Estrés y ansiedad perioperatorios en padres de niños intervenidos de cardiopatías congénitas / Perioperative stress and anxiety in parents of children operated on for congenital heart disease

Introducción: Los niveles de estrés y la ansiedad que sufren los padres y madres de niños con cardiopatía congénita (PMNCC) durante el ingreso para cirugía cardíaca de sus hijos pueden ser más elevados que los que sufren otros padres y madres que pasan por la misma experiencia. Objetivo: El objetivo general de este estudio fue medir el estrés y la ansiedad que sufren los PMNCC y los padres de niños tratados mediante cirugía renal (PMNCR) en relación con la intervención de sus hijos. El objetivo específico del estudio cuantitativo fue comparar el estrés y ansiedad global con relación al sexo, el momento del periodo perioperatorio y la cohorte. El objetivo general del apartado cualitativo es explorar la vivencia que tienen los PMNCC y PMNCR durante su estancia hospitalaria e identificar los factores específicos que influyen en la génesis del estrés y la ansiedad. Método: Se realizó un estudio de cohortes en el que se incluyeron los PMNCC y los PMNCR. La parte cuantitativa se realizó comparando las puntuaciones de 3cuestionarios que miden los niveles de estrés (PSS-14), ansiedad estado (STAIE) y ansiedad rasgo (STAIR) a lo largo de 3momentos perioperatorios. Paralelamente se hizo un estudio cualitativo con entrevistas semiestructuradas y recogida de diarios sobre los que se realizó un análisis fenomenológico descriptivo, según Munhall. El análisis del texto se realizó según la propuesta de Colaizzi. Resultados: Los niveles de estrés y ansiedad fueron significativamente más altos en los PMNCC respecto a los PMNCR. Las madres de la cohorte cardíaca fueron las que presentaron las puntuaciones más altas en todas las escalas. En el estudio cualitativo emergieron 4temas: «estrés y ansiedad desde el momento del diagnóstico», «intervención quirúrgica como momento crítico», «dureza del postoperatorio en la Unidad de Cuidados Intensivos» y «alegría y agradecimiento versus dependencia y temor ante el futuro»...(AU)

Introduction: Levels of stress and anxiety suffered by parents of children with congenital heart disease (PCUCS) during their children's admission for cardiac surgery may be higher than those suffered by other parents who go through the same experience. Objective: General objective of this study was to measure the stress and anxiety suffered by PCUCS and parents of children undergoing renal surgery (PCURS) in relation to the intervention of their children. The specific objective of the quantitative study was to compare global stress and anxiety according to sex, time of the perioperative period, and cohort. The general objective of the qualitative section is to explore the experience that PCUCS and PCURS have during their hospital stay and to identify the specific factors that influence the genesis of stress and anxiety. Method: A cohort study was carried out in which PCURS and PCUCS were included. The quantitative part was performed by comparing the scores of 3questionnaires that measure stress levels (PSS-14), state anxiety (STAIE) and trait anxiety (STAIR) throughout 3perioperative moments. At the same time, a qualitative study was carried out with semi-structured interviews and collection of diaries on which a descriptive phenomenological analysis was carried out, according to Munhall. The analysis of the text was carried out according to Colaizzi. Results: Stress and anxiety levels were significantly higher in PCUCS compared to PCURS. Mothers in the cardiac cohort were those with the highest scores on all scales. In the qualitative study, 4themes emerged: “stress and anxiety from the moment of diagnosis”, “surgical intervention as a critical moment”, “harshness of the postoperative period in the Intensive Care Unit” and “joy and gratitude versus dependence and fear for the future”...(AU)

Perioperative stress and anxiety in parents of children operated on for congenital heart disease.

