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Klee L, Fabrice A, Eisenburger N, Feddern S, Gabriel C, Kossow A, Niessen J, Schmidt N, Wiesmüller GA, Grüne B, Joisten C. Corrigendum to "Coping strategies during legally enforced quarantine and their association to psychological distress level: a cross-sectional study" [Public Health 209 (2022) 52-60]. Public Health 2024; 226:273. [PMID: 38071185 PMCID: PMC10834371 DOI: 10.1016/j.puhe.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Affiliation(s)
- L Klee
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany; Institute for Occupational Medicine and Social Medicine, University Hospital, Medical Faculty, RWTH Aachen University, Aachen, Germany.
| | - A Fabrice
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany; Institute for Occupational Medicine and Social Medicine, University Hospital, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - N Eisenburger
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - S Feddern
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany
| | - C Gabriel
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany
| | - A Kossow
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany; Institute of Hygiene, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - J Niessen
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany
| | - N Schmidt
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - G A Wiesmüller
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany; Institute for Occupational Medicine and Social Medicine, University Hospital, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - B Grüne
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany
| | - C Joisten
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany; Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
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Klee L, Fabrice A, Eisenburger N, Feddern S, Gabriel C, Kossow A, Niessen J, Schmidt N, Wiesmüller GA, Grüne B, Joisten C. Coping strategies during legally enforced quarantine and their association to psychological distress level: a cross-sectional study. Public Health 2022; 209:52-60. [PMID: 35809351 PMCID: PMC9197782 DOI: 10.1016/j.puhe.2022.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 05/03/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The non-pharmacological measures to contain the COVID-19 pandemic may lead to considerable psychological distress. The aim of the CoCo-Fakt study was to investigate possible coping strategies and their effects on psychological distress during legally enforced quarantine of infected persons (IPs) and their close contacts (CPs). STUDY DESIGN This was a cross-sectional cohort study. METHODS From 12 December 2020 to 6 January 2021, all IPs and their CPs (n = 8232) registered by the public health department (Cologne, Germany) were surveyed online. Psychosocial distress and coping were measured using sum scores; free-text answers related to specific strategies were subsequently categorised. RESULTS Psychosocial distress was higher in IPs than in CPs (P < .001). Although the mean coping score did not differ between both groups, it was influenced by the reason for quarantine (IP vs CP) besides gender, age, socio-economic status, living situation, psychological distress, resilience, physical activity and eating behaviour. This final regression model explained 25.9% of the variance. Most participants used active coping strategies, such as contact with the social environment, a positive attitude and hobbies. CONCLUSIONS Although psychological distress was higher in IPs than in CPs during the quarantine period, the mean coping score did not differ. The strategies most frequently used by IPs and CPs were activating social networks, a healthy lifestyle and professional support systems, such as the health department helpline. Appropriate advice should be implemented to prevent long-term psychological consequences when supporting affected people.
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Affiliation(s)
- L Klee
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany; Institute for Occupational Medicine and Social Medicine, University Hospital, Medical Faculty, RWTH Aachen University, Aachen, Germany.
| | - A Fabrice
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany; Institute for Occupational Medicine and Social Medicine, University Hospital, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - N Eisenburger
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - S Feddern
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany
| | - C Gabriel
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany
| | - A Kossow
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany; Institute of Hygiene, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - J Niessen
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany
| | - N Schmidt
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - G A Wiesmüller
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany; Institute for Occupational Medicine and Social Medicine, University Hospital, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - B Grüne
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany
| | - C Joisten
- Cologne Health Department, Infektions- und Umwelthygiene, Neumarkt 15-21, 50667, Köln, Germany; Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
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Paul G, Meißner A, Neuneier J, Neuschmelting V, Grau S, Yagdiran A, Scheyerer MJ, Malin JJ, Suárez I, Lehmann C, Exner M, Wiesmüller GA, Higgins PG, Seifert H, Fätkenheuer G, Zweigner J, Jung N. Outbreak of Pseudomonas aeruginosa infections after CT-guided spinal injections. J Hosp Infect 2021; 116:1-9. [PMID: 34298033 DOI: 10.1016/j.jhin.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Meningitis and spinal infections with Gram-negative bacteria after local injections for treatment of chronic back pain are rare. This study investigated an outbreak of Pseudomonas aeruginosa infections following computed tomography (CT)-guided spinal injections (SI). METHODS A case was defined as a spinal infection or meningitis with P. aeruginosa after SI between 10th January and 1st March 2019 in the same outpatient clinic. Patients without microbiological evidence of P. aeruginosa but with a favourable response to antimicrobial therapy active against P. aeruginosa were defined as probable cases. FINDINGS Twenty-eight of 297 patients receiving CT-guided SI during the study period developed meningitis or spinal infections. Medical records were available for 19 patients. In 15 patients, there was microbiological evidence of P. aeruginosa, and four patients were defined as probable cases. Two of 19 patients developed meningitis, while the remaining 17 patients developed spinal infections. The median time from SI to hospital admission was 8 days (interquartile range 2-23 days). Patients mainly presented with back pain (N=18; 95%), and rarely developed fever (N=3; 16%). Most patients required surgery (N=16; 84%). Seven patients (37%) relapsed and one patient died. Although the source of infection was not identified microbiologically, documented failures in asepsis when performing SI probably contributed to these infections. CONCLUSIONS SI is generally considered safe, but non-adherence to asepsis can lead to deleterious effects. Spinal infections caused by P. aeruginosa are difficult to treat and have a high relapse rate.
