Bremen, Germany


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Schmedt N.,BIPS GmbH | Garbe E.,BIPS GmbH | Garbe E.,University of Bremen
Journal of Clinical Psychopharmacology | Year: 2013

The aim of this study was to investigate the association between the use of antipsychotics and the risk of venous thromboembolism (VTE) in elderly patients with dementia. Based on data from the German Pharmacoepidemiological Research Database, a nested case-control study was conducted within a cohort of 72,591 patients with dementia aged at least 65 years at cohort entry. Cases were patients with a hospitalization due to VTE. Up to 4 controls were matched to each case according to age, sex, health insurance, and calendar time of the VTE. Users of antipsychotics were classified into current or former users, and in addition, all current users were categorized as prevalent or new users. For a further analysis, we distinguished between users of either conventional or atypical antipsychotics or concurrent users of both conventional and atypical antipsychotics. Multivariate conditional logistic regression was applied to calculate odds ratios (ORs) of VTE for all user groups compared with nonusers. The case-control data set comprised 1028 VTE cases and 4109 controls. An increased risk of VTE was found for current users (OR, 1.23; 95% confidence interval [CI], 1.01-1.50) and for users of a combination of atypical and conventional antipsychotics (OR, 1.62; 95% CI, 1.15-2.27). In current users, only new use was associated with an increased risk (OR, 1.63; 95% CI, 1.10-2.40). Increased attention to clinical signs of VTE should be paid during the first 3 months of treatment with antipsychotics and in patients receiving both conventional and atypical agents, especially if other risk factors for VTE exist. © 2013 by Lippincott Williams & Wilkins.

Langner I.,BIPS GmbH | Garbe E.,BIPS GmbH | Garbe E.,University of Bremen | Banaschewski T.,University of Heidelberg | And 3 more authors.
PLoS ONE | Year: 2013

Background and Aims:Twin studies are used to assess the contribution of genetic factors to the aetiology of diseases. To show the feasibility of such research on the basis of health insurance data, we analysed twin and sibling data on the attention deficit/hyperactivity disorder (ADHD) in the German Pharmacoepidemiological Research Database (GePaRD).Methods:The GePaRD consists of data from four statutory health insurances, including around 17% of the total population of Germany. Among those insured in 2005, we identified 286,653 non-twin sibling pairs and 12,486 twin pairs. Each pair consisted of an index child (6 to 12 years old) and a co-sibling of equal age or up to five years older. ADHD cases were identified by hospital or ambulatory ICD-10 diagnoses (F90.0 or F90.1) and prescriptions. We estimated tetrachoric correlations, percentage of concordant pairs, concordance rates, and heritability. Weighted estimates for the indirect assessment of mono- and dizygotic pairs were derived.Results:Tetrachoric correlations were highest for twin pairs of the same sex (males: 0.85, 95% CI 0.81-0.89; females: 0.81, 95% CI 0.73-0.88) and lowest for opposite-sex non-twin sibling pairs (0.43, 95% CI 0.41-0.45). Heritability estimates were 0.88 (95% CI: 0.79-0.97) for males and 0.77 (95% CI: 0.60-0.95) for females.Conclusions:The study clearly reproduced the well-known strong genetic component in the aetiology of ADHD. This approach could be used for further assessments of genetic components in other diseases. © 2013 Langner et al.

Erdmann F.,International Agency for Research on Cancer IARC | Kaatsch P.,Johannes Gutenberg University Mainz | Zeeb H.,BIPS GmbH | Roman E.,University of York | And 2 more authors.
European Journal of Cancer | Year: 2014

Background Sex, age, immunophenotype and white blood cell count at diagnosis are well accepted predictors of survival from acute lymphoblastic leukaemia (ALL) in children. Less is known about the relationship between socio-economic determinants and survival from paediatric ALL, studied here for the first time in German children. Methods ALL cases were diagnosed between 1992 and 1994 and their parents interviewed during a previous nationwide case-control study. Children were followed-up for 10 years after diagnosis by the German Childhood Cancer Registry. Cox proportional hazards models estimating hazard ratios (HRs) were calculated to assess the impact of selected socio-demographic characteristics on overall and event-free survival. Results Overall survival was 82.5%, with a higher proportion of girls than boys surviving (85% versus 81%). We found a non-linear relationship between age at diagnosis and survival, with poorer survival in infants and children aged >5 years. There was no association between socio-economic factors and survival or risk of relapse. For five levels of increasing family income, all HRs were close to one. No relationship was seen with parental educational level. Conclusion Socio-economic determinants did not affect ALL survival in West German children, in contrast to studies from some other countries. Dissimilarities in social welfare systems, including access to health care, lifestyle and differences in treatment may contribute to these differences in findings. Our observation of no social inequalities in paediatric ALL survival is reassuring, but needs continued monitoring to assess the potential impact of evolvement of treatment options and changes in paediatric health service. © 2014 Elsevier Ltd. All rights reserved.

