Biomedical subjects

U Keil

Publications and source records attributed to U Keil.

At least 109 records · Page 6Linked to original sources

PubMed1994

[Smoking among children and adolescents: a challenge for primary prevention].

The best way to prevent the deleterious health effects of cigarette smoking is helping children to refrain from starting the habit. As a part of a survey of the prevalence of asthma symptoms in children and adolescents, we investigated the smoking habits of grade seven and eight school children in Bochum, a city of approximately 400,000 people in northwestern Germany. A random sample of 2050 children (93%) answered a confidential questionnaire. Fifty-three percent of the children responded that they had ever smoked cigarettes and 26% indicated that they had smoked during the previous month. 10% of the teenagers smoked daily, and 5% smoked more than 10 cigarettes per day. The prevalence of active smoking during the previous month was more frequent among girls (28%) than among boys (23%), but slightly more boys (5%) than girls (4%) smoked more than 10 cigarettes per day. The prevalence of active smoking was increased among children living in families of lower socio-economic status or in households with smokers. The high prevalence of cigarette smoking among the school children in Bochum, Germany, emphasizes the need to develop and implement effective intervention programs for children and adolescents and to contribute to a social environment which is conductive to refraining from smoking.

Adolescent↗

PubMed1994

Self-reported wheezing and allergic rhinitis in children and traffic density on street of residence.

A survey of 2050 seventh- and eighth-grade schoolchildren was conducted in Bochum, Germany, in 1991. The prevalence of wheezing and allergic rhinitis was assessed by self-completed written questionnaires and video questionnaires. To estimate the traffic density on the street of residence, children were asked about the frequency of heavy truck traffic on weekdays and to describe the street either as a main road or as a side street. There was a positive correlation between the prevalence of wheezing as well as allergic rhinitis and the indicators of traffic density, controlling for age, sex, nationality, passive smoking, active smoking, parental history of asthma, and so on. The adjusted prevalence odds ratio (ORs) and 95% confidence intervals (CIs) contrasting the "frequent" and "constant" categories for truck traffic with the "never" category were as follows: for wheezing (written questionnaire), OR = 1.53 (CI: 1.06 to 2.20) and OR = 1.67 (CI: 1.05 to 2.66); for wheezing (video questionnaire), OR = 1.58 (CI: 1.13 to 2.20) and OR = 1.94 (CI: 1.26 to 2.99); and for allergic rhinitis, OR = 1.67 (CI: 1.17 to 2.38) and OR = 1.54 (CI: 0.97 to 2.44). In conclusion, a possible role of factors associated with automobile exhausts causing or exacerbating asthma symptoms and allergic rhinitis in children is supported.

Adolescent↗

PubMed1994

Alcohol consumption as a modifier of the relation between blood lead and blood pressure.

Hypothetically, blood lead may be involved in blood pressure elevations owing to a facilitation of vascular adrenergic stimulation by extrinsic factors like alcohol. We therefore investigated whether self-reported alcohol consumption was a modifier of the blood lead-blood pressure relation in 3,664 men and women, age 28-67 years, from the MONICA Augsburg study in Germany. In women, only heavy drinkers (40 gm alcohol per day or more) showed a strong relation of blood lead with systolic and diastolic blood pressure, whereas little association was observed for abstaining and for moderately drinking women. In men, we found similar alcohol modifications of the lead-pressure relation only for those with rural, rather than urban, places of residence. We have no explanation for this subgroup divergence. Our results may be taken to indicate a possible role of alcohol consumption in modifying the action of lead on blood pressure.

Adult↗

PubMed1994

Weekly variation of acute myocardial infarction. Increased Monday risk in the working population.

BACKGROUND: Seasonal and circadian variations in the occurrence of myocardial infarction and sudden cardiac death have been documented, suggesting that triggering factors may play a role in the causation of cardiac events. However, there are only sparse and conflicting data on the weekly distribution of the disorders. METHODS AND RESULTS: To determine the weekly variation of acute myocardial infarction and sudden cardiac death, 5596 consecutive patients (71% men; age, 63 +/- 1 years) were analyzed in a regionally defined population (n = 330,000; age, 25 to 74 years) monitored from 1985 to 1990. The exact time of onset of symptoms was used to determine the day of the event. Patients with myocardial infarction (n = 2636) demonstrated a significant weekly variation (P < .01) with a peak on Monday, whereas patients with sudden cardiac death (n = 2960) were evenly distributed throughout the week. A similar weekly pattern was observed in subgroups of patients with myocardial infarction defined with respect to age, sex, cardiac risk factors, prior cardiac medication, and infarct characteristics. The working population demonstrated a weekly variation of myocardial infarction as opposed to the nonworking population, with a 33% increase in relative risk of disease onset on Monday (P < .05) and a trough on Sunday compared with the expected number of cases, if homogeneity was assumed. CONCLUSIONS: The onset of acute myocardial infarction demonstrates a peak on Monday primarily in the working population. If this finding is confirmed in other communities, it may aid in identifying acute triggering events of myocardial infarction and perhaps in improving prevention of the disease.

