TY - JOUR A1 - Wiedmann, Silke A1 - Heuschmann, Peter U. A1 - Hillmann, Steffi A1 - Busse, Otto A1 - Wiethoelter, Horst A1 - Walter, Georg M. A1 - Seidel, Guenter A1 - Misselwitz, Bjoern A1 - Janssen, Alfred A1 - Berger, Klaus A1 - Burmeister, Christoph A1 - Matthias, Christine A1 - Kolominsky-Rabas, Peter A1 - Hermanek, Peter T1 - The Quality of Acute Stroke Care-an Analysis of Evidence-Based Indicators in 260 000 Patients JF - Deutsches Ärzteblatt International N2 - Background: Stroke patients should be cared for in accordance with evidence-based guidelines. The extent of implementation of guidelines for the acute care of stroke patients in Germany has been unclear to date. Methods: The regional quality assurance projects that cooperate in the framework of the German Stroke Registers Study Group (Arbeitsgemeinschaft Deutscher Schlaganfall-Register, ADSR) collected data on the care of stroke patients in 627 hospitals in 2012. The quality of the acute hospital care of patients with stroke or transient ischemic attack (TIA) was assessed on the basis of 15 standardized, evidence-based quality indicators and compared across the nine participating regional quality assurance projects. Results: Data were obtained on more than 260 000 patients nationwide. Intravenous thrombolysis was performed in 59.7% of eligible ischemic stroke patients patients (range among participating projects, 49.7-63.6%). Dysphagia screening was documented in 86.2% (range, 74.8-93.1%). For the following indicators, the defined targets were not reached for all of Germany: antiaggregation within 48 hours, 93.4% (range, 86.6-96.4%); anticoagulation for atrial fibrillation, 77.6% (range, 72.4-80.1%); standardized dysphagia screening, 86.2% (range, 74.8-93.1%); oral and written information of the patients or their relatives, 86.1% (range, 75.4-91.5%). The rate of patients examined or treated by a speech therapist was in the target range. Conclusion: The defined targets were reached for most of the quality indicators. Some indicators, however, varied widely across regional quality assurance projects. This implies that the standardization of care for stroke patients in Germany has not yet been fully achieved. KW - Hesse KW - study-group ADSR KW - ischemic-stroke KW - Germany KW - implementation KW - rehabilitation Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-114747 SN - 1866-0452 VL - 111 IS - 45 ER - TY - JOUR A1 - Berger, Susanne A1 - Ellersiek, Ulrike A1 - Steinmüller, Klaus T1 - Cyanobacteria contain a mitochrondrial complex I-homologous NADH-dehydrogenase N2 - Thylakoid and cytoplasmic membranes of the cyanobacterium Syncchocystis sp. PCC 6803 were purified by sucrose gradient centrifugation. Both membranes oxidize NADH in a rotenone-sensitive reaction. Antibodies prepared against psbG/ndhKand ndhJ fusion proteins detect the corresponding polypeptides in both membrane preparations. This demonstrates that a NADH-dehydrogenase, homologous to the mitochondrial NADHubiquinone-oxidoreductase (complex I of the respiratory chain) is present in cyanobacteria, The NADH-dehydrogenase can be solubilized with the detergent /-D-dodecylmaltoside. Sedimentation analysis of the solubilized enzyme on a sucrose gradient indicates that it is a multisubunit protein complex. KW - Respiratory chain KW - NADH-dehydrogenase KW - Cyanobacteria KW - Synechocystis 6803 Y1 - 1991 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-31223 ER - TY - JOUR A1 - Berger, Susanne A1 - Ellersiek, Ulrike A1 - Kinzelt, Dagmar A1 - Steinmüller, Klaus T1 - Immunopurification of a subcomplex of the NAD(P)H-plastoquinone-oxidoreductase from the cyanobacterium Synechocystis sp. PCC6803 N2 - An antibody against the NDH-K subunit of the NAD(P)H-dehydrogenase from the cyanobacterium Synechocystis sp. PCC6803 was used to isolate a subcomplex ofthe enzyme from Triton X-lOO solubilized total membranes by immunoaffinity chromatography. The isolated subcomplex consisted of seven major polypeptides with molecular masses of 43, 27, 24, 21, 18, 14 and 7 kDa. The amino-terminal amino acid sequences of the polypeptides were determined. By comparing the sequences with the amino acid sequences deduced from DNA. three proteins were identified as NDH-H (43 kDa). NDH-K (27 kDa) and