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A Rosenberger

Publications and source records attributed to A Rosenberger.

At least 19 recordsLinked to original sources
PubMed2006

[Acute effects on the health of children after accidental exposure to epichlorohydrine].

PURPOSE: In September 2002, two freight trains collided at Bad Muender, Germany. The inhabitants were potentially exposed to combustion products and to the human carcinogen epichlorohydrine (ECH). We aimed to describe the geographical distribution of and potential risk factors for acute symptoms among children residing in Bad Muender. METHODS: The parents of a random sample of children were invited to answer a mail-in questionnaire (response rate 63%). The main outcome measures were self-reported acute symptoms potentially associated with combustion products (e. g., irritation of the eyes, nose, or throat) and stress-related unspecific symptoms (e. g., gastrointestinal complaints, sleep problems, headaches). The main location during the first 26 hours after the train accident served as exposure proxy measure. In addition, potential predictors for the symptoms under study were assessed. RESULTS: The prevalence of symptoms associated with combustion products was 5.9%. Unspecific symptoms were reported for 6.3% of the children. Main location and prevalence of symptoms were not significantly associated. Physician-diagnosed asthma and nasal allergies were the main predictors of symptoms. CONCLUSION: The prevalence of acute symptoms was relatively high in a random sample of children living close to the incident. However, associations between exposure to the accident and symptoms could not be established conclusively.

Accidents↗
PubMed2006

Significant association of a M129V independent polymorphism in the 5' UTR of the PRNP gene with sporadic Creutzfeldt-Jakob disease in a large German case-control study.

BACKGROUND: A single nucleotide polymorphism (SNP) in the coding region of the prion protein gene (PRNP) at codon 129 has been repeatedly shown to be an associated factor to sporadic Creutzfeldt-Jakob disease (sCJD), but additional major predisposing DNA variants for sCJD are still unknown. Several previous studies focused on the characterisation of polymorphisms in PRNP and the prion-like doppel gene (PRND), generating contradictory results on relatively small sample sets. Thus, extensive studies are required for validation of the polymorphisms in PRNP and PRND. METHODS: We evaluated a set of nine SNPs of PRNP and one SNP of PRND in 593 German sCJD patients and 748 German healthy controls. Genotyping was performed using MALDI-TOF mass spectrometry. RESULTS: In addition to PRNP 129, we detected a significant association between sCJD and allele frequencies of six further PRNP SNPs. No significant association of PRND T174M with sCJD was shown. We observed strong linkage disequilibrium within eight adjacent PRNP SNPs, including PRNP 129. However, the association of sCJD with PRNP 1368 and PRNP 34296 appeared to be independent on the genotype of PRNP 129. We additionally identified the most common haplotypes of PRNP to be over-represented or under-represented in our cohort of patients with sCJD. CONCLUSION: Our study evaluated previous findings of the association of SNPs in the PRNP and PRND genes in the largest cohorts for association study in sCJD to date, and extends previous findings by defining for the first time the haplotypes associated with sCJD in a large population of the German CJD surveillance study.

5' Untranslated Regions↗
PubMed2005

Effects of socio-demographic variables on health-related quality of life determined by the quality of life index--German version.

STUDY OBJECTIVE: The purpose of this study was to determine subjective health-related quality of life (HRQoL) in a sample of the Austrian population over 14 years of age in order to evaluate the effect of socio-demographic variables on HRQoL. DESIGN/SETTING: HRQoL was determined by means of the quality of life index-German version (QLI-Ge). The influence of socio-demographic variables on HRQoL was assessed by statistical analysis using the Kruskal-Wallis test and an analysis of variance. PARTICIPANTS: A random-quota procedure was used to get balanced representation from regions and demographic groups of the Austrian population. The sample consisted of 1049 participants, 493 men and 556 women. MAIN RESULTS: Age was found to influence the QLI-Ge total score (index score) and most individual items, with increasing age resulting in a decrease in HRQoL. Differences between the sexes were observed in three dimensions: males scored higher in 'physical well-being', 'psychological well-being' and 'occupational functioning'. Marital status impacted most items with married persons showing better values than divorced persons or singles. Profession had only a minor effect on HRQoL, the level of education showed no influence at all. CONCLUSIONS: The socio-demographic variables age, sex and objective living conditions had a major influence on subjectively rated HRQoL, whereas profession and education were found to play a minor role in this context. It is recommended that in the interpretation of studies assessing HRQoL the above-mentioned objective factors be considered. This will be of particular importance when determining the effect of a pharmacotherapy on HRQoL in patients.

