Search PubMed⌕ Search

Biomedical subjects

T Abelin

Publications and source records attributed to T Abelin.

At least 19 recordsLinked to original sources
PubMed1998

[The role of local health departments in reducing inequalities in health in Switzerland].

Examples from Switzerland: In Switzerland, as in other countries, several studies have demonstrated social inequality in health. The aim of this study is to demonstrate practical approaches to reducing these differences, as they offer themselves on the local level, and to analyse the implications for the functioning of local departments of Public Health. Case studies, mainly from the health department of the city of Bern, are used to demonstrate measures taken 1. to identify and correct unmet needs of the socially disadvantaged disabled elderly; 2. to find children from marginal groups who failed to be immunised before entering school age, and to arrange for them to be immunised; and 3. to include psychosocial measures when routine school health examinations have led to observations of a biomedical nature. Recent difficulties are pointed out which developed in this connection as a consequence of the privatisation of traditional Public Health functions. The examples show that considerable effort is needed if local health departments attempting to correct social inequalities try to solve individual problem cases. The task is often multidisciplinary. It involves other administrative sectors such as education, social services and housing construction, and is greatly influenced by measures taken on the Federal or Cantonal (Federal Provincial) level. Whereas demonstrating social inequalities through periodic health reporting can be seen as belonging to the traditional activities of health departments, eliminating or reducing the inequalities not only requires a far-reaching re-orientation of local Public Health services, but also a re-definition of the job description and training of Public Health physicians; and as this process continues, it appears that health departments in Continental Europe will increasingly be led to adopt approaches developed previously by Public Health departments in Anglo-Saxon countries.

Community Health Services↗
PubMed1997

The epidemiological situation of thyroid cancer in Belarus.

Starting in 1990, an increasing number of children in regions adjacent to the site of the Chernobyl nuclear accident have been diagnosed as suffering from thyroid cancer. Using available data up to 1994, the geographical distribution, time and cohort trends, age distribution and other characteristics of this epidemic are reviewed. The results show that the geographical distribution is similar to that of iodine-131 after the nuclear accident. When looking at cohorts of children born in the same years, one can see that the incidence has been increasing steadily since 1990; deviations from this pattern might be explained by active case finding. A causal relationship with the Chernobyl accident appears the most likely interpretation of these results. Possible modifying factors should, however, be examined closely.

Adolescent↗
PubMed1997

Absence of chronic effect of exposure to short-wave radio broadcast signal on salivary melatonin concentrations in dairy cattle.

A pilot study was conducted to investigate the influence of electromagnetic fields in the short-wave range (3-30 MHz) radio transmitter signals on salivary melatonin concentration in dairy cattle. The hypothesis to be tested was whether EMF exposure would lower salivary melatonin concentrations, and whether removal of the EMF source would be followed by higher concentration levels. For this pilot study, a controlled intervention trial was designed. Two commercial dairy herds at two farms were compared, one located at a distance of 500 m (exposed), the other at a distance of 4,000 m (unexposed) from the transmitter. At each farm, five cows were monitored with respect to their salivary melatonin concentrations over a period of ten consecutive days. Saliva samples were collected at two-hour intervals during the dark phase of the night. As an additional intervention, the short-wave transmitter was switched off during three of the ten days (off phase). The samples were analyzed using a radioimmunoassay. The average nightly field strength readings were 21-fold greater on the exposed farm (1.59 mA/m) than on the control farm (0.076 mA/m). The mean values of the two initial nights did not show a statistically significant difference between exposed and unexposed cows. Therefore, a chronic melatonin reduction effect seemed unlikely. However, on the first night of re-exposure after the transmitter had been off for three days, the difference in salivary melatonin concentration between the two farms (3.89 pg/ml, CI: 2.04, 7.41) was statistically significant, indicating a two- to seven-fold increase of melatonin concentration. Thus, a delayed acute effect of EMF on melatonin concentration cannot completely be excluded. However, results should be interpreted with caution and further trials are required in order to confirm the results.

Animals↗
PubMed1997

Chernobyl-related thyroid cancer: what evidence for role of short-lived iodines?

Over 500 cases of thyroid cancer were diagnosed in Belarus between 1986 and 1995 among persons exposed as children (under 15 years of age) to radioactive contamination from the Chernobyl nuclear accident. There is little doubt that radioactive iodine isotopes emitted during the nuclear explosion and subsequent fire were instrumental in causing malignancy in this particular organ. Comparison of the observed geographic distribution of Chernobyl-associated thyroid cancer incidence rates by districts with contamination maps of radioactive fallout shows a better fit for estimated 131I contamination than for 137Cs. Because 131I used for medical purposes had not been considered carcinogenic in humans in the past, and in view of the unusually short latency period between exposure and clinical manifestation of cancer, it is suspected that not only 131I but also energy-rich shorter-lived radioiodines may have played a role in post-Chernobyl thyroid carcinogenesis. Measurements of iodine isotopes are not available, but reconstruction of geographic distributions and estimations of radioactive fallout based on meteorological observations immediately following the accident could provide a basis for comparison with the distribution of thyroid cancer cases. In this paper, data from the Epidemiological Cancer Register for Belarus will be used to show geographic and time trends of thyroid cancer incidence rates in the period from 1986 to 1995 among persons who were exposed as children, and these will be compared with the estimated contamination by radioiodines. Tentative conclusions are drawn from the available evidence and further research requirements discussed.

