Monitoring and tracking the spread of SARS-CoV-2 in Asturias, Spain.

Mutational analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can quantify the relative importance of variants over time, enable dominant mutations to be identified, and facilitate near real-time detection, comparison and tracking of evolving variants. SARS-CoV-2 in Asturias, an autonomous community of Spain with a large ageing population, and high levels of migration and tourism, was monitored and tracked from the beginning of the pandemic in February 2020 until its decline and stabilization in August 2021, and samples were characterized using whole genomic sequencing and single nucleotide polymorphisms. Data held in the GISAID database were analysed to establish patterns in the appearance and persistence of SARS-CoV-2 strains. Only 138 non-synonymous mutations occurring in more than 1 % of the population with SARS-CoV-2 were found, identifying ten major variants worldwide (seven arose before January 2021), 19 regional and one local. In Asturias only 17 different variants were found. After vaccination, no further regional major variants were found. Only half of the defined variants circulated and no new variants were generated, indicating that infection control measures such as rapid diagnosis, isolation and vaccination were efficient.

[Risk factors for developing laryngeal cancer in adult population at the Hospital Español in Mexico City]. / Factores de riesgo de desarrollo de cáncer de laringe en la población adulta del Hospital Español de México.

INTRODUCTION: Laryngeal cancer is the most frequent head and neck cancer. Considerable geographic differences exist in its incidence by gender. In Spain, there is male predominance (>90%). Numerous authors have documented exposure to tobacco and/or alcohol as the main risk factors for laryngeal cancer. Gastroesophageal reflux, genetics, occupational factors and also human papilloma virus are also cited. PATIENTS AND METHOD: The present study involved 43 patients diagnosed with laryngeal cancer and 130 healthy control subjects. The goal was to establish the frequency affecting both sexes and to identify the risk factors of those born in Spain but living in Mexico. Odds ratios (OR) for each risk factor were analyzed using univariate analysis. RESULTS: A considerable predominance of laryngeal cancer was found in males (90.6%). Tobacco (OR=6.56) and alcohol consumption (OR=3.04) are significant risk factors with a multiplier effect. Gastroesophageal reflux does not show any significant OR. Occupational exposure had a significant OR=37.28. CONCLUSIONS: The main advantage of this type of studies is the ability to design strategies to modify the risk factors. Male predominance and risk factors were no different from other findings reported in Spain, except for the considerable risk relating to occupational exposure.

Factores de riesgo de desarrollo de cáncer de laringe en la población adulta del Hospital Español de México / Risk factors for developing laryngeal cancer in adult population at the Hospital Español in Mexico city

Introducción: De los diversos tipos de cáncer de cabeza y cuello, el cáncer de laringe es el más frecuente. El patrón geográfico de su incidencia difiere en uno y otro sexo. En España, predomina en varones (> 90%). Numerosos autores documentan que los principales factores de riesgo de cáncer de laringe son la exposición al tabaco y/o el alcohol. También se señala al reflujo gastroesofágico, factores genéticos, factores ocupacionales y el virus del papiloma humano. Pacientes y método: Se realiza un estudio en 43 pacientes con cáncer de laringe y 130 controles sanos, teniendo como objetivo conocer la frecuencia de afección en cada sexo e identificarlos factores de riesgo en pacientes con cáncer de laringe nacidos en España y residentes en México. Se analiza la razón de momios (OR) de manera univariable para cada uno. Resultados: Se encuentra un predominio importante de cáncer de laringe en varones (90,6 %). El tabaquismo (OR = 6,56) y el alcoholismo (OR = 3,04) son importantes factores de riesgo, con un efecto multiplicativo. La enfermedad por reflujo gastroesofágico no demostró tener una OR significativa. Se evidencia un riesgo significativo (OR = 37,28) por exposición ocupacional. Conclusiones: La ventaja evidente de este tipo de estudios consiste en que permite diseñar estrategias para incidir en los factores de riesgo. El predominio de afección en varones y los factores de riesgo no difieren de lo publicado de pacientes en España, con excepción del importante riesgo de la exposición ocupacional (AU)

Introduction: Laryngeal cancer is the most frequent head and neck cancer. Considerable geographic differences exist in its incidence by gender. In Spain, there is male predominance (> 90%). Numerous authors have documented exposure to tobacco and/or alcohol as the main risk factors for laryngeal cancer. Gastroesophageal reflux, genetics, occupational factors and also human papilloma virus are also cited. Patients and method: The present study involved 43 patients diagnosed with laryngeal cancer and 130 healthy control subjects. The goal was to establish the frequency affecting both sexes and to identify the risk factors of those born in Spain but living in Mexico. Odds ratios (OR) for each risk factor were analyzed using univariate analysis. Results: A considerable predominance of laryngeal cancer was found in males (90.6 %). Tobacco (OR = 6.56) and alcohol consumption (OR = 3.04) are significant risk factors with a multiplier effect. Gastroesophageal reflux does not show any significant OR. Occupational exposure had a significant OR = 37.28.Conclusions: The main advantage of this type of studies is the ability to design strategies to modify the risk factors. Male predominance and risk factors were no different from other findings reported in Spain, except for the considerable risk relating to occupational exposure (AU)

[Experience with Epley's manoeuvre and vestibular habituation training in benign paroxysmal positional vertigo]. / Experiencia con la maniobra de Epley y con ejercicios de habituación vestibular en el vértigo posicional paroxístico benigno del canal semicircular posterior.

