Medical Bulletin Research Articles

Bahrain Medical Bulletin Announces the Establishment of Dr. Mohamed Al Khalifa Research Prizes

Bahrain Medical Bulletin Announces the Establishment of Dr. Mohamed Al Khalifa Research Prizes

The Journey of Publication Process of The Eurasian Journal of Medicine: From a Local University Journal Promoting to Emerging Sources Citation Indexed (ESCI).

Ataturk University, which was established in 1957, is one of the oldest universities of Turkey. Ataturk University School of Medicine was found in 1962, and began the education life in 1964 [1]. The official journal of Ataturk University School of Medicine started the publication life as ‘Medical Bulletin of Ataturk University’ in Turkish language in 1968. In 1995, the name of the journal was changed as ‘Medical Journal of Ataturk University’. In 2006, the current name of the journal was approved as ‘The Eurasian Journal of Medicine’, and its publication language is English since 2008 [2]. The Eurasian Journal of Medicine is indexed by PubMed Central since 2008, by ULAKBIM/Turkish Medical Index since 2009, by Turkiye Citation Index, ProQuest, DOAJ, CINAHL, Gale/Cengage, and EBSCO since 2010, by Index Copernicus since 2011, by Scopus since 2012, and finally by ESCI/Emerging Sources Citation Index beginning with 2015 [3]. The Eurasian Journal of Medicine is currently the official journal of Ataturk University School of Medicine, which is published three issues per year on February, June and October. The journal is aimed to be indexed by SCIE/Science Citation Index expanded in near future as a general medicine journal with increasing recognition and impact in a geographic location which is bridging many cultures [2]. As known, the publication of a journal needs a team work, in which editors, members of the editorial board, other employees of the journal, and reviewers play important roles. We, as the editors of The Eurasian Journal of Medicine, are grateful for their helps in our success story.

Outcome of a public consultation on the Draft Scientific Opinion of the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) on Dietary Reference Values for vitamin E as ɑ‐tocopherol

Outcome of a public consultation on the Draft Scientific Opinion of the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) on Dietary Reference Values for vitamin E as ɑ‐tocopherol

Children with Type 1 Diabetes

© 2015, Bahrain Medical Bulletin. All Rights Reserved.Background: The prevalence of diabetes in the Middle East is amongst the highest worldwide; Bahrain ranks amongst the top 10 countries. In particular, increasing number of children are being diagnosed with type 1 diabetes mellitus (T1DM) posing a significant public health concern. Objective: To evaluate the magnitude of type 1 diabetes in Bahrain. Design: A Case-Control Retrospective Study. Setting: Pediatric Diabetes and Endocrine Clinic and Local Health Centers (LHC). Method: Fifty-nine cases and 53 controls were included in the study. Data from the Diabetes Registry were recorded for subjects meeting the inclusion criteria and questionnaire was administered to healthy controls. Chi Square or Student’s t-test was used as appropriate. Logistic regression analysis was used to evaluate independent predictors of T1DM. Result: Fifty-nine children aged 6-12 years diagnosed with T1DM in the years 2009 and 2010 were compared to 53 healthy controls. Children with T1DM were more likely to have suffered from a pre-diabetes illness such as tonsillitis 32 (54.2%) compared to controls 3 (5.7%), and have undergone a surgery prior to diagnosis 14 (23.7%), and to have mothers with T2DM or family history of GDM. No significant difference in infant-feeding practices was observed between children with type 1 diabetes and the healthy controls. Conclusion: Children with T1DM were more likely to have suffered from other infectious illnesses before the diagnosis was established. Whilst unable to fully investigate any potential genetic differences between cases and controls, this study provides support for the theoretical role of infections as a trigger for T1DM.

A Case of Laptop Computer-Induced Erythema Ab Igne

Ad­dress­for­Cor­res­pon­den­ce/Ya­z›fl­ma­Ad­re­si:­Nurettin Ozgur Dogan Kocaeli University Faculty of Medicine, Department of Emergency Medicine, Kocaeli, Turkey Phone: +90 262 303 85 45 E-mail: nurettinozgurdogan@gmail.com Received/Gelifl­Tarihi:­16 January 2014 Ac­cep­ted/Ka­bul­Ta­ri­hi:­21 April 2014 The Medical Bulletin of Haseki Training and Research Hospital, published by Galenos Publishing.

