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U Keil

Publications and source records attributed to U Keil.

178 records · Page 10Linked to original sources
PubMed1980

[Mortality data and statistics, importance for health services and epidemiological research (author's transl)].

In most industrialized countries mortality data are the only medically relevant complete statistics for the description of health and disease in a population. Although mortality data reflect just the opposite of the state of health of a population, specific age and sex mortality rates are important indicators of the health status of a population and beyond that for the social system, e.g. for the effectiveness of the subsystem of health services. Validation studies show that the diagnoses on death certificates are much more reliable than generally thought. Scientists must have access to information from the original death certificates because otherwise the increasingly desirable studies on the threat of environmental noxae to the population cannot be carried out.

Death Certificates↗
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Arterial hypertension and glycemia in non-diabetic subjects: is there an association independent of obesity?

BACKGROUND: A possible association of glycemia with arterial hypertension has been suggested by the frequent co-occurrence of impaired glucose tolerance or Type 2 diabetes mellitus with arterial hypertension. The objective was to examine the relationship of glycated hemoglobin (HbA1c) concentration with arterial hypertension status in non-diabetic subjects. METHODS: A cross-sectional analysis of baseline data from the EPIC-Potsdam Cohort Study, Germany, was performed. The study population comprised 1846 non-diabetic subjects, 772 men and 1074 women, age 35-65. Blood pressure was measured three times consecutively. Level of HbA1c was determined by an assay based on monoclonal antibodies. Body height, weight and circumferences were obtained. Arterial hypertension status was either determined through blood pressure measurement (blood pressure > or = 160/95 mmHg) or based on antihypertensive drug use. HbA1c was divided into sex-specific quintiles and logistic regression was used to estimate the odds of being hypertensive and the corresponding confidence intervals. RESULTS: The highest compared to the lowest quintiles of HbA1c were in univariate analysis associated with being hypertensive. Adjustment for age and body mass index completely removed any significant association with arterial hypertension status. The odds ratio in men was 1.1 (95% CI 0.7-1.8), and in women it was 0.9 (95% CI 0.5-1.4). Repeating the analysis with systolic and diastolic blood pressure among untreated hypertensives yielded similar results. CONCLUSION: Unlike previous studies, our data do not support an association of HbA1c with arterial hypertension that is statistically independent of age and body mass index. Whether these established arterial hypertension risk factors are truly confounders of the HbA1c-arterial hypertension association or rather potentially antecedent factors requires further study.

Adult↗
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The use of anti-asthmatic drugs in children: results of a community-based survey in Germany.

PURPOSE: To describe the use of anti-asthma drugs in children in the general population and in children with asthma using data from two large surveys in Germany. METHODS: Community-based random sample of 5-7 and 9-11-year-old children in Dresden and Munich were studied in 1995/96 by parental questionnaires using the Phase II protocol of the International Study of Asthma and Allergies in Childhood (ISAAC). A total of 11,094 children participated in the surveys (response rate 83%). RESULTS: In all children, inhaled beta 2-agonists were used most frequently during the last 12 months (2.6%), followed by inhaled cromolyns (2.5%), oral beta 2-agonists (1.5%), and inhaled steroids (0.9%). Drug use was significantly higher among boys than girls and in older children compared to younger ones (P < 0.05 for both). Among children with current asthma, 47% had used inhaled beta 2-agonists, 43% inhaled cromolyns, 22% oral beta 2-agonists, and 16% inhaled steroids. Inhaled steroids were used significantly more often in Dresden (21.7%) than in Munich (11.2%) (P < 0.05). CONCLUSIONS: Among anti-asthma drugs, agents used for symptomatic relief were the most frequently reported followed by inhaled anti-inflammatory agents. Most of the anti-inflammatory drugs used were SCG, which may indicate under-treatment with inhaled steroids.

Adrenergic beta-Agonists↗
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[Application of geographical information systems in epidemiological studies exemplified by the ISAAC study in Munich].

Geographical Information Systems (GIS) are increasingly applied as modern tools for analysis and visualization of health-related spatial data, especially in epidemiological research. GIS are used by medical researchers and executives in the public health service. A community-based survey was conducted according to the phase II protocol of the International Study of Asthma and Allergies in Childhood (ISAAC) in Munich. The spatial patterns of disease incidence were analysed and related to exposure data by GIS. The prevalence study on fourth-grade pupils (n = 3354) and school beginners (n = 2890) was conducted during the school term 1995/96 in Munich. Parental questionnaires and measurements of lung function and immunological parameters were used. The questionnaire data were integrated in a GIS database. In this paper we discuss methodological aspects of GIS-based spatial analysis related to epidemiological data. In addition, we investigate whether there were spatial clusters of children with wheeze in the last 12 months of a magnitude unlikely to occur by chance and which could indicate local health risks. The study was based on permutation tests where global and local methods were applied. No spatial clusters of children with asthma symptoms were identified in the city of Munich.

Asthma↗
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A single question about prior stroke versus a stroke questionnaire to assess stroke prevalence in populations.

