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D Rothenbacher

Publications and source records attributed to D Rothenbacher.

At least 55 records · Page 3Linked to original sources
PubMed1999

Helicobacter pylori among preschool children and their parents: evidence of parent-child transmission.

This study assessed the role of parental infection status in the transmission of Helicobacter pylori infection in a large population-based sample of preschool-aged children. The subjects, who lived in Ulm, Germany, and in two nearby communities, were screened for school fitness between January and July 1997. Their H. pylori infection status was determined by 13C-urea breath test. Of 1522 eligible children, 1221 (80.2%) participated in the study. Crude prevalence of H. pylori infection in children was 11.3% (95% confidence interval [CI], 9.5-13.3) and 36.4% in their parents (95% CI, 33.5-39.4). The crude odds ratio (OR) for H. pylori infection of children whose mothers were infected was 16.5 (95% CI, 8.9-30.8) and 7.9 after adjustment for potential confounders (95% CI, 4.0-15.7). The crude OR if the child's father was infected was 7.8 (95% CI, 2. 5-24.2) and 3.8 after adjustment for potential confounders (except maternal infection) (95% CI, 0.8-19.1). The results suggest that infected parents, especially infected mothers, may have a key role in transmission of H. pylori within families.

Adult↗
PubMed1999

Cytomegalovirus infection and coronary heart disease: results of a german case-control study.

This case-control study investigated whether previous infection with cytomegalovirus (CMV) was associated with coronary heart disease (CHD). In total, 312 patients of German nationality aged 40-68 years who had a coronary stenosis of >50% of the luminal diameter were recruited for study. Controls (n=479) were voluntary blood donors. CMV serology was performed to determine presence of specific CMV antibodies (IgG, IgM, IgA ELA test; Medac, Hamburg, Germany). Rheologic and inflammatory markers were determined. The prevalence of specific IgG antibodies against CMV was 54.5% in cases and 49.9% in controls (P=.116). The odds ratio for CHD was 1.21 (95% confidence interval, 0.84-1.75) given a positive serostatus of specific IgG antibodies after adjustment for covariates. With the exception of C-reactive protein in controls, none of the rheologic or inflammatory markers was associated with CMV serostatus. Thus, serologic evidence of previous infection with CMV was not a major risk factor for CHD in this population.

Adult↗
PubMed1999

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Journal Article↗
PubMed1998

Elevated liver enzyme activity in construction workers: prevalence and impact on early retirement and all-cause mortality.

BACKGROUND: Gamma-glutamyl transferase (GGT), alanine transaminase (ALT), and aspartate transaminase (AST) are widely used as markers of hepatobiliary disorders in occupational health surveillance. Little is known, however, about the prevalence and occupational and non-occupational determinants of elevated levels of these enzymes in specific occupational groups or about the prognostic value of elevated levels with respect to long-term outcomes such as all-cause mortality and vocational disability. METHODS: A cohort study was conducted among 8,043 male construction workers aged 25-64 years who had undergone occupational health examinations in 6 centers in southern Germany from 1986 to 1988 and had been followed until 1994. The prevalence of elevated levels of GGT, ALT, and AST, depending on the sociodemographic and medical characteristics determined at the baseline examination and the risk of vocational disability and all-cause mortality in relation to elevated liver enzyme activity at baseline were assessed. Covariates considered in multivariate analysis included age, nationality, occupation, body mass index (BMI), smoking, and alcohol consumption. RESULTS: The baseline prevalence of elevated activity levels of GGT (>28 U/1 at 25 degrees C), ALT (>22 U/1), and AST (>18 U/1) was 32%, 22%, and 12%, respectively. Factors most strongly related to elevated serum activity levels for all three enzymes were self-reported alcohol consumption, diabetes, and hypertension. BMI was strongly associated with elevations in GGT and ALT but not in AST. Elevated levels of AST and GGT were strongly related to early retirement and all-cause mortality. Men with AST levels exceeding 18 U/1 had a 2-fold risk of early retirement and a 3 times higher risk of all-cause mortality as compared with men with lower AST levels. No significant association was observed between ALT and either of the long-term outcomes. CONCLUSIONS: Our findings suggest that screening for elevated GGT and AST levels, which are a common finding among construction workers, may be a powerful tool for the identification of individuals at increased risk of early retirement and preterm mortality and may be helpful in targeting of prevention efforts.

