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Biomedical subjects

J Heinrich

Publications and source records attributed to J Heinrich.

At least 145 records · Page 8Linked to original sources
PubMed1998

Pulmonary function in children with initial low birth weight.

The objective of this analysis was to examine the effect of low birth weight and prematurity on bronchial air-flow, bronchial reactivity, airway symptoms and asthma diagnosis at school age. A cross-sectional epidemiological study was performed in three small towns in the eastern part of Germany on 2470 school children aged 5-14 (89.1% of eligible children). A 78 item questionnaire to determine risk factors at birth and in early childhood was employed. 7.8% of the children were born before completing 38 gestational weeks; 6.6% had a birth weight less than 2500 g. Pulmonary function analysis were done by a mobile plethysmography at the school. There were only weak restrictions in lung volume in term low birth weight (LBW) children (100 ml lower TLC, p = 0.107), and flow (257 ml lower PEFR, p = 0.108), were low. However, bronchial hyper-responsiveness indicated by 292 ml lower FEV1.0 after cold air bronchial provocation, was significantly increased compared to term normal birth weight children (p < 0.001). The effect of LBW was less in older children, only slightly stronger in girls and increased in children mechanically ventilated during the postnatal period. Correspondingly, there was a higher prevalence of diagnosed asthma in term LBW children (OR 1.6, 95%-confidence interval 1.0-2.6), however these were without an increased risk for any allergic sensitization. LBW, therefore, seems to be a risk factor for smaller lungs and hyperreactive airways primarily in term born children, whereas in preterm children the immature bronchial system seems to be recover by school age.

Adolescent↗
PubMed1998

Relationship between plasma viscosity and the severity of coronary heart disease.

Several studies have indicated that plasma viscosity contributes to cardiovascular risk in men. So far, a significant relationship between plasma viscosity and the severity of coronary heart disease has not been found. Thus, the present study is the first to report on the relationship of plasma viscosity and the severity of coronary heart disease. In a collective of 1142 male myocardial infarction patients, plasma viscosity and additional laboratory parameters were determined. Atherosclerotic changes were quantified by coronary angiography. Patients were divided into groups without any, and with one to three stenosed vessels. We found a positive relationship between plasma viscosity and the severity of coronary heart disease, even after adjusting groups for age, fibrinogen, and use of diuretics. Mean plasma viscosity ranged from 1.141+/-0.035 mPa s in patients without stenosed vessels to 1.162+/-0.044 mPa s in patients who had three coronary vessels with stenoses >50%. Differences between the groups were significant (P<0.001 to 0.05), with two exceptions: differences between patients without any and with one stenosed vessel, as well as between patients with one and two stenosed vessels, did not reach the significance level. On the whole, we can give further support to the hypothesis that cardiovascular risk factors and coronary heart disease may be linked by plasma viscosity.

Blood Viscosity↗
PubMed1998

Atopy in children and parental social class.

OBJECTIVES: This analysis was conducted to determine whether atopic disorders were related to social class in a pediatric population of a former socialist country. METHODS: A cross-sectional study of 2471 schoolchildren was carried out in 1992 and 1993 in 3 towns in the former East Germany. Parents completed a standardized questionnaire regarding health events and lifestyle factors. In addition, skin-prick tests were performed and total serum immunoglobulin (IgE) was determined. RESULTS: Lifetime prevalence rates for atopic disease and rates of allergic sensitization were highest in children from social class III (in which parents had more than 10 years of formal education) and lowest in social class I (less than 10 years of parental education), while rates in social class II (10 years of parental education) were constant at an intermediate level. CONCLUSIONS: The data confirmed the assumption that in formerly socialist countries social inequalities existed under the socialist system, which were reflected by a social gradient in health outcomes. The findings support the hypothesis that increased access to modern lifestyle could be one reason for the increasing rates of atopic disorders during the last 3 decades.

Adolescent↗
PubMed1998

[Housing conditions and allergic sensitization in children].

Genetic predisposition and indoor exposure to allergens-especially during the very early childhood years are major factors for the development of allergic diseases later in life. The present study analyzed the association between allergic sensitization in children aged 5 to 14 years and residing since birth in homes of different building types. A cross-sectional study of 811 children aged 5 to 14 years who resided in the same home since birth investigated indoor factors using a questionnaire and allergic sensitization assessed by skin prick test. The prevalence of allergic sensitization was compared between children who lived since birth in five different building types. After adjustment for age, gender, parental education and study area the odds of allergic sensitization were higher among children who lived in prefabricated concrete slab buildings built after 1970 (OR 1.56, 95% CI: 1.02-2.38) and among children who lived in new brick buildings (OR 1.75, 95% CI: 0.88-3.47) than among children who lived in old brick buildings. Moreover, the odds of pollen sensitization was higher among children who lived in the new building types (prefabricated slab buildings: OR 1.68, 95% CI: 1.04-2.72; new brick buildings: OR 1.48, 95% CI: 0.64-3.42) while living in timber-framed houses was associated with a higher odds of sensitization against mites (OR 1.63, 95% CI: 0.77-3.44). The step by step inclusion of single indoor factors like type of heating, numbers of building storeys, number of persons per room, environmental tobacco smoke, use of gas for cooking purposes, dampness of the home or visible moulds in the logistic regression model only marginally changed the odds ratios. Modern living conditions are associated with a higher odds of allergic sensitization.

