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Biomedical subjects

M Kunze

Publications and source records attributed to M Kunze.

At least 19 recordsLinked to original sources
PubMed1998

Nicotine replacement: a new approach to reducing tobacco-related harm.

Primary prevention is usually regarded as the most desirable goal in efforts to control tobacco-related diseases. However, this has not been very effective so far; moreover, it would take 30-40 yrs for primary prevention to translate into major health benefits. Modification of tobacco products and/or reduction of tobacco use may also have some impact on tobacco-related diseases. A tobacco dose-dependent risk has been observed in these diseases, including cancer, cardiovascular diseases, chronic nonspecific respiratory disorders, and problems during pregnancy. Reduced smoking (smoking fewer cigarettes, leading to a reduced intake of toxic substances) may be indicated in individuals who: 1) are failing in cessation attempts; 2) want to quit but are unable to do so; and 3) do not want to quit but want to reduce smoking. Studies have shown that nicotine replacement medications may be an untapped source in efforts to reduce smoking. Based on Austrian data, it is estimated that, approximately 10 yrs after implementation, a 1% reduction in smoking could save 14 male lung cancer deaths each year, and a 50% reduction would save 700 male lives. Inclusion of females and other tobacco-related diseases suggest that thousands of lives could be saved if smoking could be reduced by 50%. In the European Union, such a reduction in smoking could save > or = 100,000 lives annually. Even a 1% reduction would save 1,000 lives. In conclusion, reduced smoking should be explored as a valid method of reducing tobacco-related harm in those unwilling or unable to quit smoking.

Gingiva↗
PubMed1998

Impact of nasal continuous positive airway pressure treatment on quality of life in patients with obstructive sleep apnoea.

Quality-of-life (QoL) issues have become increasingly important in health care practice and research. Obstructive sleep apnoea syndrome (OSAS) results in an especially serious reduction in QoL. The purpose of this study was to measure the QoL (life satisfaction) of OSAS patients treated with nasal continuous positive airway pressure (nCPAP). We aimed to determine whether and to what extent the QoL of OSAS patients using nCPAP differs from that of randomly selected subjects without this disorder. The QoL of 67 patients treated for at least 3 months with nCPAP, 21 OSAS patients at the time of OSAS diagnosis, and 113 randomly selected persons visiting the hospital (controls) was investigated with the help of the Munich life-quality dimension list (MLDL), an instrument for cognitive assessment of elementary components (physical condition, psyche, social life, everyday life) of QoL. It was found that QoL of OSAS patients treated with nCPAP did not significantly differ from that of control subjects with regard to elementary components. The 21 untreated OSAS patients showed significantly lower scores in all four subcategories: physical condition (p<0.0005), psyche (p<0.01), social life (p<0.0005) and everyday life (p<0.007). Thus, it may be concluded that nasal continuous positive airway pressure therapy has an important impact on the quality of life of obstructive sleep apnoea syndrome patients, and signifies a further advantage in addition to clinical aspects. Treated patients are as satisfied or dissatisfied with their life as persons without this illness.

Female↗
PubMed1998

[Vienna standard in diagnosis of nicotine dependence: Vienna Standard Smoking Inventory].

The Standard Vienna Smokers' Inventory (VSSI) ("Wiener Standard Raucher-Inventar" [WSR]) is based on the authors' experience and was designed to optimize primary and additional diagnostic procedures associated with smoking cessation treatment. The aim of this inventory is to enable therapists interested in smoking cessation interventions to initiate diagnostic procedures as well as to use efficient therapeutic modalities. The study also highlights those areas of the patient's history which should be given special attention and the theoretical background of these areas. The various comprehensive sections of the WSR include general data pertaining to the patient's life, the basic situation (basic rate), especially with regard to nicotine dependence, pre-abstinence syndrome and "tar" exposition values, follow-up of smoking habits, earlier attempts to give up smoking, and possible barriers to cessation of smoking--such as insufficient motivation, "nocturnal sleep disturbing nicotine craving" or carbohydrate dependence. Furthermore, previous illnesses, pre-existing risk factors and regular intake of drugs are also discussed. Finally, the study emphasizes that the WSR should be used by the therapist according to his/her level of training and experience, thus providing the possibility to use specific, individual approaches to deal with specific individuals and situations.

Adult↗
PubMed1998

[The contribution of social medicine to vaccination in Austria].

