Christoph Erwin Minder

Unlabelled: In animal models, melanocyte-stimulating hormones (MSHs) protect the liver from various injuries. Erythropoietic protoporphyria (EPP), a metabolic disorder, leads to the accumulation of protoporphyrin (PPIX). In addition to the most prominent symptom of incapacitating phototoxic skin reactions, 20% of EPP patients exhibit disturbed liv...

Abstract Background A new generation of medical students, Generation Z (Gen Z), is becoming the predominant population in medical schools and will join the workforce in a few years’ time. Medicine has undergone serious changes in high-income countries recently. Therefore, it is unclear how attractive the medical profession still is for high school...

Erythropoietic protoporphyria (EPP) is an ultra-rare inherited disorder with overproduction of protoporphyrin in maturating erythroblasts. This excess protoporphyrin leads to incapacitating phototoxic burns in sunlight exposed skin. Its biliary elimination causes cholestatic liver injury in 20% and terminal liver failure in 4% of EPP patients. Ther...

Background The WHO defines ‘healthy ageing’ as ‘the process of developing and maintaining the functional ability’. Late-life depression and frailty compromise well-being and independence of older people. To date, there exists little research on the interaction of the dynamic processes of frailty and depression and only a few studies were longitudin...

Aims: A new generation of physicians, millennials (also known as Generation Y), are entering residency programmes in internal medicine, and these young men and women learn and work in ways that are different from those of past generations. The aim of the present study was to investigate aspects contributing to the attractiveness to young residents...

Background and objective: Healthy ageing as defined by the World Health Organization (WHO) is the development and maintenance of functional competence. Unfavourable ageing is described by the term frailty and is characterised by a decline in functional reserves. The frailty process can be influenced in a positive way. Previous interventions concer...

Objectives An RCT of a health promotion and preventive care intervention was done in 2001-2002. Here, long-term analyses based on 12 years of follow-up of survival and of change in functional competence between intervention and control group are presented. Positive 1-year results (significantly higher use of preventive services and better health be...

Background In aging populations, multimorbidity causes a disease burden of growing importance and cost. However, estimates of the prevalence of multimorbidity (prevMM) vary widely across studies, impeding valid comparisons and interpretation of differences. With this study we pursued two research objectives: (1) to identify a set of study design an...

Background Chronic pain is common in multimorbid patients. However, little is known about the implications of chronic pain and analgesic treatment on multimorbid patients. This study aimed to assess chronic pain therapy with regard to the interaction potential in a sample of inpatients with multiple chronic conditions. Methods and Findings We cond...

BACKGROUND The objective of preventive home visits (PHV) is to support independent living of elderly people. The target group is a matter of discussion and acceptance so far seems to have been low. The target group favored in studies were persons with functional impairments living independently; therefore, acceptance of this offer by frail persons...

Background: Participants of the Longitudinal Urban Cohort Ageing Study (LUCAS) were recruited from patients 60 years and older from general practitioner's offices in Hamburg. This is different from the usual methods of drawing representative samples. Objectives: The research question addressed the comparability of LUCAS results with those from c...

The detection of incipient functional decline in elderly persons is not an easy task. Here, we propose the self-reporting Functional Ability Index (FA index) suitable to screen functional competence in senior citizens in the community setting. Its prognostic validity was investigated in the Longitudinal Urban Cohort Ageing Study (LUCAS). This index...

BACKGROUND: Presently, there is no consensus on how to define multimorbidity. In this paper we investigate the connection between prevalence estimates for two or more and three or more chronic conditions to improve comparability of multimorbidity studies with different cut-offs. METHODS: In a systematic review of the literature published between Ja...

Introduction: The aim of this paper is to propose a transparent, alternative approach for network meta-analysis based on a regression model that allows inclusion of studies with three or more treatment arms. Methodology: Based on the contingency tables describing the frequency distribution of the outcome in the different intervention arms, a data...

Objective: The aim of this study was to investigate the utilization of ambulance services that resulted from alcohol and drug intoxication over a period of 1 year in a metropolitan area, with an emphasis on characteristic differences between patients with one-time versus repeated use. Method: All ambulance-service report forms filed in 2010 were...

BACKGROUND:Intoxication, whether from alcohol, drugs, or alcohol and drugs in combination, remains a challenging burden on emergency departments. The increasing alcohol consumption among adolescents and young adults, particularly heavy episodic drinking, and the resulting increase in the use of health care resources for alcohol intoxication has bee...

