Between 1888 and 1892, Mikulicz as well as Fuchs observed each a case of oculo-salivary glandular syndrome. Ten years later, Heerfordt described uveitis complicated by swelling of the lacrimal and salivary glands. Within 100 years, the interpretation of this disease changed repeatedly and considerably: infection of particularly exposed organs--non-avirulent tuberculosis--salivotropic virus--Boeck's disease--allergic-hyperergic reaction--diencephalic and nervous dystrophy with segmental projection--(auto)immune disease--oculo-salivary complex including Sjøgren's syndrome--all these were discussed as possible aetiologies. Short biographies of Johannes von Mikulicz-Radecki, surgeon at Austrian and Prussian universities; Ernst Fuchs, ophthalmologist of Vienna; Christian Frederik Heerfordt, a Danish ophthalmologist particularly fond of publicity.
137Cs activities were measured in a variety of epigeic and epiphytic lichens in Austria before and after contamination by the Chernobyl fallout. For comparison, the activity of the naturally occurring 40K was also determined in each lichen sample. The high 137Cs activities found after Chernobyl suggest that lichens are suitable and inexpensive biological detectors of the fallout pattern.
The phenomenon of patient homicides committed by health service employees has, in the previous years, repeatedly aroused much attention. The cases made known in Germany, the USA, Holland, Norway, and Austria appear to provide evidence to the effect that we are not only dealing with unique incidents. The scientific investigation of this especially sensitive taboo-topic is, to date, missing. The judicial trials carried out emphatically indicate that culprit motives, colleague behavior, but also to a large extent decisions made by superiors remain unclear. It remains controversial, what effect working conditions, strain of employees, their level of education and personal viewpoints over such criminal acts they possess. Finally, the long latency period between the first internal suspicions and the responsible parties' appropriate reactions requires duplicatable explanation. The following paper presents a German single-case study of patient homicide by a female nurse. The focus on causality rests on the presentation of developments up to the point where the long-fermenting suspicion could no longer be dismissed, and appropriate consequences took place. The account largely avoids the "definite" findings required during the judicial process. It concerns rather above all an open, uncertain, and possibly without external influence course of development which in stages each colleague in the health professions can trace, to the point where the uncertain and horrifying suspicion became a certainty. With this single-case study in hand it is made understandable in which ways personal circumstances and professional conditions at the worksituation can intertwine in such a way that the original motivation to help turns into its abysmal opposite. It is the author's intention to make preventive learning possible through this single case study. Every employee in the health professions should proceed on the assumption that such occurrences could also in his own field of work come to pass. In this respect, it is of considerable importance to differentiate between hasty and untenable incriminations and original increasing early-warning signs.
Carl Peter Thunberg, a Swedish medical doctor and botanist who visited Japan in 1775 as a medical doctor attached to the Dutch Trade House in Dejima, Nagasaki, taught the treatment of syphilis using mercury water to Japanese doctors and interpreters. This therapy is based on the oral administration of a 0.014% solution of mercuric chloride and was published in 1754 by Gerard van Swieten in Vienna, who questioned the utility of the conventional salivation therapy. The dose was set taking safety into account. Kogyu Yoshio, a Japanese-Dutch interpreter, had already read about it in a book written by J. J. Plenck, when he was taught about the therapy by Thunberg. He recorded Thunberg's teachings in his book "Komohijiki", presenting details of various formulations, including a high-dose formulation. The mercury therapy was subsequently spread across the country by medical doctors who learned Western medicine through the Dutch. In the 1820's, Genshin Udagawa, who read a number of Western medical books, published books on Western drugs. In these books, G. Udagawa included precise information on "Swieten Yakushu-hu (medicated alcohol)", including information on the dosage, formulation, mode of usage, and precautions for use. The maximum dose of mercuric chloride established chloride established by van Swieten was included in the Japanese Pharmacopoeia up to its 5th edition.
BACKGROUND: According to the WHO, insufficient attention is devoted to the problem of accident while more than one half of the death in children of 1 to 14 years of age in industrialized countries are caused by accidents. METHODS AND RESULTS: Nationwide statistical data from the Czech Republic have been evaluated and compared with those of selected European countries and the USA. In the years 1991-1993 average of 151 children died in the Czech Republic in the age group of 5- to 9-year olds. In 68 of them the cause of death was an injury that in almost half of the cases was due to a traffic accident. The trend in the mortality of children of the same age was assessed comparing the averages for 1950-1952 and 1991-1993. The overall mortality decreased by 68% while the greatest decline was in non-accident causes (75%). Mortality due to accidents decreased by 55% and that caused by motor vehicles by only 19%. The lowest mortality due to accidents was found in Sweden. CONCLUSIONS: The results show that mortality due to accidents and poisonings in younger school children in the Czech Republic is higher than, e.g. in Austria and Sweden. In order to be able to elaborate a draft of appropriate and effective preventive measures, it is necessary to obtain further information on accidents and poisonings in children that have not ended fatally.