Adolescent↗
PubMed1998

[Screening for cervix carcinoma--a retrospective comparison between new and established federal German states].

OBJECTIVE: There is no doubt about the effect of cytological screening programmes on the reduction of incident cases with invasive cervical carcinoma. The question is, to what extent this reduction was caused by cytological screening exclusively. A retrospective analysis of the former East German cytological mass screening could give information of early and late screening effects and also on the efficacy. Based on data from the Saarland cancer registry, common aspects and differences between the old and new federal states of Germany can be addressed regarding incidences and mortality trends for cervical carcinoma. RESULTS: Since the sixties the incidence of CIS has increased by 625% while the incidence of invasive carcinoma has decreased by 44% in the new federal states. Since the seventies mortality due to cervical carcinoma decreased by 44%. Incidences and mortality rates of the Saarland were considerably lower than of the new federal states. CONCLUSION: This study describes noteworthy early screening effects and proves the efficacy of mass cancer screening. Changes of incidence and, particularly, mortality rates are not exclusively due to these programmes.

Cross-Sectional Studies↗
PubMed1998

[Ductal carcinoma of the male breast].

Ductal carcinoma in the breast of a 64-year-old male is reported. Diagnosis, therapy, prognosis and follow-up are discussed. Current standard therapy is ablatio mammae, with axillary lymph node dissection. A decision in respect of chemotherapy depends on the results of staging. A follow-up control of the patients for early detection and therapy of metastasis is recommended. Our data as well as recent data from literature suggest that with respect to TNM Stages in mammary carcinoma, there is no prognostic difference between men and women.

Breast Neoplasms, Male↗
PubMed1997

Serum immunoglobulin level and skin prick test response.

OBJECTIVE: The relation of viral infections and allergic diseases is inconclusive. The objective of the analysis therefore was to examine the relation between immunoglobulin levels and sensitization to common allergens as measured by the skin prick test (SPT). METHODS: In a population-based study of 2,470 children, 2,188 skin prick tests, and 2,042 blood samples could be analyzed. RESULTS: At least one positive SPT was observed in 19.2% of the children. IgA und IgG levels did not show any association with SPT response. As expected, there was a sharp increase in the two highest quartile groups of IgE (p for trend <0.0001), while the prevalence of positive SPT continuously decreased with higher IgM levels (p for trend 0.002). This effect of IgM could be seen for all allergens examined. If an upper respiratory tract infection was reported one week prior to testing, the prevalence of a positive SPT was also reduced by nearly one half, however, this association was not significant. CONCLUSIONS: Since IgM has a half-life of approximately 5 days, the inverse association found between IgM and the prevalence of positive SPT seems to be a transient effect of a prior infection.

Allergens↗
PubMed1997

The association between baseline lung function and bronchial responsiveness to methacholine.

It has been reported that females show an increased frequency of bronchial hyperresponsiveness (BHR) compared to males and that this difference is abolished after taking into account differences in baseline FEV1. The aim of our study was to analyse how the distribution of BHR in males and females depends on the definition of BHR. Special emphasis was paid to the question whether the prevalence rates of BHR according to different definitions were related to baseline characteristics of the subjects and baseline lung function in the same manner. We analysed the data obtained within the European Community Respiratory Health Survey (ECRHS) in the Eastern German population sample of Erfurt aged 20-65 years (n = 931). In logistic regression analyses of different definitions of BHR, we used as parameters age, height, gender, smoking habits, baseline forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1 as a percent of FVC (FEV1% FVC). Symptoms and reported diagnosis of asthma did not significantly depend on gender or age. When BHR was defined as the provocative dose causing a 20% fall in FEV1, BHR was more prevalent in females than in males (27.6% vs. 13.2%). Similar gender differences were found when defining BHR via a 10% fall in FEV1 or by using corresponding cut-off values of the linear dose-response slopes of the percent decline in FEV1 (DRS). Multiple linear regression analyses of various transformations of the DRS also indicated a higher degree of BHR in females. Independently of the definition chosen, however, the gender difference in the prevalence of BHR disappeared when height and FEV1 or FEV1% FVC or appropriate combinations were included in the model. The reciprocally transformed DRS showed the best resolution of the spectrum of bronchial responsiveness. These data are compatible with the hypotheses that (1) estimates of the distribution of BHR are distorted by differences in the methacholine dosage per lung size and that (2) airway geometry affects the measurement of BHR. It appears that these factors and not intrinsic differences in BHR between males and females contribute to the gender differences in the prevalence of BHR. Furthermore, our data support the superiority of the dose response slope for the analysis of bronchial responsiveness in epidemiologic surveys.