Adult↗
PubMed1998

History of antibiotic treatment and prevalence of H. pylori infection among children: results of a population-based study.

We investigated the association of commonly prescribed antibiotics with the prevalence of current Helicobacter pylori infection among children. All children who were screened in 1996 for school fitness by physicians of the Public Health Service in Ulm, a city in the south of Germany, were invited to participate in the study. Infection status was determined by 13C-urea breath test. In addition, the parents of the children were asked to fill out a standardized questionnaire. Nine hundred forty-five out of the 1201 eligible children participated in the study (response rate = 79%). The children were aged 5 to 8 years. Seventeen children who were receiving antibiotics at the day of the breath test were excluded from the analysis. Overall, for 683 children (73.6%) a prior usage of antibiotics was reported. Prevalence of H. pylori infection was significantly lower in children with reported antibiotic usage (odds ratio = 0.46; 95% CI, 0.27-0.76 after adjustment for confounders). Our results suggest that information on prior usage of antibiotics should always be considered in studies evaluating prevalence and risk factors of H. pylori infection in children.

Anti-Bacterial Agents↗
PubMed1998

Active infection with Helicobacter pylori in an asymptomatic population of middle aged to elderly people.

The study objective was to investigate prevalence and determinants of current Helicobacter pylori infection in an asymptomatic population of middle-aged to elderly people. A cross-sectional study was conducted among 337 participants of a general education programme of the University of Ulm aged 50-85 years. Prevalence of infection as determined by means of the [13C]urea breath test was 34.8% (95% CI 29.6-40.3%); overall, 33.8% (95% CI 23.0-46.0) in the age group 50-59 years, 32.4% (95% CI 25.4-39.9) in the age group 60-69 years and 41.0% (95% CI 30.0-52.7) in the age group 70-85 years. Duration of school education of the father, sharing a bed with parents or siblings during childhood, and the area in which participants had grown up were independent determinants of current infection status in a multivariable analysis. We conclude that the prevalence of current H. pylori infection in healthy elderly subjects may not be as high as seroprevalence studies have suggested. Socioeconomic characteristics of childhood living conditions appear to be important determinants of infection status even at older age.

Age Factors↗
PubMed1998

Variation in the 13C-urea breath test value by nationality in Helicobacter pylori-infected children.

BACKGROUND: The 13C-urea breath (13C-UBT) test value is (semi-)quantitatively related to Helicobacter pylori density in the gastric antrum, and the value correlates with the grade of gastritis. The aim of this study was to assess variation of the 13C-urea breath test value by sociodemographic factors in H. pylori-positive children. METHODS: The analysis was performed on 127 asymptomatic children (aged 5-7 years) who were identified as H. pylori-positive with the 13C-UBT test in a large population-based epidemiologic study in the city of Ulm (southern Germany). The parents of the children were asked to fill out a standardized questionnaire about sociodemographic data. RESULTS: Forty-two infected children (33.1%) were of German nationality, 47 children (37.0%) were of Turkish and 38 children (29.9%) were of another nationality. Turkish children had a significantly higher 13C-UBT value (geometric mean = 27.2%) than German children (16.7%) or children with another nationality (19.3%) (P < 0.001). Girls had a trend towards higher values than boys (P = 0.058 after adjustment for nationality). Body mass index, education of the parents, and prior use of antibiotics were unrelated to the extent of the 13C-UBT. CONCLUSIONS: This study identified significant variation in the extent of the 13C value by nationality among H. pylori-infected children. Further studies are needed to elucidate the causes and potential consequences of these variations.

Age Distribution↗
PubMed1998

The individual and joint contributions of Helicobacter pylori infection and family history to the risk for peptic ulcer disease.

Family history of peptic ulcer and infection with Helicobacter pylori have been identified as major risk factors for peptic ulcer disease. It is unclear, however, to what degree their impacts are independent of each other. This question was addressed in a cross-sectional study among 299 consecutive out-patients (25-54 years old) of a general practitioner. Adjusted odds ratios (95% confidence intervals) for gastroscopically verified peptic ulcer disease were 3.8 (1.4-10.1) for persons with H. pylori infection, 8.4 (2.9-24.1) for persons with a family history of ulcer, and 29.5 (6.1-143.9) for persons with both risk factors compared with persons without these risk factors. These results suggest strong, multiplicative contributions of both factors to the risk for peptic ulcer disease.

