Sleep quality and risk of recurrent aphthous ulcers: A Spanish cohort study.

OBJECTIVE: Recurrent aphthous stomatitis (RAS) is a condition that affects 20% of the world population and is characterized by painful ulcers in the oral mucosa. So far, the epidemiology and risk factors of RAS have been infrequently studied. Our objective was to determine whether sleep-related factors are related to the occurrence of RAS in the first prospective study carried out on this topic. METHODS: A cohort of 11210 Spanish students, 13-17 years old, was followed up for one year. Sleep disorders were assessed at baseline using a standard validated questionnaire. RESULTS: We detected 2655 new cases of RAS with a total of 287,262 person-week of follow-up. Subjects with high (4th quartile) Insomnia Index showed an incidence rate ratio (IRR) of RAS of 1.29 (95% confidence interval (CI) 1.15-1.45), while subjects with high Hypersomnia Index presented an IRR of 1.42 (95% CI 1.26-1.61). A high score of sleep-related phenomena was also associated with an increased IRR: 1.53 (95% CI 1.37-1.69). Adolescents with high level of sleep satisfaction were at lower risk of RAS: 0.88 (95% CI 0.77-1.01). CONCLUSION: These findings suggest that sleep disorders are moderately associated with RAS in adolescents.

Tobacco consumption and premenstrual syndrome: A case-control study.

OBJECTIVE: To assess whether tobacco smoking is associated with Premenstrual Syndrome (PMS) and its most severe form, Premenstrual Dysphoric Disorder (PMDD). DESIGN: Case-control study with incident cases using the Spanish public healthcare system. SETTING: 3 major public hospitals and one family counseling and planning center. POPULATION: Women consulting for troubles related to menstruation and for other motives such as screening for uterine cancer, contraception counseling or desire for pregnancy. METHODS: Logistic regression. MAIN OUTCOME MEASURES: Odds Ratios of PMS and PMDD. RESULTS: 285 incident PMS cases and 285 age-matched controls on the one hand, and 88 incident PMDD cases and 176 controls on the other hand participated in the study. The odds of premenstrual disorders was higher in current smokers compared with never smokers: Odds Ratio (OR) = 1.78, 95% Confidence Interval (CI): 1.20-2.63 for PMS and OR = 2.92, 95%CI: 1.55-5.50 for PMDD. For PMS, women who smoke 1 to 5 cigarettes/day presented an OR = 2.82, 95%CI: 1.57-5.06 and those who smoke more than 15 cigarettes/day an OR = 2.52, 95%CI: 0.99-6.40. Compared to non-smokers, current and ex-smokers who smoked < 3 pack-years presented an OR = 1.79, 95%CI: 1.04-3.08 for PMS, and an OR = 3.06, 95%CI: 1.27-7.35 for PMDD. Smokers of 3 to 8 pack-years presented an OR = 2.34, 95%CI: 1.33-4.13 for PMS and OR = 3.56, 95%CI: 1.55-8.17 for PMDD. These results were confirmed by the exposure-effect curve obtained from a cubic spline model. CONCLUSIONS: This study shows that smokers are more likely to develop PMS and PMDD.

Psychological factors and premenstrual syndrome: A Spanish case-control study.

OBJECTIVE: To assess whether the psychological variables perceived stress, neuroticism and coping strategies, are associated with Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Syndrome (PMDD). DESIGN: Case-control study with incident cases using the Spanish public healthcare system. SETTING: 3 major public hospitals and one family counseling and planning center. POPULATION: Women consulting for troubles related to menstruation and for other motives such as screening for uterine cancer, contraception counselling or desire for pregnancy. METHODS: Logistic regression. MAIN OUTCOME MEASURES: Odds of PMS and PMDD. RESULTS: 285 PMS and 285 age-matched controls, as well as 88 PMDD cases and 176 controls participated in the study. Medium and high levels of perceived stress were associated with an increase in the odds of PMS (Odds Ratio (OR) = 2.49; 95%CI: 1.41-4.39 and OR = 4.90; 95%CI: 2.70-8.89, respectively). For PMDD the results were: OR = 2.61; 95%CI: 1.35-5.05 and OR = 5.79; 95%CI: 2.63-12.76, respectively. Subjects with medium and high levels of neuroticism were also at higher odds of suffering from PMS (OR = 2.53; 95%CI: 1.06-6.06 and OR = 8.05; 95%CI: 3.07-2.12, respectively). For PMDD, the results were OR = 3.70; 95%CI: 1.27-10.77 and 5.73: 95%CI: 1.96-16.77, respectively. High levels in the large majority of coping strategies were also associated with increased odds of PMS and PMDD. CONCLUSIONS: Psychological factors including perceived stress, neuroticism and coping strategies are strongly related to PMS/PMDD. This association is unlikely to be due to confounding or misclassification bias. A reverse causation process cannot be ruled out although its likelihood is remote.

