Angelina Bockelbrink

Chronic rhinosinusitis in Europe--an underestimated disease. A GA²LEN study.

To cite this article: Hastan D, Fokkens WJ, Bachert C, Newson RB, Bislimovska J, Bockelbrink A, Bousquet PJ, Brozek G, Bruno A, Dahlén SE, Forsberg B, Gunnbjörnsdóttir M, Kasper L, Krämer U, Kowalski ML, Lange B, Lundbäck B, Salagean E, Todo‐Bom A, Tomassen P, Toskala E, van Drunen CM, Bousquet J, Zuberbier T, Jarvis D, Burney P. Chronic rhinosinusitis in Europe – an underestimated disease. A GA2LEN study. Allergy 2011; 66: 1216–1223.

Knowledge of risk factors, and warning signs of stroke: a systematic review from a gender perspective

Stroke is one of the leading causes of death globally. Awareness of stroke risk factors and warning signs are important for stroke prevention and seeking care. The purpose of this systematic review was to review existing literature that assessed the knowledge of stroke risk factors and warning signs and allowed separate gender analysis. We conducted a systematic review of all published studies (to August 2008) examining knowledge of stroke risk factors and warning signs that included women and provided results separated by gender. Two reviewers selected studies for inclusion, assessed quality, and extracted data. The database search identified 2158 references for screening and 158 were selected for possible inclusion. Twenty-two studies were reviewed including 20 cross-sectional and two pretest–posttest design surveys. Overall, better stroke knowledge was observed in women compared with men in the majority of the studies although there is a general lack of knowledge in both genders. Four out of 18 studies reported better risk factor knowledge and eight out of 15 studies reported better knowledge in stroke warning signs in women compared with men. Women tended to know more evidence-based stroke risk factors than men. Stroke knowledge also appeared to be related to country of study origin, age, education, and medical history. Stroke knowledge among different populations and both in men and women is suboptimal. More research is necessary to further investigate gender differences in stroke knowledge with specific focus on how to use these differences to improve public health campaigns.

The natural history of allergic rhinitis in childhood.

Keil T, Bockelbrink A, Reich A, Hoffmann U, Kamin W, Forster J, Schuster A, Willich SN, Wahn U, Lau S. The natural history of allergic rhinitis in childhood.
Pediatr Allergy Immunol 2010: 21: 962–969.
© 2010 John Wiley & Sons A/S

Primary versus secondary immunoglobulin E sensitization to soy and wheat in the Multi-Centre Allergy Study cohort

Background IgE sensitization to soy and wheat is classified as ‘primary’ when generated by food ingestion and ‘secondary’ when it as a consequence of primary sensitization to cross‐reacting pollen antigens via inhalation. The age‐specific relevance of these categories of sensitization throughout childhood is unknown.

Dynamic evolution of serum immunoglobulin E to airborne allergens throughout childhood: results from the Multi-Centre Allergy Study birth cohort

Background Allergic rhinoconjunctivitis and asthma evolve dynamically throughout childhood. Yet, data on the evolution of serum levels of IgE antibodies against airborne allergens throughout the first decade of life are scarce.

Cataract Surgery and the Development or Progression of Age-related Macular Degeneration: A Systematic Review

Age-related macular degeneration and cataract are the most frequent eye disorders of elderly people worldwide. The aim of this systematic review was to evaluate the effect of cataract surgery on the development and progression of age-related macular degeneration. Data were collected by means of a systematic literature search in 28 databases and an additional update in Pubmed. Search results were evaluated using pre-defined inclusion and exclusion criteria. All relevant publications were rated in terms of scientific quality and analyzed regarding their results. The literature search generated a total of 2,827 hits. Seven publications on five observational studies and two non-randomized clinical trials were eligible for analysis. The observational studies provided some evidence for an increased incidence of late age-related macular degeneration, respectively, for a promoting influence of cataract surgery on the progression of early types of age-related macular degeneration. The clinical trials did yield inconsistent results. In conclusion, only a small number of published studies investigated the development or progression of age-related macular degeneration following cataract surgery. The scientific level of evidence of these articles was not high and results were inconsistent, nevertheless a promoting influence of cataract surgery on the progression of early age-related macular degeneration can be assumed.

