Biomedical subjects
U Bollag
Publications and source records attributed to U Bollag.
Asthma trends in Switzerland: the Swiss Sentinel Surveillance Network, 1988-1996.
The setting up of the Swiss Sentinel Surveillance Network (SSSN) in 1986 has provided an excellent opportunity to study the distribution and determinants of asthma. The system provides morbidity data, which are representative of family practices in primar
General practitioners want to know whether a treatment works and is safe in practice.
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The use of acoustic reflectometry in the study of middle ear effusion in children suffering from acute otits media, upper respiratory tract infection and in healthy children.
UNLABELLED: This report focuses on the occurrence of middle ear effusion in children with acute otitis media (n = 62), upper respiratory tract infection (n = 81) as well as in healthy control children (n = 152). Data are reported in age categories 0-4 and 5-13 years. Middle ear effusion was found in 86% of children with acute otitis media, 49% of children with upper respiratory infection and 13% of healthy children. The younger the child, the more likely the presence of middle ear effusion in all groups. Acute otitis media and upper respiratory tract infection were clinically indistinguishable in infants. CONCLUSION: Middle ear effusion is not generally a particularly significant clinical problem in children.
Asthma and exacerbation of chronic bronchitis: sentinel and environmental data in a time series analysis.
To see whether effects of air pollutants and other environmental factors on the respiratory tract can be detected by the Swiss sentinel reporting system, two years' data of asthma bronchiale and exacerbation of chronic bronchitis were analyzed. On average, 16 cases of asthma and 9 cases of bronchitis were reported per week. The respective figures expressed as mean percentages of all consultations were 0.12% and 0.065%. Data of SO2, NO2, ozone and total suspended particles were used to measure air pollution. Additionally, meteorologic parameters such as air temperature and atmospheric pressure were used, as well as the appearance of the most important pollen groups in Switzerland: grass, birch tree and mugwort. Environmental data were summarized using the mean or sum of all measuring stations. Autocorrelations in the time series were accounted for statistically. Our analysis could not establish any relationship between reports of asthma or exacerbation of chronic bronchitis and air pollutants or other environmental data. This result, which is partly contradicted by the literature, could be explained by low numbers of reports due to patient's self administration of medication and an imprecise determination of true exposure.
[Asthma attacks in general practice--epidemiologic markers and seasonal patterns in longitudinal observation].
The continuous registration of asthmatic attacks by the Swiss Sentinel Network "Sentinella" since November 1988 has been preceded by a pilot study which tested the methods of data collection and analysis. The original aim was (a) to use the incidence of asthmatic attacks as a possible indicator for the adverse effects of rising concentrations of air pollutants, and (b) to create a set of baseline data for future research in this field, i.e. data of asthmatic attacks for retrospective analysis of periods with increased levels of air pollution. Here, morbidity characteristics and seasonal patterns of asthmatic attacks as registered from November 1988 to May 1991, will be presented only. With regard to age and sex the data show that more than half of all asthmatic attacks occurred in children 0-14 years of age. Males outweigh females by roughly two to one, but the distribution becomes more even after adolescence. These results are in accordance with the literature (Table 1). Whereas hospital beds (hospitalisations) are occupied by a growing number of patients suffering from asthma, especially in children hospitals, the referral rate of children with asthmatic attacks by primary car physicians has remained relatively steady over the past three years (Table 2). Thus, it can be inferred that asthma, while a major problem in the hospital, is dealt with successfully by practitioners in the primary care setting. This is to the contrary of international trends which show an increasing referral rate for asthma. A differential analysis of workload from asthmatic attacks for general practitioners, internists and paediatricians is directing toward a rising incidence of asthma.(ABSTRACT TRUNCATED AT 250 WORDS)
[Pertussis in clinical practice--critical evaluation of diagnosis and epidemiology].
