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Biomedical subjects

U Keil

Publications and source records attributed to U Keil.

At least 145 records · Page 8Linked to original sources
PubMed1991

[Interdisciplinary preventive use of iodine in former East Germany following reunification and the status of packaged iodized table salt for improving alimentary iodine supply. Retrospect and prospects].

The general interdisciplinary iodine prophylaxis which began in the former GDR in 1985/86 led to the amelioration of the alimentary supply with iodine and to success which was taken notice of also internationally. The amelioration of the supply with iodine was above all derived from the use of iodized mineral mixtures in animal production. According to the analyses performed up to 1990 the state of development could be maintained for the time being. With the German reunification the general iodine prophylaxis was deprived of its legal fundament and with the reorganization of agriculture the expanding use of iodized mineral mixtures was no more guaranteed. Respecting the principle of voluntariness the application of iodized kitchen salt is to be propagandized above all in children, adolescents and pregnant women and the use in big kitchens, restaurants and in the foodstuff industry.

Adolescent↗
PubMed1990

[Dietary iodine deficiency in East Germany following introduction of interdisciplinary preventive use of iodine].

The interdisciplinary iodine prophylaxis introduced in 1985/86 comprises the iodination of 84% of the packaged salt with 32 mg KIO3/kg salt and the use of iodized mixtures of mineral substances in animal production. At the beginning of this measure with an average renal ioduria of 19.0 +/- 1.0 micrograms J/g creatinine in the GDR there was at least still an iodine deficiency of 2nd degree. It increased from north to south: 20.3 +/- 1.0 in contrast 13.4 +/- 1.5 micrograms J/g creatinine. In the middle of 1986 a clear improvement of the supply with iodine began. The renal iodurias had more than doubled. For the GDR the mean ioduria was 43.4 +/- 0.9. The relation from north to south had, if anything, inverted: 37.3 +/- 2.1 in the north, 42-49 micrograms J/g creatinine in the centre and south of the GDR. Nearly one third of the population no more undergoes an iodine deficiency. The intrathyroidal iodine content increases. The improved supply with iodine among others is evident in: reduction of the connatal goiter below 1%, reduction of the recall rate in the TSH hypothyroidism newborn screening, normal thyroid gland mass of the newborn, reduction of the goiter frequency in children and adolescents, transient increase of the frequency of hyperthyroidism, in particular based on functional autonomies in persons older than forty years. In animal production losses of produce amounting to 181 Mic/a were eliminated.

Adolescent↗
PubMed1990

Determinants of HDL-cholesterol and the HDL-cholesterol/total cholesterol ratio. Results of the Lübeck Blood Pressure Study.

Results are presented here on the relationship, in a large city in the Federal Republic of Germany, between HDL-cholesterol (HDL-C) or the HDL-cholesterol/total cholesterol ratio (HDL-C/TC) and the variables smoking, alcohol consumption, Body Mass Index (BMI), and age. The strength of each relationship is estimated and compared with the findings of other similar studies. Careful attention is given to the interactive effects of the variables. Evidence is presented to support, in a European setting, previous findings which suggest negative relationships between HDL-C or HDL-C/TC and certain lifestyle factors, namely BMI and cigarette smoking, and a positive relationship with alcohol consumption. In general, no relationship with oral contraceptive use or age is found. Several interactions among the various lifestyle factors and their relationships to HDL-C are seen, including a confirmation of a smoking/alcohol interaction found earlier.

Adult↗
PubMed1990

Morbidity and mortality of myocardial infarction in the Augsburg MONICA study area in 1985, 1986 and 1987.

