The dopamine-related polymorphisms BDNF, COMT, DRD2, DRD3, and DRD4 are not linked with changes in CSF dopamine levels and frequency of HIV infection.

We showed previously that higher levels in CSF dopamine in HIV patients are associated with the presence of the dopamine transporter (DAT) 10/10-repeat allele which was also detected more frequently in HIV-infected individuals compared to uninfected subjects. In the current study, we investigated further whether other genetic dopamine (DA)-related polymorphisms may be related with changes in CSF DA levels and frequency of HIV infection in HIV-infected subjects. Specifically, we studied genetic polymorphisms of brain-derived neurotrophic factor, catechol-O-methyltransferase, and dopamine receptors DRD2, DRD3, and DRD4 genetic polymorphisms in uninfected and HIV-infected people in two different ethnical groups, a German cohort (Caucasian, 72 individuals with HIV infection and 22 individuals without HIV infection) and a South African cohort (Xhosan, 54 individuals with HIV infection and 19 individuals without HIV infection). We correlated the polymorphisms with CSF DA levels, HIV dementia score, CD4+ T cell counts, and HIV viral load. None of the investigated DA-related polymorphisms was associated with altered CSF DA levels, CD4+ T cell count, viral load, and HIV dementia score. The respective allele frequencies were equally distributed between HIV-infected patients and controls. Our findings do not show any influence of the studied genetic polymorphisms on CSF DA levels and HIV infection. This is in contrast to what we found previously for the DAT 3'UTR VNTR and highlights the specific role of the DAT VNTR in HIV infection and disease.

Growth after intrauterine laser coagulation for twin-twin transfusion syndrome.

OBJECTIVE: The aim of this study was to investigate prenatal and postnatal growth of twins with twin-twin transfusion syndrome (TTTS) after intrauterine laser coagulation. STUDY DESIGN: The weight and length of 54 sets of twins with severe TTTS surviving intrauterine laser coagulation at the intervention (median 20+4 weeks), at birth (median 34+3 weeks) and on the occasion of neurodevelopmental follow-up (median age 3 years 10 months) were investigated. All data were converted to Z scores, and groups were compared by two-tailed paired t test. RESULTS: At all time points, donors are significantly lighter than recipients (p<0.001). After laser treatment the weight Z score of donors until birth remains unchanged (p=0.76), whereas recipients lose weight significantly (p<0.01). Postnatally, both donors and recipients show catch-up growth. CONCLUSION: Intrauterine laser coagulation stops growth acceleration in recipients that leads to a decrease in intertwin discordance. After birth, significant catch-up growth was observed for the donor group (p<0.001).

Noise-induced annoyance and morbidity results from the pan-European LARES study.

Traffic noise (road noise, railway noise, aircraft noise, noise of parking cars), is the most dominant source of annoyance in the living environment of many European countries. This is followed by neighbourhood noise (neighbouring apartments, staircase and noise within the apartment). The subjective experience of noise stress can, through central nervous processes, lead to an inadequate neuro-endocrine reaction and finally lead to regulatory diseases. Within the context of the LARES-survey (Large Analysis and Review of European housing and health Status), noise annoyance in the housing environment was collected and evaluated in connection with medically diagnosed illnesses. Adults who indicated chronically severe annoyance by neighbourhood noise were found to have an increased health risk for the cardiovascular system and the movement apparatus, as well as an increased risk of depression and migraine. Furthermore adults with chronically strong annoyance by traffic noise additionally showed an increased risk for respiratory health problems. With regards to older people both neighbourhood and traffic noise indicated in general a lower risk of noise annoyance induced illness than in adults. It can be assumed that the effect of noise-induced annoyance in older people is concealed by physical consequences of age (with a strong increase of illnesses). With children the effects of noise-induced annoyance from traffic, as well as neighbourhood noise, are evident in the respiratory system. The increased risk of illness in the respiratory system in children does not seem to be caused primarily by air pollutants, but rather, as the results for neighbourhood noise demonstrate, by emotional stress.

[Noise induced annoyance and morbidity. Results from the pan European LARES-survey]. / Lärmbedingte Belästigung und Erkrankungsrisiko Ergebnisse des paneuropäischen LARES-Survey.

