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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Onkologe 5 (1999), S. 359-369 
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Bisherige Praxis bei klinischen Studien war die Übermittlung von papiergebundenen Dokumentationsbögen auf dem Postweg und die nachfolgende manuelle Übertragung der Daten in ein Auswertesystem. Durch Einsatz einer Internetgestützten Software zur Studiendokumentation kann der Prüfarzt Patienten “online” anmelden und entsprechende Studiendaten weiterleiten. Die Prüfbögen werden als Eingabemasken im World Wide Web zur Verfügung gestellt. Damit können u.a. die Kosten für den Druck der Studienunterlagen reduziert werden. Durch Administratorfunktionalität (Benutzeranmeldung und Mahnwesen) wird auch der Monitor der Studie unterstützt. Vorteile bestehen in kurzen Kommunikationswegen, einer Validitätsprüfung bei der Eingabe und einem einheitlichen Datenpool, der dann für Auswertungen zur Verfügung steht. Dieses Pilotprojekt wendet sich an die Initiatoren klinischer Studien und Ärzte, die an klinischen Studien beteiligt sind.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1420-911X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les résultats obtenus pour l'étude allemande de prévention des maladies cardio-vasculaires sont mesurés à l'aide de la statistique fédérale des décès. Les causes de mortalité investiguées sont les maladies ischémiques du cœur (CIM-9 410–414) et les maladies cérébro-vasculaires (CIM-9 430–438). Pour l'Allemagne Fédérale, dans son ensemble, de 1970 à 1979, une baisse significative de la mortalité cérébro-vasculaire a été observée, alors que la mortalité cardio-vasculaire est restée plus ou moins stable. Par comparaison, dans les quatre régions d'intervention de l'étude pour lesquelles les données sont disponibles, les taux de mortalité, pour les deux groupes de décès, sont inférieurs à ceux du pays, avec des tendances temporelles comparables. Cependant, le poids relatif de la mortalité ischémique y est plus élevé. La discussion porte sur la comparabilité inter-régionale des données de mortalité en Allemagne Fédérale, où le codage des causes de décès se fait séparément dans chacun des Etats.
    Abstract: Zusammenfassung In der Deutschen Herz-Kreislauf-Präventionsstudie soll die Evaluation des primären Endpunktes, der kardiovaskulären Mortalität, auf der Basis amtlicher Mortalitätsstatistiken erfolgen. Im Rahmen einer geographischen Mortalitätsstudie wurden Trends und regionale Variation der Mortalität an ischämischen Herzkrankheiten (ICD-9, 410–414) und der zerebrovaskulären Krankheiten (ICD-9, 430–438) untersucht. Im Studienzeitraum 1970 bis 1979 konnte für Männer und Frauen ein relevanter Rückgang an zerebrovaskulären Krankheiten festgestellt werden, während für ischämische Herzkrankheiten kein eindeutiger Trend festzustellen war. Es lässt sich weiterhin zeigen, dass ein Wandel der Struktur der Mortalität in der Gesamtgruppe dieser Krankheiten zugunsten der ischämischen Krankheiten stattfindet, die geographische Analyse deutet auf relevante Validitätsprobleme im Zusammenhang mit den Besonderheiten der deutschen amtlichen Statistik (Signierung jeweils in den 11 statistischen Landesämtern der 11 Länder) hin. Die Mortalitätsraten der vier Interventionsregionen der «Kooperativen Prävention» (für die «Kommunale Prävention» standen keine entsprechenden Daten zur Verfügung) zeigen, dass die Interventionsregionen im Vergleich zur Bundesrepublik auf deutlich niedrigerem Niveau liegen, die Entwicklung in den Jahren 1974 bis 1979 jedoch den Bewegungen der Raten der BRD folgt. Hinsichtlich der Struktur der Mortalität besteht in den Interventionsgebieten eine höhere Bedeutung der ischämischen Herzkrankheiten gegenüber den zerebrovaskulären Krankheiten im Vergleich zur BRD.
