22 research outputs found
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)
Non-motor symptom burden in patients with Parkinson's disease with impulse control disorders and compulsive behaviours : results from the COPPADIS cohort
The study was aimed at analysing the frequency of impulse control disorders (ICDs) and compulsive behaviours (CBs) in patients with Parkinson's disease (PD) and in control subjects (CS) as well as the relationship between ICDs/CBs and motor, nonmotor features and dopaminergic treatment in PD patients. Data came from COPPADIS-2015, an observational, descriptive, nationwide (Spain) study. We used the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) for ICD/CB screening. The association between demographic data and ICDs/CBs was analyzed in both groups. In PD, this relationship was evaluated using clinical features and treatment-related data. As result, 613 PD patients (mean age 62.47 ± 9.09 years, 59.87% men) and 179 CS (mean age 60.84 ± 8.33 years, 47.48% men) were included. ICDs and CBs were more frequent in PD (ICDs 12.7% vs. 1.6%, p < 0.001; CBs 7.18% vs. 1.67%, p = 0.01). PD patients had more frequent previous ICDs history, premorbid impulsive personality and antidepressant treatment (p < 0.05) compared with CS. In PD, patients with ICDs/CBs presented younger age at disease onset, more frequent history of previous ICDs and premorbid personality (p < 0.05), as well as higher comorbidity with nonmotor symptoms, including depression and poor quality of life. Treatment with dopamine agonists increased the risk of ICDs/CBs, being dose dependent (p < 0.05). As conclusions, ICDs and CBs were more frequent in patients with PD than in CS. More nonmotor symptoms were present in patients with PD who had ICDs/CBs compared with those without. Dopamine agonists have a prominent effect on ICDs/CBs, which could be influenced by dose
Prevención de embarazos no planificados con implantes anticonceptivos subcutáneos de gestágeno desde la atención primaria
Tesis Univ. Granada. Departamento de Medicina Preventiva y Salud Pública. Leída el 3 de julio de 200
Diabetes mellitus gestacional: documento de apoyo
YesLa preocupación por disminuir la variabilidad en la práctica clínica y conseguir una atención de calidad desde el inicio del embarazo hasta el puerperio, sea cual sea el ámbito o profesional que lo atiende, planteó la necesidad de elaborar un documento de apoyo específico sobre DMG que diera respuesta, además, a los interrogantes antes planteados.
El objetivo de este documento, por tanto, es hacer recomendaciones de buenas prácticas en relación con el manejo clínico de la DMG. Para ello, se han incluido las últimas evidencias sobre cribado, diagnóstico y manejo clínico y terapéutico