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Tailor V, Brady LM, Miller J, Bays L, Zane J, Nagel G, Baker H, Crosby-Nwaobi R, Dahlmann-Noor A. 18 Engaging with young people to improve research, services and workforce development: eye-YPAG and 'visually' workshops. BMJ Open Ophthalmol 2023; 8:A6-A7. [PMID: 37797991 DOI: 10.1136/bmjophth-2023-biposa.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Involving children and young people (CYP) in service and research design improves quality and accessibility. Running events in schools to invite CYP to volunteer and explore careers in the NHS may contribute to uptake of training posts and developing the NHS workforce.Here we evaluate two activities with CYP, our Young Person's Advisory Group for research (eye-YPAG) and our workshop for secondary schools, 'visually'.We evaluated eye-YPAG in focus groups and online surveys with group members, parents/carers, researchers, facilitators and funders. We conducted thematic analysis and descriptive statistics. To evaluate 'visually', we monitored the numbers of workshops and young people applying for volunteering roles. We asked those who started working with us about their experience.eye-YPAG members valued social and creative aspects as well as learning about research and developing skills and confidence. Researchers reported that CYP gave novel suggestions, modifying research plans, and that their different perspective was helpful in making research more relevant for children and families.Over 6 months, we held 15 'visually' workshops in secondary schools. Ninety students applied for volunteering roles, and 20 have completed the Human Resources onboarding process. Young volunteers report that this work has increased their confidence and that they have gained insights into how a hospital works. One is considering training to become an orthoptist.Both eye-YPAG and 'visually' are available to all eye researchers and units in the UK and can facilitate outreach activities.
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Affiliation(s)
- V Tailor
- Moorfields Eye Hospital NHS foundation Trust, London, UK
| | - L M Brady
- Moorfields Eye Hospital NHS foundation Trust, London, UK
| | - J Miller
- Moorfields Eye Hospital NHS foundation Trust, London, UK
| | - L Bays
- Moorfields Eye Hospital NHS foundation Trust, London, UK
| | - J Zane
- Moorfields Eye Hospital NHS foundation Trust, London, UK
| | - G Nagel
- Moorfields Eye Hospital NHS foundation Trust, London, UK
| | - H Baker
- Moorfields Eye Hospital NHS foundation Trust, London, UK
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Leiherer A, Ulmer H, Muendlein A, Saely CH, Fraunberger P, Mader A, Sprenger L, Maechler M, Vonbank A, Larcher B, Brozek W, Nagel G, Zitt E, Concin H, Drexel H. Value of blood pressure measurement earlier versus later in life to predict cardiovascular mortality. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Hypertension is a potent risk factor for cardiovascular morbidity and mortality. High blood pressure (BP) correlates closely with all-cause and cardiovascular mortality.
The purpose of this study was to compare the value of systolic blood pressure earlier versus later in life to predict cardiovascular mortality.
In a cardiovascular observation study (OS) we prospectively recorded fatal cardiovascular events over up to 19 years in 1282 patients of whom 570 had the Metabolic Syndrome (MetS) at baseline. These patients had participated in a health survey (HS) 15 years prior to the OS baseline. BP was measured both at the HS and at the baseline of the OS.
We found that the increase in cardiovascular mortality matched the increase of BP in the HS in a linear way but this is not the case for BP assessed at the OS (figure). A cox regression analysis revealed that each millimeter of mercury (mm Hg) increased the risk for cardiovascular death by 2% (HR = 1.02 [1.01–1.03], p<0.001). Applying a stratification for the presence of MetS, we found that in both groups BP was a significant predictor of cardiovascular mortality (HRMetS = 1.02 [1.01–1.02], p<0.001 and HRnoMetS = 1.02 [1.01–1.03], p<0.001). In contrast, BP as measured at the baseline of the OS was not significantly associated with cardiovascular death during follow-up neither in the total population nor in any subgroup (HR = 1.00 [0.99–1.01], p=0.652; HRMetS = 1.00 [0.99–1.01], p=0.468 and HRnoMetS = 1.00 [0.99–1.01], p=4.66).
We thus conclude that BP assessed earlier in life is a better predictor of cardiovascular mortality than BP assessed later in life.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Leiherer
- Vorarlberg Institute for Vascular Investigation & Treatment , Feldkirch , Austria
| | - H Ulmer
- Agency of Preventive and Social Medicine , Bregenz , Austria
| | - A Muendlein
- Vorarlberg Institute for Vascular Investigation & Treatment , Feldkirch , Austria
| | - C H Saely
- Private University of the Principality of Liechtenstein , Triesen , Liechtenstein
| | | | - A Mader
- Academic Teaching Hospital Feldkirch , Feldkirch , Austria
| | - L Sprenger
- Academic Teaching Hospital Feldkirch , Feldkirch , Austria
| | - M Maechler
- Academic Teaching Hospital Feldkirch , Feldkirch , Austria
| | - A Vonbank
- Academic Teaching Hospital Feldkirch , Feldkirch , Austria
| | - B Larcher
- Academic Teaching Hospital Feldkirch , Feldkirch , Austria
| | - W Brozek
- Agency of Preventive and Social Medicine , Bregenz , Austria
| | - G Nagel
- Agency of Preventive and Social Medicine , Bregenz , Austria
| | - E Zitt
- Agency of Preventive and Social Medicine , Bregenz , Austria
| | - H Concin
- Agency of Preventive and Social Medicine , Bregenz , Austria
| | - H Drexel
- County Hospital Bregenz , Bregenz , Austria
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Brozek W, Ulmer H, Pompella A, Nagel G, Leiherer A, Preyer O, Concin H, Zitt E. Gamma-glutamyl-transferase is associated with incident hip fractures in women and men ≥ 50 years: a large population-based cohort study. Osteoporos Int 2022; 33:1295-1307. [PMID: 35059776 DOI: 10.1007/s00198-022-06307-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 01/08/2022] [Indexed: 12/30/2022]
Abstract
UNLABELLED The association of serum gamma-glutamyl-transferase (GGT) with hip fracture risk has not been examined in women and men ≥ 50 years. We show that elevated GGT was associated with increased hip fracture risk, particularly in men. GGT could be a candidate serum marker of long-term hip fracture risk in the elderly. INTRODUCTION We herein examined a possible relation between serum levels of GGT and hip fracture risk in women and men aged ≥ 50 years, which has not been investigated before. METHODS In this population-based prospective cohort study, approximately 41,000 women and nearly 33,000 men ≥ 50 years participating in a medical prevention program 1985-2005 in western Austria were followed up for the occurrence of osteoporotic hip fractures during 2003-2013. ICD-10 based discharge diagnoses for hip fracture included S72.0, S72.1, and S72.2 available from all regional hospitals. GGT-related hip fracture risk was ascertained at each participant´s first and last examination during the prevention program. In a subset of 5445 participants, alcohol consumption could be included as a covariate. RESULTS In men, hip fracture risk rose significantly by 75% and 86% for every tenfold increase of GGT measured at the first and last examination, respectively, and in women, hip fracture risk rose by 22% from the last examination. Elevated GGT (≥ 36 U/l in women, ≥ 56 U/l in men) at the first examination was associated with increased hip fracture risk only in men (HR 1.51, 95% CI 1.25-1.82), and at the last examination in both women (HR 1.14, 95% CI 1.02-1.28) and men (HR 1.61, 95% CI 1.33-1.95). Alcohol consumption had no significant influence on GGT-mediated hip fracture risk in women and men. CONCLUSIONS Our findings identified an association of elevated GGT and hip fracture in women and men ≥ 50 years and suggest GGT as a candidate serum marker of long-term hip fracture risk in an elderly population.
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Affiliation(s)
- W Brozek
- Agency for Preventive and Social Medicine, Bregenz, Austria.
| | - H Ulmer
- Agency for Preventive and Social Medicine, Bregenz, Austria
- Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria
| | - A Pompella
- Department of Translational Research and New Technologies in Medicine and Surgery, Università Di Pisa, Pisa, Italy
| | - G Nagel
- Agency for Preventive and Social Medicine, Bregenz, Austria
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - A Leiherer
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
- Medical Central Laboratories, Feldkirch, Austria
| | - O Preyer
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - H Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - E Zitt
- Agency for Preventive and Social Medicine, Bregenz, Austria
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Department of Internal Medicine 3 (Nephrology and Dialysis), Feldkirch Academic Teaching Hospital, Feldkirch, Austria
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Klimek M, Peter RS, Denkinger M, Dallmeier D, Rapp K, Rothenbacher D, Klenk J, Böhm B, Geiger H, Lukas A, Stingl J, Riepe M, Rapp K, Scharffetter-Kochanek K, Koenig W, Steinacker JM, Ludolph A, Nagel G, Peter R. The relationship of weather with daily physical activity and the time spent out of home in older adults from Germany – the ActiFE study. Eur Rev Aging Phys Act 2022; 19:6. [PMID: 35151273 PMCID: PMC8903592 DOI: 10.1186/s11556-022-00286-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/03/2022] [Indexed: 11/18/2022] Open
Abstract
Background There is a need for a comprehensive evaluation of the associations between varieties of weather conditions on the time spent out-of-home (TOH) and on walking duration (WD) among older adults. We aim to investigate the extent to which various weather parameters (temperature, solar radiation, sunshine duration, humidity, windspeed, and rain) determine daily WD the TOH in older adults. Methods The ActiFE (Activity and Function in Older People in Ulm) study is a prospective study of participants aged 65 years or older who wore an accelerometer and kept a movement diary in up to three temporally separated waves from 2009 to 2018 for a duration up to seven days per wave (up to three weeks in summary). We used weather data from a weather station near the participants‘ homes. Age-adjusted and gender-stratified generalized mixed models were used to predict WD and TOH (with 95% confidence interval (CI)) within and between weather categories. Generalized additive models were computed for the single predictions at the weather quartile boundaries. Cubic splines (with 95% pointwise confidence bands (CB)) visualized the continuous course of the weather values. Results Higher temperatures, solar radiation and more hours of sunshine, led to an increase in WD and TOH, while higher precipitation, humidities and windspeeds led to a decrease. Women had in general higher WD and TOH times than men. Conclusions Our data suggest that weather parameters have a considerable influence on PA and TOH. Future analyses and interpretation of PA data should therefore account for weather parameters. Supplementary Information The online version contains supplementary material available at 10.1186/s11556-022-00286-0.
