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Search Results: 1 - 10 of 2771 matches for " Elisabeth Steinhagen-Thiessen "
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Prolonged-release nicotinic acid for the management of dyslipidemia: an update including results from the NAUTILUS study
Anja Vogt,Ursula Kassner,Ulrike Hostalek,Elisabeth Steinhagen-Thiessen
Vascular Health and Risk Management , 2007,
Abstract: Anja Vogt1, Ursula Kassner1, Ulrike Hostalek2, Elisabeth Steinhagen-Thiessen11Charite-Universitatsmedizin Berlin, Germany; 2Merck KGaA, Darmstadt, GermanyAbstract: Low HDL-cholesterol (<1.02 mmol/L [40 mg/dL] in men or <1.29 mmol/L [50 mg/dL] in women) occurs in about one-third of European patients with dyslipidemia and is an independent cardiovascular risk factor. Simultaneous correction of low HDL-cholesterol and high totalcholesterol and LDL-cholesterol may provide reductions in cardiovascular morbidity and mortality beyond those possible with statins alone. Nicotinic acid (niacin in the US) is the most effective means of increasing HDL-cholesterol available and has been shown to reduce cardiovascular event rates significantly. Niaspan (prolonged-release nicotinic acid) provides a convenient, once-daily means of administering nicotinic acid. Clinical studies with Niaspan have demonstrated marked, long-term increases in HDL-cholesterol with additional useful benefits on triglycerides, LDLcholesterol, and lipid sub-profiles. The NAUTILUS study demonstrated the beneficial efficacy and tolerability profiles of Niaspan in a usual-care setting. The most common side-effect of Niaspan is flushing, which infrequently causes treatment discontinuation and which usually subsides over continued treatment. The ARBITER 2 and ARBITER 3 studies showed 1–2 years of treatment with Niaspan plus a statin induced regression of atherosclerosis in patients with coronary artery disease. The effect of Niaspan -statin treatment, relative to a statin alone, on clinical cardiovascular outcomes is currently under evaluation. Niaspan represents a practical means of correcting low HDL-cholesterol, an independent risk factor for adverse cardiovascular outcomes.Keywords: prolonged-release nicotinic acid, Niaspan , niacin, dyslipidemia, HDL-cholesterol cardiovascular risk
Mining geriatric assessment data for in-patient fall prediction models and high-risk subgroups
Michael Marschollek, Mehmet G?vercin, Stefan Rust, Matthias Gietzelt, Mareike Schulze, Klaus-Hendrik Wolf, Elisabeth Steinhagen-Thiessen
BMC Medical Informatics and Decision Making , 2012, DOI: 10.1186/1472-6947-12-19
Abstract: A data set of n = 5,176 single in-patient episodes covering 1.5 years of admissions to a geriatric hospital were extracted from the hospital's data base and matched with fall incident reports (n = 493). A classification tree model was induced using the C4.5 algorithm as well as a logistic regression model, and their predictive performance was evaluated. Furthermore, high-risk subgroups were identified from extracted classification rules with a support of more than 100 instances.The classification tree model showed an overall classification accuracy of 66%, with a sensitivity of 55.4%, a specificity of 67.1%, positive and negative predictive values of 15% resp. 93.5%. Five high-risk groups were identified, defined by high age, low Barthel index, cognitive impairment, multi-medication and co-morbidity.Our results show that a little more than half of the fallers may be identified correctly by our model, but the positive predictive value is too low to be applicable. Non-fallers, on the other hand, may be sorted out with the model quite well. The high-risk subgroups and the risk factors identified (age, low ADL score, cognitive impairment, institutionalization, polypharmacy and co-morbidity) reflect domain knowledge and may be used to screen certain subgroups of patients with a high risk of falling. Classification models derived from a large data set using data mining methods can compete with current dedicated fall risk screening tools, yet lack diagnostic precision. High-risk subgroups may be identified automatically from existing geriatric assessment data, especially when combined with domain knowledge in a hybrid classification model. Further work is necessary to validate our approach in a controlled prospective setting.Falls and their consequences are a well-known and urgent problem in our ageing population. It is known that geriatric in-patients exhibit the highest fall incidence among institutionalized persons, ranging from 6.3 to 7.2% within a period of two weeks