Traffic noise (road, train and flight noise, and the noise of parking cars), is the dominant source of annoyance in the living environment of many European countries. This is followed by neighbourhood noise (neighbouring apartments, staircases and noise within the apartment). The subjective experience of noise stress can, through central nervous processes, lead to an inadequate neuro-endocrine reaction and finally to regulation diseases. Within the context of the LARES-survey, noise annoyance within the everyday living environment was collected and evaluated in connection with medically diagnosed illnesses. Adults who indicated chronically strong annoyance due to neighbourhood noise were found to have an increased health risk in the cardiovascular system, the movement apparatus as well as depression and migraine. For adults with chronically strong annoyance caused by traffic noise, the risks to the respiratory system also increased. In older people, both neighbourhood and traffic noise indicated, in general, a lower risk of noise annoyance induced illness than in adults. It can be assumed that the effects of noise induced annoyance in older people is concealed by the physical consequences of age (with a strong increase in illnesses). With children, the effects of noise induced annoyance from traffic as well as neighbourhood noise is evident in the respiratory system. The increased illness risks in the respiratory system in children do not seem to be caused primarily by air pollutants but rather, as with case of neighbourhood noise, though emotional stress.

Stress hormones and sleep disturbances - electrophysiological and hormonal aspects.

In noise effect research often the awakening reaction is maintained to be the only important health related reaction. The main argument is that sleep represents a trophotropic phase ("energy storing"). In contrast to this awakening reactions or lying awake belong to the ergotropic phase ("energy consuming"). Frequent or long awakening reactions endanger therefore the necessary recovery in sleep and, in the long-run, health. Findings derived from arousal and stress hormone research make possible a new access to the noise induced nightly health risk. An arousal is a short change in sleeping condition, raising the organism from a lower level of excitation to a higher one. Arousals have the function to prevent life-threatening influences or events through activation of compensation mechanisms. Frequent occurrences of arousal triggered by nocturnal noise leads to a deformation of the circadian rhythm. Additionally, the deep sleep phases in the first part of the night are normally associated with a minimum of cortisol and a maximum of growth hormone concentrations. These circadian rhythms of sleep and neuroendocrine regulation are necessary for the physical as well as for the psychic recovery of the sleeper. Noise exposure during sleep which causes frequent arousal leads to decreased performance capacity, drowsiness and tiredness during the day. Long-term disturbances of the described circadian rhythms have a deteriorating effect on health, even when noise induced awakenings are avoided.

Nocturnal awakenings due to aircraft noise. Do wake-up reactions begin at sound level 60 dB(A)?

Night-time wake-up thresholds at noise levels of 60 dB(A) are frequently employed in Germany to establish "noise polluted areas". The criterion is, however, based on an incorrect processing of statistical data gathered from an evaluation of literature performed by Griefahn et al. (1976). This finding has emerged from an extensive revision of the study. Using appropriate statistical methods, maximum levels of under 48 dB(A) are assessed as waking-up thresholds at ear level in sleeping persons, in contrast to maximum levels of 60 dB(A) calculated by Griefahn et al. in 1976. The linear dose-response relationship, which in the course of the revision could be derived from the early publications, agrees with the results of more recent literature evaluations. The present contribution is not intended to give rise to the question whether in the interest of medical prevention it is reasonable to develop night-time protective policies merely founded on noise levels marking the "statistical" onset of nocturnal wake-up reactions. In this context, emphasis is laid on the deformation of the biological rhythm of sleep.

The influence of stressors on biochemical reactions--a review of present scientific findings with noise.

For every faculty of perception there is, according to the degree of irritation, a biochemical or psychobiological activation. This is also true for the perception of sound or noise. Initially, these processes allow for the adjustment of the organism to a changed situation (eustress). Prolonged effects of stressors may ultimately lead to regulatory disturbances and induce pathological processes (distress). The pathogenetic concept that psychobiological stresses (e.g. noise) may be connected with the well-known risk factors of cardiovascular diseases, through excitation of the central nervous system, is based on the known stress models. The central connective factors are the activation hormones of the adrenal gland, also referred to as stress hormones. From blood and urine parameters recorded in epidemiological and experimental studies under the influence of acute or chronic noise, a simplified model of the pathogenetic mechanism has been developed. Fundamental conditions for future assessing the "stress hormones" have been derived, by means of which premorbid conditions can be determined on a population or group basis.

[Environmental noise and satisfaction with area of residence]. / Umweltbedingter Lärm und Wohnzufriedenheit.