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Kanisch G, Nagel G, Krüger A, Kellermann HJ. Radiological implications from the temporal development of radioactivity in marine food from the North Sea / Bedeutung der Entwicklung der Radioaktivität ın Meerestieren der Nordsee für die Strahlenexposition. KERNTECHNIK 2021. [DOI: 10.1515/kern-2000-650418] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Schumacher J, Peter RS, Nagel G, Rothenbacher D, Rosenbohm A, Ludolph AC, Dorst J. Statins, diabetes mellitus and prognosis of amyotrophic lateral sclerosis: data from 501 patients of a population-based registry in southwest Germany. Eur J Neurol 2020; 27:1405-1414. [PMID: 32396653 DOI: 10.1111/ene.14300] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/30/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE A wide variety of metabolic changes, including an increased incidence of diabetes mellitus (DM) and dyslipidaemia, has been described in amyotrophic lateral sclerosis (ALS). The aim of this study was to investigate the associations of statin use and history of DM with onset of disease and survival in patients with ALS. METHODS In all, 501 patients (mean age 65.2 ± 10.9 years; 58.5% male) from the ALS Registry Swabia recruited between October 2010 and April 2016 were included in this prospective cohort study. Data were collected using a standardized questionnaire. RESULTS Statin use (n = 65) was not associated with overall survival (P = 0.62). Age of ALS onset in patients with DM was 4.2 years later (95% confidence interval 1.3-7.2 years) than in patients without DM (P < 0.01). The overall survival of patients with high body mass index at study entry (>27.0 kg/m2 , upper quartile, n = 127) was prolonged by more than 5 months compared to patients with low body mass index (<22.0 kg/m2 , lower quartile, n = 123; P = 0.04). CONCLUSIONS This study supports the view that statin use is not associated with overall survival of ALS patients, suggesting that statins are not harmful and should not be discontinued in ALS. Furthermore, the delayed onset of ALS in patients with DM may mirror the potentially protective metabolic profile associated with type 2 DM. Consistently, this study provides further evidence that high body mass index is a positive prognostic factor in ALS.
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Affiliation(s)
- J Schumacher
- Department of Neurology, University of Ulm, Ulm, Germany
| | - R S Peter
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
| | - G Nagel
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
| | - D Rothenbacher
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
| | - A Rosenbohm
- Department of Neurology, University of Ulm, Ulm, Germany
| | - A C Ludolph
- Department of Neurology, University of Ulm, Ulm, Germany
| | - J Dorst
- Department of Neurology, University of Ulm, Ulm, Germany
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Nagel G, Peter RS, Föger B, Concin H. Body mass index and mortality in relation to age and follow-up of 30 years in large Austrian cohorts. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Obesity and its health consequences will dominate health care systems in many countries during the next decades. Prevention programs have been implemented. However, the optimum body mass index (BMI) in relation to all-cause mortality on population level is still a matter of debate.
Material and Method
Data 1/1989-6/2005 of the Vorarlberg Health Monitoring & Prevention Program (VHM&PP,) and 8/2005-12/2015 for Vorarlberg provided by the Main Association of Austrian Social Security Institutions were analyzed. In both cohorts, information was available on age, sex, measured height and weight as well as the date and cause of death. Generalized additive models were used to model the mortality rate as function of calendar time, age and follow-up.
Results
The VHM&PP cohort consisted of 85,488 men and 99,873 women and the later of 129,817 men and 152,399 women. In the second cohort, men (mean age 48 (SD16.9) vs. 45.3 (SD 15.5) and women (48.3 (SD 17.7) vs. 45.6 (SD 16.6) years) were slightly older than in the VHM&PP cohort. The average BMI was slightly higher in men (26.1 (SD4.0) vs. 25.7 (SD3.8) kg/m2) but not in women (24.6 (SD 4.8) vs. 24.7 (SD 4.9) kg/m2), respectively. In the VHM&PP cohort more ever smokers were found in both men (40.3 vs. 22.4%) and women (24.8 vs. 18.4%) than in the subsequent cohort.
BMI optimum increased slightly between 1985 and 2015, from 24.9 (95%-CI: 24.0-25.9) to 26.4 (25.3-27.3) in men and from 22.4 (21.8-23.1) to 23.3 (22.5-24.5) kg/m2 in women. However, age and follow-up had major impact on the increase. In younger age the associations are quite stable, while in men over 50 years and in women over 60 years the BMI optimum decreased with length of follow-up.
Conclusions
Overall the BMI optimum increased slightly over time. However, age and follow-up had major impact on the association. These results suggest, that prognosis of obesity related diseases has improved over time. To detangle this further research is necessary.
Key messages
In Austria the BMI optimum increased slightly over time. Age and follow-up time had major impact on the association.
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Affiliation(s)
- G Nagel
- Ulm University, Ulm, Germany
- Agency for Preventive and Social Medicine (aks), Bregenz, Austria
| | | | - B Föger
- Agency for Preventive and Social Medicine (aks), Bregenz, Austria
| | - H Concin
- Agency for Preventive and Social Medicine (aks), Bregenz, Austria
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8
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Klenk J, Peter RS, Rapp K, Dallmeier D, Rothenbacher D, Denkinger M, Büchele G, Becker T, Böhm B, Scharffetter-Kochanek K, Stingl J, Koenig W, Riepe M, Peter R, Geiger H, Ludolph A, von Arnim C, Nagel G, Weinmayr G, Steinacker JM, Laszlo R. Lazy Sundays: role of day of the week and reactivity on objectively measured physical activity in older people. Eur Rev Aging Phys Act 2019; 16:18. [PMID: 31673299 PMCID: PMC6815398 DOI: 10.1186/s11556-019-0226-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 10/09/2019] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this study was to assess the effect of day of the week and wearing a device (reactivity) on objectively measured physical activity (PA) in older people. Methods Walking duration as a measure for PA was recorded from 1333 German community-dwelling older people (≥65 years, 43.8% women) over 5 days using accelerometers (activPAL). Least-square means of PA with 95%-confidence intervals (95%-CI) from multi-level analysis were calculated for each day of the week and each measurement day (days after sensor attachment). Results Walking duration on Sundays was significantly lower compared to working days (Sunday vs. Monday-Friday: − 12.8 min (95%-CI: − 14.7; − 10.9)). No statistically significant difference compared to working days was present for Saturdays. The linear slope for measurement day and walking duration was marginal and not statistically significant. Conclusions Studies using PA sensors in older people should assess Sundays and working days to adequately determine the activity level of the participants.
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Affiliation(s)
- Jochen Klenk
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany
| | - Raphael Simon Peter
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany
| | - Kilian Rapp
- 2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany
| | | | - Dietrich Rothenbacher
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany
| | | | - Gisela Büchele
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany
| | | | - T Becker
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany.,Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany
| | - B Böhm
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany.,Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany
| | - K Scharffetter-Kochanek
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany.,Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany
| | - J Stingl
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany.,Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany
| | - W Koenig
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany.,Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany
| | - M Riepe
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany.,Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany
| | - R Peter
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany.,Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany
| | - H Geiger
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany.,Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany
| | - A Ludolph
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany.,Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany
| | - C von Arnim
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany.,Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany
| | - G Nagel
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany.,Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany
| | - G Weinmayr
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany.,Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany
| | - J M Steinacker
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany.,Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany
| | - R Laszlo
- 1Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr 22, 89081 Ulm, Germany.,2Department of Clinical Gerontology, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.,IB University of Applied Sciences Berlin, Study Center Stuttgart, Paulinenstraße 45, 70178 Stuttgart, Germany.,Bethesda Geriatric Clinic, Zollernring 26, 89073 Ulm, Germany
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Andexlinger S, Fritz J, Edlinger M, Concin H, Nagel G, Brozek W, Ruttmann E, Foeger B, Ulmer H. P3402Validation of the SCORE O.P. for prediction of cardiovascular disease mortality in a large population of elderly individuals. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Estimation of absolute cardiovascular risk in apparently healthy individuals, using SCORE (Systematic COronary Risk Evaluation) is recommended by the ESC guidelines on cardiovascular disease (CVD) prevention in clinical practice. Recently, the SCORE system has been extended by the SCORE O.P. aiming to improve estimates of cardiovascular risk specifically in older persons (65 years and older).