Adolescent↗
PubMed1998

Prevalence and determinants of Helicobacter pylori infection in preschool children: a population-based study from Germany.

BACKGROUND: Helicobacter pylori is among the most common infections in humans and has been recognized as major cause of various gastroduodenal diseases. There is limited knowledge, however, on the prevalence and determinants of this infection in children. We addressed these issues in a population-based cross-sectional study in Southern Germany. METHODS: Study subjects were all preschool children in Ulm, a city in the South of Germany, who were screened for school fitness by physicians of the public health service in 1996. Infection status was determined by 13C-urea breath test. In addition, the parents of the children were asked to fill out a standardized questionnaire. RESULTS: In total, 945 out of the 1201 eligible preschool children participated in the study (response rate = 79%). The children were aged 5-8 years. The majority were of German nationality (72.6%). Overall, 127 children (13.4%) were infected with H. pylori. Nationality, place of residence in the first year of life and duration of living in Germany were strongly associated with H. pylori infection status. The prevalence varied from 4.8% (95% confidence interval [CI]: 3.3-6.8%) in children with German nationality who were born in Germany or had lived in Germany since their first year of life to 66.7% (95% CI: 29.9-92.5%) in the children with Turkish nationality who came to Germany after the first year of life. CONCLUSION: Our results showed a large variation in prevalence of H. pylori infection in children living in the same geographical area according to nationality. They indicate an association between living conditions in early childhood and H. pylori infection and indicate that H. pylori associated morbidity may evolve very differently in population subgroups living in the same area.

Adult↗
PubMed1998

Pets are not a risk factor for Helicobacter pylori infection in young children: results of a population-based study in Southern Germany.

BACKGROUND: Helicobacter pylori may have multiple routes of transmission. It is unclear, however, whether the agent is also zoonotic and therefore transmitted from an animal reservoir. AIMS: The aim of this population-based study was to assess the relationship of exposure to pets and H. pylori infection among children in a population-based sample in Ulm, a city in the South of Germany. SUBJECTS AND METHODS: All children of German nationality who were to attend first grade in the school year 1996/1997 were included in the study. The 13C-urea breath test was used to determine active infection status. In addition the parents filled out a questionnaire to provide information about pets in the household as well as living conditions and socioeconomic factors of the family. RESULTS: Of 927 eligible preschool children 685 (74%) participated in the study. Prevalence of infection was 6.3%. Infection with H. pylori was not positively associated with contact with pets in general (p = 0.720) or to a specific kind of animal in bivariate and multivariable analyses as evaluated by means of logistic regression. CONCLUSIONS: These results suggest that pets in the household are not a risk factor for H. pylori infection among children in this population.

Animals↗
PubMed1998

Early retirement due to permanent disability in relation to smoking in workers of the construction industry.

Little is known about the relation of cigarette smoking and early retirement due to permanent disability. We conducted a cohort study among 4796 construction workers aged 40 to 59 who underwent occupational health examinations in 1986-1988 in occupational health centers located in the southern region of Germany. They were followed up with respect to working status until July 1994. The effect of smoking on early retirement due to permanent disability was assessed using the Cox proportional hazard model. Overall, smoking prevalence at baseline was 52%. The relative rate (RR) for permanent disability was 1.3 (95% CI 1.0-1.8) for all current smokers, compared with never-smokers. A positive dose-response relationship between smoking and the rate of early retirement due to permanent disability was found after adjustment for covariates. RR ranged from 1.3 in persons who reported smoking 1-19 cigarettes a day to 1.6 in persons who reported smoking > or = 30 cigarettes a day (P value for trend = 0.02). These findings underline the need for comprehensive efforts at the workplace to reduce smoking and its negative consequences for the individual, as well as to limit the associated social burden for society.

Adult↗
PubMed1998

Dyspepsia in relation to Helicobacter pylori infection and psychosocial work stress in white collar employees.

