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Biomedical subjects

U John

Publications and source records attributed to U John.

At least 73 records · Page 4Linked to original sources
PubMed2001

Ambulatory blood pressure monitoring in children with unilateral multicystic dysplastic kidney.

UNLABELLED: Multicystic dysplastic kidney (MCDK) is one of the most common congenital renal anomalies. Arterial hypertension is a potential complication of MCDK. Blood pressure (BP) has so far been measured only casually and the frequency of hypertension has been estimated to be between 0%-8%. Ambulatory blood pressure monitoring (ABPM) provides more precise information on BP than the casual BP measurement. The aim of this study was to investigate the BP profile in children with MCDK using ABPM. A group of 25 children (16 girls), with a mean age of 7.8 years (range 3.8-17.7 years) were investigated. ABPM was performed using the oscillometric SpaceLabs 90207 device. Hypertension was defined as mean systolic and/or diastolic BP during the day and/or in the night exceeding 95th percentile for ABPM. Five (20%) children showed hypertension, two of them had combined daytime and night-time hypertension and three had isolated nocturnal hypertension, although daytime BP was between the 90th-95th percentile in two of them. Children with ultrasonographical and/or laboratory signs of contralateral kidney abnormalities showed a higher incidence of hypertension than those without abnormalities (two of four versus 3 of 21). The mean night-time systolic and diastolic BP of children with MCDK was significantly higher than in healthy children (+ 0.50 and + 0.54 SDS, respectively, P = 0.012 and 0.03, respectively). Three of the hypertensive children were already nephrectomised. All five hypertensive children showed ultrasonographical and/or laboratory signs of contralateral kidney abnormalities. Hypertensive children had significantly higher microalbuminuria than normotensive children (6.9 +/- 3.2 mg/mmol creatinine versus 1.8 +/- 0.7, P = 0.03). The nocturnal BP fall (dip) was attenuated in five children, only one of whom was hypertensive. CONCLUSION: Arterial hypertension in children with multicystic dysplastic kidney is seen more often if based on ambulatory blood pressure monitoring than on casual blood pressure recordings. The main risk factor for developing hypertension is contralateral kidney damage. Ambulatory blood pressure monitoring should be performed in children with multicystic dysplastic kidney, especially in those with contralateral kidney abnormalities.

Adolescent↗
PubMed2001

Factors influencing remission from alcohol dependence without formal help in a representative population sample.

AIMS: To analyse factors related to remission without formal help by using a representative sample and standardized instruments. DESIGN: Two groups of untreated alcohol-dependent subjects were compared. SETTING: General population survey. PARTICIPANTS: Thirty-two subjects fully remitted without formal help (NFH) and 26 current alcohol-dependent individuals (CAD) according to DSM-IV drawn from a representative general population sample in northern Germany (response rate: 70.2%, n = 4075). MEASUREMENTS: Data focusing on the 2 years prior to remission from NFH were compared with past-year data from CAD. Groups were compared on variables found to be associated with remission without formal help in previous research. FINDINGS: Logistic regression analysis revealed that individuals remitted from alcohol-dependence without formal help reported a higher non-physiological severity of alcohol dependence, less social pressure to quit drinking and more incidents of driving while intoxicated. Furthermore, they tended to report more satisfaction with work and financial situation and were more likely to live in a stable partnership. CONCLUSIONS: Findings support the concept of psychosocial resources as important enabling factors in remission from alcohol dependence without formal help. Implications for brief interventions are discussed.

Adolescent↗
PubMed2001

[Tobacco smoking attributable mortality in Germany].

OBJECTIVE: The goal of the study is the estimation of mortality rates attributable to tobacco smoking (TAM) for the Federal States of Germany. METHODS: The 0.5% representative sample of the German population with data about tobacco smoking (microcensus 1995) as well as the data about causes of death according to ICD from the Federal Office of Statistics are used. On these grounds the mortality as well as the smoking prevalence and, on the basis of data of the U. S. Department of Health and Human Services, the mortality risks for smokers in comparison to never-smokers are estimated. RESULTS: Tobacco-smoking attributable mortality rates vary in females from 5.6% to 13.2% in the Federal States, in males from 24.3% to 29.2% (age: 35 years or older). Women in the City States show the highest TAM rates. The TAM rate for Germany (females and males taken together) is 17.0% of the total mortality at an age of 35 years and above. CONCLUSION: The data reveal for Germany that tobacco smoking is the most preventable health risk.

Adult↗
PubMed2001

The association between degree of nicotine dependence and other health behaviours. Findings from a German general population study.