In memoriam: John C. Norman (1930-2014).

In memoriam: John C. Norman (1930-2014).

To Click or Not to Click : Introducing Audience Response System during Undergraduate Teaching to Improve Academic Performance \\ Bahrain Medical Bulletin .- 2014 , Vol. 36 , No. 4 , pp. 232 - 234.

Objective: To determine if the use of audience response system (ARS) during large group teaching to undergraduate medical students promotes active learning, improves retention of information and leads to an improvement in academic performance. Design: A Prospective Interventional Study. Setting: RCSI Bahrain. Method: ARS was used during a 12-week teaching period in the first semester of the first year of the medical program from October 2012 to December 2012. Lecturers integrated Multiple Choice Questions (MCQs) into their PowerPoint presentations together with ARS during Anatomy and Physiology lectures. Students were asked to discuss and respond to the MCQs during the lectures. Result: Using ARS did not improve academic performance in Anatomy and Physiology, but students reported that using clickers during lectures provided a more interactive learning environment increasing student engagement, promoted active-learning and helped students identify gaps in knowledge. Conclusion: Using ARS in large group teaching had no impact on academic performance in the Anatomy and Physiology rich modules. However, students overwhelmingly enjoyed using clickers during lectures as they promoted active learning and helped them identify gaps in their knowledge. ___________________________________________________________________________ * Senior Lecturer in Physiology ** Senior Lecturer in Anatomy *** Professor of Anatomy **** Lecturer in Epidemiology and Public Health Medicine Royal College of Surgeons in Ireland-Medical University of Bahrain Kingdom of Bahrain Email: frdoubell@rcsi-mub.com

Books

New Aspects of Human Genetics. British Medical Bulletin, January 1969.Tile Eye in General Practice (5th. Edition) by C.R. S. Jackson. E. & S. Livingstone Ltd. 30/-.Recent Advances in Pharmacology (4th. Edition).Edited by Robson & Stacey. J. & A. Churchill,London.Body Fluids in Surgery (3rd. Edition) by J. Wilkinson. E. & S. Livingstone Ltd.The Logic of Medicine by D. A. K. Black. Oliver & Boyd Ltd. 7/6d.A Manual of English for Overseas Doctors by Joy E. Parkinson. E. & S. Livingstone Ltd.

PTU-192 Role of the 75Sehcat Scan in Evaluating Chronic Diarrhoea

Introduction75Se-HCAT nuclear medicine scanning is used to diagnose Bile Salt Malabsorption (BAM) in patients with chronic diarrhoea. Previous studies suggest that 30–60% of patients with previously unexplained chronic diarrhoea have...

Causes of death certification of adults: an exploratory cross-sectional study at a university hospital in Riyadh, Saudi Arabia

BACKGROUND AND AIMSSaudi Arabia has no precise data on causes of death. We sought to ascertain the commonest causes of death as stated in death certificates of adults and evaluate the completeness of death certificates at a teaching hospital in Riyadh.DESIGN AND SETTINGA cross-sectional study carried out at King Khalid University Hospital in Riyadh, Saudi Arabia, during the year 2008.METHODSAll death certificates that were issued in 2008 were reviewed and data were checked by two reviewers. Causes of death were coded according to specially-designed codes.RESULTSThe mean (SD) age of death was 63.9 (20.7) years. More than 80% arrived alive at the hospital. Among the 410 certificates, 62.2% had the first reported cause of death being classified as “inappropriate” and this tended to be slightly, but significantly more frequent among women. The first most common appropriately reported cause of death was malignancy of any type (7.3%) followed by ischemic heart diseases (4.9%). Accidents and fractures were more common in the younger age groups and among men.CONCLUSIONSThis is the first study that documents the possible gaps among healthcare professionals in Saudi Arabia in their understanding of death and its certification based on the clinical assessment of the deceased. The findings needs to be validated by similar studies from other health care sectors. It is clear, however, that proven educational, system-related and legal interventions to improve the accuracy of death certification are strongly needed if the health care priorities are to be properly identified.

