A population-based case-control study on social factors and risk of testicular germ cell tumours.

Objectives: Incidence rates for testicular cancer have risen over the last few decades. Findings of an association between the risk of testicular cancer and social factors are controversial. The association of testicular cancer and different indicators of social factors were examined in this study.

Exposure to metal-working fluids in the automobile industry and the risk of male germ cell tumours.

Introduction: In a previous analysis of a case-control study of testicular cancer nested in a cohort of automobile workers, we observed an increased risk for testicular cancer among workers who had ever been involved in occupational metal-cutting tasks. We investigated whether this risk increase was due to exposure to metal-working fluids (MWF).

Methods: Occupational exposure to MWF was assessed in detail using a job-specific questionnaire for metal-cutting work.

Development and evaluation of a tool for retrospective exposure assessment of selected endocrine disrupting chemicals and EMF in the car manufacturing industry.

Objectives: A system for retrospective occupational exposure assessment combining the efficiency of a job exposure matrix (JEM) and the precision of a subsequent individual expert exposure assessment (IEEA) was developed. All steps of the exposure assessment were performed by an interdisciplinary expert panel in the context of a case-control study on male germ cell cancer nested in the car manufacturing industries.

Methods: An industry-specific JEM was developed and automatic exposure estimation was performed based on this JEM.

Case-control study of male germ cell tumors nested in a cohort of car-manufacturing workers: Findings from the occupational history.

Background: To examine whether the previously observed excess risk of male germ cell cancer in a cohort of car-manufacturing workers can be attributed to occupational activities inside and/or outside the car industry.

Methods: A nested case-control study among workers in six plants included 205 cases of germ cell cancer and 1,105 controls, individually matched by year of birth (±2 years). Job periods of the individual occupational histories were coded based on the International Standard Classification of Occupations (ISCO) and the industrial classification of economic activities (NACE).

Local cluster of germ cell cancer in a cohort of male automotive workers in Germany not explained by previous or concurrent activities and exposures in farming and forestry.

Objective: To examine whether exposures or activities in farming, forestry and related occupations explain the excess incidence of germ cell cancer (GCC) observed among male employees in one of the six car-manufacturing plants that is located in a geographic area where farming is frequent.

Methods: A cohort based case-control study was conducted among workers in six car-manufacturing plants located in areas with different industrial structure. The study involved 188 cases of germ cell cancer identified through active retrieval in 38 hospitals and 1000 controls, drawn from administrative accounting files, individually matched by year of birth (± 2 years).

Occupational exposure to pesticides and bile tract carcinoma in men: results from a European multicenter case-control study.

Objectives: To estimate the associations between occupational exposure to pesticides and extrahepatic biliary tract carcinoma in men, a population-based case-control study was carried out.

Methods: Cases (n = 104), aged 35-70, diagnosed in 1995-1997, were sampled by active reporting systems from hospitals. Controls (n = 1,401) were a random sample of the general male population.

Life course social mobility and risk of upper aerodigestive tract cancer in men.

The aim of this study was to explore associations between social mobility and tumours of the upper aero-digestive tract (UADT), focussing on life-course transitions in social prestige (SP) based on occupational history. 1,796 cases diagnosed between 1993 and 2005 in ten European countries were compared with 1585 controls. SP was classified by the Standard International Occupational Prestige Scale (SIOPS) based on job histories.

Socioeconomic factors associated with risk of upper aerodigestive tract cancer in Europe.

Introduction: In the European Union, there are 180,000 new cases of upper aerodigestive tract (UADT) cancer cases per year--more than half of whom will die of the disease. Socioeconomic inequalities in UADT cancer incidence are recognised across Europe. We aimed to assess the components of socioeconomic risk both independently and through their influence on the known behavioural risk factors of smoking, alcohol consumption and diet.

[Hygiene provisions for the processing of food in nurseries and child care facilities. Approaching problems in practical experience].

In Germany more than 2 million children under the age of six attend child care institutions. Among the duties, these institutions have to provide meals to the children. Several food-borne viruses pose a particular threat to infants.

Comparison of social support and psychosocial stress after heart and liver transplantation.

We studied social support, psychological symptoms, and subjective appraisal of quality of life among 233 patients at 1 to 3 years after heart (HTX) or orthotopic liver transplantation (OLT): 78 HTX in 62.8% men and 155 OLT in 51% men. Patients after OLT versus HTX were more often single or divorced (14.

[Occupational epidemiology].

The aim of occupational epidemiology is to describe workplace-related diseases and to identify their underlying causes. Its primary goal is to protect workers from hazardous effects of the working process by applying work-related primary and secondary prevention measures. To assess health risks different study designs and a wide array of complex study instruments and methods are frequently employed that cannot be replaced by toxicological investigations.

Effect of an antiretroviral regimen containing ritonavir boosted lopinavir on intestinal and hepatic CYP3A, CYP2D6 and P-glycoprotein in HIV-infected patients.

This study aimed to quantify the inhibition of cytochrome P450 (CYP3A), CYP2D6, and P-glycoprotein in human immunodeficiency virus (HIV)-infected patients receiving an antiretroviral therapy (ART) containing ritonavir boosted lopinavir, and to identify factors influencing ritonavir and lopinavir pharmacokinetics. We measured activities of CYP3A, CYP2D6, and P-glycoprotein in 28 patients before and during ART using a cocktail phenotyping approach. Activities, demographics, and genetic polymorphisms in CYP3A, CYP2D6, and P-glycoprotein were tested as covariates.

