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  • 1
    ISSN: 1432-0428
    Keywords: Keywords Epidemiology, geographical variation, incidence, increase, modelling, prediction, trend, Type I diabetes.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aims/hypothesis. Several reports on the incidence of Type I (insulin-dependent) diabetes mellitus have suggested that the incidence is increasing. The aim of this study was to find out whether the incidence is increasing globally or restricted to a selected populations only and to estimate the magnitude of the change in incidence.¶Methods. During 1960 to 1996 37 studies in 27 countries were carried out. To fulfil the inclusion criteria the study periods ranged from 8–32 years. The temporal trend was fitted by linear regression, with the logarithm of the age-standardized incidence as the dependent variable and the calendar year as the independent variable. Then, the regression coefficient ( × 100 %) is approximately the average relative increase in incidence per year (as percentage).¶Results. Results from the pooled data from all 37 populations showed that the overall increase in incidence was 3.0 % per year (95 % CI 2.6; 3.3, p = 0.0001). The statistically significant increase was found in 24 of 37 populations including all high incidence ( 〉 14.6 per 100 000 a year) populations. The relative increase was, however, steeper in the populations with a lower incidence. The correlation between logarithm of the incidence and the increase in incidence was r = –0.56, p = 0.0004.¶Conclusion/interpretation. The incidence of Type I diabetes is increasing worldwide both in low and high incidence populations. By the year 2010 the incidence will be 50 per 100 000 a year in Finland and also in many other populations it will exceed 30 per 100 000 a year. [Diabetologia (1999) 42: 1395–1403]
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  • 2
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; elderly ; mortality ; cardiovascular disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We studied the association of glucose intolerance with total and cause-specific mortality during a 5-year follow-up of 637 elderly Finnish men aged 65 to 84 years. Total mortality was 276 per 1000 for men aged 65 to 74 years and 537 per 1000 for men aged 75 to 84 years. Five-year total mortality adjusted for age was 364 per 1000 in diabetic men, 234 per 1000 in men with impaired glucose tolerance and 209 per 1000 in men with normal glucose tolerance. The relative risk of death among diabetic men was 2.10 (95% confidence interval 1.26 to 3.49) and among men with impaired glucose tolerance 1.17 (95% confidence interval 0.71 to 1.94) times higher compared with men with normal glucose tolerance. Cardiovascular disease was the most common cause of death in every glucose tolerance group. The multivariate adjusted relative risk of cardiovascular death was increased (1.55) in diabetic patients, albeit non-significantly (95% confidence interval 0.84 to 2.85). Diabetes resulted in an increased risk of cardiovascular mortality among men aged 65–74 years but not among the 75–84-year-old men. Relative risk of death from non-cardiovascular causes was slightly increased among diabetic subjects. In conclusion, diabetes mellitus is a significant determinant of mortality among elderly Finnish men.
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  • 3
    ISSN: 1432-0428
    Keywords: Keywords Diabetes ; Type I (insulin-dependent) diabetes mellitus ; incidence ; Finland.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aims/hypothesis. In Finland, the incidence of Type I (insulin-dependent) diabetes mellitus in children aged 14 years or under is the highest in the world and the trend in incidence has been increasing. Our aim was to determine the most recent trends in incidence and the age distribution at diagnosis of Type I diabetes. Methods. Data on the incidence of Type I diabetes in Finland nationwide were obtained from two sources: for the period 1965 to 1986 from the Central Drug Registry of the Social Insurance Institution and for the period 1987 to1996 from the prospective childhood Type I diabetes registry. The annual incidence was calculated per 100 000 people. The increase and the trend in incidence were estimated by fitting the linear regression model with the annual incidence data. Results. During 1987 to 1993 the incidence of Type I diabetes seemed to be rather stable at 36 per 100 000 per year. The incidence has continued to increase thereafter and reached 45 per 100 000 per year in 1996. The analysis of the long-term trend in incidence between 1965 and 1996 showed an absolute incidence increase of 0.67 per year on average being 3.4 % compared with the incidence in 1965. The increase from 1987 to 1996 was highest in very young children 1–4 years old at diagnosis. Conclusion/interpretation. The high incidence of Type I diabetes in Finnish children has thus far not levelled off but is increasing further. If the trend continues, the predicted incidence in Finland will be approximately 50 per 100 000 per year in the year 2010. [Diabetologia (1999) 42: 655–660]
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  • 4
    ISSN: 1432-0428