Effects of cultural shock on foreign health care professionals: An analysis of key factors

This review is based upon the foreign health care professionals (FHCP) who go to various developed countries (United Kingdom, United States of America, Australia, Germany and France) from developing countries (India, Pakistan, Africa, Philippines etc) for work to have a better life style, good income, more opportunities, but experienced cultural shock with other types of problem. “Cultural shock” is the mixture of anxiety and feelings of confusion, excitement and insecurity and each person feels it differently. To explore this topic in depth, we divided the topic into separate themes to achieve maximum knowledge that followed by reflection, recommendations and conclusion. FHCP generally feel the unfamiliar environment when they visit to a completely different culture in a foreign country and feel certain problems (familial, professionals, technical etc.) along with cultural shock. Following these findings, we have identified three themes: The first theme will discuss about the cultural shock among FHCP and its impact. The second theme will be a focus on different issues of FHCP about their failure or struggle due to culture shock and third theme which is management challenges in order to establish appropriate culture in organization. For this review, we searched and selected various peer reviewed articles online using search engines and databases including Medline, Scopus, Cinahl and Cochrane and books from the University of Northampton library and peer reviewed journals including International Journal of Intercultural Relations, Human Resources for Health, British Medical Journal and Bulletin of The World Health Organization as well. This review will help to explore different aspects of FHCP such as adjustment with entirely different culture, lack of experience, different lifestyles, face problems being immigrants, and working in a completely different setup with certain rules and regulations.

Abstract C13: Human Eag1 potassium channel expression in lung cancer biopsies.

Abstract Introduction. Lung cancer is the most common malignancy in the world including Mexico [1, 2]. Smoking is the main risk factor for the development of different types of lung cancer, about 70–80% of lung cancer cases are associated with smoking and approximately 50% of new cancer cases are diagnosed in ex-smokers. Current therapies rarely cure the disease, and the high relapse rate with the delay in diagnosis results in a poor prognosis and overall survival rates of 10% [1]. Several ion channels are over-expressed in cancer including Kv1.3, K2p9.1, Kv10.1 (Eag1) and Kv11.1 (HERG) channels. These channels are expressed in different cell types and tumor tissues and have been shown to increase cell proliferation. Eag1 is expressed aberrantly with a high frequency (75%) in tumor cells of different histological origins including sarcomas, carcinomas of the breast, colon, and cervix. Eag1 inhibition by either astemizole, imipramine, or Eag1 specific monoclonal antibodies reduces tumor cell proliferation in vitro and in vivo [3, 4, 5]. Eag1 channels are over-expressed in lung cancer [6]. However, a detailed study of Eag1 expression in the different types of lung cancer is missing. Materials and Methods: Lung biopsies: 44 Lung biopsies were obtained from patients attending the Instituto Nacional de Enfermedades Respiratorias (National Institute for Respiratory Diseases) in Mexico City following local ethical considerations. Patients had no prior treatment (chemotherapy or radiotherapy). 37 biopsies were classified as lung cancer samples and included adenocarcinoma, epidermoid, small cell, adenosquamous and neuroendocrine tumors. 5 samples were diagnosed as inflammatory disease and 2 were form patients with thyroid carcinoma. RNA extraction was performed with TRIzol (Life Technologies, Invitrogene) according to the manufacturer's recommendation. cDNA was synthesized by reverse transcription under the manufacturer's recommendations (New England BioLabs). Eag1 gene expression was assessed by real-time PCR under the manufacturer's recommendations (Fermentas SYBR Green/ROX qPCR Master Mix). Eag1 expression in lung biopsies was compared to Eag1 basal expression in fibroblasts from normal lung (WI-38) which was given the value of 1. Results: Eag1 expression was found in 81% of the cancer biopsies while 8% of the samples did not showed changes and in 10% of the biopsies Eag1 was found to be under-expressed. Interestingly, Eag1 was over-expressed in 80% of the samples from chronic inflammation while no changes were observed in the samples from thyroid carcinoma. Conclusions: Our results suggest Eag1 as a tumor marker for different types of lung cancer and as a potential early marker of the disease.

