Abstract Background : In 2002, colonoscopy was introduced as a tool for colorectal cancer screening in Germany. The long-term objective was to reduce the incidence in colorectal cancer (CRC) by ...detection and removal of advanced adenomas. Currently, the effect of colonoscopy screening on the population-based incidence of CRC in Germany is unknown. Methods : We provide data on stage-specific (age-standardized) incidence rates in three federal states in Germany, 6 years after the implementation of colonoscopy. Results : Between 2002 and 2008 a statistically significant decrease in CRC incidence could be observed (annually 3.0%, 95% confidence interval CI: −3.8; −2.2). The decline could be observed in all advanced tumor categories (T2, T3, and T4), whereas the incidence of in situ carcinomas (Tis) increased annually by 51.6% (95% CI: 28.0; 79.4) until 2004, and remained stable until 2008. Conclusion : The observed changes cannot be attributed definitively to the screening activities, but the presented data support a possible causal association.
Intranasal corticosteroids (INS) are the first line treatment for allergic rhinitis (AR). To guide clinical decision-making, we created a therapeutic index (TIX) for INS reflecting efficacy and ...safety.
A Medline search (1966 to June 2009) was carried out to identify all placebo-controlled randomized trials, and observational reports for safety issues, with Dexamethasone, Budesonide (BUD), Fluticasone propionate (FP), Fluticasone furoate (FF), Flunisolide, Mometasone furoate (MF), Triamcinolone (TRIAM), and Beclomethasone dipropionate (BDP) as treatment for AR. Data on three efficacy (nasal symptoms, ocular symptoms, global assessment) and three safety outcomes (epistaxis, growth, systemic ocular effects) were extracted. Meta analyses were performed for each INS and outcome and results were categorised into scores by quartiles. Scores of the three efficacy and safety outcomes were summed up to create summation scores for efficacy (ES) and side effects (AES), respectively with a maximum of 9 points. The TIX was then defined as the ratio of ES and AES.
Data of 84 studies were extracted. Based on availability of data, a TIX was calculated for 6 substances. BUD showed the highest efficacy score followed by MF and TRIAM. The lowest scores for side effects were achieved by MF and TRIAM followed by FP. These findings resulted in TIX scores of 7 and 5 for MF and TRIAM, respectively, indicating a high efficacy and low potential of adverse events. Medium scores were reached by BUD and FP and lower scores by BDP and FF.
Although safety and efficacy is proven for all available INS by multiple studies, the systematic aggregation and analysis of data allows for a differentiated summary on clinically important features.
Disturbance by traffic noise can result in health problems in the long run. However, the subjective perception of noise plays an important role in their development.
The aim of this study was to ...determine if speed cameras are able to reduce subjective traffic noise disturbance of residents of high-traffic roads in Luebeck?
In August 2012 a speed camera has been installed in 2 high-traffic roads in Luebeck (IG). Residents living 1.5 km in front of the installed speed cameras and behind them received a postal questionnaire to evaluate their subjective noise perception before (t0), 8 weeks (t1) and 12 months (t2) after the installation of the speed camera. As controls (CG) we asked residents of another high-traffic road in Luebeck without speed cameras and residents of 2 roads with several consecutive speed cameras installed a few years ago. Furthermore, objective measures of the traffic noise level were conducted.
Response rates declined from 35.9% (t0) to 27.2% (t2). The proportion of women in the CG (61.4-63.7%) was significantly higher than in the IG (53.7-58.1%, p<0.05), and responders were significantly younger (46.5±20.5-50±22.0 vs. 59.1±17.0-60.5±16.9 years, p<0.05). A reduction of the perceived noise disturbance of 0.2 point, measured on a scale from 0 (no disturbance) to 10 (heavy disturbance), could be observed in both IG and CG. Directly asked, 15.2% of the IG and 19.3% of the CG reported a traffic noise reduction at t2. The objective measure shows a mean reduction of 0.6 dB at t1.
The change of noise level of 0.6 dB, which could only be experienced by direct comparison, is in line with the subjective noise perception. As sole method to reduce traffic noise (and for health promotion) a speed camera is insufficient.
In 2007, an organized population-based mammography screening program in Schleswig-Holstein has been implemented. According the European guideline a participation rate of 70% should be reached as a ...measurement of quality. In Schleswig-Holstein participation rate reached only 45% and is one of the lowest rates in Germany. The reasons are unknown.
To 20,000 women, aged 50-69, who did not participate in mammography screening after an invitation letter, a questionnaire was sent to assess reasons of non-participation and knowledge about the program. We calculated the proportion of women answering to given aspects in the questionnaire.
The response rate was 14.8% (n = 2591). Women reported multiple reasons for non-participation. Medical reasons and personal attitude were the most frequent ones. Organizational reasons were of minor importance. 75% of women get primarily informed about the program by the invitation letter. 25% of women talked with their practitioner about the program.
The low participation rate of mammography screening in Schleswig-Holstein is not based on worse organization but on medical reasons or personal attitudes of the women. It seems, that information about the program and benefits and harms of mammography screening has not reached the general population. So general practitioner or gynecologists should advice women more intensively. Leaflets and pamphlets should be more disseminated.
The integrated project COSYCONET, as part of the competence network ASCONET funded by the BMBF, has the aim to investigate the relationship between the pulmonary disorder, comorbidities and systemic ...inflammation in patients with chronic obstructive pulmonary disease (COPD) by adopting cross-sectional as well as longitudinal analyses.
