Impact of severe aortic stenosis on quality of life

Stenosis; Quality of life; QuestionnairesEstenosis; Calidad de vida; CuestionariosEstenosi; Qualitat de vida; QüestionarisIntroduction Among individuals ≥ 65 years old, aortic stenosis is highly prevalent and the number of cases is expected to increase in the coming decades, due to the increased life expectancy. Nevertheless, the actual aortic stenosis burden is not well known in population settings and the impact of aortic stenosis on quality of life has not been studied. The aim of this study was to evaluate aortic stenosis impact on health-related quality of life in patients > 65 years old. Methods An epidemiological case-control study was carried out to compare quality of life in patients ≥65 years old with severe symptomatic aortic stenosis. Demographical and clinical information was prospectively obtained and quality of life information was collected with the Short Form Health Survey_v2 (SF-12) questionnaire. The association between quality of life and aortic stenosis was determined using multiple logistic regression models. Results Patients with severe aortic stenosis self-perceived worse quality of life on all dimensions and summary components of the SF-12 questionnaire. In the final multiple logistic regression model a significant inverse association was observed between the dimensions ‘physical role’ and ‘social role’ (p = 0.002 and p = 0.005) and an association close to significance with ‘physical role’ (p = 0.052) of the SF-12 questionnaire. Conclusion The use of quality of life scales allows the assessment of the impact of aortic stenosis on quality of life and may improve the therapeutic approach to severe aortic stenosis, providing evidence for patient‐centered care

Sex-specific genetic effects associated with pigmentation, sensitivity to sunlight, and melanoma in a population of Spanish origin

Background Human pigmentation is a polygenic quantitative trait with high heritability. In addition to genetic factors, it has been shown that pigmentation can be modulated by oestrogens and androgens via up- or down-regulation of melanin synthesis. Our aim was to identify possible sex differences in pigmentation phenotype as well as in melanoma association in a melanoma case-control population of Spanish origin. Methods Five hundred and ninety-nine females (316 melanoma cases and 283 controls) and 458 males (234 melanoma cases and 224 controls) were analysed. We genotyped 363 polymorphisms (single nucleotide polymorphisms (SNPs)) from 65 pigmentation gene regions. Results When samples were stratified by sex, we observed more SNPs associated with dark pigmentation and good sun tolerance in females than in males (107 versus 75; P = 2.32 × 10−6), who were instead associated with light pigmentation and poor sun tolerance. Furthermore, six SNPs in TYR, SILV/CDK2, GPR143, and F2RL1 showed strong differences in melanoma risk by sex (P < 0.01). Conclusions We demonstrate that these genetic variants are important for pigmentation as well as for melanoma risk, and also provide suggestive evidence for potential differences in genetic effects by sex.We thank the Madrid College of Lawyers and all patients from the different contributing Hospitals. We would like to thank Tais Moreno, M. Rosario Alonso, and Guillermo Pita for their expert technical assistance with Illumina genotyping, performed at the Spanish National Genotyping Centre (CeGen, Madrid). MI-V is funded by the “Ministry of Health Carlos III” under a Sara Borrell contract (CD15/00153). ML-C is funded by a Prometeo contract (2015/005). SSO is funded by the “ Ministry of Education, Culture and Sport” under a FPU fellowship (FPU13/04976). GR is funded by the “Ministry of Health Carlos III” under a Miquel Servet II contract (CPII14-00013). This work has also been partly funded by a research project from the Spanish Ministry of Economy and Competitiveness (CGL2014-58526-P), whose principal investigator is S

Neoadjuvant Chemotherapy plus Interval Cytoreductive Surgery with or without Hyperthermic Intraperitoneal Chemotherapy (NIHIPEC) in the Treatment of Advanced Ovarian Cancer: A Multicentric Propensity Score Study

