Germany
Germany, West
Germany, East
Berlin
Europe
National Socialism
Austria
Disease Outbreaks
Prevalence
World War II
Health status of Persian Gulf War veterans: self-reported symptoms, environmental exposures and the effect of stress. (1/5356)
BACKGROUND: Most US troops returned home from the Persian Gulf War (PGW) by Spring 1991 and many began reporting increased health symptoms and medical problems soon after. This investigation examines the relationships between several Gulf-service environmental exposures and health symptom reporting, and the role of traumatic psychological stress on the exposure-health symptom relationships. METHODS: Stratified, random samples of two cohorts of PGW veterans, from the New England area (n = 220) and from the New Orleans area (n = 71), were selected from larger cohorts being followed longitudinally since arrival home from the Gulf. A group of PGW-era veterans deployed to Germany (n = 50) served as a comparison group. The study protocol included questionnaires, a neuropsychological test battery, an environmental interview, and psychological diagnostic interviews. This report focuses on self-reported health symptoms and exposures of participants who completed a 52-item health symptom checklist and a checklist of environmental exposures. RESULTS: The prevalence of reported symptoms was greater in both Persian Gulf-deployed cohorts compared to the Germany cohort. Analyses of the body-system symptom scores (BSS), weighted to account for sampling design, and adjusted by age, sex, and education, indicated that Persian Gulf-deployed veterans were more likely to report neurological, pulmonary, gastrointestinal, cardiac, dermatological, musculoskeletal, psychological and neuropsychological system symptoms than Germany veterans. Using a priori hypotheses about the toxicant effects of exposure to specific toxicants, the relationships between self-reported exposures and body-system symptom groupings were examined through multiple regression analyses, controlling for war-zone exposure and post-traumatic stress disorder (PTSD). Self-reported exposures to pesticides, debris from Scuds, chemical and biological warfare (CBW) agents, and smoke from tent heaters each were significantly related to increased reporting of specific predicted BSS groupings. CONCLUSIONS: Veterans deployed to the Persian Gulf have higher self-reported prevalence of health symptoms compared to PGW veterans who were deployed only as far as Germany. Several Gulf-service environmental exposures are associated with increased health symptom reporting involving predicted body-systems, after adjusting for war-zone stressor exposures and PTSD. (+info)Quality circles in ambulatory care: state of development and future perspective in Germany. (2/5356)
OBJECTIVE: To survey the quantitative development of quality circles (peer review groups; QC) and their moderators in ambulatory care in Germany, to describe approaches to documentation and evaluation, to establish what types of facilities and support is available and to assess opinions on the future importance of QC. DESIGN: Cross-sectional survey using a standardized questionnaire and supplementary telephone interviews. SETTING: All 23 German regional Associations of Statutory Health Insurance Physicians (ASHIP) were surveyed. RESULTS: The total number of QC in ambulatory care in Germany increased rapidly from 16 in 1993 to 1633 in June 1996, with about 17% (range 1.0-52.1%) of all practicing physicians (112 158) currently involved. Throughout Germany, 2403 moderators were trained in 168 training courses by the qualifying date. Follow-up meetings were held or being planned in 20 ASHIP, with approximately 39% (23-95%) of the moderators participating. Systematic documentation of QC work was undertaken or planned in all 23 ASHIIP, and 10 ASHIP carried out comparative evaluation, with at least five others planning to start it. The ASHIP promoted the work of QC by providing organizational (22) or financial (20) support, materials (20) or mediation of resource persons (16). Eleven ASHIP received grants from drug companies. ASHIP rated the future importance of QC as increasing (18) or stable (four), but in no case as decreasing. CONCLUSIONS AND RECOMMENDATIONS: The quantitative growth of QC in Germany is encouraging, but the extent of support and evaluation appears insufficient. Increased methodological support and facilitation, follow-up meetings on a more regular basis, improved documentation and evaluation of individual QC, and problem oriented evaluation of their impact on health care are essential for further successful development. Principles, problems and solutions discussed may be relevant for similar QI activities in other countries. (+info)Erich Muhe and the rejection of laparoscopic cholecystectomy (1985): a surgeon ahead of his time. (3/5356)
