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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Kongress Medizin und Gesellschaft 2007; 20070917-20070921; Augsburg; DOC07gmds745 /20070906/
    Publication Date: 2007-09-07
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
    Keywords: CANCER ; cohort studies ; RISK-FACTORS ; PREVALENCE ; nutrition ; GENETIC EPIDEMIOLOGY ; PHYSICAL-ACTIVITY ; CORONARY-HEART-DISEASE ; SPAIN ; type 2 diabetes ; LOCI ; Diabetes Mellitus ; GENOME-WIDE ASSOCIATION ; Epidemiologic research design ; Gene-lifestyle interaction ; POPULATION-BASED INCIDENCE
    Abstract: Studying gene-lifestyle interaction may help to identify lifestyle factors that modify genetic susceptibility and uncover genetic loci exerting important subgroup effects. Adequately powered studies with prospective, unbiased, standardised assessment of key behavioural factors for gene-lifestyle studies are lacking. This case-cohort study aims to investigate how genetic and potentially modifiable lifestyle and behavioural factors, particularly diet and physical activity, interact in their influence on the risk of developing type 2 diabetes. Incident cases of type 2 diabetes occurring in European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts between 1991 and 2007 from eight of the ten EPIC countries were ascertained and verified. Prentice-weighted Cox regression and random-effects meta-analyses were used to investigate differences in diabetes incidence by age and sex. A total of 12,403 verified incident cases of type 2 diabetes occurred during 3.99 million person-years of follow-up of 340,234 EPIC participants eligible for InterAct. We defined a centre-stratified subcohort of 16,154 individuals for comparative analyses. Individuals with incident diabetes who were randomly selected into the subcohort (n = 778) were included as cases in the analyses. All prevalent diabetes cases were excluded from the study. InterAct cases were followed-up for an average of 6.9 years; 49.7% were men. Mean baseline age and age at diagnosis were 55.6 and 62.5 years, mean BMI and waist circumference values were 29.4 kg/m(2) and 102.7 cm in men, and 30.1 kg/m(2) and 92.8 cm in women, respectively. Risk of type 2 diabetes increased linearly with age, with an overall HR of 1.56 (95% CI 1.48-1.64) for a 10 year age difference, adjusted for sex. A male excess in the risk of incident diabetes was consistently observed across all countries, with a pooled HR of 1.51 (95% CI 1.39-1.64), adjusted for age. InterAct is a large, well-powered, prospective study that will inform our understanding of the interplay between genes and lifestyle factors on the risk of type 2 diabetes development
    Type of Publication: Journal article published
    PubMed ID: 21717116
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  • 3
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  GMS Psycho-Social-Medicine; VOL: 7; DOC04 /20100831/
    Publication Date: 2010-09-01
    Description: Objectives: Successful long-term results are extremely rare in non-surgical obesity treatment. Interactional difficulties with the attending physicians and the limited compliance of obese patients are a frequently described dilemma in repeated psychotherapeutic group treatment attempts. The type of relationship initiation and the attachment behavior probably play a central role in this connection but have not yet been systematically investigated.Methods: This paper focuses on the attachment styles of obese subjects and their effects on psychodynamic group therapy within the context of a weight-reduction program.Results: The attachment styles are characterized in 107 pre-obese and obese patients, and their effects on patients and therapists in group therapy are described.Conclusion: The paper surveys the motivational situation, clinical pictures, and repeated group topics.
    Description: Ziele: Langanhaltende Therapieerfolge in der nicht operativen Adipositasbehandlung sind äußerst gering. Interaktionelle Schwierigkeiten mit den behandelnden Ärzten und eine eingeschränkte Compliance von adipösen Patienten stellen das immer wieder beschriebene Dilemma bei sich wiederholenden Gruppenpsychotherapieversuchen von adipösen Patienten dar. Die Art der Beziehungsaufnahme und das Bindungsverhalten spielen hierbei vermutlich eine zentrale Rolle, wurden bisher jedoch noch nicht systematisch untersucht. Methoden: Der Beitrag fokussiert daher als einen neuen Zugangsweg die Bindungsstile Adipöser und deren Auswirkungen auf die psychoanalytisch-interaktionelle Gruppentherapie bei TeilnehmerInnen eines einjährigen Gewichtsreduktionsprogramms.Ergebnisse: Es werden die Charakteristika der Bindungsstile bei 107 untersuchten übergewichtigen und adipösen Patienten sowie deren Effekte auf die Gruppentherapie beschrieben.Konklusion: Es wird ein Überblick über die Motivationslage, die Störungsbilder und die wiederkehrenden Gruppenthemen der TeilnehmerInnen gegeben.
