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Biomedical subjects

A Tschopp

Publications and source records attributed to A Tschopp.

At least 19 recordsLinked to original sources

[Recording of multiple sclerosis in Swiss cause of death statistics. A 10-year mortality follow-up of the Bern prevalence study].

Based on data from a multiple sclerosis (MS) prevalence study which had been carried out in 1986 in the canton of Berne, Switzerland, a follow-up was performed 10 years later to gather information on mortality in the original study population. The authors used information on residency and death as gathered from municipal offices and, additionally, by record-linkage with the Swiss cause of death statistics. Slightly more than 80% of the cases were identified unequivocally as of January 1996. Among them, 21% of the cases died during the ten-year period; 70% of them have an MS entry in the cause of death statistics, mostly as the main cause of death. A large proportion of the non-identifiable cases appear to be related to mortality; thus, the findings here do not provide a promising basis for certain further analyses. In conclusion, continuous updating of personal data is the only way to avoid loss to follow-up in the carefully assembled prevalence database.

Cause of Death

Interleukin 1 alpha hematological examination in mechanics exposed to low benzene concentrations.

OBJECT: To examine the hypothesis of Renz and Kalf relative to the involvement of interleukin 1 alpha (IL-1 alpha) in the development of anemia in benzene-exposed workers. According to this hypothesis, benzene inhibits the cleavage of the IL-1 alpha precursor (proIL-1 alpha) to mature IL-1 alpha and the lack of this cytokine is responsible for benzene-induced bone marrow suppression. This inhibition of the processing of proIL-1 alpha is attributed to an inhibition of calpain. METHOD: Selection of a population of mechanics exposed to low levels of benzene from fuels, assessment of usual exposure and lifetime exposure duration, and measurements of concentrations of workplace-air benzene and urinary benzene metabolites. Determination of IL-1 alpha concentrations was done by a whole-blood assay after lipopolysaccharide stimulation and a hematological examination was carried out. Statistical analysis considered several possible confounding factors, particularly smoking and drinking habits. DESIGN: Cross-sectional study. RESULTS: The level of exposure of the mechanics to benzene from fuels was mostly well below 1 ppm. IL-1 alpha production was not decreased in mechanics exposed to benzene from fuels, and no correlation between IL-1 alpha concentrations and red blood cell counts appeared. With the exception of a slight decrease in red blood cell counts in mechanics, no hint of a toxic effect of exposure on hematological parameters was found. CONCLUSIONS: The hypothesis of Renz and Kalf could not be confirmed. Although the low level exposure of the study population and methodological factors are possible explanations, it cannot be excluded that the hypothesis of Renz and Kalf is not generalizable to benzene-exposed humans. Presently, one cannot advise the measurement of IL-1 alpha production for biological effect monitoring of workers exposed to low concentrations of benzene.

Adult

Impact of melatonin on driving performance.

BACKGROUND: Because millions of people are self-prescribing melatonin for various indications, the safety aspects of this substance have become very important. The aim of our study was to determine whether or not melatonin impairs driving-related performance. METHODS: Twenty healthy men and women aged 21-57 years volunteered for this randomized, placebo-controlled, double-blind, crossover study. The crossover arms were separated by an interval of at least 4 weeks. On each testing day, melatonin 5 mg or placebo was taken at 1630 h; 60 minutes later a test series was performed, consisting of a medical examination, body sway measurement, and a standardized driving computer test battery to assess attention, reaction time, power of concentration, and sensomotor coordination. Subjective sleepiness was measured on three occasions during the test session using the Stanford Sleepiness Scale questionnaire. RESULTS: Just one of the 16 main variables of the driving computer test battery, the selective attention tested by signal-detection, was significantly affected by melatonin (p < .05). However, even those values were still within the normal range. Subjective sleepiness was increased by melatonin, although the result was significant only after the prolonged concentration task (p < .05). Neither the clinical examination nor the body sway test showed signs of any drug influence. CONCLUSIONS: The overall result of the computer test battery showed no objective adverse impact of melatonin on driving performance. However, due to the increased subjective sleepiness after administration of this hormone, caution should be exercised when driving under the influence of melatonin.

Adult

Comparative study to determine the optimal melatonin dosage form for the alleviation of jet lag.

