Showing papers by "Heart and Diabetes Center North Rhine-Westphalia published in 2003"

INR Self-Management Permits Lower Anticoagulation Levels After Mechanical Heart Valve Replacement

Abstract: Background— The Early Self Controlled Anticoagulation Trial (ESCAT I) showed that anticoagulation self-management after mechanical heart valve replacement decreased complication rates by maintaining INR levels closer to the target range than International Normalized Ratio (INR) home doctor management. The therapeutic range for the INR in that study was between 2.5 and 4.5 for all positions of prosthetic valves. ESCAT II should find out whether lowering the target range for INR self-management would further reduce complication rates. Methods— ESCAT II is a prospective controlled randomized (valves: St. Jude Medical Standard or Medtronic Hall, treatment: conventional/low-dose) multicenter study with 3 300 patients. We present interim results of 1 818 patients. 908 were categorized as having a low-dose target range, which was INR 1.8 to 2.8 for prostheses in aortic position and 2.5 to 3.5 for prostheses in mitral position or in combined valve replacement. The control group (conventional group) with 910 patie...

Hormonal counterregulation and consecutive glimepiride serum concentrations during severe hypoglycaemia associated with glimepiride therapy

Abstract: Objective To examine the release of counterregulatory hormones and consecutive glimepiride serum concentrations during severe hypoglycaemia (SH) associated with glimepiride therapy.

Performance of a device to minimise radiation dose to the hands during radioactive syringe calibration

Abstract: The preparation of syringes for routine applications in nuclear medicine, and in particular the calibration procedure, is associated with high radiation exposure to the hands To reduce this radiation burden, our group developed a modified calibration procedure based on a device that we refer to as the ActivoFix, which allows syringes to be drawn up inside the dose calibrator This study investigated the performance of the new device as compared to the usual procedure of syringe calibration with regard to the absorbed radiation dose to the hands (fingertips and middle finger bases), the precision of the calibration procedure and the time required to calibrate syringes Fourteen experienced nuclear medicine technologists drew up syringes from an initial eluate of 82 GBq using the conventional technique and the new calibration procedure All technologists had to calibrate syringes with 50 MBq, 250 MBq and 650 MBq This sequence was repeated four times using the conventional technique and then the new procedure The equivalent dose to the hands was measured with thermoluminescent dosimeters The exact amount of radioactivity in the syringe and the time needed for the calibration procedure were also recorded The reduction in equivalent dose using the new device compared with the routine procedure ranged from 83- to 196-fold (mean 143-fold) for the fingers of the dominant hand and from 136- to 403-fold (mean 27-fold) for those of the non-dominant hand (total mean 213-fold) For small volumes, time could be saved with the ActivoFix, whereas for greater volumes time was lost The device produced less variability in calibrating doses at 250 MBq and 650 MBq Following the ALARA principle, the new device can be recommended for syringe calibration in nuclear medicine because the use of the ActivoFix-based procedure reduces finger dose by an average factor of 21, improves the precision of calibration and reduces the filling time for small volumes