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Background: In patients without diabetes (DM) hyperglycemia is associated with high mortality from community-acquired pneumonia(CAP). Hyperglycemia, however, is a common condition among patients with DM and preexisting hyperglycemia should be accounted for in studies of a possible association between hyperglycemia and mortality in patients with DM. Aim: To investigate the association between the glycemic gap (the difference between admission hyperglycemia and the estimated average glucose (EAG)) and 90-day mortality. Methods: A prospective cohort study. EAG was derived from hemoglobin A1c. The absolute-glycemic gap was defined as; “admittance blood glucose - EAG“. The proportional glycemic-gap was defined as; “((admittance blood glucose/EAG)*100)-100”. The association between the absolute-glycemic gap and the proportional-glycemic gap and 90-day mortality was assessed with Cox proportional hazard model. We categorized the proportional-glycemic gap according to quartiles. Results: 1933 adults were included. The absolute-glycemic-gap was not associated with an increased risk for 90-day mortality, HR 1.02 (95% CI 0.93-1.11). Compared to the 2nd quartile, the 1st and 4th proportional-glycemic gap quartile was associated with a higher risk with HR 2.7 (95% CI 1.11-6.65) and HR 2.5 (95% CI 1.05-5.69), respectively. No interaction between DM and the proportional-glycemic gap or the absolute-glycemic gap was found (p=0.82 and p=0.25, respectively). Conclusion: Patients with the lowest and highest proportional-glycemic gap had the highest risk for 90-day mortality and it was not modified by DM. The proportional-glycemic gap might be incorporated into future risk assessment tools for CAP.

Objectives: We aimed to identify clinical characteristics and to assess effectiveness of different initial antibiotic regimens in adult patients with community-acquired pneumonia (CAP) caused by Haemophilus influenzae. Methods: Characteristics were compared between patients with H. influenzae monoinfection versus CAP of other and unknown aetiology enrolled by the German prospective cohort study CAPNETZ. Impact of initial antibiotic treatment on "early clinical response" according to FDA criteria and overall clinical cure were analysed. Results: H. influenzae was found in 176 out of 2790 patients with pathogen detection (6.3%). Characteristics significantly associated with a H. influenzae CAP (p

Right ventricular pump performances were assessed in 14 patients with chronic obstructive pulmonary disease by means of radionuclide angiocardiography using krypton-81m as a tracer. Right ventricular ejection fraction (RVEF) was significantly lower in the patients than in normal volunteers. Additionally there was a striking difference in RVEF between patients with normal pulmonary artery pressure (PAP) and those with pathologically elevated PAP. A linear negative correlation between RVEF and mean PAP could be demonstrated. From this data we suggest that radionuclide angiocardiography using krypton-81m allows non invasive assessment of right heart afterload and thus indirectly PAP.

8 healthy male volunteers performed jogging (as an example of an aerobic metabolic condition) and squash (as an example of an intermittently anaerobic metabolic condition). The platelet sensitivity to prostacyclin (PGI 2 ) decreased after jogging. After squash, a statistically sijnificant (p 0,001) decrease in the sensitivity of the platelets could be seen. Our findings suggest that an early alteration of platelet sensitivity might play a key role in maintaining the hemostatic balance and could be of greater importance than the vascular wall PGI 2 -synthesis, as the sensitivity changes immediately, whereas the PGI 2 -formation change is a long-term process.