To compare the impact of various dosage forms of melatonin and placebo on jet lag symptoms, 320 volunteers who had flights over 6 to 8 time zones were recruited for a double-blind, randomized, placebo-controlled study. The volunteers received either melatonin 0.5-mg fast-release (FR) formulation, melatonin 5-mg FR formulation, melatonin 2-mg controlled-release (CR) formulation, or placebo. The study medication was taken once daily at bedtime during 4 days after an eastward flight. The volunteers completed the Profile of Mood States (POMS), sleep log, and symptoms questionnaires once daily and the Karolinska Sleepiness Scale (KSS) three times daily prior to departure and during the 4 days of medication intake postflight. A total of 234 (73.1%) participants were compliant and completed the study. The FR melatonin formulations were more effective than the slow-release formulation. The 5-mg FR formulation significantly improved the self-rated sleep quality (p < .05), shortened sleep latency (p < .05), and reduced fatigue and daytime sleepiness (p < .05) after intercontinental flight. The lower physiological dose of 0.5 mg was almost as effective as the pharmacological dose of 5.0 mg. Only the hypnotic properties of melatonin, sleep quality and sleep latency, were significantly greater with the 5.0-mg dose.

Adult

[Prevention of gastrointestinal and lungworm infections in alpine calves: use of doramectin pour-on in before and after the alpine grazing season].

The effect of doramectin pour-on (Dectomax 0.5% pour-on, Pfizer) against gastrointestinal nematodes (GIN) and lungworms was investigated in calves grazed on alpine pastures in Switzerland. Doramectin pour-on (0.5 mg/kg body weight) was administered topically to calves (n = 57, Group D) before and after the alpine grazing season (mid-June to end of September) when the calves were kept on altitudes between 1800 and 2600 m together with 20 untreated calves (Group K). Calves of both groups were grazed together during the alpine season and were subsequently moved to prealpine and home pastures where they were kept until stabling (end of November). Faecal examinations, performed 4 to 5 weeks after anthelmintic treatment of Group D calves showed a marked reduction of the trichostrongyle egg output, which was also low in the untreated calves. Low numbers of Dictyocaulus-larvae were excreted by the calves at turnout to the alpine pastures. At the end of September the mean excretion of Dictyocaulus-larvae had increased markedly in both groups. After treatment of Group D calves the larval output remained negative until stabling. In contrast, the larval excretion of the untreated calves (Group K) reached highest levels at the end of October and 4 calves exhibited clinical signs of dictyocaulosis. The results indicate that the strategic use of doramectin pour-on in June and in late September provided good protection against severe infections with D. viviparus. The infection level with GIN confirmed that these parasites are of minor relevance under the extensive grazing conditions on high alpine pastures.

Animals

Biological monitoring of vehicle mechanics and other workers exposed to low concentrations of benzene.

It has been suggested that the threshold limit value (TLV) for the time-weighted average (TWA), of benzene be lowered because of its possible leukemogenic effect at low exposure concentrations. This requires the development of new methods of biological monitoring. In this cross-sectional study the diagnostic power of blood and breath benzene and of urinary phenol, catechol, hydroquinone, S-phenylmercapturic acid, and muconic acid were compared in a population of 410 male workers exposed to benzene in garages, in two coke plants, and in a by-product plant. Benzene exposure was assessed by personal air sampling (charcoal tube and passive dosimeter). In all, 95% of the workers were exposed to less than 0.5 ppm benzene. According to the multiple regression equation, the muconic acid and S-phenylmercapturic acid concentrations detected in nonsmokers exposed to 0.5 ppm benzene were 0.3 mg/g and 6 micrograms/g, respectively (range 0.2-0.6 mg/g and 1.2-8.5 micrograms/g, respectively). With muconic acid very few false-positive test results were found, and this determination remained reliable even around a cutoff level of 0.1 ppm benzene. Moreover, the diagnostic power of this test proved to be good even when diluted or concentrated urine samples were not excluded. S-Phenylmercapturic acid (S-PMA) also performed fairly well. Blood and breath benzene as well as urinary phenol (PH) and hydroquinone (HQ) were clearly less suitable biomarkers than muconic acid (MA). Catechol (CA) was not associated with occupational benzene exposure. According to the results of biological monitoring, the skin resorption of benzene from gasoline or other fuels seems negligible. Correlation, multiple regression, and likelihood ratios consistently showed that MA and S-PMA concentrations were fairly good indicators of benzene exposure in the 0.1- to 1-ppm range, even in a population comprising both smokers and nonsmokers. PH, HQ, CA, and blood and breath benzene were less suitable, if at all, in the same exposure range.

Adult

Assessment for Subclinical Kidney Damage in Workers Exposed to Low Concentrations of Hydrocarbons.

It has been suggested the risk of hydrocarbon-induced chronic nephropathy is negligible at low exposure levels. The first purpose of the study was to test this hypothesis by selecting a population slightly exposed to hydrocarbons. Moreover, as hypertension might be associated with an increased excretion of nephrotoxic mercapturates, the association between blood pressure and urinary concentration of S-phenylmercapturic acid (S-PMA) was also examined. Lifetime exposure assessment, main tests of subclinical kidney damage, and statistical approach were taken from a previous study that had included primarily moderately or heavily exposed workers and had found hydrocarbon-induced nephrotoxic effects. No nephrotoxic effect of exposure could be ascertained in the present study. S-PMA concentration was not increased in hypertensive workers. Thus, the risk of hydrocarbon-induced chronic nephropathy might be extremely low in workers slightly exposed to hydrocarbons. The negative results of some studies might be due to the low lifetime hydrocarbon exposures of the study populations.

