Browsing by Author "Korb, Katrin"

Background: Early onset lung cancer shows some familial aggregation, pointing to a genetic predisposition. This study was set up to investigate the role of candidate genes in the susceptibility to lung cancer patients younger than 51 years at diagnosis. Methods: 246 patients with a primary, histologically or cytologically confirmed neoplasm, recruited from 2000 to 2003 in major lung clinics across Germany, were matched to 223 unrelated healthy controls. 11 single nucleotide polymorphisms of genes with reported associations to lung cancer have been genotyped. Results: Genetic associations or gene-smoking interactions was found for GPX1(Pro200Leu) and EPHX1(His113Tyr). Carriers of the Leu-allele of GPX1(Pro200Leu) showed a significant risk reduction of OR = 0.6 (95% CI: 0.40.8, p = 0.002) in general and of OR = 0.3 (95% CI:0.10.8, p = 0.012) within heavy smokers. We could also find a risk decreasing genetic effect for His-carriers of EPHX1(His113Tyr) for moderate smokers (OR = 0.2, 95% CI:0.10.7, p = 0.012). Considered both variants together, a monotone decrease of the OR was found for smokers (OR of 0.20; 95% CI: 0.070.60) for each protective allele. Conclusion: Smoking is the most important risk factor for young lung cancer patients. However, this study provides some support for the T-Allel of GPX1(Pro200Leu) and the C-Allele of EPHX1(His113Tyr) to play a protective role in early onset lung cancer susceptibility.

PURPOSE This review summarizes the evidence regarding the efficacy of adjuvant steroids for pain reduction in acute pharyngitis. METHODS We searched for randomized controlled trials, using MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews, published between 1966 and December 2008. Two reviewers assessed the quality of each retrieved article and summarized the data. RESULTS Our review found 8 relevant randomized controlled trials (RCTs) with a total of 806 patients. There were 5 RCTs with adult patients and 3 with children. All RCTs found a statistically significant faster reduction of pain or complete pain relief from steroid use compared with placebo. The trials used different steroids (dexamethasone, betamethasone, prednisone), and most participants had received antibiotics at least initially. Analgesic medication, such as acetaminophen, was allowed in all studies, but this factor was not always controlled. No serious adverse side effects were reported. CONCLUSIONS Steroids are effective in relieving pain in acute pharyngitis. Although no serious adverse effects were observed, the benefits have to be balanced with possible adverse drug effects. There are safe and effective over-the-counter medications to relieve throat pain. Most patients received concomitant antibiotics; however, reducing the prescription of antibiotics for generally benign upper respiratory tract infection is a public health goal. We therefore recommend further studies to establish both the safety of steroids without antibiotic coverage and the additional benefits of steroids when used with regular administration of over-the-counter analgesic medications.

For the identification of susceptibility loci in complex diseases the choice of the target phenotype is very important. We compared results of genome-wide searches for linkage or for association related to three phenotypes for alcohol use disorder. These are a behavioral score BQ, based on a 12-item questionnaire about drinking behavior and the subject's report of drinking-related health problems, and ERP pattern and ERP magnitude, both derived from the eyes closed resting ERP measures to quantify brain activity. Overall, we were able to identify 11 candidate regions for linkage. Only two regions were found to be related to both BQ and one of the ERP phenotypes. The genome-wide search for association using single-nucleotide polymorphisms did not yield interesting leads.

Background: National and international guidelines for the management of congestive heart failure (HF) suggest a variety of procedures for establishing its diagnosis and monitoring its course. The aim of this crosssectional study was to investigate which of these recommendations were actually implemented and documented in the setting of general medical practice. Methods: Patients receiving at least one cardiovascular drug (World health [WHO] anatomical chemical classification [ATC] class C) were identified from electronic medical records from 5 general practices from 1.4.2001 to 1.10.2004. Those patients with the documented diagnosis of HF were selected. All patients' records were reviewed and those diagnostic procedures and clinical findings were recorded on a standarized data extraction form that had been used to establish the diagnosis of HF. Results: An electrocardiogram had been documented or retrieved in the chart in 41.2% of a total of 829 patients, an chest X-ray in 28.2%, an echocardiogram in 17.2%, and a cardiac catheterization performed in 1.8%. Serum natriuretic peptides were never recorded. Additionally the following symptoms and clinical signs were extracted from the paper chart: ankle edema (39.3%), exertional dyspnea (22.7%), rales (21.5%), cardiomegaly (19.0%), paroxysmal dyspnea (16.6%), pleural effusions (9.2%), tachycardia (6.7%) and acute pulmonary edema, hepatomegaly, nocturnal cough or jugular venous distension in fewer than 5%. Conclusion: Only a few of those clinical signs and diagnostic procedures recommended by guidelines for diagnosing HF were recorded in general practice. The reasons for this finding remain unclear. Even under the assumption that not all observed clinical signs and diagnostic procedures were documented, these findings reflect the actual diagnostic strategy in daily practice. The observed discrepancy between guideline recommendation and reality in everyday practice deserve attention. On the one hand, there is a need for improving the diagnostic approach to HF; on the other, guidelines need to set priorities of the recommendations for diagnosing HF.