La mortalidad por cáncer en las comarcas de cataluña (1983–1989)

ResumenObjectivosComparar la mortalidad intercomarcal de Cataluña para algunos de los tumores malignos más frecuentes.MetodologíaSe han analizado los datos globales y de cinco localizaciones tumorales específicas relativos a la mortalidad por cáncer de un período de siete años (1983-1989). Se han obtenido las tasas brutas de mortalidad y las específicas para cada localización analizada. La comparación intercomarcal se ha realizado ajustando las tasas por edad mediante el método directo, tomando como referencia la población de Cataluña de 1986. Se han calculado las razones comparativas de mortalidad (RCM) de cada comarca respecto a Cataluña.ResultadosLa mortalidad global por cáncer es más alta en la comarca del Barcelonés para los hombres y en la de Osona para las mujeres. La RCM de los hombres del Barcelonés es la más alta para el cáncer de tráquea, bronquios y pulmón; la de la comarca del Solsonés es la más alta para el cáncer de estómago, y la de la Cerdanya es la más alta para el cáncer de colon y recto. Entre las mujeres, la RCM más alta para el cáncer de tráquea, bronquios y pulmón la presenta la comarca del Montsiá, para el cáncer de mama la del Baix Empordá y para el cáncer de estómago la del Alt Urgell.ConclusionesEl análisis comparativo de la mortalidad por cáncer, por comarcas y por sexos, permite observar importantes diferencias en la manifestación del fenómeno, lo cual puede orientar de manera más específica las políticas de control del cáncer y de investigación a desarrollar en cada territorio.SummaryObjectivesTo compare mortality among counties (comarques) in Catalonia, Spain for the most frequent malignant tumors.MethodsOverall mortality data and for five specific tumor sites were analyzed for a five-year period (1983-1989). Crude and site-specific mortality rates were computed. The comparison between counties was adjusted for the 1986 population of Catalonia using the direct method. Comparative mortality ratios (CMR) were obtained for each county with respect to Catalonia.ResultsOverall cancer mortality was higher in the Barcelonés for men and in Osona form women. The CMR for men in the Barcelonés was the highest for cancer of the trachea, bronchi and lungs; the CMR in Solsonés was the highest for stomach cancer, while in Cerdanya it was the highest for colorectal cancer. Among women, the highest CMR for cancer of the trachea, bronchi and lungs was in Montsiá, whereas for breast cancer it was Baix Empordá, and Alt Urgell for stomach cancer.ConclusionsComparative analyses of cancer mortality by county in Catalonia and sex underscores differences in its distribution, allowing the orientation of cancer control policies and research to be developed in each geographical area

Percepción del estado de salud en varones y mujeres en las últimas etapas de la vida

ResumenObjetivoAnalizar las diferencias en la percepción del estado de salud de los varones y mujeres en las últimas etapas de la vida y explorar su relación con variables sociodemográficas y de salud.MétodosDatos procedentes de la Encuesta de Salud de Cataluña de 1994, de 1.459 varones y 1.993 mujeres de 60 y más años. Se realizó un análisis de la autovaloración del estado de salud según la edad, el sexo, la clase social, la declaración de enfermedades crónicas y la discapacidades y se aplicó un modelo de análisis multivariable de regresión logística teniendo en cuenta el diseño muestral.ResultadosEl 57,3% de las mujeres de 60 y más años declaraba no tener buena salud, frente al 43,6% de los varones. También fue superior la proporción de mujeres que padecía una o más discapacidades (41,2%) respecto a los varones (28,7%), así como la de enfermedades crónicas, el 92,2% de las mujeres y el 85,6% de los varones. En el modelo de regresión logística multivariable continúa manteniéndose una percepción de mala salud superior en las mujeres y aparecen como factores explicativos el número de enfermedades crónicas, padecer discapacidades y pertenecer a las clases sociales más desfavorecidas. La edad en interacción con las enfermedades crónicas amortigua el efecto de éstas en la valoración del estado de salud.ConclusionesEntre la población anciana, la percepción de mala salud fue superior en las mujeres incluso ajustando por otras variables explicativas significativas (clase social, edad, discapacidades y enfermedades crónicas). Padecer enfermedades crónicas y/o discapacidades constituyen los factores explicativos más importantes en la percepción del estado de salud. El impacto del padecimiento de enfermedades crónicas en relación con la percepción de mala salud disminuye a medida que los grupos son de mayor edad.SummaryObjectivesTo analyze the differences in health self-perception between men and women in the later stages of life and to assess their association with sociodemographic and health variables.MethodsData on 1,459 men and 1,993 women aged 60 or older from the 1994 Catalan Health Survey, were collected and an analysis of health self-perception according to age, gender, social class, reporting of chronic disease and handicaps was performed. Multivariate logistic regression analysis was used, taking into account the survey design.ResultsOf the women aged 60 and older, 57.3% reported poor health compared with 43.6% of men of the same age. The proportion of women with one or more handicaps was also greater (41.2%) than that of the men (28.7%), as was the case with chronic disease (92.2% inwomen and 85.6% in men). The multivariate model also revealed that health self-peerception was poorer among women than among men. Other explanatory factors were the number of chronic diseases, having handicaps, and being a member of a lower social class. Age interacted with the number of chronic diseases to mitigate the effect of chronic diseases on perceived health status.ConclusionsIn the elderly population, poor health self-perception was greater among women, even when other significant explanatory variable (social class, age, handicaps and chronic disease) were adjusted for. The most important explanatory factors in health self-perception were having chronic disease and/or handicaps. The impact of chronic disease on poor health self-perception decreased in older age groups