INTRODUCTION: Levels of stress and anxiety suffered by parents of children with congenital heart disease (PCUCS) during their children's admission for cardiac surgery may be higher than those suffered by other parents who go through the same experience. OBJECTIVE: General objective of this study was to measure the stress and anxiety suffered by PCUCS and parents of children undergoing renal surgery (PCURS) in relation to the intervention of their children. The specific objective of the quantitative study was to compare global stress and anxiety according to sex, time of the perioperative period, and cohort. The general objective of the qualitative section is to explore the experience that PCUCS and PCURS have during their hospital stay and to identify the specific factors that influence the genesis of stress and anxiety. METHOD: A cohort study was carried out in which PCURS and PCUCS were included. The quantitative part was performed by comparing the scores of three questionnaires that measure stress levels (PSS-14), state anxiety (STAIE) and trait anxiety (STAIR) throughout three perioperative moments. At the same time, a qualitative study was carried out with semi-structured interviews and collection of diaries on which a descriptive phenomenological analysis was carried out, according to Munhall. The analysis of the text was carried out according to Colaizzi. RESULTS: Stress and anxiety levels were significantly higher in PCUCS compared to PCURS. Mothers in the cardiac cohort were those with the highest scores on all scales. In the qualitative study, four themes emerged: "stress and anxiety from the moment of diagnosis", "surgical intervention as a critical moment", "harshness of the postoperative period in the Intensive Care Unit" and "joy and gratitude versus dependence and fear for the future". CONCLUSIONS: PCUCS suffer higher levels of stress and anxiety than PCURS, being the mothers of the cardiac cohort those who suffer these disorders with greater intensity. This study can constitute a starting point to develop strategies that cover these parental needs.

Oxidative stress in the ovaries of mice chronically exposed to a low lead concentration: A generational approach.

Lead (Pb) is a heavy metal that alters the oxidation-reduction balance, affecting reproductive health and transfer during pregnancy and lactation. However, the multigenerational impact of exposure to low concentrations of Pb on mammalian ovaries has not been assessed. This study evaluated general parameters, histology, redox state (RS), protein carbonylation (PC), lipid peroxidation (LP), and hormone concentrations in the ovaries of mice (CD1® ICR) of three successive generations with both unigenerational (E1) and multigenerational (E2) exposure to 0.2 ppm lead acetate through the drinking water and a control group. Body weight, food consumption, the number of born pups, and their weight after weaning were not significantly affected by Pb exposure in E1 and E2. However, the ovaries of three successive generations of the E1 group, in which only the F0 was exposed, showed alterations in the ovarian histoarchitecture, increase in follicular atresia, decrease in the number of available follicles, and a significant RS and PC elevation that were surprisingly similar to those observed in the E2 group. LP increased in the second generation of E1 and E2, while hormone concentration was not altered. This is the first demonstration that exposure to low concentration of Pb induces multigenerational histological alterations and oxidative stress in mouse ovaries, that the termination of this exposure does not ensure the safety of later generations and that the lack of modifications in general parameters may facilitate the silent development of pathologies that affect ovarian health.

¿Ha dejado de disminuir la mortalidad por enfermedades cerebrovasculares en España? / Has stroke mortality stopped declining in Spain?

Objetivos: Analizar los cambios en las tendencias de la mortalidad por enfermedades cerebrovasculares según comunidad autónoma y sexo en España durante el período 1980-2016 utilizando modelos de regresión joinpoint. Métodos: Los datos de mortalidad se obtuvieron del Instituto Nacional de Estadística. Para cada comunidad autónoma y sexo se calcularon las tasas brutas y estandarizadas. El análisis de regresión joinpoint se utilizó para identificar los puntos más adecuados donde se produjo un cambio estadísticamente significativo en la tendencia. Resultados: El análisis joinpoint permite diferenciar comunidades en las que las tasas muestran un descenso continuado a lo largo de todo el periodo en ambos sexos (Asturias, Cantabria, Castilla y León, Ceuta y Melilla) o solo en los hombres (Extremadura). En los hombres, en las comunidades en las que se observan cambios en la tendencia se aprecia, en todas ellas (excepto en Aragón, Baleares y Murcia, donde las tasas permanecen estables), un primer periodo de descenso, que oscila entre el −3,4% en Cataluña y Extremadura y el −6,0% en Madrid, y un periodo final donde las tasas muestran tendencias divergentes: siguen descendiendo en Andalucía, Aragón, Baleares y Madrid, han comenzado a estabilizarse en Castilla-La Mancha y Murcia y aumentan en Canarias. En las mujeres, en las comunidades en que se observan cambios en la tendencia se aprecia, en todas ellas (excepto en Aragón, Murcia y País Vasco, donde las tasas permanecen estables), un primer periodo de descenso, que oscila entre el −3,1% en Cataluña y el −6,4% en Navarra, y un periodo final donde las tasas muestran tendencias divergentes: siguen descendiendo en Andalucía, Aragón, Cataluña, Galicia, Madrid y País Vasco, han comenzado a estabilizarse en Extremadura y Murcia, y aumentan en Canarias. [...] (AU)

