Breast cancer mortality in Spain: Has it really declined?

Objectives: In recent years, the incidence of breast cancer has increased in Spain but mortality has decreased, particularly since 1992. Despite the general decrease in mortality, the intensity of this disease differs between age groups. The main objective of this study was to examine mortality due to breast cancer for different age groups in Spain from 1981 to 2007, and to forecast the mortality rate in 2023. Study design: Ecological study. Methods: Trends in mortality due to breast cancer were analysed using the LeeeCarter model, which is the typical analysis for mortality in the general population but is rarely used to analyse specific causes of death. Results: This study found a decreasing trend in mortality due to breast cancer from 1993 to 2007, and it is predicted that this trend will continue. However, mortality rates varied between age groups: a decreasing trend was seen in younger and middle-aged women, whereas mortality rates remained stable in older women. Conclusions: Preventive breast cancer practices should differ by patient age.Ministerio de Educacion y Ciencia, Spain, Projects MTM2010-14961 and MTM2008-05152.Álvaro Meca, A.; Debón Aucejo, AM.; Gil Prieto, R.; Gil De Miguel, Á. (2012). Breast cancer mortality in Spain: Has it really declined?. Public Health. 126(10):891-895. doi:10.1016/j.puhe.2012.05.031S8918951261

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified

Greater dietary variety is associated with better biochemical nutritional status in Spanish children: the Four Provinces Study

BACKGROUND AND AIM: Although dietary variety has been associated with a better nutritional profile, its possible role in obesity raises doubts about its overall health benefits. In this study, we examined the association between dietary variety and anthropometric variables, food intake and various food intake biomarkers in Spanish children. METHODS AND RESULTS: This was a cross-sectional study of 1112 children aged 6-7 years from Cadiz, Murcia, Orense and Madrid, who were selected by means of the random cluster-sampling of schools. Information concerning food and nutrient intake was obtained using a food frequency questionnaire, and a dietary variety index (DVI) was calculated on the basis of the number of different foods consumed more than once a month. The anthropometric variables (weight and height), and plasma lipid and vitamin levels were determined using standardised methods. Our results show that the body mass index (BMI) did not vary substantially as a function of DVI: it was 16.9 in the lowest DVI tertile and 17.2 in the highest (p=0.20). Unlike BMI, the DVI positively correlated (p<0.05) with the plasma levels of alpha and beta-carotene, lycopene, retinol, alpha-tocopherol and vitamin E, with energy intake, and with most of the foods, particularly vegetables, fruit and sausages (respective correlation coefficients of 0.43, 0.26 and 0.23). CONCLUSIONS: Dietary variety is associated with a better food and nutritional profile in Spanish children. Nevertheless, the presence of a positive association between the DVI and energy intake, and the consumption of sausages and pre-cooked products calls for the recommendation of a varied diet of healthy foods, such as cereals (especially whole grains), fruits and vegetables

Influenza vaccine and risk of acute myocardial infarction in a population-based case-control study

Objective To assess the relationship between influenza vaccination and risk of a first acute myocardial infarction (AMI) in the general population by different epidemic periods. Methods This is a population-based case?control study carried out in BIFAP (Base de datos para la investigación farmacoepidemiológica en atención primaria), over 2001?2015, in patients aged 40?99 years. Per each incident AMI case, five controls were randomly selected, individually matched for exact age, sex and index date (AMI diagnosis). A patient was considered vaccinated when he/she had a recorded influenza vaccination at least 14 days before the index date within the same season. The association between influenza vaccination and AMI risk was assessed through a conditional logistic regression, computing adjusted ORs (AOR) and their respective 95% CIs. The analysis was performed overall and by each of the three time epidemic periods per study year (pre-epidemic, epidemic and postepidemic). Results We identified 24 155 AMI cases and 120 775 matched controls. Of them, 31.4% and 31.2%, respectively, were vaccinated, yielding an AOR of 0.85 (95% CI 0.82 to 0.88). No effect modification by sex, age and background cardiovascular risk was observed. The reduced risk of AMI was observed shortly after vaccination and persisted over time. Similar results were obtained during the pre-epidemic (AOR=0.87; 95% CI 0.79 to 0.95), epidemic (AOR=0.89; 95% CI 0.82 to 0.96) and postepidemic (AOR=0.83; 95% CI 0.79 to 0.87) periods. No association was found with pneumococcal vaccine (AOR=1.10; 95% CI 1.06 to 1.15). Conclusions Results are compatible with a moderate protective effect of influenza vaccine on AMI in the general population, mostly in primary prevention, although bias due to unmeasured confounders may partly account for the results.Instituto de Salud Carlos IIIMinisterio de Ciencia e InnovaciónHospital Universitario Príncipe de Asturia

Review of concepts in therapeutic decision-making in HER2-negative luminal metastatic breast cancer

Purpose: Hormone receptor (HR)-positive, Human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) requires a therapeutic approach that takes into account multiple factors, with treatment being based on anti-estrogen hormone therapy (HT). As consensus documents are valuable tools that assist in the decision-making process for establishing clinical strategies and optimize the delivery of health services, this consensus document has been created with the aim of developing recommendations on cretiera for hormone sensitivity and resistance in HER2-negative luminal MBC and facilitating clinical decision-making. Methods: This consensus document was generated using a modification of the RAND/UCLA methodology, which included the definition of the project and identification of issues of interest, a non-exhaustive systematic review of the literature, an analysis and synthesis of the scientific evidence, preparation of recommendations, and external evaluation with a panel of 64 medical oncologists specializing in breast cancer. Results: A Spanish panel of experts reached consensus on 32 of the 32 recommendations/conclusions presented in the first round and were accepted with an approval rate of 100% about definition of metastatic disease not susceptible to local curative treatment, definition of hormone sensitivity and hormone resistance in metastatic luminal disease and therapeutic decision-making. Conclusion: We have developed a consensus document with recommendations on the treatment of patients with HER2-negative luminal MBC that will help to improve therapeutic benefits

