Re: "Heterogeneity of hip fracture: age, race, sex, and geographic patterns of femoral neck and trochanteric fractures among the US elderly".
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Age Factors↗
Biomedical subjects
K E Bergmann
Publications and source records attributed to K E Bergmann.
Estimating the incidence of hip fractures in East Germany from hospital discharge statistics.
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Adolescent↗
[Sleep behavior in the first 3 years of life].
A review of the literature on sleeping "disorders" in infants and toddlers shows that sleep problems are very common. We report the results of a German multicenter epidemiological study on a birth cohort (N = 1314). The children had medical examinations at 4 weeks, 3 months, 6 months, 1 year, 18 months, 2 years and 3 years. Most of the information on the sleeping behavior was gathered by structured interview and questionnaires. This paper gives information on the prevalence and the persistence of sleep problems in one to three year old children in Germany. Statistical analysis of correlations between breastfeeding and sleep and the place of sleep are reported. The consequences of sleep problems on the family overall well-being are also examined.
Child, Preschool↗
Predictability of early atopy by cord blood-IgE and parental history.
BACKGROUND: Atopic family history and cord blood IgE have been used as predictors of atopic disease in newborns for about 20 years, but at least for cord blood IgE the sensitivity has been shown to be very low. The objective of this paper was to evaluate whether parental history and cord blood-IgE were more accurate predictors for the appropriate atopic phenotypes in the infants rather than for any atopy. METHODS: A total of 1314 newborn infants was recruited in six German obstetric departments in 1990 and followed-up for 2 years. Four hundred and ninety-nine (38%) were at high risk for atopy with at least two first degree atopic family members and/or elevated cord-blood IgE concentrations. RESULTS: The cumulative incidence of atopic dermatitis over the first 2 years of life (AD24) amounted to 20.1%, and there was a significant association with AD history of the mother (OR 2.5, 95%CI 1.46-4.26) and of the father (OR 3.53, 95%CI 1.90-6.54). The cumulative incidence of recurrent wheezing in the first 2 years of life (RW24) amounted to 16.1%, and was positively associated with asthma history (OR 2.11, 95%CI 1.33-3.60) and sensitization history (OR 1.64, 95%CI 1.34-2.36) of the mother, but with neither for the father. RW24 was less prevalent in girls than in boys (OR 0.64, 95%CI 0.47-0.89). Thirty-one per cent of infants were sensitized (CAP test value > 0.35 kU/L) against at least one of nine food or inhalative allergens (S24) and this was significantly associated with cord blood-IgE value (OR 2.43, 95%CI 1.69-3.49), and sensitization history of the mother (OR 1.64, 95%CI 1.18-2.41). Using multiple logistic regression analysis, the prediction of AD24 by AD of parents, of RW24 by asthma of parents, and of sensitization by cord blood IgE was of low accuracy. CONCLUSION: The predictive capacity of parental history and cord blood IgE is not high enough to recommend them as screening instruments for primary prevention. The majority of atopic manifestations and of sensitization occur in infants with no demonstrable risk at birth.
Adult↗
Quantitative structure-activity relationships for the in vitro antimycobacterial activity of pyrazinoic acid esters.
Substituted pyrazinoic acid esters have previously been reported to have in vitro activity against Mycobacterium avium and Mycobacterium kansasii as well as Mycobacterium tuberculosis. Modification of both the pyrazine nucleus and the ester functionality was successful in expanding the antimycobacterial activity associated with pyrazinamide to include M. avium and M. kansasii, organisms usually not susceptible to pyrazinamide. In an attempt to understand the relationship between the activity of the esters with the needed biostability, a quantitative structure-activity relationship has been developed. This derived relationship is consistent with the observation that tert-butyl 5-chloropyrazinoate (13) and 2'-(2'-methyldecyl) 5-chloropyrazinoate (25), compounds which are both 100-fold more active than pyrazinamide against M. tuberculosis and possess a serum stability 900-1000 times greater than the lead compounds in the series.
AIDS-Related Opportunistic Infections↗
Pyrazinoic acid esters with broad spectrum in vitro antimycobacterial activity.