We mostly deal here with socio-medical aspects of vaccinations. Various initiatives are summed up that are intended to optimize the system of immunization by vaccines and to establish certain innovative, and also internationally remarkable approaches. In spite of the undoubted successes of vaccinations in Austria, there still are some major deficits that should be eliminated. The Austrian system of immunization by vaccines has been mainly concentrating on continuously adapting its vaccination schedules. Such modifications are based on current scientific knowledge and thus dynamic in nature whereas the public health system necessarily relies on commonly established and easily adoptable requirements. This discrepancy has brought about a certain degree of uncertainty in some instances.--(See K. Spork, I. Mutz: "Recommendations for Vaccination in Childhood and for Adults".) By further developing immunization programs into a general concept of immunization by vaccines we should be able to put the potential benefits of preventive medical care better into effect than before because such a concept based on clearly defined public health objectives provides strategic and tactical measures and, what is even more important, also includes evaluation.--(See Vutuc, Kunze: "Epidemiology as Background for Vaccinations".) In this connection it has also been necessary to develop various activities in the field of social marketing, examples of which will be mentioned in this issue. There is mainly one recurring source of dispute that must be discussed here, the question of what is immunization of the public at large and what is immunization to be recommended for certain groups (so called risk groups). It has to be principally noted that the idea of risk group immunization has not been too effective in many areas. A typical example for such a project that has to be reconsidered is the active immunization against Central European Encephalitis (CEE) or Tick Bone Encephalitis (TBE).--(See U. Kunze. G. Böhm: "Epidemiology of TBE and Consequences for Further Control Measures Including Vaccination"). Similar considerations also apply to active immunization against influenza or pneumococcal diseases.--(See Süss et al.: "Project 'Vaccinating Hospital Patients' in Upper Austria--Technical Report". Steger, Maczek, Berger. Grubeck-Loebenstein: "Immunizing Against Tetanus in the Elderly: How Long Does Protection Last?") So far, the basic question has been: "Who shall be vaccinated?". Very detailed recommendations have been worked out for that purpose, and some have led to highly complex definitions of which groups should be protected by a particular vaccine. For the future, we will have to reconsider if this question should not be asked the other way round, that is: "Who should not receive a certain vaccination?", based on the hypothesis that this approach may simplify many decision making processes. This would also guarantee optimal information for different target groups in the public health care system but mostly for the general public. Public health care officials and the general public alike have been much concerned with reactions and aversive reactions and side effects. We have to mention that this subject has been the topic of political debates on health, and that single interest groups, even though we must presume in the best of beliefs, have contributed to quite upsetting the public. Without doubt, the Australian health care system still has deficits in organization and substance which to some extent stem from these highly unobjective discussions. It must not be denied, however, that the system of medical care too has not always responded in an optimal way. As a consequence, public health research has been done on background-morbidity which is absolutely essential for scientific discussion. The name of the study, SERMO, is an abbreviation of the term "self-reported-morbidity"; another source for this name is the latin expression "sermo, sermonis".

Adolescent↗
PubMed1998

Self-reported prevalence of venous diseases in the general population of Austria--results of the SERMO (Self-Reported Morbidity) Study.

Venous diseases are common in Western societies, their causes, however, have remained largely unknown. The prevalence of venous diseases in the general population of Austria was assessed, and information on the background morbidity of venous diseases obtained from the data base of the SERMO study (Self-Reported Morbidity Study). The SERMO study consists of 9 representative population surveys conducted between December 1994 and December 1995; the study aimed at describing and monitoring the characteristics of background morbidity in the Austrian population. 5.9% of the sample reported to suffer from venous diseases (vein varicosis, phlebitis, vein thrombosis) in 1995; the point prevalence was 4.1%. The prevalence rate of chronic vascular disorders of the lower extremities was 5.9%. The prevalence of venous diseases is much higher among women than men. Advanced age is as much a risk factor for venous diseases as is low education. This study has shown that persons suffering from venous diseases, especially those advanced in age, suffer more often from concomitant diseases and disorders than others. In addition to clinical and mortality data, self-reported morbidity data provide important information on the health of a general population. Persons above 60 years of age are expected to constitute one third of the entire Austrian population by the year 2030. With this anticipated demographic development in view, the need for long-term prevention plans of chronic venous diseases appears to be of particular importance.

Adolescent↗
PubMed1997

[Health monitor (SERMO study)--concept, methodology and a paradigmatic result on subjective morbidity in headache].

In Austria, microcensus surveys on self-reported morbidity are carried out at regular intervals every ten years, generally by the Federal Statistic Centre. In the following, we describe an epidemiological observational service which could be regarded as an additional public health instrument. This service is termed "health monitor", and the SERMO (self-reported morbidity) study is the scientific project associated with it. The "health monitor" data provide information on the prevalence of various illnesses and impairment, characteristics and variables of background morbidity by repeated short-term representative surveys on self-reported morbidity. The health monitor permits continual observation of the background morbidity of an entire population, while scientific questions pertaining to the SERMO study can be investigated via the health monitor data base. Self-reported morbidity data provide important information about the health of a general population, in addition to clinical and mortality data, and help to make decisions in health policy. By collecting informations (e.g. nearly every month) on background morbidity, "health monitor" and SERMO project could complement other Austrian public health systems to measure the overall health of the population in general.

Adolescent↗
PubMed1997

[Cancer preventive value of natural, non-nutritive food constituents].

