Vaccinations no Risk Factor for MS

Tweet

    

    

Doctors newspaper online, 31.07.2019

    

        
        
        

Thank you for your rating

        
    

    

     

    

• 

•         

• 

•         
          
      

    

Multiple Sclerosis

MUNICH. As a known risk factor for multiple sclerosis (MS), vaccinations are also discussed. New data from scientists at the Technische Universität München (TUM) again oppose such a connection ( Neurology 2019; online July 30 ).

The research team led by Professor Bernhard Hemmer has evaluated a large population-representative dataset of the Association of Statutory Health Insurance Physicians of Bavaria of more than 200,000 persons, including more than 12,000 MS sufferers, TUM reports. It was found that individuals receiving fewer vaccinations five years prior to a diagnosis of MS than those who did not develop MS.

This was the case for the investigated vaccines against pneumococci, meningococci, mumps, measles, rubella and chickenpox, the human papilloma virus (HPV), hepatitis A and B, TBE and influenza. In the latter three, the effect was particularly pronounced: the control group was vaccinated much more frequently than the later MS patients.

"We do not know the causes yet. It may take people long before their diagnosis, the disease and therefore renounce additional burden on the immune system. Such effects are also reflected in our data. Or the vaccine has a protective effect and keeps the immune system from attacking the nervous system.

No connection with first MS pushes

Ultimately, given the large amount of data, we can clearly state that there is no indication that the likelihood of MS disease or the onset of a first MS shock from vaccination is immediate. Alexander Hapfelmeier, first author of the study, quoted in the TUM communication.

The researchers also wanted to rule out that the results could be a fundamental effect of chronic diseases. They therefore additionally evaluated the data of two further patient groups: people with Crohn's disease and psoriasis. The vaccinations had also been recorded five years before their diagnosis.

These patients were vaccinated just as often as the healthy control group. "The results are not solely due to a chronic disease, but an MS-specific behavior," says Hemmer and adds: "We also know from other studies that MS sufferers are conspicuous in their behavior and medical history long before diagnosis. For example, they often suffer from mental illness and rarely have children.

All this makes it clear that MS is there long before the neurological symptoms. We need to find suitable markers to diagnose earlier. We see that as one of our most important tasks. " (eb)

• 

•     

• 

•     
      

        

More articles from this topic

Nerve damage: Are you an expert?

Tweet

White Paper: Catholic Church supports palliative care

Tweet

    

    

Doctors newspaper online, 27.07.2019

    

        
        
        

Thank you for your rating

        
    

    

     

    

• 

•         

• 

•         
          
      

    

White Paper

In order to improve palliative care worldwide, the Pontifical Academy for Life has published a White Paper on the initiative of the German Palliative Foundation.

By Christian Beneker

A White Paper aims to improve palliative care worldwide

© photographee.eu / Stock.adobe.com (Photo with photo models)

NEW ISENBURG. Around 40 million people a year need palliative care. But the offers for the patients are very different internationally. Often painkillers, trained personnel or education in the population are missing, reports Dr. med. Thomas Sitte, Chairman of the Board of the German Palliative Foundation.

Now, on the initiative of the German Palliative Foundation, the Pontifical Academy for Life has written a "White Paper on the Global Promotion of Palliative Care" . The aim of the booklet is to improve the care of dying patients worldwide.

Among other things, the 13 palliative experts who wrote the white paper recommend that all patients with chronic diseases have access to palliative care before they die.

Low Cost Painkillers

For example, pharmacies and health centers should provide painkillers at affordable prices – even in non-standardized dosage forms. Authorities should provide morphine, charities should support palliative care, doctors and nurses working there should have their work certified and trained.

All universities involved in the training of health professionals (such as doctors, nurses, pharmacists, social workers, pastors) should offer palliative training as a compulsory course in the first stages of training, the White Paper states.

"We approached the Catholic Church because it has an incredibly dense international network," says Sitte of the "Ärzte Zeitung". Custom continue: "We want to work on a small scale to be successful on a large scale. But we know that God's mills grind slowly, the mills of politics slower. "

In fact, the need for painkillers often does not seem to be met. "Russia, for example, has the red lantern in the supply of morphine," says Sitte. "In India, on the other hand, the situation is better, not least because the Catholic Church is active here." There is still a lot to do.