Adolescent↗
PubMed1996

[Occupational status and prevalence of cardiovascular risk indicators in employed men in German-speaking Switzerland].

Based on a sample of 623 employed men from the Berne Workplace Health Project ("Härz-As-Project") we studied the relationship between the occupational status and prevalence of cardiovascular risk indicators. Besides "biological" risk indicators, like high total cholesterol, low HDL-cholesterol, hypertension, and overweight, we also studied two behavioral risk indicators (current smoking, physical inactivity in leisure time) and a summary risk score. Odds ratios for several risk indicators controlled for age, were markedly different among different occupational status groups. High cholesterol/HDL-cholesterol ratios were more common in lower occupational status groups, while the likelihood for hypertension and high total cholesterol was highest among qualified workers. There was a strong association between occupational status and the behavioral risk indicators smoking and physical inactivity in leasure time. Similarly, 1 or more risk indicators, and more than 2 risk indicators, respectively, were also found to be strongly related to occupational status. Our results confirm former findings of unequal distribution of cardiovascular disease risk indicators among groups of different occupational status. Future studies will have to focus upon the underlying causes for these inequities.

Adult↗
PubMed1994

[Evaluation of advertisements of weight-reducing cures in the press].

The aim of this study was to obtain an overview of the weight control programmes advertised in the Swiss press and to explore them in terms of their scientific basis and success rates. 875 advertisements and questionnaires from 507 patients and 52 advertisers were analyzed. Scientifically questionable methods usually remained ineffective. In contrast, methods based on a reasonably balanced long term diet proved more successful. With the latter, an average weight loss of 15 kg was achieved in 32 weeks at a cost of Sfr. 456.-. In doing so, 56.1% of the patients reported they had reached their target weight and it was entirely or partly maintained for a prolonged period by 39.6%. In terms of cost/benefit ratios, scientifically based programmes which follow the principles of physiology and behavioural psychology are the most favourable, and physicians should know and recommend them. Unfortunately, in Switzerland health insurance still pays for programmes which were shown to be unsuccessful in the long term, such as appetite lowering medication, or costly, such as short-term courses of treatment in hotels.

Advertising↗
PubMed1994

Thyroid cancer in Belarus post-Chernobyl: improved detection or increased incidence?

There is debate on whether the reported increase in the number of cases of childhood thyroid cancer in Belarus is real and attributable to radiation released following the Chernobyl nuclear accident, or rather an artefact due to incorrect histological diagnosis, more complete case reporting and mass screening of children after the accident. We have scrutinised the histological slides of 120 (75%) of the 160 cases reported among children aged up to 15 years to the Belarus tumour registry from 1986 to 1992 and examined time trends and geographical patterns in incidence and tumour characteristics. Incidence based on reported cases increased from 0.041 per 100,000 in 1986 to 2.548 in 1992. Carcinoma was confirmed in 94% of reviewed tumours. Except for one medullary carcinoma all histologies were of the papillary type. Most of the tumours had spread beyond the organ capsule and measured over 10 mm in diameter. There was a weak and statistically non-significant trend (p = 0.19) towards smaller tumours in the later years. The proportion of cases with lymphnode or distant metastasis remained unchanged. Incidence based on histologically confirmed cases was highest adjacent and to the west and north of Chernobyl, matching best estimates of iodine-131 contamination. Our data thus strongly suggest that the observed increase is real but more data are needed in order to assess the impact of mass screening and to clarify the possible association with radiation released at Chernobyl in 1986.

Adolescent↗
PubMed1993

Research and teaching in social and preventive medicine and in public health.

Both public health and social and preventive medicine are characterised by the common goal of promoting, maintaining and improving health and preventing disease, and both are concerned with a population-related, preventive and environmental perspective. But whereas public health is interdisciplinary and goes far beyond the medical focus, social and preventive medicine is medically based and forms a bridge between public health and medical practice. Research in a department of social and preventive medicine serves to support preventive and medico-social activities in medical practice as well as in public health. This is illustrated by results from research conducted at the author's department during the last twenty years. Examples are research in support of smoking cessation activities, and research used for the planning of care for the elderly. Both the research and the teaching activities of the department take into account the population focus of public health as well as the focus on individual medicine in clinical practice.

Aged↗
PubMed1992

[Rubella epidemiology in military recruit schools].

In 1986, at the start of their training, 6877 male recruits were screened for the presence of anti-rubella IgG antibodies. 595 (9%) were seronegative. Of the latter group, 475 (80%) were retested in the week prior to discharge. During their four months of training, 113 (24%) exhibited seroconversion which proved acquisition of a rubella virus infection during the period of service. A clinical diagnosis of rubella was established in 15 (13%) of the persons with seroconversion. Catarrhal symptoms were present in half of those infected, whereas 41 (36%) did not report sick, suggesting a subclinical course of infection. Rubella is hardly a problem for the military in Switzerland. However, outbreaks such as the ones reported may have implications for the epidemiology of rubella in the general population, and hence should be taken into account in the planning of programs attempting to eliminate rubella virus infections.

