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  • 1
    Keywords: COHORT ; BIOMARKERS ; HEALTH ; COLORECTAL-CANCER ; OXIDATIVE STRESS ; antioxidants ; RETINOL ; PHYSICAL-ACTIVITY ; EPIC PROJECT ; SERUM ALPHA-TOCOPHEROL
    Abstract: Carotenoids and vitamins A, C and E are possibly associated with a reduced colorectal cancer (CRC) risk through antioxidative properties. The association of prediagnostic plasma concentrations and dietary consumption of carotenoids and vitamins A, C and E with the risk of colon and rectal cancer was examined in this case-control study, nested within the European Prospective Investigation into Cancer and Nutrition study. Plasma concentrations of carotenoids (alpha- and beta-carotene, canthaxanthin, beta-cryptoxanthin, lutein, lycopene, zeaxanthin) and vitamins A (retinol), C and E (alpha-, beta- and gamma- and delta-tocopherol) and dietary consumption of beta-carotene and vitamins A, C and E were determined in 898 colon cancer cases, 501 rectal cancer cases and 1,399 matched controls. Multivariable conditional logistic regression models were performed to estimate incidence rate ratios (IRR) and corresponding 95% confidence intervals (CIs). An association was observed between higher prediagnostic plasma retinol concentration and a lower risk of colon cancer (IRR for highest quartile = 0.63, 95% CI: 0.46, 0.87, p for trend = 0.01), most notably proximal colon cancer (IRR for highest quartile = 0.46, 95% CI: 0.27, 0.77, p for trend = 0.01). Additionally, inverse associations for dietary beta-carotene and dietary vitamins C and E with (distal) colon cancer were observed. Although other associations were suggested, there seems little evidence for a role of these selected compounds in preventing CRC through their antioxidative properties.
    Type of Publication: Journal article published
    PubMed ID: 24771392
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  • 2
    Keywords: CANCER ; tumor ; carcinoma ; MODEL ; COHORT ; RISK ; POLYMORPHISMS ; WOMEN ; colorectal cancer ; RISK FACTOR ; TOBACCO ; ALCOHOL-CONSUMPTION ; LIFE-STYLE FACTORS ; RECTAL-CANCER ; ASSOCIATIONS ; METAANALYSIS ; INCREASED RISK ; COLON TUMORS ; Tumor Location ; TUMOR MICROSATELLITE INSTABILITY
    Abstract: BACKGROUND & AIMS: There has been consistent evidence for a relationship between smoking and colorectal cancer (CRC), although it is not clear whether the colon or rectum is more sensitive to the effects of smoking. We investigated the relationships between cigarette smoking and risk of CRC and tumor location. METHODS: We analyzed data from 465,879 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study; 2,741 developed CRC during the follow-up period (mean 8.7 years). Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS: The risk of colon carcinoma was increased among ever smokers (HR 1.18, 95%CI 1.06-1.32) and former cigarette smokers (HR 1.21, 95%CI 1.08-1.36), compared with never smokers; the increased risk for current smokers was of borderline significance (HR 1.13, 95%CI 0.98-1.31). When stratified for tumor location, the risk of proximal colon cancer was increased for former (HR 1.25, 95%CI 1.04-1.50) and current smokers (HR 1.31, 95%CI 1.06-1.64), but the risks for cancers in the distal colon or rectum were not. Subsite analyses showed a non-significant difference between the proximal and distal colon (p=0.45) for former smokers and a significant difference for current smokers (p=0.02). For smokers that had stopped smoking for at least 20 years, the risk of developing colon cancer was similar to that of never smokers. CONCLUSIONS: Ever smokers have an increased risk of colon cancer, which appeared to be more pronounced in the proximal than the distal colon location.