Prevalence of obesity in primary care using different anthropometric measures – Results of the German Metabolic and Cardiovascular Risk Project (GEMCAS)
Hans Hauner, Peter Bramlage, Christian L?sch, Elisabeth Steinhagen-Thiessen, Heribert Schunkert, Jürgen Wasem, Karl-Heinz J?ckel, Susanne Moebus
BMC Public Health , 2008, DOI: 10.1186/1471-2458-8-282
Abstract: This was a point prevalence study with 1,511 primary care physicians and 35,869 adult patients in 2005. Bodyweight, height and waist circumference was measured and blood samples taken to determine the presence of cardiovascular risk factors, including lipids, blood pressure, fasting glucose, low physical activity, smoking and family history of myocardial infarction. We calculated rate ratios stratified for age and gender.There was a high prevalence of overweight (45.7% male [95%CI 44.9–46.5]; 30.6% female [95%CI 30.0–31.2]) and obesity (24.7% male [95%CI 24.0–25.4]; 23.3% female [95%CI 22.8–23.9]). 36.4% of male [95%CI 35.6–37.2] and 41.5% of female [95%CI 40.8–42.1] had a high WC (male > 102, female > 88 cm). A high WC in addition to an overweight BMI identified patients with more risk factors (male: mean of 3.93 risk factors (RF) at a WC > 102 cm vs. 2.88 RF in patients ≤ 94 cm; female 3.58 RF at a WC > 88 cm vs. 2.41 RF ≤ 80 cm).There is a high prevalence of obesity (24.7% of male and 23.3% of female) and, in particular, abdominal obesity (36.4% of male and 41.5% of female) in adults attending a primary care physician in Germany. The determination of the BMI is sufficient to assess risk in normal weight and obese patients, while a high WC identifies high risk patients from within the overweight group.Overweight and obese persons have an increased prevalence of cardiometabolic risk factors compared to patients with normal weight, especially when they are abdominally obese. Different anthropometric measures like weight, height, waist- and/or hip circumference, direct measurements of abdominal fat using MRI scans and various computations of these variables have been proposed to identify patients with an increased risk for developing diabetes and cardiovascular events [1].Body mass index (BMI) is the most widely accepted measure of obesity in populations and in clinical practice. Therefore, most reports on the prevalence of obesity and its trends over time and distri
Dyslipidemia in primary care – prevalence, recognition, treatment and control: data from the German Metabolic and Cardiovascular Risk Project (GEMCAS)
Elisabeth Steinhagen-Thiessen, Peter Bramlage, Christian L?sch, Hans Hauner, Heribert Schunkert, Anja Vogt, Jürgen Wasem, Karl-Heinz J?ckel, Susanne Moebus
Cardiovascular Diabetology , 2008, DOI: 10.1186/1475-2840-7-31
Abstract: In a nationwide study with 1,511 primary care physicians and 35,869 patients we determined the prevalence of dyslipidemia, its recognition, treatment, and control rates. Diagnosis of dyslipidemia was based on TC and LDL-C. Basic descriptive statistics and prevalence rate ratios, as well as 95% confidence intervals were calculated.Dyslipidemia was highly frequent in primary care (76% overall). 