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Biomedical subjects

U John

Publications and source records attributed to U John.

At least 37 records · Page 2Linked to original sources
PubMed2005

Mental and physical distress is modulated by a polymorphism in the 5-HT transporter gene interacting with social stressors and chronic disease burden.

Previous studies have yielded conflicting results as to the putative role of the functional polymorphism of the promoter region of the serotonin transporter gene (SLC6A4) in the etiology of anxiety-related traits and depressive disorders. Recently, a significant gene-environment interaction was found between life stressors, the short allele of the SLC6A4 polymorphism and depression. The aim of the present study was to investigate if such a gene-environment interaction could be replicated within a different population with a different risk structure. A total of 1005 subjects from a general population sample (Study of Health in Pomerania) were genotyped. Mental and physical distress were assessed on 38 items of the modified complaint scale (BL-38). The interaction between the SLC6A4 genotype, social stressors and chronic diseases with regard to the BL-38 score was evaluated by ANOVA. There was no independent association of genotype with mental and physical distress. However, significant interactions between genotype, unemployment and chronic diseases (F = 6.6; df = 3, 671; P < 0.001) were found in females but not in males. The genotype explained 2% of the total variance of the BL-38 score and 9.1% of the explained variance. The results partly confirm previous findings of a significant gene-environment interaction of the short allele, indicating a higher mental vulnerability to social stressors and chronic diseases. The relevance of this finding is sustained by the fact that the sample characteristics and the risk structure were highly different from previous studies.

Adaptation, Physiological↗
PubMed2005

[Health Risk drinking and problematic consumption of alcohol in Pomerania: comparative analysis of the Study of Health in Pomerania (SHIP) compared with the Federal German Health and Examination Survey in 1998].

PURPOSE: Epidemiological studies show a "North-South" gradient in drinking patterns in Germany, with the South-Eastern regions consuming more alcohol. Hence, patterns of alcohol consumption as well as at-risk drinking were evaluated in West Pomerania using a representative sample. In addition, the average daily quantities and the proportions of at-risk drinking were compared with representative data for Germany (Federal German Health and Examination Survey 1998 [FGHES]). METHODS: A representative random sample of the Pomeranian population (4,310 persons) was analysed. The response rate was 68.8 %. The amount and frequency of alcohol consumption was surveyed with a standardized questionnaire. Prevalence rates for at- risk drinking (> or = 30 g ethanol per day for men, > or = 20 g ethanol per day for woman), indications of abuse / dependence, and episodes of heavy drinking (number of days with 5 and more drinks consumed per day) are presented. To identify socio-economic correlates of high-risk drinking multiple logistic regression modelling was used. Alcohol consumption was evaluated via a frequency-quantity-measure and by using the "Luebeck Alcohol Dependence and Abuse Screening Test" (LAST). RESULTS: Average daily consumption of pure alcohol was about 11.8 g per day, 18.5 g per day for men and 5.8 g per day for women. The consumed quantities exceeded the levels calculated with the FGHES about 1.5 g, 1.8 g for men and 1.2 g for women. Prevalence of risk drinking and harmful alcohol use in Pomerania is higher than the FGHES as well. At-risk drinking was especially associated with age. In women, belonging to a higher social class at-risk drinking was higher, whereas in men of the lower social class consumption rates were higher. The highest alcohol consumption was observed among middle-aged men and women. CONCLUSIONS: The results suggest that alcohol consumption on a high level as well as high-risk drinking is a common phenomenon in the north-eastern part of Germany. Public health measures are indicated for this region. Such intervention projects should focus on population groups with higher alcohol intake.

Adult↗
PubMed2005

Risk factors for goiter in a previously iodine-deficient region.

OBJECTIVE: Little information exists from formerly iodine-deficient areas regarding gender-specific risk factors for goiter and their synergisms. The aim of the present study was to investigate such gender-specific risk factors and their interactions in a large population-based sample. METHODS AND RESULTS: The Study of Health in Pomerania (SHIP) comprised 4310 randomly selected participants, aged 20 - 79 years. SHIP was performed in a previously iodine-deficient region. Data from 3915 participants with no known thyroid disorders were analyzed. Goiter was determined by thyroid ultrasound. Sociodemographic characteristics, smoking and alcohol drinking habits, marital status, education level, urine thiocyanate concentrations, and specifically in women, parity and previous or current use of oral contraceptives and hormone replacement therapy, were considered as candidate risk factors for multivariable statistical tests. Only two variables, an advanced age and current smoking, were independently associated with an increased risk for goiter in both genders. Analyses further revealed specific risk factor profiles for goiter which were different among men, pre- and postmenopausal women. CONCLUSION: We conclude that besides previous iodine deficiency, other risk factors for goiter exist which differ between gender. Among the avoidable risk factors, current smoking was strongly associated with the risk of goiter in men and women. These findings should influence activities which are intended to prevent thyroid disease.

