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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS); 20160612-20160615; Frankfurt am Main; DOCDI.18.08 /20160608/
    Publication Date: 2016-06-17
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 2
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    German Medical Science; Düsseldorf, Köln
    In:  104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft (DOG); 20060921-20060924; Berlin; DOC06dogSO.06.04 /20060918/
    Publication Date: 2006-09-19
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science; Düsseldorf, Köln
    In:  104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft (DOG); 20060921-20060924; Berlin; DOC06dogSA.02.03 /20060918/
    Publication Date: 2006-09-19
    Keywords: ddc: 610
    Language: German
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  • 4
    ISSN: 1573-7241
    Keywords: congestive heart failure ; digitoxin ; diuretics ; heart rate ; blood pressure ; left ventricle ; exercise capacity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Summary. The effects of digitoxin and/or diuretic agents were investigated in patients with congestive heart failure (CHF) in sinus rhythm with respect to changes in hemodynamić parameters, cardiac dimensions, and bicycle ergometric exercise capacity. In a randomized, double-blind study, 16 male patients with CHF NYHA class II and III received a placebo for 1 week (baseline) and then were randomly allocated, double blind, to take either digitoxin (digitalis group, DI: N 〈5 8) or trichlormethiazide/amiloride (diuretic group, DG: N 〈5 8) for 3 weeks (VP I). The patients who were first treated with digitoxin received the diuretic agent for a further 3 weeks and vice versa (VP II). At baseline and after VP I and II, a physical examination, 2D echocardiography, and bicycle ergometry were performed. Heart rate (HR), systolic (BPs), and diastolic (BPd) blood pressure at rest, and BPs at 50 watts, were not significantly changed during the observation period. HR at 50 watts was decreased in DI (11.5 〈6 10.1 beats/mh) after VP I and II, but not in DG. BPd was significantly reduced after VP II in DI (8.2 〈6 4.6 mmHg) and in DG (9.3 〈6 8.9 mmHg). DI presents at baseline significantly higher end-diastolic (LVEDV) and end-systolic (LVESV) left ventricular dimensions, whereas left atrial diameter (LA) and stroke volume (SV) and ejection fraction (LVEF) were not significantly different. After VP I, a significantly decreased LA was found in DI, but not in DG. After VP II, all cardiac dimensions were significantly reduced compared with the baseline in DI, whereas in DG only a decrease in LVESV was found. SV was significantly increased in DI, but not in DG after VP I. SV and LVEF were significantly improved in DI and in DG after VP II. Exercise capacity did not change significantly in DI and DG. Digitoxin in combination with trichlormethiazide/amiloride is effective in reducing primarly enlarged left atrial and left ventricular dimensions, and is sufficient to improve the impaired systolic left ventricular function in CHF of NYHA class II and III in sinus rhythm. However, a significant increase in exercise capacity was not found. Treatment with digitoxin seems to be more relevant as a monotherapy with trichlormethiazide/amiloride.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1439-6327
    Keywords: Key words Paraplegia ; Exercise testing ; Anaerobic threshold ; Heart rate threshold ; Lactate threshold
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The deflection point (DP) of the heart rate in relation to the work rate (WR) of 8 male endurance-trained paraplegics and 11 male physically active sports students was investigated during nonsteady-state incremental arm cranking ergometry (IT) and compared to the 4 mmol · l−1 blood lactate concentration threshold and to blood lactate concentration in steady-state exercise (SST). Heart rate, and lactate concentration from capillary blood, were determined at rest, during IT and SST. The DP was calculated by linear regression analysis of the heart rate during IT. The SST consisted of three consecutive exercise intensities over a period of 8 min at exercise intensities of 10 W below, and at 10 W above the work rate at deflection point (WRDP). No difference was found between the paraplegics and non-handicapped subjects regarding heart rate and blood lactate concentration at rest and during exercise. A DP was established in all the paraplegics and in 72.7% of the non-handicapped subjects, but lactate accumulation was observed in 75% of the paraplegics and in 62.5% of the non-handicapped subjects at the lowest intensity of SST. In summary, endurance-trained paraplegics with an injury level below T5 showed heart rate and blood lactate concentration values comparable to non-handicapped subjects during IT. A linear increase at moderate exercise intensities and a levelling-off at higher to maximal intensities could be identified in all the paraplegics and in 72.7% of non-handicapped subjects. The determination of the anaerobic threshold by DP should be applied with caution, since no causal relationship of DP and the anaerobic threshold was found and the WRDP tended to overestimate threshold values.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1435-1285
