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Introduction Data on willingness to participate in population-based long-COVID studies are sparse. We invited all citizens of Essen aged 18-74 years with a positive SARS-CoV-2 PCR test between Mar-Aug 2020 and assessed COVID-related symptoms in responders ∼1.5 years after infection. Methods The invited population included 1282 infected citizens (48% women). At the time of testing 64% reported symptoms. We asked responders about past and current symptoms, hospitalization, smoking, sport, pre-existing conditions (heart attack, stroke, diabetes), subjective health status as compared to before infection, assessed BMI, and performed descriptive statistics. Results We investigated 255 participants (50% women, 19-73 years, response rate 20%) ∼20 month (median) after the PCR test. 95% reported symptoms at the time of testing: 67% fatigue, 58% taste disorders, 56% limb pain, 55% odor disorders, 54% headache, 50% cough, 43% fever; 10% needed hospitalization, 3% intensive care, 1.6% artificial ventilation. Compared to the non-hospitalized the formerly inpatients were more often male (62% vs 49%), older (56±13 vs 49±14 years), less often never smokers (42% vs 53%), had a higher BMI (31±7 vs 28±5 kg/m2), and more pre-existing conditions (23% vs 10%). Compared to before infection, 53% rated their current health worse, with a higher rate among inpatients (81%). After ∼1.5 years, 55% still reported symptoms: 25% fatigue, 20% concentration disorder, 18% breathing problems, 13% odor and 11% taste disorders. Persistent symptoms were more common in inpatients than in non-hospitalized (69% vs 53%). Conclusions Symptomatic individuals are more likely to participate in a COVID19 follow-up study than asymptomatic ones. This may overestimate the number of individuals with long-term symptoms in population-based long-COVID study populations. However, persistent symptoms seem to be more likely in formerly inpatients compared to non-hospitalized individuals with former SARS-CoV-2 infection. Key messages • Symptomatic individuals are more likely to participate in a COVID19 follow-up study than asymptomatic ones. • Persistent symptoms seem to be more likely in formerly inpatients compared to non-hospitalized individuals with former SARS-CoV-2 infection.

Objectives Cardiovascular diseases (CVDs) occur more often in people living with HIV (PLWH) than in the general population. It has been reported that CVD risk scores developed for the general population underestimate the CVD risk in PLWH. Performances of the Framingham Risk Score (FRS), the Systematic Coronary Risk Evaluation (SCORE) and the atherosclerotic cardiovascular disease (asCVD) risk score in PLWH were compared with the general population to quantify score-specific differences in risk prediction. Methods HIV-positive outpatients from the HIV-HEART (HIVH) study (n = 567) were compared with participants from the population-based Heinz Nixdorf Recall (HNR) study (n ~ 4440) both recruited from the German Ruhr area. During a follow-up time of around 5 years, the associations between the FRS and incident CVD and peripheral artery disease (CVD_pAD), SCORE and coronary heart disease (CHD), and asCVD and incident CVD were examined using logistic regression. Score performances were assessed by comparing the areas under the curve (AUCs). Results The mean ages were 52.9 ± 6.7 and 59.1 ± 7.7 years in the HIVH and HNR studies, respectively. There were fewer incident CVD events in the HNR study than in the HIVH study (CVD_pAD: 3.9% vs. 12.1%; CHD: 2.1% vs. 7.8%; CVD: 3.5% vs. 9.9%). Age- and sex-adjusted CVD risk was greater with increasing FRS, SCORE and asCVD in both cohorts, but the scores performed more accurately in the HNR than in HIVH study (AUCs FRS: 0.71 vs. 0.65; SCORE: 0.70 vs. 0.62; asCVD: 0.74 vs. 0.62). Conclusions Associations between risk scores and future CVD were observed in both cohorts, but the score performances were less reliable in PLWH than in the general population.

