Wirksamkeit der umfassenden kardiologischen Rehabilitation und Sekundärprävention: klinische und epidemiologische Evidenz

Zusammenfassung Die umfassende kardiologische Rehabilitation ist die Summe von koordinierten Maßnahmen, welche die Folgen von Herzerkrankungen vermindern, die Morbidität und Mortalität reduzieren und die gesundheitsbezogene Lebensqualität einschließlich der psychosozialen Situation der Patienten verbessern sollen. Dazu ist die Bereitstellung strukturierter sekundärpräventiver Strategien besonders wichtig. Schwerpunkte dieser Maßnahmen sind die Trainingstherapie und Aktivitätsberatung sowie Ernährungstherapie und -beratung, Raucherentwöhnung, psychosoziale Intervention und Pharmakotherapie (Ades 2001).

Long-term Outcome After Monosegmental L4/5 Stabilization for Degenerative Spondylolisthesis With the Dynesys Device.

STUDY DESIGN Retrospective analysis of prospectively collected clinical data. OBJECTIVE To assess the long-term outcome of patients with monosegmental L4/5 degenerative spondylolisthesis treated with the dynamic Dynesys device. SUMMARY OF BACKGROUND DATA The Dynesys system has been used as a semirigid, lumbar dorsal pedicular stabilization device since 1994. Good short-term results have been reported, but little is known about the long-term outcome after treatment for degenerative spondylolisthesis at the L4/5 level. METHODS A total of 39 consecutive patients with symptomatic degenerative lumbar spondylolisthesis at the L4/5 level were treated with bilateral decompression and Dynesys instrumentation. At a mean follow-up of 7.2 years (range, 5.0-11.2 y), they underwent clinical and radiographic evaluation and quality of life assessment. RESULTS At final follow-up, back pain improved in 89% and leg pain improved in 86% of patients compared with preoperative status. Eighty-three percent of patients reported global subjective improvement. Ninety-two percent would undergo the surgery again. Eight patients (21%) required further surgery because of symptomatic adjacent segment disease (6 cases), late-onset infection (1 case), and screw breakage (1 case). In 9 cases, radiologic progression of spondylolisthesis at the operated segment was found. Seventy-four percent of operated segments showed limited flexion-extension range of <4 degrees. Adjacent segment pathology, although without clinical correlation, was diagnosed at the L5/S1 (17.9%) and L3/4 (28.2%) segments. In 4 cases, asymptomatic screw loosening was observed. CONCLUSIONS Monosegmental Dynesys instrumentation of degenerative spondylolisthesis at L4/5 shows good long-term results. The rate of secondary surgeries is comparable to other dorsal instrumentation devices. Residual range of motion in the stabilized segment is reduced, and the rate of radiologic and symptomatic adjacent segment degeneration is low. Patient satisfaction is high. Dynesys stabilization of symptomatic L4/5 degenerative spondylolisthesis is a possible alternative to other stabilization devices.

Zu den Dialekten des Talmudisch-Hebräischen

Harald Louis Ginsberg

Emil Ludwig [Illustration] : Bronzebüste

Kurt Harald Isenstein

Ernst Toller [Illustration] : Porträtbüste

Kurt Harald Isenstein

Prof. Ernst Cassirer, Hamburg [Illustration] : Porträtbüste

Kurt Harald Isenstein

Dr. James Simon [Illustration] : Bronzebüste

Kurt Harald Isenstein

Die Fünfzehnjährige [Illustration] : Terrakotta

Kurt Harald Isenstein

Alfred Döblin [Illustration] : Porträtskizze

Kurt Harald Isenstein

Heinrich Heine [Illustration] : Plastik

Kurt Harald Isenstein

Na 1 Nachlass Max Horkheimer, 16 - Korrespondenzen u.a. mit Gerhart Jacoby Gordon (p. I 8, 202-379)