48.6% of male and 39.9% of female patients with dyslipidemia was diagnosed by the physicians. Life style intervention did however control dyslipidemia in about 10% of patients only. A higher proportion (34.1% of male and 26.7% female) was controlled when receiving pharmacotherapy. The chance to be diagnosed and subsequently controlled using pharmacotherapy was higher in male (PRR 1.15; 95%CI 1.12–1.17), in patients with concomitant cardiovascular risk factors, in patients with hypertension (PRR 1.20; 95%CI 1.05–1.37) and cardiovascular disease (PRR 1.46; 95%CI 1.29–1.64), previous myocardial infarction (PRR 1.32; 95%CI 1.19–1.47), and if patients knew to be hypertensive (PRR 1.18; 95%CI 1.04–1.34) or knew about their prior myocardial infarction (PRR 1.17; 95%CI 1.23–1.53).Thresholds of the ESC seem to be difficult to meet. A simple call for more aggressive treatment or higher patient compliance is apparently not enough to enhance the proportion of controlled patients. A shift towards a multifactorial treatment considering lifestyle interventions and pharmacotherapy to reduce weight and lipids may be the only way in a population where just to be normal is certainly not ideal.Dyslipidemia is one of the top 5 major risk factors leading to cardiovascular disease. Its treatment has been shown to improve prognosis – morbidity and mortality is substantially reduced in successfully treated as compared to non-treated dyslipidemic controls [1-3].Although there are differences in defining dyslipidemia and the goals to achieve when treating dyslipidemia there is a general trend to recommen
Psychological and sociodemographic predictors of premature discontinuation of a 1-year multimodal outpatient weight-reduction program: an attrition analysis
Ahnis A,Riedl A,Figura A,Steinhagen-Thiessen E
Patient Preference and Adherence , 2012,
Abstract: Anne Ahnis1, Andrea Riedl1, Andrea Figura1, Elisabeth Steinhagen-Thiessen2, Max E Liebl3, Burghard F Klapp11Internal Medicine and Dermatology, Medical Department, Division of Psychosomatic Medicine, Charité – Universit tsmedizin Berlin, Campus Mitte, 2Internal Medicine with Gastroenterology and Nephrology, Specialty network of Gastroenterology, Endocrinology and Metabolic Diseases, Division of Lipid Metabolism, Charité – Universit tsmedizin Berlin, Campus Virchow-Klinikum, 3Medical Department, Division of Rheumatology and Clinical Immunology, Department for Physical Medicine, Charité – Universit tsmedizin Berlin, Campus Mitte, Berlin, GermanyObjective: Attrition rates of up to 77% have been reported in conservative weight-reduction programs for the treatment of obesity. In view of the cost of such programs to the health system, there is a need to identify the variables that predict premature discontinuation of treatment. Previous studies have focused mainly on somatic and sociodemographic parameters. The prospective influence of psychological factors has not been systematically investigated to date.Methods: A total of 164 patients (138 of whom were women) with a mean age of 45 years and a mean body mass index of 39.57 participated in a 1-year outpatient weight-reduction program at the Charité – Universit tsmedizin Berlin University Hospital. The program included movement therapy, dietary advice, psychoeducational and behavioral interventions, relaxation procedures, and consultations with a specialist in internal medicine and a psychologist. Patients also underwent regular laboratory and psychological testing. The results were evaluated using a t-test, χ2-test, and logistic regression analysis.Results: Seventy-one of the 164 patients (61 women, mean age = 43 years, mean body mass index = 39.53) withdrew before the end of the program (attrition rate = 43.3%). While there were no differences between the somatic and metabolic characteristics of those who withdrew and those who remained, the sociodemographic and psychological factors had some relevance. In particular, “expectation of self-efficacy” (Fragebogen zu Selbstwirksamkeit, Optimismus und Pessimismus [SWOP]), “not working,” “tiredness” (Berliner Stimmungsfragebogen [BSF]), “pessimism” (SWOP) and “positive reframing” (Brief-COPE) were found to play a role in whether participants subsequently dropped out of the treatment. “Support coping” (Brief-COPE) and “older age” prior to the start of treatment were identified as variables that promoted treatment adherence.Conclusion: The results are discussed in l
A Systematic Literature Review of the Association of Lipoprotein(a) and Autoimmune Diseases and Atherosclerosis