Adolescent↗
PubMed2004

Results of a surveillance programme for patients at high risk of malignant melanoma using digital and conventional dermoscopy.

Patients with a high number of atypical naevi and a personal and/or family history of melanoma are at high risk of malignant melanoma. The objective of this study was to design a special documentation and surveillance programme using epiluminescence microscopy (ELM) and digital epiluminescence microscopy (DELM) to improve the surveillance of these patients. High-risk patients (n=212) were categorized by the number and phenotype of their naevi and their personal and family history of melanoma. Then patients were screened by the unaided eye, conventional photography, ELM and, in selected cases of atypia, DELM. Median follow-up was 18 months, and 2939 pigmented lesions were followed by DELM. Examination on the first visit identified 17 cutaneous melanomas. During the following observation period, another 17 melanomas were identified. Fifteen of these follow-up melanomas were exclusively identified based upon DELM. In these cases, subtle lesional changes occurred over time, and ELM diagnostic algorithms for differentiating benign melanocytic lesions from melanoma did not score a suspicion of melanoma. All melanomas, either pre-existing or developing during follow-up, were identified in an early, curable phase of tumour growth. We conclude that DELM follow-up for patients at high risk allows the early detection of melanomas that have not yet acquired melanoma-typical ELM features.

Adult↗
PubMed2003

Modeling and dissection of longitudinal blood pressure and hypertension phenotypes in genetic epidemiological studies.

We discuss analyses of the Genetic Analysis Workshop 13 data from the Framingham Heart Study and simulations based on this study. We summarize analyses that investigated measures of systolic blood pressure or hypertension as the main phenotype, with the main focus being the modeling of this complex longitudinal phenotype. The approaches include familial aggregation methods and one-stage and two-stage linkage methods. For one-stage linkage methods, phenotype modeling is carried out jointly with the linkage analysis or incorporated in the analysis design. For two-stage linkage methods, phenotypes are first modeled in order to develop summary measures that are then analyzed in a subsequent linkage analysis. Results depend on phenotype selection and on how analyses account for longitudinality, treatment effects, and heterodasticity.

Blood Pressure↗
PubMed2003

[Retrospective study of malignant melanoma patients treated with mistletoe extracts].

OBJECTIVE: The aim of the present investigation was to analyze survival time and survival rate of all patients with malignant melanoma who had been counseled at the Tumorambulanz Herdecke of the Community Hospital Herdecke. PATIENTS AND METHODS: 284 melanoma patients were included in a retrospective questionnaire study. Only those patients were considered for analysis in whom the prognostic factors histology, tumor localization, and Clark level were known. The data of the study population were compared with patient data obtained from the literature. RESULTS: 94 patients were included in the analysis. 66 of whom had received and 7 had not received mistletoe treatment, in the remaining 21 patients there was no information whether or not mistletoe treatment had been given. Thus, we did our study without a clearly defined internal control group. The median survival time among patients treated with mistletoe had been 14.1 years. The 5- and 10-year survival rates were 80 and 68% for the mistletoe-treated patients, respectively. DISCUSSION: The 5-year survival rate of the mistletoe-treated patients is comparable to that of patients without mistletoe therapy while the 10-year survival rate is a little bit lower. This may be due to the fact that, in contrast to the patients from the relevant literature, 33.3% of the patients suffered from lymph node and/or distant metastases already before counseling the Tumorambulanz Herdecke. Moreover, 50% of our patients had melanoma of Clark level IV in contrast to 22.2% or 31% in the relevant literature. CONCLUSIONS: In spite of the theoretical reservations against mistletoe treatment in melanoma patients, our retrospective analysis did not show any clues about disadvantages of mistletoe treatment in melanoma patients. A controlled prospective study therefore should prove the efficacy of a mistletoe therapy in patients with malignant melanoma.

