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Biomedical subjects

Ulrich John

Publications and source records attributed to Ulrich John.

At least 109 records · Page 6Linked to original sources
PubMed2003

The Fagerström test for nicotine dependence in two adult population samples-potential influence of lifetime amount of tobacco smoked on the degree of dependence.

BACKGROUND: The Fagerström test for nicotine dependence (FTND) has been widely used in clinical samples but seldom in population samples. Data are particularly lacking for a large range of ages. The goal was to describe the FTND sum score distribution in the adult population and to show potential variation according to the number of years of smoking. METHODS: Random adult population samples from two northern areas in Germany were used. Sample 1 included 1460 current smokers aged 20-64 years and sample 2 included 1135 current smokers aged 20-79 years. One cross-sectional and longitudinal and one cross-sectional study were conducted. The FTND was administered during face-to-face computer-aided interviews. RESULTS: The mean FTND sum score for those aged 20-64 was 3.2 among sample 1 and 2.5 among sample 2. The number of years of smoking and age did not affect the FTND sum score whereas it was positively correlated with the lifetime amount of tobacco smoked. CONCLUSIONS: Dependence according to the FTND does not increase with the number of years of smoking. Population-based interventions addressing the needs of dependent smokers across all age groups are needed.

Adult↗
PubMed2003

Alcohol high risk drinking, abuse and dependence among tobacco smoking medical care patients and the general population.

BACKGROUND: Little is known about the synergies of smoking and alcohol consumption in medical care patients. The objective, therefore, is to estimate the coincidence of hazardous and harmful alcohol consumption as well as alcohol abuse and dependence with tobacco smoking in a general hospital and general practices. METHODS: Three samples of 18-64 year olds include 510 consecutively admitted currently smoking in-patients of a general hospital, 271 patients of a randomized sample of general practices, and 1567 current smokers from a regional population in Germany. Data include the number of cigarettes and a diagnosis of alcohol dependence and abuse (DSM), harmful or hazardous alcohol use. RESULTS: The rates of current daily cigarette smokers with an alcohol dependence or abuse, harmful or hazardous alcohol consumption are 47.1% in the general hospital and 32.1% in the general practice sample compared with 18.4% in the general population. The rates increase from nonsmokers to smokers and with the number of cigarettes. CONCLUSIONS: The findings fit into the evidence about alcohol and tobacco interactions in morbidity and mortality. General medical care settings are appropriate for the detection of alcohol dependence or abuse via smoking.

Adolescent↗
PubMed2003

Relation among stage of change, demographic characteristics, smoking history, and nicotine dependence in an adult German population.

BACKGROUND: The aim of this study was to provide evidence about the individual intention to quit smoking and accompanying characteristics in a country with a low amount of tobacco control (TC) provisions. METHODS: This study used a random sample of the population aged 18-64 in a German area to make a quantitative estimation of the stages of change to quit smoking among current smokers who had at least one quit attempt (n = 1075). RESULTS: The rate of those who did not intend to stop smoking (precontemplators) was 76.4%, that of those who intended to quit during the next 6 months (contemplators) was 17.0%, and that of those who intended to quit during the next 4 weeks was 6.6%. The three groups did not differ according to gender or age. Of those who had at least 16 years of education, more were contemplators than were those with fewer years of education. Among those who had somatic complaints or nausea from smoking, who had their first cigarette within 1 h or less after awakening, and who had more quit attempts, more were in the contemplation or preparation stage. CONCLUSIONS: Nicotine dependence may add to contemplating about quitting. The precontemplation rate was substantially higher than in samples from nations or states which show a large amount of TC provisions.

Adult↗
PubMed2003

Late onset alcoholism.

