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Songiso M, Nuñez O, Cabanes A, Mutale M, Munalula J, Pupwe G, Henry-Tillman R, Parham GP. Three-year survival of breast cancer patients attending a one-stop breast care clinic nested within a primary care health facility in sub-Saharan Africa-Zambia. Int J Cancer 2024; 155:261-269. [PMID: 38525795 PMCID: PMC11096003 DOI: 10.1002/ijc.34920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/26/2024]
Abstract
In Zambia, women with breast symptoms travel through multiple levels of the healthcare system before obtaining a definitive diagnosis. To eradicate this critical barrier to care, we nested a novel breast specialty service platform inside a large public-sector primary healthcare facility in Lusaka, Zambia to offer clinical breast examination, breast ultrasound, and ultrasound-guided core needle biopsy in a one-stop format, tightly linked to referral for treatment. The objective of the study was to determine the life expectancy and survival outcomes of a prospective cohort of women diagnosed with breast cancer who were attended to and followed up at the clinic. The effect of breast cancer stage on prognosis was determined by estimating stage-specific crude survival using the Kaplan-Meier method. Survival analysis was used to estimate mean lifespan according to age and stage at diagnosis. We enrolled 302 women with histologically confirmed breast cancer. The overall 3-year survival was 73%. An increase in patients presenting with early breast cancer and improvements in their survival were observed. Women with early-stage breast cancer had a lifespan similar to the general population, while loss of life expectancy was significant at more advanced stages of disease. Our findings suggest that implementing efficient breast care services at the primary care level can avert a substantial proportion of breast cancer-related deaths. The mitigating factor appears to be stage of disease at the time of diagnosis, the cause of which is multifactorial, with the most influential being delays in the referral process.
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Affiliation(s)
- Mutumba Songiso
- Levy Mwanawasa University Teaching Hospital, Lusaka, Zambia
- Levy Mwanawasa Medical University, Lusaka, Zambia
| | - Olivier Nuñez
- National Center of Epidemiology (Pab,12) Instituto de Salud Carlos III Monforte de Lemos 5 28029 Madrid, Spain
| | | | - Mpimpa Mutale
- University of Lusaka, Department of Physiological Sciences, Lusaka, Zambia
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Parisi A, Nuñez O, López-Perea N, Masa-Calles J. Reduced pertussis disease severity in infants following the introduction of pertussis vaccination of pregnant women in Spain, 2015-2019. Vaccine 2024; 42:2810-2816. [PMID: 38531728 DOI: 10.1016/j.vaccine.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 02/21/2024] [Accepted: 03/11/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Maternal pertussis vaccination during the third trimester of pregnancy was implemented in 2015 in Spain, reaching a national coverage of 84% in 2019. In this ecological study, we investigated whether there was a change in the disease severity for pertussis in infants upon introduction of prenatal pertussis vaccination. METHODS We performed a time-trend analysis of infant pertussis hospitalizations during 2005-2019 in Spain using national register data. Annual hospitalization rates per 100,000 population and the mean length of hospitalization were calculated for infants < 3 months of age (target group benefiting from the prenatal vaccination) and a reference group aged 3-11 months. We compared overall rates and annual percent changes of the above variables in both groups for the time period before (2005-2014) and after vaccination introduction (2015-2019), using segmented Poisson regression. RESULTS During the pre-vaccination period, infants aged 0-2 months had a 5-times higher rate of pertussis hospitalization and spent on average 50 % longer in hospital than the reference group. After the maternal vaccination introduction, the hospitalization rate decreased more rapidly in infants aged 0-2 months than in infants aged 3-11 months: annual reduction of 34 % (95 % CI: 31-38) versus 26 % (95 % CI: 21-31) in the hospitalization rate and 13 % (95 % CI: 11-15) versus 6 % (95 % CI: 2-9) in the mean hospital stay, respectively. In 2019, the mean hospital stay for pertussis was about 4.5 days in both groups. CONCLUSIONS Maternal pertussis vaccination in Spain led to a reduction in disease severity in the target group as compared to older infants, highlighting the need for increased efforts on educating healthcare professionals on the importance of maternal vaccinations.