Adult↗

PubMed1993

[The effect of education and professional position on changes in cigarette smoking and alcohol consumption: results of the MONIKA Augsberg cohort study].

This study examined the influence of educational achievement and occupational position on changes in risk behavior. Study population were 3753 men and women aged 25-64 years who were sampled by the first MONICA Augsburg Survey (Monitoring trends and determinants in cardiovascular disease). The subjects were sampled in 1984-85, were followed up for three years, and were reexamined in 1987-88. The baseline findings showed for both men and women a statistically significant inverse association between current cigarette smoking and educational level. During the follow-up period the differences between highest and lowest educational levels increased significantly among men. In 1987-88 only 21% of the best educated men were smokers compared to 38% of those with the lowest educational level. Men with low educational levels also drank more alcohol than better educated men, whereas among women those with lowest educational level drank less alcohol than the better educated. Statistically independent of education and age it was found that male civil servants and farmers had the lowest proportion of smokers in cross-sectional as well as longitudinal analyses. Among women, smoking was and remained most prevalent in simple white-collar occupations. In general, the findings indicate that the type of occupation and the actual working conditions have effects on life-style related risk factors which are in part independent of a social gradient. The results also suggest that the tendency to change unhealthy behavior is less pronounced in "high risk" groups.

Adult↗

PubMed1993

Lack of an association between serum vitamin E and myocardial infarction in a population with high vitamin E levels.

The antioxidant effects of vitamin E may protect low density lipoproteins from peroxidation and thus inhibit the development of arteriosclerosis. Inverse associations between vitamin E levels and coronary heart disease have been reported from cross-sectional and ecologic studies. In the population-based MONICA Augsburg cohort (2023 men, 1999 women, age 25-64 years at baseline in 1984, 93% of whom were reexamined in 1987/88) we investigated the relationship between serum vitamin E concentrations and the risk of subsequent myocardial infarction (MI). Between 1984 and 1991, 46 cases of fatal and non-fatal myocardial infarction from this cohort were recruited for a nested case-control study. Four controls were sampled from the cohort for each case of MI with matching for age, sex, and total cholesterol. There were no marked differences between cases and their matched controls in the means of vitamin E concentrations (33.9 mumol/l vs. 32.8 mumol/l, P = 0.37) or in the mean vitamin E/total cholesterol ratios (4.89 mumol/mmol vs. 4.82 mumol/mmol, P = 0.75). The covariate adjusted relative risk (RR) for fatal plus non-fatal MI in the lowest tertile of vitamin E relative to the upper two tertiles was 0.72 (90% confidence interval: 0.33-1.57). Likewise, for the lowest tertile of the ratio (vitamin E/total cholesterol) the RR was 0.81 (0.42-1.56). The association was not modified by history of previous coronary heart disease, fatality of MI, temporal distance of MI onset from vitamin E determinations, or season.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1993

Five-year changes in population blood pressure and hypertension prevalence. Results from the MONICA Augsburg surveys 1984/85 and 1989/90.

Two cardiovascular risk factor surveys were carried out in 1984/85 and 1989/90 in the Augsburg study region of the international World Health Organization (WHO) Monitoring Trends and Determinants of Cardiovascular Disease (MONICA) project. Independent random samples of the 25- to 64-year-old population were examined at each survey. Five-year changes in blood pressure (BP) and hypertension parameters were monitored in a population not targeted by any formal intervention program. Response rates in both surveys ranged close to 80%. Evaluation of selected quality indicators confirmed comparability of the two surveys in terms of BP measurement quality. Small but consistent decreases in mean systolic and diastolic BP were observed, particularly for women 35 years and older, whereas BP changes in men were less pronounced and inconsistent. Likewise, downward shifts of the 10th, 50th, and 90th percentiles of systolic and diastolic BP occurred in women and their slopes of BP rise with age decreased while such changes were less clear in men. The age-standardized prevalence of men and women with hypertensive BP (HBP; > or = 160/95 mm Hg) decreased slightly. This contrasted with rises in the prevalence of actual hypertension (those with HBP plus those taking antihypertensive drugs) for 45- to 64-year-old men, which originated from changes in hypertension management involving a more frequent drug treatment of borderline-hypertensive men (140 to 159/90 to 94 mm Hg) in 1989/90. There were notable overall increases in the awareness, treatment, and control of men and women with hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1993

Physical activity at work and cardiovascular disease risk: results from the MONICA Augsburg study.