    Notes: Summary The primary endpoint of the German Cardiovascular Prevention Study (GCP), cardiovascular mortality, has to be based on the official mortality statistics. In the scope of a geographic mortality study trends and regional variations of ischemic heart disease (ICD-9, 410–414) and cerebrovascular disease (ICD-9, 430–438) mortality were investigated. During the study period from 1970 to 1979 a relevant decline of cerebrovascular diseases in men and women was observed, whereas ischemic heart disease mortality figures remained relatively stable. Over time the importance of ischemic heart disease mortality has increased. The geographic analysis points to relevant problems concerning the validity of mortality data due to the particularities of the German mortality statistics (separately signed in the 11 statistical offices of the 11 federal states). The mortality rates of the four intervention regions of the “Kooperative Prävention” (corresponding data of “Kommunale Prävention” not available) indicate that the intervention regions are at a considerably lower level than the FRG, the mortality patterns, however, paralleling those of the FRG. As far as mortality structures are concerned, ischemic heart diseases are more important in the intervention regions than in the FRG as a whole.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1615-6722
    Keywords: Schlüsselwörter Cholelithiasis ; Cholezystektomie ; Epidemiologie ; Prävalenz ; Key words Cholelithiasis ; Cholecystectomy ; Epidemiology ; Prevalence ; Germany
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Study Objective: The prevalence of gallstone disease, time trends in the frequency of cholecystectomies and risk factors for the occurrence of cholelithiasis were examined in a cross-sectional population study. Methods: The survey was based on a random sample from the populations of 4 regions in Germany, stratified by region, age and sex. Information on the frequency of gallstone disease and on potential risk factors were collected by standardized interviews. For the statistical analysis, multiple logistic regression was used. Results: Overall, 1,085 persons were interviewed. The age-standardized prevalence of known gallstones was 4.2% for men and 14.5% for women. The frequency of cholecystectomy almost tripled in women from 1985 to 1994 as compared to 1975 to 1984 despite a decreasing trend in gallstone diagnoses in the same time period. No such trend was apparent in men. In men, age, body weight, changes in body weight, diabetes and use of corticosteroids were identified as risk factors for gallstone disease. In women, gallstone disease was also associated with body weight, changes in body weight and age, and, in addition, the number of births. An inverse association with gallstone disease was found for use of oral contraceptives and level of education in women.
    Notes: Zusammenfassung Studienziel: Prävalenz des Gallensteinleidens, zeitliche Trends in der Häufigkeit von Cholezystektomien und Risikofaktoren für die Entwicklung von Gallensteinen wurden in einer bevölkerungsbezogenen Studie in vier deutschen Regionen erfasst. Methoden: Als Studienpopulation diente eine nach Region, Alter und Geschlecht stratifizierte Zufallsstichprobe aus den Bevölkerungen von Hamburg, Bremen, Essen und dem Saarland, die als Kontrollgruppe für eine multizentrische Fallkontrollstudie zwischen 1995 und 1997 durch standardisierte Interviews befragt wurde. Die statistische Analyse erfolgte mittels multipler logistischer Regression. Ergebnisse: Ingesamt wurden 1 085 Personen befragt. Die altersstandardisierte Gallensteinprävalenz für die 35– bis 69-Jährigen betrug 4,2% bei den Männern und 14,5% bei den Frauen. Die Häufigkeit der Cholezystektomien hat sich bei den Frauen im Zeitraum von 1985 bis 1994 verdreifacht im Vergleich zu 1975 bis 1984, trotz einer abnehmenden Tendenz bei den Gallensteindiagnosen im gleichen Zeitraum. Bei den Männern war dieser Trend nicht zu beobachten. Als Risikofaktoren für das Auftreten von Gallensteinen wurden für Männer höheres Alter, Körpergewicht und Gewichtsschwankungen, Diabetes mellitus und Corticoideinnahme identifiziert. Bei den Frauen zeigten sich eine ansteigende Häufigkeit mit der Anzahl der Geburten und mit Gewicht, Gewichtsschwankungen und Alter sowie eine negative Assoziation mit dem Ausbildungsstand und der Einnahme oraler Kontrazeptiva.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1573-7225