COSYCONET includes a number of projects addressing the issue of comorbidities at the basic science level. Its core project, however, is the establishment of a cohort of patients with COPD, which is compared with two population-based control cohorts. The COPD cohort will include 3,000 patients, among them 1,500 with severity according to GOLD category I/II and 1,500 with category III/IV. Patients will be recruited in study centers covering all major regions of Germany, and this will be achieved in close cooperation with pneumologists from private practices. After recruitment, patients will be studied upon an initial visit as well as 6 and 18 months later. Each visit includes a comprehensive battery of functional tests and questionnaires that aim at assessing the state of the disease as accurately and completely as feasible, comprising lung function and the individual pattern and risk factors of comorbidities including cardiovascular disorders, metabolic disorders, osteoporosis, exercise capacity, acticity and mental status. In addition blood samples will be taken and asservated in a biobank in order to assess markers of systemic inflammation and aging as well as organ-specific markers. Moreover morphological information on the lung as available from HR-CT pictures that have not been specifically taken for the study will be analysed semi-quantitatively in a central facility and standardised manner.
Guidelines recommend dual-therapy consisting of a beta-lactam/macrolide (BLM) for hospitalized patients with community-acquired pneumonia. Nevertheless, the superiority over beta-lactam-monotherapy ...(BL) remains unproven.
Analyses from an observational study initiated by the German competence network CAPNETZ were performed.
One thousand eight hundred and fifty-four patients were treated with either BL (49.0%) or BLM (51.0%). BLM therapy was associated with lower adjusted 14 day mortality odds ratio (OR) 0.53; 95% confidence interval (CI): 0.30-0.94. CRB65, neoplastic disease, age and nursing home residency were confirmed as independent predictors of death. Adjusted 14 day mortality risk was clearly reduced in patients with CRB65 = 2 (n = 411; OR 0.35; CI: 0.12-0.99) and CRB65 > or = 2 (n = 519; OR 0.42; CI: 0.18-0.997). However, this could not be shown for adjusted 30 day mortality. Patients with CRB65 < or = 1 showed low mortality (2.1%) without the influence of BLM. BLM therapy was associated with lower adjusted risk of treatment failure at 14 days (n = 1854; OR 0.65; CI: 0.47-0.89) and 30 days (OR 0.69; CI: 0.51-0.94) as well as in the subgroup of patients with CRB65 = 2 and CRB65 > or = 2.
This study suggests the superiority of BLM therapy in patients with CRB65 risk classes of 2 or higher on 14 day mortality. BLM therapy was also associated with lower risk of treatment failure.
Macrophages are an important part of the cellular immune system and play a key role during immune responses. Thus, macrophages are interesting targets in basic and clinical research. Primary ...monocytes or monocyte-derived macrophages do not proliferate on a suitable scale so that their use for functional studies
in
vitro is limited. Immortal proliferating cell lines, such as the human THP-1 monocytic leukemia cell line, are therefore often used instead of primary cells. Transfection is a useful tool to study the function of gene products, but transfection of THP-1 monocytes and pre-differentiated THP-1 macrophages with subsequent differentiation into mature THP-1 macrophages using phorbol esters is usually accompanied by a progressive loss of cell viability. In this study, we describe a simple and rapid approach for efficient transfection of THP-1 monocytes and pre-differentiated THP-1 macrophages using a modified Nucleofection-based approach. The protocol maintains cell viability and functionality, thus allowing efficient transfection of THP-1 cells combined with subsequent differentiation of transfected THP-1 cells into mature macrophages.
Since 2002, the German competence network CAPNETZ has been collecting data from inpatients and outpatients with community acquired pneumonia (CAP) at eight local clinical centres. Contrary to the ...literature reports, the proportion of outpatients in CAPNETZ averages out at 28 %. Therefore, this study determines whether an active reporting system can increase the number of cases reported in medical practices.
In ten medical practices in Lübeck, the passive reporting system was changed to an active reporting system consisting of a) a weekly announcement of CAP cases including negative reporting, b) a study nurse who was responsible for the reporting, c) additional payment, d) a telephone call after two weeks by absent announcements and e) incentives like benchmarking or additional information. The number of the reported cases between the active reporting period (2004) and the same period in the year before was recorded.
The number of reported cases increased in eight of the ten medical practices. Overall 72 CAP cases were reported, 33 % more than in the period of passive reporting. The number of patients encompassed in CAPNETZ increased from 17 to 34.
We did not find a comparable increase of CAP cases either in Lübeck overall (including inpatients) or in all the local clinical centres together. Thus, it is assumed that the increase of reported cases depends on the methodical effect.
We studied the distribution of the PAT family proteins TIP47 and adipophilin in lipid bodies of THP-1 cell-derived macrophages using freeze-fracture immunolabeling and other techniques. Lipid bodies ...in macrophages comprise lipid droplets and extensive, previously scantily characterized sheet-like organelles, which we descriptively call “lipid sails.” TIP47 and adipophilin are components of many, but not all, the lipid droplets. Both proteins are not confined to the surface of lipid droplets, as supposed, but are also inside lipid droplet cores. They are not codistributed stoichiometrically in lipid droplets. How TIP47 and adipophilin, which are polar proteins, enter the lipid droplets and are packaged among the hydrophobic neutral lipids of the core is unclear. However, in the lipid layers of the core, these proteins are directed sometimes inward and sometimes outward. Because TIP47 and adipophilin also localize to lipid sails, lipid sails are intimately involved in intracellular lipid metabolism.
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