Biomedical subjects

Ralf Winkler

Publications and source records attributed to Ralf Winkler.

3 recordsLinked to original sources

PubMed2006

Statin use and survival in patients with chronic heart failure--results from two observational studies with 5200 patients.

BACKGROUND: There is minimal evidence that HMG-CoA reductase inhibitors (statins) are beneficial in patients with chronic heart failure (CHF). Treatment with statins may lead to a lower mortality in CHF, independent of cholesterol levels, CHF etiology and clinical status. METHODS: In a first study, we included 3132 patients with CHF from the ELITE 2 study in whom information on body mass index (BMI) and statin use at baseline were available. In a second study, we pooled the databases of 5 tertiary referral centers with 2068 CHF patients. In this cohort 705 patients were on a statin (34%), 585 of 1202 (49%) patients with ischemic etiology, and 120 of 866 (14%) patients with non-ischemic etiology (established by coronary angiography). FINDINGS: Patients in ELITE 2 who received statin therapy at baseline (n=397, 13%) had lower mortality (hazard ratio [HR] 0.61, 95% CI 0.45-0.83; p=0.0007). In univariate analysis, increasing age, NYHA class, creatinine, and decreasing BMI, LVEF, and cholesterol, as well as lack of beta-blocker treatment and ischemic etiology (all p<0.002) related to higher mortality. In multivariable analysis, statin therapy related to lower mortality independently of all these variables (adjusted HR 0.66, 95% CI 0.47-0.93; p=0.017). In the second study CHF patients on statins had lower mortality (adjusted HR 0.58, 95% CI 0.44-0.77; p=0.0001). Both in patients with ischemic (p<0.0001) and non-ischemic etiology (p=0.028) statin treatment related to better survival. INTERPRETATION: In chronic heart failure, treatment with statins is related to lower mortality, independent of cholesterol levels, disease etiology and clinical status.

Aged↗

PubMed2006

EGG open quotient in aging voices--changes with increasing chronological age and its perception.

This paper presents the results of open quotient (OQ) measurements in electroglottographic (EGG) signals of young (18-30 years) and elderly (60-82 years) male and female speakers. The paper further presents quantitative results of the relation between the EGG OQ and the perception of a speaker's age. Higgins and Saxman found a decreased EGG OQ with increased age for females, while the EGG OQ increased for males as the speaker's age increased in sustained vowel material 1. Although laryngeal degeneration due to increased age seems to occur to a lesser extent in females, the significant decrease of the OQ in elderly female voices could not be explained in terms of age-related physiological changes. Linville found increased spectral amplitudes in the region of F0 for the elderly (obtained by long-term average spectra (LTAS) measurements of read speech material), independent of gender, which could be indirectly interpreted as an increasing OQ 3. We measured the EGG OQ, not only for sustained vowels but also in vowels taken from isolated words and read speech material. To analyse the relation between breathiness in terms of an increased EGG OQ and the mean perceived age per stimulus, a perception test was carried out, in which listeners were asked to estimate speaker's age based on sustained /a/-vowels varying in vocal effort (soft-normal-loud) during production. 1) The decreased EGG OQ for elderly females originally found by Higgins and Saxman 1 is not apparent in our data for sustained /a/-vowels; for males, however, we also found an increased EGG OQ for the elderly speakers. 2) In addition, an increased EGG OQ for the group of elderly in comparison to the younger males occurs for the unstressed syllable of the word material. 3) Our results show a strong positive relation between perceived age and EGG OQ in male vowel stimuli. Regarding 2), depending on the speech task at least a male speaker's voice gets more breathy as age increases. Considering 3), increased breathiness may contribute to the listener's perception of increased age.

Adolescent↗

PubMed2005

Isotope characteristics of vegetables and wheat from conventional and organic production.

Multielement isotope ratio analysis was checked for its suitability as a means for the discrimination between agricultural products from integrated/conventional or organic production, respectively. Differences were mainly found for delta15N-values. Paprika and tomatoes from organic production in greenhouses showed delta15N-values above+7 per thousand, whereas corresponding products from conventional cultivation had delta15N-values near 0 per thousand. Lettuce, onions, cabbage and Chinese cabbage from field production had delta15N-values in the range of+5 to+6 and+5.5 to+7.5 per thousand, respectively (conventional and organic production); these overlapping differences do not permit a reliable discrimination. The same is true for wheat, showing average delta15N-values of+2.3+/-1.0 and+3.6+/-1.6 per thousand, respectively. The unexpected relative high 15N-enrichments of vegetables from integrated production are discussed as originating, at least partially, from 15N-enrichment in the soil by NH3 evaporation and denitrification.

Ammonia↗