To assess and compare clinical observations and interpretations by physicians trained in biopsychosocial internal medicine (group A) and a control group (C) of physicians with no such special training. A verbatim first-interview of a 36-year old woman, seen for consultation by RHA, was presented to both groups (A, trained physicians: n = 30, and C,...

We present concept, study protocol and selected baseline data of the Longitudinal Urban Cohort Ageing Study (LUCAS) in Germany. LUCAS is a long-running cohort study of community-dwelling seniors complemented by specific studies of geriatric patients or diseases. Aims were to (1) Describe individual ageing trajectories in a metropolitan setting, doc...

There is a need for a simple self-administered instrument to assess frailty in community-dwelling seniors. We present a new marker set to assess the functional state of seniors. Contrary to current literature, we focus not only on risks, but also include resources. The questions relate to facts (ways to do things), rather than on subjective informa...

The goal of this work was to characterise and distinguish persons without (fit), with earliest signs (pre-frail) or accelerated functional decline (frail) during self-referral (geriatric centre) or preventive home visits. After screening independently living older people in an urban longitudinal cohort (n = 1,995) using a self-administered question...

Hintergrund Es gibt Bedarf für ein einfaches Selbstausfüller-Instrument zur Erkennung von Frailty in der heterogenen, selbstständig lebenden älteren Bevölkerung. Methoden Vorgestellt wird ein neuer Fragenkatalog zur Einschätzung des funktionellen Status älterer Menschen. Im Unterschied zur Literatur wird der Fokus gleichermaßen auf Risiken und Res...

Ziele Ziel dieser Arbeit ist die Beschreibung und Unterscheidung von Personen ohne funktionelle Verluste (FIT), mit Frühzeichen (pre-FRAIL) und beschleunigten funktionellen Verlusten (FRAIL) in verschiedenen Zugangsformen (Geriatrische Ambulanz und präventiver Hausbesuch). Methoden Bei Zufallsstichproben selbstständig lebender älterer Menschen (mi...

In the linear calibration problem, when the regression variable y is related to the independent variable x by the equationlikelihood methods are used to make inferences about an unknown value of x given the corresponding observed values of y and previous observed pairs (y, x). Krutchkoff's suggestion of using an inverse estimator for the unknown r,...

BACKGROUND: There is a need for a simple self-administered instrument to assess frailty in community-dwelling seniors. METHODS: We present a new marker set to assess the functional state of seniors. Contrary to current literature, we focus not only on risks, but also include resources. The questions relate to facts (ways to do things), rather than...

PURPOSE: The goal of this work was to characterise and distinguish persons without (fit), with earliest signs (pre-frail) or accelerated functional decline (frail) during self-referral (geriatric centre) or preventive home visits. METHODS: After screening independently living older people in an urban longitudinal cohort (n = 1,995) using a self-ad...

The interactions between rising life expectancy, morbidity and development of disability warrant interdisciplinary research on functional disability, health promotion and prevention as well as healthcare provision for older people. Therefore, the interdisciplinary LUCAS (Longitudinal Urban Cohort Ageing Study) research consortium of university and...

In our work we studied the impact of outliers on the power of the randomization tests for two independent groups. Four variables were manipulated: simple size, number of groups with outliers, type of distributions and effect size. To simulate data with outliers Normal contaminated distributions were used. For the simulations, we used R software, na...

In this paper we evaluate the impact of non-normally on the power of randomization tests for two independent groups with the fifteen densities used in Marron and Wand [19] simulation study, which can all be written as normal mixtures and are believed to model many real data situations. We evaluate the power of the randomization test, and also the p...

To determine the factors contributing most to variability in patient experience in order to present approaches for fairer benchmarking of hospitals and for quality improvement. Secondary analysis of data from a widely used survey on patient experience. Inpatients from all 24 acute hospitals in the Canton of Bern in Switzerland. Data collection foll...

Decline in functional competence is a major determinant of older persons' needs, the development of dependency, use of care, clinical outcome and mortality. The interactions between rising life expectancy and changes in morbidity and disability warrant interdisciplinary research on functional disability, health promotion and prevention. The LUCAS (...

The inherited disease protoporphyria is characterized by acute dermal phototoxicity, due to accumulation of the porphyrin metabolite protoporphyrin. Protoporphyria impairs life quality and working capabilities seriously, as only complete avoidance of sunlight exposure prevents protoporphyria-related dermal pain. Afamelanotide induces skin tanning a...

Background. To explore effects of a health risk appraisal for older people (HRA-O) program with reinforcement, we conducted a randomized controlled trial in 21 general practices in Hamburg, Germany. Methods. Overall, 2,580 older patients of 14 general practitioners trained in reinforcing recommendations related to HRA-O-identified risk factors were...

