Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Keywords: COHORT ; POPULATION ; RISK ; INFECTION ; FAMILY ; RISK-FACTORS ; MEMBERS ; CHILDREN ; PREVALENCE ; GASTRIC-CANCER ; CHILDHOOD ; review ; FAMILIES ; LIFE ; TRANSMISSION ; OCCURS ; PARENTS ; ULCER ; PRESCHOOL-CHILDREN
    Abstract: OBJECTIVES: Infected siblings, mothers, and fathers have all been suggested to be major sources for Helicobacter pylori acquisition among children, but few studies have addressed the potential role of various family members simultaneously. METHODS: A systematic review was performed on studies investigating intrafamilial transmission of childhood H. pylori infection. Within the Ulm Birth Cohort Study, which consists of 1,066 healthy newborns, born between November 2000 and November 2001 and followed up to age 4, and their siblings and parents, the independent role of the infection status of parents and siblings in transmission of H. pylori among children at age 4 was assessed. RESULTS: Among four studies reporting infected mothers and siblings as independent risk factors for childhood H. pylori infection, odds ratios (ORs) for childhood infection given an infected sibling decreased meaningfully after adjustment for maternal infection status. Within the Ulm Birth Cohort Study, the prevalence of infection was 3.0% among index children at age 4. In bivariate analyses, maternal, paternal, and sibling infection were all strongly and significantly related to infection of the child. However, after multivariate adjustment, only maternal infection persisted as the single strong and significant risk factor (OR 13.0, 95% confidence interval 3.0-55.2). CONCLUSIONS: These patterns suggest that mutual control for H. pylori status of other family members is crucial for estimating the role of mothers, fathers, and siblings in the transmission of childhood H. pylori infection. In populations with low H. pylori prevalence the infected mother is likely to be the main source for childhood H. pylori infection
    Type of Publication: Journal article published
    PubMed ID: 19098867
    Signatur Availability
    BibTip Others were also interested in ...
  • 2
    Keywords: CANCER ; colonoscopy ; POLYPS ; TASK-FORCE
    Abstract: OBJECTIVES:Quantitative and qualitative immunochemical fecal occult blood tests (FOBTs) have been proposed for noninvasive colorectal cancer screening, but comparative evaluation is lacking. The aim of this study was to determine the diagnostic accuracy of two (quantitative) enzyme-linked immunosorbent assay (ELISA)-based immunochemical FOBTs for identifying colorectal adenomas in the target population of screening and to compare the results with six (qualitative) immunochromatographic FOBTs, previously evaluated in the same study participants using the same stool samples.METHODS:A total of 1,319 participants of screening colonoscopy at average risk for colorectal neoplasia (mean age 63 years; age range 31-86 years; 50% men) were recruited prospectively from January 2006 to December 2007 in collaboration with 20 gastroenterological practices in Germany. Fecal hemoglobin and hemoglobin-haptoglobin levels were measured using an automated ELISA (RIDASCREEN). Test performance characteristics at different cutoff values were derived by comparing the results of stool testing with the results of colonoscopy in a blinded manner.RESULTS:A total of 130 participants (10%) had an advanced adenoma. The area under the receiver-operating characteristic curve with regard to advanced adenomas was 0.68 (0.65-0.71) for hemoglobin and 0.64 (0.61-0.67) for hemoglobin-haptoglobin (P=0.034). At a specificity of approximately 95%, the sensitivity (95% confidence interval) for advanced adenomas was 33% (25-42%) for hemoglobin and 24% (17-32%) for hemoglobin-haptoglobin, respectively. The sensitivity for hemoglobin was very close to sensitivities of the six qualitative FOBTs at (strongly divergent) levels of specificity observed for the latter.CONCLUSIONS:ELISA-based measurement of hemoglobin was superior to hemoglobin-haptoglobin, but showed a similar sensitivity for advanced adenomas compared with (qualitative) immunochromatographic FOBTs at defined levels of specificity. Compared with the latter, its quantitative nature offers advantages in terms of transparency and flexibility regarding the positivity threshold (e.g., specificity can be oriented toward available colonoscopy resources or personal risk profiles) and in terms of a higher level of standardization regarding test analysis and interpretation.
    Type of Publication: Journal article published
    PubMed ID: 19953091
    Signatur Availability
    BibTip Others were also interested in ...