Adult↗
PubMed1997

The internal burden of lead among children in a smelter town--a small area analysis.

Hettstedt, a city in former East Germany with a history of mining and smelting of nonferrous ores, has multiple lead waste deposits and the remains of a former lead and copper-silver smelter. A small-area analysis of lead concentrations in blood and in household dust was undertaken in a cross-sectional study to determine if children living near the sources had particularly high burdens of lead. The overall geometric mean of the region was 38.0 micrograms Pb/liter blood with a 95% confidence interval (CI) of 36.5-39.5. The burden of lead among children living in the region containing the lead tailings piles and adjacent smelters was almost twice as high (77.4 micrograms Pb/liter blood; 95% CI 65.0-92.0). It decreased in the areas farther northeast from the smelter. Lead levels in the children residing in areas southwest of the smelters were not appreciably elevated. The same pattern was found in house dust lead concentrations. This analysis helped target areas where follow-up is needed and found that not only distance from lead sources, but also meteorological factors played an important role in lead exposure.

Adolescent↗
PubMed1997

[Results of a dietary survey in adults in Erfurt in 1991/92: nutritional intake].

A dietary survey using weighted 3-day-records was carried out in the sample of the third MONICA risk-factor survey in the Thuringian city of Erfurt (eastern Germany) in 1991/92. The aim was to collect detailed intake data in a defined population after the first phase of consolidation on the food market after the German reunification. The dietary sample consisted of 1,118 men and 1,179 women aged 20-64 years; we received 469 acceptable records from men and 333 from women. The German national nutrient datafile BLS (version 2.1) was used to code the records and for the transformation into nutrients. Mean energy intake in men was 2,624 kcal per day, 15.3% came from protein, 40.0% from fat, 38.5% from carbohydrates and 6.0% from alcohol. Corresponding figures for women were 1,916 kcal per day, 15.8%, 40.5%, 41.5% and 2.1%. Only a small percentage of participants achieved the recommendations of the German Society for Nutrition for the intake of selected nutrients.

Adult↗
PubMed1997

[Results of a dietary survey in adults in Erfurt 1991/92: food and supplement intake].

A dietary survey using 3-day weighed records was carried out in the sample of the third MONICA risk-factor-survey in the Thuringian city of Erfurt (former East Germany) in 1991/92 consisting of 1,118 men and 1,179 women aged 20-65 years. Mean daily food intake, the contribution of food groups to nutrient intake and the percentage of participants using supplements are shown here. For instance, men have a mean daily intake of meat and meat products of 199 g, delivering 20.7% of energy, 31.8% of fat and 42.7% of cholesterol. In women 18.6% of energy, 26.8% of fat and 37.2% of cholesterol origin from their mean daily intake of 130 g meat and meat products. Women in older age groups consume distinctly more meat than women in younger age groups. 0.4% of men and 2.6% of women use supplements during their three recording days.

Adult↗
PubMed1997

High serum IgE concentrations: association with HLA-DR and markers on chromosome 5q31 and chromosome 11q13.

BACKGROUND: Linkage studies mapped a locus regulating total serum IgE concentrations in a noncognate fashion to chromosome 5q31 and a locus for atopy to chromosome 11q13. In contrast, antigen-driven IgE production seems to be largely controlled by major histocompatibility complex class II genes. OBJECTIVE: We therefore analyzed the association between the phenotype of high IgE serum levels and six microsatellite markers on chromosomes 5q31 and 11q13, as well as HLA-DRB1, in a random sample of the adult East German population. METHODS: One hundred twenty-nine persons identified as "cases" (serum IgE level > 200 kU/L) and 266 control subjects (serum IgE level < or = 200 kU/L) were genotyped for five 5q31 microsatellites (D5S436, D5S393, D5S210, IL-4, and IL-9) and an 11q13 microsatellite (FCERIB). Cases and controls were also typed for HLA-DRB1. Allele frequencies were compared between cases and controls by means of a two-sided Fisher's exact test. RESULTS: None of the markers was significantly associated although a weak association to the markers within the IL-9 gene and the FCER1B gene and to the HLA-DRB1*01 allele was found when specific IgE-positive cases were compared with negative controls. CONCLUSIONS: The weak associations observed after stratification for specific IgE might point to a contribution of genes in these regions to the development of allergy.

Adult↗
PubMed1997

Trends in food intake in adults from the city of Erfurt before and after the German reunification.

