Healthy ageing and home: the perspectives of very old people in five European countries.

This paper reports on in-depth research, using a grounded theory approach, to examine the ways in which very old people perceive healthy ageing in the context of living alone at home within urban settings in five European countries. This qualitative study was part of a cross-national project entitled ENABLE-AGE which examined the relationship between home and healthy ageing. Interviews explored the notion of healthy ageing, the meaning and importance of home, conceptualisations of independence and autonomy and links between healthy ageing and home.

Household contacts were key factor for children's colonization with resistant Escherichia coli in community setting.

Objective: In young children infections with resistant Escherichia coli (E. coli) can lead to life-threatening situations. Epidemiological data on the prevalence and major determinants of carriage of antibiotic resistant E.

Case-control study supports extension of surveillance interval after colonoscopic polypectomy to at least 5 yr.

Objective: Colonoscopy with removal of polyps may strongly reduce colorectal cancer (CRC) incidence and mortality. Recommended time intervals to surveillance colonoscopy differ between countries and have recently been extended to 5 yr or longer for the majority of cases in the United States. Whereas previous evidence is mainly based on observations of adenoma recurrence, we aimed to assess risk of CRC occurrence according to time since polypectomy.

Genotype combinations of plasminogen activator inhibitor-1 and angiotensin-converting enzyme genes and risk for early onset of coronary heart disease.

Background: Both angiotensin-converting enzyme genotype and plasminogen activator inhibitor type 1 genotype have an effect on fibrinolytic components and hence, may increase risk or advance occurrence of coronary heart disease. We examined the association of the angiotensin-converting enzyme and the plasminogen activator inhibitor type 1 genotypes, and their combinations, with early onset of coronary heart disease in a cohort of 907 patients with coronary heart disease.

Design And Methods: All patients with a coronary heart disease (International Classification of Diseases, 9th Rev.

Do older adults using NSAIDs have a reduced risk of colorectal cancer?

Background And Objectives: Colorectal cancer (CRC) is primarily a disease of older adults. Although NSAIDs are thought to protect from CRC, and long-term use of NSAIDs is common in the elderly, little is known about the impact of NSAID use on CRC risk at advanced age. We specifically reviewed current evidence regarding the effects of NSAIDs on CRC risk in individuals aged > or =65 years, a rapidly growing age group.

Clustering of antibiotic resistance of E. coli in couples: suggestion for a major role of conjugal transmission.

Background: Spread of antibiotic resistance in hospitals is a well-known problem, but studies investigating the importance of factors potentially related to the spread of resistant bacteria in outpatients are sparse.

Methods: Stool samples were obtained from 206 healthy couples in a community setting in Southern Germany in 2002-2003. E.

Up-to-date and precise estimates of cancer patient survival: model-based period analysis.

Monitoring of progress in cancer patient survival by cancer registries should be as up-to-date as possible. Period analysis has been shown to provide more up-to-date survival estimates than do traditional methods of survival analysis. However, there is a trade-off between up-to-dateness and the precision of period estimates, in that increasing the up-to-dateness of survival estimates by restricting the analysis to a relatively short, recent time period, such as the most recent calendar year for which cancer registry data are available, goes along with a loss of precision.

Restrictions in quality of life in colorectal cancer patients over three years after diagnosis: a population based study.

Despite the burden and prevalence of colorectal cancer (CRC), there is only limited information regarding quality of life of patients who have survived beyond the first year post treatment. We assessed quality of life in a population-based cohort of 309 patients with CRC from Saarland (Germany) one and three years after diagnosis using the QLQ-C30 questionnaire and the tumour specific module QLQ-CR38. When compared with reference data from the general population, most patients with CRC reported high overall quality of life and only small deficits in physical functioning but deficits in emotional and social functioning persist over years in patients with colorectal cancer.

Prognostic value of physicians' assessment of compliance regarding all-cause mortality in patients with type 2 diabetes: primary care follow-up study.

Background: Whether the primary care physician's assessment of patient compliance is a valuable prognostic marker to identify patients who are at increased risk of death, or merely reflects measurement of various treatment parameters such as HbA1C or other laboratory markers is unclear. The objective of this prospective cohort study was to investigate the prognostic value of the physicians' assessment of patient compliance and other factors with respect to all-cause mortality during a one year follow-up period.