BACKGROUND: To investigate the association between degree of nicotine dependence and unhealthy nutrition, lack of physical activity, and hazardous alcohol drinking. METHODS: Data with respect to cigarette and alcohol consumption, nutrition, and physical activity was collected in a representative general population sample (N = 4.075). RESULTS: Smokers with high compared to moderate and low degrees of nicotine dependence consume unhealthy foods more frequently, report less physical activity and more hazardous alcohol drinking. CONCLUSION: From a public health point of view, special secondary preventive interventions for smokers with high nicotine dependence and additional unhealthy behaviours are necessary.

Adolescent↗
PubMed2000

[Lifetime prevalence of mental disorders in general adult population. Results of TACOS study].

The present paper reports lifetime prevalence rates of mental disorders in the 18- to 64-year-old general population of a northern German region. A representative random sample from registration office files of 4,075 individuals was examined in personal interviews using the fully standardized and computerised "Munich Composite International Diagnostic Interview" (M-CIDI). The response rate was 70.2%. Individuals were classified according to the DSM-IV. Substance use disorders were most frequent with 25.8% followed by anxiety (15.1%), somatoform (12.9%), affective (12.3%), and eating disorders (0.7%). Disorders other than substance use were more frequent in women and less frequent in men. A trend toward less psychiatric morbidity exists in individuals with higher educational level, higher income, and those who are married or reside in rural communities. Of all individuals affected by mental disorders, 42% fulfilled the criteria for at least one additional disorder. The results are discussed against the background of selected previous studies.

Adult↗
PubMed2000

Prevalence of alcohol consumption, abuse and dependence in a country with high per capita consumption: findings from the German TACOS study. Transitions in Alcohol Consumption and Smoking.

BACKGROUND: The aim of the Transitions in Alcohol Consumption and Smoking (TACOS) project is to investigate substance use and use disorders in the adult general population in a region of the under-researched north of Germany, focussing on smoking and alcohol consumption. In this study, the design and quality assurance provisions of the baseline cross-section of the longitudinal project are described. Prevalence rates of alcohol use disorders, consumption pattern, and the nature of their association are also analysed with regard to preventive strategies. METHOD: A random sample of 4075 participants, aged 18 to 64 and drawn from residents registration office files, was interviewed with a DSM-IV adapted version of WHO CIDI. Fieldwork resulted in a response rate of 70.2% and an unbiased database with regard to demographic characteristics. RESULTS: Low lifetime prevalence of alcohol use disorders (4.5% abuse, 3.8% dependence) and hazardous consumption (13.2% lifetime; 6.0% 12-month) was found compared to southern regions of Germany and US American data. In contrast, we found a comparatively high percentage of moderate alcohol uses. Male subjects are more affected by lifetime alcohol use disorders (abuse OR 8.3, 95% CI 5.3-13.2; dependence OR 4.3, 95% CI 2.8-6.4). The association between alcohol use disorders and alcohol consumption pattern revealed a weaker relation for alcohol abuse compared to dependence. CONCLUSION: National and regional drinking habits and norms have to be considered as a significant source of variance, supporting the need for European epidemiological research on substance use in addition to US American activities, and emphasising the advantages of community-based preventive measures. An evaluation of public recommendations for safe limits of alcohol consumption and prevention targets referring to average consumption is indicated. There is also a need for a clear distinction between alcohol abuse and dependence.

Adult↗
PubMed2000

Prevalence, quality of life and psychosocial function in obsessive-compulsive disorder and subclinical obsessive-compulsive disorder in northern Germany.

BACKGROUND: Despite the worldwide relevance of obsessive-compulsive disorder (OCD) there are considerable differences in prevalence rates and gender ratios between the studies and a substantial lack of prevalence data on subclinical OCD. Moreover, data on quality of life and on psychosocial function of subjects with OCD and subclinical OCD in the general population are missing to date. METHODS: German versions of the DSM-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 4075 persons aged 18-64 years living in a northern German region. Specific DSM-IV based criteria for subclinical OCD were used. RESULTS: The life-time prevalence rates for OCD and subclinical OCD were 0.5% and 2%, respectively. Twelve month prevalence rates were 0.39% and 1.6%, respectively. The gender female:male ratio was 5.7 in OCD and 1.2 in subclinical OCD. In various measures of psychosocial function and quality of life, OCD and subclinical OCD were significantly impaired. However, subclinical OCD subjects did not visit mental health professionals more often than controls. CONCLUSION: Due to different epidemiological characteristics subclinical OCD might represent a syndrome distinct from OCD which is also associated with significant impairments in personal and interpersonal functions and in quality of life.

