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Biomedical subjects

R Hornung

Publications and source records attributed to R Hornung.

At least 55 records · Page 3Linked to original sources
PubMed1994

[The so-called "minor hand injury" and its socioeconomic sequelae].

A study was carried out involving 167 patients who had received primary treatment in alio loco for injuries diagnosed as 'minor cuts, twists and sprain', and who were then seen in the out-patient department at a later date. The patient group was analyzed with regard to the following: a more precise identification of the initial injury, the initiated treatment regimen and more particularly, the socio-economic consequences of the injury. Duration of treatment programmes, loss of working days and compensatory payments were cost-analyzed. The results showed that a delayed primary surgical intervention was possible in only 17% of cases, it was necessary to alter the treatment regimen in 29% and in 28% it was no longer realistic even to initiate treatment. Comparisons between this population and a group of a patients who had received adequate primary care showed that in the study group length of treatment and days lost at work was prolonged by the factor 1.3; furthermore the number of cases in which the reduction of working ability was 20% and more was increased by 2.7. Increased costs incurred by financial compensations were approx. DM 27,000/patient.

Absenteeism↗
PubMed1993

Exposure-response analysis of cancer mortality in a cohort of workers exposed to ethylene oxide.

The authors previously reported results from the largest cohort mortality study of ethylene oxide-exposed workers that has been conducted to date. Here they extend their previous work by quantitatively examining the relation between cancer mortality and ethylene oxide exposure. This study included workers from 13 of the 14 geographically distinct facilities that were included in the previous investigation. These facilities began regularly using ethylene oxide to sterilize medical supplies or spices sometime between 1938 and 1969. Workers were followed from first exposure through December 31, 1987. Historical exposures to ethylene oxide were estimated using a regression model. Standard life-table analysis was used to examine cancer mortality in three categories of cumulative exposure to ethylene oxide. The Cox proportional hazards model was also used to examine cumulative and other measures of ethylene oxide exposure as predictors of cancer mortality. In both the life-table analysis and the Cox model, a positive trend was observed in all lymphatic and hematopoietic cancer mortality for cumulative ethylene oxide exposure. This trend was strengthened when ethylene oxide exposures 10 years prior to death were discounted (lagged) and when the analysis was restricted to neoplasms of lymphoid cell origin. Despite limitations discussed in this paper, the authors believe that these findings provide some support for the hypothesis that exposure to ethylene oxide increases the risk of mortality from lymphatic and hematopoietic neoplasms. The authors intend to continue follow-up of this relatively young cohort, which may allow more definitive conclusions to be drawn in the future.

Cohort Studies↗
PubMed1993

[Evaluation of visual field defects, motility disorders and diplopia within the scope of accident insurance law].

Visual Field: The determination of the level of compensation for loss of integrity is based on the Goldmann Perimetry. In case of concentric loss of the visual field the SUVA Tables 1989 are used. Hemi- and Quadrantanopsias are still evaluated according to the Rintelen Tables from 1954. No guidelines are available for the evaluation of central and paracentral skotomas. It is uncertain if automatic perimetry can be used routinely in the future for the evaluation of visual function. Motility Disorders and Diplopia: The evaluation of functional loss caused by diplopia is very difficult. Therefore a big variation of 5-30% has been determined. It is up to the specialist to evaluate the extent of the damage. In this study we looked for a correlation between the objective findings and the subjective complaints. Such a correlation could not be found so that an arbitrary classification depending on the extent of the diplopia must be recommended. This would create an analogy to the evaluation of the loss of visual acuity and visual field where no freedom is left to the judgement of the physician. Some reflections are given on the sense and benefit of the unique Swiss law concerning compensation for loss of integrity.

Diplopia↗
PubMed1991

Mortality among workers exposed to ethylene oxide.