    Type of Publication: Journal article published
    PubMed ID: 21029790
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  • 3
    Keywords: CANCER ; BLOOD ; Germany ; THERAPY ; RISK ; RISKS ; PROTEIN ; colon ; CYCLE ; ASSOCIATION ; hormone ; HEALTH ; resistance ; AGE ; WOMEN ; MEN ; OBESITY ; smoking ; COLORECTAL-CANCER ; cancer risk ; COLON-CANCER ; cholesterol ; C-REACTIVE PROTEIN ; body mass index ; nutrition ; education ; NESTED CASE-CONTROL ; CROHNS-DISEASE ; inflammation ; insulin ; SERUM ; case-control study ; REGRESSION ; ASSOCIATIONS ; colon cancer ; METAANALYSIS ; PHASE ; INSULIN-RESISTANCE ; metabolic syndrome ; REPLACEMENT THERAPY ; prospective ; CANCER-RISK ; colorectal neoplasms ; C-PEPTIDE ; REPLACEMENT ; WAIST CIRCUMFERENCE ; INFLAMMATORY MARKERS ; nested case-control study ; BODY-MASS ; COLLECTION ; HORMONE-THERAPY ; Abdominal ; Hyperinsulinism ; journals ; nested case control study ; hyperglycemia ; hyperlipidemias
    Abstract: The authors investigated associations between serum C-reactive protein (CRP) concentrations and colon and rectal cancer risk in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (1992-2003) among 1,096 incident cases and 1,096 controls selected using risk-set sampling and matched on study center, age, sex, time of blood collection, fasting status, menopausal status, menstrual cycle phase, and hormone replacement therapy. In conditional logistic regression with adjustment for education, smoking, nutritional factors, body mass index, and waist circumference, CRP showed a significant nonlinear association with colon cancer risk but not rectal cancer risk. Multivariable-adjusted relative risks for CRP concentrations of 〉= 3.0 mg/L versus 〈 1.0 mg/L were 1.36 (95% confidence interval (CI): 1.00, 1.85; P-trend = 0.01) for colon cancer and 1.02 (95% CI: 0.67, 1.57; P-trend = 0.65) for rectal cancer. Colon cancer risk was significantly increased in men (relative risk = 1.74, 95% CI: 1.11, 2.73; P-trend = 0.01) but not in women (relative risk = 1.06, 95% CI: 0.67, 1.68; P-trend = 0.13). Additional adjustment for C-peptide, glycated hemoglobin, and high density lipoprotein cholesterol did not attenuate these results. These data provide evidence that elevated CRP concentrations are related to a higher risk of colon cancer but not rectal cancer, predominantly among men and independently of obesity, insulin resistance, and dyslipidemia
    Type of Publication: Journal article published
    PubMed ID: 20634278
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  • 4
    Keywords: SURVIVAL ; colon ; HEALTH ; WOMEN ; colorectal cancer ; REGION ; UNITED-STATES ; nutrition ; INEQUALITIES ; rectum ; SOCIOECONOMIC-STATUS ; DEPRIVATION ; Educational level ; Tumor Location
    Abstract: Existing evidence is inconclusive on whether socioeconomic status (SES) and educational inequalities influence colorectal cancer (CRC) risk, and whether low or high SES/educational level is associated with developing CRC. The aim of our study was to investigate the relationship between educational level and CRC. We studied data from 400,510 participants in the EPIC (European Prospective Investigation into Cancer and Nutrition) study, of whom 2,447 developed CRC (colon: 1,551, rectum: 896, mean follow-up 8.3 years). Cox proportional hazard regression analysis stratified by age, gender and center, and adjusted for potential confounders were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). Relative indices of inequality (RII) for education were estimated using Cox regression models. We conducted separate analyses for tumor location, gender and geographical region. Compared with participants with college/university education, participants with vocational secondary education or less had a nonsignificantly lower risk of developing CRC. When further stratified for tumor location, adjusted risk estimates for the proximal colon were statistically significant for primary education or less (HR 0.73, 95% CI 0.57-0.94) and for vocational secondary education (HR 0.76, 95% CI 0.58-0.98). The inverse association between low education and CRC risk was particularly found in women and Southern Europe. These associations were statistically significant for CRC, for colon cancer and for proximal colon cancer. In conclusion, CRC risk, especially in the proximal colon, is lower in subjects with a lower educational level compared to those with a higher educational level. This association is most pronounced in women and Southern Europe
    Type of Publication: Journal article published