Simple Summary Advanced ovarian cancer (Stages III-IV) continues to be one of the gynecological tumors with the highest mortality. Standard treatment consists of debulking surgery and subsequent adjuvant chemotherapy. Recently, some authors have postulated that the administration of hyperthermic chemotherapy during surgery could increase the survival of patients, especially in cases in which chemotherapy had already been administered before surgery to reduce tumor volume. Our study is important because it collects data from 11 tertiary hospitals in Spain, and the data are subjected to a statistical technique that reproduces the data that we would find in a prospective study but using retrospective data (propensity score matching). It also offers a current view of the status of ovarian cancer treatment in our country.Abstract Introduction: Epithelial ovarian cancer (EOC) is primarily confined to the peritoneal cavity. When primary complete surgery is not possible, neoadjuvant chemotherapy (NACT) is provided; however, the peritoneum-plasma barrier hinders the drug effect. The intraperitoneal administration of chemotherapy could eliminate residual microscopic peritoneal tumor cells and increase this effect by hyperthermia. Intraperitoneal hyperthermic chemotherapy (HIPEC) after interval cytoreductive surgery could improve outcomes in terms of disease-free survival (DFS) and overall survival (OS). Materials and Methods: A multicenter, retrospective observational study of advanced EOC patients who underwent interval cytoreductive surgery alone (CRSnoH) or interval cytoreductive surgery plus HIPEC (CRSH) was carried out in Spain between 07/2012 and 12/2021. A total of 515 patients were selected. Progression-free survival (PFS) and OS analyses were performed. The series of patients who underwent CRSH or CRSnoH was balanced regarding the risk factors using a statistical analysis technique called propensity score matching. Results: A total of 170 patients were included in each subgroup. The complete surgery rate was similar in both groups (79.4% vs. 84.7%). The median PFS times were 16 and 13 months in the CRSH and CRSnoH groups, respectively (Hazard ratio (HR) 0.74; 95% CI, 0.58-0.94; p = 0.031). The median OS times were 56 and 50 months in the CRSH and CRSnoH groups, respectively (HR, 0.88; 95% CI, 0.64-1.20; p = 0.44). There was no increase in complications in the CRSH group. Conclusion: The addition of HIPEC after interval cytoreductive surgery is safe and increases DFS in advanced EOC patients

Estudi dels mecanismos fisiopatológics de la incontinència fecal

Hemos realizado un estudio descriptivo de una cohorte de 135 pacientes con incontinencia fecal, recogiendo la información necesaria para clasificarlos según dos clasificaciones publicadas anteriormente en la literatura, ambas basadas en la etiología de la incontinencia fecal. Al analizar los datos, observamos que una clasificación basada sólo en la etiología de la incontinencia puede no ser adecuada a la hora de establecer grupos de pacientes homogéneos, por ello pensamos proponer un nuevo modelo de clasificación basada en los mecanismos fisiopatológicos de la incontinencia, lo que nos permitirá obtener grupos más homogéneos, con problemas similares, y a los que podamos ofrecer líneas de tratamiento similares.Hem fet un estudi descriptiu d´una cohort de 135 pacients amb Incontinència Fecal, recollint la informació necessària per classificar-los seguint dues classificacions publicades anteriorment a la literatura, basades en la etiologia de la incontinència fecal. Al analitzar les dades hem vist que una classificació només basada en els factors causals de la incontinència pot quedar-se curta a l´hora d´establir grups homogenis de pacients, i pensem que s´ha d´establir un nou model de classificació, bassat en els mecanismes fisiopatológics de la incontinència. Això ens permetrà obtenir grups més homogenis, amb problemes similars, i als que podem oferir una mateixa línia de tractament

Modelling MC1R rare variants: A structural evaluation of variants detected in a Mediterranean case-control study

4 páginas, 1 figura.This study was supported by a Grant from the Ministerio de Salud Carlos III (ISCIII) (FI10-00405) and Ministerio de Economia y Competitividad (SAF2012-31405). MP-C is funded by the VALi+d from the Generalitat Valenciana (ACIF/2011/207). MJLC is funded by the Generalitat Valenciana under a Geronimo Forteza contrat (FPA/2013/A/037). GR is funded by the Ministerio de Salud Carlos III under a ‘Miquel Servet’ contract (CP08-00069). We thank the Madrid College of Lawyers and all the participants from all contributing Hospitals.Peer reviewe