Objectives: To analyse the changes in stroke mortality trends in Spain by autonomous community and by sex during the period 1980-2016, using joinpoint regression models. Methods: Mortality data were obtained from the Spanish National Statistics Institute. Crude and standardised rates were calculated for each Spanish autonomous community, and for each sex. Joinpoint analysis was used to identify the best-fitting points showing a statistically significant change in the trend. Results: Joinpoint analysis enabled us to differentiate between communities in which mortality rates showed a continuous decline throughout the study period in both sexes (Asturias, Cantabria, Castile and Leon, Ceuta, and Melilla) or in men only (Extremadura). In men, in all those communities in which changes in the trend were observed (all but Aragon, the Balearic Islands, and Murcia, where rates remained stable), we observed an initial period of decline (ranging from –3.4% in Catalonia and Extremadura, to –6.0% in Madrid) and a final period where the trends diverged: mortality rates continued to fall in Andalusia, Aragon, the Balearic Islands, and Madrid, but began to stabilise in Castile-La Mancha and Murcia and to increase in the Canary Islands. In women, in those communities where changes were observed (all but Aragon, Murcia, and the Basque Country, where rates remained stable), we observed an initial period of decline (ranging from –3.1% in Catalonia to –6.4% in Navarre) and a final period where divergent trends were observed: rates continued to decline in Andalusia, Aragon, Catalonia, Galicia, Madrid, and the Basque Country, but began to stabilise in Extremadura and Murcia and to increase in the Canary Islands. [...] (AU)

Comparison of leg dynamic models for quadrupedal robots with compliant backbone.

Many quadrupeds are capable of power efficient gaits, especially trot and gallop, thanks to their flexible trunk. The oscillations of the system that includes the backbone, the tendons and musculature, store and release elastic energy, helping a smooth deceleration and a fast acceleration of the hindquarters and forequarters, which improves the dynamics of running and its energy efficiency. Forelegs and hindlegs play a key role in generating the bending moment in the trunk. In this paper we present our studies aimed at modeling and reproducing such phenomena for efficient quadrupedal robot locomotion. We propose a model, called mass-mass-spring model, that overcomes the limitation of existing models, and demonstrate that it allows studying how the masses of the legs generate a flexing force that helps the natural bending of the trunk during gallop. We apply our model to six animals, that adopt two different galloping patterns (called transverse and rotatory), and compare their energy efficiency.

Tumor miofibroblástico inflamatorio de laringe: a propósito de un caso / Inflammatory myofibroblastic tumor of the larynx: a case report

Resumen El tumor miofibroblástico inflamatorio (TMI) es una patología muy poco frecuente. Los TMI localizados en laringe pueden ocasionar disfonía o sensación de cuerpo extraño. El diagnóstico se realiza a través de pruebas de imagen y visualización directa con obtención de muestras para estudio histopatológico. Presentamos el caso de una mujer de 43 años, con antecedentes personales de carcinoma indiferenciado de nasofaringe, tratado con radioterapia y quimioterapia, que acude a revisiones periódicas en consulta de otorrinolaringología. Se objetiva por nasofibroscopia una lesión rugosa en cuerda vocal izquierda. Se realiza biopsia con fibroscopio de canal, compatible con tumoración fusocelular atípica, con áreas celulares y mixoides, sospechosa de malignidad, con necesidad de completar estudio inmunohistoquímico. En comité de tumores de cabeza y cuello se decide cirugía programada (laringectomía supracricoidea con cricohioidoepiglotopexia) y posterior tratamiento adyuvante con quimioterapia y/o radioterapia, según resultados del estudio histopatológico. Como conclusión, el TMI es una patología que se encuentra predominantemente en el pulmón, siendo rara la afectación laríngea. Su pronóstico es favorable y el diagnóstico histopatológico es de vital importancia. El diagnóstico correcto va seguido de una escisión local amplia para prevenir la recurrencia, sin embargo, el tratamiento debe adaptarse a la ubicación del tumor y al estado del paciente.

