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  • German Medical Science; Düsseldorf, Köln  (3)
  • Blackwell Science Ltd  (2)
  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.; 20050504-20050508; Erfurt; DOC05hno220 /20050922/
    Publication Date: 2005-09-23
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 2
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    German Medical Science; Düsseldorf, Köln
    In:  121. Kongress der Deutschen Gesellschaft für Chirurgie; 20040427-20040430; Berlin; DOC04dgch0474 /20041007/
    Publication Date: 2004-10-07
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science; Düsseldorf, Köln
    In:  GMS Medizinische Informatik, Biometrie und Epidemiologie; VOL: 1; DOC02 /20050407/
    Publication Date: 2005-04-08
    Description: Before general application of a primary prevention program its efficacy has to be demonstrated. For this purpose a randomized controlled trial with active or passive follow-up may be conducted. In the last 5 years, the ratio of controlled trials with passive versus those with active follow-up was 1:13. However, under certain circumstances a passive follow-up may be more appropriate and useful to overcome the drawbacks of an active follow-up, as e.g. high costs and many drop-outs. In a randomized controlled trial, a passive follow-up is based on the reporting of cases by physicians or hospitals instead of actively following up all study participants individually. The statistical evaluation can be carried out using a one-sample chi2-test. Advantages and limitations are discussed. A passive follow-up may be advantageous in situations with low incidence, large number of participants, complete ascertainment of conditions with obligatory notification or effective disease registries and should be preferred in such a context.
    Description: Vor dem Einsatz primärer Präventionsprogramme auf Bevölkerungsebene ist deren Wirksamkeit zu prüfen. Standardmäßig werden dazu randomisierte kontrollierte Studien mit aktivem oder passivem Follow-up durchgeführt. In den letzten 5 Jahren kamen auf 1 Studie mit passivem Follow-up 13 Studien mit aktivem Follow-up. Unter bestimmten Voraussetzungen kann ein passives Follow-up jedoch geeigneter und sinnvoll sein und dazu dienen die Nachteile eines aktiven Follow-ups, wie z.B. hohe Kosten und viele Drop-outs, zu vermeiden. In einer randomisierten kontrollierten Studie mit passivem Follow-up werden alle Patienten mit der interessierenden Erkrankung von den behandelnden Ärzten oder den Krankenhäusern der Region direkt an das Studiensekretariat gemeldet. Die statistische Auswertung kann mit einem 1-Stichproben-Chi2-Test erfolgen. Die Vor- und Nachteile dieses Vorgehens werden diskutiert. Ein passives Follow-up kann in Situationen mit niedriger Inzidenz, großer Anzahl von Studienteilnehmern, Gewährleistung einer vollständigen Erhebung der Krankheitsfälle durch Betrachtung einer meldepflichtigen Erkrankung und gut geführte Krankheitsregister vorteilhaft sein und sollte dann durchaus bevorzugt werden.
    Keywords: active follow-up ; passive follow-up ; study design ; randomized controlled trial ; primary prevention program ; aktives Follow-up ; passives Follow-up ; Studiendesign ; randomiserte kontrollierte Studie ; primäres Präventionsprogramm ; ddc: 610
    Language: English
    Type: article
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  • 4
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  There are very few data regarding sun exposure behaviour of patients with basal cell carcinoma (BCC) in central Europe.Objectives  A case–control study of patients with sporadic BCC was conducted to assess the risk of occupational and leisure-time sun exposure behaviour, precursor lesions for skin cancer and phenotypic factors on the development of sporadic BCC in Ulm and Dresden, Germany.Methods  A comparison was made of 213 patients with BCC (128 from Ulm, 85 from Dresden; 103 men and 110 women; median age at diagnosis 69 years) and 411 controls (237 from Ulm, 174 from Dresden; 197 men and 214 women; median age 58 years). Crude odds ratios (ORs) and corresponding 95% confidence intervals for all of 64 possible risk factors revealed strong associations in 33 items. Selection of important risk factors was performed in a multiple logistic regression.Results  For sporadic BCC, an increased risk was shown for persons with actinic cheilitis (OR 7·1), actinic keratosis (OR 2·7) and solar lentigo (OR 2·5). The only phenotypic factor indicating risk of sporadic BCC was hair colour, with a higher risk for red/fair than brown/black hair (OR 4·3). There was an increased risk for persons with BCC in first-degree relatives (OR 5·1) and those with sunburn 20 years before sporadic BCC was diagnosed (OR 3·6). Additionally, occupational ultraviolet (UV) exposure appeared to be a risk factor (OR 2·4). In contrast, clinical actinic elastosis showed a protective effect (OR 0·1).Conclusions  In contrast to earlier reports, clinical actinic elastosis turned out to be the only protective factor for sporadic BCC. A special relationship between wrinkling and BCC risk could not be shown. For basic research, future work should be aimed at elucidating further the different forms of collagen repair processes after intermittent and/or chronic UV exposure. The data strongly support the recommendation that a change in recreational UV exposure habits in individuals, and sunburn avoidance in particular, are necessary not only because of the increased long-term risk of melanoma, but also because of the risk of other skin cancers such as sporadic BCC.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background A matched case–control study was performed in Munich, Germany, in 1996–97 to evaluate the risk of cutaneous melanoma due to ultraviolet (UV) exposure behaviour in Southern Bavaria, Germany. Objectives Patients with cutaneous melanoma and controls were investigated by two physicians using a standardized questionnaire to identify risk factors for the development of melanoma, such as professional and leisure sun exposure behaviour. In each person, a total body examination was performed to detect benign skin alterations, phenotypic characteristics and precursor lesions for skin cancer. Patients/methods A total of 271 melanoma patients and 271 controls were individually matched for residence, age and gender. A multiple conditional logistic regression analysis was performed. Results Of 56 factors, those risk factors with a strong effect on the development of melanoma were: the existence of melanoma in first degree relatives, solar lentigo, actinic keratosis, actinic cheilitis, skin phototype, immediate skin reaction to UV light at the start of the outdoor season, sunburn in childhood and sun exposure during holidays in sunny areas 20 years before melanoma was diagnosed; outdoor activities in childhood were found to be protective. Conclusions Sunburn in childhood and increased sun exposure during annual holidays in sunny areas should be avoided. In contrast, outdoor activities in childhood, including soccer and gardening, should be encouraged because they are associated with a lower risk of melanoma formation.
    Type of Medium: Electronic Resource
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