Autoestima en personas con daño cerebral adquirido según práctica de actividad física / Self-esteem in people with acquired brain injury according to physical activity

La literatura científica señala la importancia de la actividad física (AF) en las personas con daño cerebral adquirido (DCA) para mantener su salud y funcionalidad; sin embargo, en general presentan secuelas crónicas, bajos niveles de AF y baja autoestima. Con el objetivo de analizar la autoestima en personas con DCA en fase crónica en función de la práctica de AF, se realizó un estudio quasi-experimental ex post facto, comparando dos grupos: personas que realizaban AF(n=50)y personas que no realizaba AF(n=49), evaluando la autoestima con la Escala de Rosenberg. Se realizó un análisis descriptivo y se utilizó la prueba T para muestras independientes. Así, el grupo que realizó AF mostró mejor autoestima y mayor autonomía personal (p≤0.05). Por ello, se recomienda la práctica de AF para mejorarla autoestima en personas con DCA. Además, haber practicado AF antes del DCA parece ser determinante para su práctica a posteriori. (AU)

People with acquired brain injury (ABI) have long-term consequences and show low levels of physical activity (PA), presenting worse self-esteem. Nevertheless, it is proven that the practice of PA in people with ABI improve psychological dimension. The aim was to study if self-esteem in people with ABI in the chronic phase is influenced by PA practice. A quasi-experimental ex post facto design was used, where there were two groups: PA group (n=50) and the sedentary group (n=49). The Rosenberg Scale was used to measure self-esteem. A descriptive analysis was carried out and the T test for independent samples was used. People who practice PA perceived better self-esteem and higher autonomy (p ≤0.05). Therefore, the practice of PA is recommended to improve self-esteem in people with ABI. Furthermore, having practiced PA before the ABI seems to be decisive for its subsequent practice. (AU)

Influence of nitric oxide signaling mechanisms in cancer.

Nitric oxide (NO) is a molecule with multiple biological functions that is involved in various pathophysiological processes such as neurotransmission and blood vessel relaxation as well as the endocrine system, immune system, growth factors, and cancer. However, in the carcinogenesis process, it has a dual behavior; at low doses, NO regulates homeostatic functions, while at high concentrations, it promotes tissue damage or acts as an agent for immune defense against microorganisms. Thus, its participation in the carcinogenic process is controversial. Cancer is a multifactorial disease that presents complex behavior. A better understanding of the molecular mechanisms associated with the initiation, promotion, and progression of neoplastic processes is required. Some hypotheses have been proposed regarding the influence of NO in activating oncogenic pathways that trigger carcinogenic processes, because NO might regulate some signaling pathways thought to promote cancer development and more aggressive tumor growth. Additionally, NO inhibits apoptosis of tumor cells, together with the deregulation of proteins that are involved in tissue homeostasis, promoting spreading to other organs and initiating metastatic processes. This paper describes the signaling pathways that are associated with cancer, and how the concentration of NO can serve a beneficial or pathological function in the initiation and promotion of neoplastic events.

Identifying Features of Cardiac Disease Phenotypes Based on Mechanical Function in a Catecholaminergic Polymorphic Ventricular Tachycardia Model.

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is characterized by an arrhythmogenic mechanism involving disruption of calcium handling. This genetic disease can lead to sudden death in children and young adults during physical or emotional stress. Prior CPVT studies have focused on calcium handling, but mechanical functionality has rarely been investigated in vitro. In this research we combine stem cell-derived cardiomyocytes from a CPVT patient (RyR2-H2464D mutation) and a healthy familial control with an engineered culture platform to evaluate mechanical function of cardiomyocytes. Substrates with Young's modulus ranging from 10 to 50 kPa were used in conjunction with microcontact printing of ECM proteins into defined patterns for subsequent attachment. Digital Image Correlation (DIC) was used to evaluate collections of contracting cells. The amplitude of contractile strain was utilized as a quantitative indicator of functionality and disease severity. We found statistically significant differences: the maximum contractile strain was consistently higher in patient samples compared to control samples on all substrate stiffnesses. Additionally, the patient cell line had a statistically significantly slower intrinsic contraction rate than the control, which agrees with prior literature. Differences in mechanical strain have not been previously reported, and hypercontractility is not a known characteristic of CPVT. However, functional changes can occur as the disease progresses, thus this observation may not represent behavior observed in adolescent and adult patients. These results add to the limited studies of mechanical function of CPVT CMs reported in literature and identify functional differences that should be further explored.

