Unprocessed red meat and processed meat consumption and risk of stroke in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC).

BACKGROUND/OBJECTIVES: High intakes of unprocessed red or processed meat may increase the risk of stroke. We aimed to examine the association between unprocessed red meat, processed meat and total red meat consumption and risk of total stroke and ischaemic stroke. SUBJECTS/METHODS: Cox proportional hazards regression analyses were conducted based on the data for 41,020 men and women aged 29-69 years at baseline. RESULTS: During a mean follow-up of 13.8 years, 674 incident cases of stroke (531 ischaemic strokes, 79 haemorrhagic strokes, 42 subarachnoid haemorrhages and 22 mixed or unspecified events) were identified. After multiple adjustment, unprocessed red meat, processed meat and total red meat consumption were not correlated with incidence of total stroke or ischaemic stroke in either men or women. The hazard ratios (HRs) for unprocessed red meat and processed meat and risk of total stroke comparing the highest with the lowest quintiles were, respectively, 0.81 (95% confidence interval (CI) 0.54-1.21; P-trend=0.15) and 0.92 (95% CI 0.64-1.32; P-trend=0.82) in men and 1.21 (95% CI 0.79-1.85; P-trend=0.10) and 0.81 (95% CI 0.51-1.27; P-trend=0.17) in women. The HRs for unprocessed red meat and processed meat and risk of ischaemic stroke were, respectively, 0.80 (95% CI 0.51-1.25; P-trend=0.51) and 0.86 (95% CI 0.57-1.29; P-trend=0.77) in men and 1.24 (95% CI 0.74-2.05; P-trend=0.13) and 0.82 (95% CI 0.47-1.42; P-trend=0.31) in women. CONCLUSIONS: In the Spanish European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, unprocessed red meat and processed meat consumption were not associated with risk of stroke in men or women.

Tabaco y esclerosis múltiple / Smoking and multiple sclerosis

Introducción. La esclerosis múltiple (EM) es una enfermedad autoinmune de etiología compleja, hoy por hoy desconocida, en la que factores genéticos y ambientales determinan la susceptibilidad. En los últimos años, el efecto del tabaco ha sido uno de los factores ambientales que ha emergido en la EM, y se ha asociado tanto a un aumento de la susceptibilidad como a un aumento de la progresión. Objetivo. Revisar la evidencia actual sobre el papel del tabaco en la EM. Desarrollo. Se incluye una actualización de los estudios publicados que han analizado distintos aspectos del tabaco en laEM: vías patogénicas implicadas, asociación del tabaco y riesgo de EM, interacción con otros factores de riesgo y efecto del tabaco en el curso de la enfermedad. Conclusiones. Los estudios observacionales demuestran que el tabaquismo incrementa de forma significativa el riesgo de EM (odds ratio ~ 1,5) y es un factor de riesgo independiente. Sin embargo, la EM es una enfermedad compleja y el aumento de riesgo por el tabaco puede diferir en función de la interacción con otros factores genéticos y ambientales. El papel del tabaco como factor de progresión es más controvertido, con resultados contradictorios y estudios de gran variabilidad, lo que dificulta establecer una conclusión firme. Los mecanismos por los que el tabaquismo modifica el riesgo y posiblemente la progresión de la enfermedad no son aún conocidos (AU)

Introduction. Multiple sclerosis (MS) is a complex autoimmune disease of unknown etiology, in which genetic and environmental factors interact and determine the disease susceptibility. In recent years, smoking effect has been one of the emerging environmental factors in the study of MS and has been associated with an increased susceptibility and an increase in disease progression. Aim. To review the current evidence on the role of smoking in MS. Development. The review includes an update of studies that have analyzed different aspects of tobacco in MS, including the potential pathogenic pathways involved, association of smoking and risk of MS, interactions with other risk factors and the effect of smoking in the disease course. Conclusions. Observational studies show that smoking significantly increases the risk of MS (odds ratio ~ 1.5) and is an independent risk factor. However, MS is a complex disease and this risk may be modified depending on the interaction with other genetic and environmental factors. The role of smoking as a progression factor is more controversial, with confronted results and highly variable studies, making it difficult to draw any conclusion. The mechanisms by which smoking may modify the risk and progression of the disease have to be further investigated (AU)

[Epidemiology of tuberculosis in Navarre]. / Situación epidemiológica de la tuberculosis en Navarra, 2006.