Abstract Inflammatory myofibroblastic tumor (IMT) is a very rare pathology. IMTs located in the larynx can cause dysphonia or foreign body sensation. The diagnosis is made through imaging tests and direct visualization and confirmation with samples for histopathological study. We present the case of a 43-year-old woman with a personal history of undifferentiated carcinoma of the nasopharynx treated with radiotherapy and chemotherapy, who attended periodic check-ups in an otolaryngology clinic. A rough granulomatous lesion was observed by nasofibrolaryngoscopy in the left vocal cord. A canal fibroscope biopsy is performed, compatible with an atypical spindle cell tumor, with cellular and myxoid areas, suspicious of malignancy, requiring an immunohistochemical study to be completed. The head and neck tumor committee decides on scheduled surgery (supracricoid laryngectomy with cricohyoidoepiglottopexy) and subsequent adjuvant treatment with chemotherapy and/or radiotherapy, according to the results of the histopathological study. As a conclusion finally, the IMT is a pathology found predominantly in the lung, laryngeal involvement being rare. Its prognosis is favorable and the histopathological diagnosis is of vital importance to be able to be differentiated from other malignant neoplasms. The correct diagnosis is followed by a wide local excision to prevent recurrence, however, treatment must be tailored to the location of the tumor and the condition of the patient.

Has stroke mortality stopped declining in Spain?

OBJECTIVES: To analyse the changes in stroke mortality trends in Spain by autonomous community and by sex during the period 1980-2016, using joinpoint regression models. METHODS: Mortality data were obtained from the Spanish National Statistics Institute. Crude and standardised rates were calculated for each Spanish autonomous community, and for each sex. Joinpoint analysis was used to identify the best-fitting points showing a statistically significant change in the trend. RESULTS: Joinpoint analysis enabled us to differentiate between communities in which mortality rates showed a continuous decline throughout the study period in both sexes (Asturias, Cantabria, Castile and Leon, Ceuta, and Melilla) or in men only (Extremadura). In men, in all those communities in which changes in the trend were observed (all but Aragon, the Balearic Islands, and Murcia, where rates remained stable), we observed an initial period of decline (ranging from -3.4% in Catalonia and Extremadura, to -6.0% in Madrid) and a final period where the trends diverged: mortality rates continued to fall in Andalusia, Aragon, the Balearic Islands, and Madrid, but began to stabilise in Castile-La Mancha and Murcia and to increase in the Canary Islands. In women, in those communities where changes were observed (all but Aragon, Murcia, and the Basque Country, where rates remained stable), we observed an initial period of decline (ranging from -3.1% in Catalonia to -6.4% in Navarre) and a final period where divergent trends were observed: rates continued to decline in Andalusia, Aragon, Catalonia, Galicia, Madrid, and the Basque Country, but began to stabilise in Extremadura and Murcia and to increase in the Canary Islands. CONCLUSIONS: Current data show that stroke mortality rates have decreased (in women in Andalusia), stabilised (in both sexes in Murcia, in men in Castile-La Mancha, and in women in Extremadura), and have even reversed (in both sexes in the Canary Islands). Further study is needed to identify the causes of these trends.

Unusual co-infection of severe malaria by Plasmodium vivax and dengue virus in Mexico.

Malaria and dengue fever are among the most common mosquito-borne diseases worldwide; however, reports of coinfection are rare. We present a case of severe malaria and dengue coinfection in a 16-yearold female patient presenting with fever, thrombocytopenia, pleural effusion, myopericarditis, and acute respiratory distress syndrome. Dengue infection was confirmed by the presence of immunoglobin M antibodies and nonstructural protein 1, while malaria was confirmed by the presence of Plasmodium vivax in thick and thin blood smears. This is the first report of a dengue/malaria coinfection in Mexico.