Magical-religious beliefs

In many places, rigid bureaucracies and "stupid regulations" prevented access to pain medication, reports Sitte. "But also magical-religious beliefs that understand illness as a punishment."

Even in Europe, palliative care has almost white spots on the map. 4.4 million people in the EU need palliative care every year. The supply differences are enormous. For example, the APCA Atlas of Palliative Care in Europe 2019 lists the number of palliative care teams (inpatient teams, consultation services and specialized outpatient palliative care teams). At the top is Austria with 2.2 teams per 100,000 inhabitants.

Germany is in the upper midfield with 1.1 teams and Greece is far behind on the scale with 0.0 teams. In addition, European countries with high per capita income provide much more morphine than countries with low per capita income. The range is between one milligram per capita per year and 159 milligrams per capita and year.

Finally, the recommendation is also refuted euthanasia clubs says custom. "We want to explain that we do not need business-related suicide aid in Germany to relieve suffering."

• 

•     

• 

•     
      

        

More articles from this topic

World Hepatitis Day: Investment Against Hepatitis Required

Tweet

    

    

Doctors newspaper online, 27.07.2019

    

        
        
        

Thank you for your rating

        
    

    

     

    

• 

•         

• 

•         
          
      

    

World Hepatitis Day

GENEVA. According to World Health Organization (WHO) estimates, around 325 million people worldwide are infected with hepatitis B and C.

About 1.4 million people die each year as a result. The 67 most-affected low and middle-income countries needed $ 6 billion in investment annually (around € 5.4 billion) to cut the number of new cases of hepatitis by 90 percent by 2030, WHO reported on world hepatitis. Day on July 28th.

"It's affordable and very cost effective," said Marc Bulterys, WHO hepatitis expert, in Geneva. The health services even saved money within three years because they would have to treat fewer hepatitis-infected people with complications. In the 67 countries 4.5 million deaths could be prevented by 2030.

There are now generic drugs for hepatitis C in India. There, a three-month treatment cost less than $ 40, Bulterys said. In the US, the same treatment costs $ 18,000. 98 percent of patients were cured after three months of treatment.

Pakistan most affected

Of the five hepatitis viruses, B and C are the most serious, with liver inflammation and liver cancer as the sequelae. Chronic hepatitis B and C infections accounted for 96 percent of deaths.

Pakistan is hit hardest by ten million cases, followed by China and Egypt. According to the WHO, one problem is that the infection often breaks out only after 30 or more years. Probably only one in ten knows about his infection. Even after diagnosis, only 17 percent of patients are treated.

Hepatitis C is often transmitted in the health care system or among drug users, for example, by unclean syringes. Hepatitis B is particularly dangerous for toddlers who were infected with their mothers or relatives.

With them the infection becomes mostly chronic. Essential transmission routes in adults are sex and contaminated drug injections. (dpa)

See also:
Case Numbers: Hepatitis Curves Go Up

• 

•     

• 

•     
      

        

More articles from this topic

No help for tobacco withdrawal worldwide

Tweet

    

    

Doctors newspaper online, 26.07.2019

    

        
        
        

Thank you for your rating

        
    

    

     

    

• 

•         

• 

•         
          
      

    

World Tobacco Report

Tobacco use is harmful, stopping is good for your health. Who smokes, knows that mostly, but getting out is still hard. The World Health Organization has concrete ideas that can help.

Whether it is a home-made or a cigarette packet: Worldwide, there is no help in quitting nicotine addiction – even in Germany, the WHO complains in its latest World Tobacco Report.

© Robert Schlesinger / zb / dpa

Although non-smoker protection is growing worldwide and smoking is becoming more expensive and more difficult in most countries – but there is still a lack of help with weaning. This is the conclusion of the World Health Organization (WHO) in its new World Tobacco Report. She introduced him on Friday in Rio de Janeiro, because Brazil is only the second country in the world after Turkey that has fully implemented all of WHO's recommended tobacco control measures. Not only can tobacco be smoked, it can also be snorted or chewed.

In Germany, the WHO criticizes that there are still too few strict rules for smoke-free public spaces. She also sees a need to catch up with helping smokers who want to get rid of nicotine addiction. Likewise, there must be more effective campaigns against smoking in the media. Advertising bans should be tightened and taxes increased.