Cumplimiento de la dieta mediterránea en el personal sanitario de la provincia de Las Palmas / Adherence to the Mediterranean diet in health personnel from the province of Las Palmas

Antecedentes y objetivos Demostrado efecto protector de la dieta mediterránea, se evaluó su seguimiento y la influencia de distintos factores en el cumplimiento dietético. Material y métodos Se realizó un estudio transversal con encuestas anónimas para obtener datos sobre características demográficas, actividad laboral, antecedentes de factores de riesgo cardiovascular, consumo de alcohol y tabaco, actividad física y consumo de dieta mediterránea. Se evaluó el cumplimiento por medio del cuestionario 14-point Mediterranean Diet Adherence Score (MEDAS) y los factores estadísticamente relacionados con el mismo. Resultados y conclusiones De 922 personas encuestadas (664 mujeres) de edad media 42,61 años (rango: 20 a 69 años), un 61,2% mostró buen cumplimiento. De manera independiente, el consumo de la dieta mediterránea se asoció con la categoría profesional, siendo superior en el personal médico (OR = 1,92; IC 95%: 1,20 a 3,06; p = 0,01) y de enfermería (OR = 1,67; IC 95%: 1,08 a 2,57) comparado con los técnicos auxiliares en cuidados de enfermería. Además, se relacionó con realizar actividad física (OR = 1,78; IC 95%: 1,29 a 2,47; p < 0,001) y cocinar en casa (OR = 1,35; IC 95%: 1,00 a 1,80; p = 0,05). Sin embargo, no se asoció significativamente con la edad, el sexo ni con la presencia de comorbilidades, con las características de la jornada laboral, ni con el consumo de alcohol ni tabaco. Convendría cuantificar el conocimiento sobre la dieta e incrementar los programas educativos, fomentando el ejercicio y el hábito culinario (AU)

Introduction and objectives Given the proven protective effect of the Mediterranean Diet, adherence to it by healthcare personnel and the influence of different factors on dietary compliance were evaluated. Methods A cross-sectional study was conducted on healthcare personnel, obtaining the data through anonymous surveys that collected demographic characteristics, professional activity, history of cardiovascular risk factors, alcohol, and tobacco consumption, physical activity, and adherence to the Mediterranean Diet, using the 14-point Mediterranean Diet Adherence Score (MEDAS). Adherence and related factors were measured. Results and conclusions Of a total of 922 respondents (664 women) mean aged 42.61 years (range 20 to 69), 61.2% showed a good adherence to the Mediterranean Diet. Adherence was significantly associated with the professional categories of physicians (OR = 1.92; 95% CI: 1.20-3.06; p = 0.01) and nurses (OR = 1.67; 95% CI: 1.08-2.57). Furthermore, it was associated with physical exercise (OR = 1.78; 95% CI: 1.29 – 2.47; p < 0.001) and cooking at home (OR = 1.35; 95% CI: 1.00 – 1.80; p = 0.05). However, adherence was not significantly associated with age or sex, comorbidities, working hours, alcohol, or tobacco consumption. Quantifying knowledge of the diet would be useful, as well as increasing educational programs, promoting physical exercise and cooking habits (AU)

Adherence to the Mediterranean diet in health personnel from the province of Las Palmas.

