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Hussenoeder FS, Conrad I, Pabst A, Engel C, Zachariae S, Zeynalova S, Yahiaoui-Doktor M, Glaesmer H, Hinz A, Witte V, Wichmann G, Kirsten T, Löffler M, Villringer A, Riedel-Heller SG. Connecting chronic stress and anxiety: a multi-dimensional perspective. PSYCHOL HEALTH MED 2024; 29:427-441. [PMID: 36106349 DOI: 10.1080/13548506.2022.2124292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
Studies show a connection between anxiety and stress, but with little differentiation between different domains of stress. In this article, we utilize a multi-dimensional approach to better understand the relationship between different chronic stress domains and anxiety. This will allow researchers to identify and address those areas of stress that are most relevant with regard to anxiety. We used data from a sub sample of the LIFE-Adult-Study (n = 1085) to analyze the association between nine different areas of chronic stress (Trier Inventory for Chronic Stress, TICS) and anxiety (General Anxiety Disorder 7, GAD-7), controlling for sociodemographic variables, personality, and social support. There was a significant and positive association between Work Overload, Pressure to Perform, Social Tensions, Social Isolation, Chronic Worrying, and anxiety. After including the control variables, only Work Overload and Chronic Worrying remained significant. By focusing on Work Overload and Chronic Worrying researchers, practitioners, and policy makers can help to mitigate anxiety and related health problems in the population in an efficient way.
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Affiliation(s)
- Felix S Hussenoeder
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Ines Conrad
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
- Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Silke Zachariae
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
| | - Samira Zeynalova
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
| | - Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
- Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Veronika Witte
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Gunnar Wichmann
- Department of Otorhinolaryngology, University of Leipzig, Leipzig, Germany
| | - Toralf Kirsten
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
- Department for Medical Data Science, University Medical Data Center Leipzig, Leipzig, Germany
| | - Markus Löffler
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
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Holzhey M, Petroff D, Wirkner K, Engel C, Baber R, Tönjes A, Zeynalova S, Yahiaoui-Doktor M, Berg T, Karlas T, Wiegand J. Relevance of GLP-1 receptor agonists or SGLT-2 inhibitors on the recruitment for clinical studies in patients with NAFLD. Eur J Gastroenterol Hepatol 2024; 36:107-112. [PMID: 37823453 DOI: 10.1097/meg.0000000000002656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Guidelines increasingly recommend the use of glucagon-like peptide-1 receptor agonists (GLP-1 RA) or sodium-glucose co-transporter-2 inhibitors (SGLT2i) to prevent cardiovascular and cardiorenal endpoints. Both drugs also show beneficial effects in nonalcoholic fatty liver disease (NAFLD). Preexisting GLP-1 RA and SGLT2i therapies are frequently defined as exclusion criterion in clinical studies to avoid confounding effects. We therefore investigated how this might limit recruitment and design of NAFLD studies. METHODS GLP-1 RA and SGLT2i prescriptions were analyzed in NAFLD patients with diabetes mellitus recruited at a tertiary referral center and from the population-based LIFE-Adult-Study. Individuals were stratified according to noninvasive parameters of liver fibrosis based on vibration-controlled transient elastography (VCTE). RESULTS 97 individuals were recruited at tertiary care and 473 from the LIFE-Adult-Study. VCTE was available in 97/97 and 147/473 cases.GLP-1 RA or SGLT2i were used in 11.9% of the population-based cohort (LSM < 8 kPa), but in 32.0% with LSM ≥ 8 kPa. In the tertiary clinic, it was 30.9% overall, independent of LSM, and 36.8% in patients with medium and high risk for fibrotic NASH (FAST score > 0.35). At baseline, 3.1% of the patients in tertiary care were taking GLP-1 RA and 4.1% SGLT2i. Four years later, the numbers had increased to 15.5% and 21.6%. CONCLUSION GLP-1 RA and SGLT2i are frequently and increasingly prescribed. In candidates for liver biopsy for NASH studies (VCTE ≥ 8 kPa) the use of them exceeds 30%, which needs careful consideration when designing NASH trials.
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Affiliation(s)
- Michael Holzhey
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Centre
- Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Centre
| | | | - Kerstin Wirkner
- Leipzig Research Centre for Civilization Diseases, University of Leipzig
| | - Christoph Engel
- Leipzig Research Centre for Civilization Diseases, University of Leipzig
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig
| | - Ronny Baber
- Leipzig Research Centre for Civilization Diseases, University of Leipzig
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig
| | - Anke Tönjes
- Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig, Germany
| | - Samira Zeynalova
- Leipzig Research Centre for Civilization Diseases, University of Leipzig
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig
| | - Maryam Yahiaoui-Doktor
- Leipzig Research Centre for Civilization Diseases, University of Leipzig
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig
| | - Thomas Berg
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Centre
- Leipzig Research Centre for Civilization Diseases, University of Leipzig
| | - Thomas Karlas
- Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Centre
| | - Johannes Wiegand
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Centre
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Gurk K, Quintana Pacheco D, Yahiaoui-Doktor M, Zeynalova S, Treudler R. Atopic dermatitis, diet, heart: Unravelling. J Eur Acad Dermatol Venereol 2023. [PMID: 38126625 DOI: 10.1111/jdv.19747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Affiliation(s)
- K Gurk
- Department of Dermatology, Venerology and Allergology, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - D Quintana Pacheco
- Department of Dermatology, Venerology and Allergology, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - M Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Medical Faculty, University of Leipzig, Leipzig, Germany
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - S Zeynalova
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Medical Faculty, University of Leipzig, Leipzig, Germany
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - R Treudler
- Department of Dermatology, Venerology and Allergology, Medical Faculty, University of Leipzig, Leipzig, Germany
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Hussenoeder FS, Conrad I, Löbner M, Engel C, Reyes N, Yahiaoui-Doktor M, Glaesmer H, Hinz A, Witte V, Schroeter ML, Medawar E, Wichmann G, Kirsten T, Löffler M, Villringer A, Riedel-Heller SG. The different areas of chronic stress and food addiction: Results from the LIFE-Adult-Study. Stress Health 2023. [PMID: 37994391 DOI: 10.1002/smi.3348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 09/22/2023] [Accepted: 11/02/2023] [Indexed: 11/24/2023]
Abstract
There is an empirical association between stress and symptoms of food addiction (FA), but it is still not clear which domains of stress are the most relevant when it comes to FA, limiting the ability of researchers and practitioners to address problematic eating-related health outcomes. In order to address this gap in the literature, we analysed how different domains of chronic stress are related to FA. We used data from a subsample of the LIFE-Adult-Study (N = 1172), a German cohort study. We conducted a linear regression analysis with stress domains (Trier Inventory for Chronic Stress, TICS) as predictors of FA (Yale Food Addiction Scale, YFAS). In the second regression analysis we included sociodemographic variables, personality, and smoking as control variables. There was a significant and positive association between Social Overload, Work Discontent, Excessive Demands from Work, and Chronic Worrying and FA. After adding control variables, only Social Overload, Excessive Demands from Work, and Chronic Worrying remained significant predictors. Connections between stress domains and FA can serve as starting points for the development of meaningful interventions that support individuals self-care strategies (Social Overload), complexity management (Excessive Demands from Work), and coping with negative emotions (Chronic Worrying).
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Affiliation(s)
- Felix S Hussenoeder
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Ines Conrad
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Leipzig University, Statistics and Epidemiology (IMISE), Leipzig, Germany
- Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Nigar Reyes
- Institute for Medical Informatics, Leipzig University, Statistics and Epidemiology (IMISE), Leipzig, Germany
- Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Leipzig University, Statistics and Epidemiology (IMISE), Leipzig, Germany
- Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Veronica Witte
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Evelyn Medawar
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Gunnar Wichmann
- Department of Otorhinolaryngology, University of Leipzig, Leipzig, Germany
| | - Toralf Kirsten
- Institute for Medical Informatics, Leipzig University, Statistics and Epidemiology (IMISE), Leipzig, Germany
- Department for Medical Data Science, University Medical Data Center Leipzig, Leipzig, Germany
| | - Markus Löffler
- Institute for Medical Informatics, Leipzig University, Statistics and Epidemiology (IMISE), Leipzig, Germany
| | - Arno Villringer
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
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Seethaler B, Lehnert K, Yahiaoui-Doktor M, Basrai M, Vetter W, Kiechle M, Bischoff SC. Omega-3 polyunsaturated fatty acids improve intestinal barrier integrity-albeit to a lesser degree than short-chain fatty acids: an exploratory analysis of the randomized controlled LIBRE trial. Eur J Nutr 2023; 62:2779-2791. [PMID: 37318580 PMCID: PMC10468946 DOI: 10.1007/s00394-023-03172-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/04/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE Adherence to the Mediterranean diet is associated with beneficial health effects, including gastrointestinal disorders. Preclinical studies suggest that omega-3 polyunsaturated fatty acids (n-3 PUFAs), found in Mediterranean foods like nuts and fish, improve intestinal barrier integrity. Here, we assessed possible effects of n-3 PUFAs on barrier integrity in a randomized controlled trial. METHODS We studied 68 women from the open-label LIBRE trial (clinicaltrials.gov: NCT02087592) who followed either a Mediterranean diet (intervention group, IG) or a standard diet (control group, CG). Study visits comprised baseline, month 3, and month 12. Barrier integrity was assessed by plasma lipopolysaccharide binding protein (LBP) and fecal zonulin; fatty acids by gas chromatography with mass spectrometry. Median and interquartile ranges are shown. RESULTS Adherence to the Mediterranean diet increased the proportion of the n-3 docosahexaenoic acid (DHA) (IG + 1.5% [0.9;2.5, p < 0.001]/ + 0.3% [- 0.1;0.9, p < 0.050] after 3/12 months; CG + 0.9% [0.5;1.6, p < 0.001]/ ± 0%) and decreased plasma LBP (IG - 0.3 µg/ml [- 0.6;0.1, p < 0.010]/ - 0.3 µg/ml [- 1.1; - 0.1, p < 0.001]; CG - 0.2 µg/ml [- 0.8; - 0.1, p < 0.001]/ ± 0 µg/ml) and fecal zonulin levels (IG - 76 ng/mg [- 164; - 12, p < 0.010]/ - 74 ng/mg [- 197;15, p < 0.001]; CG - 59 ng/mg [- 186;15, p < 0.050]/ + 10 ng/mg [- 117;24, p > 0.050]). Plasma DHA and LBP (R2: 0.14-0.42; all p < 0.070), as well as plasma DHA and fecal zonulin (R2: 0.18-0.48; all p < 0.050) were found to be inversely associated in bi- and multivariate analyses. Further multivariate analyses showed that the effect of DHA on barrier integrity was less pronounced than the effect of fecal short-chain fatty acids on barrier integrity. CONCLUSIONS Our data show that n-3 PUFAs can improve intestinal barrier integrity. TRIAL REGISTRATION NUMBER The trial was registered prospectively at ClinicalTrials.gov (reference: NCT02087592).