BACKGROUND: Ethylene oxide is a sterilant gas that causes leukemia and other cancers in animals. Studies in Sweden have shown an excess of leukemia and stomach cancer in humans exposed to ethylene oxide, but other studies have generally failed to confirm these findings. METHODS: We conducted a study of mortality in 18,254 U.S. workers exposed to ethylene oxide at 14 plants producing sterilized medical supplies and spices. The subjects averaged 4.9 years of exposure to the gas and 16 years of follow-up. The exposure levels in recent years averaged 4.3 ppm (eight-hour time-weighted adjusted exposure) for sterilizer operators and 2.0 ppm for other workers. The levels in earlier years are likely to have been several times higher. Mortality in this cohort was compared with that in the general U.S. population. RESULTS: Overall there was no significant increase in mortality from any cause in the study cohort. The standardized mortality ratios (SMRs) were 0.97 for leukemia (95 percent confidence interval, 0.52 to 1.67; 13 deaths observed), 1.06 for all hematopoietic cancers (95 percent confidence interval, 0.75 to 1.47; 36 deaths), and 0.94 for stomach cancer (95 percent confidence interval, 0.45 to 1.70; 11 deaths). Analyses according to job category and according to the duration of exposure showed no excess in cancers, as compared with the rate in the general population, but there was a significant trend toward increased mortality with increasing lengths of time since the first exposure for all hematopoietic cancers. The rate of death from hematopoietic cancer (especially non-Hodgkin's lymphoma) was significantly increased among men (SMR, 1.55; 27 deaths). Mortality from leukemia in recent years (1985 through 1987) was significantly increased among men (SMR, 3.45; 5 deaths). CONCLUSIONS: For the entire cohort, there was no increase in mortality from hematopoietic cancer. There was a slight but significant increase among men, however. Among men and women combined, there was a trend toward an increased risk of death from hematopoietic cancer with increasing lengths of time since the first exposure to ethylene oxide.

Cohort Studies↗
PubMed1987

Benzene and leukemia. An epidemiologic risk assessment.

To assess quantitatively the association between benzene exposure and leukemia, we examined the mortality rate of a cohort with occupational exposure to benzene. Cumulative exposure for each cohort member was estimated from historical air-sampling data and, when no sampling data existed, from interpolation on the basis of existing data. The overall standardized mortality ratio (a measure of relative risk multiplied by 100) for leukemia was 337 (95 percent confidence interval, 154 to 641), and that for multiple myeloma was 409 (95 percent confidence interval, 110 to 1047). With stratification according to levels of cumulative exposure, the standardized mortality ratios for leukemia increased from 109 to 322, 1186, and 6637 with increases in cumulative benzene exposure from less than 40 parts per million-years (ppm-years), to 40 to 199, 200 to 399, and 400 or more, respectively. A cumulative benzene exposure of 400 ppm-years is equivalent to a mean annual exposure of 10 ppm over a 40-year working lifetime; 10 ppm is the currently enforceable standard in the United States for occupational exposure to benzene. To examine the shape of the exposure-response relation, we performed a conditional logistic-regression analysis, in which 10 controls were matched to each cohort member with leukemia. From this model, it can be calculated that protection from benzene-induced leukemia would increase exponentially with any reduction in the permissible exposure limit.

Adult↗
PubMed1987

Target cell DNA fragmentation is mediated by lymphotoxin and tumor necrosis factor.

Supernatant fluids containing lymphotoxin (LT) activity were examined for their ability to mediate the fragmentation of cellular DNA in target L929 cells in the manner observed in cytotoxic T lymphocyte mediated killing. These supernatants were able to mediate L929 target cell DNA fragmentation, requiring a time course of 48 hours. In an effort to determine whether or not LT was directly involved in mediating this activity, recombinant-derived human lymphotoxin was tested for its ability to bring about the same effect. Both recombinant-derived LT and recombinant-derived tumor necrosis factor (TNF), a factor produced by macrophages and having some activities in common with LT, were able to cause DNA fragmentation in L929 over the same time course. Electrophoretic analysis of DNA isolated from LT-treated L929 target cells revealed that it is fragmented into low molecular weight fragments in a pattern similar to that produced in DNA isolated from target cells after attack by cytotoxic T cell lethal hit.

Animals↗
PubMed1986

[Self medication with drugs in everyday complaints].

The occurrence of incidents of illness and their surmounting by the medical layman are an integral part of everyday life. Amount and importance of self-medication depend greatly on the actual health disturbance. Self-medication is above all employed against headache and minor ailments. With small restrictions of everyday activities, as was observed for headache, the concerned persons show already little symptom tolerance. About 4 persons out of 10 assume a treatment strategy using drugs.

Age Factors↗
PubMed1986

The use of regression analyses in a cohort mortality study of welders.