Numerous epidemiologic studies have shown that a diet rich in vegetables, fruits and fiber is associated with a decreased risk of cancer, particularly of epithelial tumors. Especially this association is evident for various citrus fruits, carrots, leafy green vegetables, as well as cruciferous-(sorts of cabbage, broccoli) and leak vegetables (garlic, onions, etc.). In the course of investigation of the protective mechanisms exerted by vegetable foodstuffs, a great number of secondary plant products such as carotenoids, sulfides, glucosinolates, plant sterols saponins, terpens, phytoestrogens, flavones, protease inhibitors, or phenolic acids, which are substantial constituents of our daily food, have changed their meaning from a non-nutritive constituent to a probably cancer preventive biological-active substance. But also fermentable, soluble fibers and substances in fermented foods can exert protective effects on development of cancer. Mostly the anticarcinogenic action of biological-active substances is limited to an early stage of carcinogenesis. Therefore it seems to be important to start prevention of cancer by nutrition as early as possible and adhere to it over a long period.

Animals↗
PubMed1997

[Prevalence and significance of carbohydrate craving in Austria].

Among disorders of appetite and eating frequent craving of carbohydrate containing snacks between meals is well known. Excessive carbohydrate consumption causes increased caloric intake and may lead to overweight and risks of obesity regarding metabolism and vascular remodelling. Up to now prevalence and consequences of that disorder have never been studied in the Austrian population. Hence we investigated by questionnaires and interviews eating habits in samples of 1058 women and 942 men of the Austrian population. Evaluation showed that carbohydrate craving is a more or less serious problem for about 30% of Austrians. Women, especially those with overweight, were affected more frequently than men. In the whole population sample investigated there was a seasonal variation with a tendency to increased carbohydrate craving in fall and winter. This was, however, not significant for overweight women, they probably eat their snacks over the whole year. A subgroup of males reported craving of snacks containing sausage or meat instead of carbohydrate. Craving of carbohydrate is considered the consequence of a decrease of serotonin in appetite regulating neurons and centers of the brain. Treatment of craving by drugs inhibiting the re-uptake of serotonin into afferant neurons is discussed. Medication of this type is, however, hampered by cardiovascular side effects observed with fenfluramines.

Adolescent↗
PubMed1996

Nicotine dependence versus smoking prevalence: comparisons among countries and categories of smokers.

OBJECTIVES: To collect available international data on nicotine dependence as defined by the Fagerström Test of Nicotine Dependence, and to compare levels of dependence among countries and categories of smokers. DATA SOURCES: Published and unpublished studies known to the authors and a search of EMBASE from 1985-1995. STUDY SELECTION: Studies included were those based on a nationally representative sample of a country's population, or a sample of smokers seeking cessation assistance. DATA SYNTHESIS: Smokers who seek help in stopping smoking are much more dependent than the average smoker. Men consistently score higher on dependence than women. Ex-smokers appear to have lower dependence than current smokers. A country with low smoking prevalence, the United States, seems to have smokers with higher dependence scores than countries where smoking is more prevalent (such as Austria and Poland). CONCLUSIONS: Successful tobacco control may result in a higher dependence among the remaining smokers (due to selective quitting by low-dependent smokers). The remaining highly dependent smokers may need more intensive treatment.

Culture↗
PubMed1995

[Cellular immunodeficiency (including AIDS): incidence and length of stay of hospitalized cases in Austria in 1990].

The incidence of cellular immunodeficiency (including AIDS), treated at hospitals in Austria in the year 1990, was 3.8 per 100,000 (n = 294, males 6.3 per 100,000, females 1.5 per 100,000). On the average every patient with this diagnosis was admitted to the hospital 3.6 times per year. The average hospitalization time was 7.5 days, summing up to a mean of 27.3 days of stay per case per year. A total of 8031 days was necessary for the hospital care of these patients, costing AS 86873 for care per person in 1990 (AS 3,180 per day in the hospital). In relation to the grand total of approximately 1.8 million admissions to Austrian hospitals, patients with the diagnosis "cellular immunodeficiency (including AIDS)" cover only 0.06% of all admission and 0.03% of patient days per year respectively.

Acquired Immunodeficiency Syndrome↗
PubMed1995

[Social medicine aspects of pre- and postmenopause].

Due to the increasing life expectancy most women nowadays suffer from menopausal problems. These include not only menopausal symptoms, but also osteoporosis and atherosclerosis. Hormone replacement therapy therefore is a measure for keeping physiological standards. It has both preventive and therapeutic importance, for the individual as well as for the public. Menopause Management is a task for lifestyle medicine, as a combination of pharmaceutical treatment and lifestyle changes. The women and physicians are working in a menopause managing team, and prevention and treatment of diseases and disorders are not separated.

Adult↗
PubMed1995

[Haemophilus influenzae meningitis in Austria: 1990-1992 incidence].

The incidence of Haemophilus influenzae meningitis in children aged less than 5 years in Austria was 9.5/10(5) (n = 42) in the year 1990, 12.4/10(5) (n = 56) in 1991 and 10.4/10(5) (n = 48) in 1992. In each of the other 5-year age groups the incidence was lower than 1/10(5). In 1992 Hib vaccine was registered and recommended for children below 5 years of age. So far no impact of immunisation has been observed on the incidence of meningitis. A new strategy must be found to improve the implementation of immunisation.

Adolescent↗