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Affiliation(s)
- Andrea Parisi
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | - Olivier Nuñez
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Noemí López-Perea
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Josefa Masa-Calles
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Redondo-Sánchez D, Fernández-Navarro P, Rodríguez-Barranco M, Nuñez O, Petrova D, García-Torrecillas JM, Jiménez-Moleón JJ, Sánchez MJ. Socio-economic inequalities in lung cancer mortality in Spain: a nation-wide study using area-based deprivation. Int J Equity Health 2023; 22:145. [PMID: 37533035 PMCID: PMC10399030 DOI: 10.1186/s12939-023-01970-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/19/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Lung cancer is the main cause of cancer mortality worldwide and in Spain. Several previous studies have documented socio-economic inequalities in lung cancer mortality but these have focused on specific provinces or cities. The goal of this study was to describe lung cancer mortality in Spain by sex as a function of socio-economic deprivation. METHODS We analysed all registered deaths from lung cancer during the period 2011-2017 in Spain. Mortality data was obtained from the National Institute of Statistics, and socio-economic level was measured with the small-area deprivation index developed by the Spanish Society of Epidemiology, with the census tract of residence at the time of death as the unit of analysis. We computed crude and age-standardized rates per 100,000 inhabitants by sex, deprivation quintile, and type of municipality (rural, semi-rural, urban) considering the 2013 European standard population (ASR-E). We further calculated ASR-E ratios between the most deprived (Q5) and the least deprived (Q1) areas and mapped census tract smoothed standardized lung cancer mortality ratios by sex. RESULTS We observed 148,425 lung cancer deaths (80.7% in men), with 73.5 deaths per 100,000 men and 17.1 deaths per 100,000 women. Deaths from lung cancer in men were five times more frequent than in women (ASR-E ratio = 5.3). Women residing in the least deprived areas had higher mortality from lung cancer (ASR-E = 22.2), compared to women residing in the most deprived areas (ASR-E = 13.2), with a clear gradient among the quintiles of deprivation. For men, this pattern was reversed, with the highest mortality occurring in areas of lower socio-economic level (ASR-E = 99.0 in Q5 vs. ASR-E = 86.6 in Q1). These socio-economic inequalities remained fairly stable over time and across urban and rural areas. CONCLUSIONS Socio-economic status is strongly related to lung cancer mortality, showing opposite patterns in men and women, such that mortality is highest in women residing in the least deprived areas and men residing in the most deprived areas. Systematic surveillance of lung cancer mortality by socio-economic status may facilitate the assessment of public health interventions aimed at mitigating cancer inequalities in Spain.
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Grants
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- PI18/01593 EU/FEDER Instituto de Salud Carlos III
- PI18/01593 EU/FEDER Instituto de Salud Carlos III
- PI18/01593 EU/FEDER Instituto de Salud Carlos III
- Not applicable Acciones de Movilidad CIBERESP, 2022
- JC2019-039691-I Juan de la Cierva Fellowship from the Ministry of Science and the National Research Agency of Spain
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Affiliation(s)
- Daniel Redondo-Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain.
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain.
| | - Pablo Fernández-Navarro
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, 28029, Spain
| | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain
| | - Olivier Nuñez
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, 28029, Spain
| | - Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain
| | - Juan Manuel García-Torrecillas
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Emergency and Research Unit, Torrecárdenas University Hospital, Almería, 04009, Spain
| | - Jose Juan Jiménez-Moleón
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, 18071, Spain
| | - María-José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain
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Asenjo S, Nuñez O, Segú-Tell J, Pardo Romaguera E, Cañete Nieto A, Martín-Méndez I, Bel-Lan A, García-Pérez J, Cárceles-Álvarez A, Ortega-García JA, Ramis R. Cadmium (Cd) and Lead (Pb) topsoil levels and incidence of childhood leukemias. Environ Geochem Health 2022; 44:2341-2354. [PMID: 34286388 DOI: 10.1007/s10653-021-01030-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/30/2021] [Indexed: 06/13/2023]
Abstract
There are few well-established risk factors for childhood leukemias. While the frequency of childhood leukemias might be partially attributable to some diseases (accounting for a small fraction of cases) or ionizing radiation, the role of heavy metals has not been assessed. The objective of our study was to assess the potential association between levels of cadmium (Cd) and lead (PB) in soil and childhood leukemias incidence. We conducted a population-based case-control study of childhood leukaemia in Spain, covering 2897 incident cases gathered from the Spanish Registry of Childhood Tumours and including 14 Spanish Regions with a total population of 5,307,433 children (period 1996-2015). Cd and Pb bioavailable levels at every children's home address were estimated using data from the Geochemical Atlas of Spain. We used logistic regression to estimate odds ratios (ORs) and their 95% confidence intervals (95%CIs); we included as covariates: sex, rurality, employment rate and socioeconomic status. Metal levels were analysed according to two definitions: as continuous variable assuming linearity and as categorical variables to explore a potentially nonlinear association (quantiles). Increases in both Cd and Pb topsoil levels were associated with increased probability of childhood leukemias incidence. The results for the models with the continuous variables showed that a unit increase on the topsoil level was associated with an OR of 1.11 for Cd (95%CI 1.00-1.24) and an OR of 1.10 for Pb (95%CI 0.99-1.21). Our study may point towards a possible link between residential Cd and Pb topsoil levels and the probability of childhood leukemias incidence. Residing in a location with the highest concentrations of these heavy metals compared to those locations with the lowest could increase the risk around a 20%, for both Cd and Pb.