INTRODUCTION AND OBJECTIVES: Given the proven protective effect of the Mediterranean Diet, adherence to it by healthcare personnel and the influence of different factors on dietary compliance were evaluated. METHODS: A cross-sectional study was conducted on healthcare personnel, obtaining the data through anonymous surveys that collected demographic characteristics, professional activity, history of cardiovascular risk factors, alcohol, and tobacco consumption, physical activity, and adherence to the Mediterranean Diet, using the 14-point Mediterranean Diet Adherence Score (MEDAS). Adherence and related factors were measured. RESULTS AND CONCLUSIONS: Of a total of 922 respondents (664 women) mean aged 42.61 years (range 20-69), 61.2% showed a good adherence to the Mediterranean Diet. Adherence was significantly associated with the professional categories of physicians (OR = 1.92; 95% CI: 1.20-3.06; p = 0.01) and nurses (OR = 1.67; 95% CI: 1.08-2.57). Furthermore, it was associated with physical exercise (OR = 1.78; 95% CI: 1.29-2.47; p < 0.001) and cooking at home (OR = 1.35; 95% CI: 1.00-1.80; p = 0.05). However, adherence was not significantly associated with age or sex, comorbidities, working hours, alcohol, or tobacco consumption. Quantifying knowledge of the diet would be useful, as well as increasing educational programs, promoting physical exercise and cooking habits.

Nivel de deterioro cognitivo del adulto mayor de la comunidad de Tlahuelilpan, Hidalgo, México / Level of cognitive impairment of older adults in the community of Tlahuelilpan, Hidalgo, Mexico

Introducción: la Organización Mundial de la Salud (OMS) declara que el deterioro cognitivo afecta a nivel mundial a unos 50 millones de personas y se calcula que entre un 5 y un 8 % de la población general de 60 años o más sufre deterioro cognitivo en un determinado momento. En la población mexicana se espera un crecimiento exponencial de la población geriátrica y, en consecuencia, un aumento significativo de casos de demencia. Ahora, se cuenta con algunos reportes clínicos sobre la presencia de 500 mil a 700 mil personas con demencia, de las cuales se estima que 25 % no han sido diagnosticadas. Objetivo: evaluar el nivel de deterioro cognitivo del adulto mayor de la comunidad de Tlahuelilpan, Hidalgo. Material y métodos: investigación de aplicabilidad básica con un enfoque cuantitativo y un nivel de alcance descriptivo además un diseño descriptivo transversal Resultados: en nuestra población de estudio predominó el género femenino, el rango de edad se centró entre 60 y 90 años de edad, prevalece el nivel de escolaridad primaria y estado civil casados, el más alto porcentaje de los adultos mayores no tienen deterioro cognitivo. Conclusión: se encontró a nuestra población sin deterioro cognitivo.

Introduction: the World Health Organization (WHO) states that cognitive impairment affects glo¬bally about 50 million people and it is estimated that between 5% and 8% of the general population aged 60 years or older suffers cognitive impairment at any given time. A significant increase in cases of cognitive impairment is expected In the Mexican population, an explosive growth of the geriatric population is expected and, consequently, a significant increase in cases of dementia. Currently there are some clinical reports on the presence of 500,000 to 700,000 people with dementia, of which it is estimated that 25 % have not been diagnosed. Objective: to assess the level of cognitive impairment of older adults in the community of Tlahuelilpan, Hidalgo. Material and methods: research of basic applicability with a quantitative approach and a descriptive scope level in addition to a cross-sectional descriptive design. Results: in our study population there was a predominance of female gender, the age range was between 60 and 90 years of age, with a predominance of primary school level and mostly married, the highest percentage of older adults were found without cognitive impairment. Conclusion: our population was found without cognitive impairment.

Long-term outcomes of induction chemotherapy followed by chemoradiotherapy vs chemoradiotherapy alone as treatment of unresectable head and neck cancer: follow-up of the Spanish Head and Neck Cancer Group (TTCC) 2503 Trial.