    Keywords: Schlüsselwörter Kardiovaskuläre Prävention – koronare Herzkrankheit – metabolisches Syndrom – Endothelfunktion – körperliche Mehraktivität – Bewegungstherapie ; Key words Cardiovascular prevention – coronary artery disease – metabolic syndrome – endothelial function – physical activity – exercise training
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Current trends in public health provided potential arguments to, first, intensify the recommendations of a physically active lifestyle in the primary prevention of atherosclerosis and, second, to prescribe a supervised outpatient exercise training program for secondary prevention of cardiovascular diseases. Regular physical exercise may positively influence cardiovascular risk factors (overweight, hypertension, hyperlipoproteinaemia, insulin resistance, hemostatic markers). Physical conditioning modifies the body composition in favor of an increased skeletal muscle mass, changes the eating habits, and other life style characteristics. The dietary modifications characterized by a low-fat, more vegetarian food supports the weight control and the adjustment of the other metabolic risk factors. All these changes are suitable to reduce the manifestation of atherosclerosis and to minimize the risk of an acute thromboembolic arterial occlusion. Physical conditioning on one's own initiative in primary prevention or an exercise training program supervised by health professionals in secondary prevention of atherosclerosis should predominantly include a low intensive aerobic endurance exercise training. Lactate concentration in capillary blood can be measured to objectify and regulate exercise intensity. The additional energy turnover should amount to a minimum of 1,000 kcal and a maximum of 3,500 kcal weekly. This energy expenditure could be realized either with an increased physical activity level in daily routine (e.g., stair climbing, go for a walk, gardening) or by a regular leisure-time physical exercise. A turnover of 300 kcal per session should be prescribed. In long-term clinical trials investigating the benefit of primary and secondary cardiovascular prevention a reduction of the cardiovascular mortality of about 20–30% has been demonstrated.
    Notes: Zusammenfassung Die aktuellen Tendenzen im Gesundheitswesen liefern gewichtige Gründe, in der Primärprävention der Arteriosklerose einen körperlich aktiven Lebensstil stärker zu propagieren und in der Sekundärprävention von kardiovaskulären Erkrankungen, insbesondere der koronaren Herzkrankheit, eine ambulante Bewegungstherapie zukünftig vermehrt zu verordnen. Regelmäßige körperliche Mehraktivität eröffnet eine therapeutische Möglichkeit, die atherogenen Risikofaktoren (Übergewicht, Hypertonie, Dyslipoproteinämie, Insulinresistenz, Thrombogenese) günstig zu beeinflussen. Körperliche Mehraktivität ist mit einer Modifizierung der Körperkomposition zugunsten des Muskelanteils verbunden und führt zu Veränderungen des Ernährungsverhaltens und der allgemeinen Lebensweise. Der Verzehr von fettärmeren, stärker vegetarisch ausgerichteten Nahrungsmitteln unterstützt die Regulierung des Körpergewichtes und der übrigen metabolischen Risikofaktoren. Alle genannten Veränderungen sind dem arteriosklerotischen Gefäßprozeß entgegengerichtet und vermindern das Risiko eines akuten thromboembolischen arteriellen Gefäßverschlusses. Für eine eigeninitiativ praktizierte körperliche Mehraktivität zur Primärprävention bzw. eine ärztlich überwachte Bewegungstherapie in Herzgruppen zur Sekundärprävention der Arteriosklerose eignet sich vorzugsweise ein niedrig intensives, aerobes Ausdauertraining. Die Intensitäten der absolvierten Belastungen können mittels Laktatbestimmungen im Kapillarblut objektiviert und reguliert werden. Der durch die körperliche Mehraktivität induzierte wöchentliche Energiemehrumsatz sollte mindestens 1000 bis maximal 3500 kcal betragen. Er kann durch einen erhöhten kalorischen Basisverbrauch im Alltag (z.B. Treppensteigen, Spazierengehen, Gartenarbeit) und/oder durch eine regelmäßige körperliche Aktivität in der Freizeit realisiert werden und sollte mindestens 300 kcal/Einheit (z.B. Ergometertraining mit 100 W über 40 min) beinhalten. Langzeitstudien über den Nutzen einer primären und sekundären kardiovaskulären Prävention zeigen eine Absenkung der kardiovaskulären Mortalität um 20–30%.
