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Roentogenographic chest screening in the detection and survival of patients with lung cancer. Cooperative Study Group for Early Detection of Lung Cancer in the German Democratic Republic.

In the German Democratic Republic (GDR), annual mass roentgenographic screening of the chest was introduced twenty years ago. To ascertain its value in the detection of lung cancer, data were collected about treatment results at the country's main chest clinics. The study cover 13,283 operations and 10,838 resections, accounting for nearly 90% of all patients with lung cancer treated surgically in the GDR from 1949-1974. From 1965 to 1968, the five-year survival was more favorable in patients who were screened than in those who were diagnosed after clinical symptoms had appeared (36% for the former, 29% for the latter). For improvement of overall results, we recommend differentiated regular chest roentgenographic screening of men 40 to 70 years of age, individualized on the basis of tobacco usage, and full exploitation of all diagnostic and surgical tools now available.

Adult↗

Strategy for the primary and secondary prevention of occupational diseases in the German Democratic Republic.

This review explains the German Democratic Republic's strategy for preventing occupational diseases, which is considered one of the primary purposes of public health. It is a complex challenge that is being tackled through close cooperation between enterprise-linked occupational health services, the inspectorates of industrial hygiene, public health centers, and trade unions. In primary prevention, planning is based on results obtained in thorough analyses of all the relevant parameters, such as work conditions, industrial accidents, occupational diseases, morbidity records, and the quality of social services, and a complex work analysis has been developed to provide comprehensive and measurable information on health hazards due to harmful physical and chemical factors, dust, and job-related physical and neuropsychic stresses. Primary prevention is realized mainly through the elimination of health hazards and the improvement of work conditions, both based on a comprehensive framework of legislation. At the level of secondary prevention, company-linked occupational health services are a part of the national health services. A nationwide information system consists of compatible components for primary and secondary prevention, thus enabling control of exposure-effect relationships and the optimization of health policy.

Accident Prevention↗

Epidemiological analysis of acute respiratory diseases (ARD) of viral etiology in the Czech Socialist Republic (CSR)) and German Democratic Republic (GDR) over the period 1979 to 1984.

An analysis is made of the ARD reported in CSR and the GDR over the period July 1st, 1979 to June 30th, 1984. During that time, there were 27,810,000 cases reported in CSR in the framework of ARD epidemiological surveillance, representing 2.67 cases per one inhabitant, whereas in the GDR, the total number of reported ARD was 28,900,000 yielding 1.73 cases per person. However, the GDR reported higher morbidity per one child of preschool age. The authors believe that the differences in the reported incidence of ARD between the two countries are due to differences in the reporting systems and medical officers' activity during an epidemic and in the interim period. Approximately one third of ARD reported annually in the two countries falls to the period of influenza epidemics. The authors also analyze the etiology of the influenza epidemics which affected the two countries in 1980, 1981, 1982, 1983 and 1984. In most seasons, the causative agents and morbidity excesses were different in the two countries. The drift variant B/USSR/100/83, which caused a major epidemy in CSR in 1984, has not to date been implicated in the DGR in the etiology of ARD. The cyclic epidemic due to Mycoplasma pneumoniae occurred in the GDR already in 1979-80, while CSR experienced it a year later. There was a temporal and territorial correlation between the course of A(H1N1) influenza epidemic in the two countries in 1984.

Acute Disease↗

Epidemiology of influenza during 1957--75 in the Union of Soviet Socialist Republics and the German Democratic Republic.

Analysis of clinical data collected by the epidemiological services in both countries showed that each shift or drift in the antigenic structure of the influenza virus resulted in epidemics in both countries. Depending on the degree of antigenic change, both shifts and drifts influenced the speed of epidemic spread and the time of occurrence and the intensity of the epidemics. However, the analyses did not reveal a direct relation between degree of antigenic variation and the attack rate or the severity of the epidemic. The mean attack rate in both countries was about 13% depending on the pathogenicity of the circulating virus. The severity of the epidemics varied in the two countries but the fourth epidemic after each shift was severe in both countries. The reasons for this and other features of the epidemiology are discussed.

Disease Outbreaks↗

Maternal serum alpha-fetoprotein screening for neural tube defects and other disorders using an ultramicro-ELISA. Collaborative study in Cuba and in the German Democratic Republic.

In Cuba and in the German Democratic Republic (GDR) a total of 24,412 pregnant women were tested for maternal serum alpha-fetoprotein (MSAFP) at the 16th to 20th week of gestation. An inexpensive and partly automated ultramicroliter enzyme immunoassay (ELISA) with final volumes of 10 microliter was used to analyze simultaneously 50 samples. The intraassay coefficient of variation (CV) of 5-8% and day/day CVs of 6-10.5% were obtained with a test frequency of 320 assays/day. A cut-off level of twice the median value (MoM) was chosen. An amniocentesis was done in a total of 0.5% (in the GDR) and 0.7% (in Cuba) of the screened women. The prevalence of open neural tube defects (ONTD) was calculated from the present study and was 1.43% in Cuba and 1.34% in the GDR. Through MSAFP screening 88.2% ONTD were detected. There was no therapeutic abortion of a normal fetus. The approximate cost for this program was about 2.36 marks-GDR per patient screened, or about 2,048 marks per ONTD detected.

Abortion, Spontaneous↗

[Satisfaction with health status in the German Federal Republic and the former German Democratic Republic--a comparison].

The subjective feeling of the status of health by persons residing in the FRG and GDR is compared on the basis of data from the German Socio-Economic Panel (SOEP), which were collected shortly before the merger of both states. The subjective state of health is on the whole approximately similar in both states. Differences in influencing factors are revealed by multivariate analysis.

Adolescent↗

Ergonomics in the German Democratic Republic.

A survey of ergonomics in the German Democratic Republic (GDR) was conducted over approximately a two-month period starting in mid-May 1982. This study was sponsored by the International Research and Exchanges Board (IREX) located in New York City. IREX maintains scientific exchange agreements with Eastern European countries and the USSR. This survey is one of a series of similar studies conducted in Eastern Europe. Earlier countries surveyed were Romania (Seminara, 1975), Bulgaria (Seminara, 1976a, 1976b, 1982), the USSR (Seminara, 1977, 1979/80), Poland (Seminara, 1979a), Czechoslovakia (Seminara, 1979b), Hungary (Seminara, 1980), and Yugoslavia (Seminara, 1983).

Journal Article↗