Adult↗
PubMed1992

[Therapy for smoking: consensus in German-speaking countries].

The german speaking countries (Austria, Germany, Switzerland) are not the most advanced in the world when it comes to the control of tobacco related diseases. The medical system in these countries has yet to be convinced that smoking cessation is not only necessary but feasible. In order to provide a basic document for further activities, a consensus development process was initiated. The consensus development process forms part of the activities performed by the UICC (International Union Against Cancer) Project Smoking Cessation, which is a project within the framework of the UICC Tobacco and Cancer Programme. The 1988 Report of the US Surgeon General states very clearly, that the use of tobacco products is not a matter of free choice, but is the result of an addiction as scientifically valid as the addiction to heroin and other narcotics. The scientific literature provides informations on many methods and techniques for a smoking cessation, both pharmacological and non-pharmacological. Many pharmacological approaches have been tried to treat nicotine dependence in man. According to scientific standards and many controlled studies, nicotine has been the only drug found to be effective in treating nicotine dependence. Many techniques, ranging from self help to sophisticated combined therapeutic approaches including pharmacological interventions, are now available to deal with the nicotine addiction. Smoking cessation treatment uses time, effort and other resources and the question of reimbursement for these services has to be considered. As with any other form of treatment, costs needed to be paid either by the individual patient/client and/or by other sources including private and national health insurance systems.(ABSTRACT TRUNCATED AT 250 WORDS)

Acupuncture Therapy↗
PubMed1992

Pathomorphological findings in thyroid cancers of children from the Republic of Belarus: a study of 86 cases occurring between 1986 ('post-Chernobyl') and 1991.

Recently, an impressive increase in malignant thyroid tumours has been observed among children less than 15 years of age living in the Republic of Belarus at the time of the nuclear accident of Chernobyl in 1986. More than half of these patients lived in the region of Gomel, nearest to Chernobyl. Because of the very short time interval between the accident and the tumour occurrence an independent review of the available histopathological material was done. Out of 101 cases diagnosed as thyroid cancers, we reviewed slides of 93 cases and agreed the diagnosis of malignancy in 92.5%. Of these tumours 96.5% were papillary carcinomas, 61.5% were moderately or poorly differentiated. Extrathyroidal extension was observed in 60.5%, regional lymph node metastases in 74% and distant metastases in 7%. One of the patients died from lung metastases. Our results confirm that the neoplasms increasingly diagnosed between 1986 and 1991 among children of this region are thyroid carcinomas. In addition, we correlate several histopathological findings with sex and age of the patients and other parameters, and compare the results with data from other studies.

Accidents↗
PubMed1991

[Is iodination of cooking salt still necessary? Current studies on iodine supply in Switzerland].

Salt with 3.75 mg iodide per kg was introduced in Switzerland stepwise in the individual cantons between 1922 and 1952. The iodide content was raised to 7.5 mg in 1962 and to 15 mg per kg in 1980. 92% of retail salt and 78% of all salt for human consumption (including salt used in industrial food processing) was iodized in 1989. Under this measure, prevalence of grade 1b or larger goiter dropped continuously to a present value of 1.3% in school-children and 0.3% in male army recruits. Endemic cretinism has disappeared completely. Urinary iodine has reached the desired range of 150 +/- 77 (SD) micrograms per g creatinine. The following facts prove that iodization of salt (and not other changes of food habits) have corrected the iodine deficiency in Switzerland: 1. Urinary iodine is highly correlated with urinary sodium. Backward extrapolation yields a theoretical urinary iodine of 30 micrograms per g creatinine in the absence of iodized salt, a value typical of severe deficiency. 2. Goiter prevalence declined later in those cantons which introduced iodized salt last. 3. Surrounding countries without iodized salt (France, Italy, Federal Republic of Germany, Spain) suffer from considerable iodine deficiency with areas of high goiter prevalence and even endemic cretinism. The new data underscore the absolute and continued need for iodized salt in Switzerland.

Adolescent↗
PubMed1990

[Smoking and smoking cessation in the context of preventive cardiology].

Knowledge about the effects of smoking on the development of cardiovascular disease is constantly growing. As an example, we know today that myocardial infarction is more frequent among smokers, also among monozygous twins, and that the relative risk of women who smoke is comparable to that of male smokers. The mechanisms of action are in atherogenesis, in the stimulation of the adrenergic system and in an increase of plasma fibrinogen. In order to best support his patients to give up smoking, the practicing physician has to be aware of the factors influencing the smoking habit. The parallel development of psychological dependence and physical addiction to nicotine is described, and it is shown how nicotine substitution therapy can help to stagger psychological and physical withdrawal. The introduction of transdermal nicotine substitution opens new possibilities in this context.

Adult↗