Adolescent↗
PubMed2000

Studies on natural recovery from alcohol dependence: sample selection bias by media solicitation?

AIMS: To assess the selection bias of recruiting participants in studies on natural recovery from alcohol dependence through media solicitation. DESIGN: Two samples with different recruitment strategies are compared. SETTING: Media solicitation and general population. PARTICIPANTS: Sample 1 consists of 176 alcohol-dependent individuals remitted without formal help and recruited through media solicitation, sample 2 consists of 32 natural remitters derived from a representative general population study with a sample size of 4075 respondents and a response rate of 70.2%. MEASUREMENTS: Several triggering mechanisms and maintenance factors of remission were assessed in a personal interview using standardized questionnaires. FINDINGS: Results of logistic regression analyses show that media-solicited subjects were more often abstinent in the last 12 months, were more severely dependent, were less satisfied with eight life domains prior to remission and showed higher scores in a coping behaviour measure. Besides these major differences from the multivariate analysis, media subjects revealed more health problems prior to remission, experienced more social pressure to change drinking behaviour, and showed differences in reasons for not seeking help. CONCLUSIONS: Media solicitation leads to a sample selection bias in research on natural recovery from alcohol dependence. When measures to foster self-change are derived from such studies, findings from representative samples have to be considered.

Female↗
PubMed2000

[Methods for quality assurance of medical examination in epidemiological field studies: the "Study of Health in Pomerania" (SHIP)].

The aims of the population-based, cross-sectional survey "Study of Health in Pomerania" (SHIP) are to describe prevalences and distributions of a broad range of diseases, as well as environmental and behavioural risk factors in the region of Pomerania (North-eastern Germany). The examinations are performed in two study units by different physicians, technicians and interviewers and laboratory analyses in two separate laboratories. In addition, the study will take at least 3 years and approximately 7000 persons will be examined. Because of the design of the study a special concept of quality assurance is indispensable. In the present paper methods are presented for quality assurance and control in anthropometry, ECG, echocardiography, abdominal sonography, carotid ultrasound, sonography of the thyroid gland, blood pressure measurements as well as clinical laboratory analyses. The technical control protocols, the training programmes of the observers and methods to establish observer and method variabilities are presented by means of typical examples. The logistic, personal and technical measures for quality assurance and control require appropriate attention. The methods and procedures presented here are expected to provide an effective instrument to continually monitor the quality of medical examinations in the SHIP study.

Adult↗
PubMed2000

[Health behavior of smokers--results of the TACOS (Transitions in Alcohol Consumption and Smoking) Study].

The German TACOS Project (Transitions in Alcohol Consumption and Smoking) provided an opportunity to examine the patterns of health behaviours (nutrition, physical activity, alcohol consumption) of current smokers, ex-smokers and non-smokers with special regard to different degrees of severity of nicotine dependence. Data were collected in the adult general population of Lübeck and 46 surrounding communities, resulting in a representative sample of 4075 individuals. In this sample, 37.3% were current smokers, 22.5% were ex-smokers, 25.0% of smokers were severely nicotine-dependent. As in other empirical investigations, current smokers had an unhealthy lifestyle in general. Smokers compared to ex-smokers and non-smokers consumed unhealthy foods more frequently, reported less physical activity and were more likely to consume hazardous levels of alcohol. Special attention was paid to comparing different degrees of severity of nicotine dependence. A high degree of nicotine dependence was associated with poor health behaviours. Data show that smoking, unhealthy nutrition, lack of physical activity, and hazardous levels of alcohol consumption occur in combination and that unhealthy behaviour patterns vary according to the severity of nicotine dependence. The presence of multiple unhealthy behaviours requires special secondary preventive interventions for smokers. The association of these combined health hazards must be controlled in determining the independent health risk due to one of these factors.

Adolescent↗
PubMed2000

Gender differences in natural recovery from alcohol dependence.

OBJECTIVE: Data from epidemiological research reveal that most alcohol dependent individuals recover without professional treatment. Little is known, however, about individuals remitting from alcohol dependence without formal help, and almost no data are available with respect to gender differences in natural recovery. METHOD: Women (n = 38) and men (n = 106) who remitted from alcohol dependence according to DSM-IV without utilization of formal help (treatment or self-help groups) are compared. A standardized interview assessed reasons for not seeking help, and triggering mechanisms and maintenance factors of remission. RESULTS: Compared with male subjects, female subjects, prior to remission, experienced lower extents of social pressure to change drinking behavior, drove less often under the influence of alcohol, revealed less satisfaction with different life domains and reported a higher impact of health problems on the remission process. Female subjects also informed fewer individuals about their former drinking problems. CONCLUSIONS: Female and male natural remitters differ in factors that trigger the process as well as the maintenance of natural remission.