BACKGROUND: To describe the tendency and epidemiological characteristics of tuberculosis and estimate the prevalence of tuberculosis infection in Navarre. Methods. An analysis was made of the cases of tuberculosis reported in the 1993-2006 period, completed with microbiological information and data from other registries. RESULTS: The incidence of tuberculosis in Navarre declined from 24.0 cases per 100,000 inhabitants in 1993 to 13.7 per 100,000 in 2006. Between 2000 and 2006 the incidence of tuberculosis fell by an annual 6.5% in those born in Spain and by an annual 9.3% in those born in other countries. In the 2004-2006 period, the diagnoses of tuberculosis were more frequent in males (60%), between the ages of 25 and 34 years (26.1%), and over 65 years of age (24.1%), and in persons born in Spain (69.0%). Four point three percent of the cases were coinfected with HIV. Six point six percent had had prior antituberculosis treatment, 5.4% showed resistance to some antituberculosis drug, and 2.3% resistance to more than one. There was a predominance of pulmonary forms (68.9%) and 37% of the total had positive sputum bacilloscopy. Death occurred in 6.2% of the cases before treatment was finalised. Between 2004 and 2006 15 clusters of cases were detected, 11 amongst cohabitants. Ninety-three percent of the secondary cases occurred from index cases born in Spain. CONCLUSION: There has been a notable advance in the control of tuberculosis, both in the native population and in that from other countries, although there is still room for improvement.

Changes in breast cancer mortality in Navarre (Spain) after introduction of a screening programme.

OBJECTIVE: The aim of this study was to assess changes in the trend of breast cancer mortality in Navarre, and the effect that a screening programme may have had on these changes. METHODS: A breast cancer screening programme targeting women aged 45-65 years was launched in Navarre in September 1990. Breast cancer deaths between 1975 and 2004 were identified from the Navarre Mortality Registry, and the date of diagnosis was obtained by linkage with the population-based Navarre Cancer Registry. We compared breast cancer mortality during the pre-screening (1987-89) and screening (2002-04) periods, and with the estimated rate in the last period calculated by a linear model with a Poisson distribution. The long-term trends (from 1975 through 2004) were described by joinpoint regression analysis. Prevalent cases (those diagnosed before 1991) were excluded to minimize dilution of the benefit in the post-screening period due to deaths from tumours diagnosed before screening began. RESULTS: The joinpoint analysis showed a rising trend in breast cancer mortality rates until 1994, followed by a continual decrease of just over 5% per year. A comparison of mortality rates between the last pre-screening and the screening periods showed a decrease of 36% (95% confidence interval [CI] 21-48%), with the largest reduction in the 50-69 years age group (52%; CI: 33-65%). In this age group, mortality in the 2002-04 period was 62% lower than that projected from extrapolation of the pre-screening trend, while in unscreened age groups (30-44 and > or =75 years), mortality was only 22% lower. When prevalent tumours were excluded, the 50-69 years age group presented a further decrease in mortality than when all tumours were considered. CONCLUSIONS: Fourteen years after the introduction of a screening programme, a major reduction in breast cancer mortality has been observed.