During the early 1980s, news of Semm's laparoscopic appendectomy was rippling through German medical circles. Erich Muhe, fascinated by Semm's technique and spurred by successes of the Erlangen endoscopists, came up with the idea of laparoscopic removal of gallstones. In 1984, Muhe had already worked out the details of an operative laparoscope, the "Galloscope," and on September 12, 1985, he carried out the first laparoscopic cholecystectomy. Later, he modified his technique and operated through a trocar sleeve. Finally, he designed an "open laparoscope" with a circular light. By March 1987, Muhe had conducted 97 endoscopic gallbladder removals. He published information about his technique at the Congress of the German Surgical Society (April 1986) and at other surgical meetings in Germany. His concept, however, was ignored. In the middle of the 1980s, the surgical community was still not prepared for the era of "minimally invasive therapy." Erich Muhe was a surgeon ahead of his time. (+info)Moxifloxacin: a comparison with other antimicrobial agents of in-vitro activity against Streptococcus pneumoniae. (4/5356)
Two hundred representative isolates, including 26 strains of Streptococcus pneumoniae with intermediate resistance to penicillin, were selected from a collection obtained from blood cultures of patients with bacteraemic pneumococcal pneumonia. The MICs of moxifloxacin (BAY 12-8039), grepafloxacin, sparfloxacin, levofloxacin, ofloxacin, ciprofloxacin, erythromycin, tetracycline and penicillin G were determined by a standard agar dilution technique. Moxifloxacin had the highest in-vitro activity against S. pneumoniae (MIC90 = 0.25 mg/L; MIC range 0.06-0.25 mg/L). The MIC90 values were one dilution lower than those obtained with sparfloxacin and grepafloxacin, three dilutions lower than those obtained with levofloxacin, and four dilutions lower than those of ofloxacin and ciprofloxacin. (+info)Linkage disequilibrium and haplotype analysis in German Friedreich ataxia families. (5/5356)
The main mutation causing Friedreich ataxia (FRDA) is the expansion of a GAA repeat localized within the intron between exon 1 and exon 2 of the gene X25. This expansion has been observed in 98% of FRDA chromosomes. To analyze frequencies of markers tightly linked to the Friedreich ataxia gene and to investigate wheter a limited number of ancestral chromosomes are shared by German FRDA families, a detailed analysis employing nine polymorphic markers was performed. We found strong linkage disequilibria and association of FRDA expansions with a few haplotypes. FRDA haplotypes differ significantly from control haplotypes. Our results confirm that GAA repeat expansions in intron 1 of the frataxin gene are limited to a few chromosomes and indicate an obvious founder effect in German patients. Based on these analyses, we estimate a minimum age of the mutation of 107 generations. (+info)Autoantibody appearance and risk for development of childhood diabetes in offspring of parents with type 1 diabetes: the 2-year analysis of the German BABYDIAB Study. (6/5356)
The temporal development of autoantibodies was studied in 1,353 offspring of parents with type 1 diabetes. Islet cell antibodies (ICAs) and autoantibodies to insulin (IAAs), glutamic acid decarboxylase, and IA-2 were measured at birth, 9 months, 2 years, and 5 years of age. At birth, no offspring had islet autoimmunity other than maternally acquired antibodies, which were shown to influence antibody prevalence up to age 6 months. Antibodies detected thereafter were likely to represent a true de novo production, since prevalences were the same for offspring from mothers and fathers with diabetes, antibodies detected at 9 months were almost always confirmed in the 2-year sample and were associated with an increased likelihood of having or developing other antibodies. By 2 years of age, autoantibodies appeared in 11% of offspring, 3.5% having more than one autoantibody. IAAs were detected most frequently, and few had autoantibodies in the absence of IAAs. In 23 offspring with multiple islet autoantibodies, IAAs preceded other antibodies in 10 cases and were first detected concurrently with other antibodies in 12 and after detection of other antibodies in 1. Development of additional antibodies and changes in levels, including decline of IAAs at older age, was frequent. Nine children, all with IAAs and ICAs, developed diabetes. Overall cumulative risk for disease by 5 years of age was 1.8% (95% CI 0.2-3.4) and was 50% (95% CI 19-81) for offspring with more than one autoantibody in their 2-year sample. Autoimmunity associated with childhood diabetes is an early event and a dynamic process. Presence of IAAs is a consistent feature of this autoimmunity, and IAA detection can identify children at risk. (+info)Inverse graded relation between alcohol consumption and active infection with Helicobacter pylori. (7/5356)
