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Biomedical subjects

H Schlegel

Publications and source records attributed to H Schlegel.

At least 19 recordsLinked to original sources
PubMed1989

[Concept: occupational medicine 2000].

The group of physicians practising occupational medicine in Switzerland is actually still small, and it will need a very important development to reach, on a nation-wide base and not only within a few large companies, a standard of occupational medicine which satisfies from a social security as well as from an economical point of view. The occupational medicine has, therefore, to elucidate to the social partners and to the public the benefit for health and public welfare of its preventive activity at the workplace. The following goals are thus to be pursued: Further development of a legal basis in Switzerland equal to the standard of the neighbouring countries of the European Community Provision of sound models assuring occupational medical care of all business, in particular of the small and middle-sized business Promotion of student's education, specialist formation and continuative schooling in occupational medicine Provision of an adequate university teaching and research capacity with firm links to the practice A more powerful and competent representation of occupational medical aspects in actual discussions of health legislation and social legislation.

Forecasting↗
PubMed1989

[Effects after 3 months of uvulopalatopharyngoplasty in the treatment of obstructive sleep apnea syndromes in adults].

The results at three months of uvulopalatopharyngoplasty (UPPP) have been evaluated in thirty adult patients with an obstructive sleep apnoea syndrome (SAOS). For the group overall the mean apnoea index (IA) decreased from 57 apnoeas per hour and the mean maximal desaturation decreased to 60% post operatively. However in the overall results different individual facts overlap. 20 of the 30 patients, or 67%, have an IA post operatively of less than 50% of the pre-operative value (responders). 14 of these or 47% have a post operative IA of less than 10 apnoeas per hour, a value considered as non pathological. Finally 33% of the patients have no improvement in their post operative IA (non responders). A stricking diminution of nocturnal desaturation and of the disorganisation of sleep was seen in responders to UPPP. No predictive factor for the results of UPPP could be determined. This study shows that UPPP is an effective treatment in a large number of patients having SAOS at the price of minor and transitory complications.

Adult↗
PubMed1983

[Diagnostic verification of Group III and III D cytological tests with special reference to follow-up].

The diagnostic verification of Pap III and Pap III D-smears from mass screening is described with special regard to the importance of colposcopical and cytological long-term controls. 233 (59.8%) out of 390 patients were verified within one year (1.1.-31.12. 1977). A high percentage (27.5%) of the first control smears was negative or the cytological picture had become normal (19.5%) after vaginal treatment by antibiotics and application of estrogens. 50 women were cured by conization or primary hysterectomy as the cytological diagnosis yielded suspicion of severe dysplasia or carcinoma in situ. Depending on cytological differential diagnosis, individual situations and the developmental tendency of the atypical epithelium 157 patients (40.2%) were observed for several years. The great diagnostical-therapeutical importance of colposcopy for the early recognition of cervical intraepithelial neoplasia (CIN) is demonstrated. A direct microbiopsy controlled by colposcopy is a valuable completing method if there are differences between colposcopical and cytological findings during a long-term control of the cases. A slight or moderate dysplasia can be observed for about 2 or 3 years, as most regressions are seen in this period. In problematic cases (young nullipare, patients treated because of infertility or sterility, pregnant women, old women) with severe dysplasia/carcinoma in situ it is possible and justifiable to control the patient temporarily in short distances. All cases which are suspicious of an early stromal invasion call for a definite diagnosis and therapy without any delay. Primary hysterectomy is preferred in patients aged 35 years or more.

Adolescent↗
PubMed1982

Persistent protoporphyrinemia in hereditary porphobilinogen synthase (delta-aminolevulinic acid dehydrase) deficiency under low lead exposure. A new molecular basis for the pathogenesis of lead intoxication.

For several years, a 4-12-fold increase of the upper normal limit in erythrocyte protoporphyrin concentrations persisted in two men 34 and 39 years of age who were chronically exposed to lead. We are dealing with a zinc protoporphyrinemia in both cases, without lead intoxication or anemia. The 34-year-old had been a regular blood donor for 10 years and had already been treated for iron deficiency several times. Hemoglobin, red cell counts, hematocrit, and iron were at the lower normal limit. The activity of porphobilinogen synthase (PBG-S), uroporphyrinogen-synthase and -decarboxylase as well as urinary porphyrin precursors and porphyrin excretion were normal. Protoporphyrinemia was said to be due to a prelatent/latent iron deficiency. In the 39-year-old, the activity of PBG-S was lowered to 388 mumol/1 . h, as compared to the mean of controls (1,190 +/- 210, x +/- SD, n = 50), in connection with a slightly elevated excretion of delta-aminolevulinic acid and coproporphyrin in the urine and a high-normal blood lead level. In his family there was no history of either a protoporphyrinemia or a hematological disturbance. Six of eight family members in three generations showed a diminished activity of PBG-S: 600 +/- 160, P less than 0.001 compared to controls. These family members are heterozygous with regard to the PBG-S deficiency; they are clinically unobtrusive in comparison to homozygotes with an acute prophyria syndrome. Activation by zinc and reactivation by dithiothreitol were normal in contrast to PBG-S from patients with lead intoxication. The cause of biochemical symptoms of subclinical lead intoxication developed by the propositus is probably due to the hereditary PBG-S deficiency which sensitizes him to low-level lead exposure. The determination of red cell PBG-S activity can be recommended as a test detecting heterozygotes. The hereditary PBG-S deficiency is recognized as a new molecular basis for the pathogenesis of lead intoxication.