Three-day weighed dietary records from two surveys conducted in independent random population samples from Erfurt (East Germany) in 1987/88 (S1) and in 1991/92 (S2) were used to analyze trends in food intake before and after the German reunification. Structured records of 281 men and 256 women from S1 and open-ended records of 353 men and 252 women from S2, all aged 25-64, were included into the comparison. Distinct changes were found for most foods. For instance, for men mean daily intake of fruit and fruit products increased from 115 to 154 g, intake of bread and baked goods decreased from 286 to 249 g and intake of meat from 91 to 77 g. Respective figures for women were 137 vs. 180 g; 209 vs. 174 g and 62 vs. 53 g. Surprisingly similar changes in eating habits were observed with men and women. The majority of changes could be explained by the improved variety in food supply after the reunification.

Adult↗
PubMed1997

Coagulation factor VII and the risk of coronary heart disease in healthy men.

Numerous investigations have demonstrated the role of thrombus formation in the pathogenesis of coronary heart disease (CHD). A tendency to thrombosis may also be indicated by elevated levels of coagulation factor VII clotting activity (FVIIc). Significant associations of FVIIc with increased coronary risk, however, have been found only in the Northwick Park Heart Study. Here we present the results of the 8-year follow-up of FVIIc measurements in 2780 healthy men of the Prospective Cardiovascular Münster study. In the study population (age at entry, 49.3 +/- 6.1 years, mean +/- SD), 130 CHD events occurred during follow-up. FVIIc was significantly higher in subjects with coronary events than in those without (112.4 +/- 20.1% vs 108.7 +/- 21.4%, P = .023). Compared with individuals without coronary events, FVIIc was not significantly higher in men with nonfatal events (111.7 +/- 20.4%; P = .196, n = 93), but there was a tendency toward higher FVIIc activity in subjects with fatal events (114.6 +/- 19.5%; P = .076, n = 37). In the multiple logistic regression analysis, we did not find FVIIc to be an independent risk factor for CHD, and the significance of FVIIc disappeared after total cholesterol, LDL-cholesterol, and triglycerides were taken into account. The increase in the number of CHD events through higher levels of FVIIc was more pronounced in the presence of additional cardiovascular risk factors: smoking; myocardial infarction events in family; angina pectoris; high levels of fibrinogen, total cholesterol, LDL cholesterol, and triglycerides; and a low level of HDL cholesterol. We conclude that FVIIc is a risk factor for CHD, especially in the presence of additional risk factors, and must be taken into account when assessing cardiovascular risk in men.

Adult↗
PubMed1997

Respiratory effects are associated with the number of ultrafine particles.

The association between fine and ultrafine particles and respiratory health was studied in adults with a history of asthma in Erfurt, Eastern Germany. Twenty-seven nonsmoking asthmatics recorded their peak expiratory flow (PEF) and respiratory symptoms daily. The size distribution of ambient particles in the range of 0.01 to 2.5 microm was determined with an aerosol spectrometer during the winter season 1991-1992. Most of the particles (73%) were in the ultrafine fraction (smaller than 0.1 microm in diameter), whereas most of the mass (82%) was attributable to particles in the size range of 0.1 to 0.5 microm. Because these two fractions did not have similar time courses (correlation coefficient r = 0.51), a comparison of their health effects was possible. Both fractions were associated with a decrease of PEF and an increase in cough and feeling ill during the day. Health effects of the 5-d mean of the number of ultrafine particles were larger than those of the mass of the fine particles. In addition, the effects of the number of the ultrafine particles on PEF were stronger than those of particulate matter smaller than 10 microm (PM10). Therefore, the present study suggests that the size distribution of ambient particles helps to elucidate the properties of ambient aerosols responsible for health effects.

Air Pollutants↗
PubMed1997

Medication use modifies the health effects of particulate sulfate air pollution in children with asthma.

Previous controlled studies have indicated that asthma medication modifies the adverse effects of sulfur dioxide (SO2) on lung function and asthma symptoms. The present report analyzed the role of medication use in a panel study of children with mild asthma. Children from Sokolov (n = 82) recorded daily peak expiratory flow (PEF) measurements, symptoms, and medication use in a diary. Linear and logistic regression analyses estimated the impact of concentrations of sulfate particles with diameters less than 2.5 microns, adjusting for linear trend, mean temperature, weekend (versus weekday), and prevalence of fever in the sample. Fifty-one children took no asthma medication, and only 31 were current medication users. Most children were treated with theophylline; only nine used sprays containing beta-agonist. For the nonmedicated children, weak associations between a 5-day mean of sulfates and respiratory symptoms were observed. Medicated children, in contrast, increased their beta-agonist use in direct association with an increase in 5-day mean of sulfates, but medication use did not prevent decreases in PEF and increases in the prevalence of cough attributable to particulate air pollution. Medication use was not a confounder but attenuated the associations between particulate air pollution and health outcomes.

Adolescent↗