460 research outputs found
Determination of nasal and oropharyngeal microbiomes in a multicenter population-based study – findings from Pretest 1 of the German National Cohort
We examined acceptability, preference and feasibility of collecting nasal and
oropharyngeal swabs, followed by microbiome analysis, in a population-based
study with 524 participants. Anterior nasal and oropharyngeal swabs were
collected by certified personnel. In addition, participants self-collected
nasal swabs at home four weeks later. Four swab types were compared regarding
(1) participants’ satisfaction and acceptance and (2) detection of microbial
community structures based on deep sequencing of the 16 S rRNA gene V1–V2
variable regions. All swabbing methods were highly accepted. Microbial
community structure analysis revealed 846 phylotypes, 46 of which were unique
to oropharynx and 164 unique to nares. The calcium alginate tipped swab was
found unsuitable for microbiome determinations. Among the remaining three swab
types, there were no differences in oropharyngeal microbiomes detected and
only marginal differences in nasal microbiomes. Microbial community structures
did not differ between staff-collected and self-collected nasal swabs. These
results suggest (1) that nasal and oropharyngeal swabbing are highly feasible
methods for human population-based studies that include the characterization
of microbial community structures in these important ecological niches, and
(2) that self-collection of nasal swabs at home can be used to reduce cost and
resources needed, particularly when serial measurements are to be taken
prevalence and lack of association with selected cardiovascular and metabolic disorders—findings of a multicenter population-based study
Background We determined the prevalence of anti-nuclear autoantibodies (ANAs)
in the German adult population and examined the association between ANAs and
cardiovascular and metabolic disorders. Methods We used data and blood samples
from the pretest phases of the German National Cohort, obtained from six of
the 18 study centers (n = 1199). All centers applied standardized instruments
including face-to-face interviews, anthropometric measurements and collection
of blood samples. Self-reported histories of diabetes mellitus, heart attack
and elevated blood cholesterol and/or lipids were recorded. Height, weight and
blood pressure were measured. ANAs were detected using a semi-automated system
(AKLIDES®; Medipan GmbH, Dahlewitz, Germany). A positive ANA was defined as a
titer ≥ 1:80. ANA were classified as weakly (1:80 or 1:160), moderately (1:320
or 1:640) or strongly (≥1:1280) positive. Specific autoantibodies against
nuclear antigens were detected with second-step assays according to the ANA
staining pattern. Associations between the assessed disorders and ANA
positivity and pattern were examined using sex and age-adjusted mixed-effects
logistic regression models. Results Thirty-three percent (95% confidence
interval; 31–36%) of the 1196 participants (measurements could not be obtained
from three samples) were ANA positive (titer ≥ 1:80). The proportions of
weakly, moderately and strongly positive ANA were 29%, 3.3% and 1.3%,
respectively. ANA positivity was more common among women than men across all
titers (χ2, p = 0.03). ANA positivity, even when stratified according to
height of titer or immunofluorescent pattern, was not associated with
diabetes, elevated blood cholesterol and/or lipids, obesity or hypertension.
Second-step autoantibody assays were positive in 41 of the 83 samples (49%)
tested, with anti-DFS70 (n = 13) and anti-dsDNA (n = 7) being most frequent.
These subgroups were too small to test for associations with the disorders
assessed. Conclusions The prevalence of ANA positivity in the German general
population was similar to values reported from other countries. Contrary to
other studies, there was no association with selected self-reported and
objectively measured cardiovascular and metabolic variables
Mortality and life expectancy of professional fire fighters in Hamburg, Germany: a cohort study 1950 – 2000
BACKGROUND: The healthy worker effect may hide adverse health effects in hazardous jobs, especially those where physical fitness is required. Fire fighters may serve as a good example because they sometimes are severely exposed to hazardous substances while on the other hand their physical fitness and their strong health surveillance by far exceeds that of comparable persons from the general population. METHODS: To study this effect a historic cohort study was conducted to assess mortality and life expectancy of professional fire fighters of the City of Hamburg, Germany. Fire departments and trade unions questioned the validity of existing studies from outside Germany because of specific differences in the professional career. No mortality study had been conducted so far in Germany and only few in Europe. Information on all active and retired fire fighters was extracted from personnel records. To assure completeness of data the cohort was restricted to all fire fighters being active on January 1, 1950 or later. Follow up of the cohort ended on June 30th 2000. Vital status was assessed by personnel