Hintergrund: Ob Diabetiker mit Übergewicht oder moderater Adipositas eine geringere Mortalität aufweisen als Diabetiker mit Normalgewicht, wird kontrovers diskutiert. Während einige Autoren ein solches Adipositasparadox bei Diabetikern für plausibel halten, vermuten andere methodische[zum vollständigen Text gelangen Sie über die oben angegebene URL], 64. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS)

Background: Road traffic noise affects a large number of people in urbanized areas and increases the risk of cardiovascular disease. Recent studies suggested a possible link between exposure to noise and metabolic outcomes. Objective: This study investigated the effect of outdoor and indoor residential[for full text, please go to the a.m. URL], 51. Kongress für Allgemeinmedizin und Familienmedizin

Health-Related Control Belief and Quality of Life in Chronically Ill Patients after a Behavioral Intervention in an Integrative Medicine Clinic – an Observational Study Background: In 1999 the Clinic for Internal Medicine and Integrative Medicine was founded in Essen as a regular part of the German inpatient health care system. Integrative medicine (standard internal medicine, evidence-based complementary and alternative medicine combined with intensified lifestyle modification) aims to help patients with chronic illness to cope with their condition more effectively and to achieve a health-promoting lifestyle. Techniques include cognitive restructuring, the elicitation of the relaxation response, and lifestyle education. The goal is to increase health-related quality of life (QoL) as well as control beliefs and to reduce morbidity in later life. Aim: To demonstrate changes in quality of life, lifestyle, and control beliefs after a two-week hospital stay. Methods: Uncontrolled prospective observational study with 557 consecutive hospital patients. Outcome parameters were quality of life (SF36), control beliefs (GKU), and daily health-related behavior (nutrition, physical activity, relaxation) on admission, at discharge, as well as 3 and 6 months after discharge. Results: Weekly physical activity increases by 29%, consumption of not recommendable foods decreases by 18%. The majority of patients (57%) engage in relaxation exercises 6 months after discharge (on admission 23%). The physical sum scale (SF36) increases from 33.9 (95% KI 32.5–35.3) on admission to 37.3 (35.8–38.9) 6 months after discharge, the mental sum scale from 41.2 (39.5–42.9) to 45.1 (43.5–46.7). The ratio internal/external control belief rises from 1.17 (95% KI 1.11–1.24) to 1.32 (1.24–1.40). Pretherapeutic ratio internal/external control belief and its increase are associated with rises in QoL. Conclusions: After integrative medicine treatment a lasting increase in QoL and lifestyle changes can be achieved. Reinforcement of internal control beliefs and own competence is possible and enhances outcomes in chronically ill patients.

Einleitung: Die Grose des linken Vorhofs ist mit kardiovaskularen Erkrankungen assoziiert. Wahrend die Messung der Vorhofgrose zumeist mittels Echokardiografie erfolgt, ermoglicht auch die CT-Untersuchung des Herzens eine zuverlassige Quantifikation der Vorhofgrose. In dieser Analyse wird die Assoziation der CT-basierten Vorhofgrose mit kardiovaskularen Risikofaktoren in einem populationsbasierten Kollektiv untersucht. Methodik: Zwischen 2000 und 2003 wurden Manner und Frauen im Alter von 45–75 Jahren in die Heinz Nixdorf Recall Studie, eine populationsbasierte prospektive Kohortenstudie, eingeschlossen. Bei Einschluss wurden kardiovaskulare Risikofaktoren gemessen und eine Elektronenstrahl-CT-Untersuchung des Herzens durchgefuhrt. Die Grose des linken Vorhofs wurde in einer axialen Schicht auf Hohe der Mitralklappe erfasst. Probanden mit bekannten kardiovaskularen Erkrankungen wurden von der Analyse ausgeschlossen. Die Assoziation der linksatrialen Grose mit kardiovaskularen Risikofaktoren wurde mittels uni- und multivariater Regression beurteilt. Ergebnisse: Insgesamt wurden 3945 Probanden (53% Frauen, 59±8 Jahre) in die Analyse eingeschlossen. Die mittlere Vorhofgrose betrug 1761±418mm2. Manner hatten grosere Vorhofe als Frauen (1856±439mm2 vs. 1677±379mm2, p

Ungünstige Expositionen während der prä-, peri- und postnatalen Entwicklungsphasen können Einfluss auf den Gesundheitszustand in der Kindheit und im weiteren Lebensverlauf haben. Geburtskohortenstudien sind geeignete Instrumente zur Erforschung solcher Zusammenhänge. Als Beitrag[for full text, please go to the a.m. URL], Mainz//2011; 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi)