Risk of Acute Myocardial Infarction Among New Users of Allopurinol According to Serum Urate Level: A Nested Case-Control Study

Abstract: Objectives: To test the hypothesis that allopurinol reduces the risk of acute myocardial infarction (AMI) in hyperuricemic patients and to assess whether the effect is dependent on dose, duration and serum uric acid (SUA) level attained after treatment. Methods: Nested case-control study over the period 2002?2015. From a cohort of patients aged 40?99 years old, we identified incident AMI cases and randomly selected five controls per case, matched for exact age, sex and index date. Adjusted odds ratios (AOR) and 95% CI were computed through unconditional logistic regression. Only new users of allopurinol were considered. Results: A total of 4697 AMI cases and 18,919 controls were included. Allopurinol use was associated with a reduced risk of AMI mainly driven by duration of treatment (AOR ?180 days = 0.71; 95% CI: 0.60?0.84). Among long-term users (>180 days), the reduced risk was only observed when the SUA level attained was below 7 mg/dL (AOR7mg/dL = 1.04; 95% CI: 0.75?1.46; p for trend = 0.001). A dose-effect was observed but faded out once adjusted for the SUA level attained. The reduced risk of AMI occurred in both patients with gout and patients with asymptomatic hyperuricemia. Conclusions: The results confirm a cardioprotective effect of allopurinol which is strongly dependent on duration and SUA level attained after treatment

Improving speech intelligibility in hearing aids. Part II: Quality assessment

[EN] Subjective tests are the most reliable methods for quantifying the perceived speech intelligibility, but the process to perform these tests usually is time consuming and cost expensive. For this reason, different objective measures have been proposed in the literature to evaluate the intelligibility and/or quality of speech in such a way that cooperation of human listeners is not necessary. In this paper, we describe a wide range of subjective tests reported in the literature, focusing on those proposed to evaluate speech intelligibility of Spanish language, not only for normal hearing listeners, but for hearing impaired as well. Afterwards we summarize the most common objective measures of speech quality, and finally we perform a comparison between them and some subjective speech intelligibility tests. In the subjective tests, clean Spanish speech material has been contaminated with different real background noises: cafeteria and outside traffic noise. Results show that Short-Time Objective Intelligibility (STOI) and Perceptual Evaluation of Speech Quality (PESQ) indices present a better correlation and a lower mean square error when predicting intelligibility compared to other objective measures tested.This work has been supported by European Union ERDF and Spanish Government through TEC2012-38142-C04 project, and Generalitat Valenciana through PROMETEOII/2014/003 project. Participation of author A. Padilla has been supported by a postdoctoral fellowship from Conacyt (Mexico). The authors wish to acknowledge Prof. Felipe Orduña for his insightful comments that contributed to improve the manuscript, and to everyone who participated in the listening tests.Padilla, A.; Piñero Sipán, MG.; Diego Antón, MD.; Ferrer Contreras, M.; González Téllez, A.; Ayllón, D.; Gil Pita, R.... (2014). Improving speech intelligibility in hearing aids. Part II: Quality assessment. Waves. 6:73-85. http://hdl.handle.net/10251/57900S7385

WadD, a New Brucella Lipopolysaccharide Core Glycosyltransferase Identified by Genomic Search and Phenotypic Characterization

Brucellosis, an infectious disease caused by Brucella, is one of the most extended bacterial zoonosis in the world and an important cause of economic losses and human suffering. The lipopolysaccharide (LPS) of Brucella plays a major role in virulence as it impairs normal recognition by the innate immune system and delays the immune response. The LPS core is a branched structure involved in resistance to complement and polycationic peptides, and mutants in glycosyltransferases required for the synthesis of the lateral branch not linked to the O-polysaccharide (O-PS) are attenuated and have been proposed as vaccine candidates. For this reason, the complete understanding of the genes involved in the synthesis of this LPS section is of particular interest. The chemical structure of the Brucella LPS core suggests that, in addition to the already identified WadB and WadC glycosyltransferases, others could be implicated in the synthesis of this lateral branch. To clarify this point, we identified and constructed mutants in 11 ORFs encoding putative glycosyltransferases in B. abortus. Four of these ORFs, regulated by the virulence regulator MucR (involved in LPS synthesis) or the ByrR/ByrS system (implicated in the synthesis of surface components), were not required for the synthesis of a complete LPS neither for virulence or interaction with polycationic peptides and/or complement. Among the other seven ORFs, six seemed not to be required for the synthesis of the core LPS since the corresponding mutants kept the O-PS and reacted as the wild type with polyclonal sera. Interestingly, mutant in ORF BAB1_0953 (renamed wadD) lost reactivity against antibodies that recognize the core section while kept the O-PS. This suggests that WadD is a new glycosyltransferase adding one or more sugars to the core lateral branch. WadD mutants were more sensitive than the parental strain to components of the innate immune system and played a role in chronic stages of infection. These results corroborate and extend previous work indicating that the Brucella LPS core is a branched structure that constitutes a steric impairment preventing the elements of the innate immune system to fight against Brucella

Parametrization of the average ionization and radiative cooling rates of carbon plasmas in a wide range of density and temperature

In this work we present an analysis of the influence of the thermodynamic regime on the monochromatic emissivity, the radiative power loss and the radiative cooling rate for optically thin carbon plasmas over a wide range of electron temperature and density assuming steady state situations. Furthermore, we propose analytical expressions depending on the electron density and temperature for the average ionization and cooling rate based on polynomial fittings which are valid for the whole range of plasma conditions considered in this work