Adult↗
PubMed2000

Maintenance factors of recovery from alcohol dependence in treated and untreated individuals.

BACKGROUND: Research on natural recovery from alcohol dependence has focused mainly on triggering mechanisms of the remission process. Only a few studies have considered maintenance factors of natural recovery. METHODS: In the present study, 93 natural remitters and 42 self-help group participants were compared. Both groups remitted from alcohol dependence according to DSM-IV criteria. Several alcohol-related variables and maintenance factors of the remission process were assessed in a personal interview by using standardized questionnaires. RESULTS: Logistic regression analysis that focused on maintenance factors showed that, independent from direct self-help group context, self-help group attendees informed more individuals about their former alcohol problems and sought social support more often as a coping strategy to deal with craving. No further group differences could be identified. CONCLUSIONS: Self-help group participants revealed a higher social engagement to maintain their recovery. Besides this major difference, data support the assumption that more commonalities than differences exist within successful recoveries from alcohol dependence, independent of help-seeking status.

Adaptation, Psychological↗
PubMed2000

A simulation approach to study planning for large-scale epidemiological surveys.

In study planning for large-scale epidemiological studies with multi-type examinations, important resource questions have to be answered, e.g. study horizons, personnel and other resources and cost estimates are needed. A simulation approach for scheduling that uses relevant parameters to simulate examination times gives simulation distributions that can be utilised to answer planning questions.

Adult↗
PubMed1999

Contrast-enhanced sonography of vesicoureterorenal reflux in children: preliminary results.

OBJECTIVE: The aim of our study was to evaluate contrast-enhanced sonography as an alternative to radiographic voiding cystourethrography in the detection of vesicoureteral reflux. SUBJECTS AND METHODS: A total of 46 children, ranging in age from 3 weeks to 14 years (median: 4 years, 6 months) with 92 ureterorenal units were investigated for reflux using radiographic voiding cystourethrography and contrast-enhanced sonography in one session. After sonography of the urinary tract, the bladder was filled with saline solution via a catheter. Later, a contrast-enhancing agent was instilled and sonography was repeated. Documentation was done using S-VHS video and a laser camera. Reflux was diagnosed when microbubbles were observed in the ureter or in the renal pelvis. In addition, conventional voiding cystourethrography was performed. Patients without micturition during either sonography or radiographic examination were excluded (eight ureterorenal units). RESULTS: The findings obtained by contrast-enhanced sonography and voiding cystourethrography were concordant in 78 ureterorenal units (92.9%). No reflux was detected in 67 units (79.8%) by either method. With voiding cystourethrography as the standard of reference, the sensitivity of contrast-enhanced sonography was 91.7%; the specificity, 93.1%; and the accuracy, 92.9%. The positive predictive value was 68.8%, and the negative predictive value was 98.5%. CONCLUSION: Contrast-enhanced sonography is highly sensitive for the detection of vesicoureteral reflux. Therefore, it may reduce the number of radiographic investigations.

Child, Preschool↗
PubMed1998

[Length of stay of patients with alcohol abuse or alcohol dependence in internal medicine and surgery].

To determine the length of stay (LOS) of alcoholic and non-alcoholic patients, all consecutive admissions to medical and surgical departments of a general hospital in Lübeck, Germany, were registered over a period of six months. The study sample comprised 625 medical and 661 surgical patients aged 18 to 64 years, 42% female. Alcohol abuse and dependence were detected using an expert interview (Schedules for Clinical Assessment in Neuropsychiatry, SCAN). The median LOS of patients with alcohol abuse or dependence was equal to that of the other patients (Z = 9 days). Differences occurred in the surgical clinic where alcohol abusers as well as alcohol dependent patients stayed longer than the others. There was significant trend in the medical clinic towards longer LOS for alcohol abusers and shorter LOS for alcohol dependent patients compared to the other medical patients respectively. Patients suffering from infections, tumors or gastrointestinal diseases had significantly increased LOS if having an alcohol problem. In conclusion, there is no general elongation of LOS in alcoholic patients. Differences occur if single departments or somatic or psychiatric subgroups of patients are regarded. However, high concentrations of alcohol-related diseases in these settings stress the importance of preventative measures.

Adolescent↗