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Affiliation(s)
- Benjamin Seethaler
- Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany
| | - Katja Lehnert
- Institute of Food Chemistry, University of Hohenheim, Stuttgart, Germany
| | - Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Maryam Basrai
- Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany
| | - Walter Vetter
- Institute of Food Chemistry, University of Hohenheim, Stuttgart, Germany
| | - Marion Kiechle
- Department of Gynecology, Center for Hereditary Breast and Ovarian Cancer, Klinikum Rechts der Isar, Technical University Munich and Comprehensive Cancer Center Munich, Munich, Germany
| | - Stephan C Bischoff
- Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany.
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Hussenoeder FS, Conrad I, Pabst A, Luppa M, Stein J, Engel C, Zachariae S, Zeynalova S, Yahiaoui-Doktor M, Glaesmer H, Hinz A, Witte V, Wichmann G, Kirsten T, Löffler M, Villringer A, Riedel-Heller SG. Different Areas of Chronic Stress and Their Associations with Depression. IJERPH 2022; 19:ijerph19148773. [PMID: 35886625 PMCID: PMC9315834 DOI: 10.3390/ijerph19148773] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 01/10/2023]
Abstract
Background: Research shows a connection between stress and depression, but there is little differentiation between areas of stress, making it difficult to identify and address specific areas in the context of public health measures. We utilized a multi-dimensional approach to chronic stress to better understand the relationship between different areas of stress and depression. Methods: We conducted linear regression analyses and used data from a sub-sample of the LIFE-Adult-Study (N = 1008) to analyze the connection between nine different areas of chronic stress (TICS) and depression (CES-D). In the second analysis, we controlled for sociodemographic variables, personality, physical activity, and social support. Results: There was a significant positive association between the stress domains Excessive Demands from Work, Lack of Social Recognition, Social Isolation, and Chronic Worrying and depression and a significant negative association between Pressure to Perform and depression. After adding control variables, only Pressure to Perform, Social Isolation, and Chronic Worrying remained significant predictors. Conclusions: By focusing on the connections between chronic stress and depression, researchers can help identify the areas that matter most and contribute to the creation of meaningful and efficient interventions. On the basis of our results, measures for the prevention of depression that focus on the reduction of worrying and social isolation are recommended.
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Affiliation(s)
- Felix S. Hussenoeder
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, 04103 Leipzig, Germany; (I.C.); (A.P.); (M.L.); (J.S.); (S.G.R.-H.)
- Correspondence: ; Tel.: +49-03-41-9715404; Fax: +49-03-41-9724569
| | - Ines Conrad
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, 04103 Leipzig, Germany; (I.C.); (A.P.); (M.L.); (J.S.); (S.G.R.-H.)
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, 04103 Leipzig, Germany; (I.C.); (A.P.); (M.L.); (J.S.); (S.G.R.-H.)
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, 04103 Leipzig, Germany; (I.C.); (A.P.); (M.L.); (J.S.); (S.G.R.-H.)
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, 04103 Leipzig, Germany; (I.C.); (A.P.); (M.L.); (J.S.); (S.G.R.-H.)
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, 04107 Leipzig, Germany; (C.E.); (S.Z.); (S.Z.); (M.Y.-D.); (T.K.); (M.L.)
- Leipzig Research Centre for Civilization Diseases, Leipzig University, 04103 Leipzig, Germany
| | - Silke Zachariae
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, 04107 Leipzig, Germany; (C.E.); (S.Z.); (S.Z.); (M.Y.-D.); (T.K.); (M.L.)
| | - Samira Zeynalova
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, 04107 Leipzig, Germany; (C.E.); (S.Z.); (S.Z.); (M.Y.-D.); (T.K.); (M.L.)
| | - Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, 04107 Leipzig, Germany; (C.E.); (S.Z.); (S.Z.); (M.Y.-D.); (T.K.); (M.L.)
- Leipzig Research Centre for Civilization Diseases, Leipzig University, 04103 Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, Leipzig University, 04103 Leipzig, Germany; (H.G.); (A.H.)
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Leipzig University, 04103 Leipzig, Germany; (H.G.); (A.H.)
| | - Veronica Witte
- Max-Planck-Institute for Human Cognitive and Brain Sciences, 04303 Leipzig, Germany; (V.W.); (A.V.)
| | - Gunnar Wichmann
- Department of Otorhinolaryngology, University of Leipzig, 04103 Leipzig, Germany;
| | - Toralf Kirsten
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, 04107 Leipzig, Germany; (C.E.); (S.Z.); (S.Z.); (M.Y.-D.); (T.K.); (M.L.)
- Department for Medical Data Science, University Hospital Leipzig, 04103 Leipzig, Germany
| | - Markus Löffler
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, 04107 Leipzig, Germany; (C.E.); (S.Z.); (S.Z.); (M.Y.-D.); (T.K.); (M.L.)
| | - Arno Villringer
- Max-Planck-Institute for Human Cognitive and Brain Sciences, 04303 Leipzig, Germany; (V.W.); (A.V.)
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, 04103 Leipzig, Germany; (I.C.); (A.P.); (M.L.); (J.S.); (S.G.R.-H.)
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Engel C, Wieland K, Zachariae S, Bucksch K, Enders U, Schoenwiese U, Yahiaoui-Doktor M, Keupp K, Waha A, Hahnen E, Remy R, Ernst C, Loeffler M, Schmutzler RK. [HerediCaRe: Documentation and IT Solution of a Specialized Registry for Hereditary Breast and Ovarian Cancer]. Gesundheitswesen 2021; 83:S12-S17. [PMID: 34731888 DOI: 10.1055/a-1658-0313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The national registry "HerediCaRe" for the evaluation and improvement of risk-adjusted prevention in hereditary breast and ovarian cancer is one of six "model registries in health services research" funded by the BMBF. In this paper, we describe and discuss the documentation and IT solution chosen for standardized data collection based on the specific functional requirements previously defined. The documentation is divided into different modules to be used individually for each patient, which are based on a previously defined catalog of documentation items. Due to special functional requirements, a specific data entry application based on ORACLE and ORACLE Forms was developed and implemented. The specific requirements included the integration of graphical pedigree representations, the structured upload of pedigree data and molecular genetic information, the automated transfer of old data from the previous system, as well as the free programmability of complex database queries for central data quality control. A database for patient-independent management of genetic risk variants was seamlessly integrated into the application and linked to the patient-related data. The advantages and disadvantages of the chosen IT solution are critically discussed. Overall, we come to the conclusion that, in view of the complex documentation and the special functional requirements, there are no alternative ready-made software products to the in-house development we have chosen.