Using an internal nonexposed comparison group, and two types of regression analysis, we have reanalyzed the data from a cohort mortality study of 3247 welders and 5432 nonwelders who worked in Western Washington during the period 1950-1976. Previous analyses relied primarily on the standardized mortality ratio (SMR) for lung cancer as a summary statistic to estimate relative risk; welders were compared to the U.S. population, stratified by age, sex, race, and calendar time. In the present study, nonwelders from the same union were used as the reference group; an internal referent group is often preferable to the U.S. population, because it is likely to have shared similar lifestyles (e.g. smoking habits) as the exposed. Cox regression was used to estimate relative risk. In addition, the data was analyzed via logistic regression in order to compare Cox to logistic regression. A regression analysis of these data enabled us to analyze exposure as a continuous variable and simultaneously adjust for potentially confounding variables without stratification. Interactions terms could also be easily tested. The previous analysis found as SMR for lung cancer of 1.32 (p = 0.06). Cox regression with an internal comparison group yielded similar results. Issues discussed include the differences between logistic and Cox regression, the appropriate variable for time in Cox regression, and the definition of risk set in Cox regression. Finally, a newly available program is discussed which selects random samples of the risk sets used in Cox regression, in order to do a case-control analysis.

Age Factors↗
PubMed1986

Age at death and risk factors in sudden infant death syndrome.

The age at death curve of the Sudden Infant Death Syndrome (SIDS) is considered to be its most unique characteristic. Investigation of SIDS in Cook County, Illinois, for the years 1975-80 indicate that: it is similar to that observed for SIDS in numerous other geographical areas, with low neonatal rates, high rates during the first 2-3 months of life and declining rates thereafter; the age at death for SIDS significantly differs from that of 21 other causes of infant mortality; and the age at death is independent of risk factors such as race, birthweight, urbanization, the month in which prenatal care was initiated, maternal age, legitimacy, gender and seasonality, all of which factors are quantitatively associated with SIDS mortality rates. These observations indicate that the aetiology of SIDS may be multifactorial with the underlying mechanism, which may be associated with normal growth and development, operating primarily in the period of high susceptibility i.e. at 2-4 months of age. Secondary factors, possibly present since birth, operate during this period of high susceptibility. Any suggested underlying aetiology for SIDS must account for the unique age at death pattern.

Adult↗
PubMed1985

Coronary thrombolysis with intravenous anisoylated plasminogen-streptokinase complex BRL 26921.

BRL 26921 is a protected plasminogen-streptokinase complex with selective affinity for thrombus. When given intravenously within three hours of the onset of a first acute myocardial infarction angiographic patency of the infarct related vessel was seen in all 16 patients receiving the active drug compared with only two of 16 receiving a placebo. There was relative sparing of left ventricular function in the active treatment group with anterior infarction (mean left ventricular ejection fraction 37% compared with 23% for placebo), but no significant difference in left ventricular function between the active and placebo groups was seen in patients with inferior infarction. Intravenous BRL 26921 is highly effective in causing coronary reperfusion and may help to preserve left ventricular function when given early in the course of anterior infarction.

Adult↗
PubMed1982

Assessment of the accuracy and role of self-recorded blood pressures in the management of hypertension.

Self-recording of the blood pressure by patients away from hospital or office ("home blood pressure") has been advocated as providing a better estimate of "true" blood pressure. The reliability of home blood-pressure recording has been assessed only by standard indirect methods which themselves are subject to considerable error and variability. The accuracy of self-recorded blood pressures was therefore assessed in 57 patients with essential hypertension by comparison with simultaneous measurements of clinic blood pressures and with intra-arterial blood pressures recorded at home and at hospital. Home systolic blood pressures showed good agreement with clinic and intra-arterial pressures, but home diastolic blood pressures overestimated intra-arterial pressures, as did clinic diastolic pressures. The clinic and home diastolic pressures showed good agreement. There was considerable variability in individual differences comparing the indirect and intra-arterial methods, though the two indirect methods showed much closer agreement. This study suggests that home blood pressures are as accurate as clinic readings but may be recorded more frequently and thus provide more useful information. Neither is likely to approximate the intra-arterial blood pressure.

Adult↗
PubMed1981

A peripheral vascular insufficiency test using photocell plethysmography.

A preliminary laboratory study seeking an objective test for vascular insufficiency of the fingertips (Raynaud's syndrome) is described. In a limited number of subjects, circulatory changes in the vascular bed of one hand were examined by photocell plethysmography while the opposite had was immersed in ice water. The time to complete recovery after cessation of the cold stimulus was significantly longer with primary Raynaud's patients than with the control subjects (p = 0.0045). The analysis of another parameter, the relative change in pulse amplitude during cold immersion, was confounded by age and sex differences between the Raynaud's and the control group. A follow-up investigation of the application of this technique to a population of vibration-exposed chipper and grinder and control workers is in progress.

Adult↗