Age-period-cohort analysis of lung cancer mortality inequalities in Southern Spain: missed opportunities for implementing equitable tobacco control policies

Background Lung cancer mortality in European countries shows different epidemiological patterns according to sex and socioeconomic variables. Some countries show decreasing rates in both sexes, while others show a delayed profile, with increasing mortality in women, inconsistently influenced by socioeconomic status. Our aim was to evaluate the effect of age, period and birth cohort on lung cancer mortality inequalities in men and women in Andalusia, the southernmost region in Spain. Methods We used the Longitudinal Database of the Andalusian Population, which collects demographic and mortality data from the 2001 census cohort of more than 7.35 million Andalusians, followed up between 2002 and 2016. Mortality rates were calculated for men and women by educational level, and small-area deprivation. Poisson models were used to assess trends in socioeconomic inequalities in men and women. Finally, age-period-cohort (APC) models were used separately for each educational level and gender. Results There were 39,408 lung cancer deaths in men and 5,511 in women, yielding crude mortality rates of 78.1 and 11.4 × 105 person-years, respectively. In men higher mortality was found in less educated groups and inequalities increased during the study period: i.e. the rate ratio for primary studies compared to university studies increased from 1.30 (CI95:1.18–1.44) to 1.57 (CI95:1.43–1.73). For women, educational inequalities in favour of the less educated tended to decrease moderately. In APC analysis, a decreasing period effect in men and an increasing one in women were observed. Cohort effect differed significantly by educational level. In men, the lower the educational level, the earlier the peak effect was reached, with a 25-year difference between the least-educated and college-educated. Conversely, college-educated women reached the peak effect with a 12-year earlier cohort than the least-educated women. The decline of mortality followed the same pattern both in men and women, with the best-educated groups experiencing declining rates with earlier birth cohorts. Conclusions Our study reveals that APC analysis by education helps to uncover changes in trends occurring in different socioeconomic and gender groups, which, combined with data on smoking prevalence, provide important clues for action. Despite its limitations, this approach to the study of lung cancer inequalities allows for the assessment of gaps in historical and current tobacco policies and the identification of population groups that need to be prioritised for public health interventions.This work was supported by the project entitled “Impacto de los determinantes sociales, sanitarios y ambientales en la morbimortalidad por cáncer en la provincia de Cádiz” funded by the Andalusian Health Ministry (Consejería de Salud), grant PI0034-2018

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Prevención del cáncer

Tít. tomado de la cub. Publicado en la página web de la Consejería de Salud: www.juntadeandalucia.es/salud (Consejería de Salud / Ciudadanía / Quiénes somos / Planes y Estrategias). Este documento se enmarca dentro del Plan Integral de Oncología de Andalucía 2007-2012.YesEl objetivo de este documento es difundir entre el personal de atención primaria cuales son las recomendaciones actuales, basadas en estudios científicos realizados con criterios de calidad, sobre la prevención del cáncer. Dichas recomendaciones se sustentan, como punto de partida, en el documento denominado “Código Europeo contra el cáncer”, elaborado a partir de la información difundida por las agencias internacionales de Cáncer y los estudios epidemiológicos presentes en la literatura internacional, al que se le han añadido datos de nuestro contexto

How a deliberative approach includes women in the decisions of screening mammography: a citizens' jury feasibility study in Andalusia, Spain.