    PubMed ID: 21412763
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  • 5
    Keywords: NITRIC-OXIDE ; DNA ; CARCINOGENESIS ; DIETARY ; C-REACTIVE PROTEIN ; SERUM
    Abstract: Oxidative stress has been shown to play an important role in carcinogenesis, but prospective evidence for an association between biomarkers of oxidative stress and colorectal cancer (CRC) risk is limited. The authors investigated the association between prediagnostic serum levels of oxidative stress indicators (i.e., reactive oxygen metabolites (ROM) and ferric reducing ability of plasma (FRAP)) and CRC risk. This was examined in a nested case-control study (1,064 CRC cases, 1,064 matched controls) in the European Prospective Investigation Into Cancer and Nutrition cohort (1992-2003). Incidence rate ratios and 95% confidence intervals were calculated using conditional logistic regression analyses. ROM were associated with overall CRC risk (highest tertile vs. lowest: adjusted incidence rate ratio (IRR(adj)) = 1.91, 95% confidence interval (CI): 1.47, 2.48), proximal (IRR(adj) = 1.89, 95% CI: 1.06, 3.36) and distal (IRR(adj) = 2.31, 95% CI: 1.37, 3.89) colon cancer, and rectal cancer (IRR(adj) = 1.69, 95% CI: 1.05, 2.72). When results were stratified by tertile of follow-up time, the association remained significant only in participants with less than 2.63 years of follow-up (IRR(adj) = 2.28, 95% CI: 1.78, 2.94; P-heterogeneity 〈 0.01). FRAP was not associated with CRC risk. In conclusion, prediagnostic serum ROM levels were associated with increased risk of CRC. However, this association was seen only in subjects with relatively short follow-up, suggesting that the association results from production of reactive oxygen species by preclinical tumors.
    Type of Publication: Journal article published
    PubMed ID: 22422922
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  • 6
    ISSN: 1432-1041
    Keywords: Key words Tamsulosin ; Benign prostatic hyperplasia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: This study was performed to estimate whether the pharmacokinetics and safety of tamsulosin, an α1A-adrenoceptor antagonist for the treatment of symptomatic benign prostatic hyperplasia (BPH), are influenced by impaired renal function. Methods: In an open-label study design, the plasma concentration profile of 0.4 mg tamsulosin p.o. was studied in age-matched groups of male subjects with normal (n = 10), moderately impaired (n = 10), and severely impaired (n = 8) renal function after single-dose administration and in steady state, i.e. after 21 days of multiple-dose administration. Results: The AUC of total, but not of unbound, tamsulosin was correlated to creatinine clearance and α1-acid glycoprotein plasma levels, and was found to be significantly higher in both groups of subjects with impaired renal function than in controls after single- and multiple-dose administration. However, the pharmacokinetics of total and unbound tamsulosin were comparable for both trial periods. Conclusions: Impaired renal function increases total tamsulosin plasma concentration by approximately 100% after single-dose administration and in steady state. Since active unbound drug levels are not affected, no dose modification is required in symptomatic BPH patients with renal impairment.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1041
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1041
    Keywords: Key words Adverse drug event reporting ; Hospitalized ; patients ; Source/relative value of reports
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: This study investigated the relative value of adverse drug events reported by doctors, nurses and patients. Methods: The study was conducted on a total of four wards: the paediatric and internal medicine wards (including geriatric patients) of two peripheral hospitals in the Netherlands. Adverse drug events were collected by spontaneous reporting (doctor and nurse reports) and by daily ward visits, during which the patients were interviewed by a hospital pharmacist (patient reports). Criteria for relative value of the reported adverse drug events were the number of potentially serious reactions, the number of reactions not mentioned in the patient information leaflet and the number of reactions reported to new drugs (5 years or less on the Dutch market). No formal causality assessment was applied. Results: Over a period of 2 months in 1996 (Hospital I) and 2 months in 1997 (Hospital II) a total of 620 patients were included in the study and adverse drug events were