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  • 7
    ISSN: 1435-1285
    Keywords: Schlüsselwörter Ultraschall – Arteria carotis communis – Intima-media-Dicke – Steifigkeit – Hämodynamik ; Key words Ultrasonics – carotid artery – intima-media thickness – stiffness – hemodynamic
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Atherosclerotic changes of the carotid tree comprise changes of the wall structure, the wall stiffness, and local blood flow properties. They are associated with atherosclerotic changes in other arterial beds such as the coronary and cerebral arteries and with manifest atherosclerotic diseases. It has also been shown that they are at least in part potent predictors for future cardiovascular disease. Transcutaneous ultrasound of the carotid tree offers the possibility of detecting ahterosclerotic changes on a noninvasive basis. In the following, the different methods for the assessment of atherosclerotic changes of the carotid wall structure, wall stiffness, and local hemodynamics with noninvasive ultrasound are briefly reviewed. The combined assessment of all these arterial properties may increase the predictive value of noninvasive ultrasound in detecting early atherosclerosis in other arterial beds. However, more prospective studies are necessary to examine the possible value of increased wall stiffness, altered local hemodynamics, and the combined assessment of these parameters together with the assessment of arterial wall structure in this respect. Therefore, the current ultrasound methods for the measurement of structure, function, and hemodynamics has yet to be optimized for usage in routine medical examinations.
    Notes: Zusammenfassung Atherosklerotische Veränderungen der Carotiden umfassen Veränderungen der Wandstruktur, der Wandsteifigkeit und der lokalen Blutflußeigenschaften. Sie treten zusammen mit atherosklerotischen Veränderungen in anderen arteriellen Gefäßprovinzen wie den koronaren oder zerebralen Arterien und mit manifesten atherosklerotischen Erkrankungen. Es wurde auch gezeigt, daß sie zumindest partiell aussagekräftige Prädiktoren für zukünftige kardiovaskuläre Erkrankungen sind. Der transkutane Ultraschall der Carotiden ermöglicht die nichtinvasive Erkennung von atherosklerotischen Veränderungen. Im Folgenden soll ein kurzer Überblick über die verschiedenen Methoden der Erhebung von atherosklerotischen Gefäßveränderungen der Wandstruktur, -steifigkeit und der lokalen Hämodynamik der Carotiden mit nichtinvasivem Ultraschall gegeben werden. Die kombinierte Erfassung aller genannten arteriellen Eigenschaften könnte den prädiktiven Wert des nichtinvasiven Ultraschalls bei der Erkennung von atherosklerotischen Veränderungen der Arterien steigern. In dieser Hinsicht scheinen jedoch noch mehr prospektive Studien notwendig zu sein, um den denkbaren Wert einer erhöhten Wandsteifigkeit, veränderter lokaler Hämodynamik und ihrer kombinierten Erfassung zusammen mit der Wandstruktur zu untersuchen. Dafür müssen jedoch die derzeit verfügbaren Ultraschallverfahren zur Messung von Struktur, Funktion und Hämodynamik der Arterien für die Verwendung in der täglichen Routine der medizinischen Diagnostik optimiert werden.
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