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  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie; 20050912-20050915; Freiburg im Breisgau; DOC05gmds126 /20050908/
    Publication Date: 2005-09-09
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 2
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  • 3
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Mainz//2011; 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi); 20110926-20110929; Mainz; DOC11gmds148 /20110920/
    Publication Date: 2011-09-20
    Keywords: Screening Strategies ; Prediction ; Pre-Diabetes ; Diabetes mellitus type 2 ; Fasting Plasma Glucose ; Hemoglobin A1c ; Cohort Study ; Elderly ; ddc: 610
    Language: English
    Type: conferenceObject
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  • 4
    Keywords: Germany ; screening ; RISK ; SAMPLE ; SAMPLES ; INFECTION ; IMPACT ; RISK-FACTORS ; ASSOCIATION ; HEALTH ; DESIGN ; ESCHERICHIA-COLI ; resistance ; risk factors ; CHILDREN ; INFECTIONS ; PREVALENCE ; YOUNG ; ASSOCIATIONS ; RE ; SIBLINGS ; DETERMINANTS ; RESISTANT ; odds ratio ; RISK-FACTOR ; population-based ; E ; TRANSMISSION ; COMMUNITY ; CONTACT ; HEALTHY-CHILDREN ; URINARY-TRACT-INFECTION ; bacterial ; antibiotic resistance ; ANTIBIOTIC-RESISTANCE ; DAY-CARE-CENTERS ; e.coli ; household ; TRIMETHOPRIM-RESISTANT
    Abstract: Objective: In young children infections with resistant Escherichia coli (E. coli) can lead to life-threatening situations. Epidemiological data on the prevalence and major determinants of carriage of antibiotic resistant E. coli among children in the community setting are sparse. Study Design and Setting: In a population-based study from Germany, stool samples were obtained from children aged 6 months to 4 years attending a pediatrician for a regular health screening (N = 568) or an acute infection (N = 316), as well as from their parents (N = 1,594) and siblings (N = 624). E coli was cultured, and minimal inhibitory concentrations to various antibiotics were tested. We determined prevalences of E. coli resistance to commonly prescribed antibiotics and their association with potential risk factors. Results: Prevalence of E. coli resistance was 16.6%, 8.7%, and 11.6% for ampicillin, cotrimoxazole, and doxycycline, respectively. Strong associations were found with antibiotic resistance among siblings (odds ratios [95% confidence intervals] for ampicillin, doxycycline, and cotrimoxazole resistance: 4.4 [1.8-10.81, 8.0 [3.0-21.2], and 10.8 [3.5-32.71, respectively). Conclusion: Resistance prevalences in this community-based study were much lower than those reported from the clinical sector. Household contacts seem to be the key factor for children's colonization with resistant E. coli in the community setting. (C) 2007 Elsevier Inc. All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 17938057
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  • 5
    Keywords: COMBINATION ; Germany ; COHORT ; DISEASE ; DISEASES ; liver ; MORTALITY ; IMPACT ; RISK-FACTORS ; ASSOCIATION ; WOMEN ; CIGARETTE-SMOKING ; MEN ; smoking ; COFFEE ; SERUM ; DETERMINANTS ; GENERAL-POPULATION ; AUSTRIAN ADULTS ; CARDIOVASCULAR-DISEASE MORTALITY
    Abstract: There is increasing evidence that serum levels of the liver enzyme gamma-glutamyltransferase (gamma-GT) are an important predictor of incidence and mortality of various diseases. Apart from alcohol consumption, body mass index and smoking have been found to be associated with serum levels, but little is known about potential interactions of these factors. The aim of this study was to assess the individual and joint impact of alcohol consumption and smoking on levels of gamma-GT, with particular attention to potential differences by sex. The study was based on data of 8465 subjects aged 50 to 74 years, obtained at baseline examination of the ESTHER study, a large population-based cohort study in Germany. Exposure-outcome relationships were assessed in women and men, adjusting for potential confounders by multiple regression. In both sexes, moderate to heavy alcohol consumption (100+ g/week) was associated with 1.7-fold increased odds of elevated gamma-GT (〉 50 IU/L) in reference to nonsmoking alcohol abstainers, whereas smoking by itself was unrelated to gamma-GT. However, when moderate to heavy alcohol consumption was present in combination with heavy smoking, the odds ratios (95% CI) increased to 2.9 (1.1-7.6) in women and to 3.8 (2.2-6.6) in men (test for interaction between alcohol consumption and smoking: P-females = 0.12, P-males = 0.0017). Conclusion: Our results support the notion of a detrimental interaction between cigarette smoking and alcohol consumption as determinants of elevated serum gamma-GT, especially in men. (HEPATOLOGY 2009;49:802-808.)