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Affiliation(s)
- G Paul
- Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Department of Gastroenterology, Hepatology, Pneumology and Infectious Diseases, Katharinenhospital, Klinikum Stuttgart, Stuttgart, Germany.
| | - A Meißner
- Department of Hospital Hygiene and Infection Control, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - J Neuneier
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - V Neuschmelting
- Centre for Neurosurgery, Department of General Neurosurgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - S Grau
- Centre for Neurosurgery, Department of General Neurosurgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - A Yagdiran
- Department of Orthopaedics and Trauma Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - M J Scheyerer
- Department of Orthopaedics and Trauma Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - J J Malin
- Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany
| | - I Suárez
- Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany
| | - C Lehmann
- Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany
| | - M Exner
- Institute of Hygiene and Public Health, Bonn University, Bonn, Germany
| | - G A Wiesmüller
- Abteilung Infektions- and Umwelthygiene, Gesundheitsamt der Stadt Köln, Germany
| | - P G Higgins
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany
| | - H Seifert
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany
| | - G Fätkenheuer
- Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Cologne-Bonn, Cologne, Germany
| | - J Zweigner
- Department of Hospital Hygiene and Infection Control, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - N Jung
- Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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Dwenger LV, Funke N, Stephany P, Suarez I, Wiesmüller GA, Neuhann F. [Frequency Distribution and Risk Factors for Latent Tuberculosis in Contact Persons: Cologne 2012-2016]. Pneumologie 2021; 75:567-576. [PMID: 33971674 DOI: 10.1055/a-1479-0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND As part of tuberculosis control and the WHO end-TB strategy, contact persons of tuberculosis patients in Germany are examined for a possible infection with latent tuberculosis (LTBI). Activation of LTBI contributes a considerable proportion of newly reported tuberculosis cases in low-incidence countries such as Germany. Therefore, the aim is to detect cases of LTBI and, through chemopreventive treatment of these cases, prevent future, post-primary, active tuberculosis.In Germany, the rate of LTBI among contact persons of people diagnosed with active tuberculosis is not systematically recorded. The aim of the present work was to close this data gap for Cologne, a major city in Germany with a TB incidence of around 9/100,000 in the past years. The study further aimed to describe risk factors for LTBI and to reevaluate the standard inclusion criteria for contact investigation for tuberculosis under routine conditions in Germany. MATERIAL AND METHODS For the period 07/2012 to 12/2016, the retrospective cohort study examined the rate of LTBI diagnoses among contact persons of those with pulmonary tuberculosis notified at the Cologne public health department, as well as factors that increase the LTBI infection risk of contact persons. The diagnosis of latent tuberculosis was made when the interferon-gamma release assay (IGRA) was positive and there were no signs of active tuberculosis. The study included contact persons who cumulatively had a previously defined minimum total contact time with a tuberculosis patient, who were at least 5 years old at the time of the study and who were registered in Cologne. Statistical evaluation was carried out descriptively as absolute and relative frequency with a significance level of p ≤ 0.05. The analytical evaluation was carried out with univariate and multivariate logistic regression. RESULTS Of a total of 3862 IGRA examinations among contact persons, 2834 cases met the inclusion criteria. A median of seven contact persons per index patient was reported. 12.5 % of the study group tested positive for LTBI. In contact persons of microscopically open index patients, the positivity rate was 11.4 %, in culturally open but microscopically negative index patients, it was 14.3 %. Factors associated with a higher risk of LTBI included male sex (OR = 1.95), age ≥ 50 years (OR = 1.8) and household exposure (OR = 2.37). CONCLUSION Using the German standard criteria, the positivity rate of IGRA testing and the diagnosis of LTBI among contacts in the present study was 12.5 %, which is lower than in other similar studies. Factors identified in the cohort for an increased risk of LTBI confirm known constellations. The significantly higher positivity rate among contact persons of microscopically negative but culturally positive index patients (p = 0.033) underscores the need to conduct a detailed contact examination of individuals of this group as well.