Adult↗
PubMed2005

No considerable long-term weight gain after smoking cessation: evidence from a prospective study.

The aim of the study was to analyse predictors of the body mass index (BMI) after smoking cessation. The sample included 4075 residents aged 18-64 years in a northern German area (participation rate 70.2%), drawn randomly from the resident registration files, among them 1545 current and 903 former daily smokers. The current smokers were followed up 36 months after baseline. Face-to-face in-home computer-aided interviews (Composite International Diagnostic Interview) including questions about body weight and height at baseline and postal questionnaires at follow-up were employed. The data reveal that the number of cigarettes smoked at time of peak consumption in life contributed substantially, and years of abstinence from daily smoking contributed marginally to the BMI in a general linear model. It is concluded that the contribution of smoking cessation to the BMI increase was practically negligible. Efforts to prevent weight gain after smoking cessation should focus especially on heavy smoking.

Adolescent↗
PubMed2005

Influence of psychiatric comorbidity in alcohol-dependent subjects in a representative population survey on treatment utilization and natural recovery.

BACKGROUND: It is well known that only a minority of alcohol-dependent subjects seek help and that the majority of alcohol-dependent individuals recover without utilization of formal help. Psychiatric comorbidity is highly prevalent among alcohol-dependent individuals. However, no data are available on the impact of psychiatric comorbidity on natural recovery. AIMS: To analyse the impact of non-psychotic psychiatric comorbid Axis I disorders on remission rate and utilization of formal help in alcohol-dependent individuals drawn from a representative general population sample in northern Germany (response rate: 70.2%, n = 4075). Psychiatric diagnoses and utilization of help were assessed in a personal interview using standardized instruments. One hundred and fifty-three life-time alcohol-dependent individuals were assessed, among whom 98 fulfilled the criteria for sustained long-term remission according to the Diagnostic and Statistical Manual version II (DSM-IV) criteria. Any coincidence of DSM-IV non-psychotic Axis I disorders with alcohol dependence was counted as comorbidity. Comorbidity rate in the whole sample was 36.1%. RESULTS: The rate of individuals who remitted from alcohol dependence without formal help was 36.9% in the non-comorbid and 42.6% in the comorbid group. Utilization of formal help was unrelated to comorbidity. Dually diagnosed subjects without a history of help-seeking showed minor differences concerning reasons for not seeking help. Seeking help was not related to schooling, severity of dependence and gender. CONCLUSION: Data reveal that remission without formal help is equally prevalent among non-comorbid as among comorbid alcohol-dependent individuals. Axis I comorbidity is not related directly to utilization of alcohol-related help. Negative prognoses for untreated comorbid alcohol-dependent individuals are not justified from an epidemiological point of view.

Adolescent↗
PubMed2005

Mental and physical complaints in thyroid disorders in the general population.

OBJECTIVE: To test the hypothesis that untreated overt and subclinical thyroid disorders and autoimmune thyroiditis (AIT) are associated with mental and physical complaints in the general population. METHOD: A total of 3790 participants from the Study of Health in Pomerania (SHIP) with no known thyroid disorders were analyzed concerning their thyroid function (TSH, FT3, FT4), autoantibodies (TPO-Ab), their thyroid structure and size and their mental and physical complaints (Zerssen Complaint Scale). RESULTS: Overt hyperthyroidism (prevalence: 0.4%) was associated with a significantly lower total complaint-score than euthyroid subjects. Subjects with overt hypothyroidism (0.5%), subclinical hypothyroidism (0.7%), or subclinical hyperthyroidism (1.6%) were not different from controls in their total complaints. Females with AIT showed higher scores of tachycardia and anxiety independent from their thyroid function. CONCLUSION: In non-patient samples, hyperthyroidism is associated with positive effects on self-rated mental and physical health. AIT may be associated with negative effects on health also in euthyroid subjects.

Adult↗
PubMed2005

Risk determinants of periodontal disease--an analysis of the Study of Health in Pomerania (SHIP 0).

