Influence of immigration on tuberculosis transmission patterns in Castellón, Spain (2004–2007)

Objetivo Describir los patrones de transmisión de la tuberculosis en Castellón en un periodo de importantes cambios demográficos. Métodos Estudio prospectivo descriptivo de los pacientes con cultivo positivo en la provincia de Castellón entre 2004 y2007. Se describen los pacientes por año y nacionalidad, y se cotejan con los casos declarados a la Dirección General de Salud Pública (DGSP). Se estudia la población con patrón molecular disponible por RFLP (restriction fragment length polymorphism) y se analizan las variables de los pacientes agrupados (clusters) a partir de los datos de la DGSP y del Programa de Gestión del Laboratorio. Resultados Según la DGSP, la tasa global de tuberculosis por 100.000 habitantes en la provincia de Castellón fue de 15,7 en 2004, 19,9 en 2005, 18,2 en 2006 y 17,5 en 2007. En nuestro laboratorio se identificaron las cepas de 301 pacientes, que suponen el 77% (301/390) de los casos declarados y el 94% (301/321) aquellos con cultivo positivo. El porcentaje de tuberculosis en extranjeros aumentó hasta superar el 50% en 2007. Se disponía de estudio molecular en el 95% de los casos (286), con un 58% de españoles y un 42% de extranjeros. El porcentaje de agregación fue del 40%, con un 30% de clusters mixtos. Según el estudio convencional de contactos, el 85% de los pacientes en cluster habían sido considerados casos aislados. Conclusiones El aumento de la tasa de tuberculosis en Castellón se debe, principalmente, al creciente número de los casos en extranjeros. Disponer del estudio molecular de todos los pacientes con cultivo positivo nos ha permitido analizar cómo y dónde se transmite la tuberculosis. El 40% de los pacientes se agruparon en clusters, y eran mixtos un tercio de ellos, lo que indica una elevada integración de los inmigrantes.Background This study aimed to identify tuberculosis transmission patterns in Castellón in a period of major demographic changes. Methods A prospective study of patients with positive culture in the province of Castellon over a 4-year period (2004–2007) was carried out. Cases were described by year and nationality and were compared with those reported to the Department of Public Health. We studied the population with available molecular patterns, identified through restriction fragment length polymorphism (RFLP) and analyzed the variables from patient clusters, based on data collected in surveys of the Department of Health and the Laboratory Management Program. Results According to data from the Department of Public Health, the overall rate of tuberculosis per 100,000 inhabitants in the province of Castellón was 15.7 in 2004, 19.9 in 2005, 18.2 in 2006 and 17.5 in 2007. In our laboratory, strains were identified from 301 patients, representing 77% (301/390) of reported cases and 94% (301/321) of reported cases with a positive culture. The percentage of tuberculosis among foreigners increased with age, exceeding 50% in 2007. Molecular studies were available in 95% of patients (286); 58% were Spanish and 42% were foreigners, of whom 54% were Romanians. The cluster percentage was 40%, with 30% of mixed clusters. According to conventional contact studies, 85% of patients in clusters had been considered isolated cases. Conclusions The increased rate of tuberculosis in Castellón was mainly due to the increasing number of cases among foreigners, mostly Romanians. The availability of molecular studies in all patients with a positive culture allowed us to analyze how and where tuberculosis is transmitted in our province. Forty percent of the patients were grouped into clusters; of these, mixed clusters accounted for one third, indicating the high integration of immigrants in our area

New GOLD classification: longitudinal data on group assignment

Rationale: Little is known about the longitudinal changes associated with using the 2013 update of the multidimensional GOLD strategy for chronic obstructive pulmonary disease (COPD). Objective: To determine the COPD patient distribution of the new GOLD proposal and evaluate how this classification changes over one year compared with the previous GOLD staging based on spirometry only. Methods: We analyzed data from the CHAIN study, a multicenter observational Spanish cohort of COPD patients who are monitored annually. Categories were defined according to the proposed GOLD: FEV1%, mMRC dyspnea, COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ), and exacerbations-hospitalizations. One-year follow-up information was available for all variables except CCQ data. Results: At baseline, 828 stable COPD patients were evaluated. On the basis of mMRC dyspnea versus CAT, the patients were distributed as follows: 38.2% vs. 27.2% in group A, 17.6% vs. 28.3% in group B, 15.8% vs. 12.9% in group C, and 28.4% vs. 31.6% in group D. Information was available for 526 patients at one year: 64.2% of patients remained in the same group but groups C and D show different degrees of variability. The annual progression by group was mainly associated with one-year changes in CAT scores (RR, 1.138; 95%CI: 1.074-1.206) and BODE index values (RR, 2.012; 95%CI: 1.487-2.722). Conclusions: In the new GOLD grading classification, the type of tool used to determine the level of symptoms can substantially alter the group assignment. A change in category after one year was associated with longitudinal changes in the CAT and BODE index

