12/31/2011

Living a Longer and Healthier Life by keeping Score

Do you want to live a longer and healthier life? holding score will help you do so. Let me account for how.

Remember when you were in school and you got your report card? You'd look at the grade and discover how well you had done the past semester. If you did well you received determined reinforcement for your good work. If you didn't do as well as you wanted, you got feedback on where to improve. Optimal health is just like being in school again. But this time what you're graded on is risk factors which reflect your lifestyle and health practices.

Afib Stroke

Risk factors recount data about you and a definite disease that helps health care providers assess your present and time to come health. Each risk factor is like a piece of a puzzle representing your health..

Living a Longer and Healthier Life by keeping Score

Each risk factor that you have increases your chances of prematurely dying. Many risk factors overlap and are tasteless to many diseases. The five most tasteless are:

  • Unhealthy eating
  • Smoking
  • Weight issues/obesity
  • Physical inactivity
  • Air pollution

Other risk factors include:

  • High blood pressure
  • High Cholesterol
  • Low Hdl Cholesterol
  • High Triglycerides
  • Elevated lipoproteins
  • Stress
  • Diabetes
  • Race
  • Age
  • Geography
  • Family History
  • Poor hygiene

Lifestyle changes are effective in mitigating most risk factors. That's why it's leading to identify and normally check the risk factors that are most leading to your optimal health. Meet with your health care provider and recapitulate you curative family history as well as your curative profile. Determine what risk factors you should monitor, how you'll monitor them and how often. This is you're your optimal health report card. Personalize it and make sure that what you keep score on matters to you and has the biggest impact on your health.When your scores aren't on the mark make the important life style changes to get your life back on track.

Let me account for how holding score probably saved my life...

Because I have a history of high blood pressure and take medication for it, I normally check my blood pressure and resting heart rate. One day I consideration that my blood pressure was normal but my resting heart rate was higher than normal. My resting heart rate is normally 50-55 but on this day it was 85. This is still in the normal range for most people. But it wasn't normal for me. While working out later that day I noticed that I became out of breath and tired sooner than usual while running at a slower pace than usual. I checked my heart rate the next morning and it was still in the 80s so I went to see my former care physician. During the visit we discovered that I had an arterial fibrillation or irregular heart beat. Citizen with A Fib, as it's called, are at risk of a stroke. The appropriate protocol is prescribing a blood thinner to sell out this risk. Had I not been holding score and monitoring my numbers normally I would have been in a high risk mode for a stroke and not know it. After six months my heart rate returned to normal and I stopped taking blood thinners. But I still keep score by monitoring my resting heart rate. If the A Fib returns I can conduct the risk.

Remember normal isn't optimal. What happens to most Citizen is what is normal. It's very normal for men to have a heart attack by 72 and women by 76. Neither is optimal. To live a longer and healthier life we must move from normal to optimal. Make sure the guidelines you set for yourself in your optimal health score card help you achieve optimal health. Don't settles for less.

For more facts on optimal health go to: http://antiagingoptimalhealth.com

Living a Longer and Healthier Life by keeping ScoreAtrial Fibrillation & Coumadin® Replacements--StopAfib.org interviews Dr. Manish Shah Video Clips. Duration : 7.47 Mins.


Dr. Manish Shah talks about Dabigatran and Rivaroxaban, new drugs in clinicals trials to replace the blood thinner Coumadin® (warfarin), an anticoagulant frequently used to avoid strokes by those with atrial fibrillation. He talks about the two categories of these new drugs, thrombin inhibitors and Factor Xa (10a) inhibitors. Dr. Shah is Associate Director of Cardiac Arrhythmia Research at the Washington Hospital Center in Washington, DC, and Assistant Professor of Medicine at Georgetown University School of Medicine. StopAfib.org, at www.StopAfib.org, is for atrial fibrillation patients by afib patients. A full video transcript can be found at stopafib.org

Tags: dabigatran, coumadin, atrial fibrillation, rivaroxaban, warfarin, Dr. Manish Shah, clotting cascade, thrombin inhibitor, Factor Xa inhibitor, blood thinner drugs, Stop, Afib

12/30/2011

The Inr Range and Anti-Coagulation

The Inr range for every health except heart valves is 2.0 to 3.0. A bileaflet aortic valve is 2.0 to 3.0 except that it is easier to lump these together with other valves and just say 2.5 to 3.5 for all mechanical valves. On-X may be an irregularity but the jury is still out on that. The healing journal puts out the most ample guidelines for anti-coagulation therapy.

