Search PubMed⌕ Search

Biomedical subjects

S Böthig

Publications and source records attributed to S Böthig.

At least 19 recordsLinked to original sources

Coronary heart disease mortality, morbidity, and case fatality in five east and west German cities 1985-1989. Acute Myocardial Infarction Register Teams of Augsburg, Bremen, Chemnitz, Erfurt, and Zwickau.

Cardiovascular mortality (CVD; International Classification of Diseases [ICD] 390-458) is higher in East than in West Germany, but the differences in official coronary heart disease mortality (CHD; ICD 410-414) are not so pronounced. The aim of this study was to validate the official mortality statistics based on the five German AMI registers and to analyze whether these mortality differences are due to differences in the attack rates of acute myocardial infarction (AMI) or to differences in the 28-day case fatality rates. This comparison includes the MONICA study cities of Augsburg and Bremen, both in West Germany, as well as the cities of Chemnitz, Erfurt, and Zwickau in East Germany (former the German Democratic Republic). The rates were calculated on the basis of all MONICA cases of definite AMI or coronary death aged 35 to 64 years occurring in the respective study populations between 1985 and 1989. All study populations except women in Augsburg showed higher coronary death rates compared to the rates based on the official cause of death statistics (ICD 410-414), but this difference was significant only for men in Chemnitz. In men there were no significant differences in the register-based coronary death rates between these urban areas (160/100,000 in Zwickau to 170/100,000 in Chemnitz) nor in the AMI attack rates (327/100,000 in Augsburg to 363/100,000 in Chemnitz), and consequently no significant center differences in the overall 28-day case fatality. However, the prehospital case fatality was significantly higher in Erfurt (34%) than in Bremen (27%). There were no significant differences in the AMI attack rates in women as well (60/100,000 in Chemnitz to 70/100,000 in Bremen and Erfurt), but the overall 28-day case fatality showed a clear gradient from the East (61-71%) to the West German cities (48-56%) and therefore also the register-based coronary death rates (38-50/100,000 and 34-38/100,000, respectively). However, the higher 28-day case fatality in women found in the MONICA registers in East compared to West Germany is not reflected in the CHD mortality statistics because of a stronger underestimation of the official mortality rates and in East than in West Germany, in particular in women. Nevertheless, the total mortality rates and in most cases also the CVD mortality rates were in women significantly higher in the East German compared to the West German cities. The East German official preunification CHD mortality data cannot be used for national and international comparisons. The results of the MONICA AMI registers in East and West Germany indicate, furthermore, the need to improve coronary care in women in the eastern part of the country. Nevertheless, because of the relatively high AMI attack rate in both parts of Germany primary prevention must generally be intensified.

Adult↗

[Role of the occupational health service in the control of hypertension].

By a representative random sample in an order of magnitude of 5,150 employees the determination of the degree of knowledge of the hypertensives in the factory health service of metal mines showed nearly 100%. In the dispensary of the factory medical officer 64.2% were registered. 36.6% of the hypertensives were stabilised to blood pressure values below 160/95 mm Hg. Forms of therapy, cardiovascular risk factors associated with high blood pressure and effects of the working environment were investigated by means of factor and discriminance analysis with regard to the influence on the quality of the stabilisation of high blood pressure. The compliance resulted as essential limiting factor in the treatment of hypertension. 71% of the hypertensives reported a regular intake of medicaments, in which case 51% admitted to interrupt it without consulting the physician in charge when the constitution is disturbed. 4 features were determined as essential factors which have influence on the compliance: the opinion concerning the duration of the treatment of hypertension, the attitude to the intake of medicaments, the frequency of the intake of the tablets and the observation of the terms of blood pressure control. The investigation of the physician's compliance resulted, apart from an overestimation of the patient's compliance, in distinct deviations from the recommendations for diagnosis and therapy given. The compliance of nurses showed deficiencies in the standardized measurement of blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Physician compliance in the treatment of hypertension].

The physician compliance is determined by knowledge, skill and behaviour. In 103 physicians working in the basic medical care investigations of the compliance were performed. Partly clear deviations from the guidelines recommended were found in the habits of diagnostics and therapy. These deviations frequently concerned even the majority of the physicians asked for. While the knowledge can relatively easily be judged according to objective criteria, the behaviour is difficult to be measured. Of 4 physicians with comparable knowledge concerning the clinical picture of hypertension the influence of the behaviour of the physician on the success of therapy was investigated during a psycho-physiologically orientated group therapy and the breath-induced relaxation training. The univariate and discriminance-analytic investigations as well as the factor analyses showed the behaviour of the physician as essentially determinating for the success of the therapy. The determination of the physician compliance gives the possibility to recognize still existing insufficiencies in the treatment of hypertension. It serves for the further optimization of the therapy of hypertension. Measures increasing the compliance among others can be derived also for the training and further training.