La visita infantil a la unidad de cuidados intensivos pediátricos desde la experiencia de las enfermeras / Children's visits to the paediatric intensive care unit from the nurses’ experience

Objetivo Explorar la experiencia de las enfermeras en relación con la facilitación de la visita infantil a la UCIP. Método Estudio fenomenológico interpretativo mediante entrevistas en profundidad. El estudio se desarrolló en las UCIP de dos centros públicos madrileños de nivel IIIC. Participaron 12 enfermeras con experiencia mayor de dos años en UCIP que, en el momento de la entrevista, prestaban servicios en dichas unidades. Además, se entrevistó a una psicóloga con experiencia de cuatro años en UCIP cuya información se consideró en el contexto de los datos en la sombra. La información se analizó mediante un análisis temático del discurso. ResultadosLa experiencia de las enfermeras en relación a la facilitación de la visita infantil a la UCIP se puede condensar en cuatro temas: el emerger de la demanda, la preparación progresiva, la toma de decisiones desde el consenso y la creación de espacios de intimidad. Conclusiones Las experiencias de facilitación de la visita responden, principalmente, a la demanda de las familias que viven hospitalizaciones prologadas o al final de la vida. El rol de la enfermera es de acompañamiento reconociendo la labor prioritaria de los padres en la preparación de los niños y el desarrollo de la visita. Las enfermeras se sienten inseguras y faltas de recursos para el apoyo emocional y reclaman protocolos de actuación que orienten la intervención y toma de decisiones. (AU)

Aim To explore nurses’ experience related to promoting the visits of siblings to PICU. Methods An interpretative phenomenological study was carried out through in-depth interviews in two PICUs belonging to third level public hospitals in Madrid. Twelve nurses with more than two years of experience in PICU were interviewed. They all were working in PICU during the study. Furthermore, a PICU psychologist with an experience of four years was interviewed and this was considered shadowed data. Data analysis followed a thematic discourse analysis. Results Nurses’ experience of facilitating children's visits to PICU can be condensed into four themes: emerging demand for visits, progressive preparation, decision-making through common consensus and creating intimate spaces. Conclusions The experience of nurses in facilitating visits is mainly in response to the demand of families going through prolonged hospitalisation or end-of-life situations. The role of the nurse is one of accompaniment, recognising the major role of parents in the preparation of children and in developing the visit. Nurses feel insecure and lack resources for emotional support and demand action protocols to guide intervention and decision making. (AU)

Melanoma nasofaríngeo: caso clínico

Resumen El melanoma mucoso primario (MM) de la cavidad nasal y los senos paranasales sigue siendo un tumor maligno poco frecuente. El pico de incidencia se sitúa entre 50 y 60 años, siendo la epistaxis y la obstrucción nasal unilateral los síntomas más frecuentes. La resección quirúrgica es el tratamiento primario con radioterapia y quimioterapia adyuvante si es necesario, el pronóstico depende de la extensión. Presentamos el caso de una paciente mujer de 81 años con hemoptisis y halitosis de un año de evolución. La nasofibrolaringoscopia mostró una lesión parduzca, excrecente, irregular y friable, en el borde derecho del rodete tubárico derecho. El resultado histopatológico fue MM nasofaríngeo. Perfil inmunohistoquímico: S100 +, MelanA +, HMB45 +, SOX10 +, AE1AE3 negativo. El PET-CT mostró una hipercaptación a nivel del rodete tubárico derecho, sin evidencia de adenopatías o metástasis a distancia. Se realizó la resección tumoral completa mediante abordaje endoscópico. El Comité de Oncología del Melanoma decidió que no era necesario un tratamiento adyuvante debido a la resección completa de la lesión y considerando la edad y el deterioro cognitivo de la paciente.