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Affiliation(s)
- L V Dwenger
- Gesundheitsamt der Stadt Köln, Abteilung Infektions- und Umwelthygiene, Tuberkulose-Beratungsstelle.,Institut für Arbeits-, Sozial- und Umweltmedizin, Universitätsklinik, RWTH Aachen
| | - N Funke
- Gesundheitsamt der Stadt Köln, Abteilung Infektions- und Umwelthygiene, Tuberkulose-Beratungsstelle
| | - P Stephany
- Gesundheitsamt der Stadt Köln, Abteilung Infektions- und Umwelthygiene, Tuberkulose-Beratungsstelle
| | - I Suarez
- Medizinische Klinik 1, Infektionsambulanz, Universitätsklinikum Köln
| | - G A Wiesmüller
- Gesundheitsamt der Stadt Köln, Abteilung Infektions- und Umwelthygiene, Tuberkulose-Beratungsstelle.,Institut für Arbeits-, Sozial- und Umweltmedizin, Universitätsklinik, RWTH Aachen
| | - F Neuhann
- Gesundheitsamt der Stadt Köln, Abteilung Infektions- und Umwelthygiene, Tuberkulose-Beratungsstelle.,Heidelberger Institut für Global Health, Universitätsklinikum Heidelberg.,School of Medicine and Clinical Sciences, Levy Mwanawasa Medical University, Lusaka, Zambia
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Fehr R, Hornberg C, Bunte A, Baumgart S, Claßen T, Wiesmüller GA, Trojan A, Köckler H, Rüdiger A, Mekel O. StadtGesundheit/Urban Health. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1639236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- R Fehr
- Universität Bielefeld, Hamburg, Germany
| | | | - A Bunte
- Universität Bielefeld, Bielefeld, Germany
| | | | - T Claßen
- TU Dortmund, Fakultät Raumplanung, Dortmund, Germany
| | - GA Wiesmüller
- Landeszentrum Gesundheit Nordrhein-Westfalen, Bochum, Germany
| | - A Trojan
- Gesundheitsamt der Stadt Köln, Köln, Germany
| | - H Köckler
- Universität Hamburg, Hamburg, Germany
| | - A Rüdiger
- Hochschule für Gesundheit, Bochum, Germany
| | - O Mekel
- Landeszentrum Gesundheit Nordrhein-Westfalen, Bielefeld, Germany
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Wiesmüller GA, Schoenemann B, Bunte A. Lassa-Fall 2016 aus Sicht des ÖGD. Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1602065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - A Bunte
- Gesundheitsamt Stadt Köln, Köln
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Borgschulte HS, Bunte A, Neuhann F, Weber LT, Wiesmüller GA. [Health care of refugees in 2015 - Evaluation of an ambulance for refugees in a Cologne emergency accommodation (Cologne Model)]. Gesundheitswesen 2016; 78:808-813. [PMID: 28008581 DOI: 10.1055/s-0042-121251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Access to medical care is a core element in the care of refugees and asylum seekers, and should therefore be guaranteed in a barrier-free way. In practice, there are usually numerous access barriers and the first contact with the German Health Care System takes place in form of a statutory examination to exclude infectious diseases. In addition to the introduction of health insurance cards for refugees, an offer of medical consultation for several hours a week in the municipal emergency accommodations provides an opportunity for low threshold access to primary care and a bridging function to the integration into the regular health care system. This offer is independent of the obligatory initial examination according to § 62 Asylum Law (AsylG) 1. The evaluation of the first year of such a health care center is presented.