BACKGROUND: In this study, risk determinants were determined for periodontal disease in the representative population sample (n=3146) of the Study of Health in Pomerania. METHODS: After examining the net random sample (response 69%) and exclusion of edentulous cases and those with missing values, 2595 subjects remained. Using a multivariate, fully adjusted logistic regression, different definitions of "periodontally diseased/healthy" were examined as the dependent variable (extent of attachment loss (AL> or =4 mm, combined AL and tooth loss). The independent variables used were sociodemographic factors (age, gender, income, education), medical factors (systemic diseases, drugs), behavioral factors (regular dental checkup, smoking), and oral factors (presence of supragingival calculus and plaque). RESULTS: The following risk determinants were found for AL: male gender, presence of supragingival plaque and calculus, smoking, low educational level. For the combination of AL and tooth loss, risk determinants were female gender, supragingival plaque, smoking, and low educational level. Consumption of antiallergic medications and regular dental checkups proved to be protective. Smoking was the most influential risk determinant. These parameters explained approximately 43-55% of the variation. CONCLUSION: These results concur with those of the literature. In order to explain disease status further, host-response and microbiological factors must also be examined.

Adult↗
PubMed2005

Relation between psychological strain and carotid atherosclerosis in a general population.

OBJECTIVE: To investigate the hypothesis that psychological strain is related to carotid atherosclerosis in a large general population sample. METHODS: Intima-media thickness and the prevalence of atherosclerotic plaques in the carotid arteries were quantitatively assessed by high resolution ultrasound among 2164 participants (1112 women and 1052 men, aged 45 to 75 years) of the SHIP (study of health in Pomerania), an epidemiological survey of a random sample of the population of north eastern Germany. Psychological strain was measured by 13 items reflecting typical psychological complaints. Each item was graded by the study participants on a four point scale (from 0, absent, to 3, severe) and a psychological strain score was generated by summing these 13 items. RESULTS: Mean psychological strain score was 10.8 (7.0) (median score 10) among women and 8.5 (6.2) (median score 8) among men. Psychological strain did not predict carotid intima-media thickness among either men or women. However, after adjustment for covariates, high psychological strain and carotid plaques were independently and linearly related, with plaque prevalence odds of 1.03 (95% confidence interval (CI) 1.01 to 1.05, p = 0.009) per increment of the psychological strain score among women and 1.04 (95% CI 1.01 to 1.07, p = 0.003) among men. CONCLUSIONS: This study identified a relation between general psychological strain and carotid atherosclerosis.

Aged↗
PubMed2005

Magnesium deficiency is associated with periodontal disease.

In the multifactorial pathogenesis of periodontitis, there are still unknown factors influencing the outcome of the disease. An association between magnesium and periodontitis has been suggested by preliminary studies. However, relevant clinical data are lacking. We investigated the association between magnesium status and periodontal health in a population-based analysis. We conducted a cross-sectional epidemiological investigation involving 4290 subjects aged 20-80 yrs. We recorded periodontal risk factors and determined concentrations of serum magnesium and calcium, relating them to periodontal parameters. In a matched-pair study, 60 subjects using oral magnesium-containing drugs and 120 without were compared. In subjects aged 40 yrs and older, increased serum Mg/Ca was significantly associated with reduced probing depth (p<0.001), less attachment loss (p=0.006), and a higher number of remaining teeth (p=0.005). Subjects taking Mg drugs showed less attachment loss (p<0.01) and more remaining teeth than did their matched counterparts. These results suggest that nutritional magnesium supplementation may improve periodontal health.

Adult↗
PubMed2004

Self-efficacy to refrain from smoking predicted by major depression and nicotine dependence.

Little is known about the specific pathways between depression and low self-efficacy to stop smoking, particularly among the general population. The goal was to examine whether depression and nicotine dependence may predict the confidence in the ability to refrain from smoking (CAS). A random population sample aged 18-64 was used from northern Germany. It included 1520 current smokers, who were eligible for a first follow-up after 30 months and a second follow-up after 36 months. The results show that DSM-IV major depression and nicotine dependence, the Fagerström Test for Nicotine Dependence (FTND), the number of cigarettes smoked, the age at onset of daily smoking, and the intention to stop smoking predict the CAS. It is concluded that there may be an additive effect from nicotine dependence and major depression on the CAS.

Adolescent↗
PubMed2004

A short form of the Fagerström Test for Nicotine Dependence and the Heaviness of Smoking Index in two adult population samples.

