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Biomedical subjects

B Bach

Publications and source records attributed to B Bach.

At least 19 recordsLinked to original sources

The Swiss Orthopaedic Registry.

Following the tradition of the IDES European Hip Registry inaugurated by M. E. Müller in the 1960s, the Institute for Evaluative Research in Orthopaedic Surgery at the University of Bern started a new era of data collection using internet technology (www.memdoc.org). With support of the Swiss Orthopaedic Society, the pilot of the Swiss Orthopaedic Registry was conducted, and in cooperation with different academic and non-academic centers the practicability of integrating the various data collection instruments into the daily clinical workflow was evaluated. Three different sizes of hip and knee questionnaires were compiled, covering the individual demands of the participating hospitals whereby the smaller questionnaires always represent a subset of the next larger one. Different types of data collection instruments are available: the online interface, optical mark reader paper questionnaires, and barcode sheets. Precise implant tracking is implemented by scanning the implant barcodes directly in the operating theaters and linking them to the clinical data set via a central server. In addition, radiographic information can be linked with the clinical data set. The pilot clinics suggested enhancements to the user interface and additional features for data management. Also, recommendations were made to simplify content in some instances and diversify in others. With a new software release and adapted questionnaires the Swiss Orthopaedic Registry was officially launched in Summer 2005.

Arthroplasty, Replacement, Hip↗

Initial RNA expression in human monocytes after multiple injury: a screening pilot study on potentially trauma-sensitive factors by using the microarray-technique.

BACKGROUND: Pathological affection of the immune system is one of the initiating mechanisms for the induction of multiple organ failure (MOF) in patients suffering from multiple injuries. Potential responsible intracellular mechanisms such as initial monocyte mRNA expression of specific mediators remain poorly studied, so far. Hence, we applied the microarray technique for screening of a wide variety of genes in circulating monocytes of multiple injured patients and compare the molecular results to the clinical course of the patients (MOF-score). METHODS: In our prospective pilot study 6 patients were enclosed presenting with blunt multiple injuries (Injury Severity Score 16 to 57 points). Monocytes were isolated out of sequentially drawn samples (6, 12, 24 and 48 hours after trauma) using magnetic cell sorting (CD14) and a human microarray system was used (Atlas stress 1.2, Clontech, 1176 genes). Alterations in the sequential samples were identified by calculating ratios to baseline levels on admission and cluster analysis was performed (Spotfire Decision). RESULTS: Only 86 (ca.5%) genes displayed an obvious signal. The house-keeping genes clustered well together in all patients in contrast to a substantial inter-individual variability of the other signal giving genes. No mediator burst of the classical pro- or anti-inflammatory cascade were detected. CONCLUSION: We demonstrate for the first time a screening analysis of mRNA expression patterns in circulating monocytes of multiple injured patients indicating that only very few genes appeared to be influenced by the traumatic event. So far, no correlation to the severity of trauma or MOF could be detected.

Adult↗

[A quality assessment of notified occupational diseases submitted to the National Occupational Environment Service].

The aim of this study was to assess the quality of a consecutive sample of occupational disease notifications submitted to the National Working Environment Service during 1994. The sample consisted of 860 notifications describing occupational diseases among persons working in companies situated in the county of Vejle. The data information e.g. company name and address, time of employment, harmful exposure and disease, were registered. An overall data quality assessment was performed including evaluation of the etiological connection between described occupational exposure and disease and potential preventive perspectives. The study showed that the notified informations in general were adequate, but doctors need to pay more attention to dose description of the harmful exposure. About 80% of the notifications presented an adequate connection between occupational exposure and disease. Only half of the notifications described preventable and recent (less than five years) harmful exposure. In conclusion, the Danish occupational disease notification system is in general of a high standard, and the National Working Environment Service could make more use of doctors' information provided in these notifications.

Cross-Sectional Studies↗

[Decentralized special training in pulmonary medicine. A project using telemedicine].

In arctic Norway, where there is a lack of specialists in pulmonary medicine two postgraduate students, already qualified as specialists in internal medicine at Tromsø Regional Hospital, applied to continue their training at their respective local hospitals. The regional hospital in Tromsø has a long tradition of telemedicine, with network links to local hospitals in the region, and is equipped for interactive consultation and the bilateral transmission of x-rays and video recordings, and digital transmission of x-rays. Accordingly, supported by their supervisor, the two postgraduate students applied to the committee for postgraduate education in pulmonary medicine to have a year's work at their respective local hospitals, supervised via the telemedicine facilities, accepted as equivalent to a six-month module of the normal syllabus. The project was approved and executed as planned. The registrars, who were responsible for pulmonary service at their local hospitals, served four days a month at the regional hospital, and their supervisor visited the local hospitals one day each month. All internal education at the regional hospital was made available by means of a weekly interactive televised link-up, x-rays being displayed on screen as transmitted digitally; bronchoscopies were shown by video, and ad hoc tutorials arranged as needed. Evaluated by the national committee, the project was found satisfactory, and the registrars were duly qualified.

Arctic Regions↗

[Occupational respiratory tract allergy in trout processing workers].

Out of 16 workers in a trout processing industry, ten experienced work-related cough, dyspnoea, and nasal secretion. A clinical examination was performed including specific IgE, precipitating antibodies IgG for trout and processing water, skin prick testing and peak flow monitoring. A total of four workers showed a positive allergic reaction. Processing water contained endotoxin and bacteria in high amounts. It is concluded, that work-related respiratory symptoms should be investigated and the cause at the workplace identified, so that preventive measures can be introduced.