Journal Article

Tolerance of mefloquine by SwissAir trainee pilots.

Due to presumed adverse performance impact, a World Health Organization clause currently restricts the use of mefloquine malaria chemoprophylaxis in individuals requiring fine coordination and spatial discrimination. We conducted a double-blind, placebo-controlled, cross-over study to quantitatively assess the effects of mefloquine at steady state on performance in 23 trainee airline pilots. Flying performance was assessed using a flight simulator, psychomotor function was evaluated, sleep and wake cycles were monitored, and symptoms and moods were assessed using standardized questionnaires. A simplified postural sway meter recorded sway in three test positions. In the mefloquine loading dose phase, there was one withdrawal due to dizziness, diarrhea, and flu-like symptoms, and three volunteers reported nonserious, sleep-related adverse events. There was no significant difference in flying performance, psychomotor functions, or mean sway for any test position. Nonsignificant reductions in mean total nocturnal sleep (mefloquine = 450 min versus placebo = 484 min) and poorer sleep quality were detected in the mefloquine phases. The mood findings indicated a predominance of positive states, with vigor the predominant mood in all phases. No significant performance deficit was documented under laboratory conditions during use of mefloquine at steady state.

Adult

[Evaluation of the smoking cessation course (1984-1990) of the Cancer and Lung Society of canton Zurich].

The present study is to evaluate the smoking cessation therapy of the working team of the Cancer Association and Lung Association of the State of Zurich. Roughly 1/3 of all 913 participants of the therapy from 1984 to July 1990 have responded to the survey. Of these 1/3, more than a quarter did not smoke any more one year after the therapy. An antismoking program with a 1-year smoking cessation rate of 20 to 30% is considered successful in professional circles. The smoking cessation rate of all 913 therapy participants is probably below the 27% obtained in as much as the share of the successful ones among those replying, by experience is bigger than the share of those failling. Also the more precise inquiry in the first 7 therapies of 1990 confirms these findings. There the rate of success is barely 15% after 1 to 1 1/2 year. It cannot be ascertained whether the smoking cessation rate of all therapy courses is that high or only at the time after the program restructurations at the beginning of 1990. Only a precise achievement control can guarantee a consequent and continuous therapy evaluation within the next years.

Adolescent

Safer sex behavior and alcohol consumption. Research Group of the Swiss HIV Prevention Study.

To test the hypothesis that safer sex procedures are less consistently observed by persons under the influence of alcohol, data from the Swiss human immunodeficiency virus (HIV) Prevention Study (HIPS) were evaluated. HIPS is a large prospective cohort study involving 724 HIV-negative and mainly heterosexual subjects who entertain casual sexual contacts. Of the 724 participants, 36% reported that they had had sex while under the influence of alcohol. Of this group, 31% indicated that safer sex procedures were neglected owing to the influence of alcohol. No significant differences with regard to unprotected sexual intercourse were found between subjects who combine sex and alcohol and those who do not. The same was found to be true among subjects with different levels of general alcohol consumption. However, a significant correlation was found between the intensity of alcohol consumption (i.e., the quantity of alcohol intake per sitting) and the incidence of unprotected sexual intercourse. These findings show that the relationship between alcohol consumption and safer sex is complex; they also emphasize the need for preventive efforts to reinforce safer sexual behavior, for example through individual counseling of persons at risk for HIV-infection.

Adolescent

Mefloquine tolerability during chemoprophylaxis: focus on adverse event assessments, stereochemistry and compliance.

This longitudinal study of travellers to Africa taking mefloquine (MQ) chemoprophylaxis aimed to quantify and assess non-serious adverse events (AE) occurring during short-term prophylaxis and relate these to concentrations of racemic MQ, its enantiomers and metabolite. A total of 420 volunteers (52% F) participated. AEs with some impact on activities were reported by 11.2% of participants including 7.9% of neurological/psychiatric symptoms. Women were more likely to report AEs (P = 0.02). The standardized questionnaires used showed more pathological indicators in travellers who reported subjective AE with significantly more dizziness, distress, sleep disturbances and a high total mood disturbance (TMD) in the AE group. There was, however, no significant performance deficit in computerized psychomotor tests in those experiencing AE. Furthermore, no significant differences were observed in enantiomer ratios, metabolite concentrations, or racemic MQ levels in participants with or without AEs suggesting that these factors are not the main predictors of mefloquine intolerability.