BACKGROUND: Our previous phase-3 study (TTCC 2503) failed to show overall survival advantage of 2 induction chemotherapy (IC) regimens followed by standard concurrent chemoradiotherapy (CRT) over CRT alone in patients with unresectable locally advanced head and neck squamous-cell carcinoma (LAHNSCC). This study described the long-term survival of those patients. MATERIALS AND METHODS: Long-term follow-up study of patients with untreated LAHNSCC assigned to IC (three cycles), with either docetaxel, cisplatin and 5-fluorouracil (TPF arm) or cisplatin and 5-fluorouracil (PF arm), followed by CRT, or CRT alone, included in the previous TTCC 2503 trial. RESULTS: In the intention-to-treat population (n = 439), the median OS times were 25.4 (95% CI, 16.8-34.4), 26.2 (95% CI, 18.2-36.6) and 25.4 months (95% CI, 17.4-36.0) in the TPF-CRT, PF-CRT and CRT arms, respectively (log-rank p = 0.51). In the per-protocol population (n = 355), patients with larynx-hypopharynx primary tumors treated with IC (TPF or PF) followed by CRT had a longer median PFS than those who received CRT alone. Moreover, patients with ECOG 0 treated with IC (TPF or PF) followed by CRT had a better TTF than those with CRT alone. There were no statistically significant differences in terms of OS, PFS or TTF, according to the tumor load or affected nodes. CONCLUSION: After a long follow-up, the TTCC 2503 trial failed to show the benefit of IC-CRT in unresectable LAHNSCC regarding the primary end point. However, fit patients with ECOG 0 and primary larynx-hypopharyngeal tumors may benefit from the use of IC if administered by an experienced team. ClinicalTrials.gov identifier NCT00261703.

Effect of Noble Metal Addition on the Disorder Dynamics of Ni3Al by Means of Monte Carlo Simulation.

In this work, the effect of the addition of noble metals on the order-order disorder process of the L12 structure corresponding to the intermetallic Ni3Al is analyzed. Stoichiometric, nonstoichiometric, and quasi-binary compositions doped with noble metals such as Ag, Au, Pd, and Pt (1 at%) were analyzed. It was observed that depending on the composition, there is a modification in the activation energies calculated from the two time constants that characterize the disorder process. The statistic of atomic jumps was typified based on the configuration of the window to be crossed and, with this, it was identified that the origin of the negative activation energy of the long disorder process is due to an increase in the corresponding energy of the AlAl-Ni jump through unnatural windows.

Rare Earth-Based Compounds as Inhibitors of Hot-Corrosion Induced by Vanadium Salts.

In this study, the performance evaluation of lanthanum compounds as corrosion inhibitors of vanadium salts was performed. The inhibitors tested were lanthanum acetate and La2O3. The performance of the inhibitors was tested using sodium metavanadate (NaVO3) as a corrosive medium at 700, 800, and 900 °C. The corrosion inhibitory effect was evaluated on the corrosion process of 304H stainless steel. The corrosion rate of the steel was determined by the mass loss technique after 100 h of immersion in the corrosive salt with and without the addition of the corrosion inhibitor. The results show that lanthanum compounds act as corrosion inhibitors of vanadium salts. The inhibitory effect increases by increasing the concentration and tends to decrease when increasing the test temperature. Lanthanum compounds act as excellent corrosion inhibitors due to their ability to stabilize vanadium cations. Vanadium is stabilized by forming a new compound, lanthanum vanadate (LaVO4), with a melting point much higher than the compounds formed when Mg or Ni compounds are used as corrosion inhibitors.

SEOM clinical guidelines for the treatment of head and neck cancer (2017).

Head and neck cancer (HNC) is defined as malignant tumours located in the upper aerodigestive tract and represents 5% of oncologic cases in adults in Spain. More than 90% of these tumours have squamous histology. In an effort to incorporate evidence obtained since 2013 publication, Spanish Society of Medical Oncology (SEOM) presents an update of HNC diagnosis and treatment guideline. The eighth edition of TNM classification, published in January 2017, introduces important changes for p16-positive oropharyngeal tumours, for lip and oral cavity cancer and for N3 category. In addition, there are new data about induction chemotherapy and the role of immunotherapy in HNC.

Mortality hospital of nonagenarian patients in Internal Medicine. / Mortalidad hospitalaria de pacientes nonagenarios en Medicina Interna.