"Quit smoking is one of the best things one can do for one's own health," said WHO boss Dr. Tedros Adhanom Ghebreyesus.

Eight Million Tobacco Deaths

Further Facts and Figures from the WHO Report:

• The proportion of smokers in the total population is falling worldwide. However, population growth remains constant at around 1.1 billion.
• Eighty percent of smokers live in low- and middle-income countries.
• Eight million people die from tobacco use every year.
• The economy is losing $ 1.4 trillion a year in health costs and lost work.
• Europe's statistics show that in Georgia, nearly 57 percent of men smoke (2016), in Germany 29 percent (2013) and in Iceland 15 percent (2015).
• Six out of ten people live in countries that have taken at least one measure against tobacco use. This is four times as many as in 2007. Almost half of the people live in countries that have "nausea-pictures" on packs.
• However, only 2.4 billion people live in countries that support people who smoke with tobacco

For this support, the WHO recommends, for example, hotlines for instant telephone counseling or the corresponding online or mobile services. In addition, family doctors should address smokers and point out aids in quitting. For this, experts recommend the "Five A of minimal intervention" (see box). Also, nicotine replacement therapies should be funded, writes the WHO. Handicap in Germany: So far, drug support by the so-called "Lifestyle Paragraph" 34 in SGB V is exempted from the reimbursement. The treatment of tobacco dependence is one of the most cost-effective measures, and thus higher consequential costs could be prevented by treatments for smoking-related diseases.

WHO warns against cigarette replacement

Incidentally, WHO also warns in its report about cigarette substitutes, such as e-cigarettes and products that heat tobacco instead of burning it. All are harmful to health.

Just last week, the German Cardiac Society – Cardiovascular Research also critically commented on e-cigarettes and tobacco heaters. The company complained that statements on the harmfulness of health were only conditionally resilient, since there were no well-founded results on the long-term effects of e-cigarettes. However, there are first disturbing indications of serious late damage caused by e-cigarettes, explained Professor Harm Wienbergen in a statement from the company.

The Society also criticized studies that use e-cigarettes and tobacco heaters as aids to weaning. In February, a study by British researchers led by Professor Peter Hajek of the Queen Mary University of London attracted attention that claimed that electronic inhalation products were twice as effective as smoke evacuation aids than the nicotine replacement products recommended by the guidelines ( N Engl J Med 2019, online January 30 ). But actually, the study results suggested the exact opposite.

Not for weaning

Scientists investigated whether more smokers succeed in quitting smoking by using nicotine replacement products (NRTs) or e-cigarettes instead. Result: with e-cigarettes, 18 percent of smokers were able to exit, with NRT managed to ten percent. Hajek and colleagues concluded that "e-cigarettes are more effective in smoking cessation than nicotine replacement products."

The fact that this statement is simply false is clear when you look at the results on nicotine abstinence: 80 percent of the subjects who had denied their smoking cessation with the e-cigarette still used it after one year. Of the group of participants who had used NRT, nine percent still used the tool.

The conclusion of the study should therefore be rather: Four percent of e-cigarette users overcame their nicotine addiction compared to nine percent of smokers with NRT. When it comes to success in coping with addiction, NRTs are the better tool. (mmr / dpa)

• 

•     

• 

•     
      

        

More articles from this topic

With cardiology less frequently in the clinic

Tweet

    

    

Doctors newspaper online, 25.07.2019

    

        
        
        

Thank you for your rating

        
    

    

     

    

• 

•         

• 

•         
          
      

    

Baden-Württemberg

In Baden-Wuerttemberg indications of advantages for cardiac patients receiving the AOK selective contract are confirmed.

STUTTGART. Patients in the specialist cardiology contract of the AOK Baden-Württemberg are less frequently hospitalized than those with heart disease in the standard care setting. This is clear from the first evaluation results communicated by the contract partners AOK, Medi-Verbund and the family doctor association Baden-Württemberg.

Scientists led by Professor Ferdinand Gerlach from the Institute of General Medicine at the University of Frankfurt have analyzed the data from 13,400 registered insured persons from the years 2015 and 2016, and about 8,700 insured persons also suffering from heart failure belonged to the control group.