Abstract Primary mucous melanoma (MM) of the nasal cavity and paranasal sinuses remains a rare malignancy. The peak of incidence is between 50 and 60 years old, being epistaxis and unilateral nasal obstruction the most frequent symptoms. Surgical resection is the primary treatment with radiotherapy and adjuvant chemotherapy if necessary, the prognosis depends on the spreading. We present the case of an 81-year-old female patient attending for hemoptysis and halitosis of a year of evolution. The nasofibrolaryngoscopy showed a brownish, excrescent, irregular and friable lesion, outgrowth of the right tube rim. Histopathology result was nasopharyngeal MM. Immunohistochemical profile: S100 +, MelanA +, HMB45 +, SOX10 +, AE1AE3 negative. PET-CT showed a hypercaptation at the level of the right tube rim, without evidence of adenopathies or distant metastases. Complete tumor resection was performed by endoscopic surgery. Melanoma Oncology Committee decided no need of adjuvant therapy due to the complete resection of the lesion and considering the age and cognitive deterioration of the patient.

Children's visits to the paediatric intensive care unit from the nurses' experience.

BACKGROUND: Family process disruption is one of the main consequences of the hospitalization of a critically ill child in a Paediatric Intensive Care Unit (PICU). Children's visits to PICU may help improve family coping. However, this is not standard practice and nurses' experiences in facilitating children's visits to units where it is encouraged is unknown. AIM: To explore nurses' experience related to promoting the visits of siblings to PICU. METHODS: An interpretative phenomenological study was carried out through in-depth interviews in two PICUs belonging to third level public hospitals in Madrid. Twelve nurses with more than two years of experience in PICU were interviewed. They were all were working in PICU during the study. Furthermore, a PICU psychologist with an experience of four years was interviewed and this was considered shadowed data. Data analysis followed a thematic discourse analysis. RESULTS: Nurses' experience of facilitating children's visits to PICU can be condensed into four themes: emerging demand for visits, progressive preparation, decision-making through common consensus and creating intimate spaces. CONCLUSIONS: The experience of nurses in facilitating visits is mainly in response to the demand of families going through prolonged hospitalisation or end-of-life situations. The role of the nurse is one of accompaniment, recognising the major role of parents in the preparation of children and in developing the visit. Nurses feel insecure and lack resources for emotional support and demand action protocols to guide intervention and decision making.

Detection of Candidatus Bartonella odocoilei n. sp. in Lipoptena mazamae associated with white-tailed deer in Campeche, Mexico.

The deer ked Lipoptena mazamae (Diptera: Hippoboscidae) (Róndani), is a blood-feeding obligate ectoparasite of several species of deer and brocket. However, at present little information is available about its role as a vector of hemoparasites. Nonetheless, it is considered a competent vector for the transmission of Bartonella species. The aim of this study was performing the morphological and molecular identification of ked flies and to carry out the detection of Bartonella. We collected specimens from Chiná, Campeche, Mexico associated with white-tailed deer. Using polymerase chain reaction (PCR), of COI, gltA and rpoB genes, we were able to obtain the first barcode for L. mazamae from Mexico and identified a new species of Bartonella which was found with a prevalence of 73%. The data obtained in this study confirmed the presence of L. mazamae associated with white-tailed deer and its possible role as vector of Candidatus Bartonella odocoilei n. sp. in Mexico and we considered that it may also be present in white-tailed deer populations in the U.S.A. Additional investigations into Bartonella species associated with deer ked could provide further insight into their pathogenicity and its role as a zoonotic agent.

Critically ill COVID-19 patients attended by anesthesiologists in northwestern Spain: a multicenter prospective observational study. / Pacientes críticos COVID-19 atendidos por anestesiólogos en el Noroeste de España: estudio multicéntrico, prospectivo, observacional.