Adult↗

Rheumatic fever and rheumatic heart disease in developing countries.

Rheumatic fever and rheumatic heart disease can be prevented by simple methods of primary health care. Well-organized prevention programmes can be cost-effective. Lasting benefit depends on the maintenance of both local interest and financial support from governments.

Adolescent↗

WHO MONICA Project: objectives and design.

The WHO MONICA Project is a multicentre international collaborative project coordinated by the World Health Organization. Its objective is to measure trends in cardiovascular mortality and morbidity and to assess the extent to which these trends are related to changes in risk factor levels and/or medical care, measured at the same time in defined communities in different countries. Thirty-nine collaborating centres from 26 countries of Europe, North America, and the Western Pacific collaborate in this project, using a standardized protocol and covering a population of approximately 10 million men and women aged 35-64. The WHO MONICA Project is directed by the Council of Principal Investigators and a Steering Committee, and it is managed by a Management Centre, Data Centre, Quality Control Centres (for event registration, ECG coding and lipid determinations) and Reference Centres (for optional studies). The MONICA methodology is increasingly used as a measurement tool for cardiovascular and non-communicable diseases prevention and control programmes by centres within and outside the project.

Adult↗

Hypertension in developing countries.

Population surveys carried out since the 1970s in 15 developing countries including 23 population groups show that the prevalence of hypertension ranges from as low as 1% in some African countries to over 30% in Brazil. A trend analysis of the mortality statistics for 35-74 year-olds from 16 countries in which data are available shows a downward trend in mortality from hypertension and cerebrovascular diseases in most of these countries. In spite of the current low prevalence in some countries, the total number of hypertensives in the developing world is high, and a cost assessment of possible antihypertensive drug treatment indicates that developing countries cannot afford the same drug treatment levels as developed countries.

Adult↗

Incidence and fatality of acute myocardial infarction in the community.

The incidence rate for acute myocardial infarction (AMI; diagnostic categories "definite AMI" + "possible AMI" + "insufficient data"), defined as number of cases per 10 000 population (20 years and older) and year, are highest in Berlin, GDR (63 for males, 42 for females), intermediate in Budapest (46/22) and lowest in Warsaw (38/21). In Budapest and Warsaw younger and middle-aged men suffer more frequently from AMI than in Berlin, while in the GDR capital AMI is more frequent in older men and women. In younger and middle-aged groups AMI occurs in women ten years later than in men. After standardization for age, the AMI incidence rates are not significantly different between Budapest and Warsaw, but are significantly higher in Berlin, particularly for older women. The standardized fatality rates of AMI (percentage of cases died within 28 days from all cases) for males were equally high for Berlin and Budapest (each about 50%), but in Warsaw significantly lower (42%). For females they are significantly highest in Berlin (69%), intermediate in Budapest (57%) and significantly lowest in Warsaw (40%). This is due mainly to an excess fatality within the oldest groups in the Berlin Register.

Adult↗

[Results of the myocardial infarct registers in the German Democratic Republic and their significance for the reduction of early mortality in myocardial infarce].

From preliminary results of the registers of myocardial infarction in the GDR follows that the definitive myocardial infarction (classification of the WHO) occurs in Berlin with an incidence rate of 17 cases per 10,000 inhabitants and annum, in Erfurt 10 and at Pasewalk 11 cases per 10,000 inhabitants and annum. More than three fourths of all cases of myocardial infarction appear outside the hospital. After three months the lethality is 60%, whereby the half of all cases of death appears already in the prehospital phase. More than 8 hours are passing before half of all patients with infarction are admitted into the hospital. The greatest retardation takes place between arrival of the physician and admission into the hospital. In the second place follows the interval onset of the infarction and demand of medical aid. An improvement of the early diagnostics and the transport of the patient as well as an adequate information and collaboration of the patient and his surroundings might contribute to a shortening of the prehospital phase and thus to a decrease of the early mortality in cases of myocardial infarction.

Germany, East↗