Efficacy of different antimuscarinics (starting dosages) compared to placebo (reference line through 0) according to Chapple et al, Eur Urol 2008;54:543‐62 and Staskin et al, Eur Urol 2009;55:e49‐50. (TIF)

Flow diagram of literature searches and results. (TIF)

Neurological adverse event profiles (from 52 trials) of different antimuscarinic treatments with currently used starting dosages per day compared with placebo (reference line through 0). ○ mean, 95% confidence interval, TDS transdermal system, VAS visual analogue scale. (TIF)

Cardiac adverse event profiles (from 22 trials) of different antimuscarinic treatments with currently used starting dosages per day compared with placebo (reference line through 0). ○ mean, 95% confidence interval, TDS transdermal system, VAS visual analogue scale. (TIF)

Dermatological adverse event profiles (from 21 trials) of different antimuscarinic treatments with currently used starting dosages per day compared with placebo (reference line through 0). ○ mean, 95% confidence interval, TDS transdermal system, VAS visual analogue scale. (TIF)

Database of included trials. (XLS)

Ocular/visual adverse event profiles (from 45 trials) of different antimuscarinic treatments with currently used starting dosages per day compared with placebo (reference line through 0). ○ mean, 95% confidence interval, TDS transdermal system, VAS visual analogue scale. (TIF)

Urinary tract related adverse event profiles (from 37 trials) of different antimuscarinic treatments with currently used starting dosages per day compared with placebo (reference line through 0). ○ mean, 95% confidence interval, TDS transdermal system, VAS visual analogue scale. (TIF)

Respiratory tract related adverse event profiles (from 20 trials) of different antimuscarinic treatments with currently used starting dosages per day compared with placebo (reference line through 0). ○ mean, 95% confidence interval, TDS transdermal system, VAS visual analogue scale. (TIF)

Additional information kindly provided by authors of eligible trials that reported insufficient data. (DOC)

Background: Overactive bladder (OAB) affects the lives of millions of people worldwide and antimuscarinics are the pharmacological treatment of choice. Meta-analyses of all currently used antimuscarinics for treating OAB found similar efficacy, making the choice dependent on their adverse event profiles. However, conventional meta-analyses often f...

To explore effects of a health risk appraisal for older people (HRA-O) program with reinforcement, we conducted a randomized controlled trial in 21 general practices in Hamburg, Germany. Overall, 2,580 older patients of 14 general practitioners trained in reinforcing recommendations related to HRA-O-identified risk factors were randomized into inte...

The purpose of this ecological study is the investigation of the relation of lung cancer mortality and radon in Switzerland, considering confounding risk factors and taking into account the particular spatial structure of the data. We make use of a Bayesian model pioneered by Clayton and Kaldor (1987) and by Besag et al. (1991): The Poisson model f...

Estimation problems in nonlinear regression situations are often most easily attacked using an iterative estimation procedure for the nonlinear parameters of the regression equation and re-estimating the linear parameters at each step of the iteration. This paper proposes a method to compute an estimate of the full observed Fisher information matri...

Protoporphyria (PP) resulting from two rare, inherited diseases of heme biosynthesis leads to dermal phototoxicity by accumulation of the heme precursor protoporphyrin IX. No standardized tools to quantify the degree of PP-related phototoxicity and its change by medical intervention have been published. Results from a questionnaire completed by 17...

Erythropoietic protoporphyria (EPP) is a rare hereditary disorder characterized by dermal accumulation of the photosensitizer protoporphyrin IX. Following sunlight exposure, the resulting photosensitivity is manifested first as pain, later as erythema, edema and dermal lesions. Afamelanotide (Nle(4)-D-Phe(7)-alpha-MSH), a synthetic analog of alpha-...

The majority of community-dwelling people 60 years and older are independent and live actively. However, there is little information about elderly persons' views on aging, health and health promotion. Therefore, an anonymous, written questionnaire survey was performed in a representative sample of inhabitants from a section of the city of Hamburg,...

Questionnaire data may contain missing values because certain questions do not apply to all respondents. For instance, questions addressing particular attributes of a symptom, such as frequency, triggers or seasonality, are only applicable to those who have experienced the symptom, while for those who have not, responses to these items will be miss...

Background The majority of community-dwelling people 60 years and older are independent and live actively. However, there is little information about elderly persons’ views on aging, health and health promotion. Methods Therefore, an anonymous, written questionnaire survey was performed in a representative sample of inhabitants from a section of th...