The relative risk reduction of hospitalization for acute decompensated heart failure is approximately 24 percent. In CHD patients, the risk reduction of hospitalization is 13 percent. Gerlach describes these effect sizes as "impressive" compared to the standard supply. This shows that fragmented health care "can make substantial progress in terms of integrated care delivery, quality and efficiency". The evaluation also shows that the interplay between home and specialist doctors work, according to the contract partners: the referral rate in the selective contract is almost 100 percent, in the standard care it is only 66 percent.

At the end of September, the evaluation of the Universities of Frankfurt, Jena and Heidelberg as well as of the Aqua-Institut will be submitted to the Joint Federal Committee. The expertise has been funded by the Innovation Fund.

In order to be able to successfully continue the specialist medical contracts, the draft of the so-called "Fair Electoral Code" (FKG) must be changed. Werner Baumgärtner, CEO of Medi Baden-Württemberg. The draft bill of the Federal Ministry of Health provides for a ban on treatment diagnoses as a prerequisite for defined benefit payments. This requirement would make care services tailored to specific patient groups impossible, says Baumgärtner. (FST)

• 

•     

• 

•     
      

        

More articles from this topic

Majority of schoolchildren have a headache

Tweet

    

    

Doctors newspaper online, 24.07.2019

    

        
        
        

Thank you for your rating

        
    

    

     

    

• 

•         

• 

•         
          
      

    

survey

Headaches are perceived as a "real" disease, emphasizes the German Society for Neurology (DGN).

© tzidanic / iStock / Thinkstock

BERLIN. More than two-thirds of children and adolescents in Germany have regular headaches.

Among the high school students, the proportion is even close to 80 percent, as revealed by an investigation ( Cephalalgia 2019; 39: 1030-1040 ). However, only a few sought a doctor.

"This shows that headaches are not perceived as a 'real' disease in our society," according to a statement from the German Neurological Society (DGN) on the study.

Headache already represented a relevant health problem in childhood and adolescence and should be treated in time by a doctor.

Over 5000 students interviewed

Between March 2015 and March 2016, 5419 students were interviewed who attended a primary or secondary school in Dresden. 2706 answered the questionnaire and gave it to the evaluation. It was ascertained how often in the past three months headaches occurred, in what strength and what measures were taken.

Just under 32 percent of respondents said they did not have a headache at all, almost 37 percent had a headache once a month, just under 32 percent even more than twice a month.

The latter group was further investigated: 55 percent had headaches 2-5 days a month, 27 percent 5-10 days. 7 percent even reported having headaches for more than 15 days a month.

It was also noticeable that the frequency of headaches varied with the type of school: in primary schools almost 64 percent of the students regularly had headaches, in high schools almost 68 and in secondary schools almost 80 percent. Overall, girls were more affected than boys.

Rarely to the doctor

624 children and adolescents said they were taking analgesics or homeopathic remedies for pain; in acute headache attacks, the most commonly used agents were ibuprofen (49 percent) and paracetamol (32 percent).

In the group that suffered from headaches once a month, just under a fifth took painkillers, and in the group that had headaches more than twice a month, nearly half said they regularly take painkillers.

It was noticeable that almost all children who had headaches only once a month and about 80 percent of those who had headaches more than twice a month had not consulted a doctor.

Professor Hans-Christoph Diener of the DGN sees this as an aberration. "The advertising of painkillers suggests that everyone can treat their headaches themselves and you do not need a diagnosis from the doctor. This is certainly wrong, a migraine is treated differently than a cluster headache, "Diener is quoted in the message.

He also warns against a thoughtless use of painkillers, as headache medications, if taken frequently, can in turn cause and intensify headaches. "In childhood, the foundation is laid for a lax attitude towards painkillers, which can then lead to painkiller overuse in later phases of life," Diener says.

Serious illness!

Study author Private lecturer Gudrun Goßrau emphasizes that the unwillingness to seek medical treatment also reflects a lack of awareness of headaches as a serious illness in our society. According to the study, over a fifth of all children and adolescents who had headaches more than twice a month are more likely to miss school because of headaches.

"Headaches often lead to a vicious circle. School miscarriages can lead to loss of performance, school failure, school fear, many affected children are socially isolated, and the risk of depression is increased, "reports Goßrau. All the more important is a timely medical diagnosis and individual therapy.