Rather high prevalence rates of alcohol abuse in the elderly have been reported in the literature. However, there is some evidence that many elderly persons with alcohol problems are not identified, probably due to the nonspecificity of alcohol-related presentations in old individuals. Thus, there is an ongoing discussion on appropriate diagnostic criteria for alcohol dependence in elder people who frequently begin to abuse alcohol in late life. This study was aimed to explore whether alcoholics with late onset (beginning after the age of 45) differ from those with an early onset (prior the age of 25). Two hundred and sixty eight subjects consecutively referred to a ward of a general hospital specialized for alcohol detoxification were divided into three groups by the age at onset of harmful alcohol consumption. The duration of harmful drinking was rather similar in all groups. However, alcohol dependence according to the ICD-10 criteria (three or more have to be fulfilled) was diagnosed in 94.1% of the alcoholics with an early onset (</= 25 years), but only in 62.2% of those with late onset (P < 0.0001). Significant differences between these groups were found for the following criteria: preoccupation with drinking (P < 0.0001), impaired capacity to control drinking (P < 0.01), strong desire to drink alcohol (P < 0.01), and a trend towards a lower rate of lifetime psychiatric comorbidity. The alcoholics with late onset reported fewer previous detoxifications and a lower actual alcohol consumption. Moreover, they showed a higher rate of abstinence in the 12 month follow-up. Regarding the difficulties in comparing groups of different ages at onset of harmful alcohol use our results suggest that the alcoholics with late onset differ in many ways from those with early onset.

Adult↗
PubMed2003

Probabilities of alcohol high-risk drinking, abuse or dependence estimated on grounds of tobacco smoking and nicotine dependence.

AIMS: To estimate probabilities of alcohol high-risk drinking, alcohol abuse and alcohol dependence on grounds of smoking-behaviour related variables and single nicotine dependence criteria. DESIGN: Cross-sectional population-based study. SETTING: Adult population of a region in north Germany. PARTICIPANTS: Cigarette smokers (n = 2437) among a random sample of 4075 females and males aged 18-64, drawn in 1996. MEASUREMENT: Smoking, nicotine dependence according to the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-IV) and the Fagerström Test for Nicotine Dependence (FTND); increasing alcohol-related harm (ARH): high-risk drinking, DSM-IV alcohol abuse, remitted and current alcohol dependence diagnosed by the Composite International Diagnostic Interview (CIDI). FINDINGS: Having smoked 30 cigarettes or more per day, onset of smoking at the age of 17 or younger, nicotine dependence and single nicotine dependence criteria revealed odds ratios higher than 4.0 for alcohol dependence. For alcohol dependence, a logistic regression model showed an increased odds ratios for male gender, smoking for 25 years or more, no attempt to quit or cut down, continuation of smoking despite problems, craving for nicotine, withdrawal experience 1 day or longer, smoking first cigarette in the morning 5 minutes or less after waking. The probability of increasing ARH was more likely in males, smokers for 25 years or more, no attempt to quit or cut down, continuation of smoking despite problems and smoking first cigarette in the morning 5 minutes or less after waking. CONCLUSIONS: Gender and single nicotine dependence criteria show particularly high probabilities of alcohol dependence and increasing ARH. Interventions need to take these connections into account.

Adolescent↗
PubMed2003

Intentionally reduced smoking among untreated general population smokers: prevalence, stability, prediction of smoking behaviour change and differences between subjects choosing either reduction or abstinence.

AIMS: To compare data from the general population on intentionally reduced smoking and smoking cessation. DESIGN: Longitudinal observation study. SETTING: Northern German region. SUBJECTS: Randomly sampled residents aged 18-64 (T1; n = 4075, response rate 70%). Daily cigarette smokers (n = 1520) were followed up after 30 (T2; n = 913) and 36 months (T3; n = 786). MEASURES: Self-reported smoking-related and socioeconomic variables. Participants were explicitly asked for reduction attempts (reducing cigarettes per day) and maintenance of reduction, which was defined independently of consumption measures. FINDINGS: Between T1 and T2, reduction attempts (39%) were more frequent than quit attempts (33%), and according to self-report, reduction was more likely to be maintained for up to 12 months. Smokers maintaining reduction for up to 6 months had reduced their consumption at T3 by 34% compared with T2. Between T1 and T2, the occurrence of both a reduction and a quit attempt was most frequent (22%), followed by subjects exclusively trying to reduce (17%) and subjects exclusively trying to quit (4%). Subjects who exclusively tried to reduce had a significantly increased probability of further reduction attempts at T3 (OR = 4.4, 95% CI 2.0-10.1), while the probability of quit attempts was equal compared with subjects not attempting to reduce or quit (OR = 1.1, 95% CI 0.3-3.2). DSM-IV nicotine dependence was less common in subjects who exclusively tried to reduce. Other smoking-related and socioeconomic variables did not predict whether individuals attempted to reduce or attempted to quit. CONCLUSIONS: A considerable proportion of general population smokers attempt to reduce, and are able to maintain reduction of, cigarette consumption over time. Reduction attempts did not reduce the probability of a subsequent cessation attempt.