Methods: A prospective cohort study was conducted among 1014 patients with type 2 diabetes aged 40 and over (mean age 69 years, SD 10.

Hospitalizations during the last months of life of nursing home residents: a retrospective cohort study from Germany.

Background: To describe hospitalisations of nursing home (NH) residents in Germany during their last months of life.

Methods: Retrospective cohort study on 792 NH residents in the Rhine-Neckar region in South-West Germany, newly institutionalized in the year 2000, who died until the study end (December 2001). Baseline variables were derived from a standardized medical examination routinely conducted by the medical service of the health care insurance plans in Germany.

Chlamydia pneumoniae, heat shock proteins 60 and risk of secondary cardiovascular events in patients with coronary heart disease under special consideration of diabetes: a prospective study.

Background: There have been suggestions of an association between Chlamydia pneumoniae, chlamydial heat shock protein (Ch-hsp) 60 and human heat shock protein (h-hsp) 60 infection sero-status and development of secondary cardiovascular events. Patients with diabetes might be at higher risk since they are prone to infections. The objective of this study was to investigate prospectively the role of Chlamydia pneumoniae (CP), chlamydial heat shock protein (Ch-hsp) 60 and a possible intermediate role of human heat shock protein (h-hsp) 60 sero-status in the development of secondary cardiovascular disease (CVD) events in patients with coronary heart disease (CHD) under special consideration of diabetes mellitus.

Helicobacter pylori infection and colorectal cancer risk: a meta-analysis.

Background: Several studies suggested an association between Helicobacter pylori infection and colorectal carcinoma or adenoma risk. However, different authors reported quite varying estimates. We carried out a systematic review and meta-analysis of published studies investigating this association and paid special attention to the possibility of publication bias and sources of heterogeneity between studies.

Duration of breastfeeding and risk of overweight in childhood: a prospective birth cohort study from Germany.

Background: Whereas a recently published meta-analysis showed that ever breastfeeding reduces the risk of obesity in childhood significantly, the recent literature describing the relationship between duration of breastfeeding and risk of overweight or obesity in childhood remains inconclusive.

Methods: Between November 2000 and November 2001, all mothers and their newborns were recruited after delivery at the Department of Gynecology and Obstetrics at the University of Ulm, Germany. Active follow-up was performed at the age of 12 months and 24 months.

Urine markers as possible tools for prostate cancer screening: review of performance characteristics and practicality.

Background: In recent years, an increasing number of urine-based tests have been proposed as potential screening tests for prostate cancer. The goal of this review was to summarize the current status of evidence regarding performance characteristics of the proposed tests and their practicality under screening conditions.

Method: Relevant articles published up to and including May 2005 were identified in the PubMed database.

The mother as source of Helicobacter pylori infection.

Background: To further elucidate the intrafamilial transmission of Helicobacter pylori infection, we investigated the occurrence of infection by parental infection status in a large community-based birth cohort of children from Germany.

Methods: Parental infection (at birth) and children's infection (at age 3 years) were determined by C-urea breath test and by monoclonal antigen stool test.

Results: Twenty of 834 children (2.

Calculating age-adjusted cancer survival estimates when age-specific data are sparse: an empirical evaluation of various methods.

We evaluated empirically the performance of various methods of calculating age-adjusted survival estimates when age-specific data are sparse. We have illustrated that a recently proposed alternative method of age adjustment involving the use of balanced age groups or age truncation may be useful for enhancing calculability and reliability of adjusted survival estimates.

A computer program to estimate power and relative efficiency of flexibly matched case-control studies.

Objectives: We recently introduced the concept of flexible matching strategies with varying proportions of a dichotomous matching factor among controls to increase power and efficiency of case-control studies. We now present a method and a computer program to calculate power and relative efficiency compared to an unmatched design varying the proportion of the matching factor in controls over all possible values from 0 to 100 percent.

Methods: For all these values, the program calculates the expected variance of the combined Mantel-Haenszel odds ratio and determines the power using the standard error of the expected combined Mantel-Haenszel odds ratio under the null hypothesis as derived from the Mantel-Haenszel test statistic without continuity correction.