OBJECTIVES: To describe the predictors of hospital mortality in nonagenarian patients. PATIENTS AND METHOD: We retrospectively studied 421 patients aged 90 years or older hospitalised in a department of internal medicine. Using logistic regression, we analysed the association between demographic, clinical and functional parameters and hospital mortality. RESULTS: The mean age was 92.5 years (SD±2.5), and 265 (62.9%) of the patients were women. The main diagnoses were infectious diseases (257 patients, 61%) and heart failure (183, 43.5%), and the mean stay was 11.9 days (SD±8.6). During the hospitalisation, 96 patients died (22.8%). The predictors of mortality were age (P=.002), functional state (P=.006), comorbidity (P=.018) and diagnoses of pneumonia (P=.001), sepsis (P=.012) and respiratory failure (P<.001). CONCLUSION: The hospital mortality of nonagenarian patients treated in internal medicine exceeds 20% and is associated with pneumonia, comorbidity burden and functional impairment.

Oncologist's knowledge and implementation of guidelines for breakthrough cancer pain in Spain: CONOCE study.

PURPOSE: Breakthrough cancer pain (BTcP) has been shown to be a prevalent and poor prognostic factor for oncologic patients, which remain under diagnosed and undertreated. In 2012, the Spanish Society of Medical Oncology (SEOM) published a clinical practice guideline (CPG) for the treatment of cancer pain which specifically addressed the management of BTcP. METHODS: Fundación ECO designed a qualitative study using an Internet-based survey to investigate the attitudes toward, compliance with, and use of SEOM Guideline. RESULTS: A total of 83 oncologists with a mean experience of 13 years responded. Overall, 82% were aware of different guidelines to manage BTcP. Notably, attitudes toward guidelines were highly positive and there was nearly unanimous agreement that CPG provided the best scientific evidence available (99%), on the minimum information to be gathered for the medical history (100%), on the need for a specific treatment for BTcP (100%), and fentanyl as the first-choice drug (99%). Interestingly, there were discrepancies between what oncologists agreed with and what they do in clinical practice. In fact, 87.6% declare full compliance with SEOM guideline, although adherence to registration of BTcP data in medical records ranged from 30.1 to 91.6% (mean 64.5%); therapeutic management compliance was higher ranging from 75.9 to 91.6%. Main barriers identified were time pressure together with vague statements and limited dissemination of the guidelines. CONCLUSION: Despite oncologist's clinical practice is increasingly guided by GPC, it suffers from limited compliance, at least in part due to suboptimal statements. Improved dissemination and education are needed to enhance guideline implementation.

Coexistence of GH-Producing Pituitary Macroadenoma and Meningioma in a Patient with Multiple Endocrine Neoplasia Type 1 with Hyperglycemia and Ketosis as First Clinical Sign.

We present the clinical case of a patient who was admitted with an onset of diabetes mellitus (DM) with associated ketosis and whose clinical, hormonal, and radiological evolution revealed the presence of primary hyperparathyroidism, pancreatic neuroendocrine tumor, and GH-producing pituitary macroadenoma in the context of multiple endocrine neoplasia type 1 (MEN1). DM is relatively common in cases of acromegaly, but it is not generally associated with ketosis. Simultaneously, the patient presented a meningioma, which is associated with pituitary macroadenoma only in extremely rare cases.

A novel capillary nano-immunoassay for assessing androgen receptor splice variant 7 in plasma. Correlation with CD133 antigen expression in circulating tumor cells. A pilot study in prostate cancer patients.