OBJECTIVE: We undertook an investigation of the relationship between psychosocial work stress and Helicobacter pylori (H. pylori) infection with dyspepsia. METHODS: We conducted a cross-sectional study among 189 employees of a health insurance company in the city of Ulm, Germany. RESULTS: A clear association between work-related psychosocial factors and the occurrence of dyspeptic symptoms during the past 3 months was evident. Persons who were considered to have a critical style of coping with work demands suffered more often from dyspeptic symptoms. Current infection with H. pylori was not associated with prevalence of dyspeptic symptoms. These results were also confirmed by adjustment for age, gender, smoking status, education, and use of antiinflammatory drugs within the past 3 months, by means of multivariate analysis. The odds ratio (OR) for having a dyspepsia symptom score in the upper tertile versus the 1st or 2nd was 3.22 (95% confidence interval [CI], 1.56-6.65), given that the employee was considered to have a critical style of coping with work demands. The OR for having a dyspepsia symptom score in the upper tertile given H. pylori infection was 1.23 (95% CI, 0.44-3.46), indicating no association of current H. pylori infection with dyspeptic symptoms. CONCLUSIONS: A critical style of coping with work demands may be an important determinant for dyspepsia-like symptoms. Therefore, in the absence of an underlying disease, specific intervention programs should be targeted at the behavior of the affected individual (e.g., stress-reduction programs) rather than on the treatment of specific symptoms or infection with H. pylori.

Adaptation, Psychological↗
PubMed1998

Helicobacter pylori and abdominal symptoms: a population-based study among preschool children in southern Germany.

OBJECTIVE: To determine the relation of Helicobacter pylori infection with gastrointestinal symptoms in a healthy population-based sample of children. DESIGN: Population-based cross-sectional study of preschool children. SETTING: Screening examination for school fitness by physicians of the Public Health Service in Ulm, a city with 100 000 inhabitants in southern Germany. PARTICIPANTS: One thousand two hundred one preschool children. MAIN OUTCOME MEASURES: Infection status was determined by 13C-urea breath test. Information on gastrointestinal symptoms was collected from children's parents by a standardized questionnaire and integrated into a symptom score. Results. Nine hundred forty-five children participated in the study (response rate, 79%). Overall, 127 children (13.4%) were infected. H pylori infection was not positively related to specific gastrointestinal symptomatology. Infected children had even fewer symptoms when compared with uninfected children. CONCLUSIONS: Our results indicate that H pylori infection in children is mostly asymptomatic and not associated with specific gastrointestinal symptoms.

Abdominal Pain↗
PubMed1998

Parental smoking and infection with Helicobacter pylori among preschool children in southern Germany.

Exposure to parental smoking is known to increase children's susceptibility to a variety of infections. We investigated the relation of parental smoking to infection with Helicobacter pylori in a population-based study among preschool children who were screened for school fitness in the city of Ulm, Germany, in 1996. Current infection with H. pylori was measured by a 13C-labeled urea breath test. Information on factors potentially related to H. pylori infection, including parental smoking in the household, was obtained from children's parents through a self-administered standardized questionnaire. Among 1,201 eligible children, 945 participated in the study (response rate = 79%). Overall prevalence of active infection was 13.7%. After adjustment for confounding factors, we found a strong positive relation between smoking by the father in the household and H. pylori infection (odds ratio = 3.7; 95% confidence interval = 2.3-6.1). By contrast, there was a strong negative relation between smoking by the mother and H. pylori infection (odds ratio = 0.4; 95% confidence interval = 0.2-0.8) that was most pronounced among children who had been breastfed. These striking patterns cannot be explained by current knowledge.

Child↗
PubMed1998

[Possibilities of epidemiologic studies within the scope of school entrance examinations exemplified by Ulm Helicobacter pylori studies].

