Biomedical subjects

J Grimm

Publications and source records attributed to J Grimm.

At least 37 records · Page 2Linked to original sources

PubMed2001

Correlation of thoracic and lumbar vertebral failure loads with in situ vs. ex situ dual energy X-ray absorptiometry.

In this study we explore the hypothesis that estimates of failure loads in the thoracic spine by lumbar dual energy X-ray absorptiometry (DXA) are compromised of skeletal heterogeneity throughout the spine and artifacts of spinal DXA. We studied the correlation between mechanical failure loads of thoracic and lumbar vertebrae, and that of in situ vs. ex situ lumbar DXA with thoracic and lumbar fracture loads, respectively. One hundred and nineteen subjects (76 female, age 82+/-9yr; 43 male, age 77+/-11yr) were examined under in situ conditions (anterior-posterior direction), the scans being repeated ex situ (lateral projection) in 68 cases. The failure loads of thoracic vertebrae (T) 6 and 10, and lumbar vertebra (L) 3 were determined in axial compression, using a functional 3-segment unit. The correlation between thoracic failure loads (T6 vs. T10) was significantly (p<0.01) higher (r=0.85) than those between thoracic and lumbar vertebrae (r=0.68 and 0.61, respectively). Lateral ex situ DXA displayed a significantly higher correlation (p<0.05) with lumbar vertebral fracture loads than in situ anterior-posterior DXA (r=0.85 vs. 0.71), but the correlation of thoracic failure loads with lateral ex situ lumbar DXA was similar to that obtained in situ in anterior-posterior direction (r=0.69 vs. 0.69 for T10, and r=0.61 vs. 0.65 for T6). The correlation between fracture loads of different spinal segments, and between DXA and failure loads was not significantly different between men and women. The results demonstrate a substantial heterogeneity of mechanical competence throughout the spine in elderly individuals. Because of the high incidence of fractures in the thoracic spine, these findings suggest that, clinically, lateral DXA involves no relevant advantage over anterior-posterior measurements of the lumbar spine.

Absorptiometry, Photon↗

PubMed2001

Randomized study to compare PTA alone versus PTA with Palmaz stent placement for femoropopliteal lesions.

PURPOSE: The purpose of this study was to evaluate whether percutaneous transluminal angioplasty (PTA) combined with Palmaz stent placement provides long-term advantages compared to PTA alone after 34 months of follow-up in the femoropopliteal region. MATERIALS AND METHODS: Thirty patients randomized to undergo PTA in combination with stent placement and 23 patients randomized to undergo PTA alone were evaluated. RESULTS: Mean follow-up (+/-SD) for the PTA group was 33.8 months (+/- 8.7) and for the Palmaz group 29.1 months (+/- 6.2), with a maximum follow-up period of 39 months for both groups. No significant differences in primary or secondary patency rates could be observed at 12 or 39 months. After 39 months, the primary patency rate for PTA alone was 68.4% and the secondary patency rate was 89.5%; the primary patency rate for PTA with stent placement was 62% and the secondary patency rate was 90%. CONCLUSIONS: The results of this study show that even after a long-term follow up of more than 3 years, PTA with stent placement in the femoropopliteal artery does not produce better results than PTA alone, although it does provide better initial luminal gain after the procedure.

Aged↗

PubMed2001

Comparison of in vitro effectiveness of mechanical thrombectomy devices.