  • 3
    Keywords: CANCER ; CELLS ; OBESITY ; C-REACTIVE PROTEIN ; inflammation ; ADIPOSE-TISSUE ; INSULIN-RESISTANCE ; METFORMIN ; CLINICAL-COURSE ; MESENTERIC FAT
    Abstract: OBJECTIVES: Obesity is associated with a proinflammatory state that may be involved in the etiology of inflammatory bowel disease (IBD), for which there are plausible biological mechanisms. Our aim was to perform the first prospective cohort study investigating if there is an association between obesity and the development of incident IBD. METHODS: A total of 300,724 participants were recruited into the European Prospective Investigation into Cancer and Nutrition study. At recruitment, anthropometric measurements of height and weight plus physical activity and total energy intake from validated questionnaires were recorded. The cohort was monitored identifying participants who developed either Crohn's disease (CD) or ulcerative colitis (UC). Each case was matched with four controls and conditional logistic regression used to calculate odds ratios (ORs) for body mass index (BMI) adjusted for smoking, energy intake, and physical activity. RESULTS: In the cohort, 177 participants developed incident UC and 75 participants developed incident CD. There were no associations with the four higher categories of BMI compared with a normal BMI for UC (Ptrend=0.36) or CD (Ptrend=0.83). The lack of associations was consistent when BMI was analyzed as a continuous or binary variable (BMI 18.5〈25.0 vs. 〉/=25 kg/m(2)). Physical activity and total energy intake, factors that influence BMI, did not show any association with UC (physical activity, Ptrend=0.79; total energy intake, Ptrend=0.18) or CD (physical activity, Ptrend=0.42; total energy, Ptrend=0.11). CONCLUSIONS: Obesity as measured by BMI is not associated with the development of incident UC or CD. Alternative measures of obesity are required to further investigate the role of obesity in the development of incident IBD.
    Type of Publication: Journal article published
    PubMed ID: 23318483
    Signatur Availability
    BibTip Others were also interested in ...
  • 4
    Keywords: FOLLOW-UP ; POPULATION ; COLORECTAL-CANCER ; sensitivity ; EUROPE ; PROGRAM ; colonoscopy ; METAANALYSIS ; AVERAGE-RISK ; IMMUNOCHEMICAL TESTS
    Abstract: OBJECTIVES: Randomized trials have shown that annual or biannual screening by guaiac-based fecal occult blood tests (gFOBTs) reduces colorectal cancer (CRC) mortality. Few clinical studies have evaluated diagnostic performance of gFOBT through validation by colonoscopy in all participants. We aimed for a comprehensive evaluation of diagnostic performance of gFOBT by age and sex under routine screening conditions. METHODS: Our analysis is based on 20,884 colonoscopies following up a positive gFOBT and 182,956 primary screening colonoscopies documented in a state-wide quality assurance program in Bavaria, Germany, in 2007-2009. Positive likelihood ratios (LR+), which represent an integrative measure of diagnostic performance, were derived, by age groups (55-59, 60-64, 65-69, 70-74 years) and sex, from a joint and comparative analysis of prevalences of colorectal neoplasms in both groups. RESULTS: Overall LR+ (95% confidence intervals) were 1.11 (1.06-1.15), 1.80 (1.72-1.88), and 5.04 (4.64-5.47) for non-advanced adenoma, advanced adenoma, and cancer, respectively. Assuming a specificity of gFOBT of 95.2%, as recently observed in a German study among 2,235 participants of screening colonoscopy, these LR+ would translate to sensitivities of 5.3%, 8.6%, and 24.2% for the three outcomes, respectively. Diagnostic performance was similarly poor among women and men and across age groups. CONCLUSIONS: The performance of gFOBT under routine screening conditions is even worse than previously estimated from clinical studies. In routine screening application, gFOBTs are expected to miss more than 9 out of 10 advanced adenomas and 3 out of 4 cancers. These results underline the need and the potential for better noninvasive CRC screening tests.
    Type of Publication: Journal article published
    PubMed ID: 24343548
    Signatur Availability
    BibTip Others were also interested in ...
  • 5
    Keywords: CANCER ; Germany ; screening ; HISTORY ; incidence ; POPULATION ; RISK ; PATIENT ; FAMILY ; HEALTH ; DIFFERENCE ; AGE ; family history ; WOMEN ; meta-analysis ; colorectal cancer ; MEN ; COLORECTAL-CANCER ; COLON-CANCER ; UNITED-STATES ; RELATIVES ; INITIATION ; RELATIVE RISK ; GUIDELINES ; STATES ; REGISTRY ; review ; RE ; AGGREGATION ; FAMILIES ; aging ; cancer registries ; colonoscopy ; METAANALYSIS ; LEVEL ; methods ; cancer registry ; FAMILY-HISTORY ; PEOPLE ; RECOMMENDATIONS ; population-based ; ENGLAND ; LARGE-BOWEL-CANCER ; GRADIENT ; STATE
    Abstract: OBJECTIVES: To review and combine the best available epidemiological evidence, by sex and age, that may help decision and policy makers form recommendations as to how much earlier colorectal cancer (CRC) screening should be initiated among people with a family history of CRC than among average-risk people. PATIENTS AND METHODS: Combining population-based cancer registry and health interview survey data from the United States and results of a recent meta-analysis of epidemiological studies, we estimated cumulative incidence of CRC within subsequent 10 yr (Cl-10) at various ages among men and women with and without a family history of CRC. We estimated both the Cl-10 levels reached in average-risk 45-, 50-, 55-, and 60-yr-old men and women and the age at which the same Cl-10 levels are reached in men and women with a history of CRC in a first-degree relative. RESULTS: Despite major differences in CRC risk by sex, and despite the strong age gradient in relative risk associated with a positive family history, "risk advancement periods" for those with a family history were consistently found to be between 9 and 11 yr for both sexes and at all four ages assessed. CONCLUSION: Advancement of first CRC screening by 10 yr among both men and women with a family history of CRC compared to the average-risk population (e.g., from 50 to 40 yr of age) appears to be a reasonable, evidence-based recommendation
    Type of Publication: Journal article published
    PubMed ID: 18702651
    Signatur Availability
    BibTip Others were also interested in ...