Estudio cuasiexperimental para evaluar la capacidad de los escolares para utilizar un desfibrilador externo semiautomático a los 6 meses tras un proceso formativo / Quasi-experimental study to assess schoolchildren’s ability to use a semiautomatic external defibrillator 6 months after training

Objetivo: Evaluar la capacidad por parte de los escolares para utilizar un desfibrilador externo semiautomático (DESA) y el tiempo de administración de una desfibrilación a los 6 meses tras un proceso formativo. Métodos: Estudio cuasiexperimental sin grupo control. Se incluyeron niños del tercer ciclo de Educación Primaria sin conocimientos previos en el uso del DESA. Tras aplicar un cuestionario sobre conocimientos previos, se les pidió que usasen el DESA en un maniquí de entrenamiento, midiendo el tiempo que tardaban en encenderlo, colocar los parches y administrar la primera desfibrilación (T0). Se volvió a medir el tiempo tras una sencilla explicación de unos 60 segundos de manera individual (T1) y se repitió la medición de los tiempos pasados seis meses (T2). Resultados: Se incluyeron 253 sujetos, de entre 10 y 13 años, de los cuales 128 (50,6%) fueron niñas. Un 100% de los niños fue capaz de usar el DESA sin formación previa aunque no se tuvieron en cuenta los errores en la colocación de parches en la toma inicial. Los tiempos medios fueron: T0 = 83 (DE 14) s; T1 = 44 (DE 5) s; T2 = 45 (DE 7) s. La diferencia de medias fue: T0-T1 = 39 (DE 13) s (p < 0,001), T0-T2 = 38 (DE 15) s (p < 0,001), T1-T2 = 1,4 (DE 7,5) s (p = 0,010). Conclusiones: Los escolares del tercer ciclo de Educación Primaria son capaces de utilizar un DESA sin formación. Tras una pequeña explicación se reduce significativamente el tiempo en aplicar una descarga eficaz sin cometer errores. Este tiempo apenas aumenta pasados seis meses, por lo que no sería imprescindible realizar formación tan frecuentemente como en el caso de las compresiones torácicas externas (AU)

Objective: To evaluate schoolchildren’s ability to use a semiautomatic external defibrillator (SAED) in terms of how long they take to deliver a shock 6 months after they received training. Methods: Uncontrolled, quasi-experimental study. Schoolchildren in grades 5 and 6 without prior knowledge of how to use a SAED were included. After the children answered a questionnaire about their knowledge, they were asked to position the SAED to treat a training mannequin. We measured the time it took them to switch on the device, place the electrode pads, and deliver the first shock (T0). The children were then individually given a simple explanation lasting approximately 60 seconds, after which we measured the time they took to place the SAED again and deliver a shock (T1). Each child’s time was measured again 6 months later (T2). Results: A total of 253 children aged between 10 and 13 years participated; 128 (50.6%) were girls. All the children were able to use the SAED without prior training, although we did not take into consideration mistakes they made in placing the pads at baseline (T0). The mean times were as follows: T0, 83 (SD 14) seconds; T1, 44 (SD 5) seconds; and T2, 45 (SD 7) seconds. The mean differences between times were as follows: T0–T1, 39 (SD 13) seconds (P < .001); T0–T2, 38 (SD 15) seconds (P < .001); and T1–T2, 1.4 (SD 7.5) seconds (P = .010). Conclusions: Fifth- and sixth-grade primary school students are able to use a SAED without training. After the children received a brief explanation, they were able to deliver an effective shock without committing errors. The time until the first shock scarcely changed after 6 months had passed. We conclude that it would not be necessary to provide training for SAED use as often as is required for manual external chest compressions (AU)

[Quasi-experimental study to assess schoolchildren's ability to use a semiautomatic external defibrillator 6 months after training]. / Estudio cuasiexperimental para evaluar la capacidad de los escolares para utilizar un desfibrilador externo semiautomático a los 6 meses tras un proceso formativo.

