Testicular cancer survival rates improved dramatically after cisplatin-based therapy was introduced in the 1970s. However, chemotherapy and radiation therapy are potentially carcinogenic. The purpose of this study was...Testicular cancer survival rates improved dramatically after cisplatin-based therapy was introduced in the 1970s. However, chemotherapy and radiation therapy are potentially carcinogenic. The purpose of this study was to estimate the risk of developing second primary cancers including the risk associated with primary histologic type （seminoma and non-seminoma） among testicular cancer survivors in Germany. We identified 16 990 and 1401 cases of testicular cancer in population-based cancer registries of East Germany （1961-1989 and 1996-2008） and Saarland （a federal state in West Germany; 1970-2008）, respectively. We estimated the risk of a second primary cancer using standardized incidence ratios （SIRs） with 95% confidence intervals （95% Cls）. To determine trends, we plotted model-based estimated annual SIRs. In East Germany, a total of 301 second primary cancers of any location were observed between 1961 and 1989 （SIR： 1.9; 95% Ch 1.7-2.1）, and 159 cancers （any location） were observed between 1996 and 2008 （SIR： 1.7; 95% Ch 1.4-2.0）. The SIRs for contralateral testicular cancer were increased in the registries with a range from 6.0 in Saarland to 13.9 in East Germany. The SIR for seminoma, in particular, was higher in East Germany compared to the other registries. We observed constant trends in the model-based SIRs for contralateral testicular cancers. The majority of reported SIRs of other cancer sites including histology-specific risks showed low precisions of estimated effects, likely due to small sample sizes. Testicular cancer patients are at increased risk especially for cancers of the contralateral testis and should receive intensive follow-ups.展开更多
BackgroundDisagreement exists on the association between changes in blood pressure and cognitive impairment. We aimed to ex-amine whether 4-year changes in systolic and diastolic blood pressure （SBP and DBP） are ass...BackgroundDisagreement exists on the association between changes in blood pressure and cognitive impairment. We aimed to ex-amine whether 4-year changes in systolic and diastolic blood pressure （SBP and DBP） are associated with cognitive status in a representative sample of older men and women.MethodsAnalysis of longitudinal data from 854 participants of a population-based German sample （aged 60-87 years） was performed with standard cognitive screening and blood pressure measurements. Effects of changes in SBP and DBP （10 mmHg and 5 mmHg respectively as unit of regression effect measure） on cognitive status were evaluated using non-parametric and lin-ear regression modeling.ResultsNo clear associations were seen between changes in SBP or in DBP and cognitive scores. Small effects were found after stratification for sex and hypertension awareness. Specifically, larger decreases in SBP were associated with higher cogni-tive scores in those men aware of their hypertension （10 mmHg decrease in SBP,b =-0.26, 95% CI：-0.51 to-0.02） and men with con-trolled hypertension （10 mmHg decrease in SBP,b =-0.44, 95% CI：-0.92 to-0.03）. Additionally larger increases in DBP were associated with higher cognitive scores in men with controlled hypertension （5 mmHg increase in DBP,b = 0.67, 95% CI： 0.19-1.15）. For women aware of their hypertension, larger decreases in DBP were associated with higher cognitive scores （5 mmHg decrease in DBP,b =-0.26; 95%CI：-0.51 to-0.01）.ConclusionsChanges in blood pressure were only weakly associated with cognitive status. Specifically, decreases in SBP were associated with higher cognitive scores in men aware of their hypertension and especially those that were medically controlled.展开更多
文摘Testicular cancer survival rates improved dramatically after cisplatin-based therapy was introduced in the 1970s. However, chemotherapy and radiation therapy are potentially carcinogenic. The purpose of this study was to estimate the risk of developing second primary cancers including the risk associated with primary histologic type （seminoma and non-seminoma） among testicular cancer survivors in Germany. We identified 16 990 and 1401 cases of testicular cancer in population-based cancer registries of East Germany （1961-1989 and 1996-2008） and Saarland （a federal state in West Germany; 1970-2008）, respectively. We estimated the risk of a second primary cancer using standardized incidence ratios （SIRs） with 95% confidence intervals （95% Cls）. To determine trends, we plotted model-based estimated annual SIRs. In East Germany, a total of 301 second primary cancers of any location were observed between 1961 and 1989 （SIR： 1.9; 95% Ch 1.7-2.1）, and 159 cancers （any location） were observed between 1996 and 2008 （SIR： 1.7; 95% Ch 1.4-2.0）. The SIRs for contralateral testicular cancer were increased in the registries with a range from 6.0 in Saarland to 13.9 in East Germany. The SIR for seminoma, in particular, was higher in East Germany compared to the other registries. We observed constant trends in the model-based SIRs for contralateral testicular cancers. The majority of reported SIRs of other cancer sites including histology-specific risks showed low precisions of estimated effects, likely due to small sample sizes. Testicular cancer patients are at increased risk especially for cancers of the contralateral testis and should receive intensive follow-ups.
文摘BackgroundDisagreement exists on the association between changes in blood pressure and cognitive impairment. We aimed to ex-amine whether 4-year changes in systolic and diastolic blood pressure （SBP and DBP） are associated with cognitive status in a representative sample of older men and women.MethodsAnalysis of longitudinal data from 854 participants of a population-based German sample （aged 60-87 years） was performed with standard cognitive screening and blood pressure measurements. Effects of changes in SBP and DBP （10 mmHg and 5 mmHg respectively as unit of regression effect measure） on cognitive status were evaluated using non-parametric and lin-ear regression modeling.ResultsNo clear associations were seen between changes in SBP or in DBP and cognitive scores. Small effects were found after stratification for sex and hypertension awareness. Specifically, larger decreases in SBP were associated with higher cogni-tive scores in those men aware of their hypertension （10 mmHg decrease in SBP,b =-0.26, 95% CI：-0.51 to-0.02） and men with con-trolled hypertension （10 mmHg decrease in SBP,b =-0.44, 95% CI：-0.92 to-0.03）. Additionally larger increases in DBP were associated with higher cognitive scores in men with controlled hypertension （5 mmHg increase in DBP,b = 0.67, 95% CI： 0.19-1.15）. For women aware of their hypertension, larger decreases in DBP were associated with higher cognitive scores （5 mmHg decrease in DBP,b =-0.26; 95%CI：-0.51 to-0.01）.ConclusionsChanges in blood pressure were only weakly associated with cognitive status. Specifically, decreases in SBP were associated with higher cognitive scores in men aware of their hypertension and especially those that were medically controlled.