  • 6
    Abstract: OBJECTIVES: Immunological and guaiac-based fecal occult blood tests (iFOBTs and gFOBTs) are widely used for early detection of colorectal cancer (CRC). We aimed to assess potential sex differences in performance of iFOBTs and gFOBT in the screening setting. METHODS: The sensitivity, specificity, and positive and negative predictive values for detection of advanced colorectal neoplasms (CRC or advanced adenoma) were assessed by sex for a range of cutpoints of a quantitative iFOBT (RIDASCREEN Hemoglobin), six qualitative iFOBTs, and a gFOBT (HemOccult) among 1,157 male and 1,167 female participants of the German screening colonoscopy program (mean age: 63.0 and 62.0 years, respectively). RESULTS: The prevalence of advanced colorectal neoplasms was much higher among men (13.5%) than among women (7.5%). At any cutpoint of the quantitative iFOBT, and for all qualitative iFOBTs and the gFOBT, the sensitivity and positive predictive value were substantially higher, and specificity and negative predictive value were substantially lower among men than among women. At the cutpoint of 2 mug/g stool given by the manufacturer of the quantitative iFOBT, sensitivity, specificity, and the positive and negative predictive values were 47.6, 85.0, 33.0, and 91.3% among men, and 30.7, 89.5, 19.3, and 94.1% among women (P value for sex differences 0.001, 0.002, 0.004, and 0.019, respectively). Sex differences in predictive values were mostly explained by sex differences in the prevalence of advanced colorectal neoplasms. CONCLUSIONS: There are major sex differences in the performance of fecal occult blood testing, which might require careful attention in the interpretation of test results, and in the design, modeling, and evaluation of CRC screening strategies.Am J Gastroenterol advance online publication, 10 August 2010; doi:10.1038/ajg.2010.301.
    Type of Publication: Journal article published
    PubMed ID: 20700114
    Signatur Availability
    BibTip Others were also interested in ...
  • 7
    Abstract: OBJECTIVES: Autoimmune pancreatitis (AIP) is thought to be an immune-mediated inflammatory process, directed against the epithelial components of the pancreas. The objective was to identify novel markers of disease and to unravel the pathogenesis of AIP. METHODS: To explore key targets of the inflammatory process, we analyzed the expression of proteins at the RNA and protein level using genomics and proteomics, immunohistochemistry, western blot, and immunoassay. An animal model of AIP with LP-BM5 murine leukemia virus-infected mice was studied in parallel. RNA microarrays of pancreatic tissue from 12 patients with AIP were compared with those of 8 patients with non-AIP chronic pancreatitis. RESULTS: Expression profiling showed 272 upregulated genes, including those encoding for immunoglobulins, chemokines and their receptors, and 86 downregulated genes, including those for pancreatic proteases such as three trypsinogen isoforms. Protein profiling showed that the expression of trypsinogens and other pancreatic enzymes was greatly reduced. Immunohistochemistry showed a near-loss of trypsin-positive acinar cells, which was also confirmed by western blotting. The serum of AIP patients contained high titers of autoantibodies against the trypsinogens PRSS1 and PRSS2 but not against PRSS3. In addition, there were autoantibodies against the trypsin inhibitor PSTI (the product of the SPINK1 gene). In the pancreas of AIP animals, we found similar protein patterns and a reduction in trypsinogen. CONCLUSIONS: These data indicate that the immune-mediated process characterizing AIP involves pancreatic acinar cells and their secretory enzymes such as trypsin isoforms. Demonstration of trypsinogen autoantibodies may be helpful for the diagnosis of AIP.
    Type of Publication: Journal article published
    PubMed ID: 20407433
    Signatur Availability
    BibTip Others were also interested in ...