A series of substituted pyrazinoic acid esters has been prepared and examined for their in vitro activity against Mycobacterium avium and Mycobacterium kansasii as well as Mycobacterium tuberculosis. Modification of both the pyrazine nucleus and the ester functionality have been very successful in expanding the activity of pyrazinamide to include M. avium and M. kansasii, organisms normally not susceptible to pyrazinamide. Several of these compounds have activities 100-1000-fold greater than that of pyrazinamide against M. tuberculosis.
Anti-Bacterial Agents↗
Determinants of cord-blood IgE concentrations in 6401 German neonates.
For screening atopy risk in 6401 (84%) of all infants born during the year 1990 in six obstetric departments of five German cities, cord-blood IgE values were determined with CAP-RAST-FEIA. After cases with elevated IgA values had been excluded, 25% of the values were above the detection limit of 0.35 kU/l, and 8.5% were above 0.9 kU/l. Boys had significantly higher values than girls (P < 0.001). The distribution of values was significantly different for different nationalities of mothers (P < 0.001). The percentage of elevated values (> 0.9 kU/l) increased significantly with the number of close family members with atopic history (P < 0.001). Regarding the atopic history of the father, siblings, and mother separately, only the mother's history had a significant association with the cord-blood IgE class (P < 0.001). The IgE values of 81 twin pairs correlated significantly with a coefficient of r = 0.4909 (P < 0.001). The smoking history of the parents during pregnancy showed an association with cord-blood IgE values (P < 0.02). No significant association could be shown between cord-blood IgE distribution and other variables, i.e., gestational age, birth size, birth modus, Apgar score, cord-blood pH value, neonatal problems, parity, age of the mother, medication during pregnancy, educational level of mother or father, time of year, or obstetric department. It is hypothesized that, in addition to some postpartum contamination or placental transfer of maternal IgE, cord-blood IgE values are also determined by the fetal immunologic reaction to intrauterine exposure to allergens and trigger factors, and by genetic influences.
Adrenal Cortex Hormones↗
Salt fluoridation and general health.
Salt fluoridation is a systemic form of fluoride supplementation, leaving it to the consumer whether he wants fluoride supplements or not, but thereafter not requiring special dependability for daily compliance. Most German drinking water has low fluoride concentrations. The estimated fluoride intake in German children is between 100 and 300 micrograms/day, and in adults, between 400 and 600 micrograms/day. Male subjects have higher mean intakes than females. From 70 to 90% of the salt intake of 10 to 13.5 g/day in German adults comes from commercially prepared foods. This leaves about 1 to 4 g of salt to be added as table salt at the individual level and to become the source of supplementary fluoride. To increase fluoride intake by at least 500 micrograms/d, and to prevent an additional intake of more than 3000 micrograms/day, it may be necessary to have salt at a fluoride level of around 500 micrograms/g or to include one commercial food to be prepared with fluoridated salt, e.g., bread. A salt fluoride concentration of 250 micrograms/g does not present a risk of dental fluorosis. However, clear recommendations about systemic fluoride supplementation must be given as long as there are fluoride tablets, fluoride-rich mineral waters, and fluoridated table salt available simultaneously. Persons at risk for hypertension from salt consumption require different means of fluoride supplementation. By and large, in areas of low drinking water fluoride, fluoridated table salt has the potential to become a means of systemic supplementation comparable with drinking water fluoridation.
Adolescent↗
["Public health goals"--concepts this side of utopia? Berlin Public Health Research Organization--divided project "Goals and goal indicators for East and West Berlin Public Health"].
Objectives or targets for health have been presented by the World Health Organisation as well as a number of national health administrations. Health objectives are intended as guidelines attracting the commitment of decision makers and health professionals. As a "normative health indicator" a health objective should quantify the desired progress and give the time by which it could be attained. The article discusses general and methodical aspects which are thought to be relevant in identifying and quantifying health objectives for a population.
Adult↗
[Frequency analysis for achieving health goals--I: Standardization].
