Revision of the Genus Pseudaethria Schaus (Lepidoptera, Erebidae).

The genus Pseudaethria Schaus is revised and redescribed based on morphological characters of male and female adults. Its type species, Pseudaethria cessogae Schaus, was found out to be a junior subjective synonym of Heliura cosmosomodes Dognin. Therefore, the new combination Pseudaethria cosmosomodes is proposed along with another one: Pseudaethria analis Gaede new combination. A lectotype is designated to P. cessogae, which was described from an undetermined number of specimens. The distribution of the species is discussed as well as its systematic placement.

Regional variation and time trends in mortality from ischaemic heart disease: East and West Germany 10 years after reunification.

STUDY OBJECTIVE: Within Europe, a pronounced geographical gradient of mortality from ischaemic heart disease has been observed with the highest burden in the north east and the lowest in the south west. The study objective was to compare mortality from ischaemic heart disease between former East and West Germany since reunification. DESIGN: Analyses of age standardised mortality rates from ischaemic heart disease (ICD-9 410-414, ICD-10 I20-I25) between 1990-1991 and 2000. SETTING: Former East and West Germany. MAIN RESULTS: After a peak in the early 1990s, mortality from ischaemic heart disease has substantially declined in both parts of Germany (from 222 to 169 per 100 000 in the East and from 150 to 116 per 100 000 in the West). The regional difference, however, remained rather constant: the rate ratio between the pooled mortality in the East compared with the West was 1.51 (95% CI 1.46 to 1.56) in 1991 and 1.45 (95% CI 1.39 to 1.50) in 2000. These rate ratios were higher in women (1.63 in 1991 and 1.52 in 2000) compared with men (1.45 and 1.44, respectively). CONCLUSIONS: Within Germany, there has been a pronounced east-west gradient of mortality from ischaemic heart disease since reunification. Further insight into possible underlying reasons may lead to improved preventive strategies.

[Contractile reserve as a new parameter for determining the performance of the heart muscle using a noninvasive measuring method]. / Kontraktile Reserve als neuer Parameter zur Bestimmung der Leistungsfähigkeit des Herzmuskels mit Hilfe eines nichtinvasiven Messverfahrens.

Chronic cardiac insufficiency is an illness with increasing epidemiological importance and mortality. Therefore different invasive and non-invasive investigation methods for early recording were developed. The left ventricular ejection fraction (LVEF) has played a special role in this direction. The determination of the contractile reserve by means of non-invasive measurement of blood pressure and flow through the aortic valve is a new and up to now widely unknown method for recording the capability and power reserve of the of myocardium. Since no comparative investigations are known from literature and results from a follow-up are not available yet, we tested whether, by means of contractile reserve, the discrimination of subjects with different cardiac power is possible or not. Forty-two men between 44 and 62 years of age belonging to three groups with different cardiac power (persistence trained, healthy subjects and patients with CHD) were examined non-invasively. The main result of the study is that it is possible to distinguish between the three groups significantly by means of the contractile reserve. The largest value (15.25 W +/- 3.46 W) was found in the "persistence trained" group, followed by the "healthy subjects" (10.85 W +/- 4.19 W). The smallest values were from the "patients" group (7.88 W +/- 2.95 W). The differences between the mean values of the CHD "patients" and the "persistence trained" were significant (p < 0.001). Similar comparisons of the groups of "healthy subjects" and "trained persons" and "healthy subjects" and "patients", respectively, yield p values of p = 0.007 and p = 0.040. These differences are also significant. This study is a first investigation and description of the method. A validation only can be achieved by follow-up investigations.

Social inequality and environmentally-related diseases in Germany: review of empirical results.