Purpose
The aim of this study was to validate the SCORE O.P. in an Austrian population of 34,909 healthy individuals aged between 65 and 80 years which were prospectively followed for a minimum of 10 years.
Methods
Predicted fatal CVD and coronary heart disease (CHD) event rates within 10 years were calculated using the “SCORE O.P. risk function for low risk regions” and compared to the actually observed rates, thereby assessing calibration. In addition, predicted probabilities were plotted against observed mortality by deciles of predicted risk. Regarding discrimination, receiver operating characteristics (ROC) analysis and corresponding c-statistics were used.
Results
In 14,586 males, 1,509 deaths from CVD (10.4%) and 847 deaths from CHD (5.8%) occurred within 10 years of follow-up. SCORE O.P. predicted 1,699 fatal CVD (11.7%) and 872 CHD (6.0%) events. In male high risk individuals (10th decile), SCORE O.P. overestimated mortality from CVD and CHD. C-statistics were 0.68 (95% CI 0.67–0.70) for CVD and 0.67 (0.65–0.69) for CHD.
In 20,323 females, 1,340 deaths from CVD (6.6%) and 672 deaths from CHD (3.3%) were observed. SCORE O.P. predicted 1,232 fatal CVD (6.1%) and 539 CHD events (2.7%). In female high risk individuals (8–10th deciles), SCORE O.P. underestimated mortality from CVD and CHD. C-statistics were 0.77 (0.75–0.78) for CVD and 0.77 (0.75–0.79) for CHD.
Conclusion
With regard to overall accuracy, the SCORE O.P. performed considerably well in this elderly Austrian population. However, in high-risk individuals, cardiovascular risk was overestimated for males and underestimated for females. SCORE O.P. was able to discriminate high-risk from low-risk individuals, better in women than in men.
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Affiliation(s)
- S Andexlinger
- Innsbruck Medical University, Medical Statistics, Informatics and Health Economics, Innsbruck, Austria
| | - J Fritz
- Innsbruck Medical University, Medical Statistics, Informatics and Health Economics, Innsbruck, Austria
| | - M Edlinger
- Innsbruck Medical University, Medical Statistics, Informatics and Health Economics, Innsbruck, Austria
| | - H Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - G Nagel
- University of Ulm, Institute of Epidemiology and Medical Biometry, Ulm, Germany
| | - W Brozek
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - E Ruttmann
- Innsbruck Medical University, Department of Cardiac Surgery, Innsbruck, Austria
| | - B Foeger
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - H Ulmer
- Innsbruck Medical University, Medical Statistics, Informatics and Health Economics, Innsbruck, Austria
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de Gregorio A, Nagel G, Rothenbacher D, Möller P, Rempen A, Schlicht E, Fritz S, Flock F, Felberbaum R, Friedl TWP, Thiel F, Kühn T, Kuhn P, Tzschaschel M, Janni W, Wiesmüller L, Huober J. Das BRandO Biology and Outcome (BiO)-Projekt – eine Registerstudie zum biologischen Erkrankungsprofil und klinischen Verlauf bei Mamma- und Ovarialkarzinomen (BReast and Ovarian Cancer). Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1693896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- A de Gregorio
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - G Nagel
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm
| | - D Rothenbacher
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm
| | - P Möller
- Institut für Pathologie, Universitätsklinik Ulm
| | - A Rempen
- Klinik für Frauenheilkunde und Geburtshilfe, Diakonieklinikum, Schwäbisch-Hall
| | - E Schlicht
- Klinik für Frauenheilkunde und Geburtshilfe, Kliniken Ostalb, Mutlangen
| | - S Fritz
- Klinik für Frauenheilkunde und Geburtshilfe, Sanaklinikum Biberach
| | - F Flock
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Memmingen
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten
| | - TWP Friedl
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - F Thiel
- Klinik für Frauenheilkunde und Geburtshilfe, Alb-Fils Klinik Göppingen
| | - T Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen
| | - P Kuhn
- Comprehensive Cancer Center Ulm, Universitätsklinik Ulm
| | - M Tzschaschel
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - W Janni
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - L Wiesmüller
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - J Huober
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
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11
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Leiherer A, Muendlein A, Saely C, Larcher B, Mader A, Fraunberger P, Ulmer H, Nagel G, Drexel H, Concin H. Early Assessed Total Cholesterol Significantly Improves The Prediction Of Cardiovascular Risk In Later Life. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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12
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Huober J, Nagel G, Rempen A, Schlicht E, Flock F, Fritz S, Thiel F, Wiesmüller L, Felderbaum R, Heilmann V, Bekes I, Fink V, Albrecht S, De Gregorio N, Tzschaschel M, Ernst K, Wolf C, Kuhn P, Friedl T, Janni W, De Gregorio A. Abstract OT1-11-01: The BRandO BiO registry – A multicenter regional registry for patients with primary breast and ovarian cancer with longitudinal biobanking and evaluation of epidemiological, life style and quality of life factors. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot1-11-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Further progress in the treatment of breast cancer will likely come from contributions of molecular biology and immunologic approaches. The search for druggable molecular aberrations may enable treatment based on the molecular profile. A better identification of patients with a high risk of relapse facilitates the selection of these pts for clinical trials investigating early therapeutic molecular-based interventions.
Trial Design:
The BRandO BiO Registry is a multi-center regional registry to record clinical, epidemiological, and biological data from patients with newly diagnosed breast and ovarian cancer at the University of Ulm, Dept. of Gynecology and 19 affiliated network hospitals and practices in the Alb-Allgäu Bodensee region (outreach area of the Comprehensive Cancer Center Ulm). Longitudinal biobanking is included with collection of paraffin-embedded samples of the primary tumor as well as blood samples at first diagnosis, after 6 and 12 months and at first relapse to isolate and investigate cell-free and germline DNA. Epidemiological, life style and quality of life (QOL) questionnaires are collected at first diagnosis, after 12, 36 and 60 months. The follow up is planned for 10 years.
Eligibility criteria:
Patients with primary newly diagnosed untreated breast or ovarian cancer of ≥ 18 years are eligible; primary metastatic untreated disease is allowed. Exclusion criteria comprise severe neurological or psychiatric disorders interfering with the ability to give an informed consent, no consent for registration, storage and processing of the individual disease characteristics and bio samples, and any malignant tumor in the last 3 years (except in situ disease).
Specific aims:
To register the majority of patients with newly diagnosed breast or ovarian cancer in all BRandO-BiO participating centers of a well-defined geographical area. To assess clinical characteristics and outcome data (event-free survival, overall survival) of these patients. To evaluate the primary tumor of all patients for mutational (druggable) aberrations. Further to assess cell-free DNA in the serial blood samples at baseline, 6 and 12 months and correlate these results with clinical outcome data as well as tumor and patient characteristics to look for early markers predicting relapse. To perform a longitudinal assessment of the patients' sociodemographic factors, comorbidities, lifestyle and QOL factors by analyzing serial questionnaires collected at recruitment and at 12, 36 and 60 months.
Present accrual and target accrual:
The BRandO BiO Registry started January 2016 in the Dept. of Gynecology, University of Ulm and February 2017 at the network hospitals and practices. Until June 2018, 1180 patients with primary breast or ovarian cancer have been enrolled. The current adherence to serial blood testing and serial questionnaires is good with a return rate of 90%. A sample size of 3000 patients is planned.
Contact information:
Jens Huober, University of Ulm, Dept of Gynecology, Breast Center, jens.huober@uniklinik-ulm.de
Amelie de Gregorio, University of Ulm, Dept of Gynecology, Breast Center, Amelie.de Gregorio@uniklinik-ulm.de
Citation Format: Huober J, Nagel G, Rempen A, Schlicht E, Flock F, Fritz S, Thiel F, Wiesmüller L, Felderbaum R, Heilmann V, Bekes I, Fink V, Albrecht S, De Gregorio N, Tzschaschel M, Ernst K, Wolf C, Kuhn P, Friedl T, Janni W, De Gregorio A. The BRandO BiO registry – A multicenter regional registry for patients with primary breast and ovarian cancer with longitudinal biobanking and evaluation of epidemiological, life style and quality of life factors [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT1-11-01.
