Reevaluation of the Cottbus Reinfarction Study with 30 mg aspirin per day 4 years after the end of the study.

Four to 6 years after the end of the Cottbus Reinfarction Study with 30, 60 and 1000 mg/day aspirin, the survivors (72% of the patients) were reevaluated under standardized conditions at the district hospital. Nearly all patients (82%) of the former 30 mg group took further on 30 mg aspirin daily whereas of the former 1000 mg group only 20% continued to take doses higher than 500 mg aspirin. Forty-five percent changed to very low doses. Whereas the death rate was nearly the same in all three former dosage groups the total reinfarction rate was higher (22.5%) in the previous 1000 mg group in comparison to the 30 mg group (17.4%, p less than 0.05). The non-fatal reinfarction rate was by 50% lower in the former 30 mg group compared with the previous 1000 mg group. In the age group 50-59 a 8.6% non-fatal reinfarction rate is contrasted to 1.7% reinfarctions in patients of the former 30 mg group (p less than 0.01). The risk factors were not significantly different in the three groups.

[Results of work schedule studies of hospital physicians of the Cottbus district hospital]. / Ergebnisse von Arbeitszeitstudien stationär tätiger Arzte im Bezirkskrankenhaus Cottbus.

The accomplishment of a scientific organisation of work is not an end in itself, but it is an objective necessity in Public Health, too. That is why studies of the working hours are an important instrument of management. At the district hospital Cottbus these studies were carried out not only in nurses, but also in doctors on wards of the clinic for internal diseases, of the clinic for surgical diseases, of the clinic for pediatric diseases and of the clinic for gynecological diseases. The effective action on the patient of ward physicians and interns in these departments amounts to the very balanced daily portion of about 70 to 85% on weekdays. The portion of only 2 to 5% of management of senior physicians in 2 of the 4 inspected departments seems to be too small. The portion of social and scientific work of doctors from several departments can also not be evaluated as sufficiently. The analysis of this pilot study shows a range of important results and conclusions concerning the effective utilization of the working hours fund and the opening of working hours reserves.

[Incidence of complications and surgical risk in biliary tract surgery]. / Komplikationsdichte und Operationsrisiko in der Gallenchirurgie.

Locally delimited complications originating from the surgically treated organ were recorded in 7.8 per cent of 7,640 bile duct operations, between 1970 and 1984, while systemic complications accounted for 4.6 per cent. Overall lethality was 0.8 per cent. Inflammatory gall bladder as well as choledochus findings calling for therapeutic action and advanced age together with age-related diseases were factors of relevance to prognosis. Lethality among males was higher with significance than that among females. Postoperative pancreas necrosis, pulmonary embolism, and cardiac failure were predominant causes of death. Target-oriented perioperative antibiotic prophylaxis, broader postoperative use of medicamentous thrombosis prophylaxis, and limitation of papillary dilatation to widths up to 6 mm are considered to be possible approaches to reducing the surgical risk.

Comparative studies in hypertension under different continental conditions.

Preventive studies were undertaken according to the same protocol (questionnaire, blood pressure and cholesterol assay standardized) integrated in the Public Health Services of the GDR and Cuba. In a German community (Cottbus-Land) 5,377 people (2,340 males/3,037 females) and in the Havana region 1,179 people (437 males/742 females), all aged 30-50 years, were followed up. The Germans revealed higher proportions of hypertension and hypercholesterolemia, the Cubans those of (heavy) smoking. Conditioning factors, such as overweight, physical inactivity and psychic stress, were found to be quite differently distributed, explaining however only in part prevalence differences between the continental regions even when both sex and localization of living were considered separately.

[Significance of isolated atrial stimulation as a stress test in comparison with bicycle ergometry]. / Die Bedeutung der isolierten Vorhofstimulation als Belastungstest im Vergleich zur Fahrradergometrie.

On 77 patients was performed a comparative examination of load ECG on the bicycle ergometer and isolated atrial stimulation for the diagnosis of an ischaemic heart disease. With 80.5% in the estimation of the two methods with regard to the correct diagnostic classification in relation to the number of patients in the random test a good accordance is the result. With the two methods nearly identical results can be yielded and as to small number of patients with clear indication even an supplementation of the provokation tests performed up to now can be spoken of, since additional diagnostic references to an ischaemic heart disease are possible. But the isolated atrial stimulation cannot supersede the usual load ECG in the diagnostics of the ischaemic heart disease an account of the great methodical expenditure.