Effectiveness of nonpharmacological secondary prevention of coronary heart disease

Aim To summarize the current evidence with regard to the effectiveness of nonpharmacological secondary prevention strategies of coronary heart disease (CHD) and to investigate the comparative effectiveness of interventions of different categories, specific intervention components and the effectiveness in patient subgroups. Methods A structured search of databases and manual search were conducted. Clinical trials and meta-analyses published between January 2003 and September 2008 were included if they targeted adults with CHD, had a follow-up of at least 12 months, and reported mortality, cardiac events or quality of life. Two researchers assessed eligibility and methodological quality, in which appropriate, pooled effect estimates were calculated and tested in sensitivity analyses. Results Of 4798 publications 43 met the inclusion criteria. Overall study quality was satisfactory, but only about half of the studies reported mortality. Follow-up duration varied between 12 and 120 months. Despite substantial heterogeneity, there was strong evidence of intervention effectiveness overall. The evidence for exercise and multimodal interventions was more conclusive for reducing mortality, whereas psychosocial interventions seemed to be more effective in improving the quality of life. Rigorous studies investigating dietary and smoking cessation interventions, specific intervention components and important patient subgroups, were scarce. Conclusion Nonpharmacological secondary prevention is safe and effective, with exercise and multimodal interventions reducing mortality most substantially. There is a lack of studies concerning dietary and smoking cessation interventions. In addition, intervention effectiveness in patient subgroups and of intervention components could not be evaluated conclusively. Future research should investigate these issues in rigorous studies with appropriate follow-up duration to improve the current poor risk factor control of CHD patients.

Educational intervention to improve physician reporting of adverse drug reactions (ADRs) in a primary care setting in complementary and alternative medicine

BackgroundRecent studies have shown that adverse drug reactions (ADRs) are underreported. This may be particularly true of ADRs associated with complementary and alternative medicine (CAM). Data on CAM-related ADRs, however, are sparse.Objective was to evaluate the impact of an educational intervention and monitoring programme designed to improve physician reporting of ADRs in a primary care setting.MethodsA prospective multicentre study with 38 primary care practitioners specialized in CAM was conducted from January 2004 through June 2007. After 21 month all physicians received an educational intervention in terms of face-to-face training to assist them in classifying and reporting ADRs. The study centre monitored the quantity and quality of ADR reports and analysed the results.To measure changes in the ADR reporting rate, the median number of ADR reports and interquartile range (IQR) were calculated before and after the educational intervention. The pre-intervention and post-intervention quality of the reports was assessed in terms of changes in the completeness of data provided for obligatory items. Interrater reliability between the physicians and the study centre was calculated using Cohens kappa with a 95% confidence interval (CI). We used Mann Whitney U-test for testing continuous data and chi-square test was used for categorical data. The level of statistical significance was set at P < 0.05.ResultsA total of 404 ADRs were reported during the complete study period. An initial 148% increase (P = 0.001) in the number of ADR reports was observed after the educational intervention. Compared to baseline the postinterventional number of ADR reportings was statistically significant higher (P < 0.005) through the first 16 months after the intervention but not significant in the last 4-month period (median: 8.00 (IQR [2.75; 8.75]; P = 0.605). The completeness of the ADR reports increased from 80.3% before to 90.7% after the intervention. The completeness of the item for classifying ADRs as serious or non-serious increased significantly (P < 0.001) after the educational intervention. The quality of ADR reports increased from kappa 0.15 (95% CI: 0.08; 0.29) before to 0.43 (95% CI: 0.23; 0.63) after the intervention.ConclusionThe results of the present study demonstrate that an educational intervention can increase physician awareness of ADRs. Participating physicians were able to incorporate the knowledge they had gained from face-to-face training into their daily clinical practice. However, the effects of the intervention were temporary.

Stereotactic radiosurgery for the treatment of brain metastases

BACKGROUND The objective of this systematic review was to summarise the current evidence concerning radiosurgical treatment (SRS) of newly diagnosed brain metastasis and to compare SRS as a single or additional treatment to treatment alternatives with regard to medical effectiveness and safety. METHODS A structured search of electronic databases was performed to identify relevant publications from 2002 through 2007. Studies targeting patients with brain metastases were included. Standardised quality assessment and data extraction were performed. RESULTS Of 1496 publications, 16 studies were included. The mean survival in most studies was less than 12 months. There was evidence that SRS plus WBRT was associated with improved local tumour control and neurological functioning compared to either treatment alone. Only in patients with single metastasis, this resulted in improved survival. There was inconclusive evidence when comparing SRS to WBRT, Neurosurgery (NS) or Hypofractionated Radiotherapy (HCSRT). The Quality of life (Qol) was not investigated. CONCLUSION SRS plus WBRT was associated with improved local tumour control and neurological functioning compared to either treatment alone. Only in certain patients, this resulted in improved survival. Methodologically rigorous studies are therefore warranted to investigate further treatment options, and in view of the poor prognosis, to investigate Qol and neurological functioning.

Longitudinal trends of total and allergen‐specific IgE throughout childhood

Background:  The development and the quantitative relationship between allergen‐specific IgE (S‐IgE) responses and total IgE (T‐IgE), during childhood and adolescence have not been described and understood in detail. The objective of this study was to describe and compare the longitudinal trends of serum levels of S‐IgE and T‐IgE during childhood.