Search

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To analyse the association between occupation (represented by job title) and contact allergy to thiuram vulcanising agents based on data of a clinical registry (IVDK, ). Clinical, demographic and allergy patch test data of all patients tested between 1992 and 2006 with the thiuram mix (1% in petrolatum) as part of the baseline series was analysed ( n = 121,051). Poisson regression analysis was used to quantify the association between different occupations (and other relevant factors) and a positive patch test reaction to the thiuram mix. Furthermore, the time trend of sensitisation prevalence was analysed in high-risk occupational subgroups identified. In comparison to a largely unexposed reference group (office workers and teachers), rubber manufacturers had a significantly elevated risk (prevalence ratio (PR): 5.1, 95% confidence interval (CI) 2.0–10.5). However, health care workers such as physicians and dentists (PR: 3.8, 95% CI: 3.0–4.8) or nursing staff (PR: 3.0, 95% CI: 2.5–3.6) as well as meat and fish processors (PR 3.5, 95% CI: 2.2–5.3) and cleaners (PR 3.1, 95% CI: 2.5–3.8) were found to have a high sensitisation risk as well. In case of health care workers, a significant downward trend during the study period was observed; while in food processors and cleaners, sensitisation prevalence remained largely stable. The adjusted multifactorial analysis identified occupations yet unknown to be associated with elevated thiuram contact allergy risk, e.g., food processors and cleaners. Thus, (i) further in-depth research can be targeted and (ii) efforts to prevent sensitisation to thiurams focussed, e.g., by limiting thiuram concentrations in products to a residual level which is technically inevitable. [ABSTRACT FROM AUTHOR]

A higher mortality risk for women with acute ST-elevation myocardial infarction (STEMI) has been a common finding in the past, even after acute percutaneous coronary intervention (PCI). We set out to analyze whether there are gender differences in real-world contemporary treatment and outcomes of STEMI. A retrospective analysis of all consecutive patients with STEMI and acute coronary angiography with the intention of performing a PCI at our center 6/1999-6/2006 was carried out ( n = 566). Data were examined for gender-specific differences regarding patients’ characteristics, referral patterns, timing of acute symptoms, angiographic findings, procedural details, and adverse events at 30 days after PCI. Women ( n = 161) were on average 8 years older than men ( n = 405), had higher co-morbidity, were more often transported to the hospital by ambulance and presented less often to the emergency room on their own (4.2% vs. 12.6% in men, P = 0.02). The pre-hospital delay from symptom onset to admission was significantly longer for women (median 185 vs. 135 min, P < 0.02). There was no gender difference in time from admission to PCI (median 46 min vs. 48 min, P = 0.42). Both genders received PCI with similar frequency (88.8% vs. 92.4%, P = 0.19), with similar success rates (83.2% vs. 85.3%, P = 0.68). Thirty-day overall mortality for women was not significantly higher than for men (8.7% vs. 7.2%, P = 0.6). Re-infarction or stroke within 30 days were rare for both genders without gender-specific differences whereas bleeding necessitating blood replacement was significantly more frequent in women (16.8% vs. 5.9%, P < 0.001). In multivariate analysis, female gender was not independently associated with a higher risk of 30-day mortality (OR 0.964, P = 0.93). Women underwent PCI therapy for STEMI with the same frequency and the same angiographic success as men. Despite their more advanced age and the higher prevalence of co-morbidities, they did not have a significantly higher 30-day mortality rate than men. Female gender was not an independent risk factor of 30-day mortality. Longer pre-hospital delays before hospital admission in women indicate that awareness of risk from coronary artery disease should be further raised in women. [ABSTRACT FROM AUTHOR]

Objective. The status of the axillary lymph nodes is one of the most important prognostic factors in patients with breast cancer. A panel of molecular markers of tumor aggressiveness in addition to conventional clinical and histopathologic features were analyzed in an attempt to identify a subgroup of patients with a low risk of axillary lymph node metastases. Material and methods. Data from 358 patients with T1 breast cancer who underwent level I/II axillary lymph node dissection (ALND) were investigated. Hormone receptor status, Ki-67, S-phase fraction, DNA ploidy, HER-2/ neu, p53, epidermal growth factor receptor, urokinase type plasminogen activator, plasminogen activator inhibitor-1, bone marrow micrometastases as well as patient age, menopausal status, tumor site, tumor size, histologic type, tumor grade, carcinoma in situ, multifocality, and lymph vascular invasion (LVI) were studied to predict axillary lymph node status. Results. In a multivariate logistic regression analysis LVI (present v.s. not present), Ki-67 (≥18% v.s. <18%), tumor size (1.1–2 cm v.s. ≤1 cm), and histologic grade (G3 v.s. G1/2) were identified as independent predictive factors of axillary lymph node metastases. Approximately 13% of patients ( n = 47) with well or moderately differentiated tumors less than or equal to 1 cm, no lymph vascular invasion, and a low Ki-67 staining were identified as having a low risk of axillary lymph node metastases of 4.3%. However, 20 patients with all four unfavorable predictive factors had a 75% incidence of axillary lymph node involvement. Conclusion. Primary tumor characteristics can be used to identify a subgroup of patients with a low risk of axillary lymph node metastases in T1 breast cancer. Preoperative risk assessment might be used to omit routine ALND in those patients at low risk of axillary lymph node metastases. [ABSTRACT FROM AUTHOR]