The aim was to compare cause-specific mortality, self-rated health (SRH) and risk factors in the French and German part of Switzerland and to discuss to what extent variations between these regions reflect differences between France and Germany. Data were used from the general population of German and French Switzerland with 2.8 million individuals...

This paper is concerned with checking goodness-of-fit of binary logistic regression models. For the practitioners of data analysis, the broad classes of procedures for checking goodness-of-fit available in the literature are described. The challenges of model checking in the context of binary logistic regression are reviewed. As a viable solution,...

To the Editor: Patients with erythropoietic protoporphyria, a rare inherited disease, accumulate photosensitizing protoporphyrin in the dermis, which results in severe dermal pain and incapacitating phototoxic reactions when the skin is exposed to visible light, primarily blue light (the Soret band, with the strongest absorbance among the porphyrin...

Exposure to intermittent magnetic fields of 16 Hz has been shown to reduce heart rate variability, and decreased heart rate variability predicts cardiovascular mortality. We examined mortality from cardiovascular causes in railway workers exposed to varying degrees to intermittent 16.7 Hz magnetic fields. We studied a cohort of 20,141 Swiss railway...

Airway disease in childhood comprises a heterogeneous group of disorders. Attempts to distinguish different phenotypes have generally considered few disease dimensions. The present study examines phenotypes of childhood wheeze and chronic cough, by fitting a statistical model to data representing multiple disease dimensions. From a population-based...

To investigate the relationship between extremely low frequency magnetic field (ELF-MF) exposure and mortality from leukaemia and brain tumour in a cohort of Swiss railway workers. 20,141 Swiss railway employees with 464,129 person-years of follow-up between 1972 and 2002 were studied. Mortality rates for leukaemia and brain tumour of highly expose...

In an occupational study of death certificates in the Swiss mortality register in the years 1969-1983, the mortality experience from malignancies of the haematopoietic and lymphatic systems (abbreviated as MHLS, 8th ICD: 200-209) among railway engine drivers and two reference categories was analyzed. The reference groups included professions of met...

First investigations of the interactions between weather and the incidence of acute myocardial infarctions date back to 1938. The early observation of a higher incidence of myocardial infarctions in the cold season could be confirmed in very different geographical regions and cohorts. While the influence of seasonal variations on the incidence of m...

The objective of the present study was to investigate the relationship between extremely low-frequency magnetic field (ELF-MF) exposure and mortality from several neurodegenerative conditions in Swiss railway employees. We studied a cohort of 20,141 Swiss railway employees with 464,129 person-years of follow-up between 1972 and 2002. For each indiv...

Gender differences regarding 17 childhood experiences, thought to have traumatising potential (Traumatic Childhood Experiences = TCE), and pain behaviour in adulthood were assessed using a self-administered, anonymously filled-out questionnaire. Patients were consecutively accrued in the offices of practicing physicians. Three research questions we...

Switzerland belongs to the group of nations with the highest life expectancy. However, it is unclear to what extent life expectancy varies across socio-economic groups. We used data from a large longitudinal study to quantify differentials in life expectancy across educational groups for men and women of different ages. The Swiss National Cohort li...

Study objective: Switzerland belongs to the group of nations with the highest life expectancy. However, it is unclear to what extent life expectancy varies across socio-economic groups. We used data from a large longitudinal study to quantify differentials in life expectancy across educational groups for men and women of different ages. Design: The...

This paper describes the results of a unique "natural experiment" of the operation and cessation of a broadcast transmitter with its short-wave electromagnetic fields (6-22 MHz) on sleep quality and melatonin cycle in a general human population sample. In 1998, 54 volunteers (21 men, 33 women) were followed for 1 week each before and after shut-dow...

To study the differential distribution of transportation injury mortality by educational level in nine European settings, among people older than 30 years, during the 1990s. Deaths of men and women older than 30 years from transportation injuries were studied. Rate differences and rate ratios (RR) between high and low educational level rates were o...

The aim of this study was to determine if patient narratives and interviewer reactions are specific in groups of somatic (SF) and psychogenic fatigue (PF) patients. The interview criteria and criteria of the interviewer reaction are tested against group classification. Over a 2-year period, 51 (22 PF and 29 SF) patients fulfilling the inclusion cri...

Studies of socioeconomic disparities in patterns of cause of death have been limited to single countries, middle-aged people, men, or broad cause of death groups. We assessed contribution of specific causes of death to disparities in mortality between groups with different levels of education, in men and women, middle-aged and old, in eight western...