Alcoholic beverages are known to have strong antibacterial activity. It is unclear, however, to what degree their consumption affects colonization of the human stomach with the bacterium Helicobacter pylori, a risk factor of various chronic diseases. The authors assessed the relation between alcohol consumption and active infection with H. pylori in a cross-sectional study among employees of a health insurance company and their household members (n = 425) in southern Germany. Quantitative information on alcohol consumption by beverage type and other factors that were known or suspected to be related to infection status was collected by a standardized questionnaire, and active infection was measured by the 13C-urea breath test. After control for confounding factors, there was a monotonic inverse graded relation between alcohol consumption and H. pylori infection (p for trend = 0.017). The odds ratio of infection among subjects who consumed more than 75 g of alcohol per week compared with subjects who did not drink alcohol was 0.31 (95 percent confidence interval 0.12-0.81). The inverse relation with H. pylori infection was stronger for alcohol consumed in the form of wine than for alcohol from beer. Notwithstanding its cross-sectional design, this study seems to support the hypothesis that alcohol consumption, particularly wine consumption, may reduce the odds of active infection with H. pylori. (+info)A large outbreak of hemolytic uremic syndrome caused by an unusual sorbitol-fermenting strain of Escherichia coli O157:H-. (8/5356)
Escherichia coli O157:H7 does not ferment sorbitol, a factor used to differentiate it from other E. coli. From December 1995 to March 1996, 28 children with hemolytic uremic syndrome in Bavaria, Germany, were identified; many had a sorbitol-fermenting (sf) E. coli O157:H- cultured. A case-control study showed a dose-response relationship between sausage consumption and illness. A second case-control study showed a relationship between mortadella and teewurst consumption and illness, particularly during December (mortadella odds ratio [OR], 10.5, P=.004; teewurst OR, 6.2, P=.02). Twelve sf O157:H- were characterized to determine clonality and virulence traits. The strains possessed the Stx2, eae, and EHEC-hlyA genes but were nonhemolytic on blood agar plates. The O157:H- isolates belonged to phage type 88 and had identical pulsed-field gel electrophoresis patterns. This outbreak was caused by sf E. coli O157:H-, which is not detectable by culture on sorbitol MacConkey's agar. Consumption of two sausages, including a raw beef-containing sausage, was statistically related to illness. (+info)I'm sorry for any confusion, but "Germany" is not a medical term or concept. It is the name of a country in central Europe. If you have any questions related to medical topics, I would be happy to try and help answer those for you!
"West Germany" is not a medical term. It is a geopolitical term that refers to the Federal Republic of Germany (FRG) which existed from 1949 to 1990. The FRG was established in the western part of defeated Nazi Germany and was supported by the Western Allies (the United States, the United Kingdom, and France) after World War II.
In medical contexts, references to "West Germany" might appear in older studies or publications that compare health outcomes, disease prevalence, or healthcare systems between different regions or countries, including East and West Germany before reunification in 1990. However, it is essential to understand that such distinctions are historical and do not have current medical relevance.
I'm sorry for any confusion, but "Germany, East" is not a medical term or concept. It refers to a historical and geographical region that was known as the German Democratic Republic (GDR), existing from 1949 to 1990. If you have any questions related to medical terminology or health sciences, I'd be happy to help with those!
The German Democratic Republic, colloquially known as East Germany, was a socialist state established in the Soviet occupation zone of Germany after World War II. It existed from 1949 to 1990, when it was dissolved and merged with the Federal Republic of Germany (West Germany) following the Peaceful Revolution. The term "East Germany" is often used to refer to this region during that time period in historical or geographical contexts, but it does not have any relevance to medical definitions or healthcare.