PURPOSE: To determine the in vitro efficacy of clot removal of the following hydrodynamic thrombectomy devices: the AngioJet (AJ), Hydrolyser (HL), Oasis (OS), and Amplatz Thrombectomy Device (ATD). All devices have 6-F catheters. MATERIALS AND METHODS: Thrombectomy of 5-day-old porcine clots (n = 68; 8.5 g) was performed with the AJ without a guide wire [AJ(gw0)], with a coaxial 0.016-inch guide wire [AJ(gw.016)], and with a 0.035-inch guide wire [AJ(gw.035)]), and with the HL, OS, and ATD in an artery flow model (pulsed flow: 700 L/min) simulating the superficial femoral artery (7-mm inner tube diameter). The effluent was passed through a three-step filter system (10-1,000 microm; pressure drop: 35 mm Hg). RESULTS: Mean thrombectomy time ranged from 49 seconds (AJ(gw0)) to 88 seconds (OS; P < .001). The fluid balance with use of the AJ(gw.035) was 0.89, whereas the mean ratio of applied saline solution to aspirated fluid for the other devices was not isovolumetric (AJ(gw0), 0.8; AJ(gw.016), 0.78; HL, 0.73; OS, 0.62; P < .05). Remaining thrombus ranged in size from 8.2 mg (AJ(gw0)) to 27.3 mg (AJ(gw.035); P = .079). Hydrodynamic devices (0.6% [OS] to 0.98% [AJ(gw.016)]) caused low amounts of added emboli greater 10 microm, 100 microm, and 1,000 microm. The ATD (5.19%) caused the most extensive embolization (P < .001). CONCLUSIONS: The tested mechanical thrombectomy devices have the power for sufficient thrombectomy in vitro; however, they showed moderate differences in performance. In contrast to hydrodynamic devices, the ATD fragmentation device showed a higher peripheral embolization rate of particles larger than 1,000 microm; adjunctive in vivo treatment would probably be required.

Animals↗

PubMed2001

Treatment of infrapopliteal occlusive disease by high-speed rotational atherectomy: initial and mid-term results.

PURPOSE: To assess the effectiveness and patency rates of high-speed rotational atherectomy (HSRA) for the treatment of infrapopliteal arterial occlusive disease. MATERIAL AND METHODS: During an 18-month period, a total of 19 infrapopliteal lesions in 15 consecutive patients were treated primarily by HSRA with use of the Rotablator device. Patients were followed up with documentation of clinical symptoms, standardized treadmill exercise, and Doppler sonography at 1, 3, and 6 months. Control angiography was performed 6 months after primary treatment. RESULTS: HSRA was initially successful in 14 of 15 patients, yielding an initial technical success rate of 94%. Percutaneous treatment induced an improvement of the ankle-brachial index (ABI) from 0.6 +/- 0.09 to 0.86 +/- 0.2 after intervention (P < .0001). Doppler analysis showed a mean ABI of 0.85 +/- 0.2 (P < .001) at 1 month, 0.72 +/- 0.2 (P = .012) at 3 months, and 0.7 +/- 0.2 (P = .08) at 6 months after initial therapy. Although six patients were lost to follow-up at various times, control angiography at 6 months was carried out in nine of 15 patients, allowing direct assessment of 12 of 19 treated lesions. Among six high-grade restenoses and five total occlusions in the treated vascular segments, only one arterial lumen (of 12) remained patent without presenting a hemodynamically relevant restenosis. These results led to termination of the study. CONCLUSION: Although HSRA for the treatment of infrapopliteal occlusive disease yields a very high initial technical success rate, mid-term results are extremely poor. Therefore, HSRA cannot be recommended for primary treatment of this type of lesion.

Aged↗

PubMed2001

[Value of kinematic MRI in the evaluation of patients with exacerbated pain in cervical spine motion compared with static MRI].

OBJECTIVE: To assess the clinical value of kinematic MR imaging in patients with cervical radiculopathy and increasing symptoms after provocative maneuvers at flexion, extension, axial rotation and coupled motion of the cervical spine. METHODS: Thirty-five patients with cervical disc herniation or cervical spondylosis in whom symptoms were elicited at flexion, extension, axial rotation and coupled motion were studied inside a positioning device using T2-weighted TSE, 2D-FLASH, and reformatted 3D DESS and 3D-FISP sequences. The images were evaluated for the size of disc herniations, the foraminal size and cervical cord displacement at provocative position compared with neutral position (0 degree). In addition, the value of kinematic MR images were interpretated with regard to changes in the therapeutic procedure and intraoperative patient positioning. RESULTS: Compared with the neutral position (0 degree) a change in disc herniations was not found in any (0%) of the provocative positions. In five patients (14%) cervical cord displacement was noted at axial rotation. The foraminal size varied depending on the provocative position, increasing at flexion and decreasing at extension. CONCLUSION: Kinematic MR imaging in patients with cervical radiculopathy and increasing symptoms at provocative maneuvers provides no additional information for the therapeutic decision-making process.