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Affiliation(s)
- Christoph Engel
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig, Leipzig, Deutschland
| | - Kerstin Wieland
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig, Leipzig, Deutschland
| | - Silke Zachariae
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig, Leipzig, Deutschland
| | - Karolin Bucksch
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig, Leipzig, Deutschland
| | - Ute Enders
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig, Leipzig, Deutschland
| | - Ulrike Schoenwiese
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig, Leipzig, Deutschland
| | - Maryam Yahiaoui-Doktor
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig, Leipzig, Deutschland
| | - Katharina Keupp
- Zentrum familiärer Brust- und Eierstockkrebs, Uniklinik Köln, Köln, Deutschland
| | - Anke Waha
- Zentrum familiärer Brust- und Eierstockkrebs, Uniklinik Köln, Köln, Deutschland
| | - Eric Hahnen
- Zentrum familiärer Brust- und Eierstockkrebs, Uniklinik Köln, Köln, Deutschland
| | - Robert Remy
- Zentrum familiärer Brust- und Eierstockkrebs, Uniklinik Köln, Köln, Deutschland
| | - Corinna Ernst
- Zentrum familiärer Brust- und Eierstockkrebs, Uniklinik Köln, Köln, Deutschland
| | - Markus Loeffler
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig, Leipzig, Deutschland
| | - Rita K Schmutzler
- Zentrum familiärer Brust- und Eierstockkrebs, Uniklinik Köln, Köln, Deutschland
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Zeynalova N, Guhl M, Riedel-Heller SG, Yahiaoui-Doktor M, Loeffler M, Mueller-Reichau O. The relevance of the mother tongue in conducting “cognitive abilities”. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- N Zeynalova
- University of Leipzig, Germany, Institute for Medical Informatics, Statistics and Epidemiology
| | - M Guhl
- University of Leipzig, Germany, Department of Slavic Studies
| | - SG Riedel-Heller
- University of Leipzig, Germany, Institute of Social Medicine, Occupational Medicine, and Public Health
| | - M Yahiaoui-Doktor
- University of Leipzig, Germany, Institute for Medical Informatics, Statistics and Epidemiology
| | - M Loeffler
- University of Leipzig, Germany, Institute for Medical Informatics, Statistics and Epidemiology
- University of Leipzig, Germany, LIFE – Leipzig Research Center for Civilization Diseases
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Grill S, Yahiaoui-Doktor M, Basrai M, Struck J, Schulte J, Berling-Ernst A, Engel C, Ullrich M, Lammert J, Bischoff SC, Schmidt T, Niederberger U, Chronas D, Rhiem K, Schmutzler R, Halle M, Kiechle M. Precursor fractions of neurotensin and enkephalin might point to molecular mechanisms of cancer risk modulation during a lifestyle-intervention in germline BRCA1/2 gene mutation carriers. Breast Cancer Res Treat 2021; 186:741-752. [PMID: 33543354 PMCID: PMC8019429 DOI: 10.1007/s10549-020-06070-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/23/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Germline BRCA1/2 mutation carriers (gBMC) face increased cancer risks that are modulated via non-genetic lifestyle factors whose underlying molecular mechanisms are unknown. The peptides Neurotensin (NT) and Enkephalin (ENK)-involved in tumorigenesis and obesity-related diseases-are of interest. We wanted to know whether these biomarkers differ between gBMC and women from the general population and what effect a 1-year lifestyle-intervention has in gBMC. METHODS The stable precursor fragments pro-NT and pro-ENK were measured at study entry (SE), after 3 and 12 months for 68 women from LIBRE-1 (a controlled lifestyle-intervention feasibility trial for gBMC involving structured endurance training and the Mediterranean Diet). The SE values were compared with a cohort of the general population including female subjects with and without previous cancer disease, non-suggestive for hereditary breast and ovarian cancer (OMA-reference). For LIBRE-1, we analysed the association between the intervention-related change in the two biomarkers and certain lifestyle factors. RESULTS At SE, gBMC had a higher median pro-NT than OMA-reference (in the subgroups with previous cancer 117 vs. 91 pmol/L, p = 0.002). Non-diseased gBMC had lower median pro-ENK levels when compared to the non-diseased reference group. VO2peak and pro-NT 1-year change in LIBRE-1 were inversely correlated (r = - 0.435; CI - 0.653 to - 0.151; p = 0.004). Pro-ENK correlated positively with VO2peak at SE (r = 0.323; CI 0.061-0.544; p = 0.017). Regression analyses showed an inverse association of 1-year changes for pro-NT and Omega-6/Omega-3 (Estimate: - 37.9, p = 0.097/0.080) in multivariate analysis. CONCLUSION Our results give first indications for lifestyle-related modification particularly of pro-NT in gBMC.
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Affiliation(s)
- Sabine Grill
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum Rechts Der Isar, Technical University Munich (TUM), Munich, Germany.
| | - Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Maryam Basrai
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | | | | | - Anika Berling-Ernst
- Department of Prevention, Rehabilitation and Sports Medicine, Faculty of Medicine, University Hospital Rechts Der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Mirjam Ullrich
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum Rechts Der Isar, Technical University Munich (TUM), Munich, Germany
| | - Jacqueline Lammert
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum Rechts Der Isar, Technical University Munich (TUM), Munich, Germany
| | - Stephan C Bischoff
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Thorsten Schmidt
- Comprehensive Cancer Center, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Uwe Niederberger
- Institute for Medical Psychology and Medical Sociology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Dimitrios Chronas
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum Rechts Der Isar, Technical University Munich (TUM), Munich, Germany
| | - Kerstin Rhiem
- Center for Hereditary Breast and Ovarian Cancer, University Hospital Cologne, Cologne, Germany
| | - Rita Schmutzler
- Center for Hereditary Breast and Ovarian Cancer, University Hospital Cologne, Cologne, Germany
| | - Martin Halle
- Department of Prevention, Rehabilitation and Sports Medicine, Faculty of Medicine, University Hospital Rechts Der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Marion Kiechle
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum Rechts Der Isar, Technical University Munich (TUM), Munich, Germany
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10
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Berger T, Fuchs M, Dippold S, Meuret S, Zebralla V, Yahiaoui-Doktor M, Wirkner K, Loeffler M, Engel C. Standardization and Feasibility of Voice Range Profile Measurements in Epidemiological Studies. J Voice 2020; 36:142.e9-142.e20. [PMID: 32402662 DOI: 10.1016/j.jvoice.2020.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 03/27/2020] [Accepted: 04/01/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The voice range profile (VRP) is composed of the speaking VRP (spVRP) and the singing VRP (siVRP). Different examination methods of VRP and effects of interobserver variability were evaluated to define a standard operating procedure (SOP) suitable for the specific use in epidemiological studies. Subsequently the feasibility of the SOP was investigated in a larger number of participants. STUDY DESIGN Cross-sectional study. METHODS In a first phase both the spVRP and the siVRP of 51 female students were measured by four differently experienced examiners. Using a cross-over study design the effects of two different recording methods (manual vs automatic) and three different types of instructions given by the examiner (none vs before vs during recording) were investigated. In a second phase, the SOP for VRP recording was tested in the framework of a feasibility study in 110 (55 female and 55 male) participants. RESULTS The average total investigation time was significantly (P = 0.001) higher for the manual recording method (6.1 minutes ± 1.0) in comparison to the automated (5.5 minutes ± 0.7) recording method. The manual recording method led to significantly lower values of minimum frequency (F0min) (P = 0.013) and minimum intensity (SPLmin) (P < 0.001) and higher values of the maximum frequency (F0max) (P = 0.005) of the siVRP. The maximum phonation time, F0max, SPLmax of the siVRP and the frequency and intensity of the shouting voice (Level IV) of the spVRP showed significantly (P < 0.001) higher values when the examiner was allowed to give instructions and advise during the recording. Voice parameters of the siVRP did not show significant associations with the experience of the examiner. CONCLUSIONS Standardization of VRP measurements is important to obtain correct and reproducible data in a reasonable examination time. The SOP proposed here proved to be feasible in the setting of an epidemiological study.
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Affiliation(s)
- Thomas Berger
- Department of Otorhinolaryngology, Section of Phoniatrics and Audiology, University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.
| | - Michael Fuchs
- Department of Otorhinolaryngology, Section of Phoniatrics and Audiology, University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Sebastian Dippold
- Department of Otorhinolaryngology, Section of Phoniatrics and Audiology, University of Leipzig, Leipzig, Germany
| | - Sylvia Meuret
- Department of Otorhinolaryngology, Section of Phoniatrics and Audiology, University of Leipzig, Leipzig, Germany
| | - Veit Zebralla
- Department of Otorhinolaryngology, Section of Phoniatrics and Audiology, University of Leipzig, Leipzig, Germany
| | - Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Kerstin Wirkner
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics, and Epidemiology, University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
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11
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Lammert J, Grill S, Yahiaoui-Doktor M, Basrai M, Struck J, Hartmann O, Halle M, Kiechle M. Abstract P6-10-16: High circulating levels of adrenomedullin are associated with metabolic syndrome and low cardiorespiratory fitness in BRCA1 and BRCA2 mutation carriers. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p6-10-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: Risk factors for cardiovascular disease (CVD) and breast cancer overlap substantially. Identification of the underlying mechanisms associated with this co-occurrence is of great public health importance. Adrenomedullin (AM) is an almost ubiquitously expressed peptide with vasodilator and natriuretic properties. Previous studies have observed a link between high AM levels and worse prognosis in patients with myocardial infarction and heart failure, indicating a crucial role in the pathophysiology of CVD. Moreover, AM is expressed in 80% of sporadic breast cancers, and the degree of expression is associated with tumour growth, local tumour progression and bone metastases. High plasma AM levels are linked to arterial hypertension, diabetes, obesity and smoking. Preliminary evidence suggests that AM influences the osteoclast differentiation mediated by Receptor Activator of NF-κB Ligand (RANKL), an important signalling pathway in BRCA1-associated breast tumorigenesis.
OBJECTIVE: Besides an elevated risk of breast cancer, recent studies revealed that BRCA mutation carriers are potentially at higher cardiovascular risk. The value of AM in BRCA mutation carriers is unknown. The aim of this study was to examine circulating plasma AM levels in BRCA mutation carriers and assess their association with modifiable risk factors.
METHODS: AM concentrations were measured in 290 BRCA1/2 mutation carriers without overt CVD, participating in the randomized controlled LIBRE study (NCT numbers: NCT02087592, NCT02516540), by an immunoassay (sphingotest® bio-ADM®). Subjects were classified into high versus low AM levels based on the median plasma AM level in the entire cohort (13.9 pg/mL). Univariate logistic regression models were used to estimate the odds ratio (OR) of having high circulating AM levels by metabolic syndrome (MetS), cardiorespiratory fitness (CRF), body mass index (BMI), circulating insulin, smoking, current age, BRCA mutation status (BRCA1 or BRCA2) and previous diagnosis of breast cancer. MetS was defined in accordance with the criteria of the Third Adult Treatment Panel (ATP III). CRF was measured by peak oxygen uptake (VO2peak) assessed on a cycle ergometer via standardized cardiopulmonary exercise testing.