Large scale diffuse light in the Coma cluster: a multi-scale approach

We have obtained wide field images of the Coma cluster in the B, V, R and I bands with the CFH12K camera at CFHT. In order to search for large scale diffuse emission, we have applied to these images an iterative multi scale wavelet analysis and reconstruction technique which allowed to model all the sources (stars and galaxies) and subtract them from the original images. We found various concentrations of diffuse emission present in the central zone around the central galaxies NGC4874 and NGC4889. We characterize the positions, sizes and colors of these concentrations. Some sources do not seem to have strong star formation, while another one probably exhibits spiral-like color. One possible origin for the star forming diffuse emission sources is that in the region of the two main galaxies NGC4874 and NGC4889 spiral galaxies have recently been disrupted and star formation is still active in the dispersed material. We also use the characteristics of the sources of diffuse emission to trace the cluster dynamics. A scenario in which the group around NGC 4874 is moving north is consistent with our data.Comment: 11 pages, accepted in A&A, jpg figure

The Cluster of Galaxies Abell 970

We present a dynamical analysis of the galaxy cluster Abell 970 based on a new set of radial velocities measured at ESO, Pic du Midi and Haute-Provence observatories. Our analysis indicates that this cluster has a substructure and is out of dynamical equilibrium. This conclusion is also supported by differences in the positions of the peaks of the surface density distribution and X-ray emission, as well as by the evidence of a large scale velocity gradient in the cluster. We also found a discrepancy between the masses inferred with the virial theorem and with the X-ray emission, what is expected if the galaxies and the gas inside the cluster are not in hydrostatic equilibrium. Abell 970 has a modest cooling flow, as is expected if it is out of equilibrium as suggested by Allen (1998). We propose that cooling flows may have an intermittent behavior, with phases of massive cooling flows being followed by phases without significant cooling flows after the acretion of a galaxy group massive enough to disrupt the dynamical equilibrium in the center of the clusters. A massive cooling flow will be established again, after a new equilibrium is achieved.Comment: 24 pages, 9 figures, submitted to A&

ESO Imaging Survey: Optical follow-up of 12 selected XMM-Newton fields

(Abridged) This paper presents the data recently released for the XMM-Newton/WFI survey carried out as part of the ESO Imaging Survey (EIS) project. The aim of this survey is to provide optical imaging follow-up data in BVRI for identification of serendipitously detected X-ray sources in selected XMM-Newton fields. In this paper, fully calibrated individual and stacked images of 12 fields as well as science-grade catalogs for the 8 fields located at high-galactic latitude are presented. The data covers an area of \sim 3 square degrees for each of the four passbands. The median limiting magnitudes (AB system, 2" aperture, 5\sigma detection limit) are 25.20, 24.92, 24.66, and 24.39 mag for B-, V-, R-, and I-band, respectively. These survey products, together with their logs, are available to the community for science exploitation in conjunction with their X-ray counterparts. Preliminary results from the X-ray/optical cross-correlation analysis show that about 61% of the detected X-ray point sources in deep XMM-Newton exposures have at least one optical counterpart within 2" radius down to R \simeq 25 mag, 50% of which are so faint as to require VLT observations thereby meeting one of the top requirements of the survey, namely to produce large samples for spectroscopic follow-up with the VLT, whereas only 15% of the objects have counterparts down to the DSS limiting magnitude.Comment: 24 pages, 10 figures, accepted for publication in Astronomy and Astrophysics. Accompanying data releases available at http://archive.eso.org/archive/public_datasets.html (WFI images), http://www.eso.org/science/eis/surveys/release_65000025_XMM.html (optical catalogs), http://www.aip.de/groups/xray/XMM_EIS/ (X-ray data). Full resolution version available at http://www.astro.uni-bonn.de/~dietrich/publications/3785.ps.g

Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data

<p>Abstract</p> <p>Background</p> <p>During the last part of the 1990s the chance of surviving breast cancer increased. Changes in survival functions reflect a mixture of effects. Both, the introduction of adjuvant treatments and early screening with mammography played a role in the decline in mortality. Evaluating the contribution of these interventions using mathematical models requires survival functions before and after their introduction. Furthermore, required survival functions may be different by age groups and are related to disease stage at diagnosis. Sometimes detailed information is not available, as was the case for the region of Catalonia (Spain). Then one may derive the functions using information from other geographical areas. This work presents the methodology used to estimate age- and stage-specific Catalan breast cancer survival functions from scarce Catalan survival data by adapting the age- and stage-specific US functions.</p> <p>Methods</p> <p>Cubic splines were used to smooth data and obtain continuous hazard rate functions. After, we fitted a Poisson model to derive hazard ratios. The model included time as a covariate. Then the hazard ratios were applied to US survival functions detailed by age and stage to obtain Catalan estimations.</p> <p>Results</p> <p>We started estimating the hazard ratios for Catalonia versus the USA before and after the introduction of screening. The hazard ratios were then multiplied by the age- and stage-specific breast cancer hazard rates from the USA to obtain the Catalan hazard rates. We also compared breast cancer survival in Catalonia and the USA in two time periods, before cancer control interventions (USA 1975–79, Catalonia 1980–89) and after (USA and Catalonia 1990–2001). Survival in Catalonia in the 1980–89 period was worse than in the USA during 1975–79, but the differences disappeared in 1990–2001.</p> <p>Conclusion</p> <p>Our results suggest that access to better treatments and quality of care contributed to large improvements in survival in Catalonia. On the other hand, we obtained detailed breast cancer survival functions that will be used for modeling the effect of screening and adjuvant treatments in Catalonia.</p

Duration and compliance with antidepressant treatment in immigrant and native-born populations in Spain: a four year follow-up descriptive study

<p>Abstract</p> <p>Background</p> <p>Non-compliance with antidepressant treatment continues to be a complex problem in mental health care. In immigrant populations non-compliance is one of several barriers to adequate management of mental illness; some data suggest greater difficulties in adhering to pharmacological treatment in these groups and an increased risk of therapeutic failure.</p> <p>The aim of this study is to assess differences in the duration and compliance with antidepressant treatment among immigrants and natives in a Spanish health region.</p> <p>Methods</p> <p>Population-based (n=206,603), retrospective cohort study including all subjects prescribed ADT between 2007 and 2009 and recorded in the national pharmacy claims database. Compliance was considered adequate when the duration was longer than 4months and when patients withdrew more than 80% of the packs required.</p> <p>Results</p> <p>5334 subjects (8.5% of them being immigrants) initiated ADT. Half of the immigrants abandoned treatment during the second month (median for natives=3months). Of the immigrants who continued, only 29.5% presented good compliance (compared with 38.8% in natives). The estimated risk of abandoning/ending treatment in the immigrant group compared with the native group, adjusted for age and sex, was 1.28 (95%CI 1.16-1.42).</p> <p>Conclusions</p> <p>In the region under study, immigrants of all origins present higher percentages of early discontinuation of ADT and lower median treatment durations than the native population. Although this is a complex, multifactor situation, the finding of differences between natives and immigrants in the same region suggests the need to investigate the causes in greater depth and to introduce new strategies and interventions in this population group.</p

