Medical costs of cancer attributable to work in the Basque Country (Spain) in 2008

AbstractObjetivesUnderreporting of work-related cancer in the Basque Country (Spain) is massive. The aim of our study is to estimate the job-related cancer in the Basque Country in 2008 treated by the Basque Public Health System-Osakidetza, as well as the medical costs derived from its treatment in the same year.MethodsScientific evidence from industrialised countries is used to estimate the number of processes of cancer attributable to work. Medical costs for specialised care (outpatient and hospital admissions) are derived from the National Health System cost accounts. Costs due to primary health care and pharmaceutical benefits are obtained from Spanish secondary sources. Figures were computed according to disease and sex.ResultsWe estimate 1,331 work-attributable cancers hospitalizations and 229 work-attributable cancers specialized ambulatory cases. Medical costs borne by public health care system exceed 10 million euros. Specialized care accounts for 64.2% of the total cost. Bronchus and lung cancer represents the largest percentage of total expenditure (27%), followed by the bladder cancer (12.6%), mesothelioma (8.6%), the colon cancer (7.3%), and stomach (6.7%).ConclusionsThe magnitude of cancer attributable to work in the Basque Country is much higher than reflected in the official Registry of Occupational Diseases. Underreporting of work-related cancers hampers prevention and shifts funding of medical costs from social security to the tax-financed public health system

Effect of a multifunctional biosurfactant extract obtained from corn steep liquor on orange and apple juices

Biosurfactant extracts are multifunctional ingredients composed of natural polymers that can be used in the food industry as stabilizing and antimicrobial agents, although their inclusion in food matrices has been scarcely explored. In this work, a biosurfactant extract, with antimicrobial properties, obtained from a fermented stream of the corn wet-milling industry was introduced into an apple and orange juice matrix to evaluate the changes produced in the sugar consumption, pH, and biomass formation at different temperatures (4–36 °C) and storage time (1–7 days). It was observed that the addition of biosurfactant extract reduced the hydrolysis rate of polymeric sugars, decreasing the concentration of soluble sugars from 85.4 g/L to 49.0 g/L in apple juice after 7 days at 20 °C in the absence and presence of biosurfactant extract, respectively. In general, soluble sugars increased in juices for 5–6 days and after those sugars decreased at different rates depending on the temperature of storage. Differences in sugar solubilization and degradation were more significant in apple juice than in orange juice at 20 °C and 7 days of storage, achieving for orange juice values of 101 and 102 g/L in the absence and presence of biosurfactant extract, respectively. Biomass growth was almost unaffected by the biosurfactant extract concentration and the optimal conditions for biomass production were detected at intermediated temperatures after 6–7 days of storage for both apple and orange juices, obtaining maximum concentrations of 1.68 g/L and 1.54 g/L for apple juice and orange juice, respectively, in the absence of biosurfactant extract. The pH during storage was kept in the range of 3.35–3.48 for apple juice and of 3.40–3.77 for orange juice.Xunta de Galicia | Ref. GPC-ED431B 2020/17Ministerio de Ciencia e Innovación | Ref. PID2019-103873RJ-I0

Copy-number intratumor heterogeneity increases the risk of relapse in chemotherapy-naive stage colon cancer

Optimal selection of high-risk patients with stage II colon cancer is crucial to ensure clinical benefit of adjuvant chemotherapy. Here, we investigated the prognostic value of genomic intratumor heterogeneity and aneuploidy for disease recurrence. We combined targeted sequencing, SNP arrays, fluorescence in situ hybridization, and immunohistochemistry on a retrospective cohort of 84 untreated stage II colon cancer patients. We assessed the clonality of copy-number alterations (CNAs) and mutations, CD8 + lymphocyte infiltration, and their association with time to recurrence. Prognostic factors were included in machine learning analysis to evaluate their ability to predict individual relapse risk. Tumors from recurrent patients displayed a greater proportion of CNAs compared with non-recurrent (mean 31.3% versus 23%, respectively; p = 0.014). Furthermore, patients with elevated tumor CNA load exhibited a higher risk of recurrence compared with those with low levels [ p = 0.038; hazard ratio (HR) 2.46], which was confirmed in an independent cohort (p = 0.004; HR 3.82). Candidate chromosome-specific aberrations frequently observed in recurrent cases included gain of the chromosome arm 13q (p = 0.02; HR 2.67) and loss of heterozygosity at 17q22-q24.3 (p = 0.05; HR 2.69). CNA load positively correlated with intratumor heterogeneity (R = 0.52; p < 0.0001). Consistently, incremental subclonal CNAs were associated with an elevated risk of relapse (p = 0.028; HR 2.20), which we did not observe for subclonal single-nucleotide variants and small insertions and deletions. The clinico-genomic model rated an area under the curve of 0.83, achieving a 10% incremental gain compared with clinicopathological markers (p = 0.047). In conclusion, tumor aneuploidy and copy-number intratumor heterogeneity were predictive of poor outcome and improved discriminative performance in early-stage colon cancer. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland

Growth And The Growth Hormone-Insulin Like Growth Factor 1 Axis In Children With Chronic Inflammation:Current Evidence, Gaps In Knowledge And Future Directions

Growth failure is frequently encountered in children with chronic inflammatory conditions like juvenile idiopathic arthritis, inflammatory bowel disease and cystic fibrosis. Delayed puberty and attenuated pubertal growth spurt is often seen during adolescence. The underlying inflammatory state mediated by pro-inflammatory cytokines, prolonged use of glucocorticoid and suboptimal nutrition contribute to growth failure and pubertal abnormalities. These factors can impair growth by their effects on the growth hormone-insulin like growth factor axis and also directly at the level of the growth plate via alterations in chondrogenesis and local growth factor signaling. Recent studies on the impact of cytokines and glucocorticoid on the growth plate studies further advanced our understanding of growth failure in chronic disease and provided a biological rationale of growth promotion. Targeting cytokines using biologic therapy may lead to improvement of growth in some of these children but approximately one third continue to grow slowly. There is increasing evidence that the use of relatively high dose recombinant human growth hormone may lead to partial catch up growth in chronic inflammatory conditions, although long term follow-up data is currently limited. In this review, we comprehensively review the growth abnormalities in children with juvenile idiopathic arthritis, inflammatory bowel disease and cystic fibrosis, systemic abnormalities of the growth hormone-insulin like growth factor axis and growth plate perturbations. We also systematically reviewed all the current published studies of recombinant human growth hormone in these conditions and discuss the role of recombinant human insulin like growth factor-1

A multifunctional biosurfactant extract obtained from corn steep water as bactericide for agrifood industry

The increase of crop production along with stricter requirements on food security have augmented the demand of new and eco-friendly bactericides. Most of the bactericides used at the moment consist of persistent organic substances, representing a risk for environmental and human health. For instance, agriculture bactericides used for crop protection includes copper-based, dithiocarbamate and amide bactericides, which are not biodegradable, resulting in the necessity of further research about the production of new active principles that attack microorganisms without producing any harmful effect on human health or environment. The biosurfactant extract evaluated in this work as a bactericide, is obtained from corn steep water, a residual stream of corn wet milling industry, which is fermented spontaneously by probiotic lactic acid bacteria that possess the capacity to produce biosurfactants. In previous works, it has been demonstrated that this biosurfactant extract is able to promote the growth of Lactobacillus casei in drinkable yogurts, though its antimicrobial activity against pathogenic strains has not been evaluated at the moment. The results obtained in this work have proved that this biosurfactant extract is effective as bactericide against Pseudomonas aeruginosa and Escherichia coli, at concentrations of 1 mg/mL, opening the door to its use in agrifood formulations for reducing the use of chemical pesticides and preservatives.Ministerio de Economía y Competitividad | Ref. RTI2018-093610-B-100Ministerio de Economía y Competitividad | Ref. IJCI-2016-27445Ministerio de Educación, Cultura y Deporte | Ref. FPU15/0020

Solubilization of cuprous oxide in water using biosurfactant extracts from corn steep liquor: a comparative study

In this work the chemical characterization (elemental analysis and the content of phospholipids) and surface-active properties of two biosurfactants (BS) extracted with both chloroform or ethyl acetate from corn steep liquor were compared. The phospholipids content for the BS extracted with chloroform (BS1) was considerably higher (8.15%) than that obtained for the BS extracted with ethyl acetate (BS2), 0.11%. When comparing the FTIR spectra of the two BS studied in this work with the spectrum of the commercial surfactant lecithin, a greater similarity (75%) was observed with the spectrum of the BS1. The biosurfactant extract (BS2) provided the most favorable conditions for the solubilization of cuprous oxide (Cu-Ox) in water (12.54% of copper dissolved), in comparison with BS1. The results achieved were considerably better than those obtained with chemical surfactants (Tween 80, SDS and CTAB) on solubilizing Cu-Ox, resulting in the latter cases on percentages of Cu dissolved always lower than 0.21%. In addition, a factorial design was performed obtaining the optimum conditions to solubilize Cu-Ox, where the maximum water solubility of Cu-Ox (13.17%) was achieved using 3.93 g/L of BS2 with a contact time of 19.86 min and using a concentration of Cu-Ox of 1.96 g/L. Thus, the BS2 extract could have a promising future as solubilizing agent in the formulation of more sustainable Cu-Ox based pesticides. Moreover, it was confirmed that the presence of phospholipids prevents the solubilization of copper-based pesticides in water.Ministerio de Economía y Competitividad | Ref. RTI2018-093610-B-10

Aislamiento y caracterización del microorganismo responsable de la producción de biosurfactantes en licores de lavado de maíz