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Affiliation(s)
| | - A Bunte
- Gesundheitsamt der Stadt Köln
| | | | - L T Weber
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Uniklinik Köln
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Wiesmüller GA, Heinzow B, Aurbach U, Bergmann KC, Bufe A, Buzina W, Cornely OA, Engelhart S, Fischer G, Gabrio T, Heinz W, Herr CEW, Kleine-Tebbe J, Klimek L, Köberle M, Lichtnecker H, Lob-Corzilius T, Merget R, Mülleneisen N, Nowak D, Rabe U, Raulf M, Seidl HP, Steiß JO, Szewszyk R, Thomas P, Valtanen K, Hurraß J. [Medical Diagnostics for Mold Exposure Indoors]. Pneumologie 2016; 70:699-741. [PMID: 27829254 DOI: 10.1055/s-0042-116251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- G A Wiesmüller
- Institut für Hygiene und Umweltmedizin, Uniklinik RWTH Aachen
| | - B Heinzow
- ehemals: Landesamt für soziale Dienste (LAsD) Schleswig-Holstein, Kiel
| | - U Aurbach
- Abteilung Mikrobiologie und Mykologie, Labor Dr. Wisplinghoff, Köln
| | - K-C Bergmann
- Allergie-Centrum-Charité, Charité Universitätsmedizin Berlin
| | - A Bufe
- Experimentelle Pneumologie, Ruhr-Universität Bochum
| | - W Buzina
- Institut für Hygiene, Mikrobiologie und Umweltmedizin, Medizinische Universität Graz
| | - O A Cornely
- Klinik I für Innere Medizin und Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Universität zu Köln
| | - S Engelhart
- Institut für Hygiene und Öffentliche Gesundheit, Universitätsklinikum Bonn
| | - G Fischer
- Landesgesundheitsamt Baden-Württemberg im Regierungspräsidium Stuttgart
| | - T Gabrio
- ehemals: Landesgesundheitsamt Baden-Württemberg im Regierungspräsidium Stuttgart
| | - W Heinz
- Medizinische Klinik und Poliklinik II, Schwerpunkt Infektiologie, Universitätsklinikum Würzburg
| | - C E W Herr
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit München
| | | | - L Klimek
- Zentrum für Rhinologie und Allergologie, Wiesbaden
| | - M Köberle
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München
| | - H Lichtnecker
- Institut für Umwelt- und Arbeitsmedizin MIU GmbH Erkrath
| | | | - R Merget
- Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Institut der Ruhr-Universität Bochum (IPA)
| | | | - D Nowak
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Mitglied Deutsches Zentrum für Lungenforschung, Klinikum der Universität München
| | - U Rabe
- Zentrum für Allergologie und Asthma, Johanniter-Krankenhaus im Fläming Treuenbrietzen GmbH, Treuenbrietzen
| | - M Raulf
- Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Institut der Ruhr-Universität Bochum (IPA)
| | - H P Seidl
- ehemals: Lehrstuhl für Mikrobiologie sowie Dermatologische Klinik der Technischen Universität München
| | - J-O Steiß
- Zentrum für Kinderheilkunde und Jugendmedizin, Universitätsklinikum Gießen und Marburg GmbH, Gießen
| | - R Szewszyk
- Umweltbundesamt, FG II 1.4 Mikrobiologische Risiken Berlin
| | - P Thomas
- Klinik und Poliklinik für Dermatologie und Allergologie der Ludwig-Maximilians-Universität München
| | - K Valtanen
- Umweltbundesamt, FG II 1.4 Mikrobiologische Risiken Berlin
| | - J Hurraß
- Abteilung Infektions- und Umwelthygiene, Gesundheitsamt der Stadt Köln
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Borgschulte HS, Wiesmüller GA, Neuhann F. Gesundheitliche Versorgung von Flüchtlingen in 2015 – Evaluation einer Ambulanz für Flüchtlinge in einer Kölner Notunterkunft. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1586511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
The Cologne statement resulted from both regional and nationwide controversial discussions about meaning and purpose of an initial examination for infectious diseases of refugees with respect to limited time, personnel and financial resources. Refugees per se are no increased infection risk factors for the general population as well as aiders, when the aiders comply with general hygiene rules and are vaccinated according to the recommendations of the German Standing Committee on Vaccination (STIKO). This is supported by our own data. Based on individual medical history, refugees need medical care, which is offered purposeful, economic, humanitarian and ethical. In addition to medical confidentiality, the reporting obligation according § 34 Infection Protection Act (IPA) and the examination concerning infectious pulmonary tuberculosis according to § 36 (4) IPA must be considered.