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Affiliation(s)
- J Huober
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - G Nagel
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - A Rempen
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - E Schlicht
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - F Flock
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - S Fritz
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - F Thiel
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - L Wiesmüller
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - R Felderbaum
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - V Heilmann
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - I Bekes
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - V Fink
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - S Albrecht
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - N De Gregorio
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - M Tzschaschel
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - K Ernst
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - C Wolf
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - P Kuhn
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - T Friedl
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - W Janni
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - A De Gregorio
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
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de Gregorio A, Nagel G, Rothenbacher D, Möller P, Rempen A, Schlicht E, Fritz S, Flock F, Felberbaum R, Friedl TWP, Kuhn P, Tzschaschel M, Janni W, Wiesmüller L, Huober J. Das BRandO Biology and Outcome (BiO)-Projekt – eine Registerstudie zum biologischen Erkrankungsprofil und klinischen Verlauf bei Mamma- und Ovarialkarzinomen (BReast and Ovarian Cancer). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
| | - G Nagel
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
| | - D Rothenbacher
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
| | - P Möller
- Institut für Pathologie, Universitätsklinik Ulm, Ulm, Deutschland
| | - A Rempen
- Klinik für Frauenheilkunde und Geburtshilfe, Diakonieklinikum, Schwäbisch-Hall, Schwäbisch-Hall, Deutschland
| | - E Schlicht
- Klinik für Frauenheilkunde und Geburtshilfe, Kliniken Ostalb, Mutlangen, Deutschland
| | - S Fritz
- Klinik für Frauenheilkunde und Geburtshilfe, Sanaklinikum, Biberach, Deutschland
| | - F Flock
- Klinik für Frauenheilkunde und Geburtshilfe Memmingen, Memmingen, Deutschland
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Kempten, Deutschland
| | - TWP Friedl
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - P Kuhn
- Comprehensive Cancer Center Ulm, Universitätsklinik Ulm, Ulm, Deutschland
| | | | - W Janni
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | | | - J Huober
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
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de Gregorio A, Rempen A, Schlicht E, Fritz S, Flock F, Kühn T, Thiel F, Felberbaum R, Kuhn P, Rothenbacher D, Albrecht S, Ernst K, Schochter F, Tzschaschel M, Friedl TWP, Möller P, Janni W, Huober J, Nagel G. Erste epidemiologische Daten zum Patientenkollektiv des BRandO Biology and Outcome (BiO)-Projekts (BReast and Ovarian Cancer). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
| | - A Rempen
- Klinik für Frauenheilkunde und Geburtshilfe, Diakonieklinikum, Schwäbisch-Hall, Schwäbisch-Hall, Deutschland
| | - E Schlicht
- Klinik für Frauenheilkunde und Geburtshilfe, Kliniken Ostalb, Mutlangen, Deutschland
| | - S Fritz
- Klinik für Frauenheilkunde und Geburtshilfe, Sanaklinikum, Biberach, Deutschland
| | - F Flock
- Klinik für Frauenheilkunde und Geburtshilfe Memmingen, Memmingen, Deutschland
| | - T Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen, Esslingen, Deutschland
| | - F Thiel
- Klinik am Eichert, Frauenklinik, Göppingen, Göppingen, Deutschland
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Kempten, Deutschland
| | - P Kuhn
- Comprehensive Cancer Center Ulm, Universitätsklinik Ulm, Ulm, Deutschland
| | - D Rothenbacher
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
| | - S Albrecht
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - K Ernst
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - F Schochter
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | | | - TWP Friedl
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - P Möller
- Institut für Pathologie, Universitätsklinik Ulm, Ulm, Deutschland
| | - W Janni
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - J Huober
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - G Nagel
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
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Wolters M, Volkert D, Streicher M, Kiesswetter E, Torbahn G, O'Connor E, O'Keeffe M, O'Herlihy E, O'Toole P, Timmons S, O'Shea E, Kearney P, van Zwienen-Pot J, Visser M, Maitre I, van Wymelbeke V, Sulmont-Rossé C, Nagel G, Flechtner-Mors M, Teh R, Hebestreit A. Prevalence rates of malnutrition using harmonized definitions in older adults from different settings in Europe and New Zealand – a manuel study. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gorges M, Vercruysse P, Müller H, Huppertz H, Rosenbohm A, Nagel G, Petersen A, Ludolph A, Dupuis L, Kassubek J. P 5 Volumetric analysis of the hypothalamus in a large cohort of patient with amyotrophic lateral sclerosis. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.06.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Nagel G, Peter RS, Klotz E, Brozek W, Concin H. Bone mineral density and breast cancer risk: Results from the Vorarlberg Health Monitoring & Prevention Program and meta-analysis. Bone Rep 2017; 7:83-89. [PMID: 29018837 PMCID: PMC5626919 DOI: 10.1016/j.bonr.2017.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 09/13/2017] [Accepted: 09/20/2017] [Indexed: 01/25/2023] Open
Abstract
We investigated the association between bone mineral density (BMD) and breast cancer risk in a large prospective cohort and quantified the evidence in a meta-analysis of prospective studies. Baseline BMD has been measured by dual energy X-ray absorptiometry (DXA, N = 1418). Data on medication and lifestyle has been collected by questionnaire. Cox proportional Hazards models were applied to calculate Hazard Ratios for breast cancer. In addition, a meta-analysis on categorical and dose-response values including the current results has been performed applying random-effects models. During mean follow-up of 16.3 (SD 3.3) years of 1380 women (mean age 55.5 ± 6.3 years), 52 cases of invasive breast cancer were identified. We found no statistically significant association of BMD with breast cancer risk (per one z-score increase, HR 0.91, 95% CI 0.67–1.23). In the meta-analysis, however, breast cancer risk increased by 15% and 16% per 0.1 g/m2 increase in BMD at the lumbar spine (95% CI 0.99–1.33) and at the femoral neck (95% CI 1.02–1.32), respectively. Compared to the lowest, the HRs for breast cancer were statistically significant for the highest BMD category, i.e. 1.49 (95% CI 1.04–2.13) at the lumbar spine and 1.66 (95% CI 1.26–2.18) at the femur. We found no association between BMD (DXA) and breast cancer risk in our cohort. However, overall the present meta-analysis extends and confirms the statistically significant association between increasing BMD and increased breast cancer risk. In the VHM&PP BMD (DXA) was not associated with breast cancer risk. A meta-analysis showed a positive association between BMD and breast cancer risk in postmenopausal women. Per 0.1 g/m2 increase in BMD breast cancer risk increased by 15% at the lumbar spine and 16% at the femoral neck.
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Affiliation(s)
- G Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstrasse 22, 89081 Ulm, Germany.,Agency for Preventive and Social Medicine, Rheinstrasse 61, 6900 Bregenz, Austria
| | - R S Peter
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstrasse 22, 89081 Ulm, Germany
| | - E Klotz
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstrasse 22, 89081 Ulm, Germany
| | - W Brozek
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of the Vienna Health Insurance Fund (WGKK) and Trauma Center Meidling of the Austrian Workers' Compensation Board (AUVA), 1st Medical Department, Hanusch Hospital, Vienna, Austria
| | - H Concin
- Agency for Preventive and Social Medicine, Rheinstrasse 61, 6900 Bregenz, Austria
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18
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O’keeffe M, Kelly M, O’herlihy E, O’toole P, Kearney P, Timmons S, Stanton C, Rolland Y, Sulmont Rosse C, Maitre I, Boeing H, Stelmach M, Nagel G, Wolters M, Hebestreit A, De Groot L, Teh R, Agnes Peyron M, Dardevet D, Papet I, Streicher M, Torbahn G, Kiesswetter E, Visser M, Volkert D, O’connor E. SUN-LB306: Potentially Modifiable Determinants of Malnutrition in Older Adults: A Systematic Review. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30657-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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19
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Peter RS, Keller F, Föger B, Nagel G. Discrimination of metabolically healthy and unhealthy individuals using the triglyceride glucose index – distributional considerations. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- RS Peter
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm
| | - F Keller
- Klinik für Kinder – und Jugendpsychiatrie, Universitätsklinikum Ulm, Ulm
| | - B Föger
- Arbeitskreis für Vorsorge- und Sozialmedizin, Bregenz
| | - G Nagel
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm
- Arbeitskreis für Vorsorge- und Sozialmedizin, Bregenz
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Peter RS, Mayer B, Klenk J, Nagel G. Estimating Optimum Body Mass Index: A Simulation Study Comparing Fractional Polynomials and Generalized Additive Model. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- RS Peter
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm
| | - B Mayer
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm
| | - J Klenk
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm
- Geriatrie und Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus, Stuttgart
| | - G Nagel
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm
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Nagel G, Peter RS, Rosenbohm A, Kassubek J, Rothenbacher D, Ludolph AC. Body Mass Index in Amyotrophic Lateral Sclerosis – Results from the ALS Registry Swabia. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1606000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- G Nagel
- Universität Ulm, Institut für Epidemiologie und medizinische Biometr, Ulm
| | - RS Peter
- Universität Ulm, Institut für Epidemiologie und medizinische Biometr, Ulm
| | | | - J Kassubek
- Universität Ulm, Neurologische Klinik, Ulm
| | - D Rothenbacher
- Universität Ulm, Institut für Epidemiologie und medizinische Biometr, Ulm
| | - AC Ludolph
- Universität Ulm, Neurologische Klinik, Ulm
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Fritz J, Strohmaier S, Nagel G, Concin H, Ulmer H. Overweight/obesity and coronary heart disease: Age dependencies in metabolic mediation. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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23
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Raaschou-Nielsen O, Beelen R, Wang M, Hoek G, Andersen ZJ, Hoffmann B, Stafoggia M, Samoli E, Weinmayr G, Dimakopoulou K, Nieuwenhuijsen M, Xun WW, Fischer P, Eriksen KT, Sørensen M, Tjønneland A, Ricceri F, de Hoogh K, Key T, Eeftens M, Peeters PH, Bueno-de-Mesquita HB, Meliefste K, Oftedal B, Schwarze PE, Nafstad P, Galassi C, Migliore E, Ranzi A, Cesaroni G, Badaloni C, Forastiere F, Penell J, De Faire U, Korek M, Pedersen N, Östenson CG, Pershagen G, Fratiglioni L, Concin H, Nagel G, Jaensch A, Ineichen A, Naccarati A, Katsoulis M, Trichpoulou A, Keuken M, Jedynska A, Kooter IM, Kukkonen J, Brunekreef B, Sokhi RS, Katsouyanni K, Vineis P. Particulate matter air pollution components and risk for lung cancer. Environ Int 2016; 87:66-73. [PMID: 26641521 DOI: 10.1016/j.envint.2015.11.007] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 11/05/2015] [Accepted: 11/09/2015] [Indexed: 05/06/2023]
Abstract
BACKGROUND Particulate matter (PM) air pollution is a human lung carcinogen; however, the components responsible have not been identified. We assessed the associations between PM components and lung cancer incidence. METHODS We used data from 14 cohort studies in eight European countries. We geocoded baseline addresses and assessed air pollution with land-use regression models for eight elements (Cu, Fe, K, Ni, S, Si, V and Zn) in size fractions of PM2.5 and PM10. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effect models for meta-analysis. RESULTS The 245,782 cohort members contributed 3,229,220 person-years at risk. During follow-up (mean, 13.1 years), 1878 incident cases of lung cancer were diagnosed. In the meta-analyses, elevated hazard ratios (HRs) for lung cancer were associated with all elements except V; none was statistically significant. In analyses restricted to participants who did not change residence during follow-up, statistically significant associations were found for PM2.5 Cu (HR, 1.25; 95% CI, 1.01-1.53 per 5 ng/m(3)), PM10 Zn (1.28; 1.02-1.59 per 20 ng/m(3)), PM10 S (1.58; 1.03-2.44 per 200 ng/m(3)), PM10 Ni (1.59; 1.12-2.26 per 2 ng/m(3)) and PM10 K (1.17; 1.02-1.33 per 100 ng/m(3)). In two-pollutant models, associations between PM10 and PM2.5 and lung cancer were largely explained by PM2.5 S. CONCLUSIONS This study indicates that the association between PM in air pollution and lung cancer can be attributed to various PM components and sources. PM containing S and Ni might be particularly important.