    Keywords: Type 1 (insulin-dependent) diabetes mellitus ; epidemiology ; incidence ; geographical distribution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Nearly 70 registries from more than 40 countries have collected and published incidence data of childhood Type 1 (insulin-dependent) diabetes mellitus up to the end of the 1980s. The majority of incidence data comes from regions of high incidence i. e. from Europe and North American. All these published data facilitate the descriptive comparison of incidence and variation of the occurrence of Type 1 diabetes roughly throughout the northern hemisphere. The aim of this paper is to review and compare the most recent epidemiology data on the incidence of Type 1 diabetes among children under the age of 15 years. A clear difference in incidence appeared between northern and southern hemisphere with no countries below the equator having an incidence greater than 15.0 per 100,000. In contrast above the equator the disease is common. Between continents the variation in incidence showed that the lowest incidences were found in Asia, followed by Oceania (Australia and New Zealand), South and North America, and the highest rates were in Europe. The incidence varied from 0.6 per 100,000 in Korea and Mexico to 35.3 per 100,000 in Finland showing prominent worldwide variation in incidence of Type 1 diabetes. The largest intracontinental variation in incidence appeared in Europe, varying from the highest in Finland to the lowest (4.6 per 100,000)_in northern Greece. The highest incidence in the world was in northern Europe, but within the continent scale there were some striking exceptions from the overall level of incidence. In Iceland, the northern-most island nation in Europe, the incidence is only one-half of that in Norway and Sweden and one-third of that in Finland. In contrast, in Sardinia in southern Europe the Type 1 diabetes incidence is virtually the same as in Finland, three times higher than overall incidence in Europe. Large variation was also seen in small “pockets” of countries, particularly in the Baltic sea region. The worldwide variation in incidence reflects the distribution of ethnic populations and demonstrates the importance of the differential genetic susceptibility between populations.
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  • 5
    ISSN: 1432-0428
    Keywords: Keywords Insulin-dependent diabetes mellitus ; incidence ; secular trends.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We present secular trends of childhood onset insulin-dependent diabetes mellitus (IDDM) in Finland, Estonia, Latvia and Lithuania during the period of 1983–1992. Incidence data were obtained from the national IDDM registries. The average age-standardized incidence per 100 000/year was 35.0 in Finland, followed by 10.2 in Estonia, 7.1 in Lithuania and 6.5 in Latvia. A male excess in incidence was recorded in Finland (1.15) and Latvia (1.01). In all countries, the highest age-specific risk of IDDM was observed in the 11–13 year age range. The large difference in incidence between Finland and other Baltic countries was seen even in 1–2-year-old children. During the 10-year study period overall changes in incidence of IDDM were relatively small in these four countries. The incidence increased in Finland and Lithuania on average by 1 % and 1.4 % per year, respectively. A statistically significant increase was recorded only in 0–4 year old children in Finland, at 5.6 % per year. In Estonia, an 8.3 % increase in this age group, however, was not statistically significant. The different trends in the age-group specific incidence rates were confirmed in Finland. In conclusion, from 1983 to 1992 the incidence of childhood onset IDDM was increasing in Finland and Lithuania, while in Latvia and Estonia it was stable. There are still great differences in IDDM incidence between the countries around the Baltic Sea. [Diabetologia (1997) 40: 187–192]
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  • 6
    Electronic Resource
    Electronic Resource
    [s.l.] : Nature Publishing Group
    Nature 170 (1952), S. 331-331 
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] After a fasting period of about 18 hr., in the course of which Water was given ad lib., 30 c.c. of tap water per kgm. of body Weight was introduced into the stomach of a dog. A similar dose of Water was given 1 1/2 hr. later. Urine flowing through the inserted catheter was collected in graduated ...
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  • 7
    ISSN: 1573-7284
    Keywords: Coronary heart disease ; Risk factors ; Population comparison
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sixteen cohorts of men aged 40–59 years at entry were examined with the measurement of some risk factors and then followed-up for mortality and causes of death for 25 years. These cohorts were located in the USA (1 cohort), Finland (2), the Netherlands (1), Italy (3), the former Yugoslavia (5), Greece (2), and Japan (2), and included a total of 12,763 subjects. Large differences in age-adjusted coronary heart disease (CHD) death rates were found, with extremes of 45 per 1000 in 25 years in Tanushimaru, Japan, to 288 per 1000 in 25 years in East Finland. In general, higher rates were found in the US and Northern European cohorts as compared to the Southern European and Japanese cohorts. However, during the last 10 years of follow-up large increases of CHD death rates were found in some Yugoslavian areas. Out of 5 measured entry characteristics treated as age-adjusted levels (serum cholesterol, systolic blood pressure, cigarette smoking, body mass index and physical activity at work), only serum cholesterol was significant in explaining cohort differences in CHD death rates. Over 50% of the variance in CHD death rates in 25 years was accounted for by the difference in mean serum cholesterol. This association tended to decline with increasing length of follow-up, but this was due to the great changes in mean serum cholesterol in the two Jugoslavian cohorts of Velika Krsna and Zrenjanin. When these two cohorts were excluded the association increased with time. Changes in mean serum cholesterol between year 0 and 10 helped in explaining differences in CHD death rates from year 10 onward. It can be concluded that this study suggests that mean serum cholesterol is the major risk factor in explaining cross-cultural differences in CHD.