Few data exist about the Fagerström Test for Nicotine Dependence (FTND) and the Heaviness of Smoking Index (HSI) from population samples. The goal was to prove to what degree (1) a reduced item solution of the FTND and (2) the HSI represent the FTND. Two randomized adult population samples were used from northern Germany. Sample 1 included 1462 and sample 2 included 1042 current daily cigarette smokers aged 20-64 years with FTND data. The results show that four items of the FTND as well as the HSI represent the FTND. It is concluded that both are valid measures of the urge to smoke and the tobacco-smoke-seeking behavior.

Adult↗
PubMed2004

Signs of temporomandibular disorders in tinnitus patients and in a population-based group of volunteers: results of the Study of Health in Pomerania.

The literature has documented a controversial discussion on the possible relationship of otogenous symptoms and craniomandibular dysfunction since the 1920s. Therefore, an investigation was conducted which consisted of two parts: a case study with population-based controls and a cross-sectional study. The aim of the first study was to screen a group of patients suffering from acute or chronic tinnitus for temporomandibular disorders (TMD) in comparison with a population-based group of volunteers without tinnitus. To this end, 30 patients (13 females and 17 males, age 18-71 years) suffering from acute hearing loss associated with tinnitus, isolated acute tinnitus, and chronically transient tinnitus were examined for symptoms of craniomandibular dysfunction. The results were compared with those of clinical functional analysis from 1907 subjects selected representatively and according to age distribution from the epidemiological 'Study of Health in Pomerania' (SHIP); the occurrence of tinnitus was ruled out in these control subjects. Statistical analysis was performed with Chi-square and Mann-Whitney U-tests. Sixty per cent of the tinnitus patients and 36.5% of the control subjects exhibited more than two symptoms of TMD (P = 0.004). Tinnitus patients had significantly more muscle palpation pain (P < 0.001), temporomandibular joint (TMJ) palpation pain (P < 0.001), and pain upon mouth opening (P < 0.001) than the general population group. No statistical differences were found in TMJ sounds, limitation of mandibular movement, or hypermobility of the TMJ. Furthermore, 4228 subjects of the population group examined in the epidemiological study were screened for co-factors of tinnitus with the help of a multivariate logistic regression model which was adjusted for gender, age, and a variety of anamnestic and examined data. Increased odds ratios (OR) were found for tenderness of the masticatory muscles (OR = 1.6 for one to three painful muscles and OR = 2.53 for four or more painful muscles), TMJ tenderness to dorsal cranial compression (OR = 2.99), listlessness (OR = 2.0) and frequent headache (OR = 1.84) A relationship between tinnitus and TMD was established in both examinations. Tinnitus patients seem to suffer especially from myofascial and TMJ pain. A screening for TMD should be included in the diagnostic survey for tinnitus patients.

Acute Disease↗
PubMed2004

[Medical care requested by smokers and at-risk alcohol consumers: results of a representative population survey].

PURPOSE OF THE STUDY: Due to difficult availability of subjects with substance-related disorders (especially nicotine and alcohol) via the existing specialised treatment services, the impact of proactive early interventions in hospitals and general practitioners is increasingly acknowledged. Only little is known as to known many persons with substance-related disorders are not attainable via this pathway and where such persons could be contacted. In the present study, we analysed the prevalence of substance-related disorders and the motivation to change in subjects drawn from a representative population survey with and without use of medical services during the preceding year. METHOD: The present analysis is based on data from the TACOS ("Transitions in Alcohol Consumption and Smoking") Study (N = 4075) conducted in the town of Luebeck and its environs in Northern Germany. Utilisation of medical services was differentiated in non-utilization (NI), hospital admission during the previous year (KH), at least one visit to a general practitioner (HA), specialist only (FA) and dentist only (ZA). RESULTS: 75% of the population had been to a hospital or their general practitioner in the previous year, a further 18.3% visited a specialist or a dentist only and 4.8% did not contact medical services. Analysis revealed a higher prevalence of smoking and increasing alcohol consumption combined with a higher unemployment rate in NI, followed by KH, HA, FA and ZA. CONCLUSION: The majority of smokers and subjects with at-risk alcohol consumption can be attained via medical services. Additionally, early interventions in dentist practices and employment offices might include further substantial groups of smokers and at-risk drinkers.

Adolescent↗
PubMed2004

[Medical services utilisation: which role does social support play?--Results from the Study of Health in Pomerania (SHIP)].