INTRODUCTION: The most frequent vestibular disorder is benign paroxysmal positional vertigo. In almost all patients it occurs spontaneously and mainly through involvement of the posterior semicircular canal. Treatment consists in vestibular habituation training and in canalith repositioning manoeuvres. PATIENTS AND METHOD: A retrospective review of patient files between 1999 to 2001 evaluated those diagnosed as having BPPV due to the posterior semicircular canal in order to compare the response to treatment with vestibular habituation training and with Epley's manoeuvre. The cases are described and analyzed and their response to treatment is compared using Fisher's exact test. RESULTS: The percentage of success with Epleys manoeuvre was 100 %. Eighty-two per cent of patients responded in the first seven days after the first manoeuvre. Relapses occurred in 17.6 %. With vestibular habituation training, a success rate of 90 % was obtained in the first month, and this decreased to 80 % by the end of the second and third months. Significant differences between the two therapeutic modalities were only visible at the conclusion of the first seven days of treatment (P=.01). CONCLUSIONS: The evident advantage with Epley's manoeuvre is that it greatly reduces the time required to obtain a satisfactory result. In addition, it allows patients to return quickly to their daily activities and improves their quality of life.

Experiencia con la maniobra de Epley y con ejercicios de habituación vestibular en el vértigo posicional paroxístico benigno del canal semicircular posterior / Experience with Epley’s manoeuvre and vestibular habituation training in benign paroxysmal positional vertigo

Introducción: El vértigo posicional paroxístico benigno (VPPB) es la alteración vestibular más frecuente. En la mayoría de los pacientes ocurre de manera espontánea y principalmente por afectación del canal semicircular posterior. Su tratamiento consiste en ejercicios de habituación vestibular y en maniobras de reposición canalicular. Pacientes y método: Se realiza una revisión retrospectiva de expedientes entre 1999 y 2001 para evaluar una serie de pacientes con diagnóstico de VPPB por afección del canal semicircular posterior, teniendo como objetivo comparar los resultados clínicos que se obtienen con la aplicación de la maniobra de Epley y los ejercicios de habituación vestibular. Se analizan descriptivamente los casos y se compara la respuesta al tratamiento mediante prueba exacta de Fisher. Resultados: En el período revisado se encontró a 27 pacientes. El éxito con la maniobra de Epley fue el 100 %. En el 82 % de los pacientes ocurrió 7 días tras la aplicación de la primera maniobra. Se observó recidiva en el 17,6 %. Con ejercicios de habituación vestibular se obtuvo el 90 % de éxito al final del primer mes, aunque disminuyó al 80 % para el final del segundo y el tercer mes. Únicamente se demostró diferencia significativa entre las dos modalidades terapéuticas al concluir los primeros 7 días de tratamiento (p = 0,01). Conclusiones: La ventaja evidente de la maniobra de Epley es que reduce de forma importante el tiempo necesario para obtener un resultado satisfactorio, lo que permite al paciente regresar en un tiempo breve a sus actividades cotidianas y que mejore su calidad de vida

Introduction: The most frequent vestibular disorder is benign paroxysmal positional vertigo. In almost all patients it occurs spontaneously and mainly through involvement of the posterior semicircular canal. Treatment consists in vestibular habituation training and in canalith repositioning manoeuvres. Patients and method: A retrospective review of patient files between 1999 to 2001 evaluated those diagnosed as having BPPV due to the posterior semicircular canal in order to compare the response to treatment with vestibular habituation training and with Epley’s manoeuvre. The cases are described and analyzed and their response to treatment is compared using Fisher’s exact test. Results: The percentage of success with Epley’s manoeuvre was 100 %. Eighty-two per cent of patients responded in the first seven days after the first manoeuvre. Relapses occurred in 17.6 %. With vestibular habituation training, a success rate of 90 % was obtained in the first month, and this decreased to 80 % by the end of the second and third months. Significant differences between the two therapeutic modalities were only visible at the conclusion of the first seven days of treatment (P=.01). Conclusions: The evident advantage with Epley’s manoeuvre is that it greatly reduces the time required to obtain a satisfactory result. In addition, it allows patients to return quickly to their daily activities and improves their quality of life