I apologize, but "Berlin" is not a medical term or condition. Berlin is the capital and largest city of Germany, known for its rich history, culture, and scientific contributions. It does not have a specific medical definition. If you have any questions related to medical conditions or terminology, I would be happy to try to help answer those for you.
I'm sorry for any confusion, but the term "Europe" is a geographical and political designation, rather than a medical one. It refers to the continent located entirely in the Northern Hemisphere and mostly in the Eastern Hemisphere. It is bordered by the Arctic Ocean to the north, the Atlantic Ocean to the west, and the Mediterranean Sea to the south. Europe is made up of approximately 50 countries, depending on how one defines a "country."
If you have any questions related to medical terminology or health-related topics, I'd be happy to help answer them!
National Socialism, also known as Nazism, is not a medical term. It is a political ideology that originated in Germany in the early 20th century and was associated with the Nazi Party and its leader, Adolf Hitler. The ideology was characterized by extreme nationalism, racism, anti-Semitism, and totalitarianism.
While National Socialism is not a medical term, it has had significant impacts on the history of medicine, particularly during World War II when the Nazi regime implemented policies that led to the systematic persecution and murder of millions of people, including six million Jews in the Holocaust. The Nazi regime also conducted unethical medical experiments on prisoners in concentration camps, which have been widely condemned.
Therefore, while National Socialism is not a medical term, it is important for medical professionals to be aware of its historical context and the ways in which political ideologies can impact medical ethics and practice.
I'm sorry for any confusion, but "Austria" is not a medical term or concept. It is a country located in central Europe, known officially as the Republic of Austria. It is not a medical condition, treatment, or related term. If you have any questions about a medical issue, I would be happy to try to help answer those for you!
A disease outbreak is defined as the occurrence of cases of a disease in excess of what would normally be expected in a given time and place. It may affect a small and localized group or a large number of people spread over a wide area, even internationally. An outbreak may be caused by a new agent, a change in the agent's virulence or host susceptibility, or an increase in the size or density of the host population.
Outbreaks can have significant public health and economic impacts, and require prompt investigation and control measures to prevent further spread of the disease. The investigation typically involves identifying the source of the outbreak, determining the mode of transmission, and implementing measures to interrupt the chain of infection. This may include vaccination, isolation or quarantine, and education of the public about the risks and prevention strategies.
Examples of disease outbreaks include foodborne illnesses linked to contaminated food or water, respiratory infections spread through coughing and sneezing, and mosquito-borne diseases such as Zika virus and West Nile virus. Outbreaks can also occur in healthcare settings, such as hospitals and nursing homes, where vulnerable populations may be at increased risk of infection.
Prevalence, in medical terms, refers to the total number of people in a given population who have a particular disease or condition at a specific point in time, or over a specified period. It is typically expressed as a percentage or a ratio of the number of cases to the size of the population. Prevalence differs from incidence, which measures the number of new cases that develop during a certain period.
I must clarify that there is no medical definition for "World War II." World War II (1939-1945) was a major global conflict involving many of the world's nations, including all of the great powers, organized into two opposing military alliances: the Allies and the Axis. It was marked by significant events, such as the Holocaust, and had profound social, economic, and political consequences. The medical field did play a crucial role during this time, with advancements in battlefield medicine, military medicine, and the treatment of injuries and diseases on a large scale. However, there is no specific medical definition or concept associated with World War II itself.
A questionnaire in the medical context is a standardized, systematic, and structured tool used to gather information from individuals regarding their symptoms, medical history, lifestyle, or other health-related factors. It typically consists of a series of written questions that can be either self-administered or administered by an interviewer. Questionnaires are widely used in various areas of healthcare, including clinical research, epidemiological studies, patient care, and health services evaluation to collect data that can inform diagnosis, treatment planning, and population health management. They provide a consistent and organized method for obtaining information from large groups or individual patients, helping to ensure accurate and comprehensive data collection while minimizing bias and variability in the information gathered.