The development of the mammalian heart is characterized by substantial changes in myocardial performance. We studied the ontogeny of myocardial function with and without various inotropic interventions in the developing isolated, antegrade-perfused rabbit heart (2d, 8d, 14d, 28d, n = 96). Myocardial function was related to the protein expression of the sarcolemmal Na+-Ca2+ exchanger and to the sarcoplasmic Ca2+-ATPase. In neonatal hearts an age-dependent increase in maximal developed pressure velocity (dP/dtmax) by 45 % and peak negative pressure velocity (dP/dtmin) by 75 % within days 2 to 8 were observed. In response to inotropic intervention with isoproterenol, ouabain, calcium and the Na+-channel modulator BDF 9148, dP/dtmax and dP/dtmin increased in a concentration dependent manner. Significant differences between neonatal, juvenile and adult hearts could be demonstrated in a repeated measurement ANOVA model on the concentration-response curves for BDF 9148 (dP/dtmax and dP/dtmin), ouabain (dP/dtmin) and calcium (dP/dtmin), but not for isoproterenol. At the maximum isoproterenol concentration of 1 μmol/l, the increase in dP/dtmax and dP/dtmin was significantly higher in adult compared to neonatal hearts (t-test, p < 0.01). The significant decline of the Na+-Ca2+ exchanger protein expression from neonatal (1822 ± 171) to adult hearts (411 ± 96 S.E.M. [units per 20 μg protein], p < 0.01) was related to an increase in myocardial function (dP/dtmax r = 0.63, p < 0.01, dP/dtmin r = 0.62, p < 0.01). Contractility, relaxation and the observed positive inotropic effects were in general significantly lower in neonatal compared to adult hearts. In the individual heart an increase in contractility and relaxation was related to a decrease in Na+-Ca2+ exchanger expression. [ABSTRACT FROM AUTHOR]

Copyright of Social & Preventive Medicine is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The methodological discussion about matching when recruiting controls in case–control studies has been controversial for a long time. To delineate the impact of this discussion on the practice of matching we reviewed 266 case–control studies published in nine yearly volumes of three major epidemiological journals within the period 1955–1994. Among studies published until 1980 71.7% of the control groups were recruited by individual matching compared to 46.4% in 1994. This decline is paralleled by an increase in the application of frequency matching (from 5.0% to 26.2%). As the issue of matching is closely connected with methodological questions of the statistical analysis we also examined the type of analysis applied to the data. We found that the use of logistic regression modeling has dramatically increased during this period (from 18.4% up to 87.2%), whereas application of the traditional Mantel–Haenszel technique for estimating summary odds ratios has nearly vanished. The correct approach for individually matched data in the logistic modeling framework, the conditional likelihood technique, has been unknown in the early part of the time window of our investigation, but is even nowadays applied by only three quarters of the corresponding studies. Our literature-based investigation provides thus compelling evidence that the type of control selection and statistical analysis used in case–control studies have changed substantially during recent years. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Public Health (09431853) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Occupational skin changes in hairdressers are very common. Morbidity, however, has not yet been quantified precisely. Methods: A cohort of 2,352 hairdressing apprentices (of the 2,570 invited to participate, i.e., 91.5% response) was prospectively followed for the duration of their vocational training (3 years) by three examinations. Three waves (years) were recruited in 1992, 1993, and 1994 from 15 vocational training schools in northwestern Germany. Results: The point prevalence of (mostly slight) irritant skin changes of the hands increased from 35.4% in the initial examination to 47.5% in the intermediate examination and to 55.1% in the final examination. Given a more conservative definition of a case of “hand dermatitis,” these estimates were 12.9%, 23.5%, and 23.9%, respectively. Altogether, 34.3 and 15.2 cases of “skin changes (any degree)” and “hand dermatitis,” respectively, in 100 person-years were observed during the study period. The incidence rate, i.e., the number of newly diseased study participants in relation to the person-time at risk contributed, decreased in the course of the study. The proportion of dropouts until final follow-up was 51.8%. Conclusion: The present results appear to lie in a range with those found in other, much smaller cohort studies. However, comparison of the results is hampered either by the lack of a clear definition or by a different definition of “person-time at risk” or “a case of hand dermatitis.” As compared with an external control group of office apprentices, the incidence was several times higher in hairdressing apprentices, which points to the high risk for skin damage in this occupation. [ABSTRACT FROM AUTHOR]

Copyright of Der Hautarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)