    Keywords: bladder neoplasms ; occupation ; risk factors ; women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: We examined the importance of occupational exposures for bladder cancer in women. Methods: We combined data from 11 case-control studies conducted between 1976 and 1996 in six European countries. The pooled data comprised 700 incident female cases and 2425 population or hospital controls, aged 30–79 years. Lifetime occupational and smoking history were examined using common coding. Results: Excess risks were found in only a few of the occupations previously identified at high risk for bladder cancer. Statistically significant excess risks were observed for metal workers, particularly blacksmiths, toolmakers and machine tool operators (OR: 2.0, 95% CI: 1.1–3.6), tobacco workers (OR: 3.1, 95% CI: 1.1–9.3), field crop and vegetable farm workers (OR: 1.8, 95% CI: 1.0–3.1), tailors and dress makers (OR: 1.4, 95% CI: 1.0–2.1), saleswomen (OR: 2.6, 95% CI: 1.0–6.9), and mail sorting clerks (OR: 4.4, 95% CI: 1.0–19.5). About 8% (95% CI: 3.1–19.9) of all bladder cancers in women could be attributed to occupation after adjusting for smoking. The attributable risk was higher in women aged less than 65 years (12%), compared to older women (4%). Conclusions: The calculation of the attributable risk on the basis of results from this analysis may have caused some overestimation of the proportion of occupational bladder cancer in women. A significant proportion, however, of bladder cancer cases among European women less than 65years is likely to be attributed to occupation. This link between bladder cancer in women and occupational factors has received little recognition, probably because studies addressing these issues have predominantly been done in men.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1573-7225
    Keywords: diet ; lung cancer ; non-smokers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: We have examined the role of dietary patterns and specific dietary nutrients in the etiology of lung cancer among non-smokers using a multicenter case–control study. Methods: 506 non-smoking incident lung cancer cases were identified in the eight centers along with 1045 non-smoking controls. Dietary habits were assessed using a quantitative food-frequency questionnaire administered by personal interview. Based on this information, measures of total carotenoids, beta-carotene and retinol nutrient intake were estimated. Results: Protective effects against lung cancer were observed for high consumption of tomatoes, (odds ratio (OR) = 0.5; 95% confidence interval (CI) 0.4–0.6), lettuce (OR = 0.6; 95% CI 0.3–1.2), carrots (OR = 0.8; 95% CI 0.5–1.1), margarine (OR = 0.7; 95% CI 0.5–0.8) and cheese (OR = 0.7; 95% CI 0.5–1.0). Only weak protective effects were observed for high consumption of all carotenoids (OR = 0.8; 95% CI 0.6–1.0), beta-carotene (OR=0.8; 95% CI 0.6–1.1) and retinol (OR = 0.9; 95% CI 0.7–1.1). Protective effects for high levels of fruit consumption were restricted to squamous cell carcinoma (OR = 0.7; 95% CI 0.4–1.2) and small cell carcinoma (OR = 0.7; 95% CI 0.4–1.2), and were not apparent for adenocarcinoma (OR = 0.9; 95% CI 0.6–1.3). Similarly, any excess risk associated with meat, butter and egg consumption was restricted to squamous and small cell carcinomas, but was not detected for adenocarcinomas. Conclusions: This evidence suggests that the public health significance of increasing vegetable consumption among the bottom third of the population would include a reduction in the incidence of lung cancer among lifetime non-smokers by at least 25%, and possibly more. A similar protective effect for increased fruit consumption may be present for squamous cell and small cell lung carcinomas.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1573-7225