Situación epidemiológica de la tuberculosis en Navarra, 2006 / Epidemiology of tuberculosis in Navarre

Fundamento. Describir la tendencia y características epidemiológicas de la tuberculosis y estimar la prevalencia de infección tuberculosa en Navarra. Métodos. Se analizaron los casos de tuberculosis declarados en el periodo 1993-2006, completados con información microbiológica y de otros registros sanitarios. Resultados. La incidencia de tuberculosis en Navarra pasó de 24,0 casos por 100.000 habitantes en 1993 a 13,7 por 100.000 en 2006. Entre 2000 y 2006 la incidencia de tuberculosis descendió un 6,5% anual en los nacidos en España y un 9,3% anual en nacidos en otros países. En el periodo 2004-2006 los diagnósticos de tuberculosis fueron más frecuentes en varones (60%), entre edades de 25 a 34 años (26,1%) y a partir de 65 años (24,1%), y en personas nacidas en España (69,0%). El 4,3% de los casos estaban coinfectados por VIH. Un 6,6% habían tenido tratamiento antituberculoso previo, el 5,4% presentaban resistencia a algún antituberculoso y el 2,3% a más de uno. Predominaron las formas pulmonares (68,9%) y el 37% del total tuvo baciloscopia de esputo positiva. En el 6,2% de los casos se produjo el fallecimiento antes de finalizar el tratamiento. Entre 2004 y 2006 se detectaron 15 agregaciones de casos, 11 entre convivientes. El 93% de los casos secundarios se produjeron a partir de casos índice nacidos en España. La prevalencia estimada de infección tuberculosa es inferior al 3% en niños, alcanza el 7,7% a los 14 años y el 40% en adultos. Conclusión. Se ha avanzado notablemente en el control de la tuberculosis, tanto en población autóctona como de otros países, aunque queda margen de mejora

epidemiological characteristics of tuberculosis and estimate the prevalence of tuberculosis infection in Navarre. Methods. An analysis was made of the cases of tuberculosis reported in the 1993-2006 period, completed with microbiological information and data from other registries. Results. The incidence of tuberculosis in Navarre declined from 24.0 cases per 100,000 inhabitants in 1993 to 13.7 per 100,000 in 2006. Between 2000 and 2006 the incidence of tuberculosis fell by an annual 6.5% in those born in Spain and by an annual 9.3% in those born in other countries. In the 2004-2006 period, the diagnoses of tuberculosis were more frequent in males (60%), between the ages of 25 and 34 years (26.1%), and over 65 years of age (24.1%), and in persons born in Spain (69.0%). Four point three percent of the cases were coinfected with HIV. Six point six percent had had prior antituberculosis treatment, 5.4% showed resistance to some antituberculosis drug, and 2.3% resistance to more than one. There was a predominance of pulmonary forms (68.9%) and 37% of the total had positive sputum bacilloscopy. Death occurred in 6.2% of the cases before treatment was finalised. Between 2004 and 2006 15 clusters of cases were detected, 11 amongst cohabitants. Ninety-three percent of the secondary cases occurred from index cases born in Spain. Conclusion. There has been a notable advance in the control of tuberculosis, both in the native population and in that from other countries, although there is still room for improvement

Tendencias recientes de las principales causas de muerte en Navarra. 1995-2004 / Recent trends of the main causes of death in Navarre. 1995-2004

Se presentan las estadísticas de mortalidad de Navarra para el periodo 1995-2004 por sexo, edad y causa de muerte. Material y métodos. Los datos proceden de los boletines estadísticos de defunción. Se comparan el periodo 1995-1999 con el periodo 2000-2004, utilizando las tasas ajustadas a la población de Navarra del año 2001 y la tasa de años potenciales de vida perdidos entre 0-70 años ajustada a la población europea. Resultados. La esperanza de vida al nacer en el periodo 2000-2004 fue de 77,9 años en los hombres y 85 años en las mujeres, esta última una de las más altas registradas a nivel mundial. El riesgo de muerte ha diminuido en prácticamente todos los grupos de edad, destacando un descenso de la mortalidad del 40% en el grupo de 25-34 años a costa del sida. La mortalidad infantil bajó hasta 3,3 por 1.000 recién nacidos vivos. Ha habido un importante incremento de la mortalidad por cáncer de pulmón entre las mujeres menores de 65 años (46%) en el quinquenio 2000-04 respecto al anterior y un fuerte descenso de la mortalidad por cáncer de mama (45,4%). Han continuado disminuyendo en ambos sexos la mortalidad por enfermedades cerebrovasculares, enfermedad isquémica del corazón, insuficiencia cardiaca y arterioesclerosis así como la mortalidad por úlceras y cirrosis. Las tasas de mortalidad de Navarra de todos los grandes grupos de causas son más bajas que las de España excepto la tasa de mortalidad por causas externas. Conclusiones. El incremento de la mortalidad por cáncer de pulmón y de otros cánceres relacionados con el tabaquismo debido a la extensión del consumo en las últimas décadas puede influir negativamente en la esperanza de vida de las mujeres de Navarra en los próximos años. La prevención de la mortalidad por causas externas y la prevención de las muertes ligadas al consumo de tabaco son dos prioridades que se desprenden de los datos de mortalidad de esta comunidad autónoma