Zinkhan M.,Martin Luther University of Halle Wittenberg | Berger K.,University of Munster | Hense S.,BIPS GmbH | Nagel M.,University of Munster | And 13 more authors.
Sleep Medicine | Year: 2014

Objective: To assess the agreement of sleep parameters measured by two actigraphs (SOMNOwatch plus®, ActiGraph GT3X+®) at two different placements (wrist, hip) and of self-reported sleep with polysomnography (PSG). Methods: We estimated agreement with PSG for total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), number of awakenings after sleep onset (NASO), and sleep efficiency (SE%) for 100 participants of the general population, aged 18-75 years by judging mean differences to PSG and intervals of agreement using Bland-Altman plots. Results: Mean difference to PSG for TST was 8.3 min (95% confidence intervals [CI] -7.4; 24.1) for SOMNOwatch plus. ® (wrist), 39.8 min (95% CI 24.3; 55.3) for self-report, -79.0 min (95% CI -89.0; -68.9) for SOMNOwatch plus. ® (hip), and -81.1 min (95% CI -91.9; -70.4) for GT3X+. ® (hip), respectively. The width of intervals of agreement differed with the placement of the devices. Mean differences to PSG were higher for hip-based measurements compared with wrist placement for most parameters. Conclusions: Agreement of sleep parameters assessed by actigraphy with PSG differs with the placement of the device and is limited for hip-based measurements. Agreement of self-report with PSG is comparable to that of actigraphy for some parameters. © 2014 Elsevier B.V.

Strohle A.,Leibniz University of Hanover | Wolters M.,BIPS GmbH | Hahn A.,Leibniz University of Hanover
Medizinische Monatsschrift fur Pharmazeuten | Year: 2013

Pregnant women are at greater risk of an insufficient vitamin and mineral supply. Based on hemodynamic, endocrine and metabolic changes due to pregnancy, the body weight and blood volume increase. These changes result in an increased requirement of most vitamins and minerals while the energy requirement increases by about 10 %. Besides iodine (recommended intake as supplement 150 μg/d), iron (recommended intake 30-40 mg/d), vitamin D (recommended intake as supplement 20-50 μg/d), and docosahexaenoic acid (recommended intake 200 mg/d), folic acid is one of the critical micronutrients during pregnancy. Food folate and synthetic folic acid differ in their bioavailability. About 50 % of the food folate is absorbed whereas almost 100 % of folic acid from supplements is bioavailable. The contents are thus indicated as folate equivalents. In the form of THF, folic acid functions as coenzyme for the transfer of C1 units in the metabolism of amino acids, purines and pyrimidines. Folic acid (isolated or in combination with other vitamins and minerals) reduces the total risk for neural tube defects by 72 %. For primary prevention it is recommended that all women who are planning to become pregnant take 400-800 μg synthetic folic acid along with a diet rich in folate. The additional intake should be continued at least until the end of the first trimester. For secondary prevention of neural tube defects an intake of 4 mg/d is recommended.

Strohle A.,Leibniz University of Hanover | Wolters M.,BIPS GmbH | Hahn A.,Leibniz University of Hanover
Medizinische Monatsschrift fur Pharmazeuten | Year: 2013

Ageing processes are associated with physiological changes, e. g. a reduction of metabolically active body mass and an impaired hunger-satiety regulation, which - combined with chronic diseases and psychosocial problems - significantly increase the risk for malnutrition. However, considering their nutrition and health status elderly people are a very heterogeneous group. The nutrition situation of "young" seniors does generally not differ from the situation of working-age adults while institutionalized elderly people and those in need of care often show signs of a global malnutrition. The critical nutrients in the nutrition of the elderly particularly include vitamin B12 and D. Six percent of all elderly have a manifest and 10 to 30 % a functional vitamin B12 deficiency. The main cause is vitamin B12 malabsorption resulting from a type B atrophic gastritis. The functional vitamin B12 deficiency and the associated hyperhomocysteinemia are risk factors for neurodegenerative diseases and accelerate bone loss. With increasing age the vitamin D status is deteriorating. About 50 % of the elderly living in private households is deficient in vitamin D; in geriatrics vitamin D deficiency is more the rule than an exception. This is caused by a reduced endogenous biosynthesis, low UVB exposure and a diet low in vitamin D. A vitamin D deficiency increases the risk for falls and fractures as well as the risk for neurodegenerative diseases. Also the overall mortality is increased.