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Affiliation(s)
- O Raaschou-Nielsen
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark.
| | - R Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - M Wang
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - G Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Z J Andersen
- Danish Cancer Society Research Center, Copenhagen, Denmark; Center for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - B Hoffmann
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany; University of Düsseldorf, Düsseldorf, Germany
| | - M Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RME, Rome, Italy
| | - E Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - G Weinmayr
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany; University of Düsseldorf, Düsseldorf, Germany; Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - K Dimakopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - M Nieuwenhuijsen
- Center for Research in Environmental Epidemiology, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain
| | - W W Xun
- MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - P Fischer
- National Institute for Public Health and the Environment, Center for Sustainability and Environmental Health, Bilthoven, The Netherlands
| | - K T Eriksen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - M Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - A Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - F Ricceri
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza, University of Turin and Center for Cancer Prevention, Turin, Italy
| | - K de Hoogh
- MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - T Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - M Eeftens
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - P H Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands; School of Public Health, Imperial College London, London, United Kingdom
| | - H B Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - K Meliefste
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - B Oftedal
- Norwegian Institute of Public Health, Oslo, Norway
| | - P E Schwarze
- Norwegian Institute of Public Health, Oslo, Norway
| | - P Nafstad
- Norwegian Institute of Public Health, Oslo, Norway; Institute of Health and Society, University of Oslo, Oslo, Norway
| | - C Galassi
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza, University of Turin and Center for Cancer Prevention, Turin, Italy
| | - E Migliore
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza, University of Turin and Center for Cancer Prevention, Turin, Italy
| | - A Ranzi
- Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia-Romagna, Modena, Italy
| | - G Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RME, Rome, Italy
| | - C Badaloni
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RME, Rome, Italy
| | - F Forastiere
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RME, Rome, Italy
| | - J Penell
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - U De Faire
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - M Korek
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - N Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - C-G Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - G Pershagen
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - L Fratiglioni
- Aging Research Centre, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - H Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - G Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Agency for Preventive and Social Medicine, Bregenz, Austria
| | - A Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - A Ineichen
- Human Genetics Foundation, Molecular and Genetic Epidemiology Unit, Turin, Italy
| | - A Naccarati
- Human Genetics Foundation, Molecular and Genetic Epidemiology Unit, Turin, Italy
| | | | | | - M Keuken
- Netherlands Organisation for Applied Scientific Research, Utrecht, The Netherlands
| | - A Jedynska
- Netherlands Organisation for Applied Scientific Research, Utrecht, The Netherlands
| | - I M Kooter
- Netherlands Organisation for Applied Scientific Research, Utrecht, The Netherlands
| | - J Kukkonen
- Finnish Meteorological Institute, Helsinki, Finland
| | - B Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - R S Sokhi
- Centre for Atmospheric and Instrumentation Research, University of Hertfordshire, College Lane, Hatfield, United Kingdom
| | - K Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Department of Primary Care and Public Health Sciences and Environmental Research Group, King's College London, United Kingdom
| | - P Vineis
- MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
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Rosenbohm A, Liu M, Nagel G, Cui B, Li X, Fan D, Huang X, Rothenbacher D, Cui L, Ludolph A, ALS Swabia Registry Study Group, Chinese ALS Association. Comparative phenotypical differences of Amyotrophic Lateral Sclerosis (ALS) in Germany and China. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Peter RS, Mayer B, Concin H, Nagel G. The effect of age on the shape of the BMI-mortality relation and BMI associated with minimum all-cause mortality in a large Austrian cohort. Int J Obes (Lond) 2014; 39:530-4. [PMID: 25214148 DOI: 10.1038/ijo.2014.168] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 08/26/2014] [Accepted: 09/06/2014] [Indexed: 01/14/2023]
Abstract
BACKGROUND It is unclear if the body mass index (BMI) associated with minimum all-cause mortality is constant throughout adult life or increasing with age. METHODS We applied multivariable fractional polynomials to the data of the Vorarlberg Health Monitoring and Prevention Program to quantify the BMI associated with minimum mortality over age. The analysis included data of 129,904 never-smoking women and men (mean age: 45.4 years) who were followed for a median of 18.6 years. RESULTS Optimum BMI in women increased with age, lying within the normal BMI category (according to the World Health Organization definition) from the age of 20 years (23.3 kg m(-2), 95% confidence interval (CI): 22.2-24.3) to the age of 54 years and in the lower half of the overweight category from the age of 55 years onwards, reaching 26.2 kg m(-2) (95% CI: 25.1-27.3) at the age of 69 years. In men, optimum BMI increased slightly from 23.7 kg m(-2) (95% CI: 22.1-25.2) at the age of 20 years until the age of 59 years, reaching a BMI of 25.4 kg m(-2) (95% CI: 24.8-26.0) and decreased afterwards to 22.7 kg m(-2) (95% CI: 20.9-24.6) at the age of 80 years. CONCLUSIONS Our results indicate that BMI associated with minimum all-cause mortality changes with age and that patterns differ by sex. Sex- and age-independent BMI recommendations might therefore be inappropriate. Further studies using flexible methods instead of predefined categories are necessary to revise BMI recommendations.
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Affiliation(s)
- R S Peter
- 1] Agency for Preventive and Social Medicine, Bregenz, Austria [2] Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - B Mayer
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - H Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - G Nagel
- 1] Agency for Preventive and Social Medicine, Bregenz, Austria [2] Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
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Garcia-Marcos L, Castro-Rodriguez JA, Weinmayr G, Panagiotakos DB, Priftis KN, Nagel G. Influence of Mediterranean diet on asthma in children: a systematic review and meta-analysis. Pediatr Allergy Immunol 2013; 24:330-8. [PMID: 23578354 DOI: 10.1111/pai.12071] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND There is epidemiological evidence that Mediterranean diet exposure is associated with lower asthma prevalence in children. We aimed to summarize the available data and to know whether the Mediterranean setting modifies this association. METHODS The literature search, up to May 2012, was on epidemiological studies in the general population of children assessing whether adherence to Mediterranean diet (measured as a score) was associated with the prevalence of 'current wheeze'; 'current severe wheeze'; or 'asthma ever'. Odds ratios (OR) of the eight included studies compared the highest tertile of the score with the lowest. Random-effects meta-analyses for the whole group of studies and stratified by Mediterranean setting (centers <100 Km from the Mediterranean coast) were performed. Differences between strata were assessed using the Q test. RESULTS For 'current wheeze', there was a negative significant association with the highest tertile of Mediterranean diet score (OR 0.85, 95% CI 0.75-0.98; p = 0.02), driven by Mediterranean centers (0.79, 0.66-0.94, p = 0.009), although the difference with the non-Mediterranean centers (0.91, 0.78-1.05, p = 0.18) was not significant. The results for 'current severe wheeze' were as follows: 0.82, 0.55-1.22, p = 0.330 (all); 0.66, 0.48-0.90, p = 0.008 (Mediterranean); and 0.99, 0.79-1.25, p = 0.95 (non-Mediterranean); with the difference between regions being significant. For 'asthma ever', the associations were as follows: 0.86, 0.78-0.95, p = 0.004 (all); 0.86, 0.74-1.01, p = 0.06 (Mediterranean); 0.86, 0.75-0.98; p = 0.027 (non-Mediterranean); with the difference between regions being negligible. CONCLUSIONS Adherence to the Mediterranean diet tended to be associated with lower occurrence of the three respiratory outcomes. For current and current severe wheeze, the association was mainly driven by the results in Mediterranean populations.