I. Missala,U. Kassner,E. Steinhagen-Thiessen
International Journal of Rheumatology , 2012, DOI: 10.1155/2012/480784
Abstract:
A Systematic Literature Review of the Association of Lipoprotein(a) and Autoimmune Diseases and Atherosclerosis
I. Missala,U. Kassner,E. Steinhagen-Thiessen
International Journal of Rheumatology , 2012, DOI: 10.1155/2012/480784
Abstract: Objective. To investigate the association of lipoprotein(a) and atherosclerosis-related autoimmune diseases, to provide information on possible pathophysiologic mechanisms, and to give recommendations for Lp(a) determination and therapeutic options. Methods. We performed a systematic review of English language citations referring to the keywords “Lp(a)” AND “autoimmune disease” AND “atherosclerosis,” “Lp(a)” AND “immune system” OR “antiphospholipid (Hughes) syndrome (APS)” OR “rheumatoid arthritis” OR “Sj?gren’s syndrome” OR “systemic lupus erythematosus” OR “systemic sclerosis” OR “systemic vasculitis” published between 1991 and 2011 using Medline database. Results. 22 out of 65 found articles were identified as relevant. Lp(a) association was highest in rheumatoid arthritis (RA), followed by systemic lupus erythematosus (SLE), moderate in APS and lowest in systemic sclerosis (SSc). There was no association found between Lp(a) and systemic vasculitis or Sj?gren’s syndrome. Conclusion. Immune reactions are highly relevant in the pathophysiology of atherosclerosis, and patients with specific autoimmune diseases are at high risk for CVD. Elevated Lp(a) is an important risk factor for premature atherosclerosis and high Lp(a) levels are also associated with autoimmune diseases. Anti-Lp(a)-antibodies might be a possible explanation. Therapeutic approaches thus far include niacin, Lp(a)-apheresis, farnesoid x-receptor-agonists, and CETP-inhibitors being currently under investigation. 1. Introduction Atherosclerosis is a major cause of cardiovascular disease (CVD). Autoimmune reactions and inflammation are mainly involved in their pathogenesis. Already at early onset atherosclerosis inflammatory cells (monocytes, macrophages, dendritic cells, T- and B-cells) and cytokines can be identified in the lesion area and those cells may provoke cell-mediated immune reactions (CMIR) that (i) modulate the development of atherosclerosis and may (ii) predetermine its progression [1, 2]. Immune reactions may modulate atherosclerosis in different ways: (i) 2 glycoprotein I-immunization led to an increase, (ii) heat shock protein (HSPs) 60/65 antigen led to an increase, and (iii) oxLDL-immunization led to a decrease [3, 4]. In addition to established risk factors of CVD, autoimmune processes are discussed as being highly relevant. Autoimmune disorders are associated with a high CVD risk in clinical practice. In a major autoimmune disease, SLE, animal studies identified mainly proinflammatory Th1 cytokines (e.g., IFN-gamma), whereas in humans with SLE mainly Th2 cytokines were
Psychological and sociodemographic predictors of premature discontinuation of a 1-year multimodal outpatient weight-reduction program: an attrition analysis
Ahnis A, Riedl A, Figura A, Steinhagen-Thiessen E, Liebl ME, Klapp BF
Patient Preference and Adherence , 2012, DOI: http://dx.doi.org/10.2147/PPA.S28022
Abstract: ychological and sociodemographic predictors of premature discontinuation of a 1-year multimodal outpatient weight-reduction program: an attrition analysis Original Research (1773) Total Article Views Authors: Ahnis A, Riedl A, Figura A, Steinhagen-Thiessen E, Liebl ME, Klapp BF Published Date March 2012 Volume 2012:6 Pages 165 - 177 DOI: http://dx.doi.org/10.2147/PPA.S28022 Received: 08 November 2011 Accepted: 08 December 2011 Published: 07 March 2012 Anne Ahnis1, Andrea Riedl1, Andrea Figura1, Elisabeth Steinhagen-Thiessen2, Max E Liebl3, Burghard F Klapp1 1Internal Medicine and Dermatology, Medical Department, Division of Psychosomatic Medicine, Charité – Universit tsmedizin Berlin, Campus Mitte, 2Internal Medicine with Gastroenterology and Nephrology, Specialty network of Gastroenterology, Endocrinology