In the MONICA Augsburg study the relationship between physical activity at work, cardiovascular risk factors, incidence of fatal and non-fatal myocardial infarction (MI) and total mortality was investigated in employed men. The MONICA Augsburg baseline survey of 1984/85 was designed as a cross-sectional study with follow-up. Physical activity was determined in 45-64 year old men by interview (n = 1074, 83.6%) and by a 7-day activity diary (n = 797, 62.0%). Employed men were categorized into an active versus inactive group based on interview data on physical activity at work (PAW) which had been validated against the 7-day activity diary. When stratified by PAW, age-adjusted means of diastolic (DBP) and systolic blood pressure (SBP) and total-cholesterol (T-C) were lower and the age-adjusted mean of HDL-cholesterol (HDL-C) was higher in active than in inactive men. A linear regression model controlling for age, body mass index, alcohol consumption, smoking, and heart rate confirmed this relationship for physical activity at work; regression coefficients: DBP: beta = -2.38 (95% confidence interval [CI] : -3.85(-)-0.91); SBP: beta = -2.87 (95% CI : -5.22(-)-0.52); T-C: beta = -2.80 (95% CI : -9.31-3.71); HDL-C: beta = 3.48 (95% CI : 1.28-5.79). Survey participants were followed-up for a period of 5.8 years. The incidence density (per 1000 person-years) of fatal plus non-fatal MI was 6.8 for active men versus 5.9 for inactive men; the incidence density for total mortality was 11.2 versus 5.9, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

PubMed1993

The association of blood lead and blood pressure in population surveys.

Several reports from large population surveys have indicated that blood lead is positively related to blood pressure. We assessed this relation in 1,703 men (median blood lead = 83 micrograms per liter) and 1,661 women (median blood lead = 60 micrograms per liter), age 28 to 67 years, who participated in the first follow-up examination of the MONICA Augsburg cohort study in 1987-1988. Crude analyses confirmed a strong, positive association of blood lead concentrations with systolic and diastolic blood pressure. We identified age, body mass index, hematocrit, and alcohol consumption as the quantitatively most important confounders of this association. Adjustment for these variables, in particular for hematocrit and alcohol consumption, considerably reduced the magnitude of the blood lead effect on blood pressure. There were no indications for marked nonlinearity or threshold effects. After control of confounders, a difference of 100 micrograms per liter in blood lead levels, corresponding to rather extreme positions in the lower and upper end of the population blood lead distribution, related to estimated blood pressure increases of less than 3 mmHg. The appropriateness of treating hematocrit and alcohol consumption as confounders of the blood lead-blood pressure relation is discussed on the basis of current pathophysiologic concepts. We conclude that hematocrit should always be taken into account as a relevant confounder. On the other hand, the interrelation of alcohol consumption, blood lead, and blood pressure is presently not clearly understood; that is, its appropriate analytic handling cannot be determined. The consequences of these considerations on estimates of the blood lead effect on blood pressure may be both over- and underestimations.

Adult↗

PubMed1993

Coronary heart disease case fatality in four countries. A community study. The Acute Myocardial Infarction Register Teams of Auckland, Augsburg, Bremen, FINMONICA, Newcastle, and Perth.

