Biomarkers for personalised prevention of chronic diseases: a common protocol for three rapid scoping reviews.

INTRODUCTION: Personalised prevention aims to delay or avoid disease occurrence, progression, and recurrence of disease through the adoption of targeted interventions that consider the individual biological, including genetic data, environmental and behavioural characteristics, as well as the socio-cultural context. This protocol summarises the main features of a rapid scoping review to show the research landscape on biomarkers or a combination of biomarkers that may help to better identify subgroups of individuals with different risks of developing specific diseases in which specific preventive strategies could have an impact on clinical outcomes. This review is part of the "Personalised Prevention Roadmap for the future HEalThcare" (PROPHET) project, which seeks to highlight the gaps in current personalised preventive approaches, in order to develop a Strategic Research and Innovation Agenda for the European Union. OBJECTIVE: To systematically map and review the evidence of biomarkers that are available or under development in cancer, cardiovascular and neurodegenerative diseases that are or can be used for personalised prevention in the general population, in clinical or public health settings. METHODS: Three rapid scoping reviews are being conducted in parallel (February-June 2023), based on a common framework with some adjustments to suit each specific condition (cancer, cardiovascular or neurodegenerative diseases). Medline and Embase will be searched to identify publications between 2020 and 2023. To shorten the time frames, 10% of the papers will undergo screening by two reviewers and only English-language papers will be considered. The following information will be extracted by two reviewers from all the publications selected for inclusion: source type, citation details, country, inclusion/exclusion criteria (population, concept, context, type of evidence source), study methods, and key findings relevant to the review question/s. The selection criteria and the extraction sheet will be pre-tested. Relevant biomarkers for risk prediction and stratification will be recorded. Results will be presented graphically using an evidence map. INCLUSION CRITERIA: Population: general adult populations or adults from specific pre-defined high-risk subgroups; concept: all studies focusing on molecular, cellular, physiological, or imaging biomarkers used for individualised primary or secondary prevention of the diseases of interest; context: clinical or public health settings. SYSTEMATIC REVIEW REGISTRATION: https://doi.org/10.17605/OSF.IO/7JRWD (OSF registration DOI).

Epidemiología del cáncer diferenciado de tiroides / Epidemiology of differentiated thyroid carcinoma

El cáncer diferenciado de tiroides, procedente de células foliculares, es la forma más frecuente de tumor tiroideo maligno. Incluye los subtipos papilar, variedad más común, folicular y carcinoma de células de Hürthle. La edad media al diagnóstico se sitúa entre los 40 y 45 años para el papilar, y entre los 48 y 53 años para el folicular; es mucho más frecuente en mujeres y en población blanca. Posee una baja aunque creciente incidencia, así como una baja letalidad. España ocupa una posición intermedia entre los países europeos, con una tasa de incidencia ajustada por la población europea en 1998 de 2,12 y 5,42 por 100.000 habitantes en varones y mujeres, respectivamente, y una tasa de mortalidad en 2001 de 0,41 y 0,58 por 100.000 habitantes. El único factor de riesgo fehacientemente conocido es la exposición a radiación ionizante, bien por irradiación terapéutica, bien por contaminación ambiental generalmente asociada a accidentes nucleares. Estas radiaciones afectan en mayor grado a niños e inducen cánceres principalmente de tipo papilar. Existen también estudios epidemiológicos que asocian el cáncer diferenciado de tiroides con factores dietéticos (deficiencia de yodo o alto consumo de alimentos bociógenos); ocupacionales (presentan un exceso de riesgo los técnicos sanitarios, los dentistas, los profesores y los trabajadores de la industria eléctrica y del petróleo); hormonales y reproductivos, así como con la historia previa de enfermedades tiroideas benignas, como bocio o adenomas. Finalmente, una pequeña proporción de casos tiene carácter familiar, asociados a determinados síndromes (enfermedad de Cowen y síndrome de Gardner) o como única manifestación en el llamado síndrome familiar de cáncer no medular de tiroides (AU)

Differentiated thyroid carcinomas (DTC), which arising from follicular cells, are the most frequent types of malignant thyroid cancer. They include papillary, follicular and Hurtle carcinoma, of which papillary carcinoma is the most common. The mean age at diagnosis is around 40-45 years for papillary tumors and around 48-53 years for follicular carcinomas. DTC are more frequent in women and among whites. The incidence is low but has been growing, while the lethality of these tumors is very low. Spain occupies an intermediate position among European countries, with a standardized incidence rate ­taking the standard European population as reference­ of 2.12 and 5.42 cases per 100,000 inhabitants/year among men and women respectively in 1998. Regarding mortality, the most recent information corresponds to 2001, showing a standardized rate of 0.41 per 100,000 inhabitants/year in men and 0.58 per 100,000 inhabitants/year in women. The only well established risk factor is ionizing radiation, whether from radiotherapy or environmental contamination generally associated with nuclear accidents. Children are particularly susceptible to ionizing radiation and papillary tumors represent the main histological type associated with this exposure. Other suggested risk factors comprise diet (including iodine deficiency and high consumption of goitrogens), occupational factors (with an increased risk observed among medical technicians, dentists, teachers and workers in the electric and petroleum industries), hormonal and reproductive factors, and a history of benign thyroid diseases such as goitre and adenomas. Finally, a small proportion of cases is inherited, associated with certain syndromes (Cowen disease, Gardner's syndrome) or are the only manifestation of familial nonmedullary thyroid carcinoma syndrome (AU)

[Epidemiology of malignant tumors of the nervous system in Spain]. / Epidemiología de los tumores malignos del sistema nervioso en España.