PURPOSE: Androgen receptor (AR) splice variant 7 (AR-V7) has been related with both a higher risk of prostate cancer (PC) progression and differential responsiveness to hormonal agents versus chemotherapy. The objective of this study was to investigate the feasibility of a novel capillary nano-immunoassay in assessing AR-V7 in plasma from PC patients. METHODS: Patients with either localized or advanced PC were included in the study. Assessment of AR-V7 in plasma was performed through a capillary nano-immunoassay platform. Correlation with clinical data, stem cell biomarkers (such as CD133+), AR amplification and PTEN status was identified. RESULTS: The study included 72 PC patients. AR-V7 signal was detected in 21 (29%) patients: 17 (81%) had a Gleason score ≥7, 15 (71%) castration-resistant prostate cancer (CRPC), 18 (86%) metastatic disease and PSA (median) high than AR-V7 negative (p < 0.05). CD133 was expressed in 69 (96%) patients. The median CD133+ expression in circulating tumor cells CTCs was higher among the 21 AR-V7 positive cases versus AR-V7 negative (7 vs. 3). Androgen Receptor and PTEN fluorescence in situ hybridization (FISH) on CD133+ captured cells were performed: 37 cases showed ≥four CD133+ CTCs, of which 81% showed an increased AR copy number. This percentage was similar in both AR-V7-positive and AR-V7-negative patients. A total of 68% of the cases showed deletion of PTEN: 70% were ARV-7 positive vs. 67%, which were AR-V7 negative. CONCLUSIONS: Assessing the presence of AR-V7 in plasma from PC patients is feasible by a novel capillary nano-immunoassay. AR-V7 was observed in 29% of the tumors and is more frequent in aggressive tumors.

Epidermal growth factor receptor (EGFR) pathway polymorphisms as predictive markers of cetuximab toxicity in locally advanced head and neck squamous cell carcinoma (HNSCC) in a Spanish population.

OBJECTIVES: To examine the relationship between polymorphisms of the epidermal growth factor receptor (EGFR) pathway and toxicity in head and neck squamous cell carcinoma (HNSCC) patients treated with cetuximab. MATERIAL AND METHODS: Multicenter, retrospective, observational pilot study which included 110 patients with histologically-confirmed human papillomavirus (HPV) negative HNSCC in locally advanced stages (III-IVA-B) and who were treated with chemotherapy and radiotherapy plus cetuximab between 2003 and 2013. Genetic analyses for single nucleotide polymorphisms (SNP) in genes EGFR, CCDN1, FCGR2A, FCGR3A and KRAS-LCS6 were performed though available allelic discrimination assay and/or polymerase chain reaction-restriction fragment length polymorphism methods. RESULTS: Acneiform rash was observed in 55.5% of patients, dry skin in 45.5% and pruritus in 20.9%. A significant association with dry skin and global cetuximab-related toxicity was observed for the KRAS-LCS6 (rs61764370) variant (p<0.05); carriers of the G allele (genotypes TG+GG) in the dominant model were observed to have a decreased susceptibility of developing dry skin (OR=0.287 [95%CI=0.119-0.695]). Carriers of the A (GA+AA) allele for EGFR (rs2227983) showed a decreased risk of suffering from pruritus (OR=0.345 [0.124-0.958]). Similarly, KRAS (rs1801274) was related with lower global cetuximab-related toxicity (OR=0.266 [0.114-0.622]). CONCLUSION: This pilot study provides preliminary evidence supporting genetic variation of EGFR (rs2227983), KRAS (rs61764370) and FCGR2A (rs180127) as useful biomarkers for predicting reduced skin toxicity in HNSCC patients treated with a cetuximab-based therapy. Alternative therapeutic options should be explored for these patients.

Epidemiological Characteristics of the Largest Kidney Transplant Program in Mexico: Western National Medical Center, Mexican Institute of Social Security.