Supplementary Material Metallomic Signatures of Lung Cancer and Chronic Obstructive Pulmonary Disease

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).--Lung cancer (LC) is the leading cause of cancer deaths, and chronic obstructive pulmonary disease (COPD) can increase LC risk. Metallomics may provide insights into both of these tobacco-related diseases and their shared etiology. We conducted an observational study of 191 human serum samples, including those of healthy controls, LC patients, COPD patients, and patients with both COPD and LC. We found 18 elements (V, Al, As, Mn, Co, Cu, Zn, Cd, Se, W, Mo, Sb, Pb, Tl, Cr, Mg, Ni, and U) in these samples. In addition, we evaluated the elemental profiles of COPD cases of varying severity. The ratios and associations between the elements were also studied as possible signatures of the diseases. COPD severity and LC have a significant impact on the elemental composition of human serum. The severity of COPD was found to reduce the serum concentrations of As, Cd, and Tl and increased the serum concentrations of Mn and Sb compared with healthy control samples, while LC was found to increase Al, As, Mn, and Pb concentrations. This study provides new insights into the effects of LC and COPD on the human serum elemental profile that will pave the way for the potential use of elements as biomarkers for diagnosis and prognosis. It also sheds light on the potential link between the two diseases, i.e., the evolution of COPD to LC.This work has been supported by the project “Heteroatom-tagged proteomics and metabolomics to study lung cancer. Influence of gut microbiota” (Ref.: PY20_00366) (Project of Excellence, Regional Ministry of Economy, Knowledge, Business and University, Andalusia, Spain). The authors are also grateful for grants 651/2018 and 115/2020 from the Spanish Society of Pneumology and Surgery (SEPAR) and grant 08/2018 from the Association of Pneumology and Thoracic Surgery (Neumosur), which were used to facilitate recruitment at the hospitals and biobank registration. The authors also thank Instituto de Salud Carlos III (AES16/01783) and wish to express their gratitude for the unrestricted funding from the Menarini Group and AstraZeneca.Peer reviewe

New GOLD classification: longitudinal data on group assignment

In the new GOLD grading classification, the type of tool used to determine the level of symptoms can substantially alter the group assignment. A change in category after one year was associated with longitudinal changes in the CAT and BODE index

Evolution of resistant Mycobacterium tuberculosis in the province of Castellón (Spain): 1992 throug 1998

Objetivos Conocer la frecuencia de las resistencias a Mycobacterium tuberculosis y los factores de riesgo asociados a éstas en la provincia de Castellón. Material y métodos Se ha realizado un estudio prospectivo de la sensibilidad a los tuberculostáticos, por el método de las proporciones de Canetti, de todas las cepas de M. tuberculosis aisladas en nuestra provincia (532) desde enero de 1992 a diciembre de 1998 (7 años), de las que 461 correspondían a casos nuevos. Resultados Encontramos una tasa global de resistencias del 4,7% (25/532), de las cuales el 3,9% (18/461) fueron primarias y el 11,1% (7/63) secundarias. Por fármacos, el 3% eran resistentes a isoniacida, el 1,87% a rifampicina, el 1,87% a estreptomicina y el 0,56% a etambutol. La multirresistencia hallada ha sido del 0,2% (1/461) para los casos nuevos y del 1,1% (6/532) para el total. La presencia de resistencia de M. tuberculosis se asocia al antecedente de tratamiento antituberculoso previo (OR = 3,14; p=0,017), y a la presencia de uno o más factores de riesgo para tuberculosis (OR=3,32; p=0,666). Conclusiones La tasa global de resistencias de M. tuberculosis y la multirresistencia son bajas en la provincia de Castellón; sin embargo, se asocian a un aumento de la mortalidad, de manera que el control de algunos de estos factores de riesgo de tuberculosis prevenibles podría, tal vez, disminuir la frecuencia de resistencias.Objectives To determine the frequency of resistant Mycobacterium tuberculosis and the risk factors associated with resistence in the province of Castellón (Spain). Material and methods This prospective study of M. tuberculosis sensitivity applied Canetti's method of proportions to all strains isolated in Castellón (n = 532) from January 1992 through December 1998 (7 years); 461 cases were new. Results The overall frequency of resistant strains was 4.7% (25/532), of which 3.9% (18/461) were instances of primary resistance and 11.1% (7/63) were of secondary resistance. Thre percent were resistant to isoniazid, 1.87% to rifampicin, 1.87% to streptomycin and 0.56% to ethambutol. Multiple drug resistance was found in 0.2% (1/461) of the new cases and 1.1% (6/532) overall. The presence of resistant M. tuberculosis was associated with a history of antituberculous treatment (OR=3.14; p=0.017) and the presence of one or more risk factors for tuberculosis (OR=3.32; p = 0.066). Conclusions The overall rates of resistant M. tuberculosis and multiple drug resistance are low in the province of Castellón; however resistance is associated with higher mortality such that controlling some preventable risk factors might reduce the frequency of resistance