OBJECTIVES: To evaluate schoolchildren's ability to use a semiautomatic external defibrillator (SAED) in terms of how long they take to deliver a shock 6 months after they received training. MATERIAL AND METHODS: Uncontrolled, quasi-experimental study. Schoolchildren in grades 5 and 6 without prior knowledge of how to use a SAED were included. After the children answered a questionnaire about their knowledge, they were asked to position the SAED to treat a training mannequin. We measured the time it took them to switch on the device, place the electrode pads, and deliver the first shock (T0). The children were then individually given a simple explanation lasting approximately 60 seconds, after which we measured the time they took to place the SAED again and deliver a shock (T1). Each child's time was measured again 6 months later (T2). RESULTS: A total of 253 children aged between 10 and 13 years participated; 128 (50.6%) were girls. All the children were able to use the SAED without prior training, although we did not take into consideration mistakes they made in placing the pads at baseline (T0). The mean times were as follows: T0, 83 (SD 14) seconds; T1, 44 (SD 5) seconds; and T2, 45 (SD 7) seconds. The mean differences between times were as follows: T0-T1, 39 (SD 13) seconds (P < .001); T0-T2, 38 (SD 15) seconds (P < .001); and T1-T2, 1.4 (SD 7.5) seconds (P = .010). CONCLUSION: Pulse CO-oximetry contributed to the prehospital emergency care of these patients by influencing the decision to transfer the patient to a hospital.

OBJETIVO: Evaluar la capacidad por parte de los escolares para utilizar un desfibrilador externo semiautomático (DESA) y el tiempo de administración de una desfibrilación a los 6 meses tras un proceso formativo. METODO: Estudio cuasiexperimental sin grupo control. Se incluyeron niños del tercer ciclo de Educación Primaria sin conocimientos previos en el uso del DESA. Tras aplicar un cuestionario sobre conocimientos previos, se les pidió que usasen el DESA en un maniquí de entrenamiento, midiendo el tiempo que tardaban en encenderlo, colocar los parches y administrar la primera desfibrilación (T0). Se volvió a medir el tiempo tras una sencilla explicación de unos 60 segundos de manera individual (T1) y se repitió la medición de los tiempos pasados seis meses (T2). RESULTADOS: Se incluyeron 253 sujetos, de entre 10 y 13 años, de los cuales 128 (50,6%) fueron niñas. Un 100% de los niños fue capaz de usar el DESA sin formación previa aunque no se tuvieron en cuenta los errores en la colocación de parches en la toma inicial. Los tiempos medios fueron: T0 = 83 (DE 14) s; T1 = 44 (DE 5) s; T2 = 45 (DE 7) s. La diferencia de medias fue: T0-T1 = 39 (DE 13) s (p < 0,001), T0-T2 = 38 (DE 15) s (p < 0,001), T1-T2 = 1,4 (DE 7,5) s (p = 0,010). CONCLUSIONES: Fifth- and sixth-grade primary school students are able to use a SAED without training. After the children received a brief explanation, they were able to deliver an effective shock without committing errors. The time until the first shock scarcely changed after 6 months had passed. We conclude that it would not be necessary to provide training for SAED use as often as is required for manual external chest compressions.

Risk of cancer among hairdressers and related workers: a meta-analysis.

BACKGROUND: Hairdressers and allied occupations represent a large and fast growing group of professionals. The fact that these professionals are chronically exposed to a large number of chemicals present in their work environment, including potential carcinogens contained in hair dyes, makes it necessary to carry out a systematic evaluation of the risk of cancer in this group. METHODS: We retrieved studies by systematically searching Medline and other computerized databases, and by manually examining the references of the original articles and monographs retrieved. We also contacted international researchers working on this or similar topics to complete our search. We included 247 studies reporting relative risk (RR) estimates of hairdresser occupation and cancer of different sites. RESULTS: Study-specific RRs were weighted by the inverse of their variance to obtain fixed and random effects pooled estimates. The pooled RR of occupational exposure as a hairdresser was 1.27 (95% CI 1.15-1.41) for lung cancer, 1.52 [95% confidence interval (CI) 1.11-2.08] for larynx cancer, 1.30 (95% CI 1.20-1.42) for bladder cancer and 1.62 (95% CI 1.22-2.14) for multiple myeloma. Data for other anatomic sites showed increases of smaller magnitude. The results restricted to those studies carried out before the ban of two major carcinogens from hair dyes in the mid-1970s were similar to the general results. CONCLUSIONS: Hairdressers have a higher risk of cancer than the general population. Improvement of the ventilation system in the hairdresser salons and implementation of hygiene measures aimed at mitigating exposure to potential carcinogens at work may reduce the risk.