BACKGROUND AND OBJECTIVES: There are limited information on outcome, complications and treatments of critically ill COVID-19 patients requiring admission to an intensive care unit (ICU). The aim of this study is to describe the clinical ICU course, treatments used, complications and outcomes, of critically ill COVID-19 patients admitted in seven ICU in Galicia region during the 2020 March-April pandemic peak. METHODS: Between March 21 and April 19, 2020, we evaluated critically ill COVID-19 patients admitted to the ICU of Anesthesia of seven hospitals in Galicia, northwestern Spain. Outcome, complications, and treatments were monitored until May 6, 2020, the final date of follow-up. RESULTS: A total of 97 critically ill COVID-19 patients were included. During ICU stay, mechanical ventilation became necessary in 80 (82.5%) patients, and tracheostomy in 22 (22.7%) patients. Prone position was used frequently in both intubated (67.5%) and awake (27.8%) patients. Medications consisted of antivirals agents (92.7%), corticosteroids (93.8%), tocilizumab (57.7%), and intermediate or high doses of anticoagulants (83.5%). The most frequent complications were ICU-acquired infection (52.6%), thrombosis events (16.5%), and reintubation (9.3%). After a median follow-up of 42 (34-45) days, 15 patients (15.5%) deceased, 73 patients (75.2%) had been discharged from ICU, and nine patients (9.3%) were still in the ICU. CONCLUSIONS: A high proportion of our critically ill COVID-19 patients required mechanical ventilation, prone positioning, antiviral medication, corticosteroids, and anticoagulants. ICU complications were frequent, mainly infections and thrombotic events. We had a relatively low mortality of 15,5%.

Patrón espacial de la mortalidad por EPOC en los municipios de Sevilla (2013-2017) / Spatial pattern of COPD mortality in the municipalities of Seville (2013-2017)

OBJETIVO: analizar el patrón espacial de la mortalidad por EPOC en los municipios de la provincia de Sevilla durante el período 2013-2017. SUJETOS Y MÉTODO: los datos de mortalidad por EPOC y las poblaciones necesarias para el cálculo de los indicadores fueron facilitados por el Instituto de Estadística de Andalucía. Para analizar el patrón espacial de la mortalidad por EPOC a nivel de los municipios de Sevilla se usaron tres estimadores de riesgo: la Razón de Mortalidad Estandarizada (RME), el Riesgo Relativo Suavizado (RRs) y la Probabilidad Posteriores (PP) de que el RRs sea mayor que 1. RESULTADOS: los valores de RRs en los hombres oscilan entre 0,95 en Mairena del Alcor y 1,9 en Badolatosa y El Real de la Jara y en las mujeres los valores oscilan entre 0,78 en La Puebla de Cazalla y 3,4 en Lora del Rio. Se observan 76 municipios en los hombres y 23 en las mujeres con una PP mayor o igual a 0,80. CONCLUSIÓN: nuestros hallazgos ayudan a identificar áreas de alto riesgo para futuros estudios más completos destinados a identificar los factores de riesgo específicos asociados con las áreas críticas observadas y para guiar los esfuerzos de control de la EPOC

OBJECTIVE: to analyze the spatial pattern of COPD mortality in the municipalities of the province of Seville during the 2013-2017 period. SUBJECTS AND METHOD: the COPD mortality data and the populations needed to calculate the indicators were provided by the Andalusian Institute of Statistics. To analyze the spatial pattern of COPD mortality at the level of the municipalities of Seville, three risk estimators were used: Standardized Mortality Ratio (SMR), Relative Risk Smoothing (RRs) and Posterior Probability (PP) that the RRs is greater than 1. RESULTS: RRs values in men range between 0.95 in Mairena del Alcor and 1.9 in Badolatosa and Real de la Jara and in women the values range between 0.78 in La Puebla de Cazalla and 3.4 in Lora del Rio. There are 76 municipalities in men and 23 in women with a PP greater than or equal to 0.80. CONCLUSION: our findings help identify high-risk areas for more complete future studies to identify specific risk factors associated with the critical areas observed and to guide COPD control efforts

Tendencias recientes en cáncer de próstata en España / Recent trends in prostate cancer in Spain