The formal mathematical steps of direct and indirect standardisation are deduced and it is pointed out that standardisation is an analytical concept for processing data within the framework of structurised populations to enable correct interpretation of these data in a manner modified according to specific problems. In particular, this concept is not confined to transforming age-structured mortality data of a population to the age distribution of the members of a larger population by means of a rule of three. Standardisation is in fact a model of the macrolevel (population). It makes no demands on the modalities of structuring. The structure selected as standard is arbitrarily set. With time series, standardisation usually modifies only the levels of the figures and not the frequencies. The results of standardisation are in every case valid only if the standard is also stated. A rule of thumb is: In retrospective analysis it is meaningful to standardise on the structure at the beginning or end of the time series; in extrapolations standardisation should be performed on the last structure that had been determined, whereas for comparisons a median structure should be standardised. The standardisation approach can be used in case of weighted arithmetic, geometric or harmonic means. Before effecting standardisation, the type of connection between the employed data should be examined. The examples of concepts of direct standardisation refer to cardiovascular and accident mortality in West Berlin from 1963 to 1991, whereas those of indirect standardisation are based on the accident mortality in West Berlin in 1987 structured according to city districts.
Accidents↗
[Frequency analysis for achieving health goals--II: Analysis of mortality tables for cause of death, expected mortality].
The article gives algorithms to calculate mean ages at death for specific causes, based on life table models. Parameters of interest are death due to a specific cause, dying after the "elimination" of the specific cause, or the transition into a "new" structure of mortality when a specific cause of death vanishes. The setbacks of widely used calculations are discussed in this context. These different approaches are demonstrated by means of data pertaining to accident and cardiovascular mortality of the male population of Berlin (West). The estimated impact on life expectancy varies according to both the mathematical model and the specific cause of death: differences are negligible in mortality due to accidents, whereas the results differ considerably in cardiovascular causes of death. The algorithm suggested allows to constrain the calculations to specific age groups. Topics such as "avoidable death" and "health objectives" have to be aware of these different methods.
Accidents, Traffic↗
[The Lee-Carter model of the prognosis of mortality in Germany. Berlin Public Health Research Group--partial project "Goals and Goal Indicators for Public Health in East and West Berlin"].
A model for forecasting mortality developed by Lee and Carter is applied to data of West Germany. The logs of the age-specific death rates are modeled as a linear function of an unobserved mortality index using the singular value decomposition method. The forecasts are based on projections of all individual trends of the mortality rates. Applied to life expectancy at birth between 1969 and 1992 the model implies an increase of 2.2 years in life expectancy for men and 2.4 years for women in 2002.
Adolescent↗
The future costs of hip fractures in Germany.
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Aged↗
Bivalent ligands as probes of estrogen receptor action.
The estrogen receptor (ER) is a hormone-regulated transcription factor which is thought to bind to specific DNA sequences as a homodimer. In order to better understand structural requirements for dimerization and its functional role in ER action, we synthesized a series of bivalent ligands based on the non-steroidal estrogen hexestrol. These molecular probes join two hexestrol molecules of the erythro (E, active) configuration with either 4 or 8 carbon linkers (designated E-4-E and E-8-E series, respectively), or with longer linkers comprised of ethylene glycol units (E-eg-E series). Several other bi- and monovalent control compounds were prepared. The bivalent ligands bind to ER with a relative affinity 1-7% that of estradiol. While most of the ligands demonstrated normal monophasic displacement curves in competitive binding assays with [3H]estradiol, uncharacteristic biphasic competitive binding curves were seen for some of the ligands, indicating possible structure-specific, negative site-site interaction. In ER-deficient Chinese hamster ovary (CHO) cells transfected with an expression vector encoding ER, one series of bivalent ligands (E-4-E) had little stimulatory activity and inhibited transcription stimulated by hexestrol, as determined by a transient transfection assay using an estrogen-responsive reporter gene construct [(ERE)2-TATA-CAT, containing two estrogen response elements linked to a TATA promoter and the chloramphenicol acetyl transferase reporter gene]. Monovalent or control bivalent ligands failed to antagonize hexestrol-stimulated activity and were as fully active as hexestrol itself. Studies performed in MCF-7 human breast cancer cells, which contain endogenous ER, yielded similar bioactivity profiles for the E-4-E bivalent inhibitory ligands, showing them to be effective estrogen antagonists, when using either induction of progesterone receptor or (ERE)2-TATA-CAT transcriptional activation as the endpoint. The E-8-E ligand, however, acted as a partial agonist/antagonist of ERE-reporter gene transactivation and a full agonist of progesterone receptor induction in MCF-7 cells, thus showing cell- and response-specific differences in the effects of this bivalent ligand. These bivalent ligands for ER do not show enhanced potency or receptor binding affinity; however, some of them display binding properties that suggest the possibility of structure-specific negative site-site interaction, and some of them function as quite effective estrogen antagonists.