In the years 1985, 1986 and 1987, the MONICA Augsburg Coronary Event Register recorded 1488 coronary events (1214 men and 274 women) occurring in 35-64 year old residents of the study region (population: 102,000 men and 105,000 women). The rates presented include all coronary events with a definite acute myocardial infarct (AMI), possible AMI, resuscitated cardiac arrest, and insufficient data. The age-standardized attack rates in men are 390 (1985) to 372 (1987) and in women 51 (1985) to 72 (1987) per 100,000 population. The age-standardized 28-day case fatalities in men are 44 (1985) to 44 (1987) and in women 67 (1985) to 55 (1987) per 100 coronary events. With the exception of the attack rates in women, no statistically significant differences between yearly rates could be established.

Adult↗
PubMed1990

Variation in coronary risk factor levels of men and women between the German-speaking MONICA centres.

The aim of this analysis was to compare levels of risk factors for coronary heart disease (CHD) in men and women aged 25-64 years between German-speaking MONICA collaborating centres, the German Democratic Republic (GDR), Augsburg - the Federal Republic of Germany (FRG)(Au), Bremen - FRG (Br), Heidelberg - FRG (He), and Vaud/Fribourg - Switzerland (CH, with a German-speaking minority). Prevalence of cigarette smoking in men showed little variation in four centres (34 to 40%) and was higher in BR men (49%), while it varied from 17% (GDR) to 33% (BR) in women. Mean total serum cholesterol values (mmol/L) were highest in GDR and CH men (both 6.2) and GDR women (6.1), and lowest in both He men (5.7) and He women (5.6). The proportion with cholesterol values greater than or equal to 6.7 mmol/L was largest in CH men (34%) and smallest in FRG (He) women (17%), while lowering the cut-off point from 6.7 to 6.5 mmol/L raised the prevalence of hypercholesterolaemia in all centres by 5 to 10%. Mean values (mmHg) of blood pressure (BP) were highest in both GDR men (140/88) and women (138/86), as was the prevalence of hypertensive BP values. In all centres, women aged 25-34 had BP values approximately 12/5 mmHg lower than age-matched men, but BP values similar to men at age 55-64, which indicates that age-parallel increase in BP was steeper in women than men.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Prevention of classical risk factors. A public health and health policy task].

Epidemiologic cohort studies such as Framingham, Tecumseh, Evans County and the Multiple Risk Factor Intervention Trial Cohort Study have shown, that hypercholesterolemia, hypertension and cigarette smoking are the strongest predictors for cardiovascular diseases and especially for coronary heart disease. From the intervention studies of the last two decades it has been learn that reductions of the risk factors hypercholesterolemia and hypertension have led to the predicted reductions in cardiovascular and all cause mortality. Two strategies are available for the prevention of hypercholesterolemia and hypertension: The population strategy and the high risk strategy. With regard to cholesterol and blood pressure the population approach strives for the shifting of the respective population distributions to the left i.e. to lower values. The high risk strategy on the other hand restricts itself to the 10-20% of the population with very high values. A comparison of the population and high risk strategy shows, that only the population strategy is radical in that only this strategy is capable to eliminate the causes of the incidence of hypercholesterolemia and hypertension. The high risk strategy on the other hand is unable to influence the total distribution curve. Population strategy and high risk strategy should be seen as complementary. To further reduce mortality and morbidity from cardiovascular diseases in the Federal Republic of Germany the following public health programs and health policy strategies must be applied: a) Reinforcement of the National High Blood Pressure Education Program. b) Establishment of a National High Cholesterol Education Program. c) Nationwide Anti-smoking Campaigns and Programs.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteriosclerosis↗
PubMed1989

Awareness and treatment of hypercholesterolemia: results of the first survey of the MONICA Project Augsburg.