Background: Coronary artery calcium (CAC) has been suggested to improve prediction of coronary events beyond traditional risk factor assessment. We determined whether CAC scoring improves prediction of coronary events when added to traditional risk factor analysis in the general population. Methods: We used data of the Heinz Nixdorf Recall cohort study, including 4129 randomly selected subjects aged 59.4±7.7 years (53% women) without overt coronary artery disease at baseline (2000 to 2003). Traditional risk factors and CAC, measured by electron-beam computed tomography, were assessed. Participants were stratified into low, intermediate or high risk categories using the Framingham risk score (FRS), and modified ATPIII risk score categories (modATPIII). Participants were followed for hard coronary events, i.e. coronary death and non-fatal myocardial infarction for 5.02 years. Results: The cumulative event rate was 2.3% (95% confidence intervals (CI): 1.8–2.8). Relative risks (RR) increased from the lowest to the intermediate and highest FRS and modATPIII risk categories. Crude and modATPIII-adjusted RRs in the highest versus lowest CAC quartile were 6.40 (95% CI: 3.37–12.16) and 4.25 (95% CI: 2.14–8.45), respectively. Adding CAC scores to the FRS and modATPIII-categories significantly improved the areas under the ROC curves from 0.681 and 0.667 to 0.749 (p=0.003) and 0.753 (p=0.0001), respectively. Intermediate modATPIII risk subjects with CAC

The aim of the study was to estimate the proportion of occupation-related lung cancer for males and females in Northern Germany. 1004 lung cancer cases (839 males, 165 females) were enrolled into an epidemiological case-control study in the study areas Bremen, the surroundings of Bremen and the Frankfurt/Main area. Population controls were matched for sex and region of residence. All patients born after 1913 of German nationality and with a histologically or cytologically verified carcinoma of the lung, the diagnosis not older than 3 months at the date of interview, were eligible. All individuals were personally interviewed with respect to their smoking and job history. Based on a published list of all jobs and branches of industries with sufficient evidence for lung carcinogenity (based on the reviews by IARC), the so called A-List, all individuals were classified regarding their lifelong occupational history. The same procedure was applied with regard to jobs and branches of industries with a suspected risk of lung cancer (List-B). The statistical analysis used conditional logistic regression, controlled for smoking. Being employed in a job of List-A for at least half a year was associated with a statistically significant odds ratio (OR) of 1.63 (p0.0001) and resulting attributable risk (AR) of 16% in males. For the B-List an OR of 1.34 and an AR of 10% resulted in males. The estimates of the attributable risk for jobs and branches of industry with a sufficient evidence of lung cancer risk is comparable to the estimates obtained by Doll and Peto for the US. If additionally jobs and branches of industries with a suspected risk for lung cancer is considered, it must be anticipated that approximately one quarter of all newly diagnosed male lung cancer cases in the study region may be caused by occupational risk factors. This should prompt to minimise occupational exposure.

In the context with an extensive pilot study investigating risk factors for lung cancer, aetiological and clinical questions were analysed for lung cancer mortality in women. In a first step all available data sources about the prevalence of smoking in the FRG were used to determine the correlation between the prevalence of smoking and lung cancer mortality. 88% of the variance (R2) of lung cancer mortality for women could be explained by smoking. In a second step medical records of 133 female lung cancer patients from three hospitals were analysed with regard to the histological types of lung cancer and smoking. Small cell lung cancers were more frequent among female smokers while adenocarcinoma was more prevalent among non-smokers. Survival analysis for 421 men and 97 women showed a significantly longer survival time for women as compared to men, taking into account other relevant prognostic factors. The association between smoking and lung cancer is discussed and analysed in greater detail.

Data of the social security institutions, although gathered for administrative purposes, provide important information on work-related morbidity. The validity of the data can be improved by linking several data sources and data from questionnaires or medical examinations. Hence, within the framework of the "Cooperative Programme Occupation and Health" (KOPAG) a specific procedure for data linkage was developed. Data linkage was effected via an anonymous social security number on the one hand, and on the other hand a constructed short number using informations on birthday, sex, and the first letter of the surname of the employees. By means of this short number an average 62% of the questionnaires could be linked to the health insurance sickness leave data. Data linkage was particularly successful (85%) under specific advantageous conditions. Data linkage failed in 25% of all cases because the information necessary to construct the short number was obviously wrong. In general, this procedure to link survey data to routine data of the social security proves suitable for use in routine health reporting.