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    International archives of occupational and environmental health 45 (1980), S. 15-33 
    ISSN: 1432-1246
    Keywords: Daily physical activity ; Heavy physical work ; Sport activity ; Risk factors ; Coronary heart disease ; Tägliche körperliche Aktivität ; berufliche Schwerarbeit ; sportliche Aktivität ; Risikofaktoren ; Koronarerkrankungen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusamenfassung An 120 Männern im Alter von 23–60 Jahren aus verschiedenen Beruwfsgruppen mit unterschiedlich schwerer körperlicher Arbeit wurde das Ausmaß der habituelen täglichen körperlichen Aktivät untersucht und zu Risikoindikatoren für Koronarerkrankungen im Beziehung gesetzt. Die tägliche körperliche Aktivität wurde in ihrem beruflichen Teil über ganzschichte arbeitsphysiologische Studien mit Herzfrequenzmessungen mit Hilfe von Cardiocordern und Positionsstudien im Anlehnung an Edholm durchgefürht und, falls nörtig, mit O2-Verbrauchmessungen erfaßt. Die Art der täglichen beruflichen Belastung und Beanspruchung wurde mit einer standardisierten Beobachtungsmethode zur Tätigleitsanalyse (AET) erfaßt. Für den Freizeitbereich wurden die langdauernden Trainingsgewohnheiten retrospektiv über standardisierte Interviewktechniken erhoben. Die wichtigsten Risikofaktoren wurden entsprechend den Vorschalägen der WHO ermittelt. Die Ergebnisse zeigen, daß in ihrer Freizert sportlich inaktive Schwerrauchen, Adipositas und Angina pectoris gegenüber Schwerarbeitern mit hoher sportlicher Aktivität sowie Arbeitern mit leichter körpelicher Aktovität im Beruf, aber großer sportlicher Aktivität in der Freizeit aufweisen. Aufgrund der Untersuchung schmint die Gruppe der Schwerarbeiter ohne ausgleichende körperliche Aktivität in der Freizeit die gleichzeitig eine großen Zigarettenkonsum aufweist, besonders gefährdet zu sein.
    Notes: Summary One hundred twenty men, aged 23–60 years and having various professions participated in studies on relationships between daily physical activity and risk factors for coronary heart disease (CHD). The daily physical activity at work was determined by means of heart rate recordings with an ambulatory monitoring system and of activity recordings according to Edholm over the whole shift. Where necessary, oxygen consumption was also measured. The type of load and strain at work was assessed with a standardised German version of the “Position Analysis Questionnaire” (AET). The habitual leisure time training behaviour was determined retrospectively by standardised interview technique. The risk factors were determined in accordance to WHO recommendations. Workers with high physical load on the job but with low energy expenditure during leisure time had a higher prevalence of the risk factors blood pressure, cigarette smoking, adiposity, and chest pain than workers with similar or lighter jobs but with physically active leisure habits. The intensely smoking workers with physically heavy work and inactive leisure seem to carry the highest risk.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    International archives of occupational and environmental health 50 (1982), S. 59-75 
    ISSN: 1432-1246
    Keywords: Tranport worker ; Orthopedic disorders ; Epidemiology ; Screening methods ; Ladearbeiter ; Orthopädische Beschwerden ; Epidemiologie ; Screening-Methoden
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 366 Ladearbeiter eines deutschen Großflughafens (19 his 61 Jahre), die schwere körperliche Arbeit in zum Teil ungünstigen Körperhaltungen in den beengten Frachträumen von Flugzeugen ausüben, wurden in einer epidemiologischen Querschnittstudie mittels eines standardisierten Anamnesebogens in Form eines Interviews zu subjektiven Beschwerden des Bewegungsapparates befragt; bei 104 dieser Ladearbeiter wurde zusätzlich ein klinisch-orthopädischer Untersuchungsstatus erhoben. Rückenbeschwerden wurden am häufigsten genannt: 66% der befragten Ladearbeiter klagten über gegenwärtige Beschwerden, 57% uber frühere Beschwerden. Mit zunehmendem Alter und zunehmender Körpergröße nahm die Prävalenz dieser Beschwerden zu. Mit der Dauer der Ladetätigkeit beim Flughafen nahm auch die Prävalenz der aktuellen Rückenbeschwerden zu. Neben den Rückenbeschwer-den klagten 41 % der befragten Ladearbeiter über Kniebeschwerden. Steigendes Lebensalter und erhöhtes Körpergewicht bewirkten eine signifikante Zunahme dieser Beschwerden. Nackenbeschwerden wurden in 33% und Armbeschwerden in 41% angegeben; auch hier bestanden signifikante Abhängigkeiten der Prävalenzen dieser Beschwerden vom Alter. Im klinisch-orthopädischen Status lagen die Prävalenzen der Funktionseinschränkungen für die verschiedenen orthopädischen Bereiche zum Teil noch höher als im Interview. Allerdings spielten hier individuelle Faktoren (Alter, Körpergröße, Gewicht und Dauer der