RESULTS: Of all women (median age: 43 years), 57.9% had a previous diagnosis of breast cancer. The median time between diagnosis and study entry was 3 years (range: 0-32 years). Women fulfilling the criteria of metabolic syndrome had over 17 times higher odds of having increased AM levels compared to those who did not meet the criteria (OR = 17.49, p < 0.001). Moreover, high AM levels were associated with lower VO2peak (OR = 0.91, p < 0.001), higher BMI (OR = 1.24, p < 0.001) and higher circulating insulin levels (OR = 1.1, p < 0.001). AM levels were higher in women who have ever smoked (OR = 1.73, p = 0.022), and AM levels increased with the number of pack-years smoked (OR = 1.03, p = 0.06). AM levels were not associated with age (p = 0.143), BRCA mutation status (p = 0.51) or previous diagnosis of breast cancer (p = 0.48). After adjustment for confounding variables, we observed that MetS (OR = 10.78, p = 0.002) and VO2peak (OR = 0.92, p = 0.001) were independent determinants of circulating AM.
CONCLUSIONS: This is the first study in BRCA mutation carriers that has linked circulating AM levels to MetS and CRF. The long-term clinical implications of these findings are yet to be determined.
Conflict of interest:
The study is funded by the German Cancer Aid (Deutsche Krebshilfe) within the Priority Program “Primary Prevention of Cancer” (Grant no. 110013).
JS and OH are employed by Sphingotec GmbH, a company having patent rights in and commercializing the bio-ADM assay. SG and MK received grants from Sphingotec GmbH. JL, MYD, MB and MH have nothing to disclose.
Citation Format: Jacqueline Lammert, Sabine Grill, Maryam Yahiaoui-Doktor, Maryam Basrai, Joachim Struck, Oliver Hartmann, Martin Halle, Marion Kiechle. High circulating levels of adrenomedullin are associated with metabolic syndrome and low cardiorespiratory fitness in BRCA1 and BRCA2 mutation carriers [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-10-16.
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Affiliation(s)
- Jacqueline Lammert
- 1Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, University Hospital rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Sabine Grill
- 1Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, University Hospital rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Maryam Yahiaoui-Doktor
- 2Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Maryam Basrai
- 3Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | | | | | - Martin Halle
- 5Department of Prevention, Rehabilitation and Sports Medicine, University Hospital rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Marion Kiechle
- 1Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, University Hospital rechts der Isar, Technical University of Munich (TUM), Munich, Germany
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12
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Olms C, Yahiaoui-Doktor M, Remmerbach TW. Contact allergies to dental materials. Swiss Dent J 2019; 129:571-579. [PMID: 31305034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
There is a lack of epidemiological data on allergies to dental materials. For example, in the recently published fifth German Oral Health Study (DMS V), no information was given on any common allergies or allergies to dental materials. The aim of the present observational study was therefore to determine the frequencies and symptoms of allergies to dental materials. A public consultation hour for allergies of the oral mucosa and material incompatibilities has been integrated in the Department of Dental Prosthodontics and Materials Science in Leipzig, where clinical patient data have systematically been collected since 2012. The objective mucosal findings and the patients’ complaints are documented in detail in a specifically designed data sheet. This study included 86 subjects (83.7% women and 16.3% men) with oral symptoms of a contact allergy. The average age was 63 years (24–86). The most common allergies were to metals, of which nickel and cobalt were the most common allergens. Furthermore, many allergies were indicated to ingredients of cosmetics and composites. Allergies to components in methacrylate-containing denture resins came in at rank 5. 52.4% of the patients showed mucosal changes. Contact stomatitis (54.5%) and an oral lichenoid lesion (20.5%) were most frequently diagnosed. 86% of the patients reported subjective complaints. Pain and burning sensations in the mouth were mostly reported. Appropriate dental allergy history, clinical examination of the oral cavity for changes in the oral mucosa, analysis of specific dentures, and screening for psychogenic disorders are necessary to clarify the origin of these symptoms.
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Affiliation(s)
- Constanze Olms
- Department of Dental Prosthodontics and Materials Science, University of Leipzig, Germany
| | - Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Germany
| | - Torsten W. Remmerbach
- Section of Oral Medicine, Department of Head Medicine and Oral Health, University of Leipzig, Germany
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13
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Yahiaoui-Doktor M, Luck T, Riedel-Heller SG, Loeffler M, Wirkner K, Engel C. Olfactory function is associated with cognitive performance: results from the population-based LIFE-Adult-Study. Alzheimers Res Ther 2019; 11:43. [PMID: 31077241 PMCID: PMC6511191 DOI: 10.1186/s13195-019-0494-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/12/2019] [Indexed: 11/20/2022]
Abstract
Background Studies in older adults or those with cognitive impairment have shown associations between cognitive and olfactory performance, but there are few population-based studies especially in younger adults. We therefore cross-sectionally analyzed this association using data from the population-based LIFE-Adult-Study. Methods Cognitive assessments comprised tests from the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD): verbal fluency (VF), word list learning and recall (WLL, WLR), and the Trail Making Tests (TMT) A and B. The “Sniffin’ Sticks Screening 12” test was used to measure olfactory performance. Linear regression analyses were performed to determine associations between the number of correctly identified odors (0 to 12) and the five cognitive test scores, adjusted for sex, age, education, and the presence of depressive symptoms. Receiver operating characteristic (ROC) analysis was carried out to determine the discriminative performance of the number of correctly identified odors regarding identification of cognition impairment. Results A total of 6783 participants (51.3% female) completed the olfaction test and the VF test and TMT. A subgroup of 2227 participants (46.9% female) also completed the WLL and WLR tests. Based on age-, sex-, and education-specific norms from CERAD, the following numbers of participants were considered cognitively impaired: VF 759 (11.2%), WLL 242 (10.9%), WLR: 132 (5.9%), TMT-A 415 (6.1%), and TMT-B/A ratio 677 (10.0%). On average, score values for VF were higher by 0.42 points (p < 0.001), for WLL higher by 0.32 points (p = 0.001), for WLR higher by 0.31 points (p = 0.002), for TMT-A lower by 0.25 points (p < 0.001), and for TMT-B/A ratio lower by 0.01 points (p < 0.001) per number of correctly identified odors. ROC analysis revealed area under the curve values from 0.55 to 0.62 for the five cognitive tests. Conclusions Better olfactory performance was associated with better cognitive performance in all five tests in adults — adjusted for age, sex, education, and the presence of depressive symptoms. However, the ability of the smell test to discriminate between individuals with and without cognitive impairment was limited. The value of olfactory testing in early screening for cognitive impairment should be investigated in longitudinal studies.
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Affiliation(s)
- Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04109, Leipzig, Germany. .,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.
| | - Tobias Luck
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Economic and Social Sciences and Institute of Social Medicine, Rehabilitation Sciences and Healthcare Research (ISRV), University of Applied Sciences Nordhausen, Nordhausen, Germany
| | - Steffi G Riedel-Heller
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04109, Leipzig, Germany.,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Kerstin Wirkner
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04109, Leipzig, Germany.,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
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14
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Zeynalova N, Schimpf S, Setter C, Yahiaoui-Doktor M, Zeynalova S, Lordick F, Loeffler M, Hinz A. The association between an anxiety disorder and cancer in medical history. J Affect Disord 2019; 246:640-642. [PMID: 30611061 DOI: 10.1016/j.jad.2018.12.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/07/2018] [Accepted: 12/15/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cancer patients can feel depression and anxiety any time after a cancer diagnosis. The Generalized Anxiety Disorder Scale (GAD-7) is an instrument for the assessment of anxiety. The main objective of this work was to compare general anxiety levels between cancer survivors and individuals without a history of cancer in a population-based study (LIFE-ADULT) with 10,000 participants. METHODS All participants (18-80 years) completed the GAD-7 and other psychological and medical questionnaires. A score of 10 or greater for GAD-7 (of total 21) indicates a probable generalized anxiety disorder. RESULTS 954 participants reported a diagnosis of cancer in their medical history. In the multivariate analysis an anxiety disorder was associated with prior cancer diagnosis (OR: 1.8; 95% CI [1.4-2.4]), age -every additional year- (OR: 0.983; [0.976-0.991]), female gender (OR: 1.8; [1.5-2.2]) and low socioeconomic status (OR: 2.0; [1.7-2.5]) all p < 0.001. There were no significant associations between general anxiety and other comorbidities, such as myocardial infarction (OR: 1.0; p = 0.948), stroke (OR: 1.4; p = 0.237) or diabetes (OR: 1.0; p = 0.326). There was also no significant difference in anxiety disorder among cancer survivors regarding the time passed since the initial cancer diagnosis (OR: 1.1; [0.6-1.9], p = 0.804 comparing 5-10 years after a diagnosis of cancer vs. ≤5 years and OR: 0.6; [0.4-1.1], p = 0.107 comparing >10 vs. ≤5 years). LIMITATIONS This study has a cross-sectional character, therefore, causal conclusions cannot be drawn. CONCLUSION Cancer survivors may require screening for anxiety disorders and long-term professional psychosocial support.