In the first survey of the MONICA project Augsburg (1984/1985), awareness and treatment of hypercholesterolemia was determined on a two-stage cluster sample of 5069 25-64 year old citizens (participation 79.6%). Hypercholesterolemia was defined according to the Conference of the European Atherosclerosis Society (EAS) and of the National Cholesterol Education Program (NCEP). Awareness (elevated lipid levels found during the last 12 months), and drug and dietary treatment were determined by an interview. The awareness was low and varied between 4 and 24% in the different age-sex groups with no significant differences between sexes, with one exception: The awareness in women aged 55-64 years with cholesterol levels greater than or equal to 300 mg/dl was 38% and differed significantly from that found in men in the same age group (21%). Older participants showed a higher degree of awareness than younger; in men the awareness was independent from the cholesterol level, in women those with higher levels showed a better awareness than those with lower levels (results from a logistic regression analysis for cholesterol levels greater than or equal to 240 mg/dl). The use of lipid-lowering drugs was low in the study population (2% in men, 1% in women). The drug treatment of hypercholesterolemia was low and in no age-sex group higher than 7%, despite the definition of hypercholesterolemia; the dietary treatment was not higher than 20%. In conclusion it is shown, that there is a great need for the identification and management of hypercholesterolemia in the examined population in Southern Germany.

Adult↗
PubMed1989

Worksite-screenings for hypertension with follow-up: experiences from the Munich Blood Pressure Program.

In 1983/84, the Munich Blood Pressure Program (MBP) performed worksite screenings for arterial hypertension at 18 Munich companies. A participation of 51% (n = 7310) was achieved. After duplicate measurements of casual blood pressure 1084 participants were suspected of having actual hypertension. All suspected cases were invited for a reexamination to reduce the number of false-positive hypertensives. Individuals with persisting hypertension after this two-step-screening were predominantly male, on the average younger than 50 years and showed a low level of antihypertensive drug treatment. About 75% of all detected hypertensives saw a family physician subsequent to the screenings for further management. Referrals and patient compliance were frequently reinforced by a computer based reminder system. A follow-up examination was performed among the MBP participants after two years. It showed that in 417 confirmed hypertensives of the primary screenings a marked increase in the proportion of treated and controlled hypertensives had occurred. This was true for younger and older hypertensives.

Adult↗
PubMed1989

Effects of road traffic noise on prevalence of hypertension in men: results of the Luebeck Blood Pressure Study.

Within the Luebeck Blood Pressure Study - a cross-sectional study of 2,315 Luebeck citizens, aged 30-69 years, response 83.3% - the association between blood pressure and exposure to road traffic noise at home was investigated. Road traffic noise was grouped as HIGH and LOW exposure, hypertension was defined as either SBP greater than or equal to 160 mm Hg and/or DBP greater than or equal to 95 mm Hg and/or on antihypertensive medication. A comparison of the crude prevalence of hypertension showed an increase of prevalence for men from 25.5% in the LOW to 31.1% in the HIGH exposure group (odds ratio: 1.32; 90% CI: 1.03-1.69), which was statistically significant at the alpha-level of 0.1. After univariate analyses the variables age, BMI, alcohol consumption, years of education, duration of residence, and employment status were considered as possible confounders or effect modifiers. A logistic regression model was fitted by using a backward stepping procedure. Prevalence were adjusted by using this logistic regression model. Differences between adjusted prevalences in LOW and HIGH exposure groups were similar to the crude differences. The odds ratio computed by the coefficients of this model was also similar to the corresponding odds ratio above. To validate the model we simultaneously stratified the remaining variable of the final model and combined the resulting odds ratios by Mantel-Haenzel. The results were again similar. According to the results of this study a positive association between exposure to road traffic noise and prevalence of hypertension in men is probable.

Adult↗
PubMed1989

Alcohol and blood pressure: results from the Luebeck Blood Pressure Study.