Prognosis of HIV-1-infected patients up to 5 years after initiation of HAART: collaborative analysis of prospective studies.

Objective: To estimate the prognosis over 5 years of HIV-1-infected, treatment-naive patients starting HAART, taking into account the immunological and virological response to therapy.

Design: A collaborative analysis of data from 12 cohorts in Europe and North America on 20,379 adults who started HAART between 1995 and 2003.

Methods: Parametric survival models were used to predict the cumulative incidence at 5 years of a new AIDS-defining event or death, and death alone, first from the start of HAART and second from 6 months after the start of HAART.

[When is a doctor a good doctor? An analysis of the contents of statements by representatives of the medical profession ].

Background: Several professional bodies have developed influential documents which have tried to describe the essential competences of a good doctor. Such an initiative has not been previously conducted in German-speaking countries. Differences between the published statements point towards the significance of differences in the respective sociocultural setting.

Stable coreceptor usage of HIV in patients with ongoing treatment failure on HAART.

Background: Disease progression in HIV infection has been associated with switch of viral coreceptor usage from CCR5 to CXCR4.

Objectives: To investigate the relationship between HIV-coreceptor tropism and clinical and virological outcome in 40 heavily pretreated patients over time.

Methods: Coreceptor phenotype was predicted after sequencing the V3 loop of the HIV glycoprotein 120.

Clinical outcomes of HIV-HCV co-infection in a large cohort of hemophiliac patients.

Objective: To determine the disease progression of HIV-HCV co-infected hemophiliacs in a large cohort of patients (n = 288) cared for at a single medical institution.

Patients And Methods: Annual mortality rates for AIDS- and liver-related death were calculated and Kaplan-Meier survival plots were drawn to determine the progression to AIDS and death.

Results: Between January 1985 and December 2002, 179 (62.

Preferences regarding medical and psychosocial support in HIV-infected patients.

Adherence to highly active antiretroviral therapy (HAART) is crucial for successful treatment of HIV-infected patients. Among other factors, meeting patients' preferences regarding medical and psychosocial support may have significant impact on adherence to HAART. But, systematic studies on HIV-infected patients' preferences regarding professional support are rare.

Progressive multifocal leukencephalopathy in patients on highly active antiretroviral therapy: survival and risk factors of death.

Objective: To describe the clinical course and risk factors of death in highly active antiretroviral therapy (HAART)-treated patients with progressive multifocal leukencephalopathy (PML); to evaluate the efficacy of cidofovir in addition to HAART.

Methods: Retrospective multicenter cohort study of PML in HIV-1-infected patients. Diagnosis of PML was confirmed by histology or by positive polymerase chain reaction for JC virus (JCV) in cerebrospinal fluid (CSF) or was made by typical radiologic and clinical findings.

[Internet-based conjoint analysis with the example of medical networks].

The present paper will demonstrate the usefulness of conjoint analysis in the area of medicine, a method that is well-known in consumer research. The aim was to investigate the preference structure of network-oriented physicians regarding competitive consulting and information offerings in the context of a hypothetical network between a hospital and office-based physicians. A combination of qualitative ("grounded theory") and quantitative ("conjoint analysis") methods was used.

Long-term outcome and quality of care of patients with Staphylococcus aureus bacteremia.

To assess the long-term outcome and influence of clinical management of patients with Staphylococcus aureus bacteremia (SAB), 229 patients with blood cultures positive for Staphylococcus aureus between January 1997 and December 2000 were retrospectively identified and followed up. Risk factors, source of infection, treatment, clinical course, and outcome were recorded by chart review. For the assessment of 1-year survival, a questionnaire was sent to family doctors and government registration offices.

The tandem-repeat polymorphism of the DC-SIGNR gene does not affect the susceptibility to HIV infection and the progression to AIDS.

DC-SIGNR is a C-type lectin that functions as a transreceptor for HIV-1. The exon 4 of the DC-SIGNR gene comprises a variable number of 69-bp tandem repeats, encoding for parts of the extracellular protein domain. Here, we analyzed the relevance of this gene polymorphism for the interindividual transmission of HIV-1 and the progression to AIDS.

Superior virological efficacy of ritonavir-boosted protease inhibitor regimens compared to single protease inhibitor therapy.

Low dose-ritonavir boosted protease inhibitors are increasingly being used for the first-line antiretroviral treatment, though their virological efficacy has just poorly been compared to alternative antiretroviral therapies. Here, we retrospectively investigated the virological responses of 316 protease inhibitor-naive HIV patients receiving highly active antiretroviral treatment based on a single (n = 256) or a ritonavir-boosted protease inhibitor (n = 60), both in the background of two nucleoside analogues. - By intent-to-treat analysis, a complete initial virological response was achieved in 71.

[Application of guidelines for the treatment of headache and cancer pain by private practitioners].

In a regional pain management network in Cologne, sponsored by the German Ministry of Health, structures of outpatient pain treatment in general practice and the adherence to pain management guidelines were examined. The 3-year project was divided into a 1-year observational period to analyze the present state of outpatient pain management followed by a 2-year period of interventions such as consultations and educational training programs in pain treatment. Eighty physicians with different specializations working in general practice took part in the network.