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Affiliation(s)
| | - Olivier Nuñez
- Cancer and Environmental Epidemiology Unit, National Centre of Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Centre for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Jordi Segú-Tell
- Cancer and Environmental Epidemiology Unit, National Centre of Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Centre for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Elena Pardo Romaguera
- Spanish Registry of Childhood Tumours (RETI-SEHOP), University of Valencia, Valencia, Spain
| | - Adela Cañete Nieto
- Spanish Registry of Childhood Tumours (RETI-SEHOP), University of Valencia, Valencia, Spain
- H. Universitario y Politécnico La Fe, Valencia, Spain
| | | | | | - Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, National Centre of Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Centre for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Alberto Cárceles-Álvarez
- Paediatric Environmental Health Speciality Unit, Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Clinical University Hospital Virgen de la Arrixaca, Murcia, Spain
- European and Latin American Environment, Survival and Childhood Cancer Network (ENSUCHICA), Murcia, Spain
| | - Juan Antonio Ortega-García
- Paediatric Environmental Health Speciality Unit, Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Clinical University Hospital Virgen de la Arrixaca, Murcia, Spain
- European and Latin American Environment, Survival and Childhood Cancer Network (ENSUCHICA), Murcia, Spain
| | - Rebeca Ramis
- Cancer and Environmental Epidemiology Unit, National Centre of Epidemiology, Carlos III Institute of Health, Madrid, Spain.
- Centre for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
- European and Latin American Environment, Survival and Childhood Cancer Network (ENSUCHICA), Murcia, Spain.
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5
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Ayuso-Álvarez A, Nuñez O, Martín-Méndez I, Bel-Lán A, Tellez-Plaza M, Pérez-Gómez B, Galán I, Fernández-Navarro P. Metal and metalloid levels in topsoil and municipal cardiovascular mortality in Spain. Environ Res 2022; 204:112395. [PMID: 34800529 DOI: 10.1016/j.envres.2021.112395] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 06/13/2023]
Abstract
The role of metals and metalloids beyond arsenic, copper, lead and cadmium in cardiovascular disease is not entirely clear. The aim of this study was to assess the association between 18 metal or metalloid levels in topsoil (upper soil horizon) with all-cause and specific cardiovascular mortality endpoints in Spain. We designed an ecological spatial study, to assess cardiovascular mortality in 7941 Spanish mainland towns from 2010 to 2014. The estimation of metals and metalloids concentration in topsoil came from the Geochemical Atlas of Spain from 13,317 soil samples. We also summarized the joint variability of the metals using principal components analysis (PCA). These components (PCs) were included in a Besag, York, and Mollié model to assess their association with cardiovascular mortality from all causes, coronary heart disease, cerebrovascular, hypertension, and conduction disorders. Our results showed, both in men and women, that at the lowest component scores range, PC2 (mainly reflecting Al, Be, Tl and U) was positively associated with coronary heart disease and cerebrovascular mortality. At medium/highest scores range, PC4 (mainly reflecting Hg) was positively associated with cerebrovascular mortality. For PC3 (reflecting Se), the association with coronary heart disease mortality was positive only in men at the highest PC scores range. For PC1 (partly reflecting metals such as Pb, As, Cu or Cd), we observed a strongly suggestive positive association with all-cause cardiovascular diseases mortality. Our ecological results are consistent with the available evidence supporting a cardiovascular role of excessive exposure to Se, Hg, Pb, As, Cu and Cd, but also identify Al, Be, Tl and U as potentially novel cardiovascular factors. Additional research is needed to confirm the biological relevance of our findings.
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Affiliation(s)
- Ana Ayuso-Álvarez
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Faculty of Economics and Business, Autonomous University of Madrid, Spain
| | - Olivier Nuñez
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Iván Martín-Méndez
- Geological Survey of Spain (Instituto Geológico y Minero de España, IGME-CSIC), Spain
| | - Alejandro Bel-Lán
- Geological Survey of Spain (Instituto Geológico y Minero de España, IGME-CSIC), Spain
| | - Maria Tellez-Plaza
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Autonomous University of Madrid/IdiPAZ, Madrid, Spain
| | - Beatriz Pérez-Gómez
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Iñaki Galán
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Autonomous University of Madrid/IdiPAZ, Madrid, Spain
| | - Pablo Fernández-Navarro
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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Nuñez O, Rodríguez Barranco M, Fernández-Navarro P, Redondo Sanchez D, Luque Fernández MÁ, Pollán Santamaría M, Sánchez MJ. Deprivation gap in colorectal cancer survival attributable to stage at diagnosis: A population-based study in Spain. Cancer Epidemiol 2020; 68:101794. [PMID: 32795946 DOI: 10.1016/j.canep.2020.101794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/21/2020] [Accepted: 07/27/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Socioeconomic inequalities in colorectal cancer (CRC) survival are a major concern of the Spanish public health system. If these inequalities were mainly due to differences in stage at diagnosis, population-based screening programs might reduce them substantially. We aimed to determine to what extent adverse stage distribution contributed to survival inequalities in a Spanish region before the implementation of a CRC screening program. METHODS We analyzed data from a population-based cohort study that included all patients living in a region of southern Spain with CRC diagnosed between 2004 and 2013. The European Deprivation Index was used to assign each patient a socioeconomic level based on their area of residence. The role of tumor stage in survival disparities between socioeconomic groups was assessed using a causal mediation analysis. RESULTS A total of 2802 men and 1957 women were included in the study. For men, the adjusted difference in deaths between the most deprived and the most affluent areas was 131 deaths per 1000 person-years by the first year after diagnosis. Of these deaths, 42 (per 1000 person-years) were attributable to differences in stage at diagnosis. No socioeconomic disparities in survival were detected among female patients. CONCLUSIONS In this study, we mainly detected socioeconomic disparities in short term survival of male patients. More than two thirds of these inequalities could not be attributed to differences in stage at diagnosis. Our results suggest that in addition to a screening program, other public health interventions are necessary to reduce the deprivation gap in survival.