Estudi dels mecanismos fisiopatológics de la incontinència fecal

Hemos realizado un estudio descriptivo de una cohorte de 135 pacientes con incontinencia fecal, recogiendo la información necesaria para clasificarlos según dos clasificaciones publicadas anteriormente en la literatura, ambas basadas en la etiología de la incontinencia fecal. Al analizar los datos, observamos que una clasificación basada sólo en la etiología de la incontinencia puede no ser adecuada a la hora de establecer grupos de pacientes homogéneos, por ello pensamos proponer un nuevo modelo de clasificación basada en los mecanismos fisiopatológicos de la incontinencia, lo que nos permitirá obtener grupos más homogéneos, con problemas similares, y a los que podamos ofrecer líneas de tratamiento similares.Hem fet un estudi descriptiu d'una cohort de 135 pacients amb Incontinència Fecal, recollint la informació necessària per classificar-los seguint dues classificacions publicades anteriorment a la literatura, basades en la etiologia de la incontinència fecal. Al analitzar les dades hem vist que una classificació només basada en els factors causals de la incontinència pot quedar-se curta a l'hora d'establir grups homogenis de pacients, i pensem que s'ha d'establir un nou model de classificació, bassat en els mecanismes fisiopatológics de la incontinència. Això ens permetrà obtenir grups més homogenis, amb problemes similars, i als que podem oferir una mateixa línia de tractament

Estudi dels mecanismos fisiopatológics de la incontinència fecal

Hemos realizado un estudio descriptivo de una cohorte de 135 pacientes con incontinencia fecal, recogiendo la información necesaria para clasificarlos según dos clasificaciones publicadas anteriormente en la literatura, ambas basadas en la etiología de la incontinencia fecal. Al analizar los datos, observamos que una clasificación basada sólo en la etiología de la incontinencia puede no ser adecuada a la hora de establecer grupos de pacientes homogéneos, por ello pensamos proponer un nuevo modelo de clasificación basada en los mecanismos fisiopatológicos de la incontinencia, lo que nos permitirá obtener grupos más homogéneos, con problemas similares, y a los que podamos ofrecer líneas de tratamiento similares.Hem fet un estudi descriptiu d'una cohort de 135 pacients amb Incontinència Fecal, recollint la informació necessària per classificar-los seguint dues classificacions publicades anteriorment a la literatura, basades en la etiologia de la incontinència fecal. Al analitzar les dades hem vist que una classificació només basada en els factors causals de la incontinència pot quedar-se curta a l'hora d'establir grups homogenis de pacients, i pensem que s'ha d'establir un nou model de classificació, bassat en els mecanismes fisiopatológics de la incontinència. Això ens permetrà obtenir grups més homogenis, amb problemes similars, i als que podem oferir una mateixa línia de tractament

Impact of severe aortic stenosis on quality of life

Introduction Among individuals ≥ 65 years old, aortic stenosis is highly prevalent and the number of cases is expected to increase in the coming decades, due to the increased life expectancy. Nevertheless, the actual aortic stenosis burden is not well known in population settings and the impact of aortic stenosis on quality of life has not been studied. The aim of this study was to evaluate aortic stenosis impact on health-related quality of life in patients > 65 years old. Methods An epidemiological case-control study was carried out to compare quality of life in patients ≥65 years old with severe symptomatic aortic stenosis. Demographical and clinical information was prospectively obtained and quality of life information was collected with the Short Form Health Survey_v2 (SF-12) questionnaire. The association between quality of life and aortic stenosis was determined using multiple logistic regression models. Results Patients with severe aortic stenosis self-perceived worse quality of life on all dimensions and summary components of the SF-12 questionnaire. In the final multiple logistic regression model a significant inverse association was observed between the dimensions ‘physical role’ and ‘social role’ (p = 0.002 and p = 0.005) and an association close to significance with ‘physical role’ (p = 0.052) of the SF-12 questionnaire. Conclusion The use of quality of life scales allows the assessment of the impact of aortic stenosis on quality of life and may improve the therapeutic approach to severe aortic stenosis, providing evidence for patient‐centered care

Quality of life score of all dimensions and summary components of the SF-12 questionnaire in symptomatic patients with AS ≥ 65 years old.

MCS: Mental Component Summary, PCS: Physical Component Summary. Each bar indicates the score (0–100) for cases and controls of each specific dimension. The bounds are indicating the mean ± standard deviation.</p

Logistic regression model adjusted for statistically significant variables in the baseline model (CVRF and comorbidities) and values of ‘Physical functioning’, ‘Role physical’ and ‘Social functioning’.

Logistic regression model adjusted for statistically significant variables in the baseline model (CVRF and comorbidities) and values of ‘Physical functioning’, ‘Role physical’ and ‘Social functioning’.</p