Prediction of hypertensive crisis based on average, variability and approximate entropy of 24-h ambulatory blood pressure monitoring

Approximate entropy (ApEn) of blood pressure (BP) can be easily measured based on software analysing 24-h ambulatory BP monitoring (ABPM), but the clinical value of this measure is unknown. In a prospective study we investigated whether ApEn of BP predicts, in addition to average and variability of BP, the risk of hypertensive crisis. In 57 patients with known hypertension we measured ApEn, average and variability of systolic and diastolic BP based on 24-h ABPM. Eight of these fifty-seven patients developed hypertensive crisis during follow-up (mean follow-up duration 726 days). In bivariate regression analysis, ApEn of systolic BP (P<0.01), average of systolic BP (P=0.02) and average of diastolic BP (P=0.03) were significant predictors of hypertensive crisis. The incidence rate ratio of hypertensive crisis was 14.0 (95% confidence interval (CI) 1.8, 631.5; P<0.01) for high ApEn of systolic BP as compared to low values. In multivariable regression analysis, ApEn of systolic (P=0.01) and average of diastolic BP (P<0.01) were independent predictors of hypertensive crisis. A combination of these two measures had a positive predictive value of 75%, and a negative predictive value of 91%, respectively. ApEn, combined with other measures of 24-h ABPM, is a potentially powerful predictor of hypertensive crisis. If confirmed in independent samples, these findings have major clinical implications since measures predicting the risk of hypertensive crisis define patients requiring intensive follow-up and intensified therapy.

Clinical performance of wide-body implants with a sandblasted and acid-etched (SLA) surface: results of a 3-year follow-up study in a referral clinic

PURPOSE: The aim of this study was to evaluate the 3-year success rates of wide-body implants with a regular- or wide-neck configuration and a sandblasted, large grit, acid-etched (SLA) surface. MATERIALS AND METHODS: A total of 151 implants were consecutively placed in posterior sites of 116 partially edentulous patients in a referral clinic at the School of Dental Medicine, University of Bern. All implants were restored with cemented crowns or fixed partial dentures after a healing period of 6 to 8 weeks (for implants placed without simultaneous bone augmentation) or 10 to 14 weeks (for implants with simultaneous bone augmentation). All patients were recalled 36 months following implant placement for a clinical and radiographic examination. RESULTS: One implant failed to integrate during healing, and 11 implants were lost to follow-up and considered dropouts. The remaining 139 implants showed favorable clinical and radiographic findings and were considered successfully integrated at the 3-year examination. This resulted in a 3-year success rate of 99.3%. Radiographic evaluation of 134 implants indicated stability of the crestal bone levels: During the study period, the crestal bone level changed less than 0.5 mm for 129 implants. CONCLUSION: Successful tissue integration was achieved with wide-body implants with a regular or a wide-neck configuration and an SLA surface with high predictability. This successful tissue integration was well maintained for up to 3 years of follow-up.

Endothelialization of sirolimus-eluting stents with slow and extended drug release in the porcine overstretch model

BACKGROUND: Vascular healing of intracoronary stents has been shown to be delayed in drug-eluting stents (DES) due to the cytotoxic compounds on the stent surface that prevent stent ingrowth and endothelialization. The lack of endothelialization explains the occurrence of late and very late stent thrombosis in DES. MATERIALS AND METHODS: In 11 house swines (body weight 38-45 kg), 3 stents were implanted randomly into the 3 large epicardial coronary arteries, namely a bare-metal stent (BMS), a sirolimus-eluting stent with slow-release (SES) and a SES with extended-release (SESXR). Stent length was 18 mm, and stent diameter 3 mm. All stents were of identical design. Animals were followed for 3 (n = 3), 7 (n = 4) and 14 (n = 4) days, respectively. One animal died before implantation due to hyperthermia. On the day of explantation, the animals were euthanized and endothelialization was tested by scanning electron microscopy after drying and sputtering the samples. Endothelial coverage was determined semiquantitatively by 2 observers. RESULTS: Endothelialization was more rapid with BMS and SESXR than SES at 3 and 14 days. At 7 days there were no significant differences between the 2 SES. CONCLUSIONS: Endothelialization of intracoronary stents is faster with BMS and SESXR at 3 days than with SES. These differences persist at 14 days, suggesting delayed vascular healing with the slow-release SES.