Female↗
PubMed2003

[Methods in evidence-based medicine consensus findings--a case study in trauma surgery].

The methods and processes of a guideline development programme including a structured consensus conference for the employment of Diagnostic Imaging in Trauma Surgery are presented and critically reviewed. International standards and methodical concepts described in the Guideline Manual by the Agency for Quality in Medicine (AQuMed) and the Association of the Scientific Medical Societies in Germany (AWMF) have been implemented. Experiences with this project reveal that even a small multidisciplinary panel group is potentially able to cope with the comprehensive panel work if they are methodologically supported. The establishment of an internal quality management proved to be a useful tool for the production of high-quality results in the face of limited project resources. As expected, for most sub-questions knowledge of evidence and medical experience correlated well. However, the lack of a method for ensuring that consensus recommendations finally obtained by panel work and discussions during the conference were always based on evidence was the weak spot of this evidence-based consensus conference.

Consensus↗
PubMed2002

Sleeping habits in the Austrian population.

OBJECTIVES: To gain reliable data on sleeping habits and sleep disturbances of the Austrian population. BACKGROUND: Exact data on sleeping habits are of interest in relation to assessment of sleep disturbance-related illnesses and general social processes. METHODS: A prospective, cross-sectional study was performed with recruitment of a representative sample of 1049 Austrians (aged 15-82 years), according to the Federal Statistics population characteristics. Interviews were conducted in the households of the participants by specially trained interviewers of an institute for empirical research. RESULTS: Men consider their quality of sleep to be significantly better than women (P=0.00234), and younger persons consider their quality of sleep to be significantly better than older persons (P=0.00001). In comparison, women and people over the age of 50 report worse subjective sleep quality, worse sleep efficiency, more difficulty in falling asleep and sleep maintenance, more apneic events, more pathologic limb movements, more daytime dysfunction, and more intake of sleeping medication. Other sociodemographic factors influence sleep reports to a lesser extent. CONCLUSIONS: Subjectively disturbed sleep (prevalence in the total population 24.9%), excessive hypnotic drug intake (prevalence 13.0%), and daytime dysfunction (prevalence 17.4%) are a widespread problem, especially in women and older people. With increasing life expectancy in Western societies, the prevalence of sleep disturbances will increase.

Journal Article↗
PubMed2002

Validation of questionnaires from several medical fields regarding the constitution of patients.

INTRODUCTION: To consider or determine an individual's 'warm and cold' constitution is common part of traditional Chinese medicine (TCM), Indian medicine (Ayurveda), anthroposophic medicine and classical natural medicine. OBJECTIVE: Common psychometric characteristics of 4 questionnaires should be examined. METHODS: 110 cancer patients and 110 non-cancer patients were asked to answer these questionnaires twice 4 weeks apart. Subsequent validation of the questionnaires included psychometrical qualities of item acceptability, sensitivity to change, construct validity (homogeneity), re-test reliability and group comparison. RESULTS: The Ayurveda questionnaire was considered suitable after reducing the questions from 22 to 8 (internal construct validity kappa = 0.64). The TCM questionnaire was considered unsuitable in our model because of the absence of construct validity. The questionnaire on anthroposophic medicine was considered a suitable and reliable tool with alpha = 0.57 (Cronbach's alpha) and r = 0.61 (re-test reliability) after reducing the questions from 6 to 4. The questionnaire on sensitivity to temperatures based on classical natural medicine was considered suitable after reducing the questions from 10 to 8 (alpha = 0.58; r = 0.73). Cancer and non-cancer patients differ in only one item, i.e. in their sensitivities to cold. CONCLUSION: The questionnaires for anthroposophic medicine, Ayurveda medicine and sensitivity to temperatures are in part suitable and reliable for determining individual constitutions according to their medical philosophy. The questionnaire based on traditional Chinese medicine failed these criteria. A difference between patients with or without malignant disease was only observed for sensitivity to temperatures. The anthroposophic hypothesis that cancer either changes an individual's thermic constitution or is caused by such a change could not be confirmed in this study.