    Type of Publication: Journal article published
    PubMed ID: 19152425
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  • 6
    Keywords: RECEPTOR ; Germany ; LUNG-CANCER ; COHORT ; DISEASE ; EPIDEMIOLOGY ; HISTORY ; POPULATION ; RISK ; GENE ; GENES ; ASSOCIATION ; polymorphism ; POLYMORPHISMS ; single nucleotide polymorphism ; SUSCEPTIBILITY LOCUS ; DISTRIBUTIONS ; SUBUNIT ; smoking ; genetic polymorphism ; TOBACCO ; MAPS ; SINGLE ; ADULTS ; GENETIC EPIDEMIOLOGY ; VARIANT ; DEPENDENCE ; SINGLE NUCLEOTIDE POLYMORPHISMS ; SNPs ; GENOTYPE ; HAPLOTYPES ; USA ; smoking cessation ; GENOME-WIDE ASSOCIATION ; GENERAL-POPULATION ; ROBUST ; historical cohort study
    Abstract: Background: Evidence has recently accumulated that single nucleotide polymorphisms in the genetic region encoding the nicotinic acetylcholine receptor subunits alpha-5, alpha-3, and beta-4 are associated with smoking and nicotine dependence. We aimed to determine whether these genetic variations are also predictive of smoking cessation. Methods: Lifetime history of smoking was assessed by questionnaire at enrolment into a large epidemiological study of the German elderly population (ESTHER study). Cox proportional hazards modeling was applied in a retrospective cohort approach to determine the associations of individual polymorphisms and haplotypes with smoking cessation probability in 1446 subjects who reported regularly smoking more than 20 cigarettes at some point in their lives. Results: Given the genotype distributions and number of cessation events observed, the power to detect associations ranged from 54% to 97% for hazard ratios of 1.2 to 1.4 in case of the variant with strongest prior evidence (alpha = .05). Nonetheless, neither individual polymorphisms nor inferred multilocus haplotypes were significantly associated with smoking cessation. Conclusions: Although the robust association of the nicotinic acetylcholine receptor subunit genes investigated with smoking-related phenotypes is an apparent success story of genetic epidemiology, the respective variations seem to exert no relevant influence on smoking cessation probability in heavy smokers in the general population
    Type of Publication: Journal article published
    PubMed ID: 18996504
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  • 7
    Keywords: Germany ; COHORT ; DISEASE ; EPIDEMIOLOGY ; HISTORY ; POPULATION ; RISK ; PATIENT ; IMPACT ; FREQUENCIES ; AGE ; smoking ; HIGH-RISK ; BEHAVIOR ; COMORBIDITY ; MEDICAL HISTORY ; FRAMEWORK ; CARDIOVASCULAR-DISEASE ; CORONARY-HEART-DISEASE ; development ; smoking cessation ; population-based ; CESSATION ; QUIT ; NICOTINE DEPENDENCE ; INTERVENTIONS ; STATE ; 3 ; CONFIDENCE ; INSIGHT ; OLDER ; health-related behavior ; nicotine withdrawal ; PRIMARY-CARE
    Abstract: Background: Much media attention currently focuses on demands from the organized medical profession in Germany for an altered legal framework regarding remuneration for smoking-cessation interventions. With this development, the question whether smoking is an autonomously chosen lifestyle or, alternatively, an addiction constituting a disease in its own right has once again come to the fore of public debate. Methods: In a population-based study in the German state of Saarland, 10 000 persons aged 50 to 74 were questioned about their health-related behavior and medical history. The frequency of attempts to quit smoking, and of the motivation to do so, was analyzed in relation to the total number of smokers in the survey and was stratified with respect to existing illnesses whose cardiovascular risk potential is exacerbated by smoking. Results: Among 1528 persons who were smokers at the beginning of the study, 76% (95% confidence interval [CI]: 73.7%-78.0%) reported having tried to quit at least once. Among smokers with existing high-risk conditions, this figure was higher, reaching 89% (CI: 83.1%-93.0%) in smokers with known cardiovascular disease. Only 11% of the smokers were content with their smoking behavior; 30% said they wanted to cut down, and 59% said they wanted to quit smoking entirely. Conclusions: Most older smokers in Germany would like to quit smoking and have tried to do so repeatedly without success. In particular, high-risk patients with comorbidities, whose number will further increase as the population ages, are highly motivated to quit smoking and would derive major benefit from effective assistance with smoking cessation. The description of smoking as an autonomously chosen lifestyle appears cynical and deserves to be vigorously rejected. Dtsch Arztebl Int 2009; 106(27): 451-55 DOI: 10.3238/arztebl.2009.0451