Olafsdottir S.,Gothenburg University | Eiben G.,Gothenburg University | Prell H.,Gothenburg University | Hense S.,BIPS GmbH | And 4 more authors.
International Journal of Public Health | Year: 2014

Objectives: This study investigated the associations between children's screen habits and their consumption of sweetened beverages. Because parents might be disposed to regulate their child's screen and dietary habits in a similar direction, our specific aim was to examine whether these associations were independent of parental norms. Methods: In the Swedish sample of the European Identification and prevention of dietary and lifestyle-induced health effects in children and infants (IDEFICS) study, parents filled in questionnaires about their 2 to 9-year-old children's (n = 1,733) lifestyle and diets. Results: Associations between screen habits and sweetened beverage consumption were found independent of parental norms regarding sweetened beverages. A longitudinal analysis revealed that sweetened beverage consumption at 2-year follow-up was predicted by exposure to commercial TV at baseline (OR 1.4, 95 % CI 1.1-1.9). Cross-sectional analysis showed that the likelihood of consuming sweetened beverages at least 1-3 times per week increased for each hour/day watching television (OR 1.5, 95 % CI 1.2-1.9), and for being exposed to commercials (OR 1.6, 95 % CI 1.3-2.1). TV viewing time and commercial exposure contributed to the associations independently of each other. Conclusions: The results strengthen the assumption that it is possible to influence children's dietary habits through their TV habits. © 2013 Swiss School of Public Health.

Pelz I.,BIPS GmbH | Pohlabeln H.,BIPS GmbH | Reineke A.,BIPS GmbH | Ahrens W.,BIPS GmbH
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz | Year: 2013

The quality management concept for the first wave of the German Health Interview and Examination Survey for Adults (DEGS1) included in addition to conducting internal quality assurance (QS) also the supervision by an external independent institute. After a restricted tendering procedure, the Leibniz Institute for Prevention Research and Epidemiology - BIPS was commissioned to conduct the external quality assurance. The external quality control included the review of the operation manuals, the training of the field staff, the execution of field work (including measurements), and the monitoring of sampling, response and data management. For the realization of the controls in these areas, test criteria were developed to reveal shortcomings early and to give recommendations for the internal quality assurance. This paper briefly describes the concept and the execution of the accompanying external quality assurance with regard to the above mentioned areas. An English full-text version of this article is available at SpringerLink as supplemental. © 2013 Springer-Verlag Berlin Heidelberg.

Hammer G.P.,Johannes Gutenberg University Mainz | Hammer G.P.,Laboratoire National Of Sante | Scheidemann-Wesp U.,Johannes Gutenberg University Mainz | Samkange-Zeeb F.,Johannes Gutenberg University Mainz | And 4 more authors.
Radiation and Environmental Biophysics | Year: 2013

Ionizing radiation is a well-known but little understood risk factor for lens opacities. Until recently, cataract development was considered to be a deterministic effect occurring at lens doses exceeding a threshold of 5-8 Gy. Substantial uncertainty about the level and the existence of a threshold subsists. The International Commission on Radiation Protection recently revised it to 0.5 Gy. Based on a systematic literature review of epidemiological studies on exposure to low levels of ionizing radiation and the occurrence of lens opacities, a list of criteria for new epidemiological studies was compiled, and a list of potential study populations was reviewed. Among 24 publications finally identified, six report analyses of acute exposures in atomic bomb survivors and Chernobyl liquidators, and the others report analyses of protracted exposures in occupationally, medically or accidentally exposed populations. Three studies investigated a dose threshold: in atomic bomb survivors, the best estimates were 1 Sv (95 % CI <0-0.8 Sv) regarding lensectomies; in survivors exposed as children, 0.6 Sv (90 % CI <0.0-1.2 Sv) for cortical cataract prevalence and 0.7 Sv (90 % CI 0.0-2.8 Sv) for posterior subcapsular cataract; and in Chernobyl liquidators, 0.34 Sv (95 % CI 0.19-0.68 Sv) for stage 1 cataract. Current studies are heterogeneous and inconclusive regarding the dose-response relationship. Protracted exposures and high lens doses occur in several occupational groups, for instance, in physicians performing fluoroscopy-guided interventional procedures, and in accidentally exposed populations. New studies with a good retrospective exposure assessment are feasible and should be initiated. © 2013 Springer-Verlag Berlin Heidelberg.

PubMed | BIPS GmbH
Type: Journal Article | Journal: European journal of nutrition | Year: 2014

The aim of this study was to investigate the associations between proxy-reported energy intake, daily food intake and energy density of foods and body mass index (BMI) z-score in 2-9-year-old European children.From 16,225 children who participated in the identification and prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) baseline examination, 9,782 children with 24-h proxy dietary information and complete covariate information were included in the analysis. Participating children were classified according to adapted Goldberg cutoffs: underreports, plausible energy reports and overreports. Energy intake, daily food intake and energy density of foods excluding noncaloric beverages were calculated for all eating occasions. Effect of energy intake, daily food intake and energy density of foods on BMI z-score was investigated using multilevel regression models in the full sample and subsample of plausible energy reports. Exposure variables were included separately; daily food intake and energy intake were addressed in a combined model to check for interactions.In the group of plausible energy reports (N = 8,544), energy intake and daily food intake were significantly positively associated with BMI z-score. Energy density of foods was not associated with BMI z-score. In the model including energy intake, food intake and an interaction term, only energy intake showed a significantly positive effect on BMI z-score. In the full sample (N = 9,782), only energy intake was significantly but negatively associated with BMI z-score.Proxy-reporters are subject to misreporting, especially for children in the higher BMI levels. Energy intake is a more important predictor of unhealthy weight development in children than daily food intake.

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