Pregnancy and Thyroid Diseases in China

ThyroidVol. 21, No. 10 Editorials and CommentaryPregnancy and Thyroid Diseases in ChinaWeiping Teng and Zhongyan ShanWeiping TengSearch for more papers by this author and Zhongyan ShanSearch for more papers by this authorPublished Online:23 Sep 2011https://doi.org/10.1089/thy.2011.2110.ed4AboutSectionsView articleView Full TextPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetailsCited by2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum Erik K. Alexander, Elizabeth N. Pearce, Gregory A. Brent, Rosalind S. Brown, Herbert Chen, Chrysoula Dosiou, William A. Grobman, Peter Laurberg, John H. Lazarus, Susan J. Mandel, Robin P. Peeters, and Scott Sullivan1 March 2017 | Thyroid, Vol. 27, No. 3Thyroid function testing in women who had a stillbirth29 January 2016 | Clinical Endocrinology, Vol. 85, No. 2Thyroid screening in pregnancyAmerican Journal of Obstetrics and Gynecology, Vol. 211, No. 4Subclinical thyroid disease6 August 2013 | British Medical Bulletin, Vol. 107, No. 1Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association Jeffrey R. Garber, Rhoda H. Cobin, Hossein Gharib, James V. Hennessey, Irwin Klein, Jeffrey I. Mechanick, Rachel Pessah-Pollack, Peter A. Singer, and Kenneth A. Woeber for the American Association of Clinical Endocrinologists and American Thyroid Association Taskforce on Hypothyroidism in Adults4 December 2012 | Thyroid, Vol. 22, No. 12Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid AssociationEndocrine Practice, Vol. 18, No. 6Variable Iodine Intake Persists in the Context of Universal Salt Iodization in China18 July 2012 | The Journal of Nutrition, Vol. 142, No. 9 Volume 21Issue 10Oct 2011 InformationCopyright 2011, Mary Ann Liebert, Inc.To cite this article:Weiping Teng and Zhongyan Shan.Pregnancy and Thyroid Diseases in China.Thyroid.Oct 2011.1053-1055.http://doi.org/10.1089/thy.2011.2110.ed4Published in Volume: 21 Issue 10: September 23, 2011PDF download

Maligne Hauttumoren in beruflich verursachten Narben

The occurrence of neoplasms in injury scars--as consequence of occupational accidents--may lead to compensation according to the statutory accident insurance regulations. According to newer regulatory attempts in occupational dermatology, certain criteria have to be met before the diagnosis of a neoplasm induced by a scar is accepted and compensation is due. Based on a retrospective analysis of 217 dermatological claim files between 2007 and 2009 of the IPA (including 22 follow-ups), medical opinions on neoplasms developing in possible occupational scars were re-evaluated using criteria of the German social accident insurance and the Bamberg medical bulletin, part II (Bamberger Merkblatt, BM II) to see how well they qualified for recognition as an occupational or accident-related disorder. Three cases were identified where a neoplasm was suspected of having developed in an occupationally-related scar. One of the insured events entitled for compensation. Following the guidelines of the BM II, this case was approved as an occupational disease secondary to injuries with resultant reduction in earning capacity, whereas the others did not meet the requirements. Two problems in evaluating malignant tumors in occupational scars are the long latency period and the documentation of a scar. The tumor excision specimen should be histologically re-examined to document the presence of an associated scar.

Time, Perception and the Aging Mind: The National Alzheimer's Project Act 2011 Enacted–Is This the Beginning of a New Era in Health Care Research?

