[Effectiveness of low emission zones of stage 1: analysis of the changes in fine dust concentrations (PM10) in 19 German cities]. / Wirksamkeit von Umweltzonen in der ersten Stufe: Analyse der Feinstaubkonzentrationsänderungen (PM10) in 19 deutschen Städten.

BACKGROUND: It is not known/is disputed whether introduction of low emission zones (LEZs) leads to a reduction of fine dust pollutants. METHODS: Data on PM10 concentrations obtained from measurement stations within and outside of LEZs from 19 German cities (Augsburg, Berlin, Dortmund, Duisburg, Düsseldorf, Essen, Frankfurt a. M., Hannover, Herrenberg, Ilsfeld, Karlsruhe, Köln, Ludwigsburg, Mannheim, München, Reutlingen, Stuttgart, Tübingen, Wuppertal) were analyzed in order to investigate the effect of banning vehicles ("tier 1") of the pollutant group 1 (without stickers) on the pollutant concentration, i.e, this study focused on LEZs that restricted cars of EURO 1 standard without appropriate retrofitting systems from entering these zones. For the period from about 2005 until the end of 2009, data from continuous half-hour measurements as well as gravimetrically determined daily measurements of PM10 were collected. The analysis consisted of four pairwise corresponding measurement values as matched quadruples of two index and two reference values (index stations are inside, and reference stations are outside the LEZs). One index value and the simultaneous reference value were measured during the active LEZ period, and the other pair of values was measured before the LEZ was introduced. The pairs of values had a difference in time of 364 days or a multiple of 364 days keeping the season, weekday and time of day constant within the quadruple. Differences in index values were regressed on differences in reference values while meteorological parameters (height of the inversion base, amount of precipitation, wind velocity), school holidays, period of environmental bonus paid, periods when trucks were banned as well as baseline data at index and reference stations were taken into account as covariates in so-called "fixed effects" regression analyses of the quadruples (difference score method in the two-period case). The statistical approach was successfully validated prior to this study in an analysis of simulated data from FU Berlin. RESULTS: 2,110,803 quadruples of continuous PM10 and 15,735 gravimetric quadruples were identified leading to 61,169 quadruples based on daily PM10 averages. The analyses showed that best LEZ effect estimates for fine dust reduction were (at all index stations) ≤ 0.2 µg/m3, i. e., a relative PM10 reduction ≤ 1 %. Best estimates at all index stations near traffic (excluding urban background and industry index stations) were below 1 µg/m3 (less than 5 %, respectively). CONCLUSIONS: Effects were smaller than predicted prior to the introduction of LEZs. This study is the first that investigated comprehensively the effectiveness of "tier 1" LEZs in Germany on PM10 reduction with a homogeneous approach in data collection and analysis and taking into account the most relevant confounding factors.

[Exposure to smoke and its effects on pulmonary diseases]. / Effekte von Rauchexposition auf Lungenerkrankungen.

For many diseases, tobacco smoke is the most important risk factor. To understand the different risks concerning both quality and severity of the possible diseases, the differentiation between mainstream smoke, sidestream smoke and environmental tobacco smoke (ETS) is indispensable, since the different types of smoke are associated with different diseases. Before anything else, tobacco smoke is the main risk factor for the development of lung cancer and with restrictions for laryngeal and pharyngeal carcinomas as well. Moreover, the inhalation of tobacco smoke is of great importance in the genesis of chronic obstructive lung diseases (COPD). During recent years it has generally been acknowledged that ETS, besides a general activity in cancerogenesis also, seems to induce other morbidities. Nevertheless, when looking at the risks of smoking it has to be mentioned that the difficulty of gaining reliable information concerning quality and quantity of the smoking and the exposure to ETS is significant. That is why in many cases the relation between the dose of tobacco smoke and its effect is hard to make out. Not to be denied is the fact that both active and passive smoking has a great impact on the respiratory tract, which should be considered carefully when it comes to children being exposed to ETS. The age of children when exposed to regular ETS for the first time plays a key role concerning their disposition to later developing a COPD or a bronchial asthma. This subject of ETS is especially of great interest in the work of company doctors because there are many people exposed to ETS for many hours every day in their work environment. This problem is most obvious in the gastronomic work sector.

[A scientometric analysis of leukoplakia and erythroplakia]. / Eine szientometrische Analyse der Leukoplakie und Erythroplakie.