This paper illustrates the possibilities and the evidential value of epidemiologic studies in combination with the pre-school screening examinations, which in Germany are mandatory for all children who are to attend school for the first time. Aspects of study design and study conduct are discussed primarily. We used two studies conducted in the city of Ulm in 1996 and in 1997. The aim of these studies was to investigate the prevalence, determinants and effects of Helicobacter pylori infection among pre-school children and their parents. Study subjects were all pre-school children in Ulm, a city in the South of Germany, who were screened for school fitness by physicians of the Public Health Service in 1996 and 1997, respectively. Infection status was determined by 13C-urea breath test. In addition, the parents of the children were asked to fill out a standardized questionnaire. In the 1997 study, the infection status of the accompanying parents was also evaluated by 13C-urea breath test. We present some selected results from the study of 1996. In total 945 out of the 1201 eligible pre-school children participated in the study (response rate = 79%). Overall, 127 children (13.4%) were infected with Helicobacter pylori. The prevalence varied between 6.1% in the children with German nationality to 44.8% in children with Turkish nationality and 24.8% in children with other nationality. In addition, we identified further determinants and investigated effects of the infection. The results of these studies demonstrate that epidemiologic studies combined with the mandatory screening examinations in pre-school children may be an important and feasible way to gain knowledge. The participation of the Public Health Service is of special advantage and allows to collect health related data in a efficient way.

Adult↗
PubMed1997

Relation of smoking and alcohol and coffee consumption to active Helicobacter pylori infection: cross sectional study.

OBJECTIVE: To assess the relation of smoking and alcohol and coffee consumption to active Helicobacter pylori infection. DESIGN: Cross sectional study of patients attending a general practitioner. Active H pylori infection was measured by the 15C-urea breath test and detailed quantitative information on smoking and on alcohol and coffee consumption was obtained by a standardised self administered questionnaire. SETTING: One general practice in Germany. SUBJECTS: 447 patients aged 15-79 who had not had peptic ulcer disease or treatment for H pylori infection. MAIN OUTCOME MEASURES: Prevalence of H pylori infection according to smoking and alcohol and coffee consumption. RESULTS: Overall prevalence of infection was 21% (94/447). There was no significant relation between smoking and active H pylori infection. Alcohol consumption showed a negative dose-response relation and coffee consumption a positive dose-response relation with active infection. After adjustment for potential confounders, the odds ratios for patients who drank < or = 75 g and > 75 g of ethanol a week compared with non-drinkers were 0.90 (95% confidence interval 0.55 to 1.59) and 0.33 (0.16 to 0.68), respectively (P value for trend 0.005, assuming that 1 litre of beer and 0.51 of wine contain on average 50 g of ethanol in south Germany). Adjusted odds ratios for patients who drank < 3 cups and > or = 3 cups of coffee per day compared with those who did not drink coffee were 1.49 (0.71 to 3.12) and 2.49 (1.23 to 5.03), respectively (P value for trend 0.007). CONCLUSION: These results suggest a protective effect of alcohol consumption against active infection with H pylori and an opposite effect of coffee consumption.

Adolescent↗
PubMed1997

Disorders of the back and spine in construction workers. Prevalence and prognostic value for disability.

STUDY DESIGN: A cohort study on back-related morbidity and its impact on early retirement resulting from disability among employees in the construction industry. OBJECTIVE: To describe the prevalence of back-related morbidity according to different measures in various occupational groups and to assess the prognostic value of these measures for early retirement resulting from disability. METHODS: The results of occupational health examinations conducted in 1986-1988 among 4,958 employees of the German construction industry aged 40-64 years were analyzed. Active follow-up evaluation was carried out between October 1992 and July 1994 to ascertain employment status. RESULTS: Compared with that of white-collar employees, no excess risk for self-reported back pain or sciatica was seen for any of the manual professions. In contrast, the age-adjusted prevalence of clinical findings of the spine was elevated among all employees in manual professions, and the prevalence of a recorded diagnosis related to disorders of the back and spine (ICD-9 position 720-724) was elevated among bricklayers compared with white-collar employees. The relative risk of being granted a disability pension in the follow-up period was 1.6 (95% Confidence Interval [Cl], 1.3-2.1) for persons reporting back pain or sciatica, 1.8 (95% Cl, 1.4-2.2) for persons with an abnormal clinical finding of the spine, and 1.5 (95% Cl, 1.2-1.8) for persons with a recorded medical diagnosis related to disorders of the back or spine (ICD-9 720-724). CONCLUSION: Patterns of morbidity varied according to the evaluated morbidity measure. All three measures qualified as significant predictors of disability and helped to identify high-risk occupations and high-risk employees.

Back Pain↗