The most recent just came out in June 2008. The most recent Chest guideline for atrial flap say that it should be determined using the same risk-based assessments as would be done for atrial fibrillation. In other words, as far as warfarin is involved a-flutter and a-fib are the same thing. This is a change from a few years ago when a-flutter was determined less likely to cause a stroke.

Afib Stroke

The Chest guidelines rank the evidence on which the committees base their decisions with each decision. The best level of evidence is randomized, double-blinded (neither the someone getting the medication nor the someone giving it to them knows either it is the active drug or the inactive placebo) placebo-controlled studied. The bottom level of evidence is an record detailing what happened to one individual. The level for the atrial flap decision ranks right in the middle (third place out of six ranks).

The Inr Range and Anti-Coagulation

New research finds what does and doesn't help treat AFib.(CARDIOVASCULAR HEALTH): An article from: Healthy Years Best

Rate This Product :


New research finds what does and doesn't help treat AFib.(CARDIOVASCULAR HEALTH): An article from: Healthy Years Overview

This digital document is an article from Healthy Years, published by Belvoir Media Group, LLC on April 1, 2011. The length of the article is 703 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available immediately after purchase. You can view it with any web browser.

Citation Details
Title: New research finds what does and doesn't help treat AFib.(CARDIOVASCULAR HEALTH)
Author: Unavailable
Publication:Healthy Years (Magazine/Journal)
Date: April 1, 2011
Publisher: Belvoir Media Group, LLC
Volume: 8 Issue: 4 Page: 3(1)

Distributed by Gale, a part of Cengage Learning


Customer Reviews




*** Product Information and Prices Stored: Dec 30, 2011 21:00:26

I have seen about 3,000 population at seminars on warfarin management. I get the feeling that about 70% atrial fibrillation is about right for a clinic that is open to any someone with any diagnosis. I think the best source is right here. I posted a poll a few years ago about osteoporosis with long-term use. It was not a qoute among population who took warfarin for more than 30 years.

The Inr Range and Anti-CoagulationAtrial Fibrillation & the DECAAF trial--StopAfib.org interviews Dr. Nassir Marrouche (Part 2 or 2) Video Clips. Duration : 4.62 Mins.


In this video interview, Dr. Nassir Marrouche talked about the exciting research he and his team presented at Heart Rhythm 2010 that allows them to personalize atrial fibrillation (AF) treatment. They do catheter ablations and manage stroke prevention based on the amount of atrial fibrosis and atrial remodeling detected by MRI (magnetic resonance imaging). This fibrosis is characterized as Utah 1--4 stages and provides an indication of potential success, what treatments should be used, and the risk of stroke. Dr. Nassir Marrouche is Director of the University of Utah's Electrophysiology Laboratories and Atrial Fibrillation Program, as well as Executive Director of the CARMA (Comprehensive Arrhythmia Research and Management) Center. See our recent article on this research at Personalized Atrial Fibrillation Treatment Using New Method to "Stage" AF at: www.stopafib.org See a full transcript of the interview at: www.stopafib.org Part 1 of 2 can be found at: www.youtube.com

Keywords: Dr. Nassir Marrouche video, stroke prevention, atrial fibrosis, structural remodeling, MRI, Heart Rhythm Society, afib, atrial fibrillation, Stop

12/29/2011

AFIB Atrial Fibrillation Institute at St. Vincent's HealthCare, Jacksonville

AFIB Atrial Fibrillation Institute at St. Vincent's HealthCare, Jacksonville Tube. Duration : 0.53 Mins.


This :30 TV Spot is being used to help St. Vincents HealthCare in Jacksonville, Florida, announce a new Atrial Fibrillation Institute. The institute is a collaboration between cardiologists, cardiothoracic surgeons and the hospital. It is designed to offer patients access to the latest advances from physicians working together to create treatment options designed for each individual patient. Atrial Fibrillation (AFIB) is the most common type of heart rhythm disorder or arrhythmia. It forces the heart to quiver rapidly rather than beating in a normal, rhythmic pattern. The disorder leads to a greater risk of stroke, heart failure and death. It is estimated that as many as 3 million Americans experience Atrial Fibrillation. More than 180000 people are diagnosed with AFIB each year. Atrial Fibrillation affects so many people in our community, says Christine Veal, RN, MSN, St. Vincents Director of Cardiovascular Services. In addition to being at a higher risk of stroke, AFIB patients are often living a quality of life that is less than what they want. Thanks to advances in treatment, new opportunities for a cure are in place at our institute. We are very excited about this chance to help patients.