Clustering of Helicobacter pylori infection in couples: differences between high- and low-prevalence population groups.

Purpose: Several mostly small-scale studies reported clustering of Helicobacter pylori infections as a possible indicator of conjugal transmission, but results have been inconsistent. We assessed clustering of H pylori infections in a large community-based study from Germany that included both high-prevalence and low-prevalence population subgroups.

Methods: Current H pylori infection was determined among 670 couples by means of carbon-13-urea breath test ((13)C-UBT) breath test and a monoclonal antigen immunoassay for H pylori in stool.

The impact of body weight on smoking cessation in German adults.

Objective: To assess the relevance of pre-existing body weight for successful smoking cessation among women and men.

Methods: We carried out a retrospective cohort analysis among 4270 ever smoking participants of a general health screening examination in Germany recruited from July 2000 to June 2002 aged 50 to 74, who provided lifetime histories of both body weight and smoking.

Results: In the extended Cox model, the relative cessation rate (RCR) increased significantly with increasing body mass index (BMI) among both genders (test for trend: P < 0.

Cohort- and age-related decline in elder's life satisfaction: is there really a paradox?

Absence of age-related decline in elder's life satisfaction (LS), found in several studies from the last quarter of the twentieth century, has been labelled a "paradox", as it contrasts with increasing psycho-social and health risks in old age. To explain these findings, the present study was based on the hypothesis of a cohort effect on the LS of those born in the first half of the twentieth century, which might have overlayed and thus obscured the age-related decline in cross-sectional studies. In addition, it was hypothesized that the age-related decline in LS accelerates over the old age period such that the "paradox" would not hold for old-old subjects.

Antibiotic resistant fecal isolates of Enterococci among unselected patients outside the clinical sector: an epidemiological study from Southern Germany.

Purpose: The aim of the study was to assess the prevalence and determinants of antibiotic-resistant Enterococci in a large group of outpatients in Southern Germany.

Methods: Stool samples were collected from 497 unselected patients aged 40-75 years attending general practitioners. Enterococcus faecium (E.

Differential expression of chemokines, risk of stable coronary heart disease, and correlation with established cardiovascular risk markers.

Objective: We investigated the association of several chemokines with the risk of stable coronary heart disease (CHD) in a large case-control study after adjustment for other established risk factors. Furthermore, we analyzed their correlation with various acute-phase proteins, inflammation-associated cytokines, and an adhesion molecule.

Methods And Results: We included 312 patients aged 40 to 68 years with angiographically confirmed and stable CHD and 472 age- and gender-matched controls in this study.

Role of cytomegalovirus sero-status in the development of secondary cardiovascular events in patients with coronary heart disease under special consideration of diabetes.

Objective: We investigated prospectively the role of cytomegalovirus (CMV) sero-status in the development of secondary cardiovascular disease (CVD) events in patients with coronary heart disease (CHD) under special consideration of diabetes mellitus.

Background: There have been suggestions of an association between cytomegalovirus infection sero-status and development of secondary cardiovascular events. Patients with diabetes might be at higher risk since they are relatively immunocompromised.

Breastfeeding, soluble CD14 concentration in breast milk and risk of atopic dermatitis and asthma in early childhood: birth cohort study.

Background: Breast milk contains a variety of bioactive substances, among them, soluble CD14 (sCD14), which plays an important role in innate immunity.

Objective: We analysed data of a large prospective birth cohort study to examine the determinants of sCD14 in breast milk, and investigated whether breastfeeding practice and sCD14 concentrations in breast milk are determinants of the risk of atopic dermatitis (AD) and asthma in children.

Methods: Eight hundred and three mothers and their newborns were included in this analysis.

Relationship between lifetime alcohol consumption and Helicobacter pylori infection.

Purpose: Several studies have demonstrated an inverse relationship between current moderate alcohol consumption and Helicobacter pylori (H. pylori) infection suggesting that alcohol consumption may facilitate elimination of this chronic infection. The aim of this study was to further explore this hypothesis by taking lifetime alcohol consumption, which may be a better marker of the relevant exposure than current alcohol consumption, into account.