    Keywords: obesity ; attachment styles ; psychotherapy ; group ; therapist ; ddc: 610
    Language: English
    Type: article
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  • 4
    Keywords: Germany ; human ; MODEL ; COHORT ; RISK ; GENE ; ASSOCIATION ; polymorphism ; VARIANTS ; SEXUAL DIMORPHISM ; resistance ; WOMEN ; MEN ; OBESITY ; REDUCED RISK ; BODY ; TYPE-2 ; TRENDS ; DIETARY-FAT ; EPIC-GERMANY ; insulin ; MASS INDEX ; REGRESSION ; VARIANT ; INHERITANCE ; INSULIN-RESISTANCE ; metabolic syndrome ; GENDER ; BMI ; type 2 diabetes ; A54T polymorphism ; ABORIGINAL CANADIANS ; ALA54THR POLYMORPHISM ; FATTY-ACID-BINDING ; intestinal fatty acid binding protein ; POSTPRANDIAL RESPONSES ; PROTEIN-2 GENE
    Abstract: The T54 variant of the FABP2 gene has shown an association with the insulin resistance syndrome in some, but not all, studies. Here, we tested the hypothesis that the association between FABP2 A54T genotype and type 2 diabetes (T2DM) is confounded by body mass index (BMI) and is different between the two genders. 192 incident cases of T2DM and 384 sex- and age-matched controls were taken from the EPIC-Potsdam study cohort. Logistic regression analyses revealed that BMI was a strong confounder for diabetes risk association among women. When adjusted for BMI, the homozygous T54 variant was significantly associated with reduced risk of T2DM in women (OR = 0.24, 95%CI: 0.07-0.82), but not in men in the co-dominant inheritance model. Accordingly, HbA(1c) values were significantly lower in women carrying two T54 alleles with BMI regarded as covariate. While accounting for potentially confounding effects, linear trends of increased BMI and leptin values were observed in women according to the presence of T54 alleles. The interaction term (p = 0.04) of continuous BMI and T54-coding genotypes suggested that the T54 variant is an effect-modifier for BMI in females. We conclude that the T54 allele of FABP2 A54T is associated both with higher BMI and reduced risk of T2DM in women from the German EPIC-Potsdam study
    Type of Publication: Journal article published
    PubMed ID: 16718632
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  • 5
    Keywords: CANCER ; Germany ; human ; MODEL ; INFORMATION ; screening ; TOOL ; COHORT ; cohort study ; HISTORY ; POPULATION ; RISK ; METABOLISM ; FAMILY ; RISK-FACTORS ; score ; lifestyle ; DESIGN ; AGE ; WOMEN ; MEN ; risk factors ; smoking ; POPULATIONS ; DIETARY ; HYPERTENSION ; meat ; nutrition ; TYPE-2 ; EPIC-GERMANY ; BETA-CELL FUNCTION ; insulin ; MELLITUS ; REGRESSION ; FAMILIES ; PHYSICAL-ACTIVITY ; RELATIVE VALIDITY ; development ; methods ; metabolic syndrome ; prospective ; correlation ; MEAT INTAKE ; RISK-FACTOR ; type 2 diabetes ; PREDICT ; type-2-diabetes ; FASTING GLUCOSE ; IMPAIRED GLUCOSE-TOLERANCE ; INSULIN SECRETORY DYSFUNCTION ; WHOLE-GRAIN INTAKE
    Abstract: OBJECTIVE - We aimed to develop a precise risk score for the screening of large populations for individuals at high risk of developing type 2 diabetes based on noninvasive measurements of major risk factors in German study populations. RESEARCH DESIGN AND METHODS - A prospective cohort study (European Prospective Investigation into Cancer and Nutrition [EPIC]-Potsdam study) of 9,729 men and 15,438 women aged 35-65 years was used to derive a risk score predicting incident type 2 diabetes. Multivariate Cox regression model coefficients were used to weigh each variable in the. calculation of the score. Data from the EPIC-Heidelberg, the Tubingen Family Study for Type 2 Diabetes (T F), and the Metabolic Syndrome Berlin Potsdam (MeSyBePo) study were used to validate this score. RESULTS - information on age, waist circumference, height, history of hypertension, physical activity, smoking, and consumption of red meat, whole-grain bread, coffee, and alcohol formed the German Diabetes Risk Score (mean 446 points [range 118-983]). The probability of developing diabetes within 5 years in the EPIC-Potsdam study increased from 0.3% for 300 to 23.2% for 750 score points. The area under the receiver-operator characteristic (ROC) curve was 0.84 in the EPIC-Potsdam and 0.82 in the EPIC-Heidelberg studies. Correlation coefficients between the German Diabetes Risk Score and insulin sensitivity in nondiabetic individuals were -0.56 in the TUF and -0.45 in the MeSyBePo studies. ROC values for undiagnosed diabetes were 0.83 in the TUF and 0.75 in the MeSyBePo studies. CONCLUSIONS - The German Diabetes Risk Score (available at www.dife.de) is an accurate tool to identify individuals at high risk for or with undiagnosed type 2 diabetes
    Type of Publication: Journal article published
    PubMed ID: 17327313
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  • 6
    Keywords: CANCER ; ASSOCIATION ; prevention ; nutrition ; MELLITUS ; PARTICIPANTS ; BODY-MASS INDEX ; WAIST CIRCUMFERENCE ; PRIMARY-CARE ; ABDOMINAL ADIPOSITY