Tags: st., vincents, vincent's, saint, AFIB, Institute, Atrial, Fibrillation, hospital, health, care, heart, cardiologists, cardiotharacic, surgeons, surgery, rhythmic, disorder, arrhythmia, quiver, patternstroke, death, St, Jax

12/28/2011

About the "Mini Maze" Procedure for Atrial Fibrillation

About the "Mini Maze" Procedure for Atrial Fibrillation Video Clips. Duration : 2.12 Mins.


The Shands Minimally Invasive Pulmonary Vein Isolation procedure, also known as the "Mini-Maze," is used to treat atrial fibrillation through three small incisions on each side of the chest. Two of the incisions are about the size of a nickel, and the other incision is slightly larger. Through these "ports," a surgeon can use a bipolar radiofrequency energy source to make precise linear scars on the heart. These ablation lines block the irregular electrical impulses that cause atrial fibrillation. During this procedure, surgeons may also remove or close off the left atrial appendage in order to reduce the risk of stroke. Performed on a beating heart, the mini-maze procedure takes about three to four hours, and the hospital stay averages about four days. With the mini-maze, atrial fibrillation is eliminated in about 80 to 90 percent of patients. Please visit Shands.org for more information or to find a physician.

Keywords: atrial, fibrilation, heart, vascular, health, cardiovascular, mini-maze, hospitals, in, Florida, UF, Surgery, Shands, Care

12/26/2011

Atrial Fibrillation: Coumadin to Prevent Stroke

Atrial Fibrillation: Coumadin to Prevent Stroke Tube. Duration : 1.30 Mins.


One of the potential devastating consequences of atrial fibrillation is a stroke. You can prevent a stroke with the use of a blood thinner called coumadin. HeartSmartMD co-founder, author and board certified cardiologist Dr. Matt DeVane explains the risks and benefits of using coumadin to prevent strokes in atrial fibrillation. Learn much more at www.HeartSmartMD.com

Tags: atrial fibrillation, tachycardia, coumadin, blood thinner, heart, heart disease, heart health, health, cardiology, cardiologist, doctor, dr devane, devane, heartsmartmd, heart smart, Smart, MD

12/24/2011

Atrial Fibrillation Catheter Ablation Techniques--StopAfib.org interviews Dr. Vivek Reddy

Atrial Fibrillation Catheter Ablation Techniques--StopAfib.org interviews Dr. Vivek Reddy Video Clips. Duration : 4.83 Mins.


In this video from Boston Atrial Fibrillation Symposium 2010, Dr. Vivek Reddy discusses some of the new atrial fibrillation catheter ablation technologies and also talks about non-pharmacological approaches to stroke prevention in afib, such as the Watchman and Lariat suture. Dr. Reddy is the Director of Electrophysiology at Mount Sinai Medical Center in New York City. A full video transcript can be found at: stopafib.org

Tags: atrial fibrillation, Dr. Vivek Reddy, afib, Coumadin, Warfarin, stroke, anticoagulants, Stop

12/23/2011

Atrial fibrillation Ablation (part 3 of 3): How to Perform Pulmonary Vein Isolation

Atrial fibrillation Ablation (part 3 of 3): How to Perform Pulmonary Vein Isolation Tube. Duration : 6.03 Mins.


Dr. Ong, a Cardiac Electrophysiologist, explains how pulmonary vein isolation is done with radiofrequency ablatio to CURE atrial fibrillation. Visit us at www.EndAfib.com.

Tags: atrial fibrillation, afib, a fib, atrial flutter, arrhythmia, tachycardia, irregular heartbeat, irregular heart rhythm, palpitation, stroke, ablation, RF ablation, radiofrequency ablation, catheter ablation, pulmonary vein, pulmonary vein isolation, PV, PV isolation, 3D mapping, electrophysiology, electrophysiology study, EP, EP study, dr

12/20/2011

Atrial fibrillation Ablation (part 2 of 3): How it is Done

Atrial fibrillation Ablation (part 2 of 3): How it is Done Video Clips. Duration : 5.00 Mins.