Biomechanical Phenomena↗

PubMed2001

[Comparison of biphasic spiral CT and MnDPDP-enhanced MRI in the detection and characterization of liver lesions].

INTRODUCTION: To evaluate the efficacy of biphasic spiral CT and MnDPDP (Teslascan, Nycomed Amersham) enhanced MR imaging to detect and classify liver lesions. MATERIALS AND METHODS: 39 patients with known or suspected liver lesions were included into this study and examined with biphasic spiral CT and MnDPDP-enhanced MRI. 25 histological reports and 1 extreme increased serum AFP value could be obtained from 22 patients, therefore only these 26 proven lesions were included into this analysis. RESULTS: From 39 patients CT revealed in 54% (14 lesions) and MRI in 54% correct (i.e., corresponding to the histology) diagnosis. Correct CT/wrong MRT diagnosis and vice versa was present in only 2 lesions each. Differentiating into benign versus malignant lesion was successful in 73% for MRI and 77% for CT. In 81% MRI revealed the correct type of lesion (hepatocellular or non-hepatocellular) vs. 77% with CT. Sensitivity/specificity for differentiation into benign/malignant lesions was 86%/70% (MRI) and 87%/77% (CT) and for differentiation of the lesions origin 100%/80% (MRI) and 80%/75% (CT), these differences were not significant. MnDPDP-enhanced MRI showed significantly more lesions than non-enhanced MRI. CONCLUSION: MnDPDP-enhanced MRI is better than CT in differentiating hepatocellular liver lesions from non-hepatocellular lesions. After contrast enhancement with MnDPDP significantly more lesions could be evaluated in MRI. MnDPDP improves, in combination with biphasic helical CT, the diagnosis of liver lesions.

Adenoma↗

PubMed2001

[Mechanical brush-catheter abrasion method for the isolation and culture of human umbilical vein endothelial cells. First in vitro results].

UNLABELLED: Mechanical brush-catheter abrasion method for the isolation and culture of human umbilical vein endothelial cells. First in vitro results. PURPOSE: To determine the value of a nylon brush (Cragg thrombolytic catheter system) with regard to the isolation and culture of viable human vascular umbilical vein endothelial cells (HUVEC). MATERIAL AND METHODS: Fresh human umbilical cords were collected after a maximum of 6 - 8 h post delivery. They were stored in sterile tubes till further preparation. After predilation the umbilical cord veins, a 6 French brush catheter was inserted, expanded, and removed by hand using rotating movements. The nylon brush was shaken out in cell medium containing serum proteins by a connected motor drive. After repeating these procedures, the detached endothelial cells were centrifugated and resuspended. The cell numbers were assessed and cell viability controlled. RESULTS: The endothelial cell (EC) viability depended on the umbilical cord's age and was the highest (29.8 +/- 11.4 %) within 3 h after delivery. The brush abrasion (3.32 x 10(5) +/- 52016 viable EC/10 cm vein segment) enabled us to culture these cells under different cell concentrations. They grew to confluence after 2 - 3 weeks. CONCLUSIONS: The brush-catheter abrasion is an effective method for collecting viable human endothelial cells in vitro.

Catheterization, Peripheral↗

PubMed2001

Comparison of the mechanical thrombectomy efficacy of the Amplatz thrombectomy device and the Cragg thrombolytic brush in vitro.

