Functional changes induced by extrusion during cocoa alkalization.

Polyphenols, a group of secondary metabolites, have well-known relevant effects on human health. During traditional alkalization, this content dramatically lowers. We aimed to evaluate an alternative alkalization method based on extrusion on cocoa functional characteristics. The results showed that the antioxidant capacity and total phenolic values increased as alkali concentration and temperature did, and these values doubled under less extreme conditions. Comparing the functional properties between extruded and traditionally produced powders revealed that catechin, epicatechin and dimers B1 and B2 contents were 43%, 33%, 54% and 34% lower in the extruded samples, respectively. However, this reduction was partially balanced by increased clovamide content up to 50%. Thus the total phenol content and antioxidant capacity of the extruded samples were statistically above those of the commercial one. Hence extrusion alkalization should be considered a new processing alternative to avoid markedly reducing functional properties.

[Arterial closure devices. What device for which clinical situation?]. / Arterielle Verschlusssysteme. Welches wofür?

CLINICAL/METHODICAL ISSUE: Access site complications after endovascular catheterization sometimes require open surgery and negatively impair safety, patient comfort and reimbursement. Increasing numbers of procedures and patients with multiple anticoagulants as well as cost pressure explain the demand for an immediate and stable access site closure. STANDARD RADIOLOGICAL METHODS: Manual compression followed by compression bandage and bed rest for 4-24 h is still the gold standard but is unable to prevent access site complications in all cases. METHODICAL INNOVATIONS: Arterial vascular closure devices allow immediate and stable closure of the puncture channel either by suture or by implantation of occluding foreign bodies or gluing fluids. PERFORMANCE: The safety has been proven in several clinical trials. The main advantage lies in closing large lumen access sites without surgery and in patients treated with multiple anticoagulants as well as in outpatient procedures. ACHIEVEMENTS: They have become a valuable supplement to the interventional arsenal. PRACTICAL RECOMMENDATIONS: The physician, however, has to decide between different systems and mechanisms with respect to patient constitution, selected access vessel and level of calcification and diameter. Furthermore, all systems require a defined training prior the first use.

[Analysis of personnel costs after reorganization of intensive care using calculated diagnosis-related groups comparative data. An investigation at the Charité Berlin]. / Analyse der Personalkosten nach Reorganisation der Intensivmedizin mithilfe kalkulierter DRG-Vergleichsdaten. Eine Untersuchung an der Charité, Berlin.

BACKGROUND: In an extensive project intensive care units (ICUs) of the Charité University Hospital were reorganized. The aim of this investigation was to determine if staff costs after this reorganization are financed by modular profits of diagnosis-related groups (DRGs). METHODS: Staff costs of all non-pediatric intensive care units, including ICUs, intermediate care units and post-anaesthesia care units (PACUs) in the Charité University Hospital were compared with the modular profits of all DRGs of patients older than 14 years in 2005. These DRGs were converted into the German refined DRG (GDRG) system 4.0 from 2006 with calculations based on actual income for medical doctors and nurses in 2006. Due to changed wage agreements for the incomes of physicians in 2006 there was an increase of costs. For the other professional groups an increase in income is expected, which cannot be estimated at present. RESULTS: The calculation revealed that staff costs of the ICUs at the Charité University Hospital based on a current German mean base rate of 2,836 EUR were 4.2% above the modular profits of the DRGs. As a result of a structural reorganization of the ICUs, the costs of staff could be adapted to the modular profits. Under the conditions of the actual reduced base rate of Berlin of 2,955 EUR the costs and profits were nearly equal. As the financial impact of the reorganization of the ICUs will take full effect in the coming years, it can be anticipated that with an expected base rate of 2,949 EUR in 2010 the intensive care medicine of a University hospital in Germany can become profitable. DISCUSSION: The spectrum of intensive care medicine at the Charité University Hospital covers the maximum range of operative and non-operative medicine. After an extensive reorganization of the ICUs under the aspect of staff costs, intensive care medicine can become profitable under the 4.0 G-DRG system. With consequent reorganization the cost efficiency of staff can be optimized, particularly in the setting of high-end intensive care medicine.

Neural tolerance of iotrolan 300 in ascending cervical myelography: results of a multicenter study.

This study examined the opacification, dose, and tolerance of iotrolan 300 on 231 patients in ascending cervical myelography. The contrast was rated good in 188 (81.4%) of the cases and satisfactory in 40 (17.3%) of the cases. The contrast was poor in only three (1.3%) cases. In 152 patients a dose of 10 ml or less of iotrolan 300 was administered. A good contrast quality was obtained in 84.2% of all examinations. From a total of 231 patients, 146 exhibited no concomitant effects. The intensity of the headache and neck ache was recorded by the patients themselves by means of an analog scale. The frequency and degree of the postmyelographic complaints did not increase with higher doses, i.e., they were not dose dependent. Neurologic irritation, in the form of radicular symptoms, appeared in only 2 of 231 examinations. These data demonstrate that iotrolan 300 is excellent for use in ascending cervical myelography.

Tolerance of iopromide in angiography: a multicenter study.

This prospective multicenter study analyzes the image quality and incidence of undesirable side effects in 2543 film and 1133 intravenous digital subtraction angiographic (DSA) examinations with iopromide. It can be shown that the frequency of undesired side effects in both methods is twice as high in patients at risk as in patients without special risk factors. The most frequent side effects are gastrointestinal and, in cerebral angiography, of a central nervous system nature. The image quality for 99% of the film angiographies was good or better. It could be demonstrated for the DSA that a higher iodine concentration of 370 mg I/ml tends to result in a reduction of the image quality with an increased rate of side effects.

[Use of nonionic contrast media in computerized tomography]. / Anwendung nichtionischer Kontrastmittel in der Computertomographie.

In a prospective multicentre study of 4,970 contrast enhanced CT's with intravenous application of lohexol, no contrast medium induced side effects could be diagnosed in 98.4% of the patients. Patients with a positive history of allergic diathesis had an increased risk of unexpected contrast-medium induced systemic reactions (factor 2 to 3). In 21% the diagnosis could not be established by non-enhanced CT alone, whereas in 56% the diagnostic accuracy was improved by intravenous contrast medium injection.

Methionine and cystine requirements of growing turkeys.

Sulfur amino acid requirements of starting, growing, finishing male Large White turkeys were investigated in three experiments using 3000 turkeys. Requirements were determined by least squares analyses of response curves obtained by supplementing methionine and cystine deficient basal diets with graded levels of DL-methionine and/or L-cystine. Experiments were conducted from 1 to 4, 8 to 12, and 16 to 20 weeks of age. Diets included starch, soybean meal, faba beans, and field peas. Requirements for total sulfur amino acids (TSAA) determined with diets marginally deficient in cystine were .95 to 1.01, .70 to .71, and .43 to .48% of the diet for starting (1 to 4 weeks), growing (8 to 12 weeks), finishing (16 to 20 weeks) turkeys, respectively, in different experiments. On the basis of dietary metabolizable energy, the respective TSAA requirement values (in %/therm) were .298 to .332, .205 to .221, and .128 to .134. Minimum methionine requirements (determined with excess dietary cystine) were .46, .30, and .19% of the diet for starting, growing, and finishing turkeys, respectively. Cystine replacement values, calculated by dividing the maximum usable levels of cystine (TSAA requirements minus methionine requirements) by TSAA requirements were 55, 58, and 57% of the TSAA requirement for starting, growing, and finishing turkeys, respectively.