Role of age and sex in the diagnosis of early-stage malignant melanoma: A cross-sectional study

Age and sex have been identified as predictors of outcome in malignant melanoma (MM). The aim of this multicentre, cross-sectional study was to analyse the role of age and sex as explanatory variables for the diagnosis of thin MM. A total of 2,430 patients with MM were recruited. Cases of in situ (Tis) and T1 MM were more frequent than T2–T4 MM (56.26% vs. 43.74%). Breslow thickness increased throughout decades of life (analysis of variance (ANOVA) p < 0.001), with a weak correlation between Breslow thickness and patient's age (r = 0.202, p < 0.001). Breslow thickness was significantly less in women (1.79 vs. 2.38 mm, p = 0.0001). Binary logistic regression showed a significant (p < 0.001) odds ratio for age 0–29 years (1.18), and 30–59 years (1.16), and for women (1.09). Age and sex explained 3.64% of the variation observed in Tis–T1 frequency (R2 = 0.0364). Age and sex appear to explain a low percentage of the variation in the early detection of MM

PPARγ as an indicator of vascular function in an experimental model of metabolic syndrome in rabbits

Background and aims: Underlying mechanisms associated with vascular dysfunction in metabolic syndrome (MetS) remain unclear and can even vary from one vascular bed to another. Methods: In this study, MetS was induced by a high-fat, high-sucrose diet, and after 28 weeks, aorta and renal arteries were removed and used for isometric recording of tension in organ baths, protein expression by Western blot, and histological analysis to assess the presence of atherosclerosis. Results: MetS induced a mild hypertension, pre-diabetes, central obesity and dyslipidaemia. Our results indicated that MetS did not change the contractile response in either the aorta or renal artery. Conversely, vasodilation was affected in both arteries in a different way. The aorta from MetS showed vascular dysfunction, including lower response to acetylcholine and sodium nitroprusside, while the renal artery from MetS presented a preserved relaxation to acetylcholine and an increased sensitivity to sodium nitroprusside. We did not find vascular oxidative stress in the aorta from MetS, but we found a significant decrease in PPARγ, phospho-Akt (p-Akt) and phospho-eNOS (p-eNOS) protein expression. On the other hand, we found oxidative stress in the renal artery from MetS, and PPARγ, Akt and p-Akt were overexpressed. No evidence of atherosclerosis was found in arteries from MetS. Conclusions: MetS affects vascular function differently depending on the vessel. In the aorta, it decreases both the vasodilation and the expression of the PPARγ/Akt/eNOS pathway, while in the renal artery, it increases the expression of PPARγ/Akt signalling pathway without decreasing the vasodilation

Tendencia en el diagnóstico de melanoma y sus determinantes clínicos, demográficos y sanitarios

Tesis descargada en TESEOAntecedentes: A pesar de los esfuerzos y las mejoras en política de salud que se han realizado en los últimos años para el diagnostico precoz del melanoma cutáneo (MC), no se conoce el impacto real que tienen sobre el pronostico inicial de estos pacientes. Objetivo: Analizar el papel de los factores determinantes de prestación de asistencia sanitaria en el pronóstico inicial del melanoma cutáneo. Métodos: Estudio transversal y multicéntrico se realizó en 14 hospitales públicos y reclutó 3550 pacientes con MC entre 2000 y 2009. Las variables de estudio fueron analizados utilizando análisis univariante y multivariante para identificar su papel en las variaciones observadas. Resultados: En un periodo de 10 años, el número de pacientes con MC aumentó en un 78,54%, con un porcentaje de MC in situ (Tis) o superficial con un espesor Breslow \ 1 mm (T1) que representa 51.72% del número total en el año 2000, aumentando a 62,23% al final del período de estudio (p = 0,005). Entre las variables que explican la variación en la tendencia del MC destacan los MC diagnosticados después del año 2004 (odds univariados ratio [OR], 1,43 [P \ 0,001];multivariado OR, 1,36 [p = 0,005]) y el diagnóstico en centros con sistemas de referencia específica de la vía rápida (univariante OR, 1,24 [p = 0,01]; multivariado OR, 1,59 [p = 0,025]), Limitaciones: La posible limitación principal de este estudio es su carácter retrospectivo

Role of Age and Sex in the Diagnosis of Early-stage Malignant Melanoma: A Cross-Sectional study.

Journal Article;Age and sex have been identified as predictors of outcome in malignant melanoma (MM). This aim of this multicentre, cross-sectional study was to analyse the role of age and sex as explanatory variables for the diagnosis of thin MM. A total of 2430 patients with MM were recruited. Cases of in situ-T1 MM were more frequent than T2-T4 MM (56.26% vs. 43.74%). Breslow thickness increased throughout decades of life (analysis of variance (ANOVA) p < 0.001), with a weak correlation between Breslow thickness and patient's age (r   = 0.202, p < 0.001). Breslow thickness was significantly less in women (1.79 vs. 2.38 mm, p = 0.0001). Binary logistic regression showed a significant (p < 0.001) odds ratio for age 0-29 years (1.18), and 30-59 years (1.16), and for women (1.09). Age and sex explained 3.64% of the variation observed in Tis-T1 frequency (R2 = 0.0364). Age and sex appear to explain a low percentage of the variation in the early detection of MM.The Trends in the Diagnosis of Melanoma(TEDIMEL) Project Study Group is funded by a competitive public grant of the Health Institute Carlos III of the Spanish Health Ministry (IP 10-1929 2010-2013).Ye