RATIONALE AND OBJECTIVES: To determine the efficacy of thrombectomy (without thrombolytic agents) for the Amplatz thrombectomy device (ATD) and the Cragg thrombolytic brush catheter (CBC) in vitro. METHODS: Thrombectomy was performed with the ATD or CBC (6F) in a flow model. Embolus sizes, weight, remaining thrombus, and activation time were evaluated. RESULTS: No significant difference in the activation time was found. The CBC produced significantly less embolism (3.3% vs. 0.03% in the 5-mm and 89% vs. 0.5% in the 7-mm model), but also much more thrombus remained in the system than with the ATD (1% vs. 41% in the 5-mm and 0.1% vs. 62% in the 7-mm model). CONCLUSIONS: The ATD can remove almost all thrombus (99%), whereas the CBC removes only up to 60%, producing fewer emboli than the ATD. This might be due to the lower rotational speed of the CBC compared with the ATD, which is 20 times greater. The soft nylon brush offers less resistance and shear force toward the thrombus than the stainless-steel impeller of the ATD. Because of the large amount of remaining thrombus, the CBC should not be used without lytic agents.

Catheterization↗

PubMed2001

Mechanical thrombectomy of major and massive pulmonary embolism with use of the Amplatz thrombectomy device.

RATIONALE AND OBJECTIVES: To evaluate the feasibility of mechanical thrombectomy with the Amplatz thrombectomy device (ATD) in restoring patency of acutely thrombosed pulmonary arteries resulting from pulmonary embolism for the improvement of patient outcome. METHODS: Mechanical thrombectomy with the ATD (8F) was performed in nine consecutive patients with angiographically documented thrombus in the left or right pulmonary artery resulting from deep vein thrombosis (n = 4) or unknown cause (n = 5). RESULTS: The Miller index decreased from 18 to 11. In all patients, the majority of the thrombus in the pulmonary artery was cleared after a mean activation time of the ATD of 367 seconds. Thrombectomy was performed with the ATD alone (n = 4) or with additional long-term fibrinolysis therapy (n = 5) with infusion of recombinant tissue-type plasminogen activator. Pulmonary arterial pressure decreased from a mean of 57 mm Hg before mechanical thrombectomy to 55 mm Hg directly after the procedure and to 39 mm Hg after termination of the recombinant tissue-type plasminogen activator infusion. CONCLUSIONS: Mechanical thrombectomy with the ATD in patients with minor and major pulmonary embolism is technically feasible and safe. It is a potential alternative to drug-mediated thrombolysis and surgery. However, the incremental benefit of the ATD over conventional treatments could be shown only in a randomized controlled study.

Acute Disease↗

PubMed2000

Quantitation of renal perfusion using arterial spin labeling with FAIR-UFLARE.

Quantitative perfusion imaging of human kidneys was performed using arterial spin labeling MRI with a fast spin echo readout-sequence. Perfusion maps of centrally located single slices were obtained in axial and coronal orientations. In ten healthy volunteers, the mean value of perfusion was 213+/-55 mL/(100g min) with a range from 140 to 319 mL/(100g min). These results are in accordance with literature data, considering the fact that FAIR only measures the perfusion component normal to the imaging plane. Intra-individual reproducibility errors of +/-11% were smaller than the natural interindividual variability of renal perfusion (SD = +/- 25%). Perfusion in the cortex was approximately 3-4 times higher compared to the medulla. Considering the relatively high resolution of 2x2x10 mm3, the ability to quantify perfusion, and the lack of ionizing radiation and contrast media, this technique should prove useful in diagnosing renal pathologies that are associated with reductions in tissue perfusion.

Adult↗

PubMed2000

[Mid-term follow-up after placement of the new balloon-expendable VIP-stent into the iliac arteries].

PURPOSE: To assess the effectiveness and mid-term patency of VIP balloon expandable stents in patients with iliac occlusive disease. MATERIAL AND METHODS: Between August and December 1997, 26 balloon-expandable VIP (Medtronic) stainless steel vascular stents were implanted in 19 patients with iliac occlusive disease. 22 lesions in common iliac (n = 11), external iliac (n = 5), common iliac plus contralateral external iliac (n = 1), and unilateral common and external iliac (n = 2) arteries were stented, allowing 20 limbs for assessment. There were 18 stenoses and 4 occlusions in 7 female and 12 male patients (mean age 65 years, range 45-80). RESULTS: All lesions were treated satisfactorily, yielding a technical success rate of 100%. Primary patency was 91% (20/22) at 6 months. In 2 lesions restenoses (90% and 70%) were observed, requiring repeated angioplasty. Color Doppler analysis at 12 months revealed no further restenoses. CONCLUSION: The new VIP balloon-expandable stents achieve very good initial technical success and good mid-term patency in the treatment of iliac occlusive disease.