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Affiliation(s)
- L Garcia-Marcos
- Pediatric Respiratory and Allergy Units, 'Virgen de la Arrixaca' University Children's Hospital, University of Murcia, Murcia, Spain
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Weinmayr G, Keller F, Kleiner A, du Prel JB, Garcia-Marcos L, Batllés-Garrido J, Garcia-Hernandez G, Suarez-Varela MM, Strachan DP, Nagel G. Asthma phenotypes identified by latent class analysis in the ISAAC phase II Spain study. Clin Exp Allergy 2013; 43:223-32. [DOI: 10.1111/cea.12035] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 08/15/2012] [Accepted: 08/23/2012] [Indexed: 02/02/2023]
Affiliation(s)
- G. Weinmayr
- Institute of Epidemiology and Medical Biometry; Ulm University; Ulm; Germany
| | - F. Keller
- Department of Child and Adolescent Psychiatry and Psychotherapy; Ulm University; Ulm; Germany
| | - A. Kleiner
- Institute of Epidemiology and Medical Biometry; Ulm University; Ulm; Germany
| | - J. B. du Prel
- Institute of Epidemiology and Medical Biometry; Ulm University; Ulm; Germany
| | - L. Garcia-Marcos
- Pediatric Respiratory and Allergy Units; “Arrixaca” University Children's Hospital; University of Murcia; CIBER of Epidemiology and Public Health (CIBERSP); Murcia; Spain
| | | | - G. Garcia-Hernandez
- Pediatric Allergy and Pulmonology Units; Pediatrics Department; 12 de Octubre Children's University Hospital; Madrid; Spain
| | - M. M. Suarez-Varela
- Unit of Public Health and Environmental Care; Department of Preventive Medicine; University of Valencia; Research group CIBER CB06/02/0045 CIBER actions-Epidemiology and Public Health; Research Foundation; University Hospital Dr. Peset; Valencia; Spain
| | - D. P. Strachan
- Division of Community Health Sciences; St George's; University of London; London; UK
| | - G. Nagel
- Institute of Epidemiology and Medical Biometry; Ulm University; Ulm; Germany
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Nagel G, Bjørge T, Stocks T, Manjer J, Hallmans G, Edlinger M, Häggström C, Engeland A, Johansen D, Kleiner A, Selmer R, Ulmer H, Tretli S, Jonsson H, Concin H, Stattin P, Lukanova A. Metabolic risk factors and skin cancer in the Metabolic Syndrome and Cancer Project (Me-Can). Br J Dermatol 2012; 167:59-67. [PMID: 22530854 DOI: 10.1111/j.1365-2133.2012.10974.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Little is known about the associations of metabolic aberrations with malignant melanoma (MM) and nonmelanoma skin cancer (NMSC). OBJECTIVES To assess the associations between metabolic factors (both individually and combined) and the risk of skin cancer in the large prospective Metabolic Syndrome and Cancer Project (Me-Can). METHODS During a mean follow-up of 12 years of the Me-Can cohort, 1728 (41% women) incident MM, 230 (23% women) fatal MM and 1145 (33% women) NMSC were identified. Most NMSC cases (76%) were squamous cell carcinoma (SCC) (873, 33% women). Hazard ratios (HRs) were estimated by Cox proportional hazards regression for quintiles and standardized z-scores (with a mean of 0 and SD of 1) of body mass index (BMI), blood pressure, glucose, cholesterol, triglycerides and for a combined metabolic syndrome score. Risk estimates were corrected for random error in the measurements. RESULTS Blood pressure per unit increase of z-score was associated with an increased risk of incident MM cases in men and women [HR 1·17, 95% confidence interval (CI) 1·04-1·31 and HR 1·18, 95% CI 1·03-1·36, respectively] and fatal MM cases among women (HR 2·39, 95% CI 1·58-3·64). In men, all quintiles for BMI above the reference were associated with a higher risk of incident MM. In women, SCC NMSC risk increased across quintiles for glucose levels (P-trend 0·02) and there was a trend with triglyceride concentration (P-trend 0·09). CONCLUSION These findings suggest that mechanisms linked to blood pressure may be involved in the pathogenesis of MM. SCC NMSC in women could be related to glucose and lipid metabolism.
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Affiliation(s)
- G Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr. 22, 89081 Ulm, Germany.
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Nagel G, Rosenbohm A, Ünal H, Rothenbacher D, Ludolph A. Möglichkeiten register-basierter Studien zur Erforschung seltener Erkrankungen. Akt Neurol 2012. [DOI: 10.1055/s-0031-1301340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- G. Nagel
- Institut für Epidemiologie und Medizinischen Biometrie, Universität Ulm, Ulm
| | | | - H. Ünal
- Institut für Epidemiologie und Medizinischen Biometrie, Universität Ulm, Ulm
| | - D. Rothenbacher
- Institut für Epidemiologie und Medizinischen Biometrie, Universität Ulm, Ulm
| | - A. Ludolph
- Neurologische Universitätsklinik Ulm, Ulm
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Nagel G. [Patient's competency...and as required]. Rev Med Suisse 2012; 8:194. [PMID: 22338512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- G Nagel
- Stiftung Patientenkompetenz und Brustzentrum, Facharzt Onkologie Brust-Zentrum, Seefeldstrasse 214, 8008 Zürich.
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Flohr C, Nagel G, Weinmayr G, Kleiner A, Strachan DP, Williams HC. Lack of evidence for a protective effect of prolonged breastfeeding on childhood eczema: lessons from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Two. Br J Dermatol 2011; 165:1280-9. [PMID: 21883137 DOI: 10.1111/j.1365-2133.2011.10588.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Exclusive breastfeeding for at least 4 months is recommended by many governments and allergy organizations to prevent allergic disease. OBJECTIVES To investigate whether exclusive breastfeeding protects against childhood eczema. METHODS Study subjects comprised 51,119 randomly selected 8- to 12-year-old schoolchildren in 21 countries. Information on eczema and breastfeeding was gathered by parental questionnaire. Children were also examined for flexural eczema and underwent skin prick testing. Odds ratios (ORs) were calculated for each study centre and then pooled across populations. RESULTS There was a small increase in the risk of reported 'eczema ever' in association with 'breastfeeding ever' and breastfeeding < 6 months [pooled adjusted OR 1·11, 95% confidence interval (CI) 1·00-1·22 and OR 1·10, 95% CI 1·02-1·20, respectively]. There was no significant association between reported 'eczema ever' and breastfeeding > 6 months (pooled adjusted OR 1·09, 95% CI 0·94-1·26). Risk estimates were very similar for exclusive breastfeeding < 2 months, 2-4 months and > 4 months and for eczema symptoms in the past 12 months and eczema on skin examination. As for more severe eczema, breastfeeding per se conveyed a risk reduction on sleep disturbed eczema (pooled adjusted OR 0·71, 95% CI 0·53-0·96), but this effect was lost where children had been exclusively breastfed for > 4 months (pooled adjusted OR 1·02, 95% CI 0·67-1·54). Allergic sensitization and a history of maternal allergic disease did not modify any of these findings. CONCLUSIONS Although there was a protective effect of ever having been breastfed on more severe disease, we found no evidence that exclusive breastfeeding for 4 months or longer protects against eczema. Our results are consistent with findings from a recent systematic review of prospective studies. The U.K. breastfeeding guidelines with regard to eczema should be reviewed. Intervention studies are now required to explore how and when solids should be introduced alongside breastfeeding to aid protection against eczema and other allergic diseases.
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Affiliation(s)
- C Flohr
- Department of Paediatric Allergy & Dermatology, St John's Institute of Dermatology, St Thomas' Hospital and King's College London, London, UK.