In the Swiss Sentinel System pertussis is reported according to a clinical case definition. In our Sentinel practice, we have investigated in detail nine patients fulfilling these criteria. Seven of the nine patients have previously been vaccinated with whole cell vaccine. The clinical diagnosis could be confirmed in three cases by the detection of elevated serum IgA to filamentous hemagglutinin (FHA), and in one infant based on the peripheral blood lymphocytosis and the detection of pertussis in other family members. The likely diagnosis in another brother and sister pair was a parainfluenza virus infection, possibly with concomitant pertussis. Two sisters probably had a mycoplasmal infection, which in one was accompanied by pertussis. In two patients an infectious etiology could not be determined. The laboratory tests which have been used in these cases are discussed. The occurrence of pertussis in previously vaccinated adolescents and adults has been recognized worldwide and is of epidemiological concern in view of current vaccination policies. The Swiss Sentinel System could play an important role in the surveillance of pertussis in Switzerland.
[Medical education--from captions in the examination book to the study-guidance evaluation of the learning process].
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Recommendations derived from practice audit for the treatment of acute otitis media.
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Otitis media in practice. A different approach to management. Commentary from clinical observation.
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Acute respiration infections in childhood: tackling the problem at the level of the nose.
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[Tuberculin reaction and the extent of the vaccination scar following BCG vaccination in newborn infants].
The actual incidence of tuberculosis in Switzerland is below 50 per 100,000 people and if contracted tuberculous disease can be treated readily. These were the main reasons why routine BCG vaccination in neonates was discontinued in 1987. However, the epidemiological and sociodemographic situation may change and it may be necessary to reintroduce BCG vaccination on a large scale. In view of this possibility 70 neonates who had received BCG vaccine after birth were reviewed at the time of MMR vaccination or DT booster vaccination in the second year of life. 34 (44.3%) had a positive response to tuberculin testing (Monotest). Nine had no scar, and more than half of the children with a scar had a negative Monotest. There was no correlation at all between the existence or absence of a BCG scar and a positive or negative tuberculin test. The results support the present immunization policy for tuberculosis in Switzerland, but raise questions on the timing of BCG vaccination at birth.
Utilization of local first aiders in the provision of health care for prisoners by the International Committee of the Red Cross in Nicaragua.
The results of a time study and the preliminary collection of morbidity data in rural prisons of Nicaragua prompted the medical delegate of the International Committee of the Red Cross (ICRC) to outline an assistance program based on three principles: (a) that the system be in line with the projects of the national health agencies; (b) that locally recruited and trained health workers become the primary directors of health care in prisons; and (c) that the medical delegate of the ICRC act as advisor to the local health workers.
Continuous assessment of students during clinical clerkship--experiments at Maastricht.
A method of continuous assessment of students in a clinical setting (paediatrics) was adopted at the Medical Faculty of the Rijksuniversiteit Limburg, Maastricht, the Netherlands. One out-patient department student/patient encounter per week was written up by the student, and assessed and commented upon by the clinical tutor. Criteria for assessment were predetermined, and a 4-point scale was used for rating. Score consistency was improved by asking one clinician to observe and mark the same students throughout the attachment. The co-ordinator's task was to establish the learning profile for each student on a chart, to give assistance to clinical tutors and to provide remedial education for students. Acceptability to all the parties involved was established. If this method were used with more than one student/patient encounter per week and if student/patient encounters were rated on the ward, in the emergency room, etc., continuous assessment and monitoring of students' learning would be achieved. This approach, therefore, warrants development and application in all clinical disciplines.
Medicated versus saline nose drops in the management of upper respiratory infection.
Seventy-four children from three weeks to two years of age with various upper respiratory symptoms were randomly assigned to three groups: two intervention groups (saline nose drops; medicated nose drops) and a control group (no nose drops). Forty-six children returned for check-up two days later. Subjects in all three groups improved between first and second contact. There was no significant difference between the three groups. It is concluded that medicated nose drops are not essential in the treatment of upper respiratory infection and rhinitis.
Phenoxetol-chlorhexidine cream as a prophylactic antibacterial agent in burns.
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Educational problems in low-birthweight infants who survive.
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