records, pension fund records and the German residence registries. Mortality of fire fighters was compared to mortality of the Hamburg and German male population by means of standardized mortality ratios. Life expectancy was calculated using life table analysis. Multivariate proportional hazard models were used to assess the effect of seniority, time from first employment, and other occupational characteristics on mortality. RESULTS: The cohort consists of 4640 fire fighters accumulating 111796 person years. Vital status could be determined for 98.2% of the cohort. By the end of follow up 1052 person were deceased. Standardized Mortality Ratio (SMR) for the total cohort was 0.79 (95% CI, 0.74–0.84) compared to Hamburg reference data and 0.78 (95% CI, 0.74–0.83) compared to National German reference data. Conditional life expectancy of a 30 year old fire fighter was 45.3 years as compared to 42.9 year of a German male in normal population. Job tasks, rank status and early retirement negatively influenced mortality. For fire fighters with comparably short duration of employment the mortality advantage diminished with longer time since first employment. SMR of persons who retired early was 1.25 (95% CI, 1.13–1.60) in reference to the general German population and the SMR of 1.71 (1.18–2.50) in the multivariate regression model. CONCLUSION: A strong healthy worker effect was observed for the cohort, which diminished with longer time since first employment for fire fighters with shorter duration of employment, as expected. The negative effects on mortality of job tasks, rank status and in particular early retirement indicate the presence of undetermined and specific risks related to occupational hazards of fire fighters
Mortality Rates Among Trichlorophenol Workers With Exposure to 2,3,7,8-Tetrachlorodibenzo-p-dioxin
The authors examined 1,615 workers exposed to dioxins in trichlorophenol production in Midland, Michigan, to determine if there were increased mortality rates from exposure. Historical dioxin levels were estimated by a serum survey of workers. Vital status was followed from 1942 to 2003, and cause-specific death rates and trends with exposure were evaluated. All cancers combined (standardized mortality ratio (SMR) = 1.0, 95% confidence interval (CI): 0.8, 1.1), lung cancers (SMR = 0.7, 95% CI: 0.5, 0.9), and nonmalignant respiratory disease (SMR = 0.8, 95% CI: 0.6, 1.0) were at or below expected levels. Observed deaths for leukemia (SMR = 1.9, 95% CI: 1.0, 3.2), non-Hodgkin lymphoma (SMR = 1.3, 95% CI: 0.6, 2.5), diabetes (SMR = 1.1, 95% CI: 0.6, 1.8), and ischemic heart disease (SMR = 1.1, 95% CI: 0.9, 1.2) were slightly greater than expected. No trend was observed with exposure for these causes of death. However, for 4 deaths of soft tissue sarcoma (SMR = 4.1, 95% CI: 1.1, 10.5), the mortality rates increased with exposure. The small number of deaths and the uncertainty in both diagnosis and nosology coding make interpretation of this finding tenuous. With the exception of soft tissue sarcoma, the authors found little evidence of increased disease risk from exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin
Centaur 1947
Digitised by the Faculty of the Veterinary Scienc
Serum 25-hydroxyvitamin D and postmenopausal breast cancer survival: a prospective patient cohort study
Introduction: Vitamin D has been postulated to be involved in cancer prognosis. Thus far, only two studies reported on its association with recurrence and survival after breast cancer diagnosis yielding inconsistent results. Therefore, the aim of our study was to assess the effect of post-diagnostic serum 25-hydroxyvitamin D [25(OH)D] concentrations on overall survival and distant disease-free survival. Methods: We conducted a prospective cohort study in Germany including 1,295 incident postmenopausal breast cancer patients aged 50-74 years. Patients were diagnosed between 2002 and 2005 and median follow-up was 5.8 years. Cox proportional hazards models were stratified by age at diagnosis and season of blood collection and adjusted for other prognostic factors. Fractional polynomials were used to assess the true dose-response relation for 25(OH)D. Results: Lower concentrations of 25(OH)D were linearly associated with higher risk of death (hazard ratio (HR) = 1.08 per 10 nmol/L decrement; 95% confidence interval (CI), 1.00 to 1.17) and significantly higher risk of distant recurrence (HR = 1.14 per 10 nmol/L decrement; 95%CI, 1.05 to 1.24). Compared with the highest tertile (≥ 55 nmol/L), patients within the lowest tertile (< 35 nmol/L) of 25(OH)D had a HR for overall survival of 1.55 (95%CI, 1.00 to 2.39) and a HR for distant disease-free survival of 2.09 (95%CI, 1.29 to 3.41). In addition, the association with overall survival was found to be statistically significant only for 25(OH)D levels of blood samples collected before start of chemotherapy but not for those of samples taken after start of chemotherapy (P for interaction = 0.06). Conclusions: In conclusion, lower serum 25(OH)D concentrations may be associated with poorer overall survival and distant disease-free survival in postmenopausal breast cancer patients
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