BACKGROUND: Community-based registers participating in the MONICA Project of the World Health Organization show markedly different attack and death rates of coronary heart disease. This variation is a function of both the incidence and case fatality occurring within countries. The contribution of case fatality to the international variation in coronary heart disease mortality rates is not well understood. METHODS AND RESULTS: The register data from eight study populations--Augsburg and Bremen in Germany, Auckland in New Zealand, Perth and Newcastle in Australia, and North Karelia, Kuopio, and Turku/Loimaa in Finland--were compared. All patients with definite myocardial infarction or coronary death aged 35 to 64 years occurring in the study populations in 1985 through 1989 are the basis for the case fatality calculations by different definitions: 28-day case fatality for all cases, for hospitalized cases, and for hospitalized 24-hour survivors; out-of-hospital case fatality; and 24-hour case fatality for hospitalized cases. Differences in case fatality were much smaller than differences in attack and mortality rates in these populations. About two thirds of deaths occurred before the patients reached a hospital. The 28-day case fatality ranged from 37% for men in Perth to 58% for women in Augsburg. Among those who reached the hospital alive, 28-day case fatality was 13% to 27% for men and 20% to 35% for women. In those who survived 24 hours from the onset of symptoms, 28-day case fatality was 8% to 17% for men and 12% to 26% for women. CONCLUSIONS: Differences in case fatality were not associated with differences in coronary mortality rates between these populations. As most deaths occurred before reaching a hospital, opportunities for reducing case fatality through improved hospital care are limited. This emphasizes the primary role of prevention in reducing coronary death rates.

Adult↗

PubMed1993

Trends in alcohol intake in a southern German population from 1984-1985 to 1989-1990: results of the MONICA Project Augsburg.

This study was undertaken to measure trends in alcohol intake from 1984-85 to 1989-90 in a southern German population. In the surveys of the MONICA Augsburg Project conducted in 1984-85 (Survey 1) and 1989-90 (Survey 2) data on alcohol intake (in grams/day) were gathered from two independent representative samples (Survey 1: 4,016; Survey 2: 3,960) of men and women, aged 25 to 64 years. A validated recall method was applied. Self-reported mean alcohol intake was high in Survey 1 (36 g/day in men; 11 g/day in women), but decreased from Survey 1 to Survey 2 in both men and women (32 g/day in men; 9 g/day in women). The decrease is reflected also in the median and 95th percentile values of alcohol intake and in an increase of the proportion of self-reported nondrinkers from Survey 1 to Survey 2. Alcohol intake in the MONICA Augsburg population is rather high in comparison to other countries, but a trend to lower intakes was observed from 1984-85 to 1989-90.

Adult↗

PubMed1993

Self-reported prevalence of asthma symptoms in children in Australia, England, Germany and New Zealand: an international comparison using the ISAAC protocol.

There is a need for a standardized approach to international and regional comparisons of the prevalence and severity of asthma, and for the monitoring of asthma morbidity over time. In 1991, standardized written and video questionnaires were developed and administered in surveys of schoolchildren, aged 12-15 yrs, in five regions in four countries: Adelaide, Australia (n = 1,428); Sydney, Australia (n = 1519); West Sussex, England (n = 2,097); Bochum, Germany (n = 1928); and Wellington, New Zealand (n = 1863). The self-reported prevalence of wheezing during the previous 12 months was similar in West Sussex (29% using the written questionnaire and 30% using the video questionnaire), Wellington (28 and 36%), Adelaide (29 and 37%), and Sydney (30 and 40%), but was lower in Bochum (20 and 27%). The one year prevalence of severe wheezing limiting speech was greater in Wellington (11%), Adelaide (10%) and Sydney (13%), than in West Sussex (7%) and Bochum (6%). The self-reported one year prevalences of frequent attacks, frequent nocturnal wheezing, and doctor diagnosed asthma, were also higher in the Australasian centres than in the European centres. We conclude, that an international comparison of asthma symptom prevalence in childhood, using simple standardized instruments, is feasible. Possible explanations for the differences in reported asthma severity between the Australasian and European centres include differences in exposure to risk factors and differences in the management of asthma.

Adolescent↗

PubMed1993

[The language of pediatric asthma patients. A study of symptom description].

BACKGROUND: Questions on asthma symptoms like "wheezing" or "whistling in the chest" must be easily understood by the general population. In preparation of a standardized German questionnaire we investigated, how children with asthma and their parents would describe symptoms during an asthma attack. METHODS: From June until December 1991, 72 children aged 13-15 years, and parents of 138 children aged 7-15 years with diagnosed asthma, where interviewed whilst they visited the outpatient department of the universities of Berlin, Leipzig, and Munich. The parents and children were asked to answer a questionnaire which included a list of adjectives and descriptions proposed to describe the child's breathing during an asthma attack. The items included descriptions which have been used on German questionnaires, others which we considered possibly useful, anc control items which we considered inappropriate. Parents and children were asked to rate on scales how much they would agree or disagree to the proposed items as possible descriptors. Descriptive and cluster analyses revealed those descriptions which received the best ratings. RESULTS: The rating was rather independent of the sex of the child, the respondent (child vs parent) and the severity of attacks, but differences between regions were observed. CONCLUSION: The verbal descriptors with the best rating will be used for the wording of a German questionnaire on asthma symptoms.