Animals↗
Oxohexestrol derivatives labeled with fluorine-18. Synthesis, receptor binding and in vivo distribution of two non-steroidal estrogens as potential breast tumor imaging agents.
We have prepared two non-steroidal estrogens in the 2-oxohexestrol series labeled with the positron-emitting radionuclide fluorine-18, 1-fluoro-5-oxohexestrol (4) and 1-fluoro-2-oxohexesterol (5). We anticipated that the polar ketone function at the interior of these ligands would reduce their level of non-specific binding, which might increase the selectivity of their uptake in vivo. The two compounds were prepared by total synthesis: compound 4 was prepared in fluorine-18 labeled form by [18F]fluorine ion displacement on a suitably protected methanesulfonate precursor followed by deprotection under acidic hydrogenolytic conditions; the isomer 5 was prepared from a protected alpha-keto trifluoromethanesulfonate precursor with deprotection under basic conditions as the final step. The binding affinity of these hexestrol derivatives for the estrogen receptor was determined by competitive radiometric binding assays at 0 and 25 degrees C, and their lipophilicity (as octanol-water partition coefficients, log P values) and non-specific binding were estimated. The log P values determined by a reversed phase HPLC method were higher, relative to estradiol, than those calculated by the fragment method of Rekker. In tissue distribution studies in immature (50 g) rats, both of these compounds showed selective uptake in estrogen target tissues. At 1 h, activity in the uterus reached the level of 2.5-3.0% of the injected dose per gram tissue, with uterus-to-blood and uterus-to-muscle ratios of 14-20 and 8-14, respectively. The uptake efficiency and selectivity of these fluoro-oxohexestrols in principal estrogen target tissues is less than that of fluorine-18 labeled steroidal estrogens we have prepared previously, but their receptor-mediated uptake in certain secondary target tissues is substantial. The specific and non-specific components of target tissue uptake of these two compounds appear to be directly related to their non-specific binding and their binding selectivity.
Animals↗
Atopic diseases in infancy. The German multicenter atopy study (MAS-90).
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Breast Feeding↗
[The significance of AIDS for mortality in Berlin (West)].
Following a long-term decline, death rates due to infectious diseases in West-Berlin men have dramatically increased since 1983. The Berlin mortality statistics introduced AIDS as a specific cause of death only in 1989. However, opportunistic infections, a negligible quantity until 1983, and pointing to AIDS as the underlying cause, show a steep increase in the mid and late eighties. In terms of Potential Years of Life Lost, AIDS-related mortality amounts to 8 percent of total mortality in West-Berlin men in 1989/1990.
AIDS-Related Opportunistic Infections↗
Atopic family history. Validation of instruments in a multicenter cohort study.
In order to identify newborns at risk for atopic diseases, we developed a family questionnaire and selected specific answers which were suitable to identify atopic family members. The validity of the questionnaire was evaluated by the Phadiatop test results of 793 mothers and 353 fathers. As both screening instruments do not measure the same, the Phadiatop test identifies sensitization to inhalant allergens and the history reflects the clinical manifestation of atopic disease, the agreement between sensitization and manifestation is incomplete. Sensitivity and specificity of the questionnaire screening conditions to reproduce the Phadiotop test result was 64% and 84% for mothers, and 58% and 88% for fathers, respectively. The relative risk for lifetime prevalence of atopic manifestations in Phadiatop positive over negative mothers was calculated to be 3.88 (95% confidence interval = 3.12 to 4.81), and for Phadiatop positive over negative fathers to amount 4.84 (95% confidence interval 3.25 to 7.23). A few relevant answers of 20 were identified by logistic regression analysis to predict the Phadiatop test result nearly, as well as the total questionnaire.
Adult↗