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Affiliation(s)
- Olivier Nuñez
- Cancer & Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Miguel Rodríguez Barranco
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Granada Cancer Registry, Andalusian School of Public Health, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Non-Communicable and Cancer Epidemiology Group, University of Granada, Spain
| | - Pablo Fernández-Navarro
- Cancer & Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - Daniel Redondo Sanchez
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Granada Cancer Registry, Andalusian School of Public Health, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Non-Communicable and Cancer Epidemiology Group, University of Granada, Spain
| | - Miguel Ángel Luque Fernández
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Granada Cancer Registry, Andalusian School of Public Health, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Non-Communicable and Cancer Epidemiology Group, University of Granada, Spain; London School of Hygiene and Tropical Medicine, Non-communicable Disease Epidemiology, London, UK
| | - Marina Pollán Santamaría
- Cancer & Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - María-José Sánchez
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Granada Cancer Registry, Andalusian School of Public Health, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Non-Communicable and Cancer Epidemiology Group, University of Granada, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
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7
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Ayuso-Álvarez A, Simón L, Nuñez O, Rodríguez-Blázquez C, Martín-Méndez I, Bel-Lán A, López-Abente G, Merlo J, Fernandez-Navarro P, Galán I. Association between heavy metals and metalloids in topsoil and mental health in the adult population of Spain. Environ Res 2019; 179:108784. [PMID: 31606614 DOI: 10.1016/j.envres.2019.108784] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/27/2019] [Accepted: 09/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVES Despite the biological plausibility of the association between heavy metal exposure and mental health disorders, epidemiological evidence remains scarce. The objective was to estimate the association between heavy metals and metalloids in soil and the prevalence of mental disorders in the adult population of Spain. METHODS Individual data came from the Spanish National Health Survey 2011-2012, 18,073 individuals residing in 1772 census sections. Mental health was measured with the 12-item General Health Questionnaire. The concentration estimates of heavy metal and metalloid levels in topsoil (upper soil horizon) came from the Geochemical Atlas of Spain based on 13,317 soil samples. Levels of lead (Pb), arsenic (As), cadmium (Cd) and manganese (Mn) were estimated in each census section by "ordinary Kriging". Odds ratios (OR) were calculated by multilevel logistic regression models. RESULTS Compared with the lowest Pb concentration levels quartile, the OR for the second quartile was 1.29 (95%CI: 1.11-1.50), increasing progressively to 1.37 (95%CI: 1.17-1.60) and 1.51 (95%CI: 1.27-1.79) in the third and fourth quartiles, respectively. For As, the association was observed in the third and fourth quartiles: 1.21 (95%CI: 1.04-1.41) and 1.42 (95% CI: 1.21-1.65), respectively. Cd was associated also following a gradient from the second quartile: 1.34 (95%CI: 1.15-1.57) through the fourth: 1.84 (95%CI: 1.56-2.15). In contrast, Mn only showed a positive association at the second quartile. Additionally, individuals consuming vegetables > once a day the OR for the fourth quartile of Pb concentration, vs. the first, increased to 2.93 (95%CI: 1.97-4.36); similarly for As: 3.00 (95%CI: 2.08-4.31), and for Cd: 3.49 (95%CI: 2.33-5.22). CONCLUSIONS Living in areas with a higher concentration of heavy metals and metalloids in soil was associated with an increased probability of having a mental disorder. These relationships were strengthened in individuals reporting consuming vegetables > once a day.