BACKGROUND: The oral leukoplakia and erythroplakia is one of the most common epithelial precursor lesions of the oral squamous cell carcinoma. Transformation rates are approximately 0.9-17% in 10 years for leukoplakia and in 14-50% for the erythroplakia. Despite the clinical relevance of these lesions, currently exists no detailed bibliometric analysis. METHODS: The present study combines classical bibliometric tools with novel scientometric and visualizing techniques in order to analyse and categorize research in the field of leukoplakia and erythroplakia. RESULTS: All studies related to leukoplakia and erythroplakia and listed in the ISI database since 1900 were identified by the use of defined search terms. The bibliometric analysis of the collected data shows a continuous increase in quantitative marker such as the number of publications and cooperation and qualitative markers, such as citations and H-index. The combination with density equalizing mapping revealed a distinct global structure of research and citing activity. Radar chart techniques were used to illustrate bi- and multilateral cooperations and institution research collaborations. DISCUSSION: The present study demonstrates the first scientometric approach that visualizes research activities in the area of leukoplakia and erythroplakia. It provides data that can be used for geografical context and research networks.

Height loss in elderly women is preceded by osteoporosis and is associated with digestive problems and urinary incontinence.

SUMMARY: This study explores risk factors for height loss and consequences in terms of health and wellbeing, in older women. Osteoporosis, low body-mass index, being born in Europe and using medications for both sleep and anxiety were risk factors for height loss. Height loss was associated with digestive problems; excessive height loss was also associated with urinary stress-incontinence and a decline in self-rated health. INTRODUCTION: Height loss is associated with osteoporosis, but little is known about its consequences. We aimed to examine the risk factors for height loss and the symptoms associated with height loss. METHODS: Elderly participants of the Australian Longitudinal Study on Women's Health (aged 70-75 in 1996) who provided data on height at any two consecutive surveys (held in 1996, 1999, 2002, and 2005) were included (N = 9,852). A regression model was fitted with height loss as the outcome and sociodemographics, osteoporosis, and other risk factors as explanatory variables. Symptoms related to postural changes or raised intra-abdominal pressure were analyzed using height loss as an explanatory variable. RESULTS: Over 9 years, average height loss per year was -0.12% (95% confidence intervals [95% CI] = -0.13 to -0.12) of height at baseline. Height loss was greater among those with osteoporosis and low body mass index and those taking medications for sleep and anxiety. After adjusting for confounders, symptoms associated with height loss of > or =2% were heartburn/indigestion (odds ratio [OR] = 1.19, 95% CI = 1.01 to 1.40), constipation (OR = 1.18, 95% CI = 1.01 to 1.37), and urinary stress incontinence (OR = 1.20, 95% CI = 1.02 to 1.41). CONCLUSION: These findings highlight the importance of monitoring height among the elderly in general practice and targeting associated symptoms.

A review of the development of Respimat Soft Mist Inhaler.

Respimat Soft Mist Inhaler (SMI) is a new generation inhaler from Boehringer Ingelheim developed for use with respiratory drugs. The device functions by forcing a metered dose of drug solution through a unique and precisely engineered nozzle (the uniblock), producing two fine jets of liquid that converge at a pre-set angle. The collision of these two jets generates the soft mist. The soft mist contains a high fine particle fraction of approximately 65 to 80%. This is higher than aerosol clouds from conventional portable inhaler devices, such as pressurised metered dose inhalers (pMDIs) and dry powder inhalers (DPIs). In addition, the relatively long generation time of the aerosol cloud (approximately 1.5s) facilitates co-ordination of inhalation and actuation--a major problem with pMDIs. These features, together with the slow velocity of the soft mist, result in larger amounts of the drug reaching the lungs and less being deposited in the oropharynx compared with either pMDIs or DPIs. Generation of the soft mist from Respimat SMI is purely mechanical, so propellants are not necessary. The innovative design of Respimat SMI, using water-based drug formulations, ensures patients receive consistent and reliable doses of the drug with each actuation. The device was initially tested in scintigraphic lung deposition studies and produced encouraging results when compared with the chlorofluorocarbon-based pMDI (CFC-MDI). Subsequent clinical studies have confirmed that Respimat SMI is effective and safe in delivering bronchodilators to patients with asthma or chronic obstructive pulmonary disease.