Air Pollutants, Occupational↗

Experiences in developing legislation protecting reproductive health.

The law regarding special maternity leave for pregnant women in hazardous work situations has been in effect since 1981 in Denmark. In Finland, legislation regarding the protection of the reproductive health of working men and women and of pregnant women has been in effect since 1991. According to the special maternity leave law, women who are exposed to certain chemical, physical, or biological agents that are considered to be harmful to the fetus may be entitled to special maternity leave and benefits. In Denmark and in Finland, approximately 1% and 0.1%, respectively, of pregnant women have used the special maternity leave due to a risky work situation. In Finland, the yearly costs of the leave have been US $200,000 to $250,000. Trained occupational physicians can facilitate changes at the workplace that will decrease the need for special maternity leave.

Denmark↗

Injuries to the acromioclavicular joint. Diagnosis and management.

Injuries to the acromioclavicular (AC) joint are common in athletes. Diagnosis can often be made clinically, but radiographs are needed to classify the severity of injury. Treatment is often conservative, consisting of immobilization or symptomatic modalities. Surgery is generally performed on patients with the more severe injuries. Controversy surrounds the treatment of type III injuries. The current trend is toward nonsurgical options, consisting of either symptomatic treatment or immobilization. If surgery is necessary, coracoclavicular (CC) fixation is currently the treatment of choice.

Acromioclavicular Joint↗

[A study of 11 ventilators for anesthesia: laboratory testing].

Eleven anaesthesia ventilators were instrumentally tested under various conditions. They included: Excel and Modulus II Plus (Ohmeda); 710 and Servo anaesthesia circle 985 (Siemens); Jollytronic (Soxil) and Elsa (Engström); SA2 and Cicero (Dräger); ABT 4,300 (Kontron); Monnal A and the prototype Alys (Taema). The test circuit comprised a two compartment model lung, a pneumotachograph, a pressure gauge in the "airway". The volume was calculated as the integral of flow rate. Each machine was calibrated by the firms' technicians. Before each test, the pneumotachograph was calibrated using a 11 air syringe and the pressure gauge with a 5 cm water column. Each machine ventilated the model lung for 30 min before starting the tests. There were five tests: 1) reliability of the machine's spirometer, 2) reliability of the ventilation rate, 3) reliability of pressure measurements, 4) effect of increasing fresh gas flow on spirometry, 5) effect of increasing downstream resistances. In usual simulated ventilatory conditions, all the machines accurately delivered the setted ventilation and spirometric measurements were with minimal error only. Several ventilators (SA2, Excel, 710, Elsa, ABT 4,300) did not succeed in maintaining their performances when compliance was strongly decreased or resistance of the test lung notably increased. Resistance in the circuit during simulated spontaneous ventilation was < 3.6 cmH2O.l-1.s-1. Increasing fresh gas flow raised the minute volume delivered in six ventilators. It is concluded that, during extreme ventilatory conditions, the inspired volume must be adjusted so as to maintain the inspired tidal volume. However, ventilators which increase inspiratory time in response to an increased mechanical load cannot be adjusted by this way.

Anesthesia, Closed-Circuit↗

[Accumulation of respiratory diseases among employees at a recently established refuse sorting plant].

An increasing number of plants for re-use of refuse have been constructed in Denmark in recent years. The Kaastrup Plant near Skive was opened in spring 1986. The plant accepts household rubbish and industrial refuse separately. The refuse is sorted by machine (industrial refuse is sorted partially manually) and in a large partially open machine plant, refuse is converted into fuel pellets. During a period of eight months, eight out of 15 employees developed respiratory symptoms. In seven, bronchial asthma was diagnosed and chronic bronchitis in one person. Four had initial symptoms of the organic dust toxic syndrome. After further six months, another case of occupationally-conditioned asthma occurred in the plant. Only two out of nine had previously had asthma or atopic disease. The investigation did not reveal any evidence of type-I allergy. Six out of nine had specific precipitating antibodies to refuse while all had negative RAST tests to this. In spring 1989, from six to eighteen months after the onset of the symptoms, six had still dyspnoea on exertion and three had positive histamine-provocation tests and seven out of nine had left the plant. Occupational medical measurements revealed dust concentrations of 8.1 mg/cubic millimeter in September 1986 and total germs of up to 3 x 10(9) cfu/cubic meter. Construction of the plant involved considerable contact with the refuse on account of the cleansing processes and open systems and it was reconstructed in the course of 1987/1988 so that the hygienic conditions are now acceptable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Survival of Saccharomyces cerevisiae after treatment with the restriction endonuclease Alu I.

Treatment of yeast cells proficient in the repair of radiation damage (Saccharomyces cerevisiae) with the restriction endonuclease Alu I leads to a positive dose-effect relationship between inactivation level and enzyme concentration. The data suggest an uptake of the active restriction enzyme into the cells and a relationship between induction of DNA double-strand breaks and cell killing.

Chromosome Aberrations↗

Tear fluid electrolytes and albumin in persons under environmental stress.

Sixty-two subjects selected among 287 persons with indoor air complaints were exposed to a standard mixture of 22 different organic gases and vapors normally found in Danish houses. Persons were randomly assigned to one of four exposure groups, and each subject stayed during the test day from 10:00 AM to 4:00 PM under standardized conditions in a climate chamber. During exposure the blink frequency was recorded, and after exposure the tear fluid contents of serum albumin, potassium, and sodium were measured. It was found that the persons had an increased concentration of serum albumin in the tear fluid, and that exposure to high concentrations of organic gases and vapors induced a tear reflex-mediated dilution of the tears.

Adult↗