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Affiliation(s)
| | - J Dötsch
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Köln
| | - M Weiß
- Klinik für Kinder- und Jugendmedizin, Kinderkrankenhaus Amsterdamer Straße, Köln
| | - A Wiater
- Kinderklinik, Krankenhaus Porz am Rhein Köln
| | - G Fätkenheuer
- Klinische Infektiologie, Klinik I für Innere Medizin, Universitätsklinikum Köln
| | | | - A Bunte
- Gesundheitsamt der Stadt Köln
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Wiesmüller GA, Szewzyk R, Baschien C, Gabrio T, Fischer G, Cornely OA, Engelhart S, Grün L, Heinz WJ, Heinzow B, Hummel T, Hurraß J, Lichtnecker H, Merget R, Nowak D, Ochmann U, Panašková J, Raulf-Heimsoth M, Schultze-Werninghaus G, Seidl HP, Steiß JO, Herr CEW. Häufige Fragestellungen zu gesundheitlichen Risiken von Schimmelpilzexpositionen – Antworten von Expertengruppen im Rahmen von vier Workshops der Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin (GHUP). Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1371629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Weiß O, Bunte A, Wiesmüller GA. Human-Biomonitoring aufgrund erhöhter PFC-Belastungen im Kölner Grundwasser. Gesundheitswesen 2012. [DOI: 10.1055/s-0032-1307325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hornberg C, Malsch AKF, Weissbach W, Wiesmüller GA. [Environment-related health disorders. Experience and perspectives in the care of patients with environment-related health disorders]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2004; 47:780-94. [PMID: 15340722 DOI: 10.1007/s00103-004-0875-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Environmental medicine outpatient clinics, counseling centers, and practicing physicians have observed environment-related health disorders in patient groups of mixed age as well as for groups consisting only of adults or children. Practicing physicians suspected correlations between environmental factors and health disorders in 36-45% of cases, environmental medicine outpatient clinics and counseling centers in 4-34% for mixed-age groups, 0-24% for adults, and 9-13% for children. A comparison of these data is difficult due to differences in data acquisition, evaluation methods, and descriptive statistics used. Furthermore, data on children are insufficient. Patient-oriented environmental medicine faces a number of problems regarding determination of exposure, effects, and susceptibility, including a lack of scientifically verified cause-and-effect models as well as incorrect diagnoses, attributions, and conclusions. In view of the scope and intensity of environment-related health disorders, the topic cannot be ignored. A functioning program of environmental medicine counseling and patient care is needed for practicing physicians, universities and/or the public sector to deliver effective primary medical care in this field. As always, the building blocks of environ-mental medicine counseling are medical history, physical examination, differential diagnosis, human biomonitoring, and on-site inspection with environmental monitoring while also taking gender differences into account. Uniform basic documentation procedures and health science analyses will help to optimize patient care in environ-mental medicine. The value of a diagnostic algorithm in the care of patients with environment-related health disorders is beyond dispute. Last but not least, quality assurance and control are a sine qua non of patient-oriented environmental medicine.
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Abstract
To date, relatively little is known about the etiology, pathophysiology, diagnosis, therapy, prevention and prognosis of environment-related syndromes like multiple chemical sensitivity (MCS), idiopathic environmental intolerance (IEI), sick building syndrome (SBS), chronic fatigue syndrome (CFS), candida syndrome (CS) and burnout syndrome (BS). Part of the reason is that these syndromes have not been clearly defined and classified in scientific categories distinct from each other, and that they show clinical similarities to classified somatoform disorders. Furthermore, there are at least three possible explanations for the existence of these syndromes: (1) The syndromes may result from the interaction of environmental factors, individual susceptibility and psychological factors (i.e., how they are perceived and seen by the patient); (2) they may reflect socially and culturally accepted methods of expressing distress; and/or (3) they may be iatrogenic. Despite all the uncertainties in evaluation of environmental syndromes, physicians have the duty to take the affected person's problems seriously. A comprehensive systematic classification which better accounts for these complex clinical manifestations is long overdue. Until these syndromes are well defined, the terms used for them should definitely not be applied to connote a specific disease process.