    Type of Publication: Journal article published
    PubMed ID: 19652767
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  • 8
    Keywords: RECEPTOR ; CANCER ; GROWTH ; PATHWAYS ; SYSTEM ; TOOL ; RISK ; PROTEIN ; SACCHAROMYCES-CEREVISIAE ; ACTIVATION ; MARKER ; CARCINOGENESIS ; BREAST ; breast cancer ; BREAST-CANCER ; ELEMENT ; TRIALS ; hormone ; ASSAY ; WOMEN ; EFFICACY ; BETA ; ADJUVANT ; MANAGEMENT ; POSTMENOPAUSAL WOMEN ; SERUM ; ASSAYS ; HORMONES ; ANDROGEN ; FLUORESCENT PROTEIN ; UK ; RECEPTOR-ALPHA ; STRATEGY ; oestrogen receptor ; RECOMBINANT CELL BIOASSAY ; serum bioactivity
    Abstract: BACKGROUND: Oestrogens play a crucial role in breast carcinogenesis. Earlier studies have analysed the serum levels of endogenous hormones measured by conventional assays. In this study, we analysed the capacity of serum from breast cancer cases and controls to transactivate the oestrogen receptor alpha (ER-alpha) and beta (ER-beta). METHODS: We used a receptor oestrogen-responsive element (ERE) - the green fluorescent protein (GFP)- reporter test system in Saccharomyces cerevisiae. Oestrogen receptor-alpha or ER-beta bioactivity was determined in serum from 182 randomly chosen postmenopausal women with breast cancer and from 188 age-matched controls. RESULTS: High serum ER-alpha and ER-beta bioactivity were independently associated with the presence of breast cancer. Women whose levels of serum ER-alpha and ER-beta bioactivity were in the highest quintile among controls had a 7.57-(95% confidence interval (CI): 2.46-23.32; P = 0.0004) and a 10.14 (95% CI: 3.19-32.23; P〈0.0001)-fold risk for general and oestrogen receptor-positive breast cancer, respectively. CONCLUSION: The use of serum ER-alpha and ER-beta bioactivity assays as clinical tools in the management of breast cancer warrants further research. Future studies will dictate whether surrogate markers of ER-alpha and ER-beta bioactivity will provide a means to monitor the efficacy of anti-endocrine, adjuvant and chemopreventive strategies. British Journal of Cancer ( 2009) 101, 160-165. doi: 10.1038/sj.bjc.6605106 www.bjcancer.com Published online 2 June 2009 (C) 2009 Cancer Research UK
    Type of Publication: Journal article published
    PubMed ID: 19491898
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  • 9
    Keywords: Germany ; MODEL ; MODELS ; COHORT ; EPIDEMIOLOGY ; POPULATION ; GENES ; PATIENT ; ASSOCIATION ; polymorphism ; POLYMORPHISMS ; single nucleotide polymorphism ; VARIANTS ; CARE ; HEALTH ; genetics ; smoking ; REPLICATION ; TOBACCO ; SINGLE ; REGRESSION ; VARIANT ; DETERMINANTS ; DEPENDENCE ; SINGLE NUCLEOTIDE POLYMORPHISMS ; CATECHOL-O-METHYLTRANSFERASE ; PHARMACOGENETICS ; GENOTYPE ; EVENTS ; pharmacology ; USA ; smoking cessation ; population-based ; biotechnology ; GENERAL-POPULATION ; NICOTINE DEPENDENCE ; COMT ; Genetic ; CONFIDENCE ; historical cohort study ; PROPORTION