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Affiliation(s)
- N Zeynalova
- Institute for Medical Informatics, Statistics and Epidemiology, Universität Leipzig, Härtelstraße 16-18, D-04107 Leipzig, Germany
| | - S Schimpf
- University Cancer Center Leipzig, University Medical Center Leipzig, Liebigstreet 20, 04103 Leipzig, Germany
| | - C Setter
- Department of Radiation Oncology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - M Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology, Universität Leipzig, Härtelstraße 16-18, D-04107 Leipzig, Germany
| | - S Zeynalova
- Institute for Medical Informatics, Statistics and Epidemiology, Universität Leipzig, Härtelstraße 16-18, D-04107 Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, Universität Leipzig, Philipp-Rosenthal-Straße 27, D-04103 Leipzig, Germany.
| | - F Lordick
- University Cancer Center Leipzig, University Medical Center Leipzig, Liebigstreet 20, 04103 Leipzig, Germany
| | - M Loeffler
- Institute for Medical Informatics, Statistics and Epidemiology, Universität Leipzig, Härtelstraße 16-18, D-04107 Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, Universität Leipzig, Philipp-Rosenthal-Straße 27, D-04103 Leipzig, Germany
| | - A Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
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15
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Bernhard M, Bax SN, Hartwig T, Yahiaoui-Doktor M, Petros S, Bercker S, Ramshorn-Zimmer A, Gries A. Airway Management in the Emergency Department (The OcEAN-Study) - a prospective single centre observational cohort study. Scand J Trauma Resusc Emerg Med 2019; 27:20. [PMID: 30764832 PMCID: PMC6376794 DOI: 10.1186/s13049-019-0599-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 02/07/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Emergency airway management (AM) is a major key for successful resuscitation of critically ill non-traumatic (CINT) patients. Details of the AM of these patients in German emergency departments (ED) are unknown. This observational study describes epidemiology, airway techniques, success rates and complications of AM in CINT ED patients in the resuscitation room (RR). METHODS Data was collected prospectively on adult CINT patients admitted to the RR of a single German university ED September 2014 to August 2015. Patient characteristics, out-of-hospital and in-hospital RR AM, complications and success rates were recorded using a self-developed airway registry form. RESULTS During the study period 34,303 patients were admitted to the ED, out of those 21,074 patients for non-trauma emergencies. Suffering from severe acute life-threatening problems, 532 CINT patients were admitted to the RR. 150 (28.2%) CINT patients had received out-of-hospital AM. In 16 of these cases (10.7%) the inserted airway needed to be changed after RR admission (unrecognized oesophageal intubation: n = 2, laryngeal tube exchange: n = 14). 136 (25.6%) CINT patients without out-of-hospital AM received RR AM immediately after admission. The first-pass and overall success rate in the RR were 71 and 100%, respectively, and multiple intubation attempts were necessary in 29%. A lower Cormack/Lehane (C/L) grade was associated with less intubation attempts (C/L1/2 vs. 3/4: 1.2 ± 0.5 vs. 1.8 ± 1.2, p = 0.0002). Complication rate was 43%. CONCLUSIONS OcEAN demonstrates the challenges of AM in CINT patients in a German ED RR. We propose a nation-wide ED airway registry to better track outcomes in the future.
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Affiliation(s)
- Michael Bernhard
- Emergency Department, University Hospital of Düsseldorf, Düsseldorf, Germany.,Emergency Department, University Hospital of Leipzig, Leipzig, Germany.,Working group "Trauma and Resuscitation Room Management", Task Force Emergency Medicine, German Society of Anaesthesiology and Intensiv care Medizin, Nürnberg, Germany
| | - Sönke Nils Bax
- Emergency Department, University Hospital of Leipzig, Leipzig, Germany. .,Emergency Department, Paracelsus Hospital of Henstedt-Ulzburg, Wilstedter Straße 134, D-24558, Henstedt-Ulzburg, Germany.
| | - Thomas Hartwig
- Emergency Department, University Hospital of Leipzig, Leipzig, Germany
| | - Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Sirak Petros
- Medical Intensive Care Unit, University Hospital of Leipzig, Leipzig, Germany
| | - Sven Bercker
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Leipzig, Leipzig, Germany
| | | | - André Gries
- Emergency Department, University Hospital of Leipzig, Leipzig, Germany
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16
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Kramer A, Urban N, Döll S, Hartwig T, Yahiaoui-Doktor M, Burkhardt R, Petros S, Gries A, Bernhard M. Early Lactate Dynamics in Critically Ill Non-Traumatic Patients in a Resuscitation Room of a German Emergency Department (OBSERvE-Lactate-Study). J Emerg Med 2018; 56:135-144. [PMID: 30538084 DOI: 10.1016/j.jemermed.2018.10.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/20/2018] [Accepted: 10/25/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Management of critically ill non-trauma patients in the resuscitation room of an emergency department (ED) is very challenging, and it is difficult to identify patients with a higher risk of death. Previous studies have shown that lactate indices can predict survival for selected diseases and syndromes. OBJECTIVE As reported for other patient populations, we set out to determine whether admission lactate or lactate dynamics (LD) within 24 h can predict 30-day mortality in unselected critically ill non-traumatic patients. METHODS In this retrospective study over a 1-year period, admission lactate, time weighted average lactate (LacTW) and LD of all critically ill adult patients admitted from ED to intensive care unit were analyzed. A linear regression model was implemented to estimate lactate data 1 h after admission. RESULTS The admission lactate, LacTW, and LD within 24 h were analyzed from 392 critically ill patients. The overall 30-day mortality rate was around 29%. Admission lactate (4.1 ± 4.0 mmol/L vs. 6.6 ± 6.1 mmol/L; p < 0.01) and LacTW (1.8 ± 1.7 mmol/L vs. 4.1 ± 4.8 mmol/L; p < 0.01) were different between survivors and non-survivors. LD between survivors and non-survivors did not differ at 1 h, 6 h, 12 h, or 24 h. After excluding patients with out-of-hospital or in-hospital cardiac arrest during resuscitation room management, admission lactate and LD between survivors and non-survivors did not differ at 1 h, 12 h, and 24 h. LD at 6 h (44% ± 42% vs. 33% ± 58%; p = 0.042) and LacTW (1.7 ± 1.6 mmol/L vs. 2.6 ± 3.0 mmol/L; p < 0.01) did differ. CONCLUSIONS In critically ill ED patients initially requiring treatment in a resuscitation room setting, LD at 6 h and LacTW may predict their survival beyond 30 days. These findings need to be confirmed in a prospective study design.
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Affiliation(s)
- Andre Kramer
- Emergency Department, University Hospital of Leipzig, Leipzig, Germany
| | - Norman Urban
- Institute for Informatics, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Stephanie Döll
- Emergency Department, University Hospital of Leipzig, Leipzig, Germany
| | - Thomas Hartwig
- Emergency Department, University Hospital of Leipzig, Leipzig, Germany
| | - Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Ralph Burkhardt
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital of Leipzig, Leipzig, Germany
| | - Sirak Petros
- Medical Intensive Care Unit, University Hospital of Leipzig, Leipzig, Germany
| | - André Gries
- Emergency Department, University Hospital of Leipzig, Leipzig, Germany
| | - Michael Bernhard
- Emergency Department, University Hospital of Leipzig, Leipzig, Germany; Emergency Department, University Hospital of Düsseldorf, Düsseldorf, Germany; Working Group Trauma and Resuscitation Room Management, Task Force Emergency Medicine, German Society of Anaesthesiology and Intensive Care Medicine, Nümberg, Germany
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17
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González EU, Ovaska K, Seethaler B, Basrai M, Yahiaoui-Doktor M, Lehnert K, Vetter W, Engel C, Halle M, Siniatchkin M, Kiechle M, Bischoff S. Effects of a lifestyle intervention study for mediterranean diet on the fatty acid composition in plasma and erythrocyte membrane. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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18
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Olms C, Hix N, Neumann H, Yahiaoui-Doktor M, Remmerbach TW. Clinical comparison of liquid-based and conventional cytology of oral brush biopsies: a randomized controlled trial. Head Face Med 2018; 14:9. [PMID: 29843756 PMCID: PMC5975412 DOI: 10.1186/s13005-018-0166-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 05/15/2018] [Indexed: 11/10/2022] Open
Abstract
Background Exfoliative cytology performed on oral brush samples can help dentists to decide, whether a given oral lesion is (pre-) malignant. The use of non-invasive brush biopsies as an auxiliary tool in the diagnosis of oral mucosal lesions has gained renewed interest since improvements in cytological techniques such as the development of adjuvant diagnostic tools and liquid-based cell preparation techniques. Methods The aim of this study was to compare the quality of two different preparation techniques (cell collectors): the conventional transfer procedure to glass slides and the so-called liquid-based cytology preparation method. Cell smears were collected from 10 orally healthy individuals (mean age: 24 years) from the palatine mucosa at two different times (baseline and 4 weeks later). Slides of both techniques were stained by Giemsa (n = 40) and May-Gruenwald Giemsa (n = 40). The statistical analysis was performed with Excel. Results On specimen analysis, the liquid-based cytology showed statistically significant improvement compared to conventional glass sides (p < 0.001). Thin layers, which were performed by liquid-based cytology showed significantly better results in the parameters (p < 0.001): uniform distribution, cellular overlapping, cellular disformation, mucus, microbial colonies and debris. The conventional glass slides approach showed more cell overlapping and contamination with extraneous material than thin layers, which were performed by Orcellex® Brush cell collectors. Conclusions Both techniques are diagnostically reliable. The liquid-based method showed an overall improvement on sample preservation, specimen adequacy, visualization of cell morphology and reproducibility. Liquid-based cytology simplifies cell collection due to easier handling and less transfer errors by dentists.