Ultrasonography for depiction of brachial plexus injury

Recent development of ultrasonographic equipment has allowed improved spatial resolution for visualizing normal and pathologic conditions of peripheral nerves. Regarding the brachial plexus, only ultrasonographic studies that have described the normal appearance have been reported. To the best of our knowledge, no case report regarding the ultrasonographic description of a brachial plexus lesion has been published. We report the ultrasonographic findings of a brachial plexus injury after extirpation of a suspected enlarged supraclavicular lymph node.

Living with Differences: From Everyday Fundamentalisms to Invitational Communication

This project examines fundamentalism understood as an everyday way of living poorly with difference. It demonstrates that the fundamentalist is not reducible to stereotypes of the terrorist, extremist, irrational madman, or religious zealot. All of these characterizations--common in mainstream media--depict the fundamentalist as them, and rarely, if ever, as us. Rather, this project understands fundamentalism in terms of fundamental interpretive constructs that constrain our ways of being-with others, skew our interpretive and responsive possibilities, distort our perceptions of difference, and affirm our poor treatment of others. Following Martin Heidegger's conception of the hermeneutic structure of existence, this dissertation calls attention to the ways in which such fundamentalisms filter our interpretation. Yet the hermeneutic character of existence also highlights the incompleteness of any particular frame of interpretation and indicates the possibility of alternative interpretive responses. The project turns to a feminist theological hermeneutic in order to indicate more hopeful and liberating ways of living with difference, ways that point beyond everyday fundamentalism toward invitational communication. Through new readings of familiar biblical narratives, this dissertation revisits the fundamentalisms that trigger these narratives in order to draw out an alternative feminist theological hermeneutic, or what is termed here an invitational hermeneutic. Each story offers unique ways of making sense of being-with and sharing the world with others of difference that redress the impoverished and fundamentalist forms of self-preserving care and understanding. By examining the well-loved stories of the Good Samaritan, Ruth and Naomi, Queen Esther, and the Apostle Paul and Lydia, the dissertation identifies interpretive and responsive possibilities that together issue an alternative hermeneutical invitation: to understand difference compassionately, to engage strangers and family members alike with rehabilitative care and concernful reticence, and to extend graceful hospitality to others. In these ways, the dissertation indicates possibilities beyond the horizon of fundamentalism, invitational possibilities of living and communicating with difference.

Predictors of attempted suicide among Swiss patients with alcohol-use disorders

Objective: Suicide attempts are common in patients being treated for alcohol-use disorders (AUDs). However, clinical assessment of suicide risk is difficult. In this Swiss multisite study, we propose a decision tree to facilitate identification of profiles of AUD patients at high risk for suicidal behavior. Method: In this retrospective study, we used a sample of 700 patients (243 female), attending 1 of 12 treatment programs for AUDs in the German-speaking part of Switzerland. Sixty-nine patients who reported a suicide attempt in the 3 months before the index treatment were compared using risk factors with 631 patients without a suicide attempt. Receiver operating characteristic (ROC) analyses were used to identify patients at risk of having had a suicide attempt in the previous 3 months. Results: Consistent with previous empirical findings in AUD patients, a prior history of attempted suicide and severe symptoms of depression and aggression considerably increased the risk of a suicide attempt and, in combination, raised the likelihood of a prior suicide attempt to 52%. In addition, one third of AUD patients who had a history of suicide attempts and previous inpatient psychiatric treatment, or who were male and had previous inpatient psychiatric treatment, also reported a suicide attempt. Conclusions: The empirically supported decision tree helps to identify profiles of suicidal AUD patients in Switzerland and supplements clinicians' judgments in making triage decisions for suicide management.

