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Unlabelled: Few studies have been done on the circadian rhythm of QT- und corrected QT-interval in diabetics., Method: 13 type II diabetics (mean duration 10.08 yrs +/- 1.95 (SEM), 12 insulin-dependent) and 13 hypertensives, mean age 58.2 +/- 197 (SEM) and 57.3 +/- 1.4 yrs (p = n.s.), respectively, without cardiovascular events within the last 6 months before rehabilitation underwent Holter monitoring. We investigated mean and maximum QT-interval, QTc-interval (Bazett-formula), RR-interval as well as spectral parameters LF, HF, and LF/HF ratio., Results: Both groups showed significant circadian variations of mean and maximum QT-intervals. No group differences were found. There was no significant circadian rhythm of mean or maximum QTc-interval. Diabetics had significantly prolonged maximum QTc-intervals during the day-time. Mean and maximum RR-intervals in diabetics were significantly shorter. Both groups showed a significant circadian rhythm. LF and HF were significantly shorter in diabetics. Only in diabetics could significant circadian rhythm of LF and HF be demonstrated. The LF/HF ratio was significantly shorter in diabetics. The hypertensive group showed a decreasing circadian trend whereas diabetics showed increasing LF/HF ratio trend., Conclusion: Mean and maximum QT-intervals are significantly shorter in diabetics than in hypertensives. Maximum QTc-interval prolongation is highly significant (p < 0.01) in diabetics. Spectral parameters LF and HF are reduced in comparison with hypertensives. The prolongation of the maximum QTc-interval could be expression of an increased arrythmogenic and cardiovascular risk in diabetics.

According to the guidelines and standards for a comprehensive phase II rehabilitation a new outpatient/part-time outpatient program was developed and started at an existing rehabilitation center in January 1997. All patients of the new program were included in a follow-up study and compared with patients of the same center, who met the inclusion and exclusion criteria for the outpatient mode, but wanted to perform their rehabilitation in the full-time residential mode. Both groups were examined before, at the end and 6 months after the program. Until December 1998 118 patients after an acute cardiac event such as myocardial infarction, PTCA or heart surgery were rehabilitated in the outpatient/part-time outpatient mode. The short- and medium-term results concerning somatic outcomes, e.g. the risk factor profile or the improvement of the maximum work capacity, were equal in both groups. Comparing the direct costs for a 4-week rehabilitation, the part-time outpatient program was 26%, the outpatient program even 52% cheaper than the standard full-time residential program. The new program is as effective as the residential rehabilitation, but it is cheaper. Because of the in- and exclusion criteria it is suitable for only a subgroup of cardiac patients, because of the demands and standards the new program it can be offered only in special rehabilitation centers.

The clinical histories of 133 patients with cervicofacial actinomycosis, treated stationary in the period of 1948--1976, are interpreted in regard to patients age, treatment period and microbiological of histological proof. The opinions in literature about the frequency and a change of actinomycosis in the antibiotic era are discussed.