Adolescent↗

PubMed1992

[The 1990 Bochum cholesterol and blood screening program. Incidence and degree of treatment of cardiovascular risk factors].

STUDY: Over a four-week period, 1,454 inhabitants of the town of Bochum (567 men = 39%, 887 women = 61%) were screened for cardiovascular risk factors. The sample was recruited from voluntary participants, two-thirds of whom were aged between 50 and 69. RESULTS: Age-adjusted mean total plasma cholesterol levels were 223 mg/dl for women, and 218 mg/dl for men. Age-adjusted mean systolic blood pressure were 136.7 mmHg for women, and 140.8 mmHg for men. The corresponding diastolic levels were 85.0 mmHg for women and 87.8 mmHg for men. The prevalence of hypercholesterolemia (greater than or equal to 250 mg/dl) was 32.8%, that of hypertension (greater than or equal to 160/95 mmHg) was 32.7%. Age- and sex-specific mean figures and prevalences were lower for total cholesterol and markedly higher for blood pressure as compared with representative German studies. Previously unknown hypertension (greater than or equal to 160 mmHg systolic and/or greater than or equal to 95 mmHg diastolic) was detected in 10%, and hypercholesterolemia (total cholesterol greater than or equal to 250 mgdl) in 16%. A reply postcard was received from the family doctors of only 11% of participants with elevated levels. This means that the follow-up rate remained far below the hoped-for level. CONCLUSIONS: Population screening can be useful in promoting primary and secondary cardiovascular disease by alerting the population to classical risk factors and informing participants about their own personal situation. In order to motivate individuals with high risk factors to act upon this information, screening should be associated with follow-up.

Adult↗

PubMed1992

Comparison of dietary intakes in four selected European populations.

The composition of diet and food intakes in four selected European populations were compared. Dietary data (from the World Health Organization Project on Monitoring Trends and Determinants in Cardiovascular Disease) were measured by record methods and were available for middle-aged men in Finland (n = 653), France (n = 1128), Northern Ireland (n = 356), and southern Germany (Augsburg region; n = 899). Nutritional variables--which are independent of the absolute energy intake, such as the percentage supply of energy from macronutrients and the ratio of polyunsaturated to saturated fatty acids--were on the whole similar. However, striking differences were found in food intake and in the percentage supply of fat from different foods. The results indicate that detailed knowledge of consumption figures is necessary to develop prudent and acceptable nutrition intervention programs.

Adult↗

PubMed1992

[Epidemiology of risks in the workplace].

Epidemiologic studies of occupationally exposed subjects allow to detect diseases caused by the work environment and to identify hazardous exposures. They provide the basis for preventive measures and workers compensation. Occupational epidemiology traditionally emphasized the study of work related cancer. Long latency periods for the development of most cancers and limited information about the exposure history of the study subjects are problems for all study types. The specific advantages and limitations of different study designs are discussed. Research strategies in occupational epidemiology are demonstrated using as an example two studies from the American tire and rubber industry. The specific contributions of a historical cohort study and a nested case-control study, concerning the association between lymphosarcoma and exposure to solvents, are discussed. Experiences and first results from a historical cohort study in the German rubber industry are reported. Future research in occupational epidemiology should concentrate more on the study of work related morbidity such as musculoskeletal disorders, hearing loss, accidents and the influence of the work environment on the mental and physical well being. Modern research methods such as prospective cohort studies or workforce monitoring should be used more often. Prospective cohort studies provide quantitatively and qualitatively more precise information about exposures and potential confounders, e.g. cigarette smoking or alcohol consumption, than traditional study methods. The promising perspectives of biological markers warrant further research. The situation of occupational epidemiology in Germany can only be improved if all concerned parties and institutions realize the importance of occupational epidemiology. Laws concerning data confidentiality which seriously hamper epidemiologic research must be modified.

Chronic Disease↗

PubMed1992

[Seasonal variations in nutrition behavior: results of the dietary survey of 1984/85 of the MONICA project in Augsburg].

Seven-day food records of the MONICA project Augsburg dietary survey, which were collected between October 1984 and May 1985 in 899 men aged 45-64 years, were used to analyse seasonal variations. Variations could be found in several food groups, but nutrient intake was nearly the same in autumn, winter and spring--with the exceptions of total fibre and alcohol.

Alcohol Drinking↗

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↗