AIMS: This study examined the role of social support in relation to the use of medical services in a north-eastern German population. METHODS: A representative random sample of the Pomeranian population (4,310 persons) was analysed. The response rate was 68.8 %. Bivariate and multivariate associations between socio-economic variables, need (evaluated and perceived health status), social support and the number of consultations (general practitioners or internists) were assessed. The SF-12 and the MOS social support survey were used as standardised instruments. RESULTS: Social supports showed no main effects on utilisation rates. Individuals living in a partnership showed lower levels of utilisation (median: 4.3 vs. 6.2). The combination of high morbidity and low social support or no partnership results in an increase in medical services utilisation. CONCLUSIONS: Social support treatments that target an appropriate use of the health care system can be a cost-effective measure in chronically ill patients.

Adult↗
PubMed2004

[Characteristics of patients with alcohol- or drug problems in medical practices "addiction" in Mecklenburg-Vorpommern].

BACKGROUND: The pilot scheme "Medical practices with emphasis on addiction" examines one approach in the outpatient treatment of patients with addiction. Nine medical practices in Mecklenburg-West Pomerania participate in this project, and the goal is to lower the threshold for the utilisation of help and to provide a long-term relationship between the patient and the physician. GOAL: Results of the first survey of patients and physicians are presented as part of the scientific evaluation of the entire project. METHOD: Data of 876 patients was assessed. There is data about the severity of alcohol dependence (SESA), about negative consequences of drinking and about utilisation of help for n = 627 patients. These were compared with a sample of n = 153 subjects with a diagnosis of alcohol dependence from a population-based survey. Medical doctors provided information on the duration and quality of patient contact, current drug consumption and content of treatment for n = 472 patients. RESULTS: Of all patients, 51 % were treated for more than 3 years in the respective practice. Among the patients, 45 % were current drug users, further help was recommended for 77 %. In comparison with the reference group, patients with a diagnosis of alcohol dependence in those practices were more severely dependent, reported more problems concerning health, work, or finances and utilised addiction-specific help more often. DISCUSSION: The medical practices under examination undertake the task to provide long-term support for patients with addiction diagnoses and encourage patients to utilize more help from further sources. Their patients with alcohol diagnoses differ substantially from persons in the general population with regard to severity of dependence and related problems. This justifies an intensive medical and psychosocial support by specialised practitioners.

Adolescent↗
PubMed2004

[Interventions to prevent health risks due to tobacco smoke in pregnant women, postpartum women and their infants].

The aim of this study was to develop recommendations for interventions aiming at reducing health risks due to tobacco smoking in pregnant women, women postpartum and their infants. Meta-Analyses and selected studies are summed up. Epidemiological findings and health risks due to smoking are summed up. Subsequently findings from intervention studies are cross-referenced and integrated as recommendations. Interventions may be divided into three categories: 1. interventions to obtain abstinence in pregnancy, 2. interventions for relapse prevention after abstinence has been attained in pregnancy, 3. interventions aimed at reducing exposure to environmental tobacco smoke in homes with children. Empirical evidence is cross-referenced to the following points: 1. Self-help materials, 2. brief counselling, 3. more time-consuming counselling, 4. interventions to reduce exposure to environmental tobacco smoke and 5. interventions by midwives. Results from meta-analyses as well as results from selected studies suggest the following recommendations: 1. use of a trusting relationship in counselling, 2. repeated counselling, 3. complementary use of self-help materials; self-help material alone is not effective enough, 4. use of state-of-the-art counselling approaches and, 5. theoretical foundation and appropriate individualized counselling.

Causality↗
PubMed2004

[The readiness of women, after they have given birth to children, to participate in individualized counselling for smoking cessation ].

OBJECTIVES: Smoking after pregnancy implies health risks for both the woman and the newborn. Smoking cessation interventions postpartum can prevent relapse in women who quit during pregnancy, protect the infant from environmental tobacco smoke (ETS), and motivate smokers to quit. The readiness of women postpartum to participate in smoking cessation counselling is described. METHODS: In 6 maternity wards n = 2790 women were screened for smoking, n = 1128 smoked before pregnancy. Of these n = 869 gave informed consent. Information on sociodemographic status and smoking behaviour is available for n = 642 participating women and for n = 217 non-participating women. RESULTS: No differences between women participating and non-participating were found in age (p >.05) and having a partner (p >.05). Participants were slightly higher educated (p <.001) and were mainly in maintenance (44 %) or in precontemplation stage of change (38 %). The proportions were 44 % and 22 % in the group of the non-participating women. CONCLUSIONS: The readiness of women postpartum to participate in smoking cessation counselling was high. By reaching abstinent women and women not motivated to quit, a target group was addressed that barely benefits from currently existing preventive activities. Maternity wards are an effective location for addressing smoking behaviour of mothers.

Attitude to Health↗