  • 8
    Keywords: CANCER ; ENDOTHELIAL GROWTH-FACTOR ; Germany ; DISEASE ; MESSENGER-RNA EXPRESSION ; IMPACT ; REVERSE-TRANSCRIPTASE ; colorectal cancer ; DISSEMINATED TUMOR-CELLS ; POLYMERASE-CHAIN-REACTION ; PERIPHERAL-BLOOD ; ALPHA-L-FUCOSIDASE ; CARCINOEMBRYONIC ANTIGEN CEA ; PREOPERATIVE SERUM-LEVELS ; RT-PCR DETECTION
    Abstract: A large number of blood-based markers have been proposed for early detection of colorectal cancer (CRC). Their sensitivity for detecting CRC has mostly been evaluated in clinical settings, and found to be higher in more advanced stages compared with earlier stages of the disease. The aim of this study is to estimate the overall sensitivity of blood-based markers expected in screening settings, where the proportion of advanced stages is typically lower than in clinical settings. A systematic literature review was performed on studies evaluating sensitivity and specificity of blood-based markers for early detection of CRC. For each study, overall sensitivity expected in screening settings was estimated by weighting stage-specific sensitivities according to the stage distribution of CRC expected in the screening setting. The latter was derived from 12,605 CRC cases diagnosed in the German screening colonoscopy program during 2003-2007. Overall, 73 studies evaluating 55 blood-based markers were identified. Adjusted sensitivity was lower than reported sensitivity in 120 (90%) evaluations of different markers. Median absolute reduction in sensitivity after adjustment was 9.0% (interquartile range: 4.0-13.0) units, whereas median relative reduction was 19.5% (interquartile range: 11.3-33.3%). Blood-based markers for CRC detection reported from clinical settings showed higher sensitivities than expected in the screening setting in most cases, mainly due to substantially higher proportions of advanced stage cancers. Adjustment of sensitivity to the stage distribution expected in the screening setting is crucial to obtain realistic and comparable estimates of sensitivities.
    Type of Publication: Journal article published
    PubMed ID: 20959816
    Signatur Availability
    BibTip Others were also interested in ...
  • 9
    Keywords: CANCER ; Germany ; SUPPORT ; HISTORY ; incidence ; MORTALITY ; RISK ; COMPONENTS ; TIME ; PATIENT ; ADENOMAS ; colorectal cancer ; COLORECTAL-CANCER ; COUNTRIES ; COMPONENT ; RECURRENCE ; HIGH-RISK ; SURVEILLANCE ; UNITED-STATES ; case-control studies ; case control study ; case-control study ; RE ; EXTENSION ; colonoscopy ; case control studies ; INTERVAL ; methods ; odds ratio ; population-based ; ENDOSCOPY ; SERVICES TASK-FORCE ; colorectal ; case control ; POLYPECTOMY ; United States ; ADENOMA CHARACTERISTICS ; AMERICAN-CANCER-SOCIETY ; CLINICAL GUIDELINES ; LARGE-BOWEL ; LARGE-INTESTINE ; POLYPS ; SCREENING COLONOSCOPY
    Abstract: Objective: Colonoscopy with removal of polyps may strongly reduce colorectal cancer (CRC) incidence and mortality. Recommended time intervals to surveillance colonoscopy differ between countries and have recently been extended to 5 yr or longer for the majority of cases in the United States. Whereas previous evidence is mainly based on observations of adenoma recurrence, we aimed to assess risk of CRC occurrence according to time since polypectomy. Methods: In a population-based case-control study conducted in Germany, detailed history and results of previous large bowel endoscopies were obtained by interview and from medical records. Risk of CRC among subjects with history of endoscopic polypectomy compared to subjects without previous large bowel endoscopy was assessed according to time since polypectomy among 454 cases with CRC and 391 matched controls. Results: Odds ratios (95% confidence intervals) of CRC up to 2 yr, 3-5 yr, and 6-10 yr after polypectomy (using subjects without previous endoscopy as reference group) were 0.16 (0.09-0.69), 0.27 (0.08-0.87), and 1.90 (0.67-5.43), respectively. Risk was significantly reduced (odds ratio 0.27, 95% confidence interval 0.10-0.77) within 5 yr even after detection and removal of high-risk polyps (3+ polyps, at least 1 polyp 〉= 1 cm, at least 1 polyp with villous components). Odds ratios (95% confidence intervals) for the entire 10-yr time interval following polypectomy were 0.50 (0.23-1.12) and 0.36 (0.18-0.76) for patients with recorded high-risk adenomas and other patients, respectively. Conclusions: Our study provides empirical support for extension of the surveillance interval after colonoscopic polypectomy to at least 5 yr
    Type of Publication: Journal article published
    PubMed ID: 17433018
    Signatur Availability
    BibTip Others were also interested in ...
  • 10
    Keywords: CANCER ; Germany ; COLORECTAL-CANCER ; FAMILIAL RISKS ; LOCI ; WIDE ASSOCIATION
    Type of Publication: Journal article published
    PubMed ID: 19262529
    Signatur Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...