Adult↗
PubMed1982

[Mesothelioma following occupational contact with asbestos].

From 1975 onwards, mesothelioma is by far the most often seen occupational tumour in Switzerland (about 70%). Between 1969 and 1982, there have been 49 cases registered by the SUVA (Schweizerische Unfallversicherungsanstalt, i.e. Swiss National Accident Insurance Fund). 10 together with asbestosis. Of the first 30 cases, the primary tumour only once was in the peritoneum, in all other cases the tumour always could be located in the pleura. The causative asbestos exposure was found in the production of asbestos cement (9), in the construction and reparation of waggons (6), in the insulation work at chemical plants (5) and in several other industrial work conditions (10). The average exposure time was 21 years. The average interval from exposure to diagnosis 35 years. The survival time after diagnosis about 1 year. Technical prevention consists in substitution of asbestos or elimination of respirable dust (or at least reduction below the TLV). Medical prevention: periodic fitness tests and follow up examinations. New cases should be communicated to the mesothelioma-register in Zurich and to the SUVA, for clarification of the industrial origin.

Asbestos↗
PubMed1981

[Industrial medical activities of SUVA (Swiss Accident Insurance Agency)].

The group of occupational medicine of the Swiss Accident Insurance Fund (Suva) fulfills functions of standardizing, e.g. setting TLVs, of insurance medicine, i.e. judging cases of occupational disease and, to a great extent, of medical prevention. By means of 100,000 examinations per year and 40 programs, 330,000 employees in 20,000 enterprises are attended. This is not a general provision of public health, but a specific prevention of occupational diseases. The examinations of aptitude at the time of engagement and in periodical controls, help to clarify the fitness for certain dangerous occupations and to detect potential early stages of occupational diseases.

Insurance, Accident↗
PubMed1981

[Place of occupational medicine in the Swiss health service].

Occupational medicine represents an important section of public health. It still has to be developed in Switzerland. Every physician needs basic knowledge of medicine of labour. In addition, specialists in occupational medicine must be trained and employed in enterprises and in authorities of industrial supervision. A concept is needed for training, knowledge developing and specializing in occupational medicine. For this purpose, institutes of occupational medicine must be established in all medical faculties. The government will decree the employment of occupational physicians in enterprises, according to the new accident insurance law. The industrial physician shall be integrated in the system of medical care as an imperative professional supplement, according to the new principles issued in 1981 of the association of Swiss physicians.

National Health Programs↗
PubMed1981

[Conisation and pregnancy (author's transl)].

Reference is made to experience obtained from specialised outpatient practice in an account of diagnostic and therapeutic approach to pregnant women with pathological cervix smear. Six out of 93 pregnant women were conisised during pregnancy and 41 after delivery. Postpartum primary vaginal hysterectomy was performed on three women with additional gynaecological indication. Strict follow-up checks were made on 43 patients, among them three with residual dysplasia who had undergone conisation prior to conception. Differentiated approach, which is of great practical importance, in particular to high-risk pregnancy, has proved to be possible by specialised diagnosis, with colposcopy, differential cytological testing, and microbiopsy being included. Postponement of conisation to a date after delivery or after achievement of the desired family size can be justified under the condition of regular follow-up checks for women with intra-epithelial cervical neoplasia, on account of the latter's long latency. However, immediate therapeutic action, even within pregnancy, must be the response to any indication to invasive growth.

Adolescent↗
PubMed1980

[Health hazards caused by wood in Switzerland].

The clinical signs and symptoms of health hazards caused by wood are discussed together with their etiology and pathogenesis. 165 such cases were reported to the SUVA (Swiss Accident Insurance Association) up to the end of 1978. Disorders were most common among workers having the greatest exposure to the fine wood dust produced by tropical woods (in particular during grinding and cutting processes). 130 patients suffered from allergic contact eczema or non-allergic contact dermatitis. 35 patients suffered from respiratory tract disorders, 12 of these being classic bronchial asthma. Reference is made to the literature which points to the sharply increased incidence of adenocarcinoma of the paranasal sinus after long-term exposure to wood dust.

Asthma↗
PubMed1979

Long-term observation of biochemical effects of lead in human experiments.

In extension of two previous series of experiments, the results of which have been partially reported (1), further long-term tests were performed with daily oral doses of 5 mg Pb++ in 2 subjects. Lead in whole blood, free protoporphyrin 9 (III) and 5-aminolevulinate dehydratase activity in erythrocytes, hemoglobin, and urinary 5-aminolevulinic acid and coproporphyrin III excretion values were measured. From experiences with 8 human experiments, three compartmental phases of early detectable lead effect were postulated: 1. an "erythrocytic" reaction of 5-aminolevulinate dehydratase activity, 2. "hepatic" reactions of 5-aminolevulinic acid and coproporphyrin, and 3. an "erythropoietic" reaction of protoporphyrin.

Adult↗