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Ulmer H, Strohmaier S, Borena W, Edlinger M, Concin H, Diem G, Kelleher C, Nagel G. P2-310 Gamma-glutamyltransferase as a biomarker for oxidative stress, metabolic syndrome, and alcohol consumption and its association with cancer incidence. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976k.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Strohmaier S, Bjorge T, Manjer J, Concin H, Nagel G, Stocks T, Stattin P, Ulmer H. P2-292 Total serum cholesterol and cancer incidence in the metabolic syndrome and cancer project (ME-CAN). Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976k.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Voevodina O, Nagel G, Billich C. P2-209 Association of dietary factors with breast density among women in South Germany. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976j.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Weinmayr G, Forastiere F, Kleiner A, Buchele G, Wickens K, Strachan D, Nagel G. P2-321 The relationship between BMI and wheezing in the international study of asthma and allergies in childhood phase 2. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976k.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Nagel G, Bjorge T, Concin H, Lukanova A, Manjer J, Hallmans G, Jonnson H, Stattin P, Stocks T, Ulmer H. P2-210 Metabolic syndrome and cervical cancer in the metabolic syndrome and cancer project (ME-CAN). Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976j.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nagel G, Concin H, Bjørge T, Rapp K, Manjer J, Hallmans G, Diem G, Häggström C, Engeland A, Almquist M, Jonsson H, Selmer R, Stocks T, Tretli S, Ulmer H, Stattin P, Lukanova A. Metabolic syndrome and rare gynecological cancers in the metabolic syndrome and cancer project (Me-Can). Ann Oncol 2010; 22:1339-1345. [PMID: 20966183 DOI: 10.1093/annonc/mdq597] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Risk factors for rare gynecological cancers are largely unknown. Initial research has indicated that the metabolic syndrome (MetS) or individual components could play a role. MATERIALS AND METHODS The Metabolic syndrome and Cancer project cohort includes 288,834 women. During an average follow-up of 11 years, 82 vulvar, 26 vaginal and 43 other rare gynecological cancers were identified. Hazard ratios (HRs) were estimated fitting Cox proportional hazards regression models for tertiles and standardized z-scores [with a mean of 0 and a standard deviation (SD) of 1] of body mass index (BMI), blood pressure, glucose, cholesterol, triglycerides and MetS. Risk estimates were corrected for random error in the measurement of metabolic factors. RESULTS The MetS was associated with increased risk of vulvar [HR 1.78, 95% confidence interval (CI) 1.30-2.41) and vaginal cancer (HR 1.87, 95% CI 1.07-3.25). Among separate MetS components, 1 SD increase in BMI was associated with overall risk (HR 1.43, 95% CI 1.23-1.66), vulvar (HR 1.36, 95% CI 1.11-1.69) and vaginal cancer (HR 1.79, 95% CI 1.30-2.46). Blood glucose and triglyceride concentrations were associated with increased risk of vulvar cancer (HR 1.98, 95% CI 1.10-3.58 and HR 2.09, 95% CI 1.39-3.15, respectively). CONCLUSION The results from this first prospective study on rare gynecological cancers suggest that the MetS and its individual components may play a role in the development of these tumors.
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Affiliation(s)
- G Nagel
- Institute of Epidemiology, Ulm University, Ulm, Germany.
| | - H Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - T Bjørge
- Department of Public Health and Primary Health Care, University of Bergen, Bergen; Division of Epidemiology, Norwegian Institute of Public Health, Oslo/Bergen, Norway
| | - K Rapp
- Institute of Epidemiology, Ulm University, Ulm, Germany
| | - J Manjer
- Department of Surgery, Malmö University Hospital, Lund University, Malmö
| | - G Hallmans
- Departments of Public Health and Clinical Medicine, Nutritional Research
| | - G Diem
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - C Häggström
- Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå
| | - A Engeland
- Department of Public Health and Primary Health Care, University of Bergen, Bergen; Division of Epidemiology, Norwegian Institute of Public Health, Oslo/Bergen, Norway
| | - M Almquist
- Department of Surgery, Lund University Hospital, Lund
| | - H Jonsson
- Department of Radiation Science, Oncology, Umeå University, Umeå, Sweden
| | - R Selmer
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo/Bergen, Norway
| | - T Stocks
- Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå
| | - S Tretli
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - H Ulmer
- Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria
| | - P Stattin
- Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå
| | - A Lukanova
- Department of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
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Nagel G, Weinmayr G, Kleiner A, Garcia-Marcos L, Strachan D. Effect of diet on Asthma and Allergic sensitization in Phase Two International Study on Allergies and Asthma in Childhood (ISAAC). Gesundheitswesen 2010. [DOI: 10.1055/s-0030-1266248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Weinmayr G, Genuneit J, Nagel G, Björkstén B, van Hage M, Priftanji A, Cooper P, Rijkjärv MA, von Mutius E, Tsanakas J, Forastiere F, Doekes G, Garrido JB, Suarez-Varela MM, Bråbäck L, Strachan DP. International variations in associations of allergic markers and diseases in children: ISAAC Phase Two. Allergy 2010; 65:766-75. [PMID: 20028376 DOI: 10.1111/j.1398-9995.2009.02283.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Circulating allergen-specific IgE (sIgE) and skin prick tests (SPT) are used to define atopy. Downregulation of local inflammatory responsiveness has been proposed to explain a low prevalence of positive SPTs in less affluent countries. We analysed the association between SPTs, total and allergen-specific IgE and their relationships to allergic symptoms in centres with diverse living conditions. METHODS Cross-sectional studies of stratified random samples of 8 to 12-year-old children (n = 7461) used the standardized methodology of Phase Two of the International Study of Asthma and Allergies in Childhood (ISAAC). Symptoms of asthma, rhinitis and eczema were ascertained by parental questionnaires. Skin examination, hypertonic saline bronchial challenge, six aeroallergen SPTs and measurements of serum total IgE and sIgE were performed. RESULTS In nonaffluent countries, a higher proportion of children with positive SPT had no detectable sIgE (range 37-61%) than in affluent countries (0-37%). Total serum IgE was associated with all disease outcomes among children with both positive SPT and sIgE (P < 0.001), but only with self-reported eczema in children with negative SPTs and negative sIgE. CONCLUSIONS The international pattern of discordance between SPT and sIgE results did not support the downregulation hypothesis. Among children with no evidence of sensitization to common aeroallergens, increased total IgE contributes little to the risk of wheeze and rhinitis in the general population but may play a role in eczema.
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Affiliation(s)
- G Weinmayr
- Institute of Epidemiology, Ulm University, Helmholtzstrasse 22, Ulm, Germany.
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Tjonneland A, Overvad K, Bergmann MM, Nagel G, Linseisen J, Hallmans G, Palmqvist R, Sjodin H, Hagglund G, Berglund G, Lindgren S, Grip O, Palli D, Day NE, Khaw KT, Bingham S, Riboli E, Kennedy H, Hart A. Linoleic acid, a dietary n-6 polyunsaturated fatty acid, and the aetiology of ulcerative colitis: a nested case-control study within a European prospective cohort study. Gut 2009; 58:1606-11. [PMID: 19628674 DOI: 10.1136/gut.2008.169078] [Citation(s) in RCA: 245] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Dietary linoleic acid, an n-6 polyunsaturated fatty acid, is metabolised to arachidonic acid, a component of colonocyte membranes. Metabolites of arachidonic acid have pro-inflammatory properties and are increased in the mucosa of patients with ulcerative colitis. The aim of this investigation was to conduct the first prospective cohort study investigating if a high dietary intake of linoleic acid increases the risk of developing incident ulcerative colitis. DESIGN AND SETTING Dietary data from food frequency questionnaires were available for 203 193 men and women aged 30-74 years, resident in the UK, Sweden, Denmark, Germany or Italy and participating in a prospective cohort study, the European Prospective Investigation into Cancer and Nutrition (EPIC). These participants were followed up for the diagnosis of ulcerative colitis. Each case was matched with four controls and the risk of disease calculated by quartile of intake of linoleic acid adjusted for gender, age, smoking, total energy intake and centre. RESULTS A total of 126 participants developed ulcerative colitis (47% women) after a median follow-up of 4.0 years (range, 1.7-11.3 years). The highest quartile of intake of linoleic acid was associated with an increased risk of ulcerative colitis (odds ratio (OR) = 2.49, 95% confidence interval (CI) = 1.23 to 5.07, p = 0.01) with a significant trend across quartiles (OR = 1.32 per quartile increase, 95% CI = 1.04 to 1.66, p = 0.02 for trend). CONCLUSIONS The data support a role for dietary linoleic acid in the aetiology of ulcerative colitis. An estimated 30% of cases could be attributed to having dietary intakes higher than the lowest quartile of linoleic acid intake.
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Affiliation(s)
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- University of East Anglia, Norwich, NR4 7TJ, UK.