The word deals with the results obtained in the study of the reactogenicity and immunological activity of concentrated and inactivated tissue-culture tick-borne encephalitis vaccine, manufactured by the Chumakov Institute of Poliomyelitis and Viral Encephalitides, in the immunization of children and adolescents. The vaccine proved to be moderately reactogenic and exhibited pronounced immunological activity. In 91.5% of the immunized children the fourfold increase of the antibody level was observed. On the basis of the data obtained in this study the tick-borne encephalitis vaccine was recommended for use in medical practice for the prophylaxis of tick-borne encephalitis among children and adolescents.
Adjuvant endocrine therapy compromises bone health in patients with breast cancer, causing osteopenia, osteoporosis, and fractures. Antiresorptive treatments such as bisphosphonates prevent and counteract these side-effects. In this trial, we aimed to investigate the effects of the anti-RANK ligand antibody denosumab in postmenopausal, aromatase inhibitor-treated patients with early-stage hormone receptor-positive breast cancer.
In this prospective, double-blind, placebo-controlled, phase 3 trial, postmenopausal patients with early hormone receptor-positive breast cancer receiving treatment with aromatase inhibitors were randomly assigned in a 1:1 ratio to receive either denosumab 60 mg or placebo administered subcutaneously every 6 months in 58 trial centres in Austria and Sweden. Patients were assigned by an interactive voice response system. The randomisation schedule used a randomly permuted block design with block sizes 2 and 4, stratified by type of hospital regarding Hologic device for DXA scans, previous aromatase inhibitor use, and baseline bone mineral density. Patients, treating physicians, investigators, data managers, and all study personnel were masked to treatment allocation. The primary endpoint was time from randomisation to first clinical fracture, analysed by intention to treat. As an additional sensitivity analysis, we also analysed the primary endpoint on the per-protocol population. Patients were treated until the prespecified number of 247 first clinical fractures was reached. This trial is ongoing (patients are in follow-up) and is registered with the European Clinical Trials Database, number 2005-005275-15, and with ClinicalTrials.gov, number NCT00556374.
Between Dec 18, 2006, and July 22, 2013, 3425 eligible patients were enrolled into the trial, of whom 3420 were randomly assigned to receive denosumab 60 mg (n=1711) or placebo (n=1709) subcutaneously every 6 months. Compared with the placebo group, patients in the denosumab group had a significantly delayed time to first clinical fracture (hazard ratio [HR] 0·50 [95% CI 0·39-0·65], p
Comment In: Lancet. 2015 Aug 1;386(9992):409-1026040500
Child and Adolescent Health Research Unit (CAHRU), Department of PE, Sport and Leisure Studies, University of Edinburgh, St. Leonard's Land, Holyrood Road, EH8 8AQ, Edinburgh, UK. firstname.lastname@example.org
This paper examines the relationship between family structure and smoking among 15-year-old adolescents in seven European countries. It also investigates the association between family structure and a number of known smoking risk factors including family socio-economic status, the adolescent's disposable income, parental smoking and the presence of other smokers in the adolescent's home. Findings are based on 1998 survey data from a cross-national study of health behaviours among children and adolescents. Family structure was found to be significantly associated with smoking among 15-year-olds in all countries, with smoking prevalence lowest among adolescents in intact families and highest among adolescents in stepfamilies. Multivariate analysis showed that several risk factors were associated with higher smoking prevalences in all countries, but that even after these other factors were taken into account, there was an increased likelihood of smoking among adolescents in stepfamilies. Further research is needed to determine the possible reasons for this association.
Data from 12 different European countries show a rapid increase in HIV antibody positivity among drug users or a high degree of contamination already reached wherever studies have been made. Until 31 December 1986, 698 (18%) of AIDS cases were among drug users, of which 600 (15%) of AIDS cases were solely drug users, and 98 (3%) were in addition homosexual or bisexual. A further increase is expected. Because of the epidemiological importance for transmission to the heterosexual population, this problem has become a focus of attention. Drug abusing prostitutes constitute a major source of infection for the heterosexual population and newborns. The increase in the number of AIDS cases in 1986 among male drug abusers was 98 - that is up 61% compared to previous years; among women, the increase was 56%. The 3 main approaches to solution of this problem, i.e. interdiction of the drug trade, availability of sterile needles, and an education program have not proven as successful as anticipated. Relevant indications of the progress of infection in society can only be obtained by systematic observation of conversion rates in differential subgroups, i.e. drug abusers, newly incarcerated drug abusers, male and female prostitutes who use drugs, and individuals newly reporting for treatment. Separation of HIV antibody positives and negatives in therapeutic communities which are not drug free is recommended for epidemiological purposes in view of the developments to date. Nor should forced segregation of the infected from noninfected be dismissed out of hand.