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Affiliation(s)
- A Ayuso-Álvarez
- Department of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, Autonomous University of Madrid/IdiPAZ, Madrid, Spain
| | - L Simón
- Department of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - O Nuñez
- Cancer & Environmental Epidemiology Unit, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - C Rodríguez-Blázquez
- Department of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - I Martín-Méndez
- Geochemistry Unit, Geological and Mining Institute of Spain, Madrid, Spain
| | - A Bel-Lán
- Geochemistry Unit, Geological and Mining Institute of Spain, Madrid, Spain
| | - G López-Abente
- Cancer & Environmental Epidemiology Unit, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - J Merlo
- Research Unit of Social Epidemiology, Faculty of Medicine, Lund University, Malmö, Sweden
| | - P Fernandez-Navarro
- Cancer & Environmental Epidemiology Unit, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - I Galán
- Department of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, Autonomous University of Madrid/IdiPAZ, Madrid, Spain.
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Nuñez O, Baldi BG, Radzikowska E, Carvalho CRR, Herranz C, Sobiecka M, Torre O, Harari S, Vergeer MAMH, Kolbe J, Pollán M, Pujana MA. Risk of breast cancer in patients with lymphangioleiomyomatosis. Cancer Epidemiol 2019; 61:154-156. [PMID: 31260937 DOI: 10.1016/j.canep.2019.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 05/03/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
Lymphangioleiomyomatosis (LAM) is a rare metastasizing pulmonary disease that shares some clinical, cellular, and molecular similarities with metastatic breast cancer to lung. LAM cells have been identified circulating in various body fluids of patients and, intriguingly, diverse evidence indicates that these cells may originate from a different organ to the lung. Following on from these observations, we hypothesized the existence of a common risk basis between LAM and breast cancer, and suggested increased risk of breast cancer among LAM patients. Here, by studying two additional LAM cohorts with more detailed epidemiological, life-style, and disease-related data, we show consistent results; a potential excess of estrogen-receptor-positive young breast cancer cases in LAM. This observation further suggests the need of prospective studies to precisely assess the association between both diseases.
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Affiliation(s)
- Olivier Nuñez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, and Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Bruno G Baldi
- Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Elżbieta Radzikowska
- Department of Lung Diseases III, National Tuberculosis and Lung Disease Research Institute, Warsaw, Poland
| | - Carlos R R Carvalho
- Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Carmen Herranz
- ProCURE, Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Catalonia, Spain
| | - Malgorzata Sobiecka
- Department of Lung Diseases I, National Tuberculosis and Lung Diseases Research Institute, Poland
| | - Olga Torre
- U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria, Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe, MultiMedica IRCCS, Milan, Italy
| | - Sergio Harari
- U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria, Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe, MultiMedica IRCCS, Milan, Italy
| | - Menno A M H Vergeer
- Department of Internal Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - John Kolbe
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, and Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Miquel Angel Pujana
- ProCURE, Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Catalonia, Spain.
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Rodriguez-Sanchez L, Fernández-Navarro P, López-Abente G, Nuñez O, Fernández de Larrea-Baz N, Jimenez-Moleón JJ, Páez Borda Á, Pollán M, Perez-Gomez B. Different spatial pattern of municipal prostate cancer mortality in younger men in Spain. PLoS One 2019; 14:e0210980. [PMID: 30682085 PMCID: PMC6347247 DOI: 10.1371/journal.pone.0210980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/04/2019] [Indexed: 11/25/2022] Open
Abstract
Background Prostate cancer (PC) primarily affects elderly men. However, the specific features of cases diagnosed at younger ages (<65 years) suggest that they may represent a different clinical subtype. Our aim was to assess this suggestion by contrasting the geographical PC mortality and hospital admissions patterns in Spain for all ages to those in younger men. Methods The Spanish National Institute of Statistics supplied data on PC mortality, hospital admission, and population data. We estimated the expected town-specific number of deaths and calculated the standardized mortality ratios. Spatial autoregressive models of Besag-York-Mollié provided smoother municipal estimators of PC mortality risk (all ages; <65 years). We computed the provincial age-standardized rate ratios of PC hospital admissions (all men; <60 years) using Spanish rates as the reference. Results A total of 29,566 PC deaths (6% among those <65 years) were registered between 2010–2014, with three high-mortality risk zones: Northwest Spain; Southwest Andalusia & Granada; and a broad band extending from the Pyrenees Mountains to the north of Valencia. In younger men, the spatial patterns shared the high risk of mortality in the Northwest but not the central band. The PC hospital discharge rates confirmed a North-South gradient but also low mortality/high admission rates in Madrid and Barcelona and the opposite in Southwest Andalusia. Conclusion The consistent high PC mortality/morbidity risk in the Northwest of Spain indicates an area with a real excess of risk. The different spatial pattern in younger men suggests that some factors associated with geographical risk might have differential effects by age. Finally, the regional divergences in mortality and morbidity hint at clinical variability as a source of inequity within Spain.