Der Gott der Anderen. Interkulturelle Transformationen religiöser Traditionen

Unter kulturwissenschaftlicher Perspektive lassen sich Religionen als gemeinschaftsstiftende Sinndeutungssysteme verstehen, mit deren Hilfe die Verständigung über gemeinsame Glaubens- und Wertvorstellungen geregelt werden kann. Religionen erwachsen aus interkulturellen Prozessen, denn sie speisen aus unterschiedlichen kulturellen Quellen und Bedeutungstraditionen und ‘migrieren’ aus der ursprünglichen ‘Gemeinde’ in andere kulturelle Kontexte. ‘Fremd-Religionen’ werden adaptiv verändert und in die eigene kulturelle Praxis überführt. Solche Veränderungen von Religionen werden durch Literatur begleitet und bewahrt. Sie verleiht Sinnstiftungsprozessen von Kultur sprachliche Gestalt und reflektiert damit auch immer implizit oder explizit religiöse Vorstellungen. Unter interkultureller Perspektive läßt sich Literatur also auch als Speicher religiöser Vorstellungen unter den Bedingungen ihrer epochen- und kulturspezifischen Veränderungen verstehen. Der Band sucht diesen Veränderungen in der Literatur und ihrer Spiegelung in den Medien nachzugehen und zu prüfen, wie dadurch Gemeinsamkeiten, aber auch kulturelle Differenzen bewußt gemacht werden.

Wie kann man vom 'Deutschen' leben? Zur Paxisrelevanz der interkulturellen Germanistik

In vielen Teilen der Welt ist die akademische Beschäftigung mit der deutschen Sprache, Literatur und Kultur in Bedrängnis geraten. Während mancherorts die Absolventen der (interkulturellen) Germanistik noch ohne Schwierigkeiten eine Anstellung finden, für die sie ausgebildet wurden, wird andernorts ein Studium der Germanistik mangels einschlägiger Berufsaussichten erst gar nicht mehr aufgenommen. Daher stellt sich die Frage, was im Fache und von seinen Repräsentanten getan werden kann, um die Praxisrelevanz der (interkulturellen) Germanistik zu begründen bzw. zu steigern und die Absolventen in die Lage zu versetzen, (wieder) ‘vom Deutschen’ leben zu können. Die internationale Germanistik mit ihren je eigenen, oft regional und gar lokal geprägten Fachidentitäten ist stark an der Ausbildung von komparativen, multiperspektivischen und interkulturellen Betrachtungs- und Zugangsweisen interessiert, die den methodologischen Unilateralismus überwinden. Gerade die ‘Auslandsgermanistiken’ könnten sich so als Schnittstellendisziplinen profilieren und zugleich konsolidieren.

Deutsch im interkulturellen Begegnungsraum Ostmitteleuropa

Der Band macht das ebenso geschichtsträchtige wie aktuelle und zukunftsweisende Thema «Ostmitteleuropa als Begegnungsraum» zum Gegenstand eines interdisziplinären Dialogs zwischen den Teilfächern der Germanistik einerseits und zwischen der Germanistik und anderen Fächern wie den Sozial-, Wirtschafts- und Kommunikationswissenschaften anderseits. Der Titel verweist auf alle Arten der Begegnung – kulturelle, sprachliche, literarische, wirtschaftliche, soziale, mediale, konfessionelle – in dieser (insbesondere nach der sogenannten Osterweiterung der Europäischen Union in den Focus des Interesses geratenen) Region mit all ihren komplizierten historischen, politischen und ökonomischen Verwerfungen und Verflechtungen. Ostmitteleuropa als Schnittstelle eines facettenreichen interkulturellen Raums zwischen ehemals verfeindeten politischen Blöcken bietet eine Vielzahl von wenig erforschten Fragestellungen, bei deren Bearbeitung sich verschiedene theoretische Ansätze bewähren und die nicht selten auf empirischen Untersuchungen fußen. In vollem Bewusstsein der historischen Tiefendimension des Themas konzentrieren sich die Beiträge überwiegend auf die Gegenwart und jüngere Vergangenheit, um einerseits der ständig zunehmenden Bedeutung interkultureller Kommunikation auf den tangierten Fachgebieten gerecht zu werden, andererseits um das kreative Potential dieser in vielerlei Hinsicht stimulierenden europäischen Region zu erschließen.