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Nagel G, Wabitsch M, Galm C, Berg S, Brandstetter S, Fritz M, Klenk J, Peter R, Prokopchuk D, Steiner R, Stroth S, Wartha O, Weiland SK, Steinacker J. Secular changes of anthropometric measures for the past 30 years in South-West Germany. Eur J Clin Nutr 2009; 63:1440-3. [DOI: 10.1038/ejcn.2009.86] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Nagel G, Linseisen J, van Gils CH, Peeters PH, Boutron-Ruault MC, Clavel-Chapelon F, Romieu I, Tjønneland A, Olsen A, Roswall N, Witt PM, Overvad K, Rohrmann S, Kaaks R, Drogan D, Boeing H, Trichopoulou A, Stratigakou V, Zylis D, Engeset D, Lund E, Skeie G, Berrino F, Grioni S, Mattiello A, Masala G, Tumino R, Zanetti R, Ros MM, Bueno-de-Mesquita HB, Ardanaz E, Sánchez MJ, Huerta JM, Amiano P, Rodríguez L, Manjer J, Wirfält E, Lenner P, Hallmans G, Spencer EA, Key TJ, Bingham S, Khaw KT, Rinaldi S, Slimani N, Boffetta P, Gallo V, Norat T, Riboli E. Dietary β-carotene, vitamin C and E intake and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Breast Cancer Res Treat 2009; 119:753-65. [DOI: 10.1007/s10549-009-0444-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2009] [Accepted: 06/10/2009] [Indexed: 01/10/2023]
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Gehring U, Strikwold M, Schram-Bijkerk D, Weinmayr G, Genuneit J, Nagel G, Wickens K, Siebers R, Crane J, Doekes G, Di Domenicantonio R, Nilsson L, Priftanji A, Sandin A, El-Sharif N, Strachan D, van Hage M, von Mutius E, Brunekreef B. Asthma and allergic symptoms in relation to house dust endotoxin: Phase Two of the International Study on Asthma and Allergies in Childhood (ISAAC II). Clin Exp Allergy 2009; 38:1911-20. [PMID: 18771486 DOI: 10.1111/j.1365-2222.2008.03087.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Several studies have consistently reported inverse associations between exposure to endotoxin in house dust and atopy. With regard to the association between house dust endotoxin and asthma, the results are inconsistent. OBJECTIVES To study the association between house dust endotoxin levels and respiratory symptoms and atopy in populations from largely different countries. METHODS Data were collected within the International Study on Asthma and Allergies in Childhood Phase Two, a multi-centre cross-sectional study of 840 children aged 9-12 years from six centres in the five countries of Albania, Italy, New Zealand, Sweden and the United Kingdom. Living room floor dust was collected and analysed for endotoxin. Health end-points and demographics were assessed by standardized questionnaires. Atopy was assessed by measurements of allergen-specific IgE against a panel of inhalant allergens. Associations between house dust endotoxin and health outcomes were analysed by logistic regression. Odds ratios (ORs) were presented for an overall interquartile range increase in exposure. RESULTS Many associations between house dust endotoxin in living room floor dust and health outcomes varied between countries. Combined across countries, endotoxin levels were inversely associated with asthma ever [adjusted OR (95% confidence interval (CI)) 0.53 (0.29-0.96) for endotoxin levels per m(2) of living room floor] and current wheeze [adjusted OR (95% CI) 0.77 (0.64-0.93) for endotoxin levels per gram of living room floor dust]. There were inverse associations between endotoxin concentrations and atopy, which were statistically significant in unadjusted analyses, but not after adjustment for gender, parental allergies, cat and house dust mite allergens. No associations were found with dust quantity and between endotoxin exposure and hayfever. CONCLUSION These findings suggest an inverse association between endotoxin levels in living room floor dust and asthma in children.
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Affiliation(s)
- U Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
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Nagel G, Büchele G, Weinmayr G, Björkstén B, Chen YZ, Wang H, Nystad W, Saraclar Y, Bråbäck L, Batlles-Garrido J, Garcia-Hernandez G, Weiland SK. Effect of breastfeeding on asthma, lung function and bronchial hyperreactivity in ISAAC Phase II. Eur Respir J 2009; 33:993-1002. [PMID: 19164357 DOI: 10.1183/09031936.00075708] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The association between breastfeeding and wheezing, lung function and atopy was evaluated in the International Study of Asthma and Allergy in Childhood (ISAAC) Phase II. Cross-sectional studies were performed in 27 centres in 20 countries. Information on disease and exposure factors was collected by parental questionnaires. Data from 54,000 randomly selected school children (aged 8-12 yrs, 31,759 with skin prick testing) and a stratified subsample (n = 4,888) were used for testing the correlation of breastfeeding with bronchial hyperreactivity and lung function. Random effect models for meta-analysis were applied to calculate combined odds ratios (ORs). Any breastfeeding was associated with less wheeze both in affluent (adjusted OR (OR(adj)) 0.87, 95% confidence interval (CI) 0.78-0.97) and nonaffluent countries (OR(adj) 0.80, 95% CI 0.68-0.94). Further analyses revealed that this was true only for nonatopic wheeze in nonaffluent countries (OR(adj) 0.69, 95% CI 0.53-0.90). Breastfeeding was not associated with atopic wheeze and objective measures of allergy in both affluent and nonaffluent countries. In contrast, breastfeeding was associated with higher predicted forced expiratory volume in one second in affluent countries only (mean ratio 1.11, 95% CI 1.02-1.20). Breastfeeding is associated with protection against nonatopic wheeze, which becomes particularly evident in nonaffluent countries. Overall, breastfeeding was not related to any measure of allergy. These findings may explain some of the controversy regarding breastfeeding, since the direction of the association with breastfeeding depends on the predominating wheeze phenotype (e.g. atopic, nonatopic).
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Affiliation(s)
- G Nagel
- Institute of Epidemiology, Ulm University, Ulm, Germany.
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Zander T, Debey-Pascher S, Eggle D, Staratschek-Jox A, Stoelben E, Linseisen J, Nagel G, Boffetta P, Schultze J, Wolf J. Predictive value of transcriptional changes in peripheral blood for future clinical onset of lung cancer in asymptomatic smokers. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.1509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Affiliation(s)
- G Nagel
- Bayer HealthCare AG, Wuppertal-Elberfeld
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Abstract
Salmonella meningitis is an unusual complication of Salmonella sepsis and occurs mainly in children. A rare case of Salmonella typhimurium meningitis occurring in an adult HIV positive man who presented with a history of fever and diarrhoea is reported. On examination he was dehydrated, and had oral thrush, weakness of lower limbs and neck stiffness. A septic diagnostic screen was performed and he was commenced on empiric intravenous cefotaxime therapy for meningitis. S typhimurium was cultured from cerebrospinal fluid and blood culture specimens. It was non-lactose fermenting, oxidase negative, H(2)S positive and motile. Cefotaxime was continued for 14 days and the patient responded without neurological sequelae.
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Affiliation(s)
- K Swe Swe
- Department of Microbiological Pathology, Medunsa Campus, University of Limpopo, and the National Health Laboratory Services, Pretoria, South Africa
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Abstract
The expression expert patient appeared about ten years ago. It defines the role of patients who are actively involved in their disease management. Most clinical oncologists are challenged by expert patients. Patient's expertise and complementary medicine are closely linked. Physicians respecting expert patients have to find a positive attitude towards patient self aide concepts. The medical skill to manage expert patients is increasingly important and new tools are being developed for support.
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Affiliation(s)
- G Nagel
- Stiftung Patientenkompetenz, Zürich, Switzerland.
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Rinaldi S, Peeters PHM, Bezemer ID, Dossus L, Biessy C, Sacerdote C, Berrino F, Panico S, Palli D, Tumino R, Khaw KT, Bingham S, Allen NE, Key T, Jensen MK, Overvad K, Olsen A, Tjonneland A, Amiano P, Ardanaz E, Agudo A, Martinez-García C, Quirós JR, Tormo MJ, Nagel G, Linseisen J, Boeing H, Schulz M, Grobbee DE, Bueno-de-Mesquita HB, Koliva M, Kyriazi G, Thrichopoulou A, Boutron-Ruault MC, Clavel-Chapelon F, Ferrari P, Slimani N, Saracci R, Riboli E, Kaaks R. Relationship of alcohol intake and sex steroid concentrations in blood in pre- and post-menopausal women: the European Prospective Investigation into Cancer and Nutrition. Cancer Causes Control 2006; 17:1033-43. [PMID: 16933054 DOI: 10.1007/s10552-006-0041-7] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2006] [Accepted: 05/11/2006] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Women with a moderate intake of alcohol have higher concentrations of sex steroids in serum, and higher risk of developing breast cancer, compared to non-drinkers. In the present study, we investigate the relationships between alcohol consumption and serum levels of sex steroids and sex-hormone binding globulin (SHBG) in 790 pre- and 1,291 post-menopausal women, who were part of the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS Serum levels of testosterone (T), androstenedione (Delta4), dehydroepiandrosterone sulphate (DHEAS), estrone (E1), estradiol (E2) and SHBG were measured by direct immunoassays. Free T (fT) and free E2 (fE2) were calculated according to mass action laws. Current alcohol intake exposure to alcohol was assessed from dietary questionnaires. RESULTS Pre-menopausal women who consumed more than 25 g/day of alcohol had about 30% higher DHEAS, T and fT, 20% higher Delta4 and about 40% higher E1, concentrations compared to women who were non-consumers. E2, fE2 and SHBG concentrations showed no association with current alcohol intake. In post-menopausal women, DHEAS, fT, T, Delta4, and E1 concentrations were between 10% and 20% higher in women who consumed more than 25 g/day of alcohol compared to non-consumers. E2 or fE2 were not associated with alcohol intake at all. SHBG levels were about 15% lower in alcohol consumers compared to non-consumers. CONCLUSION This study supports the hypothesis of an influence of alcohol intake on sex hormone concentrations in blood.
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Affiliation(s)
- S Rinaldi
- International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex, France.
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