Breast cancer and use of nonsteroidal anti-inflammatory drugs: a meta-analysis.

BACKGROUND: Breast cancer is one of the leading causes of mortality among women. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) may be associated with reduced risk for breast cancer, but results from these studies of the association have been inconsistent. METHODS: Studies that examined the association between risk of breast cancer and use of NSAIDs, including aspirin and ibuprofen, that were published between January 1, 1966, and July 1, 2008, were identified using Medline, EMBASE, and other databases. We performed meta-analysis by pooling studies according to the inverse of their variances and performed separate analyses of studies pooled according to aspirin use and ibuprofen use. We evaluated publication bias and study quality. RESULTS: A total of 38 studies (16 case-control studies, 18 cohort studies, 3 case-control studies nested in well-defined cohorts, and 1 clinical trial) that included 2 788 715 subjects were identified. The results of these studies suggest that overall, NSAID use was associated with reduced risk for breast cancer (relative risk [RR] = 0.88, 95% confidence interval [CI] = 0.84 to 0.93). Specific analyses for aspirin (RR = 0.87, 95% CI = 0.82 to 0.92) and ibuprofen (RR = 0.79, 95% CI = 0.64 to 0.97) yielded similar results. CONCLUSIONS: This meta-analysis provides evidence that NSAID use is associated with reduced risk for breast cancer. Future research should include careful evaluation of the biologic mechanisms involved in the relationship between NSAIDs and breast cancer.

Factores de riesgo del catarro común / Risk factors in common cold

No disponible

Intake of wine, beer, and spirits and the risk of clinical common cold.

To examine whether intakes of wine, beer, spirits, and total alcohol are associated with the risk of common cold, in 1998-1999 the authors analyzed data from a cohort study carried out in a population of 4,272 faculty and staff of five Spanish universities. Usual alcohol intake was assessed at baseline by means of a standardized frequency questionnaire that was validated in a random sample of the population. The authors detected 1,353 cases of common cold. Total alcohol intake and beer and spirits consumption were not related to the occurrence of common cold, whereas consumption of wine was inversely associated with the risk of common cold. When drinkers of >14 glasses of wine per week were compared with teetotalers, the relative risk was 0.6 (95% confidence interval: 0.4, 0.8) after adjustment for age, sex, and faculty/staff status. The association was stronger for red wine. These results remained unaltered after adjustment for total alcohol intake and for other potential risk factors for common cold. Findings suggest that wine intake, especially red wine, may have a protective effect against common cold. Beer, spirits, and total alcohol intakes do not seem to affect the incidence of common cold.

Intake of vitamin C and zinc and risk of common cold: a cohort study.

To examine whether intake of vitamin C and zinc is associated with a decrease in the risk of a common cold, we analyzed data from a cohort study carried out in a population of 4,272 faculty and staff from five Spanish universities. Participants were 21-65 years of age, were full-time workers at those universities, and did not have antecedents of asthma or chronic obstructive pulmonary disease. Daily intake of vitamin C and zinc was assessed at baseline by means of a food frequency questionnaire of which the validity and reproducibility were determined in a sample of the population. Subjects were traced for 1 year to detect episodes of common cold, the diagnosis of which was based on symptoms and was validated by additional clinical signs. We detected 1,667 cases of common cold in 79,240 person-weeks of follow-up. Intake of vitamin C and zinc was not related to the occurrence of common cold. Compared with the first quartile of intake, women in the fourth quartile of vitamin C intake showed an adjusted incidence rate ratio of 1.0 (95% CI = 0.7-1.3), and for zinc intake this figure was 1.1 (95% CI = 0.8-1.5). The incidence rate ratios for men in the fourth quartile were 1.1 (95% CI = 0.8-1.4) for vitamin C and 1.3 (95% CI = 0.9-1.8) for zinc.