The Journal of Alternative and Complementary MedicineVol. 17, No. 1 EditorialTime, Perception and the Aging Mind: The National Alzheimer's Project Act 2011 Enacted–Is This the Beginning of a New Era in Health Care Research?Kim A. JobstKim A. JobstSearch for more papers by this authorPublished Online:25 Jan 2011https://doi.org/10.1089/acm.2011.0020AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Time, Perception and the Aging Mind: The National Alzheimer's Project Act 2011 Enacted–Is This the Beginning of a New Era in Health Care Research?." , 17(1), pp. 1–2FiguresReferencesRelatedDetailsCited byOn the Run for Hippocampal Plasticity11 May 2017 | Cold Spring Harbor Perspectives in Medicine, Vol. 8, No. 4The Value of Orientation in Time to Predict the Risks of Old Age1 January 2017 | Clinical Psychology and Special Education, Vol. 6, No. 1Content analysis of neurodegenerative and mental diseases social groups3 April 2014 | Health Informatics Journal, Vol. 21, No. 4Perception and cognition of time in elderly patients (review of foreign studies)1 January 2015 | Journal of Modern Foreign Psychology, Vol. 4, No. 2Effects of Tai Chi training on arterial compliance and muscle strength in female seniors: a randomized clinical trial4 January 2012 | European Journal of Preventive Cardiology, Vol. 20, No. 2A standardized kudzu extract (NPI-031) reduces alcohol consumption in nontreatment-seeking male heavy drinkers16 October 2012 | Psychopharmacology, Vol. 226, No. 1Integrating Mindfulness Training into K-12 Education: Fostering the Resilience of Teachers and Students14 March 2012 | Mindfulness, Vol. 3, No. 4Time Orientation During the Day in the Elderly with Dementia22 August 2012 | Physical & Occupational Therapy In Geriatrics, Vol. 30, No. 3Alternative detox31 January 2012 | British Medical Bulletin, Vol. 101, No. 1Homeopathy UK: The Sick Man of Europe?Forschende Komplementärmedizin / Research in Complementary Medicine, Vol. 19, No. 3 Volume 17Issue 1Jan 2011 InformationCopyright 2011, Mary Ann Liebert, Inc.To cite this article:Kim A. Jobst.Time, Perception and the Aging Mind: The National Alzheimer's Project Act 2011 Enacted–Is This the Beginning of a New Era in Health Care Research?.The Journal of Alternative and Complementary Medicine.Jan 2011.1-2.http://doi.org/10.1089/acm.2011.0020Published in Volume: 17 Issue 1: January 25, 2011PDF download

Public Access Defibrillation

Sudden cardiac arrest (SCA) is recognized as a serious public health problem, accounting for 250 000 to 300 000 deaths per year; it is now the third-leading cause of death behind cancer and nonsudden cardiovascular deaths.1,2 Immediate, well-performed cardiopulmonary resuscitation (CPR) and early defibrillation are the only out-of-hospital interventions that improve outcomes.3 The chain of survival relies on lay responders and emergency medical services (EMS) to initiate the potentially life-saving procedures of CPR and defibrillation. Articles see pp 510 and 518 In 1994, the American Heart Association (AHA) convened the first conference on public access defibrillation (PAD) to introduce the strategy of placing easy-to-use defibrillators in public places to decrease the death rate from SCA.4 Specific recommendations encouraged the stakeholders (the AHA, the US Food and Drug Administration, the National Institutes of Health, industry, and communities) to facilitate PAD by developing user-friendly, less-expensive automated external defibrillators (AEDs); testing the concept within large clinical trials; and organizing communities to promote and support effective PAD programs. Widespread CPR and AED training of the public was emphasized. In the ensuing 15 years, many of these recommendations have been heeded, and PAD programs are now commonplace. The National Institutes of Health–sponsored PAD trial demonstrated that survival doubled when events occurred in communities equipped and trained with CPR and AEDs compared with CPR alone.5 Within the Resuscitations Outcomes Consortium (ROC), out-of-hospital cardiac arrest victims had a markedly increased chance of survival if the first shock was delivered by a bystander using an AED rather than by EMS.6 PAD programs in airports, airlines, and casinos have also validated the effectiveness of the concept. Out-of hospital cardiac arrest is treatable, and outcomes can be improved with currently available approaches. Multiple locations have been recognized as having a higher incidence of cardiac arrest …

Hair Cell Regeneration

Hair Cell Regeneration

Identification of Adjacent Binding Sites for the YY1 and E4BP4 Transcription Factors in the Ovine PrP (Prion) Gene Promoter