and Metabolic Diseases, Division of Lipid Metabolism, Charité – Universit tsmedizin Berlin, Campus Virchow-Klinikum, 3Medical Department, Division of Rheumatology and Clinical Immunology, Department for Physical Medicine, Charité – Universit tsmedizin Berlin, Campus Mitte, Berlin, Germany Objective: Attrition rates of up to 77% have been reported in conservative weight-reduction programs for the treatment of obesity. In view of the cost of such programs to the health system, there is a need to identify the variables that predict premature discontinuation of treatment. Previous studies have focused mainly on somatic and sociodemographic parameters. The prospective influence of psychological factors has not been systematically investigated to date. Methods: A total of 164 patients (138 of whom were women) with a mean age of 45 years and a mean body mass index of 39.57 participated in a 1-year outpatient weight-reduction program at the Charité – Universit tsmedizin Berlin University Hospital. The program included movement therapy, dietary advice, psychoeducational and behavioral interventions, relaxation procedures, and consultations with a specialist in internal medicine and a psychologist. Patients also underwent regular laboratory and psychological testing. The results were evaluated using a t-test, χ2-test, and logistic regression analysis. Results: Seventy-one of the 164 patients (61 women, mean age = 43 years, mean body mass index = 39.53) withdrew before the end of the program (attrition rate = 43.3%). While there were no differences between the somatic and metabolic characteristics of those who withdrew and those who remained, the sociodemographic and psychological factors had some relevance. In particular, “expectation of self-efficacy” (Fragebogen zu Selbstwirksamkeit, Optimismus und Pessimismus [SWOP]), “not working,” “tiredness” (Berliner Stimmungsfragebogen [BSF]), “pessimism” (SWOP) and “positive reframing” (Brief-COPE) were found to play a role in whether participants subsequently dropped out of the treatment. “Support coping” (Brief-COPE) and “older age” prior to the start of treatment were identified as variables that promoted tre
Die Empfehlungen des Wissenschaftsrates zur Weiterentwicklung der wissenschaftlichen Informationsinfrastrukturen in Deutschland bis 2020“: Inhalt und kritische Bewertung im Hinblick auf das wissenschaftliche Bibliothekswesen
Peter Thiessen
Perspektive Bibliothek , 2013, DOI: 10.11588/pb.2013.1.10346
Abstract: Von verschiedenen wissenschaftspolitischen Expertengremien sind in den letzten Jahren Analysen und Entwicklungsvorschl ge zur Situation der wissenschaftlichen Informationsinfrastrukturen in Deutschland vorgelegt worden. Der Wissenschaftsrat thematisierte 2012 mit seinen jüngsten Empfehlungen zur Weiterentwicklung der wissenschaftlichen Informationsinfrastrukturen in Deutschland bis 2020“ vor allem Fragen der strukturellen Organisation und Koordination von Einrichtungen aus dem Bereich der Informationsinfrastrukturen. Inwieweit die Empfehlungen des Wissenschaftsrats dabei auf Belange des wissenschaftlichen Bibliothekswesens eingehen, soll im vorliegenden Beitrag betrachtet werden. Dazu werden die Empfehlungen des Wissenschaftsrats zun chst in den bibliothekspolitischen Kontext eingeordnet (Abschnitt 1.1 und 1.3) und in ihren relevanten Aspekten vorgestellt (Abschnitt 1.2). In einer kritischen Analyse werden daraufhin wesentliche Punkte des Papiers diskutiert (Abschnitt 2), die im Hinblick auf ihre Auswirkungen auf das wissenschaftliche Bibliothekswesen in Deutschland bewertet (Abschnitt 3) werden. Als tendenziell problematisch erweisen sich dabei u. a. die Aussagen des Wissenschaftsrat zum Thema Open Access sowie zu den Finanzierungsmodalit ten künftiger Informationsinfrastrukturen und ihrer vorgeschlagenen zentralen Steuerung.
Stephen T. Ziliak and Deirdre N. McCloskey, The Cult of Statistical Significance: How the Standard Error Costs us Jobs, Justice, and Lives
Victor Thiessen
The Canadian Journal of Sociology , 2009,
Abstract:
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