    Abstract: BACKGROUND: Waist circumference (WC) is a simple and reliable measure of fat distribution that may add to the prediction of type 2 diabetes (T2D), but previous studies have been too small to reliably quantify the relative and absolute risk of future diabetes by WC at different levels of body mass index (BMI). METHODS AND FINDINGS: The prospective InterAct case-cohort study was conducted in 26 centres in eight European countries and consists of 12,403 incident T2D cases and a stratified subcohort of 16,154 individuals from a total cohort of 340,234 participants with 3.99 million person-years of follow-up. We used Prentice-weighted Cox regression and random effects meta-analysis methods to estimate hazard ratios for T2D. Kaplan-Meier estimates of the cumulative incidence of T2D were calculated. BMI and WC were each independently associated with T2D, with WC being a stronger risk factor in women than in men. Risk increased across groups defined by BMI and WC; compared to low normal weight individuals (BMI 18.5-22.4 kg/m(2)) with a low WC (〈94/80 cm in men/women), the hazard ratio of T2D was 22.0 (95% confidence interval 14.3; 33.8) in men and 31.8 (25.2; 40.2) in women with grade 2 obesity (BMI〉/=35 kg/m(2)) and a high WC (〉102/88 cm). Among the large group of overweight individuals, WC measurement was highly informative and facilitated the identification of a subgroup of overweight people with high WC whose 10-y T2D cumulative incidence (men, 70 per 1,000 person-years; women, 44 per 1,000 person-years) was comparable to that of the obese group (50-103 per 1,000 person-years in men and 28-74 per 1,000 person-years in women). CONCLUSIONS: WC is independently and strongly associated with T2D, particularly in women, and should be more widely measured for risk stratification. If targeted measurement is necessary for reasons of resource scarcity, measuring WC in overweight individuals may be an effective strategy, since it identifies a high-risk subgroup of individuals who could benefit from individualised preventive action. Please see later in the article for the Editors' Summary.
    Type of Publication: Journal article published
    PubMed ID: 22679397
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  • 7
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    German Medical Science; Düsseldorf, Köln
    In:  Evidenzbasierte Medizin - Anspruch und Wirklichkeit; 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft; 20040923-20040926; Berlin; DOC04dogDO.03.10 /20040922/
    Publication Date: 2004-09-21
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 8
    ISSN: 0945-053X
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Medicine
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1076
    Keywords: Dysostosis metaphysaria ; Chondrodysplasia metaphysaria
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Beschreibung eines vom Säuglingsalter bis gegen Ende des 18. Lebensjahres verfolgten besondersartigen Falles von metaphysärer Chondrodysplasie (Dysostosis metaphysaria der bisherigen Terminologie). Charakteristika: Angeborene Manifestation im Sinne des rhizomelen Minderwuchses (“Frühtyp”); jahrelang nachweisbar gebliebene Ossifikations-Entwicklunsverzögerung zahlreicher Wirbelkörper im Sinne “frontaler Wirbelspalten”; Nichtbeteiligung der kurzen Röhrenknochen von Händen und Füßen; auffällige Physiognomie. Die Skeletveränderungen bildeten sich während der Kindheit spontan zurück; es kam zu praktisch normaler Konfiguration der Knochen und einer Endlänge des Patienten von 166 cm. Sorgfätige Stoffwechseluntersuchungen ergaben Normalbefunde.
    Notes: Abstract This is the report of a patient with an unusual form of metaphyseal dysostosis who was followed from infancy to adulthood. The bone dysplasia of this patient is characterized by the following features: 1. Manifestation at birth. 2. Rhizomelic shortness of stature. 3. Roentgenographic bone changes consisting of splaying, cupping and irregularity of the metaphyses with deep radiolucent metaphyseal defects and bicentric ossification of the vertebral bodies. 4. Spontaneous remission of the lesions during chilhood leading to near-normal configuration of the bones and an adult height of 166 cm. 5. Normal biochemical findings including those of the calciumphosphate —amino acid — and mucopolysaccharide metabolism.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1076
    Keywords: Primordial dwarfism ; Intrauterine growth failure ; Skeletal hypoplasia ; Silver-Russell dwarfism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two pairs of siblings are described with proportionate dwarfism due to skeletal hypoplasia of prenatal onset. The head size was normal for age and disproportionately large for height. The patients had a characteristic face different from that seen in the Silver-Russell syndrome. The family data are in accordance with autosomal recessive inheritance. In spite of some similarities, the bulk of clinical and genetic evidence suggests that the described intrauterine growth retardation syndrome is different from the Silver-Russell syndrome and presents an apparently “new” entity which has been designated 3-M syndrome.
    Type of Medium: Electronic Resource
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