NDH-J (24 kDa). A fourth subunit (NDH-J, 21 kDa) was identified by Western blot analysis with an NDH-J antibody. KW - NAD(P)H-dehydrogenase KW - Cyanobacteria KW - Synechocystis sp. PCC6803 KW - NDH-H KW - NDH-I KW - NDH-J KW - NDH-K Y1 - 1993 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-31249 ER - TY - JOUR A1 - Berger, Susanne A1 - Ellersiek, Ulrike A1 - Westhoff, Peter A1 - Steinmüller, Klaus T1 - Studies on the expression of NDH-H, a subunit of the NAD(P)H-plastoquinone-oxidoreductase of higher-plant chloroplasts N2 - The plastid genomes of higher plants contain eleven reading frames (ndhA-K) that are homologous to genes encoding subunits of the mitochondrial NADH-ubiquinone-oxidoreductase (complex I). The carboxyterminal end of the NDH-H subunit from rice (Oryza sativa L.) was expressed as a fusion protein in Escherichia coli and antibodies against the fusion protein were generated in rabbits. The antibody was used to study the expression of NDH-H, and the following results were obtained: (i) NDH-H is expressed in mono- and dicotyledonous plants, (ii) NDH-H is localized on the stroma lamellae of the thylakoid membrane and (iii) NDH-H is expressed in etioplasts. Together with the finding that two other ndh genes (ndhI and ndhK) are expressed in plastids, these results point to the existence of an NAD(P)H-plastoquinone-oxidoreductase on the thylakoid membrane. The possible function of the enzyme in plastids is discussed and it is suggested that it works in balancing the ATP/ADP and the NADPH/NADP ratios during changing external (i.e. light) or internal (i.e. ATP and NADPH demands of biosynthetic pathways of the plastid) conditions. KW - NAD(P)H-plastoquinone-oxidoreductase KW - ndhH gene KW - Plastid DNA Y1 - 1993 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-31283 ER - TY - JOUR A1 - Hillmann, Steffi A1 - Wiedmann, Silke A1 - Rücker, Viktoria A1 - Berger, Klaus A1 - Nabavi, Darius A1 - Bruder, Ingo A1 - Koennecke, Hans-Christian A1 - Seidel, Günter A1 - Misselwitz, Björn A1 - Janssen, Alfred A1 - Burmeister, Christoph A1 - Matthis, Christine A1 - Busse, Otto A1 - Hermanek, Peter A1 - Heuschmann, Peter Ulrich T1 - Stroke unit care in Germany: the German stroke registers study group (ADSR) JF - BMC Neurology N2 - Background: Factors influencing access to stroke unit (SU) care and data on quality of SU care in Germany are scarce. We investigated characteristics of patients directly admitted to a SU as well as patient-related and structural factors influencing adherence to predefined indicators of quality of acute stroke care across hospitals providing SU care. Methods: Data were derived from the German Stroke Registers Study Group (ADSR), a voluntary network of 9 regional registers for monitoring quality of acute stroke care in Germany. Multivariable logistic regression analyses were performed to investigate characteristics influencing direct admission to SU. Generalized Linear Mixed Models (GLMM) were used to estimate the influence of structural hospital characteristics (percentage of patients admitted to SU, year of SU-certification, and number of stroke and TIA patients treated per year) on adherence to predefined quality indicators. Results: In 2012 180,887 patients were treated in 255 hospitals providing certified SU care participating within the ADSR were included in the analysis; of those 82.4% were directly admitted to a SU. Ischemic stroke patients without disturbances of consciousness (p < .0001), an interval onset to admission time ≤3 h (p < .0001), and weekend admission (p < .0001) were more likely to be directly admitted to a SU. A higher proportion of quality indicators within predefined target ranges were achieved in hospitals with a higher proportion of SU admission (p = 0.0002). Quality of stroke care could be maintained even if certification was several years ago. Conclusions: Differences in demographical and clinical characteristics regarding the probability of SU admission were observed. The influence of structural characteristics on adherence to evidence-based quality indicators was low. KW - stroke register KW - stroke unit care KW - quality of health care KW - quality indicators Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-159447 VL - 17 IS - 49 ER -