Adolescent↗
PubMed2003

The prevalence of undiagnosed thyroid disorders in a previously iodine-deficient area.

OBJECTIVE: The aim of the present study was to analyze the current status of morphologic and functional thyroid abnormalities in a previously iodine-deficient area. METHODS: The population based Study of Health in Pomerania (SHIP) comprised 4310 participants, aged 20-79 years. Thyroid function (thyrotropin [TSH] free triiodothyronine [FT(3)], and free thyroxine [FT(4)]) and serum autoantibodies to thyroperoxidase (TPOAb) were evaluated from blood samples. Thyroid structure and size were measured by ultrasound. Data from 3941 participants with no known thyroid disorders were analyzed. RESULTS: The median iodine urine excretion was 12.4 microg/dL. The rate of decreased serum TSH levels (<0.3 mIU/L) was 11.3%; 2.2% of participants had suppressed serum TSH levels (<0.1 mIU/L). The prevalence of subclinical hyperthyroidism was 1.8%, the prevalence of overt hyperthyroidism 0.4%. Elevated TSH levels were found in 1.2% of individuals. Subclinical hypothyroidism was observed in 0.5%, overt hypothyroidism in 0.7% of the sample. Elevated TPOAb were detected in 7% of subjects, 4.1% of participants had TPOAb greater than 200 IU/mL. The prevalence of goiter was 35.9%. An inhomogeneous echo pattern was detected in 35.2% and nodules in 20.2% of participants. Diffuse autoimmune thyroiditis was diagnosed in 47 subjects (1.2%). CONCLUSION: There are a number of thyroid disorders in this previously iodine-deficient region. Further studies are required to investigate the change of thyroid disorders during iodine supplementation programs.

Adult↗
PubMed2003

Tobacco- and alcohol-attributable mortality and years of potential life lost in Germany.

AIM: To compare the ages of death caused by tobacco smoking and alcohol risk drinking. METHODS: Smoking rates from the largest population survey, alcohol drinking data from the National Health Survey and data from the vital statistics from Germany are used and attributable fractions computed. RESULTS: Alcohol-attributable deaths occurred at the youngest age, followed by tobacco- plus alcohol-attributable cases, whereas death cases attributable to tobacco smoking only occur latest. CONCLUSION: The overlap in the two substance-use behaviours has to be taken into account when considering attributable mortality data.

Adolescent↗
PubMed2003

Functional significance of a hereditary adenine insertion variant in the 5'-UTR of the endothelin-1 gene.