Aged↗

PubMed2000

[First results after implantation of the new balloon-expanded Bridge-Stent into the iliac artery].

PURPOSE: To determine the success and patency rates of the new, balloon-expandable Bridge-stents for treatment of occlusions and stenoses of iliac arteries. MATERIAL AND METHODS: Between April and October 1999, 21 patients suffering from peripheral arterial occlusive disease were treated (22 lesions). In 20 cases high-grade stenoses and in two cases complete occlusions were treated. 23 balloon-expandable Bridge-stents were implanted in the common iliac (n = 16) and the external iliac (n = 6) artery after percutaneous transluminal angioplasty. RESULTS: All interventions were performed with technical success. The mean ankle-brachial index (ABI) increased from 0.7 +/- 0.19 before to 0.86 +/- 0.16 at 24 hours after the procedure (Rutherford +3 [n = 18] and +2 [n = 3]); the ABI measured after 6 months was 0.89 +/- 0.16. The primary cumulative patency rate amounted to 91% (20/22) at 6 months. In two cases restenosis of 75% were observed, requiring repeated angioplasty. CONCLUSION: The new balloon-expandable Bridge-stents achieve very good initial technical success and promising short-term patency in the percutaneous treatment of iliac occlusive disease.

Adult↗

PubMed2000

Characterization of ultrasmall magnetite [correction of paramagnetic magnetite] particles as superparamagnetic contrast agents in MRI.

RATIONALE AND OBJECTIVES: Very small dextran-coated magnetite particles were developed. These particles can be used either as immunospecific contrast agents for MRI by coupling to antibodies or as an interstitial contrast agent. METHODS: The particles were synthesized from iron chloride/dextran solutions. Size was evaluated by electron microscopy and photon correlation spectroscopy. The iron concentration was determined by x-ray spectroscopy. T1 and T2 values as well as relaxivities RI and R2 were evaluated with a clinical MR scanner at 1.5 T. Biocompatibility assays were performed with the cell line U937 in methylcellulose cultures. RESULTS: Superparamagnetic, dextran-coated magnetite particles with a hydrodynamic diameter of 10 nm were developed. The iron core size was 7 nm; R1,7 L/mmol x s; and R2, 19 L/mmol x s. These particles are smaller than those currently available commercially and therefore show a smaller R1 to R2 ratio. Biocompatibility tests have shown no toxic side effects so far. CONCLUSIONS: Ultrasmall magnetite particles with a dextran coating were developed; the physical properties of these particles evaluated in vitro are described in this study.

Cell Count↗

PubMed1999

[In vitro comparison of a size 6F and 8F high-speed rotational catheter for mechanical thrombus fragmentation].

PURPOSE: In vitro comparison of the 6F and 8F Amplatz thrombectomy device (ATD) for treatment of thrombotically occluded vessels in a flow-model. MATERIALS AND METHODS: Thrombectomy of clots from porcine blood was performed with either a 6F or an 8F Amplatz thrombectomy device (ATD) in a flow-model simulating a superficial femoral artery circuit (n = 40; 7.5 g: 7 mm diameter; 4.5 g: 5 mm diameter). Emboli caused during thrombectomy were determined in a three-step filter array (10 microns-1000 microns). RESULTS: Thrombectomy was successful in all cases. In 5 mm/7 mm lumen time for thrombectomy was measured from 47 s/56s (8F) to 86 s/107 s (p < 0.01) (6F). Remaining thrombus weighted in 5 mm/7 mm lumen 0.04 g/-0.02 g (8F) and 0.05 g/-0.02 g (6F). Overall weight emboli determined for 1000 microns, 100 microns and 10 microns size and percentage of emboli related to original thrombus weight measured 0.23 g/4.96% (8F, 5 mm), 0.2 g/4.36% (6F, 5 mm), 0.08 g/1.13% (8F, 7 mm). and 0.09 g/1.18% (6F, 7 mm). CONCLUSIONS: In vitro, the 6F ATD is in "vessels" with 5 mm and 7 mm diameter as effective as the 8F version. Particle embolization in flow-circuit was similar with both devices, although the 6F ATD requires a longer time for thrombectomy in vessel with larger diameter.