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Affiliation(s)
- Lara Rodriguez-Sanchez
- Urology Department, Fuenlabrada General Hospital, Fuenlabrada, Spain
- Rey Juan Carlos University, Móstoles, Spain
| | - Pablo Fernández-Navarro
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Gonzalo López-Abente
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Olivier Nuñez
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Nerea Fernández de Larrea-Baz
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Jose Juan Jimenez-Moleón
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Complejo Hospitales Universitarios, Granada, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Álvaro Páez Borda
- Urology Department, Fuenlabrada General Hospital, Fuenlabrada, Spain
- Rey Juan Carlos University, Móstoles, Spain
| | - Marina Pollán
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Beatriz Perez-Gomez
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
- Cardiovascular & Metabolic Diseases Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- * E-mail:
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Seoane-Mato D, Nuñez O, Fernández-de-Larrea N, Pérez-Gómez B, Pollán M, López-Abente G, Aragonés N. Long-term trends in pancreatic cancer mortality in Spain (1952-2012). BMC Cancer 2018; 18:625. [PMID: 29866063 PMCID: PMC5987643 DOI: 10.1186/s12885-018-4494-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/09/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Pancreatic cancer is acquiring increasing prominence as a cause of cancer death in the population. The purpose of this study was to analyze long-term pancreatic cancer mortality trends in Spain and evaluate the independent effects of age, death period and birth cohort on these trends. METHODS Population and mortality data for the period 1952-2012 were obtained from the Spanish National Statistics Institute. Pancreatic cancer deaths were identified using the International Classification of Diseases ICD-6 to ICD-9 (157 code) and ICD-10 (C25 code). Age-specific and age-adjusted mortality rates were computed by sex, region and five-year period. Changes in pancreatic cancer mortality trends were evaluated using joinpoint regression analyses by sex and region. Age-period-cohort log-linear models were fitted separately for each sex, and segmented regression models were used to detect changes in period- and cohort-effect curvatures. RESULTS In men, rates increased by 4.1% per annum from 1975 until the mid-1980s and by 1.1% thereafter. In women, there was an increase of 3.6% per annum until the late 1980s, and 1.4% per annum from 1987 to 2012. With reference to the cohort effects, there was an increase in mortality until the generations born in the 1950s in men and a subsequent decline detected by the change point in 1960. A similar trend was observed in women, but the change point occurred 10 years later than in men. CONCLUSIONS Pancreatic cancer mortality increased over the study period in both sexes and all regions. An important rise in rates -around 4% annually- was registered until the 1980s, and upward trends were more moderate subsequently. The differences among sexes in trends in younger generations may be linked to different past prevalence of exposure to some risk factors, particularly tobacco, which underwent an earlier decrease in men than in women.
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Affiliation(s)
| | - Olivier Nuñez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid, Spain
| | - Nerea Fernández-de-Larrea
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid, Spain
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid, Spain
| | - Gonzalo López-Abente
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid, Spain
| | - Nuria Aragonés
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid, Spain
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11
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Nuñez O, Román A, Johnson SR, Inoue Y, Hirose M, Casanova Á, de Garibay GR, Herranz C, Bueno-Moreno G, Boni J, Mateo F, Petit A, Climent F, Soler T, Vidal A, Sánchez-Mut JV, Esteller M, López JI, García N, Gumà A, Ortega R, Plà MJ, Campos M, Ansótegui E, Molina-Molina M, Valenzuela C, Ussetti P, Laporta R, Ancochea J, Xaubet A, Pollán M, Pujana MA. Study of breast cancer incidence in patients of lymphangioleiomyomatosis. Breast Cancer Res Treat 2016; 156:195-201. [PMID: 26951504 PMCID: PMC4788694 DOI: 10.1007/s10549-016-3737-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 02/27/2016] [Indexed: 11/30/2022]
Abstract
Molecular evidence has linked the pathophysiology of lymphangioleiomyomatosis (LAM) to that of metastatic breast cancer. Following on this observation, we assessed the association between LAM and subsequent breast cancer. An epidemiological study was carried out using three LAM country cohorts, from Japan, Spain, and the United Kingdom. The number of incident breast cancer cases observed in these cohorts was compared with the number expected on the basis of the country-specific incidence rates for the period 2000–2014. Immunohistochemical studies and exome sequence analysis were performed in two and one tumors, respectively. All cohorts revealed breast cancer standardized incidence ratios (SIRs) ≥ 2.25. The combined analysis of all cases or restricted to pre-menopausal age groups revealed significantly higher incidence of breast cancer: SIR = 2.81, 95 % confidence interval (CI) = 1.32–5.57, P = 0.009; and SIR = 4.88, 95 % CI = 2.29–9.99, P = 0.0007, respectively. Immunohistochemical analyses showed positivity for known markers of lung metastatic potential. This study suggests the existence of increased breast cancer risk among LAM patients. Prospective studies may be warranted to corroborate this result, which may be particularly relevant for pre-menopausal women with LAM.