Endothelin-1 (ET-1) is known as a potent vasoconstrictor peptide and stimulator of cell proliferation. The human preproendothelin-1 mRNA contains a frequent adenine insertion polymorphism (allele frequency = 0.28) within the 5'-untranslated region (5'-UTR), 138 bp downstream of the transcription start site, which was assumed to be related to hypertension. This 5'-UTR variant could putatively influence the mRNA secondary structure and stability, efficacy of translation initiation, or binding of sequence-specific mRNA-binding proteins. By cloning the entire ET-1 gene 5'-UTR in a pGL3 vector and transfection of two cell lines, we studied the effects on luciferase expression in vitro. Luciferase activity was significantly increased in the insertion variant (I) compared to the wild-type (D) variant for both COS1 (2.97 +/- 0.12 versus 2.17 +/- 0.10; P = 0.002) and HepG2 cells (5.42 +/- 0.90 versus 3.68 +/- 0.37; P = 0.002). Investigations performed ex vivo using human umbilical vein endothelial cells were performed to examine the influence of genotypes on the formation of mRNA and protein. Preproendothelin-1-mRNA was quantified in relation to GAPDH by a realtime polymerase chain reaction. Homozygous I-carriers showed significant elevated mRNA levels compared to I/D and I/I-carriers (I/I 9.03 +/- 1.86, I/D 2.07 +/- 1.15, D/D 2.33 +/- 0.99; P = 0.001). ET-1 protein expression, determined by enzyme-linked immunosorbent assay, was increased among I-carriers (I/I 814 +/- 144, I/D 528 +/- 103, D/D 556 +/- 75 pg/ml; P = 0.001). The observed effects may be due to an enhanced mRNA stability because the half-life of mRNA consisting of the I-variant was prolonged (35.4 +/- 7.9 versus 19.9 +/- 4.5 min). We were able to show that the +138 I/D polymorphism is of functional importance for ET-1 expression, and this may have consequences for vessel tonus regulation.

5' Untranslated Regions↗
PubMed2003

Factor V Leiden and the risk of stillbirth in a German population.

An association between the factor V Leiden variant and an increased risk of pregnancy loss has been reported. Most previous studies were performed with clinically recruited patients and controls. This approach may cause selection bias. The present analysis was performed with the aim to investigate the association between the factor V Leiden mutation and the risk of stillbirth in a population-based sample. The Study of Health in Pomerania (SHIP) is a survey that was carried out in North East Germany. A random sample from the population aged 20 to 79 years was taken. The total SHIP population comprised 4,310 participants. The presence of the factor V Leiden variant was determined by PCR and Mnl I digestion. The presence of the factor V Leiden variant was neither associated with the number of pregnancies nor with the number of children per women. Data from 1,768 females who had at least one pregnancy with known outcome was available for the present analysis. Seventy-three women (4.1%) reported at least one stillbirth. Women with and without the factor V Leiden mutation did not differ with respect to the number of women with at least one stillbirth (OR for factor V Leiden variant 1.57; 95%-CI 0.76 - 3.25). Furthermore, the number of women with two or more stillbirths, the number of stillbirths per affected woman and the number of stillbirths per number of pregnancies per woman was similar between both genotype groups. In conclusion, there is no association between the factor V Leiden mutation and the risk of stillbirth in a representative population sample.

Adult↗
PubMed2003

Measuring sense of coherence with only three items: a useful tool for population surveys.

OBJECTIVES: Sense of Coherence is the core construct of Antonovsky's salutogenetic model. To measure Sense of Coherence, a 29-item-questionnaire (SOC-29), a shortened 13-item version, and a simplified measure of only three items (SOC-3) are available. In our study, the last was tested in terms of the psychometric properties and compared with an alternative short form derived from the SOC-29. METHODS: Data with respect to the original SOC-29-scale, the SOC-3, and additional other health measures were collected in a representative general population survey, the German study 'Transitions in Alcohol Consumption and Smoking' (TACOS). Analyses of the factor structures, reliability and validity correlations are reported. RESULTS: The reliability and validity results of the SOC-3 were not encouraging. Subsequent item analyses revealed that three items taken out of the SOC-29 outperformed the SOC-3 in measuring Sense of Coherence in a simplified way. This newly developed instrument is presented as the Brief Assessment of Sense of Coherence (BASOC). CONCLUSION: The BASOC is a superior short form compared with the SOC-3 and is recommended for large surveys with limited space for questions.

Adaptation, Psychological↗
PubMed2003

Distribution and dose response of laboratory markers to alcohol consumption in a general population: results of the study of health in Pomerania (SHIP).