The NGC4839 group falling into the Coma cluster observed by XMM-Newton

We present here the first analysis of the XMM Newton EPIC-MOS data of the galaxy group around NGC4839, which lies at a projected distance to the Coma cluster center of 1.6Mpc. In our analysis, which includes imaging, spectro-imaging and spectroscopy we find compelling evidence for the sub group being on its first infall onto the Coma cluster. The complex temperature structure around NGC 4839 is consistent with simulations of galaxies falling into a cluster environment. We see indications of a bow shock and of ram pressure stripping around NGC4839. Furthermore our data reveal a displacement between NGC4839 and the center of the hot gas in the group of about 300kpc. With a simple approximation we can explain this displacement by the pressure force originating from the infall, which acts much stronger on the group gas than on the galaxies.Comment: 6 pages, Accepted for publication in the special A&A Letters issue for XMM-Newto

Emergency hospital services utilization in Lleida (Spain): A cross-sectional study of immigrant and Spanish-born populations

<p>Abstract</p> <p>Background</p> <p>The use of emergency hospital services (EHS) has increased steadily in Spain in the last decade while the number of immigrants has increased dramatically. Studies show that immigrants use EHS differently than native-born individuals, and this work investigates demographics, diagnoses and utilization rates of EHS in Lleida (Spain).</p> <p>Methods</p> <p>Cross-sectional study of all the 96,916 EHS visits by patients 15 to 64 years old, attended during the years 2004 and 2005 in a public teaching hospital. Demographic data, diagnoses of the EHS visits, frequency of hospital admissions, mortality and diagnoses at hospital discharge were obtained. Utilization rates were estimated by group of origin. Poisson regression was used to estimate the rate ratios of being visited in the EHS with respect to the Spanish-born population.</p> <p>Results</p> <p>Immigrants from low-income countries use EHS services more than the Spanish-born population. Differences in utilization patterns are particularly marked for Maghrebi men and women and sub-Saharan women. Immigrant males are at lower risk of being admitted to the hospital, as compared with Spanish-born males. On the other hand, immigrant women are at higher risk of being admitted. After excluding the visits with gynecologic and obstetric diagnoses, women from sub-Saharan Africa and the Maghreb are still at a higher risk of being admitted than their Spanish-born counterparts.</p> <p>Conclusion</p> <p>In Lleida (Spain), immigrants use more EHS than the Spanish born population. Future research should indicate whether the same pattern is found in other areas of Spain and whether EHS use is attributable to health needs, barriers to access to the primary care services or similarities in the way immigrants access health care in their countries of origin.</p

Significant differences in the use of healthcare resources of native-born and foreign born in Spain

<p>Abstract</p> <p>Background</p> <p>In the last decade, the number of foreign residents in Spain has doubled and it has become one of the countries in the European Union with the highest number of immigrants There is no doubt that the health of the immigrant population has become a relevant subject from the point of view of public healthcare. Our study aimed at describing the potential inequalities in the use of healthcare resources and in the lifestyles of the resident immigrant population of Spain.</p> <p>Methods</p> <p>Cross-sectional, epidemiological study from the Spanish National Health Survey (NHS) in 2006, from the Ministry of Health and Consumer Affairs. We have worked with individualized secondary data, collected in the Spanish National Health Survey carried out in 2006 and 2007 (SNHS-06), from the Ministry of Health and Consumer Affairs. The format of the SNHS-06 has been adapted to the requirements of the European project for the carrying out of health surveys.</p> <p>Results</p> <p>The economic immigrant population resident in Spain, present diseases that are similar to those of the indigenous population. The immigrant population shows significantly lower values in the consumption of alcohol, tobacco and physical activity (OR = 0.76; CI 95%: 0.65–0.89, they nonetheless perceive their health condition as worse than that reported by the autochthonous population (OR = 1.63, CI 95%: 1.34–1.97). The probability of the immigrant population using emergency services in the last 12 months was significantly greater than that of the autochthonous population (OR = 1.31, CI 95%: 1.12–1.54). This situation repeats itself when analyzing hospitalization data, with values of probability of being hospitalized greater among immigrants (OR = 1.39, CI 95%: 1.07–1.81).</p> <p>Conclusion</p> <p>The economic immigrants have better parameters in relation to lifestyles, but they have a poor perception of their health. Despite the fact that immigrant population shows higher percentages of emergency attendance and hospitalization than the indigenous population, with respect to the use of healthcare resources, their usage of healthcare resources such as drugs, influenza vaccinations or visits to the dentist is lower.</p