To verify whether a citizens' jury study is feasible to the Andalusian population and to know if women, when better informed, are able to answer the research question of whether the Andalusian Public Health System must continue offering screening mammography to women aged 50-69. The reasons for the pertinent decision and recommendations to the political authorities will be stated. Qualitative research study with the methodology of citizens' jury. Breast cancer screening programme in Andalusia (Spain). Thirteen women aged 50-69 with secondary school or higher education accepted to participate as a jury. Two epidemiologists were the expert witnesses. The main researcher was the neutral moderator. Jury met on Monday, 15 February 2016. The moderator indicated to the jury that it had to assess the screening programme's key benefits and main harm. On Tuesday, 16 February, the expert witnesses positioned for and against the programme. On Thursday, 18 February, the jury deliberated, reached final conclusions, submitted its vote and stated its recommendations to politicians. The deliberation session was transcribed and analysed with the support of ATLAS.ti.5.2 software. Feasibility in the Andalusian population, women's vote and opinion, reasons for votes and recommendations to political authorities. Eleven participants voted yes and two voted no. There are three reasons to vote 'yes': health, the test nature, and individual freedom. Some women invoke the lack of efficacy and the cost to justify their negative vote, at least in universal terms. On completion, they made suggestions to be submitted to the pertinent authorities for the improvement of information, psychology services and research. The deliberative strategy is feasible and causes a favourable positioning regarding screening mammography, although information changes the opinion of some women, who desire informed decision making and to keep or increase medicalisation in their lives

Cepa de trichoderma útil para el tratamiento y/o prevención de infecciones provocadas por hongos pertenecientes al género verticillium

Cepa de Trichoderma útil para el tratamiento y/o prevención de infecciones provocadas por hongos pertenecientes al género Verticillium. La invención se refiere al uso de la cepa de hongos Trichoderma atroviride IMI 206040 para la prevención y/o tratamiento de infecciones de plantas y/o suelos provocadas por hongos fitopatógenos pertenecientes al género Verticillium, preferiblemente por los patotipos defoliante o no defoliante de Verticillium dahliae, agente causante de la verticilosis del olivo. Además, la invención propone el uso de esta cepa de hongos en combinación con otros hongos del género Trichoderma.Peer reviewedUniversidad de Jaén, Nutesca S.L., Fundación Citoliva, Consejo Superior de Investigaciones Científicas (España), Universidad de SevillaA1 Solicitud de patente con informe sobre el estado de la técnic

II Plan Integral de Oncología de Andalucía : 2007-2012

Publicado en la página web de la Consejería de Salud: www.juntadeandalucia.es/salud (Consejería de Salud / Ciudadanía / Quiénes somos / Planes y Estrategias). Tiene dos documentos relacionados: Prevención del cáncer y Código de buenas prácticas en comunicación.YesEl Plan Integral de Oncología de Andalucía 2007-2012 tiene como principal finalidad ordenar las prioridades en el campo de la atención al problema del cáncer, desde una perspectiva social y sanitaria. Para ello se organiza en torno a 9 líneas de trabajo que contienen un total de 46 objetivos específicos y 77 acciones, que se orientan hacia la consecución de 6 objetivos generales. Con su desarrollo se pretende conseguir una atención sanitaria centrada en las personas afectadas, a quienes se quiere ofrecer un trato integral que incluya los aspectos físicos, emocionales y sociales

Brote epidémico de hepatitis aguda A en el área sanitaria del Hospital Universitario Virgen de la Victoria (HUVV): un cambio en la epidemiología

RESUMEN En el año 2016 se detectó en la provincia de Málaga un brote de hepatitis A en pacientes con características epidemiológicas especiales, con un predominio de sujetos del sexo masculino. Presentamos 51 casos de hepatitis A aguda con una media de edad de 35,7 años, el 90% varones, con un 55% de casos que reconocían haber mantenido relaciones sexuales con otros hombres en los últimos dos meses. La mitad de ellos requirieron ingreso hospitalario por coagulopatía significativa en el momento del diagnóstico, sin evolución a fallo fulminante, ni encefalopatía en ningún caso. Cuatro casos presentaban ascitis al diagnóstico. Este brote se suma a otros dos publicados en Reino Unido y Holanda con un número de casos similar y epidemiológicamente muy parecidos, lo cual refuerza la importancia de la vigilancia epidemiológica y la necesidad de vacunación en esta población de riesgo, así como de campañas informativas a la población para prevenir la enfermedad