OBJECTIVE: Biomarker distributions must be well known for use as screening tools for hazardous alcohol consumption in general populations. The aim of this study was to investigate characteristics of carbohydrate-deficient transferrin (CDT) and to compare it with gamma-glutamyltransferase (GGT) and erythrocyte mean corpuscular volume (MCV) in regard to distribution in the general population; the dose response relationship between alcohol consumption and biomarkers; and the effect of gender, age, body mass index (BMI) and smoking. METHOD: In a cross-sectional health survey in northeast Germany (1997-2001), a sample of 7,008 men and women aged 20-79 years was drawn, following stratification by age and gender. Of this sample, 4,310 subjects (2,193 women) took part in the study. Alcohol consumption was evaluated by self-reports with a beverage specific quantity-frequency method. RESULTS: Biomarker distributions differ across age and gender. The distribution of drinkers and nondrinking subjects showed considerable overlap. The association of alcohol consumption to laboratory markers is weak in the general population: strongest for GGT, followed by CDT and MCV For CDT and MCV it is weaker in women than in men. We found increasing risk of all three elevated marker values with increasing alcohol consumption and significant effects of age, gender, smoking and body mass index on the alcohol-biomarker dose response curve. CONCLUSIONS: When biomarkers are used for screening, all confounding effects have to be taken into account and adjusted normal ranges must be used. CDT shows no overall advantage over GGT. Low correlation of biomarkers with alcohol consumption, their high variability and widely spread ranges in nondrinking subjects limit the usefulness of these markers in general population settings.

Adult↗
PubMed2003

Study of Health in Pomerania (SHIP): a health survey in an East German region. Objectives and design of the oral health section.

The goal of the Study of Health in Pomerania (SHIP) was to estimate the prevalence of diseases, identify potential risk factors in a defined region in northeast Germany, and examine the particular living situation of this population after the reunification of East and West Germany. One of the main concerns of the SHIP design is the analysis of the relationships between dental, medical, social, and environmentally and behaviorally determined health factors. SHIP is a cross-sectional study (clinical findings and sociologic interviews). The sample was drawn in two steps: Thirty-two communities in the region were selected, and within these communities, a simple random sample was drawn from residence registries, stratified by gender and age. The final sample included 4,310 males and females, aged 20 to 79 years. This is equivalent to a participation rate of 68.8%. Data collection was completed in May 2001. The data collection and items comprised four parts: oral health examination, medical examination, health-related interview, and a health- and risk-factor-related questionnaire. The oral health examination included the teeth, periodontium, oral mucosa, morphology and function of the craniomandibular system, and prosthodontics. The medical examination included blood pressure measurements; electrocardiography; echocardiography; carotid, thyroid, and liver ultrasound examinations; neurologic screening; and blood and urine sampling. The computer-assisted interview consisted of questions on symptoms of disease, utilization of medical and dental services, self-assessment of general and oral health, health behavior and knowledge, and socioeconomic variables. The self-administered questionnaire comprised housing conditions, social network, work conditions, subjective well-being, and individual consequences of the German reunification.

Adult↗
PubMed2002

Naturalistic changes in the readiness to quit tobacco smoking in a German general population sample.

BACKGROUND: This study examines naturalistic changes, i.e., changes that occur without formal interventions, in the motivational readiness to quit tobacco smoking. The transtheoretical model (TTM) with the proposed five stages of change (precontemplation, contemplation, preparation, action, maintenance) is used as the theoretical framework. METHODS: Data were collected as part of a representative general population study in Germany. A total of 786 individuals was assessed two times, 6 months apart, with respect to stage of change. Latent Transition Analysis (LTA) was employed as a special statistical method to analyze stage movements over time. RESULTS: The best-fitting model to describe naturalistic stage movements included both forward and backward movements. A high proportion of the sample was in the precontemplation stage across both measurement occasions. There were high rates of stage regressions over the 6-month period. CONCLUSIONS: In a German representative population of smokers, smoking behavior change toward abstinence does not occur naturally in a substantial amount over the 6-month period without intervention. Differing findings in studies for populations in the United States could be due to methodological differences or differences in tobacco-control conditions.