Data from the Luebeck Blood Pressure Study, a cross-sectional study on a random sample (n = 3,100) of the 30- to 69-year-old population of Luebeck, were analyzed with regard to alcohol consumption and blood pressure. Putative confounders such as obesity, smoking, physical activity, and educational attainment were controlled for by multiple regression analyses. Luebeck men who consumed more than 40 g of alcohol per day revealed 5-6 mm Hg higher mean systolic and 4-5 mm Hg higher mean diastolic blood pressure values. A J-shaped relationship between alcohol consumption and systolic blood pressure was seen in Luebeck men. According to our calculations, about 7% of hypertension among Luebeck men is due to alcohol consumption of greater than or equal to 40 g/day. Among women, strong interactions between age and alcohol consumption were found, therefore two age groups, 30-44 and 45-69 years, were analyzed separately. In the younger age group the alcohol-blood pressure relationship was not pronounced. In the older age group a strong interaction between alcohol consumption and smoking was found. For female smokers steep increases in the adjusted mean diastolic (5.2 mm Hg) and systolic (9.6 mm Hg) blood pressure values were seen for the alcohol consumption category greater than or equal to 20 g/day. For female nonsmokers a flat curve was seen with regard to mean diastolic and systolic blood pressure values. The data from the Munich Blood Pressure Study show a very similar relationship between alcohol consumption and mean systolic and diastolic blood pressure values.

Adult↗
PubMed1989

Is increased plasma viscosity a risk factor for high blood pressure?

Data from several epidemiologic studies have suggested that, among other variables, hematocrit and fibrinogen may constitute risk factors for high blood pressure. As part of a population survey for cardiovascular risk factors, plasma viscosity and hemoglobin were measured. Blood pressure was determined under standardized conditions according to the recommendations of the AHA. A two-stage age-sex-stratified cluster sample of 5,312 persons, aged twenty-five to sixty-four years, was selected from a mixed urban/rural target population of 282,279 (total population approximately 533,000). A net response of 79.3% was achieved. Multiple logistic regression analyses including plasma viscosity, hemoglobin, body mass index, alcohol consumption, smoking behavior, and total serum cholesterol as independent variables were run controlling for both age and sex. Plasma viscosity appeared as a significant main effect in all analyses and demonstrated the strongest association with high blood pressure next to body mass index. Whether this association implies a causal relationship cannot be answered from cross-sectional data. However, even if plasma hyperviscosity represents a secondary phenomenon in hypertension, it might be of prognostic relevance. There is evidence that increased plasma viscosity may contribute to myocardial hypertrophy. Therefore hypertensives with impaired blood fluidity might constitute a subgroup at particular risk for cardiovascular complications. When antihypertensive drugs are selected, their influence on blood viscosity should be taken into account.

Adult↗
PubMed1989

[Nutrition survey of adults using a 7-day protocol--a pilot study in the Augsburg MONICA project].

During the MONICA-project nutrition as one factor for the development of coronary heart disease is examinated. The individual intake of total energy, of fat-including saturated and unsaturated fatty acids-and of alcohol should be determined. This pilot study was done before the first cohort study within the MONICA-project Augsburg. The nutritional data were collected from february to march 1984 with the 7-day-dairy-record-method. 65 of totally 112 received records were suitable for evaluation by the computer program KALI (version 2.1.4). The 35 male persons had an average energy intake of 2.677 kcal/day. The average daily energy intake of the 30 female persons decreased with age. The main energy source for all persons is fat. Five women and eight men have an average intake of more than 500 mg cholesterol/day. Estimations of the intake of fatty acids were not possible, because of the specification of the computer program. Carbohydrates supply about 36% in men and 40% in women of the total energy, protein about 13% and 16% respectively. Men are drinking about 44 g alcohol/day. This is distinctly more than women do. Womens daily intake of vitamin B1, vitamin B6 and iron was lower than the recommendations of the German Nutrition Society. It's the same with vitamin B6 for men.

Adult↗
PubMed1989

WHO MONICA Project: risk factors.