    Abstract: Genome-wide studies have identified single nucleotide polymorphisms associated with smoking behaviour and nicotine dependence. Less is known about genetic determinants of smoking cessation, but rs4680 in COMT has recently been shown to explain a substantial proportion of the variation in cessation in the general population. We attempted to replicate the reported, clinically relevant effect in a population-based retrospective cohort analysis of 1443 ever-heavy smokers, of whom 925 had reached abstinence. In Cox regression models, neither rs4680 nor two polymorphisms nearby were associated with smoking cessation. The adjusted relative cessation rate (95 percent confidence interval) in rs4680 methionine carriers in reference to valine homozygotes was 0.97 (0.83-1.12). The absence of a significant effect of rs4680 in this statistically well-powered study - the 95% confidence interval even excluding the previously reported effect - highlights the need for rigorous replication efforts and suggests that rs4680 genotype should not yet be considered informative for smoking patient care. Pharmacogenetics and Genomics 19:657-659 (C) 2009 Wolters Kluwer Health / Lippincott Williams & Wilkins
    Type of Publication: Journal article published
    PubMed ID: 19584770
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  • 10
    Keywords: CANCER ; FOLLOW-UP ; SUPPORT ; COHORT ; cohort studies ; cohort study ; DEATH ; DISEASE ; LONG-TERM ; MORTALITY ; RISK ; RISK-FACTORS ; ASSOCIATION ; GLYCOPROTEIN ; DISTRIBUTIONS ; HUMANS ; AGE ; risk factors ; RATES ; RISK FACTOR ; DATABASE ; lipids ; INDIVIDUALS ; OUTCOMES ; SELECTION ; HEART-DISEASE ; STROKE ; REGRESSION ; EXTRACTION ; prospective studies ; CORONARY-HEART-DISEASE ; METAANALYSIS ; prospective ; prospective study ; RISK-FACTOR ; Cause of Death ; coronary heart disease ; lipid ; outcome ; CONFIDENCE ; PARTICLE ; RANGE ; Coronary Disease/*blood/*epidemiology ; Lipoprotein(a)/*blood ; Stroke/*blood/*epidemiology
    Abstract: CONTEXT: Circulating concentration of lipoprotein(a) (Lp[a]), a large glycoprotein attached to a low-density lipoprotein-like particle, may be associated with risk of coronary heart disease (CHD) and stroke. OBJECTIVE: To assess the relationship of Lp(a) concentration with risk of major vascular and nonvascular outcomes. STUDY SELECTION: Long-term prospective studies that recorded Lp(a) concentration and subsequent major vascular morbidity and/or cause-specific mortality published between January 1970 and March 2009 were identified through electronic searches of MEDLINE and other databases, manual searches of reference lists, and discussion with collaborators. DATA EXTRACTION: Individual records were provided for each of 126,634 participants in 36 prospective studies. During 1.3 million person-years of follow-up, 22,076 first-ever fatal or nonfatal vascular disease outcomes or nonvascular deaths were recorded, including 9336 CHD outcomes, 1903 ischemic strokes, 338 hemorrhagic strokes, 751 unclassified strokes, 1091 other vascular deaths, 8114 nonvascular deaths, and 242 deaths of unknown cause. Within-study regression analyses were adjusted for within-person variation and combined using meta-analysis. Analyses excluded participants with known preexisting CHD or stroke at baseline. DATA SYNTHESIS: Lipoprotein(a) concentration was weakly correlated with several conventional vascular risk factors and it was highly consistent within individuals over several years. Associations of Lp(a) with CHD risk were broadly continuous in shape. In the 24 cohort studies, the rates of CHD in the top and bottom thirds of baseline Lp(a) distributions, respectively, were 5.6 (95% confidence interval [CI], 5.4-5.9) per 1000 person-years and 4.4 (95% CI, 4.2-4.6) per 1000 person-years. The risk ratio for CHD, adjusted for age and sex only, was 1.16 (95% CI, 1.11-1.22) per 3.5-fold higher usual Lp(a) concentration (ie, per 1 SD), and it was 1.13 (95% CI, 1.09-1.18) following further adjustment for lipids and other conventional risk factors. The corresponding adjusted risk ratios were 1.10 (95% CI, 1.02-1.18) for ischemic stroke, 1.01 (95% CI, 0.98-1.05) for the aggregate of nonvascular mortality, 1.00 (95% CI, 0.97-1.04) for cancer deaths, and 1.00 (95% CI, 0.95-1.06) for nonvascular deaths other than cancer. CONCLUSION: Under a wide range of circumstances, there are continuous, independent, and modest associations of Lp(a) concentration with risk of CHD and stroke that appear exclusive to vascular outcomes.
    Type of Publication: Journal article published
    PubMed ID: 19622820
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