RiskDiff: a web tool for the analysis of the difference due to risk and demographic factors for incidence or mortality data

Background Analysing the observed differences for incidence or mortality of a particular disease between two different situations (such as time points, geographical areas, gender or other social characteristics) can be useful both for scientific or administrative purposes. From an epidemiological and public health point of view, it is of great interest to assess the effect of demographic factors in these observed differences in order to elucidate the effect of the risk of developing a disease or dying from it. The method proposed by Bashir and Estève, which splits the observed variation into three components: risk, population structure and population size is a common choice at practice. Results A web-based application, called RiskDiff has been implemented (available at http://rht.iconcologia.net/riskdiff.htm webcite), to perform this kind of statistical analyses, providing text and graphical summaries. Code from the implemented functions in R is also provided. An application to cancer mortality data from Catalonia is used for illustration. Conclusions Combining epidemiological with demographical factors is crucial for analysing incidence or mortality from a disease, especially if the population pyramids show substantial differences. The tool implemented may serve to promote and divulgate the use of this method to give advice for epidemiologic interpretation and decision making in public health

Genotypic classification of patients with Wolfram syndrome: insights into the natural history of the disease and correlation with phenotype

Purpose: Wolfram syndrome is a degenerative, recessive rare disease with an onset in childhood. It is caused by mutations in WFS1 or CISD2 genes. More than 200 different variations in WFS1 have been described in patients with Wolfram syndrome, which complicates the establishment of clear genotype-phenotype correlation. The purpose of this study was to elucidate the role of WFS1 mutations and update the natural history of the disease. Methods: This study analyzed clinical and genetic data of 412 patients with Wolfram syndrome published in the last 15 years. Results: (i) 15% of published patients do not fulfill the current ­inclusion criterion; (ii) genotypic prevalence differences may exist among countries; (iii) diabetes mellitus and optic atrophy might not be the first two clinical features in some patients; (iv) mutations are nonuniformly distributed in WFS1; (v) age at onset of diabetes mellitus, hearing defects, and diabetes insipidus may depend on the patient"s genotypic class; and (vi) disease progression rate might depend on genotypic class. Conclusion: New genotype-phenotype correlations were established, disease progression rate for the general population and for the genotypic classes has been calculated, and new diagnostic criteria have been proposed. The conclusions raised could be important for patient management and counseling as well as for the development of treatments for Wolfram syndrome

Trends in incidence, mortality and survival in women with breast cancer from 1985 to 2012 in Granada, Spain: a population-based study

The incidence of breast cancer has increased since the 1970s. Despite favorable trends in prognosis, the role of changes in clinical practice and the introduction of screening remain controversial. We examined breast cancer trends to shed light on their determinants Overall, age-adjusted (European Standard Population) incidence rates increased from 48.0 cases × 100,000 women in 1985–1989 to 83.4 in 2008–2012, with an annual percentage change (APC) of 2.5% (95%CI, 2.1–2.9) for 1985–2012. The greatest increase was in women younger than 40 years (APC 3.5, 95%CI, 2.4–4.8). For 2000–2012 the incidence trend increased only for stage I tumors (APC 3.8, 95%CI, 1.9–5.8). Overall age-adjusted breast cancer mortality decreased (APC − 1, 95%CI, − 1.4 – − 0.5), as did mortality in the 50–69 year age group (APC − 1.3, 95%CI, − 2.2 – − 0.4). Age-standardized net survival increased from 67.5% at 5 years in 1985–1989 to 83.7% in 2010–2012. All age groups younger than 70 years showed a similar evolution. Five-year net survival rates were 96.6% for patients with tumors diagnosed in stage I, 88.2% for stage II, 62.5% for stage III and 23.3% for stage IV. Breast cancer incidence is increasing – a reflection of the evolution of risk factors and increasing diagnostic pressure. After screening was introduced, the incidence of stage I tumors increased, with no decrease in the incidence of more advanced stages. Reductions were seen for overall mortality and mortality in the 50–69 year age group, but no changes were found after screening implementation. Survival trends have evolved favorably except for the 70–84 year age group and for metastatic tumors.This study was supported by a grant from the Acción Estratégica en Salud plan for the High Resolution Project on Prognosis and Care of Cancer Patients (No. AC14/00036) awarded by the Spanish Ministry of Economy and Competitiveness and co-funded by the European Regional Development Fund (ERDF)

Hydroxyapatite coatings grown by pulsed laser deposition with a beam of 355 nm wavelength

Calcium phosphate coatings, obtained at different deposition rates by pulsed laser deposition with a Nd:YAG laser beam of 355-nm wavelength, were studied. The deposition rate was changed from 0.043 to 1.16 /shot by modification of only the ablated area, maintaining the local fluence constant to perform the ablation process in similar local conditions. Characterization of the coatings was performed by scanning electron microscopy, x-ray diffractometry, and infrared, micro-Raman, and x-ray photoelectron spectroscopy. The coatings showed a compact surface morphology formed by glassy gains with some droplets on them. Only hydroxyapatite (HA) and alpha-tricalcium phosphate (alpha-TCP) peaks were found in the x-ray diffractograms. The relative content of alpha TCP diminished with decreasing deposition rates, and only HA peaks were found for the lowest rate. The origin of alpha TCP is discussed