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Affiliation(s)
- Constanze Olms
- Department of Dental Prosthodontics and Materials Science, University of Leipzig, Liebigstraße 12, 04103, Leipzig, Germany.
| | - Nathalie Hix
- Department of Dental Prosthodontics and Materials Science, University of Leipzig, Liebigstraße 12, 04103, Leipzig, Germany
| | - Heinrich Neumann
- Institute of Cytopathology, Am Propsthof 3, 53121, Bonn, Germany
| | - Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Torsten W Remmerbach
- Section of Oral Medicine, Department of Head Medicine and Oral Health, University of Leipzig, Liebigstraße 10-14, 04103, Leipzig, Germany
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19
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Kiechle M, Dukatz R, Yahiaoui-Doktor M, Berling A, Basrai M, Staiger V, Niederberger U, Marter N, Lammert J, Grill S, Pfeifer K, Rhiem K, Schmutzler RK, Laudes M, Siniatchkin M, Halle M, Bischoff SC, Engel C. Feasibility of structured endurance training and Mediterranean diet in BRCA1 and BRCA2 mutation carriers - an interventional randomized controlled multicenter trial (LIBRE-1). BMC Cancer 2017; 17:752. [PMID: 29126396 PMCID: PMC5681801 DOI: 10.1186/s12885-017-3732-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 10/30/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Women with pathogenic BRCA germline mutations have an increased risk for breast and ovarian cancer that seems to be modified by life-style factors. Though, randomized trials investigating the impact of lifestyle interventions on cancer prevention and prognosis in BRCA carriers are still missing. METHODS We implemented a multicenter, prospective randomized controlled trial in BRCA1/2 patients, comparing a lifestyle intervention group (IG) with a control group (CG) with the primary aim to prove feasibility. Intervention comprised a structured, individualized endurance training alongside nutrition education based on the Mediterranean diet (MD) for 3 months, plus monthly group training and regular telephone contact during the subsequent 9 months. The CG attended one session on healthy nutrition and the benefits of physical activity. Primary endpoints were feasibility, acceptance and satisfaction over 12 months. Furthermore, effects on physical fitness, diet profile, body mass index (BMI), quality of life and perceived stress were investigated. RESULTS Sixty-eight participants (mean age 41, mean BMI 23.2 kg/m2) were enrolled, of whom 55 (81%, 26 IG, 29 CG) completed 12 months. 73% (n = 26) participated in at least 70% of all intervention sessions. Predictors for drop-outs (19%; n = 13) or non-adherence (27%; n = 7) were not found. 73% rated the program highly and 80% would participate again. Severe adverse events did not occur. Positive effects in the IG compared to the CG were observed for secondary endpoints: BMI, MD eating pattern and stress levels. CONCLUSIONS This lifestyle intervention was feasible, safe and well accepted. Positive results on eating habits, physical fitness and stress levels warrant a larger randomized trial. TRIAL REGISTRATION The study has been retrospectively registered at ClinicalTrials.gov (reference: NCT02087592 ) on March 12, 2014. The first patient was included on February 24, 2014.
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Affiliation(s)
- Marion Kiechle
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany.
| | - Ricarda Dukatz
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany
| | - Anika Berling
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technical University Munich (TUM), Georg-Brauchle Ring 56, 80638, Munich, Germany
| | - Maryam Basrai
- Institute for Nutritional Medicine, University Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany
| | - Vera Staiger
- Institute for Nutritional Medicine, University Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany
| | - Uwe Niederberger
- Institute for Medical Psychology and Sociology, University Hospital Schleswig-Holstein, Campus Kiel, Preusserstr. 1 - 9, 24105, Kiel, Germany
| | - Nicole Marter
- Institute for Medical Psychology and Sociology, University Hospital Schleswig-Holstein, Campus Kiel, Preusserstr. 1 - 9, 24105, Kiel, Germany
| | - Jacqueline Lammert
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Sabine Grill
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Katharina Pfeifer
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Kerstin Rhiem
- Center for Hereditary Breast and Ovarian Cancer, University Hospital Cologne, Kerpener Str. 34, 50931, Cologne, Germany
| | - Rita K Schmutzler
- Center for Hereditary Breast and Ovarian Cancer, University Hospital Cologne, Kerpener Str. 34, 50931, Cologne, Germany
| | - Matthias Laudes
- Department of Internal Medicine 1, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3, 24105, Kiel, Germany
| | - Michael Siniatchkin
- Institute for Medical Psychology and Sociology, University Hospital Schleswig-Holstein, Campus Kiel, Preusserstr. 1 - 9, 24105, Kiel, Germany
| | - Martin Halle
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technical University Munich (TUM), Georg-Brauchle Ring 56, 80638, Munich, Germany.,Else Kroener-Fresenius Prevention Center, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Stephan C Bischoff
- Institute for Medical Psychology and Sociology, University Hospital Schleswig-Holstein, Campus Kiel, Preusserstr. 1 - 9, 24105, Kiel, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany
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20
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Grill S, Yahiaoui-Doktor M, Dukatz R, Lammert J, Ullrich M, Engel C, Pfeifer K, Basrai M, Siniatchkin M, Schmidt T, Weisser B, Rhiem K, Ditsch N, Schmutzler R, Bischoff SC, Halle M, Kiechle M. Smoking and physical inactivity increase cancer prevalence in BRCA-1 and BRCA-2 mutation carriers: results from a retrospective observational analysis. Arch Gynecol Obstet 2017; 296:1135-1144. [DOI: 10.1007/s00404-017-4546-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 09/19/2017] [Indexed: 12/22/2022]
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21
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Yahiaoui-Doktor M, Luck T, Riedel-Heller SG, Löffler M, Wirkner K, Engel C. Association between cognitive and olfactory performance: results from the population-based LIFE-Adult-Study. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M Yahiaoui-Doktor
- University of Leipzig, Institute for Medical Informatics, Statistics and Epidemiology, Leipzig
- University of Leipzig, LIFE – Leipzig Research Centre for Civilization Diseases, Leipzig
| | - T Luck
- University of Leipzig, LIFE – Leipzig Research Centre for Civilization Diseases, Leipzig
- University of Leipzig, Institute of Social Medicine, Occupational Health and Public Health (ISAP), Leipzig
| | - SG Riedel-Heller
- University of Leipzig, Institute of Social Medicine, Occupational Health and Public Health (ISAP), Leipzig
| | - M Löffler
- University of Leipzig, Institute for Medical Informatics, Statistics and Epidemiology, Leipzig
- University of Leipzig, LIFE – Leipzig Research Centre for Civilization Diseases, Leipzig
| | - K Wirkner
- University of Leipzig, LIFE – Leipzig Research Centre for Civilization Diseases, Leipzig
| | - C Engel
- University of Leipzig, Institute for Medical Informatics, Statistics and Epidemiology, Leipzig
- University of Leipzig, LIFE – Leipzig Research Centre for Civilization Diseases, Leipzig
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22
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Hebestreit K, Yahiaoui-Doktor M, Engel C, Vetter W, Siniatchkin M, Erickson N, Halle M, Kiechle M, Bischoff SC. Validation of the German version of the Mediterranean Diet Adherence Screener (MEDAS) questionnaire. BMC Cancer 2017; 17:341. [PMID: 28521737 PMCID: PMC5437541 DOI: 10.1186/s12885-017-3337-y] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 05/09/2017] [Indexed: 01/27/2023] Open
Abstract
Background Health benefits of the Mediterranean Diet (MD) have been shown in different at-risk populations. A German translation of the Mediterranean Diet Adherence Screener (MEDAS) from the PREvención con DIeta MEDiterránea (PREDIMED) consortium was used in the LIBRE study, investigating effects of lifestyle-intervention on women with BRCA1/2 mutations. The purpose of the present study is to validate the MEDAS German version. Methods LIBRE is a multicentre (three university hospitals during this pilot phase), unblinded, randomized, controlled clinical trial. Women with a BRCA1/2 mutation of age 18 or over who provided written consent were eligible for the trial. As part of the assessment, all were given a full-length Food Frequency Questionnaire (FFQ) and MEDAS at baseline and after 3 months. Data derived from FFQ was compared to MEDAS in order to evaluate agreement or concordance between the two questionnaires. Additionally, the association of dietary intake biomarkers in the blood (β-carotene, omega-3, omega-6 and omega-9 fatty acids and high-sensitivity C-reactive protein (hsCRP)) with some MEDAS items was analyzed using t-Tests and a multivariate regression. Results The participants of the LIBRE pilot study were 68 in total (33 Intervention, 35 Control). Only participants who completed both questionnaires were included in this analysis (baseline: 66, month three: 54). The concordance between these two questionnaires varied between the items (Intraclass correlation coefficient of 0.91 for pulses at the highest and −0.33 for sugar-sweetened drinks). Mean MEDAS scores (sum of all items) were 9% higher than their FFQ counter-parts at baseline and 15% after 3 months. Higher fish consumption (at least 3 portions) was associated with lower omega-6 fatty acid levels (p = 0.026) and higher omega-3 fatty acid levels (p = 0.037), both results being statistically significant. Conclusions We conclude that the German MEDAS in its current version could be a useful tool in clinical trials and in practice to assess adherence to MD. Trial registration ClinicalTrials.gov, registered on March 12, 2014, identifier: NCT02087592. World Health Organization Trial Registration, registered on 3 August 2015, identifier: NCT02087592.