INTRODUCTION: Increasing incidences or mortality rates from brain malignant tumors have been reported in several countries. OBJECTIVE: This is a review of the studies published by the Cancer Epidemiology Unit of Carlos III Health Institute on incidence and mortality from these tumors in adults and children in Spain. RESULTS: During the period 1952-1986 mortality in adults has increased in both sexes. An ascending effect in cohorts born up to 1920 is detected, probably due to improvements in diagnosis and registration. A positive, progressive, cohort effect in males born post-1920 was detected probably because of a true increase in incidence of brain glioma or brain metastases. The incidence analysis in Navarre and Zaragoza (two Spanish provinces with population-based Cancer Registries working for more than 20 years) shows an increase in all age groups rates, reater among the older age groups. In Navarre we detected a decrease cohort effect in 1978-82 and 1988-91. A more than 50% decrease in mortality is observed among children and adolescent, probably due to treatment improvements. Great geographic differences have been observed in mortality, associated to industry development. Incidence in children, according to the Navarre and Zaragoza Registries, has increased in part due to better diagnostic methods. Incidence is 75% greater in Navarre than in Zaragoza.

Time-trend analysis of mortality from malignant tumors of the nervous system in Spain, 1952-1986.

We analyzed time trends in mortality from malignant tumors of the nervous system (MTNS) in the adult Spanish population during the period 1952-1986, using Poisson regression analysis of age at death, year of birth and year of death. During such period, mortality rose especially in the elderly as well as among young and middle-aged men. We found two modest period effects, in both sexes attributed to changes in certification practice. An ascending effect in cohorts born up to 1920 in males and females was attributed to improvements in ascertainment. A positive, progressive, cohort effect in males born post-1920 was detected. Mortality from MTNS in Spain was medium-high with a tendency to rise, most likely due to improvements in diagnosis and registration. From this analysis, the existence of a true increase in incidence of brain glioma among young and middle-aged male adults during recent decades is suggested.

Factors associated with pathogenicity of oils related to the toxic oil syndrome epidemic in Spain.

The toxic oil syndrome (TOS), which affected over 20,000 persons in Spain in 1981, has been linked to the consumption of aniline-denatured rapeseed oil, but the precise etiologic agent is still unknown. We attempted to validate the use of high concentrations of oleyl anilide as a marker for oils that contain (or contained) the causal agent. We compared the chemical compositions of oils obtained from ill (N = 59) and unaffected (N = 70) families in 1981. Case oils had higher concentrations of fatty acids and sterols in which rapeseed oil is particularly rich. In addition, case oils had more frequent and extensive contamination with oleyl anilide and other fatty acid anilides. We observed a dose-response effect; risk increased sharply with increasing concentrations of oleyl anilide, and no control oil had more than about 825 micrograms per liter of that compound. We conclude that high concentrations of oleyl anilide specifically mark oils that contain (or used to contain) the TOS etiologic agent.

[Mortality from breast cancer in the European Community (1970-1985)]. / Mortalidad por cáncer de mama en la comunidad Europea (1970-1985).

BACKGROUND: A comparative study of mortality by breast cancer in the different countries of the European Community was carried out. METHODS: Deaths by breast cancer in women over the age of 14 from 1970-1985 were considered. The data were collected from the Statistical Yearbook of the World Health Organization. Poisson log-lineal models were used to calculate the relative risk and evaluate the temporary tendency of each country. Lastly a different model was established for each age group (15-44, 45-64, > 65) to know their evolution over time in the different countries. RESULTS: A north-south pattern was observed in the mortality by this tumor. Considered altogether, the Mediterranean countries present a mortality defect of 45% with respect to the remaining countries. The global tendency is slightly upwards in all the countries. This increase is significantly greater in the Mediterranean countries (7% every 5 years). Analysis by age showed that this increase is produced in the group of women over the age of 44 years. CONCLUSIONS: The increase in death by breast cancer in the European countries continues to rise despite the existing detection programs and improvements in survival. The differences among the countries tend to decrease making the incidence of breast cancer in the north and south of Europe ever more similar.

[Hospital infections at the medical Infection Surveillance Unit from 1984 to 1988]. / Estudio de la infección hospitalaria en la UVI médica durante el período 1984-1988.

The aim of the present work was to study hospital infection tendencies and to analyze the variations that have occurred in the accumulated incidence, the localization and the responsible microorganisms in a medical ICU of the Hospital Ramón y Cajal, Madrid during a 5 years period. Nosocomial infections appear with a statistically significant decreasing tendency: the simple regression curve, estimated from the monthly accumulated incidence, presents a slope = -0.16 (p less than 0.05); the adjustment made with the annual accumulated incidence values shows a slope = -2.15 (p less than 0.001). The most frequent localization of hospital infections were: lower respiratory tract, urine, and blood. These infections show in general a decreasing tendency existing a statistical difference in respiratory = -1.5 (p less than 0.001) and urinary = -1.48 (p less than 0.001) infections. The microorganisms most frequently isolated in these patients were P. aeruginosa, S. marcescens and E. coli.

[Smoking habits: a study of hospital staff]. / Hábitos tabáquicos: estudio en personal hospitalario.

The results of a survey carried out in our hospital about the use of cigarettes in which 680 staff members participated (257 men and 423 women) are presented. The percentage of current smokers was 50% (51.8% amongst women and 45.1% amongst men). The highest percentages of smokers were found amongst nurses (61%), maintenance staff (50%) and administrative staff (45.1%); 41% of physicians smoked. Quitting the smoking habit was more frequent amongst physicians and higher grade staff, with a predominance of older males. The smallest number of quitters was found amongst nurses. 93.5% of the surveyed subjects agreed with the establishment of restrictive measures, finding no differences according to age, sex, or professional status, although there were differences according to the smoking habit. The results obtained point out the importance of the smoking problem amongst health professionals and could be used to promote programs against smoking in hospitals.