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Affiliation(s)
- Olivier Nuñez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, and Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Sinesio Delgado 6, 28029, Madrid, Spain
| | - Antonio Román
- Lung Transplant Unit, Department of Pulmonology, Lymphangioleiomyomatosis Clinic, Vall d'Hebron University Hospital, 08035, Barcelona, Catalonia, Spain
| | - Simon R Johnson
- National Centre for Lymphangioleiomyomatosis, Nottingham University Hospitals NHS Trust, Nottingham, Nottinghamshire, UK Division of Respiratory Medicine and Respiratory Research Unit, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Yoshikazu Inoue
- National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, 591-8555, Osaka, Japan
| | - Masaki Hirose
- National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, 591-8555, Osaka, Japan
| | - Álvaro Casanova
- Department of Pneumology, Henares Hospital, 28882, Madrid, Spain
| | - Gorka Ruiz de Garibay
- ProCURE, Breast Cancer and Systems Biology, Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), Gran via 199, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
| | - Carmen Herranz
- ProCURE, Breast Cancer and Systems Biology, Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), Gran via 199, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
| | - Gema Bueno-Moreno
- Department of Biochemistry, Autonomous University of Madrid (UAM), Biomedical Research Institute "Alberto Sols" (Spanish National Research Council (CSIC)-UAM), Hospital La Paz Institute for Health Research (IdiPAZ), 28029, Madrid, Spain
- MD Anderson International Foundation, 28033, Madrid, Spain
| | - Jacopo Boni
- ProCURE, Breast Cancer and Systems Biology, Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), Gran via 199, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
| | - Francesca Mateo
- ProCURE, Breast Cancer and Systems Biology, Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), Gran via 199, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
| | - Anna Petit
- Department of Pathology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
| | - Fina Climent
- Department of Pathology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
| | - Teresa Soler
- Department of Pathology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
| | - August Vidal
- Department of Pathology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
| | - José Vicente Sánchez-Mut
- Cancer Epigenetics and Biology Program, IDIBELL, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
| | - Manel Esteller
- Cancer Epigenetics and Biology Program, IDIBELL, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
- Department of Physiological Sciences II, School of Medicine, University of Barcelona, 08908, Barcelona, Catalonia, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), 08010, Barcelona, Catalonia, Spain
| | - José Ignacio López
- Cruces University Hospital, BioCruces Research Institute, University of the Basque Country, 48903, Barakaldo, Spain
| | - Nadia García
- ProCURE, Breast Cancer and Systems Biology, Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), Gran via 199, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
| | - Anna Gumà
- Department of Radiology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
| | - Raúl Ortega
- Department of Radiology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
| | - María Jesús Plà
- Breast Cancer Functional Unit, Department of Gynecology, University Hospital of Bellvitge, ICO, IDIBELL, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
| | - Miriam Campos
- Breast Cancer Functional Unit, Department of Medical Oncology, ICO, IDIBELL, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
| | - Emilio Ansótegui
- Lung Transplant and Cystic Fibrosis Unit, Hospital Universitario y Politecnico La Fe, 46026, Valencia, Spain
| | - María Molina-Molina
- Department of Pneumology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBERES), 28029, Madrid, Spain
| | - Claudia Valenzuela
- Department of Pneumology, Instituto de Investigación Sanitaria La Princesa, Hospital La Princesa, 28006, Madrid, Spain
| | - Piedad Ussetti
- Department of Pneumology, University Hospital Clínica Puerta del Hierro, 28222, Madrid, Spain
| | - Rosalía Laporta
- Department of Pneumology, University Hospital Clínica Puerta del Hierro, 28222, Madrid, Spain
| | - Julio Ancochea
- Department of Pneumology, Instituto de Investigación Sanitaria La Princesa, Hospital La Princesa, 28006, Madrid, Spain
| | - Antoni Xaubet
- Consortium for Biomedical Research in Respiratory Diseases (CIBERES), 28029, Madrid, Spain
- Department of Pneumology, Hospital Clinic of Barcelona, August Pi Suñer Biomedical Research Institute (IDIBAPS), 08036, Barcelona, Catalonia, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, and Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Sinesio Delgado 6, 28029, Madrid, Spain.
| | - Miguel Angel Pujana
- ProCURE, Breast Cancer and Systems Biology, Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), Gran via 199, L'Hospitalet del Llobregat, 08908, Barcelona, Catalonia, Spain.