Animals↗

PubMed1999

Enhancement of in vitro effectiveness for hydrodynamic thrombectomy devices. Simultaneous high-pressure rt-PA application.

RATIONALE AND OBJECTIVES: To determine the efficacy of simultaneous high-pressure recombinant tissue plasminogen activator (rt-PA) application for clot removal and procedure-related peripheral particle embolization for the hydrodynamic thrombectomy devices LF 140 AngioJet (LF 140) and triplelumen Hydrolyser (triple HL) in an in vitro flow model. METHODS: Thrombectomy of clots (n = 47) from 5-day-old human blood (8.9-9.7 g) was performed with the LF 140 and the triple HL, each with and without simultaneous rt-PA (9.97-12.59 g) application in a flow model (flow 1 liter/min) made of silicone tubes (7 mm inner tube diameter). All catheters were used according to the manufacturer's recommendations. RESULTS: The triple HL revealed no statistically significant performance differences with additional rt-PA. For the LF 140, mean thrombectomy time ranged from 23.5 sec (with rt-PA) to 33.5 sec (P = 0.05). The ratio of peripheral embolus weight to thrombus weight was reduced from 2.12% to 0.46% (rt-PA; P = 0.05). None of the tested devices had an isovolumetric performance; the mean ratio of applied saline to aspirated fluid for the devices were different from one, ranging from 0.89 to 0.92 (rt-PA) for the triple HL and from 0.43 to 0.52 (rt-PA) for the LF 140. No significant differences for remaining thrombus within the tubes were found. CONCLUSIONS: Simultaneous rt-PA-enhanced hydrodynamic thrombectomy is feasible in vitro. This combination reduces the time for thrombectomy and procedure-related peripheral particle embolization for the LF 140. No effect could be demonstrated for the triple HL in an in vitro flow model. It remains unclear whether this procedure is effective in vivo. It seems likely that the incidence of fibrinolysis-associated complications may increase in vivo.

Humans↗

PubMed1999

Mechanical assistance for enhancement of in vitro effectiveness for hydrodynamic thrombectomy.

OBJECTIVE: To determine whether the efficacy for clot removal and procedure-related peripheral particle embolization for the hydrodynamic thrombectomy device CF 105 AngioJet (CF 105) can be enhanced with the use of guiding catheters and an occlusion balloon in an in-vitro flow model. METHODS: Thrombectomy of clots (n = 97) from 5-day-old human blood (range, 9.28-9.77 g) was performed with the CF 105 alone, with additional guide wires (CF 1050.014/0.018), with a 30 degree angled tip (CF 10530 degrees), with guiding catheters (CF 105MP/HS), and with an additional occlusion balloon (CF 105OB) in a flow model (flow 1 L/min) of silicone tubes (inner tube diameter, 7 mm). RESULTS: Mean thrombectomy time ranged from 28.71 seconds (CF 105OB) to 37.02 seconds (CF 10530 degrees). When a guide wire was used, the time for thrombectomy was not prolonged. None of the devices tested worked isovolumetrically. The ratio of applied saline and aspirated fluid (0.34) for CF 105 alone was significantly better than for CF 1050.014/0.018 (0.49/0.60; for both P < 0.001). Compared with CF 105 alone (273.16 mg), wall-adhesive thrombus was reduced significantly with CF 105MP (43.66 mg), CF 105HS (48.66 mg), and CF 10530 degrees (97.27 mg; P < 0.001 for all). Compared with the highest rate of embolism for CF 105 alone (4.62%), CF 105OB (2.50%; P < 0.001), CF 105HS (3.04%; P < 0.001), CF 105MP (3.49%; P < 0.001), and CF 105018 (3.64%; P < 0.001) produced better ratios. CONCLUSIONS: The use of guiding catheters and occlusion balloons is feasible to enhance hydrodynamic thrombectomy in vitro. This combination reduces procedure-related peripheral particle embolization and wall-adhesive thrombus during hydrodynamic thrombectomy. To avoid blood loss, the device should be used only with a 0.018" guide wire.

