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Zusammenfassung??Die Anlage einer perkutanen endoskopischen Gastrostomie (PEG) ist eine sichere und etablierte Methode der k?nstlichen enteralen Ern?hrung. In Deutschland werden pro Jahr sch?tzungsweise 140 000 PEG-Sonden angelegt, etwa 65% davon bei ?lteren Menschen. Bisher ist f?r Deutschland kaum bekannt, mit welcher Indikation PEG-Sondenanlagen im Alter durchgef?hrt werden und in welchem Gesundheits- und funktionellem Zustand sich diese Patienten befinden.Um R?ckschl?sse auf die Indikation zur PEG-Sondenanlage, den Gesundheitszustand und den weiteren Verlauf von Patienten in geriatrischen Fachabteilungen zu ziehen, haben wir eine Analyse des Datensatz des Jahres 2004 der Gemidas-Datenbank durchgef?hrt. Die Gemidas-Datenbank ist ein Instrument der freiwilligen Qualit?tssicherung, in dem deutschlandweit die Behandlungsdaten von Patienten geriatrischer Abteilungen erfasst werden. Die Daten von 40 Akutgeriatrien mit 27 775 Patienten und 393 PEG-Sondenanlagen wurden analysiert. Aufgrund der Inhalte dieser Datenbank konnten Informationen zur H?ufigkeit der PEG-Sondenanlage, zu ern?hrungsrelevanten Behandlungsdiagnosen, Patientenalter, zum funktionellen und kognitiven Status, zur L?nge des station?ren Aufenthaltes, zu Herkunft, Entlassungsort und zur Krankenhaussterblichkeit von geriatrischen Patienten mit und ohne PEG-Sondenanlage gewonnen werden.Bei 1,4% aller station?ren Behandlungen wurde eine PEG-Sondenanlage durchgef?hrt. Die PEG-Sondenanlage erfolgte ?berwiegend bei Patienten mit den Behandlungsdiagnosen Schlaganfall (65,1%) und Dysphagie (64,1%). Der funktionelle Status der Patienten mit PEG-Sondenanlage war bei Aufnahme mit einem Barthel-Index von 8,2 (? 14,6) Punkten stark reduziert. Die Krankenhaussterblichkeit in der PEG-Gruppe war mit 17,6% aufgrund der Erkrankungsschwere deutlich h?her als in der Vergleichsgruppe (4,3%). Die Krankenhaussterblichkeit in der PEG-Gruppe unterscheidet sich jedoch nicht von der in anderen PEG-Studien. In der Gesamtgruppe der 27 775 akutgeriatrischen Patienten wurde eine Diagnose im Sinne der Malnutrition nur bei 7,0% der Patienten kodiert, obwohl Pr?valenzstudien weitaus h?here Raten von etwa 50% bei ?lteren Krankenhauspatienten zeigen. [ABSTRACT FROM AUTHOR]

Excessive nitrogen (N) fertilizer application and poor timing of N fertilizer application to winter wheat are common problems on the North China Plain. To study the possibilities of optimizing the timing and rate of N application, a field experiment was conducted from 1999 to 2001 in a suburb of Beijing. A control (no nitrogen) and two N fertilization strategies (conventional N application and optimized N fertilization) were designed to compare their effects on wheat growth, N nutrient status, grain yield and N balance. The conventional N fertilization strategy was given a fixed N rate of 300 kg N ha−1, which was split, half in autumn and half in spring as a top-dressing. The timing and rate of N and application of the optimized N fertilization strategy were determined by the target value of soil mineral nitrogen demand for three growth periods of wheat, which is related to the target yield, and soil mineral N (Nmin) in the effective rooting depth at the beginning of these three periods. Based on the optimized N fertilization strategy, a total of 55 and 65 kg N ha−1 had to be applied to winter wheat in the re-greening and shooting stages of the first and second experimental years, respectively. Compared with the high N rate before sowing in the conventional N fertilization treatment, the optimized N fertilization treatment did not require any N fertilizer before sowing of wheat. Despite a much lower N fertilization rate, no significant difference in N nutrient status, growth during the wheat growing period or grain yield was observed between optimized N and conventional N fertilization treatments. As a consequence of optimizing the rate and timing of the N fertilizer application to match wheat demand, a much lower residual Nmin and calculated apparent N loss was found as compared to the conventional N treatment. N recovery for the optimized N fertilization treatment (67% in 1999/2000 and 66% in 2000/2001) was much higher than that of the conventional N fertilization treatment (19% in 1999/2000 and 18% in 2000/2001). In conclusion, the optimized N fertilization strategy can synchronize N demand of wheat and the N supply from soil and fertilizer, and therefore drastically reduce N application rates without any yield losses. [ABSTRACT FROM AUTHOR]

Summary Purpose.Mammography (MG), breast (BU) and axillary ultrasound (AU), and clinical examination (CE) are commonly used for clinical staging. These different methods were compared in order to assess the accuracy of clinical tumor staging (cT). [ABSTRACT FROM AUTHOR]

Wetland ecosystems have reduced ambient levels of various organic and metallic compounds, although their effectiveness on agricultural pesticides is not well documented. Five stations within each of two 10 × 50 m constructed wetlands (two vegetated, two nonvegetated) were selected to measure the fate and effects of methyl parathion (MeP). Following a simulated storm event (0.64 cm of rainfall), aqueous, sediment, and plant samples were collected and analyzed spatially (5, 10, 20, and 40 m from the inlet) and temporally (after 3–10 days) for MeP concentrations and for the impact of those concentrations on the aquatic fauna. Aqueous toxicity to fish decreased spatially and temporally in the vegetated mesocosm. Pimephales promelas survival was significantly reduced, to 68%, at the 10‐m station of the nonvegetated wetlands (3 h postapplication), with pesticide concentrations averaging 9.6 μg MeP/L. Ceriodaphnia in both the vegetated and nonvegetated wetlands was sensitive (i.e., a significant acute response to MeP occurred) to pesticide concentrations through 10 days postapplication. Mean MeP concentrations in water ranged from 0.5 to 15.4 μg/L and from 0.1 to 27.0 μg/L in the vegetated and nonvegetated wetlands, respectively. Hyalella azteca aqueous tests resulted in significant mortality in the 5‐m vegetated segment 10 days after exposure to MeP (2.2 μg/L). Solid‐phase (10‐day) sediment toxicity tests showed no significant reduction in Chironomus tentans survival or growth, except for the sediments sampled 3 h postapplication in the nonvegetated wetland (65% survival). Thereafter, midge survival averaged >87% in sediments sampled from both wetlands. These data suggest that wetlands play a significant role in mitigating the effect of MeP exposure in sensitive aquatic biota. © 2004 Wiley Periodicals, Inc. Environ Toxicol 19: 471–479, 2004. [ABSTRACT FROM AUTHOR]