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Affiliation(s)
- G A Wiesmüller
- Institute of Hygiene and Environmental Medicine, University Hospital Aachen, Aachen, Germany
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15
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van Thriel C, Seeber A, Kiesswetter E, Blaszkewicz M, Golka K, Wiesmüller GA. Physiological and psychological approaches to chemosensory effects of solvents. Toxicol Lett 2003; 140-141:261-71. [PMID: 12676473 DOI: 10.1016/s0378-4274(03)00022-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Workplace related standard settings for solvents are based in a remarkable extent on information about sensory irritations. However, data from controlled human exposure studies are seldom available. Therefore, the aim of this study was to present the association of self-reported symptoms and physiological processes leading to sensory irritations. Three series of laboratory experiments each with 24 young male subjects were performed. Ethyl benzene (EB), 2-butanone (methyl ethyl ketone or MEK), isopropyl alcohol (IPA), 1-octanol (OCT), and 2-ethylhexanol (EHEX) were investigated in low and high concentrations. Ratings for sensory irritations (eyes and nose), olfactory symptoms, and annoyance were assessed repeatedly before, during and after the 4-h-exposures. The anterior active rhinomanometry (AAR) was employed measuring the nasal flow. The nasal lavage was used for the analysis of the neuropeptide substance P as indicator of nasal chemosensory irritations. Goodness-of-fit was calculated for non-linear regression analyses by fitting the sine function on the data of the ratings given during the 4-h-exposure. In general, ratings for annoyance and odor symptoms were fitted on a higher level than those for sensory irritations. However, a high fit could be shown for nasal irritations due to EHEX. In these experiments, a significant reduction of the nasal flow and a significant increase of substance P could be proved.
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Affiliation(s)
- C van Thriel
- Institut für Arbeitsphysiologie, Universität Dortmund, Leibniz Research Center for Working Environment and Human Factors, Ardeystr. 67, D-44139, Dortmund, Germany.
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16
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Wiesmüller GA, Etschenberg W, Koch T, Konteye C, Zahmel J. [Demand for environmental medical advice at public health offices: experiences in the district aachen public health office]. Gesundheitswesen 2002; 64:159-64. [PMID: 11904857 DOI: 10.1055/s-2002-22312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Since November, 1999 environmental medical advice is offered to interested citizens in the Aachen district at the District Aachen Public Health Office in cooperation with the outpatient unit of environmental medicine (UEM) of the Institute of Hygiene and Environmental Medicine of the University Hospital at Aachen, Germany. Advisory cases are documented in a data bank of Microsoft(R) Access 97. Until now, all advisory cases between November, 1999 and March, 2001 have been descriptively analysed. In this period, 34 personal and two telephonic advices were performed. The frequency of advisory activities is in the lower rang of published experiences in environmental medicine. Age distribution, more frequent advice utilization by women than by men and predominance of unspecific health disorders are comparable with published environmental medical experiences. However, in respect of suspected exposures, unspecific indoor-related environmental factors are predominant. In the past this was true for wood preservatives. Judgement about possible relationships between suspected environmental factors and health disorders or diseases was positive among 11.8 % of the persons seeking advice. This percentage is higher than published experiences which mostly show values below 10 %. It must be considered that this judgement depends primarily on the physician. Other reasons may be the too small number of advice seeking persons and selective influences. Furthermore, a definite judgement can be made only after environmental medical diagnostics (biological monitoring, local inspection, ambient monitoring) and differential diagnostics. Conspicuously, 76.5 % of the advisory cases had no contact to environmental medicine prior to the environmental medical advice at the Aachen District Public Health Office. This points to an information deficit about possibilities to clarify questions concerning environmental medicine in the population. In this context a regional guide on environmental medicine may be helpful. The environmental medical advice for citizens is an excellent example of a successful cooperation between a public health office and an university, which have different special experience in environmental hygiene and environmental medicine. This cooperation brings selectively citizens seeking for advice in environment-related health risks and disorders to practitioners specialised in environmental medicine.
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Affiliation(s)
- G A Wiesmüller
- Institut für Hygiene und Umweltmedizin des Universitätsklinikums Aachen, Germany.
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17
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Abstract
Concerning the syndromes in environmental medicine, like Multiple Chemical Sensitivities (MCS), Idiopathic Environmental Intolerances (IEI), Sick Building Syndrome (SBS), Chronic Fatigue Syndrome (CFS), Candida Syndrome (CS), and Burnout Syndrome (BS), scientific knowledge in etiology, pathology, pathophysiology, diagnosis, therapy, prevention and prognosis is still lacking until now. A critical comparison shows that it is still impossible to find a scientifically satisfying delimitation. Syndromes in environmental medicine show clinical similarities to somatoform disorders. Furthermore, there are the following possible explanations for the existence of these syndromes: Firstly, they may be a complex interaction of environmental impacts, individual predispositions, psychological influences, as well as processes of mental perception and interpretation. Secondly, they may be an effect of distress influenced by culture and social structures and/or thirdly, they may be an latrogenic determination. A more comprehensive characterisation which better considers the complex clinical manifestations is overdue. Although there are neither scientifically validated procedures for diagnosis or therapy nor prophylactic measures, a hardly comprehensible number of partly unvalidated methods is in practical use. Until the syndromes are not finally defined the terms for the syndromes should not be applied to a certain disease. Despite all uncertainities in the evaluation of syndromes in environmental medicine, physicians have the duty to take the affected persons' problems seriously.