Adult↗

PubMed1999

[Incidence of myocardial infarct in Germany: prevalence, incidence trends, East-West comparison].

The German National Health Interview and Examination Survey, as a descriptive cross-sectional study, allows the recording of post-myocardial infarct cases, e.g. the number (prevalence) of survivors after an infarct has occurred (non-lethal myocardial infarcts). The 18 to 79 year old residential population in Germany had a lifetime prevalence of 2.45% for conditions after a heart attack. The age-specific lifetime prevalence values increase with increasing age for both men and women. Between the ages of 30 and 59 there are more than 4 male heart attack victims for every woman; between the ages of 60 and 79 this relation is only 1 to 1.5. The 30-< 80 year old population in Germany has around 1,450,000 post-myocardial infarct cases (heart attack victims). There are about 100,000 male post-myocardial infarct cases among relatively young adults between 30 and 49 years of age. There were hardly any cases in the female population in this age group. In regard to post-myocardial infarcts there were no significant morbidity differences between the eastern and western German states in 1997/98. A comparison of the lifetime prevalence rates between 1997/98 and 1990/92 shows the following trend: the number of post-myocardial infarcts in the German population 25-< 70 years old decreased; in Western Germany the lifetime prevalence rates also declined, in Eastern Germany the prevalence rates among both men and women increased in this period of time. In the period 1997/98 there were around 190,000 non-lethal myocardial infarcts in the 18 to 79 year old German population in a full 12 month period (incidence cases of survivors after the occurrence of an acute first and/or acute reinfarcts).

Adolescent↗

PubMed1999

[Stroke: prevalence, incidence, trends, East-West comparison. Initial results of the 1998 Federal Health Survey].

The prevalence of survival after a stroke is dependent on the incidence and the fatality rate, whereby the incidence and the fatality rate are influenced by different factors. A survey can only include the minor cases of post-stroke conditions. The prevalence figures thus only reflect the less serious or rehabilitated strokes. Despite this underrepresentation of strokes in the survey we can observe an underestimation of the stroke problem in Germany. Whereas we previously assumed 440,000 to 500,000 strokes in Germany, the projection from the data of the German National Health Interview and Examination Survey amounted to around 945,000 cases (only strokes with "minor" motor, sensory and cognitive losses and restrictions which allow a participation in the survey). The lifetime prevalence rate of the 18-< 80 year old female population is somewhat higher than the male population of the same age (n.s.). The 50 to < 60 year old men have a relatively high prevalence rate. The corresponding age specific prevalence rates increase with increasing age. There are no significant differences in morbidity between the former East and West German states, the prevalence rates of men are somewhat higher in the East and those of women in the West. We can see the following trends in a comparison of the lifetime prevalence rates between 1997/98 and 1990/92: the number of post-stroke conditions among German men 25-< 70 years old declined significantly, among women they increased slightly (n.s.); the prevalence as a whole also declined significantly among men in western Germany, among women they increased slightly (n.s.) in contrast to former West Germany the prevalence rates among men in eastern Germany increased slightly, among women they were almost cut in half. 32.8% of the population with "minor" post-stroke conditions is characterized by sensory disruptions, 32.1% by impairments when walking, 31.3% by paralyses, 20.5% by speech impairments, 17.1% by cognitive disorders and 3.1% by disturbances of consciousness.

Adolescent↗