Body Temperature↗
PubMed2002

[Childhood diseases, infectious diseases, and fever as potential risk factors for cancer?].

OBJECTIVE: We investigated the assertion that past childhood diseases, acute and febrile infections as well as allergies have a preventive effect on cancer. Former studies on this topic show controversial results and methodical deficits. PATIENTS AND METHODS The investigation was conducted as a retrospective case control study with 111 cancer patients and a group of 109 control persons from 3 hospitals in Berlin. RESULTS: A significant change in the risk of developing cancer could only be observed for mumps (OR = 2.6; increased risk), whooping cough (OR = 2.7; increased risk), and colds in the recent past (OR = 0.7; decreased risk). Fever within the last 5 years showed no association with the development of malign tumors. CONCLUSION: We could not confirm the results of former studies which assumed a preventive effect of childhood diseases and fever on the cancer risk. On the contrary, on the basis of this investigation one might postulate a 2- to 3-fold rise of the cancer risk by mumps or whooping cough. Because of divergent study results, deficits in the study designs, and a low evidence of the present findings no final statement on the association between childhood diseases or fever and cancer should be made.

Adult↗
PubMed2001

N-CPAP rejecters--a specific group of noncompliant patients with obstructive sleep apnea syndrome.

A large number of studies have been focused on patients with severe obstructive sleep apnea syndrome (OSAS) being non-compliant with N-CPAP therapy, but data concerning patients who reject N-CPAP therapy from the very start, without a day of N-CPAP home therapy, do not exist. The purpose of the study was to determine differences, if any, in the quality of life (QoL) between patients rejecting N-CPAP therapy from the start, untreated patients with severe OSAS waiting for N-CPAP titration, and controls. Qol was measured in terms of life satisfaction on the basis of the Munich life quality dimension list (MLDL), an instrument for cognitive assessment of elementary components (physical condition, psyche, social life, everyday life) of QoL. Untreated patients (n = 16) with severe OSAS have a significantly worse QoL in the dimension of psyche (p = 0.00022), social life (p = 0.00582) and everyday life (p = 0.01633) than do rejecters of therapy (n = 19). In the dimension of physical condition, no significant difference was seen (p = 0.47138). Compared with controls (n = 113), rejecters of therapy have a significantly lower QoL score in regard of physical condition (p = 0.00014) but not in terms of psyche, social life and everyday life. We conclude that a good QoL and the absence of the stress of suffering is one reason why patients with severe OSAS reject N-CPAP therapy in spite of physical impairment.

Aged↗
PubMed2001

Noninvasive detection of coronary lesions by multislice computed tomography: results of the New Age pilot trial.

The reliable noninvasive assessment of coronary artery disease would constitute an important step forward in clinical cardiology. The aim of the New Age pilot trial was to evaluate the diagnostic accuracy of multislice computed tomography (MSCT) in determining coronary lesions. As a gold standard for in vivo plaque detection, intracoronary ultrasound (ICUS) was used. Forty plaques were detected by ICUS in 15 target vessels (LAD, n = 8; RCA, n = 7) in patients assigned for ICUS-guided PTCA. Preinterventional MSCT was performed in all patients and the results were compared to ICUS with regard to lesion detection and quantification. According to ICUS results, the 40 plaques were divided into three groups: group I, mild lesions < 50% (n = 14; 44.36% +/- 5.77%); group II, intermediate lesions 50%-75% (n = 12; 59.18% +/- 9.39%); and group III, severe lesions > 75% (n = 14; 91.47% +/- 3.68%). All MSCT scans showed sufficient image quality for analysis. Thirty of 40 (75%) plaques were detected by MSCT in a first blinded session. After unblinding the ICUS results, the remaining 10 (25%) plaques could be identified. Lesion severity was classified correctly in 34 of 40 (85%) plaques. Plaque calcifications were diagnosed correctly in 16 of 19 (84.2%) plaques. Quantification of vessel size revealed a good correlation to the ICUS results (r(2) 0.68; P = 0.004). Noninvasive MSCT angiography showed good diagnostic accuracy with regard to lesion detection and quantification of vessel size. The overall good image quality, makes this new technology a promising modality, which might become an alternative diagnostic approach in patients with known or suspected coronary artery disease. Cathet Cardiovasc Intervent 2001;53:352-358.

