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P Degens

Publications and source records attributed to P Degens.

8 recordsLinked to original sources
PubMed1999

Comparison of lung-function reference values.

OBJECTIVE: Lung-function reference values play an important role in medical surveillance examinations of occupational and environmental respiratory diseases, in stipulation of preventive measures, in initiation of therapeutic measures, and in granting of benefits to which individuals with lung injuries or occupational lung diseases are entitled (e.g., bronchial asthma, pneumoconiosis, or farmer's lung disease). Prediction equations most widely used are based on studies performed more than 20 years ago and may not represent the findings obtained in today's population. METHODS: We recorded case histories and lung function values of 139 healthy subjects (spirometric and plethysmographic data, T(LCO)) and computed the differences of measured values minus predicted ones as recommended by different authors. RESULTS: The means of these differences can be seen as shifts in our group versus the theoretical (predicted) values of various authors. These shifts, the standardized mean values of residuals, and their probability as determined under the assumptions of the respective regression model and the number of subjects below the threshold limits are given. FVC, FEV1, and FEV1%FVC show mostly good agreement with the recommendations by Crapo et al., Roca et al., Glindmeyer et al., Brändli et al., and Berger et al. Our IVC and FVC values do not differ significantly from each other. Normative flow-volume curve parameters of various authors deviate widely, however, and are not compatible with the values of our control group. Plethysmographically measured volumes (FRC, TLC, and RV) are only insufficiently reflected by Quanjer's reference equations. Measured T(LCO) and K(CO) show good agreement with the predictions of Cotes et al. [11] for females but display less concurrence with the predictions for males. CONCLUSIONS: Our results indicate that the ERS values of FVC, FEV1, and FEV1%FVC mainly applied in Europe should be verified. The much better-evaluated formulas of Brändli et al. are recommended. Furthermore, the age range between 60 and 70 years should be extrapolated from these formulas until better epidemiological data on lung function are available.

Adolescent↗
PubMed1998

Occupational obstructive airway diseases in Germany.

In industrialized countries, occupational asthma caused by allergens and irritants due to workplace exposure is increasing. More than 8,000 such claims were made in Germany (10.5% of all decided occupational disease claims) in 1995; 1,900 were confirmed (6.5% of all confirmed claims). The legal basis and the occupational disease-related regulations of trade-assigned statutory accident insurance institutions ('Berufsgenossenschaften') in Germany are described. Hitherto, three occupational disease categories for obstructive airway disorders existed: due to sensitizing agents, due to chemical-irritative or toxic agents, and due to isocyanates. Approximately 40% of accepted claims for occupational asthma and rhinitis result from exposure to flour. Ongoing changes in the recognition of work-related airway disease symptoms account for differences in the incidence and prevalence as reported over the years. Recently, chronic obstructive bronchitis and/or emphysema of hard coal miners have been included in the German list of occupational diseases.

Germany↗
PubMed1997

Protein and allergen content of various natural latex articles.

Proteins remaining in products made of natural rubber latex are potential sensitizers. In the present work, we quantified the releasable protein and allergen contents in 37 brands of latex gloves and 26 other latex products. Our results demonstrate the presence of widely varied protein and allergen contents in various latex articles and the lack of a correlation between the protein and allergen values. These findings may assist hospital management and medical staff to take effective preventive measures.

Allergens↗
PubMed1996

Lung function testing: the dilemma of predicted values in relation to the individual variability.

Quantitated lung function parameters are usually interpreted in relation to so-called "normal ranges' obtained from healthy study groups. The aim of this paper is the critical review of formulas and the evaluation of intraindividual variation in modern lung function testing. To which extent is the total variation of lung function parameters in cross-sectional studies (usually serving as basis for the normal range) attributed to the intraindividual variation between repeated measurements? This question raises a further question: are lung function values in the normal range really normal? To assess spirometric and body plethysmographic parameters 26 healthy subjects from three medical centers underwent 30-72 measurements over a period of 2 months for the determination of variations due to (1) intraindividual variation over time and (2) interindividual variation. For each subject, predicted values of different lung function parameters published by Quanjer et al. [Eur Respir J 1993; 6:5-40.1], of intrathoracic gas volume by Ulmer et al. [Die Lungenfunktion; Stuttgart, Thieme, 1991] and of total airway resistance by Ruehle and Matthys [Pneumologie 1976;153:223] were applied. When converted into percent predicted and adjusted for differences in medical centers, the intraindividual standard deviation was estimated to be about half of the interindividual standard deviation. We conclude that the normal range of lung function parameters derived from the standard deviation within populations is too wide for the assessment of individual values. Interpretation of individual lung function measurements should primarily be based on the "individual normal range' derived from former lung function measurements of the individual and only secondly on the "predicted value'.