Dr. James Ong, a Cardiac Electrophysiologist, explains how Atrial Fibrillation ablation is done. See www.EndAfib.com.

Keywords: atrial fibrillation, afib, a fib, atrial flutter, arrhythmia, tachycardia, irregular heartbeat, irregular heart rhythm, palpitation, stroke, ablation, RF ablation, radiofrequency ablation, catheter ablation, pulmonary vein, pulmonary vein isolation, PV, PV isolation, 3D mapping, electrophysiologist, electrophysiology, electrophysiology study, EP, EP study, dr

12/19/2011

Atrial Fibrillation, Coumadin®, & the CHADS2 Score--StopAfib.org interviews Dr. Manish Shah

Atrial Fibrillation, Coumadin®, & the CHADS2 Score--StopAfib.org interviews Dr. Manish Shah Tube. Duration : 4.58 Mins.


If you have atrial fibrillation, how do you know your risk of stroke and whether or not you should be taking Coumadin® or warfarin? Dr. Manish Shah talks about the CHADS2 scoring system that addresses this afib controversy and how your doctor will assess your CHADS2 score. Dr. Shah is an electrophysiologist, Associate Director of Cardiac Arrhythmia Research at the Washington Hospital Center in Washington, DC, and Assistant Professor of Medicine at Georgetown University School of Medicine. StopAfib.org, at www.StopAfib.org, is for atrial fibrillation patients by afib patients. A full video transcript can be found at stopafib.org

Tags: coumadin, atrial fibrillation, warfarin, chads2, Dr. Manish Shah, Stop, Afib

12/18/2011

Understanding the Risks of Atrial Fibrillation

Understanding the Risks of Atrial Fibrillation Tube. Duration : 5.45 Mins.


Leading physicians, patients and representatives from patient support groups talking about the significance of atrial fibrillation, associated risks and its impact on daily living.

Keywords: Atrial, Fibrillation;Atrial, Fibrillation, treatment;Atrial, risk;Atrial, education;Atrial, patients;afib;Arrhythmia;, Heart, Beat;, rhythm;, problems;, Palpitations;, Paroxysmal;, Stroke;, Cliffwyatt

12/16/2011

Atrial Fibrillation: an irregular or rapid heartbeat

Atrial Fibrillation: an irregular or rapid heartbeat Tube. Duration : 2.87 Mins.


Atrial fibrillation is a type of heart disease characterized by an irregular or rapid heartbeat. AF can cause palpitations, dizziness, light headedness and is one of the most common causes of stroke.

Keywords: athena, atrial, beat, condition, disease, dronedarone, fibrillation, heart, heartbeat, irregular, medication, rapid, stroke, study, Info, Your, Life

12/13/2011

EL ICTUS, Isabel Palomeque and Stroke

EL ICTUS, Isabel Palomeque and Stroke Video Clips. Duration : 9.65 Mins.


This is the the real story of overcoming hard times and finding happiness for Isabel Palomeque. On the Stroke World Day (29/10), Boehringer Ingelheim and the Spanish Society of Neurology presented a summary version of the documentary with the testimonial of a stroke patient fighting and never giving up. Complete version will be on La2 of TVE November 15th,2011 at 10am. More info: observatoriodelictus.com.mialias.net and www.1de6.es and interview at bit.ly "Ictus, un terremoto emocional" La historia real de superación y felicidad de Isabel Palomeque. Con motivo del Día Mundial del Ictus (29/10), Boehringer Ingelheim y la Sociedad Española de Neurología, presentan el tráiler de un documental con el testimonio de lucha y esfuerzo de una paciente con ictus. La emisión completa se emitirá en La2 de TVE el día 15 de noviembre a las 10am. Más información: observatoriodelictus.com.mialias.net and www.1de6.es and interview at bit.ly

Tags: ELICTUS, stroke, 1de6, observatorio, del, ictus, atrial, fibrillation, af, afib, Isabel Palomeque, neurology, spanish, Atrial Fibrillation, Health, Spain, dancing, dance, boehringeringelheim

12/12/2011

Boehringer Ingelheim - AF and the risk of stroke

Boehringer Ingelheim - AF and the risk of stroke Tube. Duration : 1.03 Mins.