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Affiliation(s)
- Katrin Hebestreit
- Institute for Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany
| | - Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany
| | - Walter Vetter
- Institute for Food Chemistry, University of Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany
| | - Michael Siniatchkin
- Institute for Medical Psychology and Sociology, University Hospital Schleswig-Holstein, Campus Kiel, Preusserstr. 1-9, 24105, Kiel, Germany
| | - Nicole Erickson
- Comprehensive Cancer Center (CCC LMU), Ludwig Maximilian University Munich, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Martin Halle
- Else Kroener-Fresenius Prevention Center, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaningerstr. 22, 81675, Munich, Germany.,Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaningerstr. 22, 81675, Munich, Germany
| | - Marion Kiechle
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Women's Hospital Klinikum Rechts der Isar der, Technical University Munich (TUM), Gynaecology and Obstetrics, Ismaningerstrasse 22, 81675, Munich, Germany.
| | - Stephan C Bischoff
- Institute for Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany
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Kiechle M, Engel C, Berling A, Hebestreit K, Bischoff S, Dukatz R, Gerber WD, Siniatchkin M, Pfeifer K, Grill S, Yahiaoui-Doktor M, Kirsch E, Niederberger U, Marter N, Enders U, Löffler M, Meindl A, Rhiem K, Schmutzler R, Erickson N, Halle M. Lifestyle intervention in BRCA1/2 mutation carriers: study protocol for a prospective, randomized, controlled clinical feasibility trial (LIBRE-1 study). Pilot Feasibility Stud 2016; 2:74. [PMID: 28031860 PMCID: PMC5165708 DOI: 10.1186/s40814-016-0114-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 11/23/2016] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Women with highly penetrant BRCA mutations have a 55-60% lifetime risk for breast cancer and a 16-59% lifetime risk for ovarian cancer. However, penetrance differs interindividually, indicating that environmental and behavioral factors may modify this risk. These include lifestyle factors such as physical activity status, dietary habits, and body weight. The modification of penetrance by changing lifestyle factors has not thus far been investigated in a randomized trial in BRCA mutation carriers. METHODS Therefore, we intend to enroll 60 BRCA1/2 mutation carriers in a pilot feasibility study (Lifestyle Intervention Study in Women with Hereditary Breast and Ovarian Cancer (LIBRE) pilot). This multi-center, prospective, controlled trial aims to randomize (1:1) participants into a (1) multi-factorial lifestyle intervention group (IG) versus (2) the control group with usual care (CG). The primary endpoint is feasibility and acceptance of a structured interdisciplinary lifestyle intervention program over 12 months (at least 70% of the patients to complete the 1-year intervention). Furthermore, the effects on physical fitness, BMI, quality of life, and stress coping capacity will be investigated. During the first 3 months, women in the IG will receive structured, individualized and mainly supervised endurance training of ≥18 MET*h/week (MET = metabolic equivalent task) and personal nutritional counseling based on the Mediterranean diet. During the subsequent 9 months, the IG will receive monthly group training sessions and regular telephone contacts for motivation, whereas the CG will only receive usual care (one general counseling on healthy nutrition and benefits of regular physical activity on health status). At randomization and subsequent time points (3, 6, 12 months), cardiopulmonary fitness will be assessed by spiroergometry and nutritional and psychological status by validated questionnaires. DISCUSSION This pilot study will investigate the optimal strategy to improve physical fitness, nutritional habits, and psychological factors in women at high risk for developing breast or ovarian cancer. The results of this pilot feasibility study will be the basis for a larger prospective randomized trial including clinical events (LIBRE). TRIAL REGISTRATION ClinicalTrials.gov, NCT02087592.
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Affiliation(s)
- Marion Kiechle
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675 Munich, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107 Leipzig, Germany
| | - Anika Berling
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675 Munich, Germany
- Else Kroener-Fresenius Prevention Center, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675 Munich, Germany
| | - Katrin Hebestreit
- Institute for Nutritional Medicine, University Hohenheim, Fruwirthstr. 12, 70593 Stuttgart, Germany
| | - Stephan Bischoff
- Institute for Nutritional Medicine, University Hohenheim, Fruwirthstr. 12, 70593 Stuttgart, Germany
| | - Ricarda Dukatz
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675 Munich, Germany
| | - Wolf-Dieter Gerber
- Institute for Medical Psychology and Sociology, University Hospital Schleswig-Holstein, Campus Kiel, Preusserstr. 1-9, 24105 Kiel, Germany
| | - Michael Siniatchkin
- Institute for Medical Psychology and Sociology, University Hospital Schleswig-Holstein, Campus Kiel, Preusserstr. 1-9, 24105 Kiel, Germany
| | - Katharina Pfeifer
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675 Munich, Germany
| | - Sabine Grill
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675 Munich, Germany
| | - Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107 Leipzig, Germany
| | - Ellen Kirsch
- Institute for Medical Psychology and Sociology, University Hospital Schleswig-Holstein, Campus Kiel, Preusserstr. 1-9, 24105 Kiel, Germany
| | - Uwe Niederberger
- Institute for Medical Psychology and Sociology, University Hospital Schleswig-Holstein, Campus Kiel, Preusserstr. 1-9, 24105 Kiel, Germany
| | - Nicole Marter
- Institute for Medical Psychology and Sociology, University Hospital Schleswig-Holstein, Campus Kiel, Preusserstr. 1-9, 24105 Kiel, Germany
| | - Ute Enders
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107 Leipzig, Germany
| | - Markus Löffler
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107 Leipzig, Germany
| | - Alfons Meindl
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675 Munich, Germany
| | - Kerstin Rhiem
- Center for Hereditary Breast and Ovarian Cancer, University Hospital Cologne, Kerpener Str. 34, 50931 Cologne, Germany
| | - Rita Schmutzler
- Center for Hereditary Breast and Ovarian Cancer, University Hospital Cologne, Kerpener Str. 34, 50931 Cologne, Germany
| | - Nicole Erickson
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675 Munich, Germany
- Else Kroener-Fresenius Prevention Center, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675 Munich, Germany
| | - Martin Halle
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675 Munich, Germany
- Else Kroener-Fresenius Prevention Center, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675 Munich, Germany
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Kiechle M, Engel C, Berling A, Hebestreit K, Bischoff SC, Dukatz R, Siniatchkin M, Pfeifer K, Grill S, Yahiaoui-Doktor M, Kirsch E, Niederberger U, Enders U, Löffler M, Meindl A, Rhiem K, Schmutzler R, Erickson N, Halle M. Effects of lifestyle intervention in BRCA1/2 mutation carriers on nutrition, BMI, and physical fitness (LIBRE study): study protocol for a randomized controlled trial. Trials 2016; 17:368. [PMID: 27473440 PMCID: PMC4966818 DOI: 10.1186/s13063-016-1504-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 06/07/2016] [Indexed: 11/19/2022] Open
Abstract
Background Women with highly penetrant BRCA mutations have a 55–60 % lifetime risk for breast cancer and a 16–59 % lifetime risk of developing ovarian cancer. However, penetrance differs interindividually, indicating that environmental and behavioral factors may modify this risk. It is well documented that the risk for sporadic breast cancer disease can be modified by changing lifestyle factors that primarily include physical activity, dietary habits, and body weight. It can thus be hypothesized that the modification of these lifestyle factors may also influence the incidence and progression of cancer in BRCA mutation carriers. Methods/design This multicenter, interdisciplinary, prospective, two-armed, randomized (1:1) controlled trial aims to enroll a minimum of 600 BRCA1 and BRCA2 mutation carriers to partake in either a lifestyle intervention or usual care. The study primarily aims to demonstrate an improvement of nutritional behavior (adherence to the Mediterranean diet), body mass index, and physical fitness. Furthermore, the effects on quality of life, stress coping capacity, breast cancer incidence, and mortality will be investigated. The intervention group (IG) will receive a structured lifestyle intervention over 12 months, whereas the control group (CG) will only receive information regarding a healthy lifestyle. During the first 3 months, women in the IG will receive structured, individualized, and mainly supervised endurance training with a minimum of 18 MET-h physical activity per week and nutrition education based on the Mediterranean diet. Over the following 9 months, IG monthly group training sessions and regular telephone contacts will motivate study participants. The CG will receive one general training session about healthy nutrition in accordance with the recommendations of the German Society of Nutrition (standard of care in Germany) and the benefits of regular physical activity on health status. At randomization and subsequent time points (3 and 12 months), cardiopulmonary fitness will be assessed by spiroergometry, and nutritional and psychological status will be assessed by validated questionnaires, interviews, and clinical examinations. Discussion As data on the role of lifestyle intervention in women with a hereditary risk for breast and ovarian cancer are currently lacking, this study will be of major importance from a scientific, as well as a practical advice viewpoint. It will investigate the optimal strategy to improve physical fitness, nutritional status, and psychological factors such as quality of life, perceived stress, optimism, as well as incidence and outcome of cancer in this selected group of women at high risk. If the study indicates a positive long-term outcome, a structured lifestyle intervention program could be added to health care prevention strategies for BRCA1 and BRCA2 mutation carriers. Trial registration ClinicalTrials.gov: NCT02516540. Registered on 22 July 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1504-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marion Kiechle
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum Rechts der Isar, Technical University Munich (TUM) and Comprehensive Cancer Center Munich (CCCM), Ismaninger Str. 22, 81675, Munich, Germany.