Ladetätigkeitserfahrung) nur eine geringe Rolle. Die vorgestellten klinisch-epidemiologischen Screening-Methoden haben sich bei der Erfassung arbeitsmedizinisch relevanter orthopädischer Beschwer den an einem arbeitenden Bevölkerungskollektiv bewährt. Für die hier untersuchten Ladearbeiter haben these Untersuchungen gezeigt, daß unter den gegenwärtigen Arbeitsbedingungen keine Personen beschäftigt werden sollten, deren Körperlänge in zu großer Diskrepanz zu den derzeitigen Frachtraum-dimensionen stehen, welche ein deutliches Übergewicht aufweisen oder anamnestische Rückenbeschwerden angeben. Gleichzeitig sollten aber Maßnahmen für die Änderung der Frachtraumhöhen, für den verstärkten Einsatz von Ladehilfen sowie für die Ausbildung des Personals im richtigen Heben und Tragen von Lasten ergriffen werden.
    Notes: Summary In an epidemiologic cross-sectional study, 366 transport workers (age-range: 19–61 years) of a big German airport who are engaged in physical heavy work in unfavorable body positions in narrow freight spaces of airplanes, were investigated with regard to their subjective musculoskeletal complaints through a standardized anamnesis in an interview questionnaire. An additional clinical orthopedic examination was performed in 104 of the transport workers. Back pains were the most frequently reported complaints: at the time of examination 66% of the transport workers reported present back complaints. 57% had experienced previous back syndroms. Increasing age and stature were associated with a higher prevalence of these complaints. Years of exposure to transport work correlated positively with the prevalence of back complaints. After back complaints, knee complaints followed in the prevalence of locomotor complaints (41% of the interviewed workers). The prevalence increased with age and body weight significantly. Neck complaints were reported by 33% of the workers, arm complaints by 41%; again, age increased the prevalence of these complaints significantly. In the standardized clinical orthopedic examination, the prevalence of the functional findings were sometimes higher than in the interview. In contrast to the subjective complaints at the interview, individual factors (age, stature, weight, and work experience in the present occupation) had very little influence on the prevalence of objective findings. The clinical, epidemiologic screening methods employed have proved efficacious in detecting orthopedic disorders in an occupational collective. This study has shown that transport workers with wide discrepancies between body length and the space available in airplane cargo bellies, considerable overweight, or a history of former back syndromes should not be employed. Means to alter cargo belly dimensions in airplanes as well as the increased use of mechanical loading aids and additional training of the workers in proper lifting and carrying of cargo should be taken in to consideration.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    International archives of occupational and environmental health 45 (1980), S. 127-140 
    ISSN: 1432-1246
    Keywords: Retrospective cohort study ; Epidemiology of shiftwork ; Gastrointestinal diseases ; Cardiovascular diseases ; Skeletal diseases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A retrospective cohort study was carried out in a firm in the chemical industry. The sick records of 370 shift workers in a 12-h shift rota and of 270 day workers with comparable work were analyzed from 1966 to 1977. The incidence of sickness in general did not differ between permanent shift workers and day workers, but was highest in shift workers who transferred later to day work mostly for medical reasons. Furthermore, on the average, shift workers were sick for longer periods than day workers. Significantly more shift workers than day workers consulted the occupational health services about gastrointestinal complaints than day workers. Shift workers had more frequent gastrointestinal diseases than day workers and more severe ones such as peptic ulcers. Gastrointestinal diseases were more frequent in the following groups of the shift workers: Young (21 to 25 years) and unmarried subjects, heavy smokers and subjects with a past history of gastrointestinal diseases. No differences between shift workers and day workers could be detected concerning cardiovascular diseases including myocardial infarction. Psychosomatic disorders were seldom diagnosed and did not differ between shift and day workers. Surprisingly, skeletal diseases including the sequelae of accidents and injuries occurred more often in the shift workers' cohort; the possible cause of this was a higher incidence of moonlightning in shift workers or other activities beside work. The need for prospective follow-up studies is emphasized.
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