2 Briefe von A. Gandon an Max Horkheimer, Februrar 1936; 1 Brief von Max Horkheimer an Lloyd K. Garrison, 25.03.1941; 4 Briefe zwischen Moritz Geiger und Max Horkheimer, 01.12.1935, 1935; 1 Lebenslauf von Alvin Johnsson an Friedrich Pollock; 1 Brief von Alvon Johnson an Friedrich Pollock, 39.09.1940; 1 Brief von Max Horkheimer an Harald Genssler, 04.09.1949; 1 Brief von der George Washington University Washington an Max Horkheimer, 01.03.1939; 2 Briefe von Wolfgang Gerloff an Max Horkheimer, 1934, 1939; 2 Briefe zwsichen Hans Gerth und Max Horkheimer, 28.10.1937, 16.11.1937; 1 Brief von M. Getzer anMax Horkheimer, 04.05.1934; 12 Briefe zwsichen Edgar V. M. Gilbert und Max Horkheimer, 1935-1940; 1 Brief von der Gillespie, Kinsports & Bears Travel Agency New York an Max Horkheimer, 16.04.1935; 1 Entwurf von Max Horkheimer an Morris Ginsberg, Dezember 1935; 19 Briefe zwsichen Morris Ginsberg, Ethel Ginsberg und Max Horkheimer, 1935-1938; 2 Briefe zwischen Robert Morrison MacIver und Max Horkheimer, 18.08.1937, 16.08.1937; 1 Brief von H. Girsberger an Max Horkheimer, 17.08.1938; 1 Brief von Max Horkheimer an Glass, 24.12.1940; 1 Brief von der Glidden Buick Corporation New York an Max Horkheimer, 05.06.1940; 1 Heiratsanzeige von Vera Gold; 4 Briefe zwischen Oskar Goldberg und Max Horkheimer, 1941, 27.08.1941; 10 Briefe zwischen Hans Goldmann und Max Horkheimer, 1934-1937; 14 Briefe zwischen Alfons Goldschmidt und Max Horkheimer, 1936-1938; 7 Briefe zwsichen dem Greater New York Coordinating Committee for German Refugees, New York und Max Horkheimer, 1937-1939; 1 Brief von Max Horkheimer an Simon Guggenheim, 24.01.1938; 3 Briefe zwischen Aron Goldschmidt und Max Horkheimer, 02.02.1939, Mai 1942; 2 Briefe zwischen Berta Goldschmidt und Max Horkheimer, 14.01.1941, 25.02.1941; 4 Briefe von Emma Goldschmidt an Juliette Favez, 1938-1940; 5 Briefe zwischen Emma Goldschmidt und Max Horkheimer, 1938-1940; 2 Briefe zwischen Ernst L. Goldschmidt und Max Horkheimer, 08.07.1937, 18.06.1937; 1 Brief von Thea Goldschmidt an Max Horkheimer, 16.04.1935; 14 Briefe zwischen Kurt Goldstein und Max Horkheimer, 1934-1941; 19 Briefe zwsichen Gerhart Jacoby Gordon und Max Horkheimer, 1934-1937;

Water stable oxygen isotope records from six Antarctic ice core sites for the present and last interglacial periods

We compare the present and last interglacial periods as recorded in Antarctic water stable isotope records now available at various temporal resolutions from six East Antarctic ice cores: Vostok, Taylor Dome, EPICA Dome C (EDC), EPICA Dronning Maud Land (EDML), Dome Fuji and the recent TALDICE ice core from Talos Dome. We first review the different modern site characteristics in terms of ice flow, meteorological conditions, precipitation intermittency and moisture origin, as depicted by meteorological data, atmospheric reanalyses and Lagrangian moisture source diagnostics. These different factors can indeed alter the relationships between temperature and water stable isotopes. Using five records with sufficient resolution on the EDC3 age scale, common features are quantified through principal component analyses. Consistent with instrumental records and atmospheric model results, the ice core data depict rather coherent and homogenous patterns in East Antarctica during the last two interglacials. Across the East Antarctic plateau, regional differences, with respect to the common East Antarctic signal, appear to have similar patterns during the current and last interglacials. We identify two abrupt shifts in isotopic records during the glacial inception at TALDICE and EDML, likely caused by regional sea ice expansion. These regional differences are discussed in terms of moisture origin and in terms of past changes in local elevation histories, which are compared to ice sheet model results. Our results suggest that elevation changes may contribute significantly to inter-site differences. These elevation changes may be underestimated by current ice sheet models