A literature search was conducted aiming at all empirical studies from Germany till mid 1997 containing data on the association between environmentally-related diseases and the socio-economic status (education, occupation, income, social class) and/or on the association between the exposure to harmful substances and the socio-economic status. With respect to the exposures, a clear picture becomes visible: the concentration of harmful substances in the ambient air as well as indoors is considerably higher with regard to the lower social class as compared with the higher social class. This applies to children as well as to adults and to West Germany as well as to East Germany. However, with respect to environmentally-related diseases, no such clear picture becomes visible. For example, several studies indicate that allergies, atopic eczema and croup occur less frequently in the lower social class than in the higher social class. Malignant tumours (lung cancer, kidney cancer or bladder cancer), however, seem to occur more frequently in the lower social class than in the higher social class. Environmental-epidemiological studies should increasingly integrate socio-epidemiological study approaches and explicitly present their results.

Use of maternal care in a rural area of Zimbabwe: a population-based study.

PURPOSE: Our aim was to determine the coverage of antenatal and delivery care and the determinants of non-compliance in a rural area of Zimbabwe in order to improve the quality and efficiency of maternal health care services. METHODS: A community-based, cross-sectional study was carried out in the catchment area of Gutu Mission Hospital, in rural Zimbabwe, from January to June 1996. Two hundred and thirty-five women, aged 16 to 54 years, who had delivered a child in the past three years were interviewed on general characteristics (age, marital status, religion, education, work), obstetric history, use of family planning, pregnancy complications, number of antenatal visits, and use of maternity waiting shelters. Associations of these factors to non-use of antenatal care facilities and hospital delivery were studied. In the Gutu district, guidelines exist to identify women at high risk of complications during pregnancy and to indicate where women should give birth (hospital, rural clinic or at home). We evaluated which factors were important for non-compliance to these guidelines. The analyses were performed using a logistic regression model. RESULTS: Ninety-seven percent of the pregnant women attended the antenatal care facilities at least once. Seventy-three percent came at least five times or more. Belonging to certain religious groups proved to be the strongest explanatory factor for not attending antenatal care facilities. Use of maternity waiting shelters and complications during the pregnancy were important factors for hospital delivery, whereas unemployment and being without a husband were associated with deliveries outside the hospital. Identification as high risk of a complicated pregnancy by application of the existing guidelines was not associated with place of delivery. Delivery at a location that did not conform to the existing guidelines was associated with non-use of maternity waiting shelters, unemployment or being without a husband and use of traditional care. CONCLUSIONS: Our study showed a high attendance rate at antenatal care facilities in the Gutu District. By analyzing determinants of non-use of antenatal care facilities, of hospital delivery and of inappropriate location of delivery according to local guidelines, we identified certain risk factors which are suitable for modification and may help to improve antenatal and perinatal care in the Gutu District in Zimbabwe.

[Differences in average hospital stay in German inpatient institutions analysed on a regional basis before and after re-unification]. / Unterschiede der durchschnittlichen Verweildauer in stationären Einrichtungen der alten und neuen Länder.

The current German average length of hospital stay (ALOS) is comparatively too high, if seen on an international level. Since 1902 a clear and permanent reduction of ALOS is evident in Germany from official statistics. The decrease of ALOS was synchronous in East and West Germany even after reunification. The interpretation of ALOS results is rendered more difficult because German statistic consider both hospitals and rehabilitation centres when calculating annual case numbers of hospital treatment and ALOS. Consequently, the ALOS data cannot be a suitable parameter for analysing the effectiveness of the German hospital system.

The effect of non-depot ACTH(1-24) on infantile spasms.

However, side-effects such as severe infections, hypertension and electrolyte imbalance have been found, assumed to be related to hypercortisolism induced by chronic ACTH treatment. The authors treated 18 patients with infantile spasms with non-depot ACTH(1-24). The therapeutic effect of non-depot ACTH was comparable to that of depot ACTH, with no severe bacterial infection or sepsis. The incidence of hypertension was significantly lower in the non-depot ACTH group, and persistent hypercortisolaemia was not found. Non-depot ACTH(1-24) appears to be as effective as ACTH(1-24) depot therapy in the treatment of infantile spasms, and its side-effects are mild. It would appear that the effect of non-depot ACTH is not mediated by hypercortisolism, but by a direct neurotropic effect on the brain.