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Gallart-Ayala H, Nuñez O, Moyano E, Galceran MT, Martins CPB. Preventing false negatives with high-resolution mass spectrometry: the benzophenone case. Rapid Commun Mass Spectrom 2011; 25:3161-3166. [PMID: 21953972 DOI: 10.1002/rcm.5200] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Benzophenone (BP) is one of the many contaminants reported as present in foodstuffs due to its migration from food packaging materials. Liquid chromatography/tandem mass spectrometry (LC/MS/MS) is acknowledged in the literature as the method of choice for this analysis. However, cases have been reported where the use of this methodology was insufficient to unambiguously confirm the presence of a contaminant. In previous work performed by the authors, the unequivocal identification of BP in packaged foods was not possible even when monitoring two m/z transitions (precursor ion - product ion), since ion ratio errors higher than 20% were obtained. In order to overcome this analytical problem a fast, sensitive and selective liquid chromatography/high-resolution mass spectrometry (LC/HRMS) methodology has been developed and applied to the analysis of BP in packaged foods. A direct comparison between LC/HRMS and LC/MS/MS data indicated better selectivity when working with LC/HRMS at a resolving power of 50,000 FWHM (full width at half maximum) than when monitoring two m/z transitions by LC/MS/MS. The resolving power used enabled the detection and identification of Harman as the compound impeding the confirmation of BP by LC-MS/MS. Similar quantitative results were obtained by an Orbitrap mass analyser (Exactive™) and a triple quadrupole mass analyser (TSQ Quantum Ultra AM™).
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Affiliation(s)
- H Gallart-Ayala
- Department of Analytical Chemistry, University of Barcelona, Barcelona, Spain
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14
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Rincon D, Lo Iacono O, Ripoll C, Gomez-Camarero J, Salcedo M, Catalina MV, Hernando A, Clemente G, Matilla A, Nuñez O, Bañares R. Prognostic value of hepatic venous pressure gradient for in-hospital mortality of patients with severe acute alcoholic hepatitis. Aliment Pharmacol Ther 2007; 25:841-8. [PMID: 17373923 DOI: 10.1111/j.1365-2036.2007.03258.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hepatic venous pressure gradient (HVPG) has prognostic value in complications and survival of patients with liver cirrhosis. However, the relationship between HVPG and the outcome of acute alcoholic hepatitis (AAH), as well as the specific features of portal hypertension syndrome in this setting, have not been defined. AIMS To evaluate the prognostic value of HVPG and to analyse the degree of portal hypertension and hyperdynamic circulation in patients with severe AAH. METHODS Early measurements of HVPG were performed in 60 patients with severe AAH, and compared with the haemodynamic findings of 37 and 29 liver transplantation candidates with alcoholic or viral end-stage cirrhosis respectively. RESULTS Twenty-three patients (38%) died during hospitalization. Portal hypertension and hyperdynamic circulation were more severe in AAH patients. HVPG was greater in non-survivors [26.9 (7.4) vs. 19.4 (5.2) mmHg, P < 0.001]. Only 4/31 (13%) patients with HVPG <or= 22 mmHg died from the episode of AAH, vs. 19/29 (66%) patients with HVPG > 22 (P < 0.001). Encephalopathy (OR 9.4; CI 1.4-64.8), Model for End-Stage Liver Disease (MELD) score > 25 (OR 7.4; CI 1.4-39.9) and HVPG > 22 mmHg (OR 6.7; CI 1.1-39.9) were independently associated to in-hospital mortality. CONCLUSIONS Early measurement of HVPG provides important prognostic information on the short-term outcome of patients with severe AAH. In addition, MELD score also seems to be a strong prognostic factor in these patients.
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Affiliation(s)
- D Rincon
- Sección de Hepatología, Servicio de Aparato Digestivo, Hospital Gregorio Marañon, Madrid, Spain
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15
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Alonso S, Bañares R, Barrio J, Rincón D, Nuñez O, Alvárez E, Vaquero J, de Diego A. [Diagnostic utility of hepatic hemodynamics study in hepatoportal sclerosis]. Gastroenterol Hepatol 2001; 24:473-7. [PMID: 11730614 DOI: 10.1016/s0210-5705(01)70217-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the diagnostic utility of catheterization of the suprahepatic veins in patients with suspected non-cirrhotic portal hypertension as well as to characterize the clinical features and evolution of this process. PATIENTS AND METHODS Hepatic hemodynamics studies, transjugular biopsy and venography were performed in seven patients with suspected non-cirrhotic portal hypertension. In all patients the combination of the three procedures gave the diagnosis of hepatoportal sclerosis, which was subsequently confirmed by direct portography and percutaneous or laparoscopic liver biopsy. RESULTS Three patients presented esophageal variceal bleeding at diagnosis. Only one patient required intrahepatic shunting due to refractory bleeding. None of the patients required surgical shunting or presented alterations in liver function. CONCLUSIONS Hepatic hemodynamics study with transjugular biopsy and venography is an effective procedure in the diagnosis of hepatoportal sclerosis and in most cases invasive confirmatory tests are not required. The course of the disease is relatively benign if variceal bleeding is controlled. The treatment of choice in these patients is pharmacological and endoscopic.
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Affiliation(s)
- S Alonso
- Laboratorio de Hemodinámica Hepática, Sección de Hepatología. Servicio de Aparato Digestivo, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
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16
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Nuñez O. [Current approach in the use and handling of different types of insulin in medical practice]. Prensa Med Argent 1967; 54:1244-50. [PMID: 5613412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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