In this work a Bacillus strain with capacity to produce biosurfactants was isolated from commercial corn steep water (CSW). The identification of this bacterium was based on phenotypic characteristics. This is a Gram-positive Bacillus, macroscopically catalase-negative, that possesses high mobility and forms terminal endospore. The colonies formed by the isolated Bacillus strain are characterized by a creaming, dull and glistening phenotype with a small point-like elevation in the center. Regarding its antimicrobial activity, the isolated Bacillus strain was effective against Candida albicans and Staphylococcus aureus observing, in the presence of pathogenic strains, a phenotype dissociation, switching the colonies from a whitish to yellowish pigmentation. The isolated microorganism, contrarily to other Bacillus strains, has the ability to produce extracellular and cell-bound biosurfactants. The analyses revealed that both biosurfactant extracts are similar to the lipopeptide biosurfactant produced by Bacillus subtilis.Ministerio de Economía y Competitividad | Ref. RTI2018-093610-B-I0

Costes sanitarios directos de las neoplasias de pulmón y vejiga de origen laboral en España en 2008

Background: The lack of recognition of the occupational etiology of some malignant tumors implies that the cost of their health care rests in the National Health System. The aim of our study is to estimate the job-related lung and bladder cancer in Spain in 2008 treated by the National Health System (NHS), as well as the medical costs derived from its treatment in the same year. Methods: Literature estimates of Attributable Fractions due to work were used to estimate the job-related cases treated. Medical costs for specialised care (outpatient and hospital admissions) are derived from the NHS cost accounts. Costs due to primary health care and pharmaceutical benefits are obtained from secondary sources. Figures were computed according to disease and sex. Results: A total of 10,652 NHS hospital discharges in 2008 were due to lung cancer and bladder cancer attributable to work (only 16 were recognized as professional the same year). The treatment of these cases cost to the NHS in 2008 almost 88 million euros, of which 61.2 million belong to lung cancer and 26.5 to the bladder. Conclusions: The magnitude of lung and bladder cancer attributable to work in Spain is much higher than reflected in the official Registry of Occupational Diseases. It should be recognized as professional to activate appropriate prevention policies. The related health care expenditure, which is financed by the NHS, is quite significant.Fundamentos: La falta de reconocimiento del origen laboral de algunos tumores malignos conlleva que el coste de su asistencia sanitaria recaiga sobre el Sistema Nacional de Salud. El objetivo de nuestro estudio es conocer el número de procesos atendidos por cáncer de pulmón y vejiga atribuibles al trabajo en España en el Sistema Nacional de Salud (SNS) en 2008, así como los costes sanitarios derivados de su atención. Métodos: El número de procesos se estimó aplicando las fracciones atribuibles al trabajo obtenidas en la literatura. Para el cálculo de los costes se utilizaron datos primarios relativos a la atención especializada del SNS (ambulatoria e ingresos hospitalarios), y fuentes secundarias para calcular el coste de la atención primaria de salud y la atención farmaceútica. Los cálculos se realizaron por enfermedad y sexo. Resultados: 10.652 altas hospitalarias durante 2008 fueron debidas a cánceres de pulmón y vejiga atribuibles al trabajo (se reconocieron 16 como profesionales el mismo año). El tratamiento de estos casos costó casi 88 millones de euros, de los cuales 61,2 corresponden al cáncer de pulmón y 26,5 al de vejiga. Destaca el enorme peso relativo de la atención especializada (64%) y el escaso peso de la atención primaria (2,3%). Conclusiones: La magnitud del cáncer de pulmón y vejiga derivado del trabajo en España es muy superior a la que refleja el registro de enfermedades profesionales, siendo imprescindible su reconocimiento como profesional para activar su adecuada prevención. La atención sanitaria de estas enfermedades supone un elevado gasto para el sistema público de salud

Evaluation of morphological changes in grapes coated with a biosurfactant extract obtained from corn steep liquor

In this work, grapes were coated with a multifunctional biosurfactant extract obtained from corn steep liquor after liquid–liquid extraction with ethyl acetate. This biosurfactant extract has been demonstrated to not only possess a surfactant capacity but also antimicrobial activity. Hence, it could be an excellent preservative for fruits, as it is more biodegradable and more biocompatible than chemically synthetized preservatives. However, before applying this biosurfactant as a preservative on fruits, it is necessary to study the changes in the surface properties of fruits produced by the addition of this bioactive compound. Therefore, in this work, grapes coated with an aqueous solution containing 1 g/L of the biosurfactant extract were subjected to surface analysis using non-invasive technologies, including profilometry. 2D digital photographs of the surface and parametric roughness of grapes were obtained. They revealed that the biosurfactant extract decreased the roughness of the grape surface compared with non-coated grapes and reduced the changes in the shape of the grapes over time. Moreover, it was observed that the biosurfactant extract increased the hydrophobicity of the grape surface observing higher contact angle compared with non-coated grapes.Ministerio de Economía y Competitividad | Ref. RTI2018-093610-B-100Xunta de Galicia | Ref. ED431B 2020/17Ministerio de Ciencia e Innovación | Ref. PID2019-103873RJ-I00Universidade de Vig