMR signals in carp seminal plasma by proton-detected 2D C,H correlation spectroscopy.

The (1)H NMR spectrum of the perchloric acid extract of carp seminal plasma was heavily congested. It is demonstrated that proton-detected C,H chemical shift correlation spectroscopy (HSQC, HSQC-TOCSY) allows an unequivocal identification of proline, glutamate, taurine, and methionine sulfoxide, although several key proton signals were strongly overlapped.

Phosphorous metabolites in boar spermatozoa. Identification of AMP by multinuclear magnetic resonance.

Boar spermatozoa revealed three prominent resonances in the 31P-NMR spectrum of intact cells. Two of these are known to be GPC and Pi, the third is a phosphomononoester (PME), the identification of which was carried out by proton-detected 2D 1H,31P and 1H,13C chemical shift correlation experiments with gradient selection. The PME was unambiguously assigned to adenosine 5'-monophosphate (AMP). The identification was confirmed by an AMP consuming enzymatic assay. Other physiologically relevant PME's, in particular inosine 5-monophosphate (IMP) and sugar phosphates, were excluded. The intensity of the 31P signal of AMP in boar sperm extract was much higher than those of ADP and ATP, and in intact cells only AMP but no ATP was visible.

Nuclear magnetic resonance studies of boar seminal plasma. Problems encountered in the identification of small molecules: hypotaurine and carnitine.

Two major components in boar seminal plasma were assigned by 1H and 13C nuclear magnetic resonance spectroscopy. The first, previously called substance X (see Ref. 1, Biochim. Biophys. Acta 1243, 101-109 (1995)), was identified with difficulty as hypotaurine. This pointed to general difficulties in the NMR assignments of small molecules in mixtures of substances, even at the highest magnetic fields. In contrast, the identification of the second component as carnitine was obtained in a straightforward manner by total correlation spectroscopy and proton-detected 13C chemical shift correlation methods (gradient-selected heteronuclear single quantum coherence and heteronuclear multiple bond correlation). Carnitine is known as a transporter of fatty acids through membranes. Both compounds were ultimately confirmed by addition of the authentic compounds.