In the German National Health Interview and Examination Survey, more than one third, i.e. 36.2% of persons interviewed on the matter of noise nuisance in their homes attributed to outdoor noise confirmed the occurrence of noise. Regarding this result only small and statistically insignificant differences have been assessed in East and West Germany. The frequency of affirmative answers given by German women, ages 20-39, was significantly higher as compared to men in the same ages bracket. Regarding the dominant noise effects in their home, 87% of persons affected mentioned traffic noise as a source. In the second place neighbour noise has been reported by 32%. Aircraft and railway noises percepted by 20%, are in the third and fourth place. Particularly severe indoor noise effects, i.e. persisting noise during the night, are accompanied with clearly increased discontent regarding the home and living area.

[Peak sound pressure levels of gunshots from starter's pistols]. / Schalldruckspitzenpegel von Schüssen aus Schreckschusswaffen.

Starter's pistols are often bought for self-defense, but can also be used for criminal activities (e.g. assaults, etc.). When a starter's pistol is loaded with blank cartridges and is fired, a powerful shooting noise results. The level of the noise produced is high enough to cause acoustic trauma. For legal examinations and giving an expert opinion further information is needed about the power of such noise. We examined how high peak sound pressure levels were of the gunshots of blank cartridges and whether there existed any directional characteristics from the noise emissions. In all, 15 different models of starter's pistols of 8 different calibres were examined. In addition to blank cartridges, 8 mm tear gas cartridges were also examined. Four transducers were situated in the horizontal plane around the muzzle: 0 degree (shooting direction), 45 degrees, 90 degrees, and 180 degrees (towards the firer). The distances between the transducers and the muzzle were 25 cm, 50 cm, 100 cm, and 200 cm. At a distance of 1 m and in the 0 degree shooting direction the peak sound pressure levels of nearly all weapons tested exceeded 160 dB. At a shooting distance of 25 cm the peak sound pressure levels reached 181 dB. In addition, we observed a directional characteristic concerning the emission of noise: pistols produced higher peak sound pressure levels to the front than backwards towards the firer.

[Environmental medical action required on exposure to noise]. / Umweltmedizinischer Handlungsbedarf bei der Lärmexposition.

Basing on request for an expertise on the medical effects of noise on healthy adults, permissible values for mainly traffic noise were estimated from the literature. If the permissible values are exceeded, preventive medical action is necessary. Below these values the probability of noise-induced health hazards is essentially zero. The authors presume that noise levels above these permissible values, but below the limit of bearability, are an increasing danger to health. Preventive medical action must be weighed against the risk involved in persistent noise, depending on the situation and the need protection. The effect of noise as a health hazard is, apart from the mechanical damage to the inner ear, a psycho-physiological deregulation which can be either indirectly due to the annoyance or directly caused by stress of the vegetative-hormonal system. Therefore different permissible values for annoyance, the stress on the vegetative-hormonal system and for the loss of hearing are suggested, for both continual and maximum noise levels. In addition, de-regulation depends on the time of acoustic exposure because the sensitivity to noise follows a 24-hour cycle (circadian rhythm). It is therefore necessary to determine personal permissible limits for the nocturnal noise (sleep disorder). Permissible values for children are also suggested.

The influence of nocturnal aircraft noise on sleep and on catecholamine secretion.

The influence of noise from night flying on electro-biological reactions and on the secretion of catecholamines (adrenaline and noradrenaline) was studied in eight healthy adults whose place of residence exposes them to day-time aircraft noise. The interrelationships were then analysed, with daytime noise exposure, personality traits and general day-to-day condition reflected in control variables. The subjects were each observed during five nights without noise exposure (Leq < 32 dB(A)) and five nights with noise exposure (Leq = 36 to 56 dB(A)), when the following factors were varied: number of flights (16, 32, 64 overflights with a constant maximum indoor sound level of 75 dB(A)); and sound level (64 overflights at a maximum indoor sound level of 55, 65 and 75 dB(A)). All these flights were transmitted electro-acoustically between the third and sixth hours of the night. When the various daytime exposures are taken into account, significant mean value differences between noisy and peaceful nights are demonstrated in 8-hour urine for both catecholamines. In the case of adrenaline, the original data already showed a significant increase with noise exposure. Furthermore, catecholamine concentration increases with sound level. The analysis confirms a close link between the volume of adrenaline in the urine collected and electro-biological reactions, with consideration given to personality traits and day-time alcohol consumption.