Strokes happen in atrial fibrillation when pools of blood form in the heart because of the upper chambers of the heart (the atria) not contracting properly. To learn more about atrial fibrillation, visit www.heartofstroke.com ©focus-AF Limited 2011: permission granted for educational purposes only

Keywords: risk of stroke, stroke, afib, af, atrial fibrillation, Boehringer Ingelheim, boehringeringelheim

12/11/2011

Heart of the Matter: New Treatment for Heart Disorder

Heart of the Matter: New Treatment for Heart Disorder Video Clips. Duration : 2.83 Mins.


Baptist Smart Medicine

Tags: atrial, fibrillation, fibrilation, a fib, stroke, cardiovascular, surgery, Dr. Ed Garrett, Convergence, BMHCC

12/10/2011

Atrial Fibrillation & Gender Differences--StopAfib.org interviews Dr. Andrea Russo

Atrial Fibrillation & Gender Differences--StopAfib.org interviews Dr. Andrea Russo Tube. Duration : 5.60 Mins.


In this video interview at Boston Atrial Fibrillation Symposium 2010, Dr. Andrea Russo talks about gender differences in atrial fibrillation treatment and afib stroke risk in women. Dr. Russo is Director of Cardiac Ablation and Arrhythmia Services at Cooper University Hospital (New Jersey) and professor of medicine at Robert Wood Johnson Medical School. A full video transcript can be found at: stopafib.org

Tags: atrial fibrillation, Coumadin, afib, women, women's health, Dr. Andrea Russo, catheter ablation, Stop

12/09/2011

ACC: New Anticoagulants Signal Start of Post-Warfarin Era

ACC: New Anticoagulants Signal Start of Post-Warfarin Era Tube. Duration : 6.72 Mins.


www.medpagetoday.com ATLANTA -- Atrial fibrillation is both a major stroke risk and a looming public health problem since the risk of afib increases with age, and the standard treatment, warfarin, is often a clinical management challenge. But a number of investigational therapies suggest that a post-warfarin era is beginning. In this MedPage Today InFocus™ report, American College of Cardiology president Ralph Brindis, MD, of the University of California San Francisco, says two new compounds, betrixaban and dabigatran, have "raised the threshold" for anticoagulation therapy.

Tags: medicine, health, Med, Page, Today

12/08/2011

Atrial Fibrillation and MRI--StopAfib.org interviews Dr. Nassir Marrouche (Part 1 of 2)

Atrial Fibrillation and MRI--StopAfib.org interviews Dr. Nassir Marrouche (Part 1 of 2) Tube. Duration : 7.68 Mins.


In this video interview, Dr. Nassir Marrouche talked about the exciting research he and his team presented at Heart Rhythm 2010 that allows them to personalize atrial fibrillation (AF) treatment. They do catheter ablations and manage stroke prevention based on the amount of atrial fibrosis and atrial remodeling detected by MRI (magnetic resonance imaging). This fibrosis is characterized as Utah 1--4 stages and provides an indication of potential success, what treatments should be used, and the risk of stroke. Dr. Nassir Marrouche is Director of the University of Utah's Electrophysiology Laboratories and Atrial Fibrillation Program, as well as Executive Director of the CARMA (Comprehensive Arrhythmia Research and Management) Center. See our recent article on this research at Personalized Atrial Fibrillation Treatment Using New Method to "Stage" AF at: www.stopafib.org See a full transcript of the interview at: www.stopafib.org Part 2 of 2 can be found at: www.youtube.com

Tags: Dr. Nassir Marrouche video, stroke prevention, atrial fibrosis, structural remodeling, MRI, Heart Rhythm Society, Stop, Afib

12/07/2011

Atrial fibrillation (part 1 of 3): Who and Why

Atrial fibrillation (part 1 of 3): Who and Why Tube. Duration : 5.70 Mins.


Dr. James Ong, a Cardiac Electrophysiologist, explains the mechanism of Atrial Fibrillation and how Radiofrequency Ablation can CURE AFib. Visit www.EndAfib.com.