reported in 179 (29%) of these cases. Doctors reported a statistically significant larger number of serious (26% of all doctor reports; odds ratio (OR) 3.2; confidence interval (CI) 1.2–8.7) and unknown (39%; OR 2.5; CI 1.0–6.0) adverse drug events than patients themselves during the daily ward visit. Doctors also reported more serious and unknown adverse drug events than nurses. Adverse reactions to new drugs were reported during the daily ward visit only (8% of all daily ward visit reports). Conclusion: This study reconfirms that doctors are the main source for reports of serious and unknown adverse drug events in hospitalized patients. However, patients themselves seem to report more adverse reactions to new drugs (during the daily ward visit). By focusing on patients using new drugs, the daily ward visit might become cost-effective. This needs to be explored in future studies.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1041
    Keywords: Key words Osteoporosis ; Treatment ; Bisphosphonates
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: To investigate whether the alkylbisphosphonate etidronate is associated with an increased risk of gastrointestinal symptoms. Methods: We conducted an observational follow-up study on a possible relationship between etidronate use and the risk of gastrointestinal symptoms in a cohort of 2754 women over 50 years of age. The study was performed with data on drug prescriptions obtained from the PHARMO database in the Netherlands. Women were included when they used either cyclical etidronate (n=1050) or estrogen (n=1704) for at least 14 days. They were followed-up for incident use of antiulcer drugs while on exposure medication. Results: The mean ages were 72 years and 59 years in the etidronate and estrogen groups, respectively. In total, there were 95 women with incident prescriptions for gastrointestinal events after a median duration of follow-up of 2.7 months (range 0.1–19.4 months). The crude relative risk of a gastrointestinal event for etidronate compared with estrogen use was 1.2 [95% confidence interval (95% CI) 0.8–1.8]. Adjusted for baseline age, use of corticosteroids, salicylates and nonsteroidal anti-inflammatory drugs, the relative risk reversed to 0.6 (95% CI 0.4–1.2). Conclusion: The use of cyclical etidronate is not associated with an elevated risk of symptoms of peptic ulcer disease.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1041
    Keywords: Key words Asthma therapy ; Corticosteroids; hospitalisation ; case-control study ; compliance ; attitude ; behaviour
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Background: The relationship between therapy and adverse outcome in asthma is debated especially for naturally occurring situations. This is due in part to insufficient information regarding actual use of medications. Objective: This study was conducted to clarify the relationship between actual intake of anti-asthma drugs and asthma hospitalisation, considered as an outcome. Methods: A case-control study was performed. Patients hospitalised for an asthma exacerbation were matched to community controls identified in surrounding general practices. Patients were questioned to identify prior use of anti-asthma medications, level of use of inhaled corticosteroids and attitude towards therapy. Results: Twenty-three cases and 31 matched controls were interviewed. Cases tended to have more severe asthma than controls, as judged by more frequent use of oral corticosteroids. Cases tended to make more frequent use of oral xanthines and inhaled anticholinergics, but the proportion of patients using inhaled β2-adrenoceptor agonists and inhaled corticosteroids was similar in both groups. Use of lower doses of inhaled corticosteroids was associated with an increased risk of hospitalisation, while higher dosage was associated with␣decreased risk. Cases and controls differed as to their answers to a questionnaire concerning attitudes: cases expressed less interest in optimal usage of inhaled␣corticosteroids than controls; they also expressed more confidence in inhaled β2-agonists. When both risks were combined, overconfidence in β2-agonists and suboptimal use of inhaled steroids, the relationship with hospitalisation was significant (OR 5.5, 95% CI 1.1; 26.1). Conclusion: The results suggest that patients' attitudes to inhaled corticosteroids and actual consumption of these medications are directly related to adverse outcome in asthma.
    Type of Medium: Electronic Resource
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