Professor Ulrike Schara, president of the Society for Neuropaediatrics, points out that the increase in headache rates in children in recent years is more likely to be due to no genetic factors. Rather, lifestyle factors are likely to play a significant role.

"In addition to alcohol, caffeine, smoking and lack of physical activity, school stress and emotional stress (for example due to family conflicts) are considered common causes of headache. At these points, a general social prevention strategy must begin ", said Schara. (eb)

• 

•     

• 

•     
      

        

More articles from this topic

Act fast in overweight infants!

Tweet

    

    

Doctors newspaper online, 22.07.2019

    

        
        
        

Thank you for your rating

        
    

    

     

    

• 

•         

• 

•         
          
      

    

Metabolic disturbances

A study makes it clear that overweight should be counteracted quickly in overweight infants – otherwise metabolic disturbances may occur.

The study findings revealed that children who were considered overweight at the time of the first data collection developed several components of the metabolic syndrome in 19 percent of the cases.

© kwanchaichaiudom / Fotolia

BREMEN. Once children are overweight, they often develop metabolic disturbances such as hypertension, poor blood lipid levels, and increased glucose or insulin levels in subsequent years.

This is the result of a recent study involving ten European institutions led by the Leibniz Institute for Prevention Research and Epidemiology – BIPS ( Int J Epidemiol 2019; online May 16 ).

In the IDEFICS study, more than 16,000 children were aged aged from two to nine years in eight European countries (Belgium, Germany, Estonia, Italy, Spain, Sweden, Hungary and Cyprus) investigated the influence of diet and lifestyle on their health.

Part of the children – now between 7 and 17 years old – was re-examined at a later time in the recently published BIPS-led follow-up study I.Family. In addition, family members were also interviewed. The data were evaluated from 6768 children, who were examined repeatedly over a six-year span.

The surveys included questionnaires as well as physical examinations and the collection of blood, saliva and urine samples. "These data enabled us to analyze changes in the metabolic status of infants through to adolescence," says study author Dr. Claudia Börnhorst from the BIPS in a statement from the institute.

16 percent abdominally overweight

The researchers identified five key groups: most children were metabolically healthy (62 percent), 16 percent had an increased waistline and were considered abdominally overweight, 9 percent had a lipid metabolism disorder, 7 percent had hypertension, and 6, 6 percent combined several components of the metabolic syndrome.

These include: obesity, hypertension, lipid disorders (poor blood lipid levels) and increased glucose / insulin levels. They are all considered as signs of a metabolic disorder. As soon as three or even four of the risk factors mentioned above exceed prescribed limits, we speak of a metabolic syndrome.

"Surprisingly we found that even in the considered 6-year period, hardly any child in the group with multiple components of the metabolic syndrome managed to return to the metabolically healthy status," says Börnhorst. This underlines the importance of early intervention. "Abdominal obesity seems to be the starting point for more metabolic disorders such as hypertension or lipid disorders in children."

If children were metabolically healthy at the first measurement, then they would most likely continue to follow up (87 percent). Children who were considered overweight at the time of initial data collection developed several components of the metabolic syndrome in 19 percent of cases.

If children had multiple metabolic disorders, such as high blood pressure or elevated insulin levels, at the first measurement, they were very likely to maintain this throughout the study period.

The researchers are planning a renewed survey of the 12 to 22-year-old study participants this year. (eb)

• 

•     

• 

•     
      

        

More articles from this topic

Game Consoles Keep Seniors Fit: Motorcycling in the Nursing Home

Tweet

    

    

Doctors newspaper online, 20.07.2019

    

        
        
        

Thank you for your rating

        
    

    

     

    

• 

•         

• 

•         
          
      

    

Game consoles keep seniors fit

Game consoles for elderly people are tested in around 100 nursing homes. In the virtual room, the residents should train their cognitive and motor skills – and just have fun playing.

By Katrin Berkenkopf

The virtual motorcycling makes the residents in the nursing home in Kaiserswerth joy.

© Katrin Berkenkopf

DÜSSELDORF. Mr. Spiller is going to Bonn by bike today. He does not always hold the track for sure, thank God there is currently no oncoming traffic. He almost missed the turnoff to Bonn, at the last moment he tore the handlebars around. Done.