The PrP gene encodes the cellular isoform of the prion protein (PrP(c)) which has been shown to be crucial to the development of transmissible spongiform encephalopathies (TSEs). PrP knock-out mice, which do not express endogenous PrP(c), exhibit resistance to TSE disease. The regulation of PrP gene expression represents, therefore, a crucial factor in the development of TSEs. Two sequence motifs in the PrP promoter (positions -287 to -263 from transcriptional start) were previously reported as being highly conserved, and it was suggested that they represent binding sites for as yet unidentified transcription factors. To test this hypothesis, binding of nuclear proteins was analyzed by electrophoretic mobility shift assays using ovine or murine cells and tissues with radiolabeled DNA probes containing the conserved motif sequences. Specific binding was observed to both motifs, and polymorphic variants of these motifs exhibited differential binding. Two proteins bound to these motifs were identified as the Yin Yang 1 (YY1) (motif 1) and E4BP4 (motif 2) transcription factors. Functional promoter analysis of four different promoter variants revealed that motif 1 (YY1) was associated with inhibitory activity in the context of the PrP promoter, whereas motif 2 (E4BP4) was linked to a slight enhancing activity. This represents the first demonstration of binding of nuclear factors to two highly conserved DNA sequence motifs within mammalian PrP promoters. The action of these factors on the PrP promoter is haplotype-specific, leading us to propose that the prion protein expression pattern and, with it, the distribution of TSE infectivity may be associated with PrP promoter genotype.

BOOKS

Acta Neurologica ScandinavicaVolume 63, Issue 3 p. 204-208 BOOKS First published: March 1981 https://doi.org/10.1111/j.1600-0404.1981.tb00773.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Books review in this article: Neurotransmitters, receptors and drug action. Ed. by W. Essman. Sz. Donhoffer: Homeothermia of the brain. British Medical Bulletin: Diagnostic imaging. Ed. by L. Kreel. N. H. Raskin & O. Appenzeller: Headache. The book is volume XIX in the series Major Problems in Internal Medicine, edited by Lloyd H. Schmith Current topics in extrapyramidal disorders. Ed. by A. Carlsson, K. Jellinger & P. Riederer. Epilepsie 1979. Ed. by H. Doose, M. Dam, G. Gross-Selbeck & H. Meinardi. Addiction and brain damage. Ed. by D. Richter. The year book of neurology and neurosurgery. Ed. by R. N. DeJong & O. Sugar. B. Pansky & D. J. Allen: Review of neuroscience. J. A. Aarli & O. Tönder: Immunological aspects of neurological diseases. Spinocerebellar degenerations. Ed. by I. Sobue. M. J. Eadie & J. H. Tyrer: Neurological clinical pharmacology. The treatment of epilepsy. Ed. by J. H. Tyrer. Neurological mutations affecting myelination. Ed. by N. Baumann. Volume63, Issue3March 1981Pages 204-208 RelatedInformation

Begutachtung von Berufskrankheiten der Haut: Eine Münchner Stellungnahme zum Bamberger Merkblatt

The Bamberg medical bulletin (Bamberger Merkblatt) is intended to assure as an anticipated expert opinion an objective as possible assessment of the sequels of an occupational disease. However, the Bamberg medical bulletin is not suitable for this task in form and content. In case of an allergic contact dermatitis recognized under No. 51 01 in appendix 1 of the German ordinance on occupational diseases the disadvantage for the insured person consists mainly in the live-long existing change of the immune system and not as much in the intensity of the skin condition triggered by a new exposure to the allergen. The prerequisite for compensation imposed by the regulator, i.e. that the skin condition must be so severe as to have forced the affected individual to refrain from all activities which led or could lead to the development, aggravation or recurrence of the condition, is in its function as a typing sign widely unnecessary in the case of an allergic occupational dermatosis. The omission of all activities which led or could lead to the development, aggravation or recurrence of the condition imposed on the affected individual by the regulator has to be taken in account for the calculation of the reduction in earning capacity in the Bamberg medical bulletin. The Bamberg medical bulletin is by no means an anticipated expert opinion. Even as a qualified experience it urgently needs a revision which might be done with, but not governed by, the statutory occupational accident insurance. Our critical scientific comments do not absolve the medical evaluator from the responsibility to consider existing recommendations as the Bamberg medical bulletin. Our aim is to initiate a process leading to an appropriate judgement of the sequels of an occupational skin disease in each individual case.