[Lead concentration in permanent teeth of the population of Erfurt and its surroundings]. / Bleikonzentration in permanenten Zähnen der Bevölkerung Erfurts und seiner Umgebung.

In this study 1616 permanent teeth were collected from 1466 stomatological patients, which are living in Erfurt and surroundings. The lead levels were investigated by flame-AAS. Comparisons were need with following parameters: sex, age, living area, vitality of teeth, smoking, caries and filling of teeth. Mean lead level from investigated teeth was 13.2 microgram Pb/g tooth by mean patients-age of 38 years. The results showed that there have not been significant differences between sex and investigated areas of Erfurt and surroundings. Low influence on lead levels in teeth were found in groups when were investigated following parameters: vitality, smoking, caries, filling of teeth. High influence on tooth lead level was connected with the age of patient that is time of exposition. We found as raising factor on 3% tooth lead level per year. It was also found that incisors pick up more lead than molars and premolars, and molars more than premolars. These differences would be depend of food and respiratory air. The general result of this investigations about the consequence of tooth lead levels by the inhabitants of Erfurt point out that there is no danger of chronic lead intoxication by adults.

[Endemic struma and its relation to various drinking water factors in 4 communities of the Suhl district]. / Untersuchungen über die endemische Struma und ihre Beziehung zu verschiedenen Trinkwasserfaktoren in 4 Gemeinden des Bezirkes Suhl.

By means of anamnestic and clinical examinations carried out on 1,055 test persons of all age groups in four adjacent communities of the County of Suhl an average frequency of struma of 53.9% was stated. The strumata of the size stage I with a diffuse condition and a preference of the younger age groups and the female sex prevailed. The prophylactic and medicamentous measures of the combat against struma introduced up to 1984 are to be estimated as ineffective. The distinctly greater formation of struma (64.6%) which is to be proved in one community might be caused by a correlating significantly higher nitrate content of the drinking water with existing considerable deficiency of iodine. No connection could be found between the frequency of struma and the calcium and magnesium content of the drinking water as well as the hardness of water and the consumption of potassium permanganate. Within the framework of a complex combat against goitre an improvement of the iodised common salt prophylaxis, measures for the decrease of the nitrate content in drinking water and soil as well as a more effective registration and treatment of the strumata are necessary.

[Accidents in children in relation to the accident site, age and sex]. / Der Kinderunfall in bezug auf Unfallort, Alter und Geschlecht.

An analysis was conducted of 1,064 child accident in-patients in the county of Suhl in 1983 and of 884 child accident out-patients in the district of Schmalkalden from July 14th, 1984 to July 13th 1985. The children were 1 to 15 years old. The analysis of the sites of the accidents was carried out with regard to age and sex. Conclusions about accident prevention were drawn from the analysis.

[Comments on stillbirth frequency in Suhl region, between 1970 and 1977 (author's transl)]. / Betrachtungen zur Totgeburtenhäufigkeit in den Jahren 1970 bis 1977 im Bezirk Suhl.

An analysis is presented in this paper of 525 stillbirths, related to 54,342 births, in the region of Suhl, between 1970 and 1977. The above number of stillbirths was subdivided by main groups of diagnosis and analysed by various parameters. Stillbirth rates were found to be somewhat increased with mothers aged 30 years and above, with the third child and more of one and the same mother, as well as with birth weights below 2,500 g. Stillbirths classified "avoidable" by competent district and regional commissions are critically appraised for their underlying causes. The following conclusions were drawn from the findings and established as demands: Intensification of general and specialised attention to pregnant women, early detection of retardation in embryonic development, high-accuracy control of labour and early detection of any risk to the "intra-uterine patient", early and properly indicated use of intrapartum surgery, and improvement in density of the network of obstetric control methods to include also smaller maternal centers as of 800 childbirths per annum.