Análisis de la supervivencia relativa en cáncer. Años 2003-2009

Background: To determine the survival of cancer allows a posteriori know the effectiveness and efficiency of the different treatments. The current justification is essential because the cancer is the second leading cause of death and many factors: etiology, early diagnosis and different treatments. The observed and relative survival are the focus of this article. Methods: Through Registry Cancer Hospital Lozano Blesa Hospital of Zaragoza, as a source of information, we selected patients who entered with a diagnosis of cancer, such as. first episode between 2003-2009 whereby a 10-year period allowed (until 2014) of study after the last patient entered the cohort The diagnostic certainty was Anatomopathological. Survival time in years was calculated and these walls were considered: age, year of entry into the Register of cancer, years of survival, sex, living or dead state. From these data the absolute and relative survival and the limits of 95% confidence WAERS providing application was calculated. Results: The largest relative survival at five years were 94% of testicular cancer (LC: 95%, 81%, 194%); breast cancer 92% (LC: 91.6%, 101%); cervix 88% (LC: 71-105); prostate cancer 85% (LC: 77%, 93%) and worst in lung cancer 1% (LC: 0,5%); brain 17% (LC: 12%, 25%), stomach 22% (LC: 17%, 29%) and 21% pancreas (LC: 14%, 32%). Conclusions: A five-year survival is better for testicular cancer and worse for lung.Fundamentos: Conocer la supervivencia del cáncer permite a posteriori saber la efectividad y eficacia de los diferentes tratamientos. La justificación actual es imprescindible debido a que el cáncer constituye la segunda causa de mortalidad e intervienen muchos factores: etiológicos, diagnóstico precoz y diferentes tratamientos. La supervivencia observada y relativa, constituye el objetivo de este artículo. Métodos: A través del Registro de cáncer hospitalario del Hospital Lozano Blesa de Zaragoza, como fuente de información, se seleccionó a los pacientes que entraron con un diagnóstico de cáncer, como primer episodio entre los años 2003 a 2009, con lo cual se permite un periodo de estudio de 10 años (hasta el año 2014), después que el último paciente entró en la cohorte. El diagnóstico de certeza fue Anatomopatológico. Se calculó el tiempo de supervivencia en años y se tuvieron en cuenta los siguientes paramentos: Edad, año de entrada en el Registro de cáncer, años de supervivencia, sexo y estado vivo o muerto. A partir de estos datos se calculó la supervivencia absoluta y relativa así como los límites de confianza al 95 % que proporciona la aplicación Waers. Resultados: las mayores supervivencias relativas a los cinco años fueron en cáncer de testículo 94% (LC: 95%: 81%; 194%); cáncer de mama 92% (LC: 91.6 %; 101%); cuello de útero 88% (LC: 71-105); cáncer de próstata 85% (LC: 77 %, 93%). Las peores en cáncer de pulmón 1% (LC: 0; 5 %); encéfalo 17 % (LC: 12%, 25%); estómago 22% (LC: 17%, 29%); páncreas 21% (LC: 14%, 32%). Conclusiones: A cinco años la mejor supervivencia es para el cáncer de testículo y la peor para el de pulmón

BS-SEM evaluation of the tissular interactions between cortical bone and calcium-phosphate covered titanium implants

The improvement of the reliability of the contact between the osseous tissues and the implant materials has been tested by recovering the metallic implants with ceramic materials, usually calcium phosphates. In our study, the calcium phosphate recovering layers were deposited by means of a pulsed-laser deposition technique. Our aim was to to evaluate the tissue interactions established between cortical bone and titanium implants covered by five different layers, ranging from amorphous calcium phosphate to crystalline hydroxyapatite, obtained by altering the parameters of the laser ablation process. The surgical protocol of the study consisted in the simultaneous implantation of the five types of implants in both the tibial dyaphisis of three Beagle dogs, sacrificed respectively one, two and three months after the last surgical procedures. After the sacrifice, the samples were submitted to a scheduled procedure of embedding in plastic polymers without prior decalcification, in order to perform the ultrastructural studies: scanning microscopy with secondary and backscattered electrons (BS-SEM). Our observations show that both in terms of the calcified tissues appearing as a response to the presence of the different coatings and of time of recovering, the implants coated with crystalline calcium phosphate layers by laser ablation present a better result than the amorphous-calcium-phosphate-coated implants. Moreover, the constant presence of chondroid tissue, related with the mechanical induction by forces applied on the recovering area, strongly suggests that the mechanisms implied in osteointegration are related to endomembranous, rather than endochondral ossification processes

REGSTATTOOLS: Freeware statistical tools for the analysis of disease population databases used in health and social studies

10.1186/1471-2458-13-201Background The repertoire of statistical methods dealing with the descriptive analysis of the burden of a disease has been expanded and implemented in statistical software packages during the last years. The purpose of this paper is to present a web-based tool, REGSTATTOOLS http://regstattools.net intended to provide analysis for the burden of cancer, or other group of disease registry data. Three software applications are included in REGSTATTOOLS: SART (analysis of disease¿s rates and its time trends), RiskDiff (analysis of percent changes in the rates due to demographic factors and risk of developing or dying from a disease) and WAERS (relative survival analysis). Results We show a real-data application through the assessment of the burden of tobacco-related cancer incidence in two Spanish regions in the period 1995¿2004. Making use of SART we show that lung cancer is the most common cancer among those cancers, with rising trends in incidence among women. We compared 2000-2004 data with that of 1995¿1999 to assess percent changes in the number of cases as well as relative survival using RiskDiff and WAERS, respectively. We show that the net change increase in lung cancer cases among women was mainly attributable to an increased risk of developing lung cancer, whereas in men it is attributable to the increase in population size. Among men, lung cancer relative survival was higher in 2000¿2004 than in 1995-1999, whereas it was similar among women when these time periods were compared. Conclusions Unlike other similar applications, REGSTATTOOLS does not require local software installation and it is simple to use, fast and easy to interpret. It is a set of web-based statistical tools intended for automated calculation of population indicators that any professional in hea