BACKGROUND: False-positive and false-negative answers to screening questions influence prevalence and incidence estimations for stroke in population studies. Despite frequent use in screening, only a few studies have examined causes and influence of incorrect self-reports. We compared the rates of false-positive and false-negative answers to a single question about prior stroke to those of the Stroke Symptom Questionnaire (SSQ), a newly developed instrument based on 6 symptom questions. Differences in stroke prevalence estimations and risk factors for incorrect reports are described. METHODS: The MEMO study (Memory and Morbidity in Augsburg Elderly) examines cognitive function and neurodegenerative diseases in an elderly population (n = 384) in southern Germany. All participants filled in the symptom questionnaire, received a neurological examination and a neuropsychological test battery. Medical records were obtained for event validation of subjects positive on screening and those negative on screening with symptoms suggesting a cerebrovascular event during examination. RESULTS: Prevalence of total stroke was 5. 3% using a single screening question and 6.8% using the questionnaire. The false-negative rate was higher for the single-question approach (34.2 versus 10.5%). It was strongly influenced by gender and cognitive function. The questionnaire had a higher false-positive rate than the single question. Based on the results, we established question combinations that best served three different research scenarios (frequency estimation, risk factor analysis, control selection), relevant to stroke research in population studies. CONCLUSIONS: A single screening question for stroke in the past with event validation by medical records underestimates stroke frequency in population studies by about 30%. Use of a number of questions for key symptoms combined with a general stroke question, as in the SSQ, improves the completeness of event ascertainment and allows the detection of stroke and transient ischemic attack at the same time.

Aged↗
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Alcohol consumption as a risk factor for high blood pressure. Munich Blood Pressure Study.

The Munich Blood Pressure Study (MBS), a 1980-81 cross-sectional study (with follow-up) of a random sample of 3198 Munich citizens aged 30-69 years (response rate 69%), revealed hypertensive blood pressure (BP) values in 17.7% of men and 10.7% of women (WHO criteria). One of the main goals of the MBS was to search for social, behavioral, and environmental risk factors for hypertension. The relationship between BP and five possible risk factors--alcohol consumption (g/day), cigarette smoking, oral contraceptive use, years of education, obesity (BMI)--has been examined. The major emphasis of this report is the relationship of alcohol consumption to BP. Multiple linear and logistic regression analyses were run controlling for both age and sex. All second- and third-order interactions between the independent variables were tested during a backward-stepping procedure. Alcohol consumption appeared as a significant main effect in many of the analyses. The coefficient of the alcohol variable ranged from 0.02 to 0.06 for men and women in the separate linear regression analyses for systolic and diastolic BP. Thus, for example, according to the model, the daily consumption of 1 liter of beer (40 g alcohol) may cause an increase in diastolic BP in women of 2.4 mm Hg.

Adult↗
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Elevated nitric oxide production mediates beta-amyloid-induced mitochondria failure.

Mitochondrial dysfunction has been identified in a large proportion of neurodegenerative disorders including Alzheimer's disease (AD). In addition, the involvement of nitric oxide (NO) has been implicated in the pathogenesis of AD. Thus, we investigated the effects of the Swedish double mutation (K670M/N671L) in the beta-amyloid precursor protein (APPsw) on NO levels and mitochondrial function in PC12 cells. Interestingly, APPsw PC12 cells showed increased NO levels, decreased cytochrome C oxidase activity and reduced ATP levels compared to wild-type APP bearing cells and empty vector transfected cells. On the basis of our data, we propose a hypothetical sequence of events linking amyloid beta-peptide and NO production with mitochondria failure.

Amyloid beta-Peptides↗
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Circadian changes in salivary constituents and conductivity in women and men.

Circadian rhythms in salivary [glucose], [Na+], [K+] and conductivity were measured in 2 age groups of men (men A, 20-45 years and men B, 46-60 years) and 8 different states of fertility in women (normally menstruating, taking oral contraceptives, pregnant, lactational amenorrhea, lactational amenorrhea and taking oral contraceptives, lactating and menstruating, menopausal, and post-menopausal). Unstimulated whole saliva (2-3 ml) was collected every 3 h over a 48 h span. Analysis of Spearman Rank Correlations indicated significant circadian rhythms (significant positive coefficients) for all groups of [Na+] (mean = 0.577 +/- 0.040) and conductivity (mean = 0.410 +/- 0.050). There was no evidence of differences in prominence of rhythm across groups for [Na+] and conductivity. [K+] showed less evidence of rhythms and much greater variability between groups (mean correlation coefficient = 0.198 +/- 0.055). Rhythms in [glucose] (mean correlation coefficient = 0.409 +/- 0.051) were evident in all groups except men B (0.016), menopausal women (0.151) and post-menopausal women (0.310). Model analysis of the data showed no discernible rhythmic trend with age for either conductivity, [Na+] or [K+], where any differences were explainable by the group characteristics. The rhythm in [glucose] showed a significant weakening with age over all groups (F-ratio = 7.46**), and was different between men A and men B (F-ratio = 6.95**). It was concluded that circadian rhythms were present in whole unstimulated saliva for conductivity and [Na+] and that these rhythms were independent of reproductive state, whereas circadian rhythms in [K+] were dependent on reproductive state. Circadian rhythms for [glucose] were dependent on age. The loss of a rhythm in [glucose] with age indicates that glucose, Na+ and K+ are not linked in their entry into saliva. The influence of entry and reabsorption on the final concentrations of glucose, Na+ and K+ in saliva is discussed.

Adult↗