Adult↗
PubMed2000

Sleep and quality of life in the Austrian population.

PURPOSE: To compare the self-reported estimation of sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI) and life quality assessed by the Quality of Life Index (QLI). BACKGROUND: The PSQI comprised 19 questions and assessed a wide variety of factors relating to sleep quality. The QLI consisted of 10 items for self assessment of different dimensions of life quality. SUBJECTS: A representative Austrian sample (n = 1049) aged above 15 years. PROCEDURE: Interviews in the homes of the participants. RESULTS: 32.1% could be classified as poor sleepers (37% females, 26.5% males). Sleep quality decreased with increasing age, especially in women. Overall quality of life was highest in younger (15-29 years) and lowest in elderly subjects (over 50 years). Life quality decreased with increasing age. Between subjective sleep quality and quality of life a moderate, significant correlation was found (r2= 0.6721). CONCLUSIONS: Complaints about a bad quality of sleep could be used as a screening method in the exploration of patients' quality of life (QoL).

Adolescent↗
PubMed2000

[Mistletoe extracts in the therapy of malignant, hematological and lymphatic diseases--a monocentric, retrospective analysis over 16 years].

OBJECTIVE: The aim of the present investigation was to investigate potentials risks of treatment with mistletoe extracts in patients with malignant haematological and lymphatic diseases consulting the Tumour Ambulance of the Community Hospital Herdecke and to evaluate the therapeutic experiences with this treatment. PATIENTS AND METHODS: All 700 patients with these diseases who had been counselled at the Tumour Ambulance of Community Hospital Herdecke since the foundation of the unit were included in a retrospective questionnaire study to collect information on the course of the disease and the survival time. Therapy with mistletoe extracts had been recommended to all patients. The treatment was carried out by the patient's physician outside the hospital. For inclusion into further analysis, information on survival time and mistletoe treatment had to be available. Survival times of patients who had actually received the recommended mistletoe treatment and of patients who had not received the recommended mistletoe treatment were compared (internal comparison). Furthermore, the results were compared to those of conventionally treated patients obtained from the literature (literature comparison). RESULTS: Of 237 patients for whom sufficient data was available, 14 had not been treated with a mistletoe extract. The median survival time was 9.18 years among patients who had received mistletoe compared to 7.54 years among those without. Before a statistical test was carried out, the equivalent distribution of diagnosis in the 2 groups was tested. Regarding this criterion, only 205 patients treated with mistletoe extract and 9 patients not treated with mistletoe extract could be included into the statistical tests of the median survival time. The median survival time was 11.4 years (mistletoe patients) and 8.6 years (patients without mistletoe therapy). The difference was not significant. There were no cases in which mistletoe treatment was associated with deterioration. The comparison with data from the literature yielded very similar survival times among patients not treated with mistletoe extract and those included in our study. CONCLUSION: No indications to risks of a mistletoe therapy on progress of the disease and the survival time could be found. Therefore, no ethical reservations should be opposed to future prospective investigations of mistletoe therapy in patients with malignant haematological diseases.

Female↗
PubMed1999

[Development of lymphocyte subsets in tumor patients after subcutaneous administration of mistletoe extracts].