    Keywords: bladder cancer ; coffee consumption ; nonsmokers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Coffee consumption has been associated with an excess bladder cancer risk, but results from epidemiological studies are inconsistent. This association has been long debated, in part due to the potential confounding by smoking. We examined the risk associated with coffee consumption in nonsmokers in a pooled analysis of ten European bladder cancer case–control studies. Methods: The pooled data set comprises 564 cases and 2929 hospital or population controls who had never smoked. They were enrolled in ten studies conducted in Denmark, Germany, Greece, France, Italy and Spain. Information on coffee consumption and occupation was re-coded following standard criteria. Unconditional logistic regression was applied adjusting for age, study center, occupation and gender. Results: Seventy-nine percent of the study population reported having drunk coffee, and 2.4% were heavy drinkers, reporting having drunk on average ten or more cups per day. There was no excess risk in ever coffee drinkers (OR = 1.0, 95% CI 0.8–1.3) compared to never drinkers. The risk did not increase monotonically with dose but a statistically significant excess risk was seen for subjects having drunk ten or more cups per day (OR = 1.8, 95% CI 1.0–3.3). This excess was seen in both men and women. There was no evidence of an association of the risk with duration or type of coffee consumption. The pooled results were not dependent on the findings of any specific study, but they depended on the type of controls with an overall excess risk observed only for studies using hospital controls. Conclusion: Nonsmokers who are heavy coffee drinkers may have a small excess risk of bladder cancer. Although these results cannot be attributed to confounding by smoking, the possibility of bias in control selection cannot be discarded. On the basis of these results, only a very small proportion of cancers of the bladder among nonsmokers could be attributed to coffee drinking.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    European journal of epidemiology 15 (1999), S. 411-419 
    ISSN: 1573-7284
    Keywords: Beer ; Bladder cancer ; Coffee ; Diet ; Smoking
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a hospital-based case–control study conducted between 1989 and 1992 in Hessen (West-Germany) 300 cases (239 male and 61 female) of histologically confirmed cancer of the lower urinary tract (LUT) were individually matched to controls from the same hospitals with respect to sex, age and area of residence. Smoking of cigarettes was associated with an elevated risk of 2.80 in males (95% confidence interval (CI): 1.65–4.76) and 5.33 (95% CI: 1.55–18.33) in females, as compared with non-smokers. Variables like daily amount of smoked cigarettes, duration of smoking, age at beginning of cigarette smoking and time since smoking cessation showed a clear dose- and time–response relationship in males, but not in females. Elevated risks were observed for higher consumption of coffee, beer and wine, but – especially for the consumption of coffee – were drastically reduced after adjustment for smoking. A weak association was found between the daily fluid intake and bladder cancer in males. Among females a significantly decreased odds ratio (OR) of 0.34 (95% CI: 0.11–0.99) was found for a daily fluid intake of more than two liters. Protective effects and risk reductions of approximately 50% were found for the regular intake of raw carrots, kale, salads and fruits. The findings of this investigation support an association between lifestyle factors and cancer of the lower urinary tract.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1573-7225
    Keywords: Case-control study ; dose-response ; Germany ; lung cancer ; nonsmoking period ; smoking cessation patterns
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case-control study of lung cancer was conducted in northwestern Germany in 1985–86. The study included 194 lung cancer cases and the same number of hospital controls and population controls who were matched to the cases by sex and age. Personal interviews were conducted by trained interviewers. We report here the effect of different smoking patterns—such as nonsmoking intervals, and time since quitting smoking—on lung cancer risk. Both quitting smoking and having a nonsmoking interval are seen to reduce lung cancer risk significantly. For a nonsmoking interval of three years or more, relative risk (RR)=0.21, 95 percent confidence interval (CI)=0.08–0.52; for quitting smoking for 10 years or more, RR=0.23, CI=0.11–0.48). A dose-response relationship was estimated for cigarette dose, length of nonsmoking interval, and time since stopped smoking.
    Type of Medium: Electronic Resource
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