Adolescent↗
PubMed2002

The role of family and partnership in recovery from alcohol dependence: comparison of individuals remitting with and without formal help.

The aim of this study was to analyse the role of family and partnership in remission from alcohol dependence in treated (n = 50) and untreated (n = 115) individuals. Standardised questionnaires to assess social support, social pressure, coping behaviour, and self-efficacy to stay remitted were used. In both media-solicited samples, social support increased from the pre- to the post-resolution period and was stated as an important resolution maintenance factor. Remitters with formal help experienced more partnership conflicts prior to remission and tended to experience more social pressure from their partner. Social support and social pressure from the family and partner were related to an increase in cognitive coping, as hypothesised, however, only in remitters without formal help, whereas an inverse relationship was found in formal help seekers. Implications for alcohol-related interventions are discussed.

Adaptation, Psychological↗
PubMed2002

Association between behavior-dependent cardiovascular risk factors and asymptomatic carotid atherosclerosis in a general population.

BACKGROUND AND PURPOSE: Physical inactivity and unfavorable dietary and lifestyle patterns are related to cardiovascular disease and premature death. Their relationship to atherosclerosis of the carotid arteries and subsequent stroke is unclear. The objective of this study was to investigate the association between those behavioral cardiovascular risk factors and asymptomatic atherosclerosis of the carotid arteries in a population of former East Germany. METHODS: The Study of Health in Pomerania (SHIP) is a cross-sectional survey in northeast Germany. In 1632 individuals aged 45 to 70 years, high-resolution B-mode ultrasound was used to assess the mean intima-media thickness of the right and left common carotid arteries. Carotid plaques and stenosis were recorded. Physical activity, dietary patterns, and cardiovascular risk factors were assessed in interviews with the use of standardized scales. Physically active participants with optimal dietary patterns were classified in the optimal lifestyle group, and those inactive with unfavorable diet were classified in the unfavorable group. RESULTS: After adjustment for sex and age, significant decreasing trends were found for both intima-media thickness and severe asymptomatic atherosclerosis from unfavorable to optimal lifestyle patterns in never smokers but not in smokers. Regression analysis revealed an increased risk of severe asymptomatic atherosclerosis in subjects with an unfavorable lifestyle pattern compared with those with an optimal pattern (odds ratio 2.68; 95% CI, 1.13 to 6.37), following a significant linear trend. CONCLUSIONS: Physical activity and optimal diet are associated with reduced risk of early atherosclerosis in subjects who never smoked, while no benefit of an otherwise optimal lifestyle is observed in smokers.

Aged↗
PubMed2002

Remission from alcohol dependence without help: how restrictive should our definition of treatment be?

OBJECTIVE: Studies on untreated remissions from addictive behaviors have utilized very different definitions of treatment, ranging from regular self-help group participation to almost no help at all. The purpose of this article is to examine the impact of different treatment definitions on triggering and maintenance mechanisms of recovery. METHOD: Sample 1 consists of 103 remitted alcohol dependent subjects (30% female) who never received any kind of treatment or counseling for alcohol problems. Sample 2 consists of 75 remitted alcohol dependent subjects (20% female) who received minor help, defined as contact with alcohol treatment not exceeding nine self-help group sessions or three counseling sessions by a specialty provider. Sample 3 consists of 50 remitted alcohol dependent subjects (24% female) who regularly participated in self-help group meetings. All participants were media recruited. Groups were compared on grounds of a comprehensive, standardized interview, including the assessment of sociodemographic and substance related variables as well as triggering and maintenance factors of remission. RESULTS: On most triggering and maintenance factors of the remission, remitters from alcohol dependence who received minor help are comparable with remitters who received no help, and both groups differ significantly from regular self-help group participants. CONCLUSIONS: Inconsistencies in studies on recovery from alcohol dependence without treatment cannot be accounted for by varying definitions of treatment, as the inclusion of subjects who received some minor help does not lead to a bias in most variables associated with remission.

Adult↗