We present the statistics for mortality in Navarre for the 1995-2004 period by sex, age and cause of death. Methods. The data proceeds from the statistical bulletins on death. The 1995-1999 period is compared with the 2000-2004 period, using adjusted rates to the population of Navarre for the year 2001 and the rate of potential years of life lost between 0- 70 years adjusted to the European population. Results. Life expectancy at birth in the 2000-2004 period was 77.9 years in men and 85 years in women, the latter being one of the highest registered at the world level. Infant mortality fell to 3.3 per 1,000 living newborn infants. The risk of death has fallen in practically all age groups, with a notable fall in mortality of 40% in the 25-34 group at the cost of AIDS. There has been a significant increase of mortality due to lung cancer amongst women under 65 years of age (46%) in the 2000-2004 period with respect to the previous five year period and a sharp fall in mortality due to breast cancer (45.4%). In both sexes there has been a continued fall of mortality due to cerebrovascular diseases, ischaemic heart diseases, cardiac failure and arteriosclerosis and of mortality due to ulcer and cirrhosis. The rates of mortality in Navarre in all the main groups of causes are lower than those of Europe, except for the rate of mortality due to external causes. Conclusions. The increase of mortality due to lung cancer and other cancers related to smoking, due to the spread of consumption in recent decades, could have a negative influence on the life expectancy of women in Navarre in coming years. The prevention of mortality due to external causes and the prevention of deaths linked to tobacco consumption are the two priorities that emerge from the data on mortality in this autonomous community

[Recent trends of the main causes of death in Navarre. 1995-2004]. / Tendencias recientes de las principales causas de muerte en Navarra. 1995-2004.

UNLABELLED: We present the statistics for mortality in Navarre for the 1995-2004 period by sex, age and cause of death. METHODS: The data proceeds from the statistical bulletins on death. The 1995-1999 period is compared with the 2000-2004 period, using adjusted rates to the population of Navarre for the year 2001 and the rate of potential years of life lost between 0-70 years adjusted to the European population. RESULTS: Life expectancy at birth in the 2000-2004 period was 77.9 years in men and 85 years in women, the latter being one of the highest registered at the world level. Infant mortality fell to 3.3 per 1,000 living newborn infants. The risk of death has fallen in practically all age groups, with a notable fall in mortality of 40% in the 25-34 group at the cost of AIDS. There has been a significant increase of mortality due to lung cancer amongst women under 65 years of age (46%) in the 2000-2004 period with respect to the previous five year period and a sharp fall in mortality due to breast cancer (45.4%). In both sexes there has been a continued fall of mortality due to cerebrovascular diseases, ischaemic heart diseases, cardiac failure and arteriosclerosis and of mortality due to ulcer and cirrhosis. The rates of mortality in Navarre in all the main groups of causes are lower than those of Europe, except for the rate of mortality due to external causes. CONCLUSIONS: The increase of mortality due to lung cancer and other cancers related to smoking, due to the spread of consumption in recent decades, could have a negative influence on the life expectancy of women in Navarre in coming years. The prevention of mortality due to external causes and the prevention of deaths linked to tobacco consumption are the two priorities that emerge from the data on mortality in this autonomous community.