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Affiliation(s)
- G A Wiesmüller
- Institut für Hygiene und Umweltmedizin, Universitätsklinikums, RWTH Aachen.
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18
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Abstract
It is a weak point of environmental medicine that health disturbances, e.g. functional affections of the upper respiratory tract, cannot be objectively judged by physicians resp. researchers. In this study, the validity of acoustic rhinometry, a method giving information on cross-sectional areas of the upper airways by means of ultrasound probing, was tested in 40 volunteers seven times during one year. Furthermore, using a simplified model of the nose the accuracy of this method to measure the minimal cross-sectional area (MCA) in the nose was tested. The measurements were extremely confounded by the mode of connection to the nose (e.g. selected adapter, direction of application) and by the MCA in the nasal cavity. Statistical analyses showed a good reproducibility of measurements repeated within minutes, but suggested an intrapersonal variability over the analyzed examination phases due to apparatus independent factors. However, this variability could not be explained by influencing and confounding factors obtained by questionnaire, medical history, and physical examination. The test model showed little to great errors (1.5 to 568.5%) between the actual and the measured MCA, depending on the diameter. It is concluded that the method of acoustic rhinometry has to be standardized before it's value for environmental medicine can finally be judged. Further studies are necessary that should focus among others on factors influencing the variability of MCA and the effect of MCA on the measurement of the area behind the MCA. So far, the use of acoustic rhinometry for the evaluation of nasal function cannot be recommended.
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Affiliation(s)
- G A Wiesmüller
- Institut für Hygiene und Umweltmedizin des Universitätsklinikums, Rheinisch-Westfälischen Technischen Hochschule Aachen.
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Wiesmüller GA, Steup A, Ranft U. Inner room-questionnaire for the German-speaking area. Zentralbl Hyg Umweltmed 1999; 202:435-70. [PMID: 10631788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The sick building syndrome (SBS) is well known in Germany, too. Because reliable objective data are missing questionnaires are essential in investigations of SBS. Internationally, different questionnaires are used which often lack thorough validation. Therefore, aim of this study was to combine the development of a questionnaire and the analysis of its sensitivity and reliability. For proofing sensitivity, 40 volunteers kept a Symptom Diary for one week and, for comparison, answered the questionnaire in the following week seven times during one year. For testing reliability, 60 volunteers filled in the questionnaire on Monday and on Friday of the same week. Agreement was tested by statistical measure kappa (kappa). The sensitivity test showed that details obtained by diary occurred less pronounced but similarly distributed in the questionnaire. The reliability test showed stable socio-demographic and work-related variables. Among the symptoms, eye troubles (kappa = 0.88), skin troubles in the face (kappa = 0.77) and on the hands (kappa = 0.75) were stable. Among the indoor complaints unpleasant odors (kappa = 0.68), sounds (kappa = 0.72), bright lighting (kappa = 0.85), and dust (kappa = 0.86) were stable. Our questionnaire recorded principally plausibly indoor complaints and well-being disturbances. A definite judgement of the questionnaire can only be made after its application to a SBS-affected group. Nevertheless, our questionnaire can be introduced into the process of developing a standardised international SBS-questionnaire. Moreover, our results indicate that events asked by questionnaire over a retrospective period of more than one week should be interpreted with caution.
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Affiliation(s)
- G A Wiesmüller
- Institut für Hygiene und Umweltmedizin des Universitätsklinikums, Rheinisch-Westfälischen Technischen Hochschule Aachen, Germany.
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Begerow J, Sensen U, Wiesmüller GA, Dunemann L. Internal platinum, palladium, and gold exposure in environmentally and occupationally exposed persons. Zentralbl Hyg Umweltmed 1999; 202:411-24. [PMID: 10546331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
In a pilot study the urinary platinum (Pt), palladium (Pd), and gold (Au) excretion was analyzed in 27 dental technicians, 17 road construction workers and 17 school-leavers using sector field inductively coupled plasma mass spectrometry (SF-ICP-MS). Detection limits in urine were 0.24 ng/l for Pt and Au and 0.17 ng/l regarding Pd. A standardized questionnaire was used to assess information about kind and degree of contact to these metals, the physical condition of the volunteers and confounding factors. Significant differences between the three study groups were found. The mean Pt, Pd, and Au excretions of the dental technicians were significantly higher than those of the road construction workers and school-leavers. This indicates that the occupational treatment of dental alloys leads to an internal exposure to these metals which is distinctly higher than that from automobile exhaust exposure. Significant differences between Monday morning (pre-shift) and Thursday afternoon (post-shift) urine samples of the dental technicians were not found. The Pt excretion of road construction workers working near a much traveled highway was comparable with that of school-leavers being less (only environmentally) exposed to automobile exhaust. Regarding Pd and Au the road construction workers showed a tendency to higher levels in urine when compared with the school-leavers, but statistically significant differences were not found. The tendency to higher urinary Pd and Au levels in the road-construction workers may be explained by their slightly greater number of noble metal containing artificial dentures, which may cause an additional exposure. A statistically significant effect of age on the urinary noble metal excretion was not detectable.