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany
| | - Anika Berling
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany.,Else Kröner-Fresenius Prevention Center, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Katrin Hebestreit
- Institute for Nutritional Medicine, University Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany
| | - Stephan C Bischoff
- Institute for Nutritional Medicine, University Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany
| | - Ricarda Dukatz
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum Rechts der Isar, Technical University Munich (TUM) and Comprehensive Cancer Center Munich (CCCM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Michael Siniatchkin
- Institute for Medical Psychology and Sociology, University Hospital Schleswig-Holstein, Campus Kiel, Preusserstr. 1-9, 24105, Kiel, Germany
| | - Katharina Pfeifer
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum Rechts der Isar, Technical University Munich (TUM) and Comprehensive Cancer Center Munich (CCCM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Sabine Grill
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum Rechts der Isar, Technical University Munich (TUM) and Comprehensive Cancer Center Munich (CCCM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Maryam Yahiaoui-Doktor
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany
| | - Ellen Kirsch
- Institute for Medical Psychology and Sociology, University Hospital Schleswig-Holstein, Campus Kiel, Preusserstr. 1-9, 24105, Kiel, Germany
| | - Uwe Niederberger
- Institute for Medical Psychology and Sociology, University Hospital Schleswig-Holstein, Campus Kiel, Preusserstr. 1-9, 24105, Kiel, Germany
| | - Ute Enders
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany
| | - Markus Löffler
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany
| | - Alfons Meindl
- Department of Gynecology and Center for Hereditary Breast and Ovarian Cancer, Klinikum Rechts der Isar, Technical University Munich (TUM) and Comprehensive Cancer Center Munich (CCCM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Kerstin Rhiem
- Center for Hereditary Breast and Ovarian Cancer, University Hospital Cologne, Kerpener Str. 34, 50931, Cologne, Germany
| | - Rita Schmutzler
- Center for Hereditary Breast and Ovarian Cancer, University Hospital Cologne, Kerpener Str. 34, 50931, Cologne, Germany
| | - Nicole Erickson
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany.,Else Kröner-Fresenius Prevention Center, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany
| | - Martin Halle
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany.,Else Kröner-Fresenius Prevention Center, Klinikum rechts der Isar, Technical University Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany
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Steiner S, Schmidt A, Bausback Y, Piorkowski M, Werner M, Yahiaoui-Doktor M, Banning-Eichenseer U, Scheinert D. Midterm Patency After Femoropopliteal Interventions. J Endovasc Ther 2016; 23:347-55. [DOI: 10.1177/1526602816628285] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: To describe and compare primary patency rates in patients undergoing endovascular femoropopliteal interventions with standard or interwoven nitinol stents or drug-coated balloons. Methods: A cohort of 1292 patients was treated for symptomatic femoropopliteal occlusive disease classified as Rutherford category ≥1 at a large vascular center between June 2006 and August 2013 using either standard nitinol stents (SNS; n=432), interwoven nitinol stents (INS; n=470), or drug-coated balloons (DCB; n=390). Primary patency rates were assessed by ultrasound or angiographic readings for over 3 years of follow-up. Propensity score–matched pairs were formed to compare each treatment with another using survival analysis. Results: Survival curves of primary patency favored INS compared with SNS in 368 propensity score–matched pairs (p<0.001). Kaplan-Meier estimates at 1, 2, and 3 years were 86.6%, 76.4%, and 68.9%, respectively, in the INS group vs 60.5%, 46.1%, and 42.1%, respectively, in the SNS group. No significant difference (p=0.232) was seen for the comparison of SNS vs DCB in 284 matched pairs over long-term follow-up (primary patency estimates at 1, 2, and 3 years were 79.8%, 53.8%, and 32.9%, respectively, in the DCB group vs 60.5%, 44.8%, and 40.3%, respectively, in the SNS group). Survival curves of primary patency favored INS over DCB in 254 matched pairs (p<0.001). Kaplan-Meier estimates at 1, 2, and 3 years were 79.0%, 51.2%, and 30.1%, respectively, in the DCB group vs 89.0%, 76.9%, and 66.2%, respectively, in the INS group. Conclusion: Propensity score–based analysis of primary patency suggests profound differences in restenosis rates between various treatment modalities for femoropopliteal disease for over 3 years of follow-up.
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Affiliation(s)
- Sabine Steiner
- Department of Interventional Angiology, Medical Faculty, University of Leipzig, Germany
| | - Andrej Schmidt
- Department of Interventional Angiology, Medical Faculty, University of Leipzig, Germany
| | - Yvonne Bausback
- Department of Interventional Angiology, Medical Faculty, University of Leipzig, Germany
| | | | - Martin Werner
- Department of Angiology, Hanusch Hospital, Vienna, Austria
| | - Maryam Yahiaoui-Doktor
- Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Germany
| | | | - Dierk Scheinert
- Department of Interventional Angiology, Medical Faculty, University of Leipzig, Germany
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Zaslansky R, Rothaug J, Chapman RC, Backström R, Brill S, Engel C, Fletcher D, Fodor L, Funk P, Gordon D, Komann M, Konrad C, Kopf A, Leykin Y, Pogatzki-Zahn E, Puig M, Rawal N, Schwenkglenks M, Taylor RS, Ullrich K, Volk T, Yahiaoui-Doktor M, Meissner W. PAIN OUT: an international acute pain registry supporting clinicians in decision making and in quality improvement activities. J Eval Clin Pract 2014; 20:1090-8. [PMID: 24986116 DOI: 10.1111/jep.12205] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2014] [Indexed: 01/12/2023]
Abstract
RATIONALE, AIMS AND OBJECTIVES Management of post-operative pain is unsatisfactory worldwide. An estimated 240 million patients undergo surgery each year. Forty to 60% of these patients report clinically significant pain. Discrepancy exists between availability of evidence-based medicine (EBM)-derived knowledge about management of perioperative pain and increased implementation of related practices versus lack of improvement in patient-reported outcomes (PROs). We aimed to assist health care providers to optimize perioperative pain management by developing and validating a medical registry that measures variability in care, identifies best pain management practices and assists clinicians in decision making. METHODS PAIN OUT was established from 2009 to 2012 with funding from the European Commission. It now continues as a self-sustaining, not-for-profit project, targeting health care professionals caring for patients undergoing surgery. RESULTS The growing registry includes data from 40 898 patients, 60 hospitals and 17 countries. Collaborators upload data (demographics, clinical, PROs) from patients undergoing surgery in their hospital/ward into an Internet-based portal. Two modules make use of the data: (1) online, immediate feedback and benchmarking compares PROs across sites while offline analysis permits in-depth analysis; and (2) the case-based clinical decision support system offers practice-based treatment recommendations for individual patients; it is available now as a prototype. The Electronic Knowledge Library provides succinct summaries on perioperative pain management, supporting knowledge transfer and application of EBM. CONCLUSION PAIN OUT, a large, growing international registry, allows use of 'real-life' data related to management of perioperative pain. Ultimately, comparative analysis through audit, feedback and benchmarking will improve quality of care.
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Affiliation(s)
- Ruth Zaslansky
- Department of Anesthesiology and Intensive Care, Friedrich-Schiller University Hospital, Jena, Germany
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Schwenkglenks M, Gerbershagen HJ, Taylor RS, Pogatzki-Zahn E, Komann M, Rothaug J, Volk T, Yahiaoui-Doktor M, Zaslansky R, Brill S, Ullrich K, Gordon DB, Meissner W. Correlates of satisfaction with pain treatment in the acute postoperative period: Results from the international PAIN OUT registry. Pain 2014; 155:1401-1411. [DOI: 10.1016/j.pain.2014.04.021] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 04/14/2014] [Accepted: 04/15/2014] [Indexed: 11/30/2022]
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Rothaug J, Zaslansky R, Schwenkglenks M, Komann M, Allvin R, Backström R, Brill S, Buchholz I, Engel C, Fletcher D, Fodor L, Funk P, Gerbershagen HJ, Gordon DB, Konrad C, Kopf A, Leykin Y, Pogatzki-Zahn E, Puig M, Rawal N, Taylor RS, Ullrich K, Volk T, Yahiaoui-Doktor M, Meissner W. Patients' perception of postoperative pain management: validation of the International Pain Outcomes (IPO) questionnaire. J Pain 2013; 14:1361-70. [PMID: 24021577 DOI: 10.1016/j.jpain.2013.05.016] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 05/28/2013] [Accepted: 05/29/2013] [Indexed: 10/26/2022]
Abstract
UNLABELLED PAIN OUT is a European Commission-funded project aiming at improving postoperative pain management. It combines a registry that can be useful for quality improvement and research using treatment and patient-reported outcome measures. The core of the project is a patient questionnaire-the International Pain Outcomes questionnaire-that comprises key patient-level outcomes of postoperative pain management, including pain intensity, physical and emotional functional interference, side effects, and perceptions of care. Its psychometric quality after translation and adaptation to European patients is the subject of this validation study. The questionnaire was administered to 9,727 patients in 10 languages in 8 European countries and Israel. Construct validity was assessed using factor analysis. Discriminant validity assessment used Mann-Whitney U tests to detect mean group differences between 2 surgical disciplines. Internal consistency reliability was calculated as Cronbach's alpha. Factor analysis resulted in a 3-factor structure explaining 53.6% of variance. Cronbach's alpha at overall scale level was high (.86), and for the 3 subscales was low, moderate, or high (range, .53-.89). Significant mean group differences between general and orthopedic surgery patients confirmed discriminant validity. The psychometric quality of the International Pain Outcomes questionnaire can be regarded as satisfactory. PERSPECTIVE The International Pain Outcomes questionnaire provides an instrument for postoperative pain assessment and improvement of quality of care, which demonstrated good psychometric quality when translated into a variety of languages in a large European and Israeli patient population. This measure provides the basis for the first comprehensive postoperative pain registry in Europe and other countries.
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Affiliation(s)
- Judith Rothaug
- Department of Anesthesiology and Intensive Care, Friedrich-Schiller University Hospital, Jena, Germany.
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