Adult↗
PubMed1996

Systemic sclerosis in German uranium miners under special consideration of autoantibody subsets and HLA class II alleles.

Systemic sclerosis (scleroderma) is a connective tissue disease with a wide range of clinical manifestations, with high or low degrees of skin and internal organ involvement together with different antinuclear antibody (ANA) specificities. Several studies provide evidence that males, who are rarely affected by systemic sclerosis, have an increased risk when working in mines. Therefore we reinvestigated 21 male subjects and 6 cases of deceased male patients who had been engaged in East German uranium mines and had shown evidence of this disease in medical examinations. Dermatological investigations, evaluation of chest X-rays and autoantibody estimation were performed. PCR-sequence-specific oligonucleotide typing was used to study the genetic association of HLA-D alleles with autoantibodies typical for scleroderma in these uranium miners suffering from systemic sclerosis and in patients with idiopathic systemic sclerosis. The determined HLA phenotype frequencies and the following statistical analysis (Fisher's exact test (2-sided)) revealed that in comparison with randomly selected controls, alleles DRB1*0300 (DR3) and DQB1*0201 (DQ2) were distinctly increased in the group of affected uranium miners, especially in those with anti-Scl-70 positivity. In contrast, we did not observe significant differences between affected and unaffected miners. Comparing anti-Scl-70-positive affected uranium miners with anti-Scl-70-positive idiopathic systemic sclerosis cases. DRB1*0300 as well as DQB1*0201 were also significantly enhanced in the former group. ACA-positive systemic sclerosis miners had significantly elevated frequencies in DRB1*0100 (DR1) and DRB1*0800 (DR8) only in comparison with unaffected miners and unexposed controls. Our genetic and immunological data lead to the assumption that a different set of HLA-D alleles in combination with exogenous factors is involved in the induction of anti-Scl-70 antibodies in uranium miners that might influence their susceptibility to the disease, whereas the same occupational exposure seems to have no influence on the induction of ACA antibodies.

Adult↗
PubMed1995

[Pilot project for evaluation of lung function reference values].

Lung function tests were performed in this study on 139 adults (mean age 36 years), as well as on 91 female persons between 16 and 18 years of age (the latter just starting on their professional careers), the lungs being healthy in each case in both groups. The findings were compared with the currently accepted reference value formulae after Quanjer et al., and Zapletal as well as further developed reference value formulae after Brändli et al., Most of the measurement data obtained by spirometry for the BGFA group of probands are between the two recommended reference values for adults with better coincidence with Brändli's predictions (exceptions being MMEF25-75 MEF 50 and MEF 25). In our studies we obtained higher values than the reference median values after Quanjer and Zapletal for IVC, FVC, FEV1 and PEF by 6-8% and 5-15%, respectively, whereas the values for adults differ from the predictions made by Brändli et al. by -4% to +5%. The flow data MMEF 75-25, MEF 50 and especially MEF 25 are set at too low levels (by 5-23%) by Zapletal's and Brändli's values. Comparatively, the values predicted by Quanjer et al. for the above mentioned flow-volume parameters (with the exception of MEF 75) are too high by 4% to 12%. There are also considerable differences in respect of the reference values for IGV to the tune of +15% in the BGFA group compared to Quanjer et al.; in the BAFAM group the values differ from those of Zapletal et al. by +17%. RV yields results in the BGFA group which are higher by 11% than according to Quanjer's formulae, whereas in the BAFAM group they are higher by 15% compared to Zapletal's predictions. In respect of Rt there are differences to the predictions by Rühle and Matthys by +16% (BGFA group) and +13% (BAFAM group), respectively. The BAFAM group differs from Zapletal's predictions by +11%. Looking at the reference limit values the overall impression is confirmed that the predictions after Quanjer et al. and mostly also those by Zapletal are too low in respect of the abovementioned lung function parameters (in the majority of cases not 5% of the examined probands, as expected, are below those levels, but only about 2%). Females, who had been underrepresented in the previous healthy proband groups, show larger deviations than males in respect of most of the parameters.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1992

A 3-year cohort study on short-term effects of air pollution in Germany. 1. Influences of medication and season.

A 3-year cohort study which started in September 1987 investigates the effect of air pollution in adult patients with chronic obstructive airway disease. Of 108 patients recruited during the pilot phase in 1987 only eight patients had left the study prematurely. The most important components of the study are the daily peakflow measurements and a diary on medication and symptoms. In a preliminary analysis the influence of medication and season has been analyzed for the period September 1988 to June 1989 for 53 patients. In general, the reactions to seasonal changes were small. However, a significant decrease in peak-flow values by about 5% was found for the months of May and June compared to December for patients with chronic bronchitis, emphysema and asthma.

Aged↗