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Affiliation(s)
- J Begerow
- Medizinisches Institut für Umwelthygiene an der Heinrich-Heine-Universität Düsseldorf, Germany.
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Wiesmüller GA, Ebel H, Schulze-Röbbecke R, Kunert HJ. 1st Aachen Symposium "Environment and psyche". Zentralbl Hyg Umweltmed 1999; 202:79-84. [PMID: 10507119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Schulze-Röbbecke R, Bodewig S, Dickel H, Dott W, Erdmann S, Günther W, Kunert HJ, Merk HF, Müller-Küppers M, Ostapczuk P, Podoll K, Prüter C, Sass H, Wälte D, Wiesmüller GA, Thelen B, Tuchtenhagen F, Ebel H. Interdisciplinary clinical assessment of patients with illness attributed to environmental factors. Zentralbl Hyg Umweltmed 1999; 202:165-78. [PMID: 10507126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Patients with health problems attributed to environmental factors such as chemical pollutants and electromagnetic fields often do not present evidence of an environmental aetiology of their symptoms. It has been postulated, that their problems are due to disorders diagnosed by other medical disciplines, especially allergology and psychiatry. Our study was designed to subject these patients to a comprehensive diagnostic program involving several medical disciplines in order to achieve diagnoses appropriate to explain the patients' symptoms. Fifty patients consecutively referred to the department of environmental medicine in the university hospital of Aachen, Germany, were submitted to the following examinations: (i) environmental medicine (history, clinical examination, biological and/or ambient monitoring for environmental agents); (ii) allergological examination (history, clinical examination, skin tests); (iii) psychiatric examination (psychopathological examination, psychometric and neuropsychological testing). In addition, the patients were examined in other hospital departments according to the symptoms presented. The findings were discussed in case conferences attended by the physicians involved in order to achieve individual diagnoses. The numbers of patients to whom diagnoses were given by different medical disciplines are as follows: psychiatry (32 patients), dermatology (4), allergology (2), neurology (2), rheumatology (2), gynaecology (1), haematology (1). The most frequent mental disorders diagnosed by the psychiatrists were somatoform disorders (19), followed by schizophreniform and delusion disorders (7). In spite of extensive diagnostic efforts, patients with health problems attributed to the environment usually do not present sufficient evidence of an environmental aetiology of their symptoms. On the other hand the symptoms often meet the diagnostic criteria of other diseases, especially of mental disorders.
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Neuhann HF, Prätor K, Szemkus M, Wiesmüller GA, Schlipköter HW. [PATIS--a questionnaire-based, PC-assisted patient information system in the field of environmental medicine]. Zentralbl Hyg Umweltmed 1992; 193:350-63. [PMID: 1290565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PATIS was developed as a questionnaire-based, PC-assisted patient-information- and documentation-systems within the framework of the "Umweltmedizinische Beratungsstelle" (advisory board for clinical environmental medicine) at the Medical Institute of Environmental Hygiene at the Heinrich-Heine-University Düsseldorf. PATIS is a substantial element of a planed knowledged-based-system in environmental medicine. This system will further-more consist of databases for chemical substances information, exposition, and literature. PATIS records information about patients concerning personal data, former diseases, symptomatology and complaints, lifestyle, residential and working area, and spare time activities. Furthermore the state of physical examination, performances of diagnostics, and laboratory investigations are documented. A different questionnaire exists for children younger than 12 years. PATIS is able to supply an automatic report based on information of the questionnaire. This system is realized in the relational-database-system dBase IV and is utilized practice since the beginning of 1991.
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Affiliation(s)
- H F Neuhann
- Medizinisches Institut für Umwelthygiene, Heinrich-Heine-Universität Düsseldorf
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