OBJETIVO: Evaluar las tendencias recientes de incidencia, supervivencia y mortalidad por cáncer de próstata en España utilizando datos actualizados. Sujetos y método: Las defunciones por cáncer de próstata se han obtenido del Instituto Nacional de Estadística (INE). Los casos incidentes se han obtenido de las bases de datos Cancer incidence in five continents (CI5) y European Cancer Information System. Para el análisis de tendencias se usaron modelos de regresión joinpoint. En los resultados se muestran los años (período) que componen cada tendencia, así como el porcentaje de cambio anual (PCA) para cada una de ellas. La dirección y magnitud de las tendencias recientes (últimos 5 años disponibles) se evaluaron mediante los porcentajes de cambio anual medio (PCAM). RESULTADOS: Las tasas de incidencia aumentaron de forma significativa, pasando de 16,4 en 1980 a 61,3 en 2014. El análisis joinpoint muestra 3 períodos: 2 iniciales de incrementos significativos (1980-1990; 3,5% y 1990-2004; 8,4%) seguidos de uno final en el que las tasas se estabilizan (2004-2014; -0,5%, no significativo). Las tasas de mortalidad descienden pasando de 12,9 en 1980 a 7,9 en el año 2018, con un PCAM de -1,2% (p < 0,05). Sin embargo, el análisis joinpoint identificó 3 períodos de tiempo: un período inicial de aumento estadísticamente significativo (1980-1998; PCA: 0,6%, p < 0,05) y 2 períodos de disminución en las tasas (1992-2008; PCA: -3,3%, p < 0,05 y 2008-2018; PCA: -2,4%, p < 0,05). CONCLUSIÓN: Las tendencias recientes (últimos 5 años) muestran que las tasas de mortalidad han disminuido y que las tasas de incidencia se han estabilizado e incluso descendido en algunos grupos de edad

OBJECTIVE: To assess recent trends in prostate cancer incidence, survival and mortality in Spain using updated data. Subjects and method: Prostate cancer mortality data have been obtained from the National Institute of Statistics (INE). Incidence cases have been obtained from the databases Cancer Incidence in Five Continents (CI5) and European Cancer Information System. Joinpoint regression models were used for trend analysis. The results show the duration (years) of each trend, as well as the Annual Percent Change (APC) for each of them. The direction and magnitude of recent trends (last 5 years available) were evaluated using the percentages of Average Annual Percent Change (AAPC). RESULTS: Incidence rates increased significantly from 16.4 in 1980 to 61.3 in 2014. The joinpoint analysis shows three periods: two initial periods of significant rise (1980-1990; 3.5% and 1990-2004; 8.4%) followed by a final one in which rates stabilize (2004-2014; -0.5%, non-significant). Mortality rates drop from 12.9 in 1980 to 7.9 in 2018, with an AAPC of -1.2% (p < 0.05). However, the joinpoint analysis identified three time periods: an initial period of statistically significant rise (1980-1998; APC: 0.6%, p < 0.05) and two periods of decreasing rates (1992-2008; APC: -3.3%, p < 0.05 and 2008-2018; APC: -2.4%, p < 0.05). CONCLUSION: Recent trends (last 5 years) show that mortality rates have decreased and incidence rates have stabilized or even decreased in some age groups

Recent trends in prostate cancer in Spain. / Tendencias recientes en cáncer de próstata en España.

OBJECTIVE: To assess recent trends in prostate cancer incidence, survival and mortality in Spain using updated data. SUBJECTS AND METHOD: Prostate cancer mortality data have been obtained from the National Institute of Statistics (INE). Incidence cases have been obtained from the databases Cancer Incidence in Five Continents (CI5) and European Cancer Information System. Joinpoint regression models were used for trend analysis. The results show the duration (years) of each trend, as well as the Annual Percent Change (APC) for each of them. The direction and magnitude of recent trends (last 5 years available) were evaluated using the percentages of Average Annual Percent Change (AAPC). RESULTS: Incidence rates increased significantly from 16.4 in 1980 to 61.3 in 2014. The joinpoint analysis shows three periods: two initial periods of significant rise (1980-1990; 3.5% and 1990-2004; 8.4%) followed by a final one in which rates stabilize (2004-2014; -0.5%, non-significant). Mortality rates drop from 12.9 in 1980 to 7.9 in 2018, with an AAPC of -1.2% (p<0.05). However, the joinpoint analysis identified three time periods: an initial period of statistically significant rise (1980-1998; APC: 0.6%, p<0.05) and two periods of decreasing rates (1992-2008; APC: -3.3%, p<0.05 and 2008-2018; APC: -2.4%, p<0.05). CONCLUSION: Recent trends (last 5 years) show that mortality rates have decreased and incidence rates have stabilized or even decreased in some age groups.