Keywords: atrial fibrillation, afib, a fib, atrial flutter, arrhythmia, tachycardia, irregular heartbeat, irregular heart rhythm, palpitation, stroke, ablation, RF ablation, radiofrequency ablation, catheter ablation, pulmonary vein, pulmonary vein isolation, PV, PV isolation, 3D mapping, electrophysiologist, electrophysiology, electrophysiology study, EP, EP study, dr

12/06/2011

Mini-Maze: Minimally Invasive Procedure

Mini-Maze: Minimally Invasive Procedure Tube. Duration : 1.42 Mins.


This video shows Dr. John Puskas performing a thoracoscopic Mini-Maze Procedure for the treatment of atrial fibrillation. This minimally-invasive procedure is performed through three small incisions on each side of the chest and involves the application of radiofrequency energy to treat the irregular heart rhythm. The video includes footage of the incision locations and size, radiofrequency ablation lesion placement, removal of the left atrial appendage for the prevention of stroke, and administration of pain medicine at the end of the procedure.

Tags: mini maze, afib, atrial fibrillation, heart, stroke, prevention of heart, heart surgery, emory, emory hospital, emory healthcare, Health, Source

12/05/2011

Boehringer Ingelheim 1 Mission 1 Million Campaign

Boehringer Ingelheim 1 Mission 1 Million Campaign Video Clips. Duration : 2.15 Mins.


To support the 1 Mission 1 Million global campaign, Boehringer Ingelheim provided €1 million to support projects chosen by the public that aim to educate about atrial fibrillation-related stroke. To see the winners, visit www.heartofstroke.com

Keywords: 1M1M, Boehringer Ingelheim, 1 Mission 1 Million, atrial fibrillation, afib, stroke, af and stroke, boehringeringelheim

12/04/2011

The Latest News about Atrial Fibrillation

The Latest News about Atrial Fibrillation Video Clips. Duration : 9.63 Mins.


Dr. Rajat Deo, a cardiovascular medicine doctor at Penn Heart and Vascular, discusses how new and better drugs will be replacing Coumadin to help atrial fibrillation patients avoid strokes. These drugs have fewer side effects and less of a need for careful monitoring. Learn more about the services at Penn Heart and Vascular: www.pennmedicine.org View Dr. Rajat Deo's profile: www.pennmedicine.org Dr. Deo was interviewed by Andrew Schorr, host and founder of Patient Power, at the 2010 American Heart Association (AHA) annual meeting.

Tags: a-fib, afib, atrial fibrillation, Patient Power, Penn Medicine, Rajat Deo, andrew schorr, aha, american heart association, penn heart and vascular, arrhythmia, rhythm, pacemaker, pennmedicine

12/03/2011

Atrial Fibrillation: Common Complications

Atrial Fibrillation: Common Complications Tube. Duration : 1.27 Mins.


Atrial fibrillation, an irregular heart rhythm, is a leading cause of congestive heart failure and stroke. Make sure you understand why treating A. Fib is so important. HeartSmartMD cofounder and board certified cardiologist Dr. Matt DeVane helps you understand the major complications of atrial fibrillation so you can dangerous outcomes. Learn much more at www.heartsmartmd.com

Tags: atrial fibrillation, atrial fib, heart disease, heart, stroke, chf, heart failure, cardiology, cardiologist, devane, dr devane, hearsmartmd, heart smart, Smart, MD

12/02/2011

Taking Action - Health: A new way to treat a-fib

Taking Action - Health: A new way to treat a-fib Tube. Duration : 2.35 Mins.


Doctors may now have another way to reduce the risk of stroke for people with atrial fibrillation, also known as a-fib.

Tags: afib, atrial, fibrillation, stroke, abcaction, News

12/01/2011

Boehringer Ingelheim - 1 Mission 1 Million Winners

Boehringer Ingelheim - 1 Mission 1 Million Winners Video Clips. Duration : 3.65 Mins.


Congratulations to the 32 winning projects who received a share of €1 million donated by Boehringer Ingelheim. Over 2 million votes were cast and the winners wre chosen from 184 projects that aim to educate about atrial fibrillation and the risk of stroke. To see the winners and learn more about AF, visit www.heartofstroke.com. FOR NON-US AND NON-UK ONLY.

Tags: Boehringer Ingelheim, atrial fibrillation, afib, AF, 1 Mission 1 Million, stroke, Jane Seymour, heart of stroke, boehringeringelheim