The WHO MONICA Project was designed to measure trends and determinants in cardiovascular disease mortality and coronary heart disease and cerebrovascular disease morbidity, and to assess the extent to which these trends are related to changes in known risk factors in 39 collaborative centres in 26 countries. Results of the baseline population surveys are presented. Use of standardized methods allows cross-sectional comparisons to be made of data from the 39 collaborating centres. The proportion of smokers varied between 34-62% among men and 3-52% among women. The median systolic blood pressure (SBP) values varied from 121 mmHg to 145 mmHg in men and from 117 mmHg to 143 mmHg in women. Median diastolic blood pressure (DBP) values varied from 74 mmHg to 91 mmHg in men and from 72 mmHg to 89 mmHg in women. The prevalence of actual hypertension, defined as SBP and/or DBP greater than 159/94 mmHg, or on antihypertensive medication, varied between 8.4% and 45.3% in men and between 12.6% and 40.5% in women. Median serum total cholesterol values varied from 4.1 mmol/l to 6.4 mmol/l in men and from 4.2 mmol/l to 6.4 mmol/l in women. The results show that there is a large variability in the risk-factor patterns among the MONICA populations. They also indicate that populations with low levels of risk factors are in the minority.

Adult↗
PubMed1988

Morbidity and mortality of myocardial infarction in the MONICA study area Augsburg in 1985.

In the year 1985, 998 (734 men, 264 women) cases of acute coronary events were registered among the 25-74 year-old residents of the study area (151,489 men and 171,093 women) of whom 583 (403 men, 180 women) died within 28 days (case fatality). Both AMI as a clinical diagnosis and AMI as a cause of death are validated by defined MONICA diagnostic criteria (acute symptoms, enzyme level, ECG, autopsy diagnosis). The AMI-risk (MONICA diagnostic categories 1, 2, 3, 9) in the study area Augsburg is relatively low (incidence: men 302, women 113; attack rate: men 444, women 138; death rate: men 241, women 92; all per 100,000 for each group). The 28-day case fatality is comparatively high (men 54%, women 67%). A comparison of the Augsburg rates with those of three other centers shows that the Augsburg figures are in the lower range.

Adult↗
PubMed1988

Smoking habits and attitude to smoking in the study population of the MONICA Project Augsburg.

Data concerning smoking habits were derived from the first MONICA-Augsburg survey 1984/85 based on a random two stage cluster sample of the 25-64 year old population of the city of Augsburg and the two surrounding rural districts (n = 5312). Data were gathered by a standardized interview. Response was 79%. Overall, about 36% of men and 18% of women are regular cigarette smokers (i.e. smoking more than one cigarette per day). In both sexes smoking decreases with increasing age. In men 43% of the 25-34 year old participants are regular smokers and 29% in the age group 55-64. In women 29% of the youngest age group but only 9% aged 55-64 are current regular smokers. In male regular cigarette smokers the mean amount of cigarettes consumed per day is 21, in women 14 cigarettes. The mean amount of nicotine and tar consumed per day is 17 mg and 277 mg in men, 10 mg and 159 mg in women. On the average men start smoking at the age of 18 and women at the age of 21. In both sexes the percentage of regular smokers, who are willing to change their smoking habits, is very high. In each age and sex group about 60% of all regular smokers affirmed their willingness to quit smoking in the future. It is hoped, that this willingness of the population to change their smoking behavior will be supported by suitable education and intervention programs.

Adult↗
PubMed1988

Social relations and smoking behavior: results from the first MONICA Survey Augsburg.

This study examines the relationship between various aspects of social relations and the prevalence of smoking, using data from the first MONICA Survey, Augsburg, FRG, 1984/85. Study population of the survey was a two-stage cluster sample of 5312 men and women aged 25 to 64. The response was 79.4%. The measurement of social relations included a modified form of the Syme/Berkman social network scale, as used in the Alameda County Study. Analyses were carried out separately for the total four-level social network index in relation to smoking, and for specific components of that index (marital status, contacts with friends and relatives, activities in informal groups). The results showed for both men and women, that there was a significant association between the social network index and the prevalence of smoking: the more social ties and contacts, the lower the percentage of smokers. The results from multiple logistic regression analyses indicated an effect of social relations on smoking, that is at least partly independent of age, gender and educational level. In general, the findings may contribute to a better understanding of 'risk groups', and the possible pathways leading from social relations to health and disease.

Adult↗