OBJECTIVE: In order to exclude the possibility that mistletoe therapy may result in immunosuppression, as indicated by a significant reduction of defined lymphocyte subsets, PATIENTS AND METHODS: peripheral blood cells of 23 tumour patients were treated subcutaneously with increasing concentrations of aqueous mistletoe extracts (Helixor(R)). RESULTS AND CONCLUSIONS: Within an observation period of 7 months, the relative amount of lymphocytes and the number of natural killer (NK) cells increased while the number of lymphocyte subsets (i. e. CD19+ B cells, CD4+ T helper cells, CD8+ CD28- suppressor cells, CD8+ CD28+ cytotoxic cells) and the proportion of CD25+ (activated) cells within T cells showed a statistically remarkable trend; due to the multiple test problem of statistical evaluation this trend is not allowed to be termed significant. The leucocytes decreased insignificantly within the observation period. However, we were unable to verify a suggested increase of defined lymphocyte subsets within 2-3 months after the onset of mistletoe treatment. Nevertheless, for the parameters CD19+ B cells, CD4+ T helper cells, CD8+ cells, CD8+ CD28+ cytotoxic cells and CD16+/CD56+ NK cells we observed statistically remarkable peaks within die 2nd and 3rd month of therapy, confirming the hypothesis. The responses to the extracts were obviously interindividually different; the immune responses especially of patients with a lower number of peripheral T cells were less significant as compared to those of patients with adequate T cell numbers. Surprisingly, even an increase of the drug concentration >3 ng mistletoe lectin (as determined within the whole plant extract) per kg body weight enhanced the number of CD4+ T helper cells. A decreased immunological reaction on mistletoe extracts was shown especially for patients with a reduced number of peripheral T cells, whereas patients with normal T-cell number were more reactive.

Adult↗
PubMed1998

[Acute generalized exanthematous pustulosis, induced by nystatin].

Despite its widespread use, the antimycotic nystatin rarely causes allergic reactions. We observed a case of acute generalized pustular exanthem with arthralgia and fever, after the oral administration of nystatin. A causal relationship was demonstrated by positive Intracutaneous testing of the drug. Immunohistology revealed positive staining for C3 in the test area, whereas circulating immune complexes could not be identified. These findings are compatible with a type-II allergic reaction. Systemic prednisolone treatment led to a complete remission of the clinical symptoms within 11 days. In two test subjects who had never received nystatin intracutaneous testing was initially negative. After 3 weeks, both developed itching erythematous papules at the injection sites. Therefore, intracutaneous testing of nystatin involves the risk of sensitization.

Adult↗
PubMed1998

Impact of nasal continuous positive airway pressure treatment on quality of life in patients with obstructive sleep apnoea.

Quality-of-life (QoL) issues have become increasingly important in health care practice and research. Obstructive sleep apnoea syndrome (OSAS) results in an especially serious reduction in QoL. The purpose of this study was to measure the QoL (life satisfaction) of OSAS patients treated with nasal continuous positive airway pressure (nCPAP). We aimed to determine whether and to what extent the QoL of OSAS patients using nCPAP differs from that of randomly selected subjects without this disorder. The QoL of 67 patients treated for at least 3 months with nCPAP, 21 OSAS patients at the time of OSAS diagnosis, and 113 randomly selected persons visiting the hospital (controls) was investigated with the help of the Munich life-quality dimension list (MLDL), an instrument for cognitive assessment of elementary components (physical condition, psyche, social life, everyday life) of QoL. It was found that QoL of OSAS patients treated with nCPAP did not significantly differ from that of control subjects with regard to elementary components. The 21 untreated OSAS patients showed significantly lower scores in all four subcategories: physical condition (p<0.0005), psyche (p<0.01), social life (p<0.0005) and everyday life (p<0.007). Thus, it may be concluded that nasal continuous positive airway pressure therapy has an important impact on the quality of life of obstructive sleep apnoea syndrome patients, and signifies a further advantage in addition to clinical aspects. Treated patients are as satisfied or dissatisfied with their life as persons without this illness.

Female↗