Applause surprises. Herbert Spiller smiles. It was only his second drive with the virtual machine. Recently, the gaming console of the special kind has moved into the parent company Kaiserswerth, a nursing home of the Diakonie. The 100-year-old likes the so-called memory box. "Wonderful, there was really power behind. If you can not go out on the street, it's fun and enjoyable. "

The Memorebox is a console designed to bring seniors to play, promoting motor and cognitive abilities. The Barmer Ersatzkasse brings her as part of a project in 100 nursing homes throughout Germany.

The Humboldt University, the Charité and the Alice Salomon Hochschule, all from Berlin, will then evaluate the effects of regular playing on the 1000 participants.

"It just brings joie de vivre"

"We arouse and encourage the natural play instinct," explained Heiner Beckmann, Country Manager of Barmer. The memory, the stability and walking safety, the endurance, all this should be promoted by the movement in the virtual space.

The results of a pilot phase in two houses in Berlin and Hamburg suggest this. "But it simply brings joie de vivre and relieves the nursing staff," says Beckmann.

A success would be, for example, if a resident can wear his own jacket again thanks to regular play, said Klaus Patzelt, head of department at the Kaiserswerth headquarters. The project shows the possibilities offered by digitization in nursing. "We have the hope that forgotten or lost abilities will come back."

Unlike the younger popular consoles, the Memorebox comes without a controller. It is controlled by movements of the arms. You steer the motorcycle, roll the ball in the direction of the cone or are panned to the beat of the dance music.

"The games adapt to the player, they realize how good somebody is," says Stev Klapschuweit, sales director at RetroBrain, which has developed the console over the course of four years. So frustration, but also under-demand is avoided. The graphics are reduced, the appearance should remind of the youth of the older users.

Consoles for Hospice or Rehabilitation

From originally three games have now become six. Singing, dancing and table tennis as new offers should appeal not least to women, explains Klapschuweit. The console is already in a late phase of development.

It is possible that in the end different models are available for different purposes – such as nursing homes, rehabilitation facilities or Parkinson's clinics. Ideally, such a box could eventually be bought by private users and connected to the home TV, he says. But you need a few years time and large cooperation partners.

• 

•     

• 

•     
      

        

More articles from this topic

Dentistry in crisis ?: Dental health is neglected

Tweet

    

    

Doctors newspaper online, 19.07.2019

    

        
        
        

Thank you for your rating

        
    

    

     

    

• 

•         

• 

•         
          
      

    

Dentistry in crisis?

Around half of the world's population suffers from problems with their teeth, without global health policies responding adequately, researchers say. They call for a rethinking.

Mouth open: Dental health is neglected, complain researchers.

© Karin & Uwe Annas / Fotolia

HEIDELBERG / LONDON. Researchers demand a radical rethinking in dealing with oral and dental diseases. Around 3.5 billion people worldwide have caries, gum disease and oral cancer – largely ignored by global health care and policies. "Dentistry is in crisis," says Professor Richard Watt of University College London (UCL), one of the authors of a series of articles on these topics in the British journal "The Lancet" .

In highly developed countries, modern dentistry, for example, focuses too much on treatment rather than prevention, he criticizes, and twelve other international experts. The scientists from ten countries, including Great Britain and Germany, also complain that dentistry has been decoupled from traditional health care for far too long.

Beverage industry in focus

The scientists also critically assess the role of the sugar, food and beverage industries. Their influence could, for example, lead to a focus on commercial products such as toothpaste with fluoride, mouthwash or sugar-free chewing gum instead of dealing with the actual causes of tooth decay. Thus, the consumption of sugar, the main cause of the destruction of teeth, is rapidly increasing, especially in less developed countries.

There is also need for action in Germany, says co-author Stefan Listl, who conducts research in the field of health economics at the University Hospital in Heidelberg. Although it is the world's most widely used for dental treatment.

Many people continued to suffer from the avoidable consequences of such diseases. The resulting loss of productivity amounts to more than twelve 12 billion euros annually. "Too much emphasis is placed on high-tech rather than precaution."

It also continues to be the case that people from lower educational backgrounds have dental problems much more often. "With the supply model in this country you can get very far, but how can you reach those who never go to the dentist?" Listl said. Many people are unaware of the importance of dental and oral hygiene. (AP)

• 

•     

• 

•     
      

        

More articles from this topic