BACKGROUND: According to the National Transplant Center (CENATRA), in 2013, a total of 2707 transplantations were performed in Mexico; of them, 10% (270 transplantations) were done in our Tertiary Care Hospital (Western National Medical Center). This means that one in 10 transplant recipients undergoes transplantation at our medical center. The aim of our study was to describe the characteristics of and to compare changes in the kidney transplantation program over time. MATERIALS AND METHODS: This was a cross-sectional study. Data were collected from the hospital transplant registry from January 1994 to December 2014. RESULTS: During the study period, 3643 kidney transplantations were conducted; most were living donor 3236 (89%), and only 407 patients (11%) received a graft from a deceased donor. Of living donors, 2786 (87%) were related, and 450 (13%) were genetically unrelated. The average recipient age was 28 years, and the average age of the donor was 34 years. It was observed that siblings donated more frequently (51%), followed by parents (34%). Among unrelated donors, spouses donated the most (66%). In 80% of cases, the cause of end-stage renal disease (ESRD) was unknown (80%). The most frequent renal replacement therapy was peritoneal dialysis (54%), followed by hemodialysis (18%); only 5% of patients received preemptive kidney transplant. The most frequent immunosuppression scheme was tacrolimus, mycophenolate mofetil, and prednisone in 70% of patients. CONCLUSION: The Western National Medical Center is the largest kidney transplantation program in Mexico. The main activity is living donor transplantation. Recipients are relatively young persons with unknown etiology of ESRD.

IFITM3 and severe influenza virus infection. No evidence of genetic association.

Influenza virus infection (IVI) is typically subclinical or causes a self-limiting upper respiratory disease. However, in a small subset of patients IVI rapidly progresses to primary viral pneumonia (PVP) with respiratory failure; a minority of patients require intensive care unit admission. Inherited and acquired variability in host immune responses may influence susceptibility and outcome of IVI. However, the molecular basis of such human factors remains largely elusive. It has been proposed that homozygosity for IFITM3 rs12252-C is associated with a population-attributable risk of 5.4 % for severe IVI in Northern Europeans and 54.3 % for severe H1N1pdm infection in Chinese. A total of 148 patients with confirmed IVI were considered for recruitment; 118 Spanish patients (60 of them hospitalized with PVP) and 246 healthy Spanish individuals were finally included in the statistical analysis. PCR-RFLP was used with confirmation by Sanger sequencing. The allele frequency for rs12252-C was found to be 3.5 % among the general Spanish population. We found no rs12252-C homozygous individuals in our control group. The only Spanish patient homozygous for rs12252-C had a neurological disorder (a known risk factor for severe IVI) and mild influenza. Our data do not suggest a role of rs12252-C in the development of severe IVI in our population. These data may be relevant to recognize whether patients homozygous for rs12252-C are at risk of severe influenza, and hence require individualized measures in the case of IVI.

Epidemiological characteristics of a Spanish cohort of patients diagnosed with squamous cell carcinoma of head and neck: distribution of risk factors by tumor location.

PURPOSE: Head and neck cancer is a highly heterogeneous disease comprising a large number of tumors located in the cervicofacial area. This study aimed to determine the epidemiological characteristics of squamous-cell carcinomas of the head and neck in the Spanish population, and the distribution of risk factors based on tumor locations. METHODS/PATIENTS: A cohort of 459 patients (75 oral cavity, 167 oro-/hypopharyngeal and 217 laryngeal cancers) recruited in 19 hospitals participating in the Spanish head and neck cancer cooperative group were included over 3 years (2012-2014). Epidemiological parameters and risk factors were obtained from a self-administered questionnaire, and tumor characteristics were obtained from clinical records. Multivariate multinomial logistic regression was used to assess factors associated with tumor location. RESULTS: Most patients were males (88.4 %), smokers (95 %) and drinkers (76.5 %). Relative to laryngeal cancer, pharyngeal cancer and oral cancer were more common in women than men (OR 3.58, p = 0.003 and 4.33, p = 0.001, respectively); pharyngeal cancer was more associated with rural environment (OR 1.81, p = 0.007) and weekly alcohol intake (10-140 g: OR 2.53, p = 0.012; 141-280 g: OR 2.47, p = 0.023; >280 g: OR 3.20, p = 0.001) and less associated with pack-years of smoking (21-40 packs: OR 0.46, p = 0.045; 41-70 packs: OR 0.43, p = 0.023; ≥71 packs: OR 3.20, p = 0.015). CONCLUSIONS: The distribution of these tumors differs between the sexes, with a higher proportion of oral cavity and pharyngeal tumors in women than in men. Oro-/hypopharyngeal cancers were more strongly associated with rural areas and with alcohol consumption, although less strongly associated with smoking than laryngeal tumors.