Adolescent

Behavioural aspects of travellers in their use of malaria presumptive treatment.

The use of stand-by treatment for malaria by travellers depends on their knowledge, attitudes and behaviour. We examined the behavioural aspects of a cohort of travellers from Switzerland to low-risk malarial areas who, on recruitment, were provided with a kit containing medication for stand-by treatment, guidelines on the diagnosis of malaria, and materials for collection of blood samples for later confirmation of malaria. All subjects were urged to seek medical advice at the first signs of possible malarial symptoms. Illness (fever as the main indicator) was reported by 123 of the 1187 participants, often accompanied by shivering/chills (36.6%), headache (35.0%), gastrointestinal symptoms (69.9%), and myalgia and/or arthralgia (41.5%). Two-thirds of those ill failed to seek medical attention despite their symptoms and pretravel advice. Only 9 (7.3%) were actually beyond the reach of medical attention. The stand-by treatment was self-administered by 6 travellers, only one of whom had confirmed malaria. Two non-serious adverse events were reported. All users consulted a physician after administering the presumptive treatment. This stand-by approach is limited by inappropriate behaviour and poor malaria awareness among travellers. These negative factors can be mitigated by development of an improved kit containing a simple test for self-diagnosis.

Adult

Efficacy and tolerance of insoluble carob fraction in the treatment of travellers' diarrhoea.

The water-insoluble carob fraction (fraction insoluble caroube, FIC, Nestlé) has been successfully used in the treatment of infantile diarrhoea. To investigate the efficacy and toxicity of FIC (1970 mg to be taken every 2 hours over a 48-hour period except during sleeping time) in the treatment of travellers' diarrhoea in adults, a double-blind, computer randomized, placebo-controlled study was conducted. Of the 755 volunteers recruited at the Zurich University Vaccination Centre, 628 (83.5%) returned their questionnaires. Among them, 164 (27.7%) had diarrhoea, but only 69 (42%) used the trial medication correctly; the others were rated non-complaint. No significant difference in efficacy (p = 0.12) or adverse effects were observed in the two study groups. In conclusion, FIC, although showed a positive trend, was not efficacious.

Adolescent

Comparison of Seven Commonly Used Agents for Prophylaxis of Seasickness.

The objective of the study was to compare the efficacy and tolerability of seven drugs frequently used for the prevention of seasickness: the drugs were namely cinnarizine, cinnarizine with domperidone, cyclizine, dimenhydrinate with caffeine, ginger root, meclozine with caffeine, and scopolamine. The design was a randomized, double-blind study with two arms. On ethical grounds, a placebo group was not included as in a previous study, in the same setting, 80% of the passengers not receiving prophylactic drugs were seasick. The setting was in Andenes (Norway) during a time period from July to September 1992. Subjects were 1741 tourist volunteers who were joining a whale safari. The main outcome measures were vomiting, malaise (modified Graybiel criteria), and subjective reports of adverse events. Follow up was possible in 1489 volunteers (85.5%). In each active treatment group, 4.1-10.2% experienced vomiting and 16.4-23.5% experienced malaise (not significant). Equally, there was no significant difference in the incidence and characteristics of adverse events reported in the various medication groups. Scopolamine Transdermal Therapeutic System (TTS) users exhibited slightly more visual problems and the agent tended to be less effective. Six of the seven medications may be recommended for prevention of seasickness; scopolamine TTS seems the least attractive.

Journal Article

Short and longterm fluctuations of generational MS risk.

According to the hypothesis that childhood is an important age stage in view of MS predisposition, alterations of MS risk may be expected in respect of generational succession. Age-period-cohort-analysis in the appropriate statistical analysis model in this connection. After having shown considerable fluctuations of generational MS risk in the long term view we have tried to derive additional informations from corresponding short term fluctuations: descriptive informations as well as results in relation to the short term fluctuations of infectious diseases' mortality. While applying again age-period-cohort-analysis the results are questioned by the fact that the underlying cohort estimates represent 5-years-moving-averages. Computerized individual death records of the Swiss mortality statistics available since 1969 will enable us to check the recent results.

Adolescent

[How well do condoms protect against HIV infection?].

A review of the literature shows that condoms offer good protection against HIV infection and other sexually transmitted diseases. A series of in vitro experiments demonstrate that quality condoms made of latex are impermeable to HIV. In addition, more than 30 in vivo studies confirm that condoms are highly effective in preventing the transmission of HIV. Condom breakage or slippage is relatively uncommon (1-5%). Most condom failure probably results from incorrect or inconsistent usage. Failures may be minimized by increasing experience, choice of quality condoms and by strictly following instructions for use.

Condoms