Supervivencia en cáncer de mama tras 10 años de seguimiento en las provincias de Granada y Almería / Breast cancer survival after 10 years of follow up, in Granada and Almeria spanish provinces

Fundamento: Describir la supervivencia global y libre de enfermedad a los cinco y diez años del diagnóstico de cáncer de mama en mujeres participantes un estudio caso control previo, y establecer las variables pronóstico relacionadas. Métodos: Se realizó el seguimiento de 202 mujeres diagnosticadas en tres hospitales públicos de Granada y Almería entre 19961998. La supervivencia se evaluó mediante el método de Kaplan-Meier, y la identificación de factores relacionados mediante el análisis de regresión de Cox. Resultados: La edad media al diagnóstico fue de 54,27±10,4 años. La supervivencia global a los 5 años fue del 83,9% (IC 95%: 78,13-89,66) y a los 10 años del 71% (IC 95%: 63,25-78,74) con un tiempo medio de seguimiento de 119,91 meses (IC 95% 113,65126,17). La supervivencia libre de enfermedad a los 5 años fue del 81% (IC 95%: 74,52-87,47) y a los 10 años del 71,3% (IC 95%: 63,33-79,26) con un tiempo medio de seguimiento de 118,75 meses (IC 95% 111,86-125,65). La mortalidad de la serie fue del 33’17%. Conclusiones: Las características de la enfermedad en las mujeres de la muestra estudiada son similares a las de otras regiones de España y Europa, con una supervivencia global superior a la descrita en Europa y y comparable a la de España amba referidas para el mismo periodo(AU)

Background: To describe the overall and disease-free survival at five and ten years after breast cancer diagnosis in women from a previous case-control study, and establish related prognostic factors. Methods: We followed up 202 patients diagnosed between 1996 and 1998 in three public hospitals in Granada and Almeria provinces in Spain. Survival rates were calculated using the Kaplan and Meier method, and the Cox proportional hazards model was applied to identify the most significant variables contributing to survival. Results: Mean age at diagnosis was 54.27±10.4 years. Mean follow-up for overall survival was 119.91 months (95%CI 113.65126.17); the five-year survival rate was 83.9% (95%CI: 78.13-89.66) and the ten-year rate was 71% (95%CI: 63.25-78.74). Mean followup for disease-free survival was 118.75 months (95%CI 111.86125.65); the five-year disease-free survival rate was 81% (95%CI: 74.52-87.47) and the ten-year rate was 71.3% (95%CI: 63.33-79.26). The mortality rate of the study population was 33.17%. Conclusions: Disease characteristics are similar in our population to those in other Spanish and European regions, while the overall survival is higher than the mean rate during the same period in Europe (5-yr rate of 79%) and similar to that in Spain (83%)(AU)

La exposición a plaguicidas se asocia con la disminución del recuento espermático / Pesticide exposure and decreased sperm count

Introducción. Recientes estudios han demostrado un posible descenso de la calidad seminal en el hombre, debido, en parte, a sustancias químicas exógenas al organismo, y entre éstas, algunas con actividad hormonal, consideradas disruptores endocrinos, como son los plaguicidas. Estos estudios se han criticado por el sesgo que pueden presentar en cuanto a la selección de las poblaciones de estudio y en cuanto a la metodología analítica empleada. Material y métodos. El objetivo de nuestro estudio es valorar la concentración de plaguicidas en las muestras de sangre, así como el recuento espermático y la calidad en las muestras de semen, según los criterios de la OMS, de una población de 273 varones con una media de edad de 20,7 años, sin antecedentes patológicos del Sudeste de España y reclutados en colaboración con la Universidad de Almería. Resultados. En la totalidad de las 224 muestras de suero disponibles se cuantificó al menos un plaguicida, con una mediana de 11 plaguicidas por muestra; el p,p’-DDE es el más frecuente, presente en el 95,98% de las muestras. Únicamente con el endosulfán-sulfato (presente en el 45,1% de los voluntarios) se encontró una fuerte tendencia a la reducción de más 1,23 millones en el número total de espermatozoides, por lo que se alcanzó la significación estadística (p = 0,009; con un intervalo de confianza del 95%: −1,43 a −1,05). En cuanto al número de espermatozoides móviles, también únicamente con el endosulfán-sulfato, se presentó un descenso estadísticamente significativo de 1,23 millones (p = 0,02; con un intervalo de confianza del 95%: −1,47 a −1,04) (AU)

Introduction. Recent studies have demonstrated a possible decline in semen quality in men. One of the reasons for this is due, in part, to exogenous chemical substances, some of which have hormonal activity, and are considered to be endocrine-disrupting chemicals. Pesticides can be included in this group. Material and methods. These studies have been criticized both for errors in selecting the study group as well as for the analytical methods employed. The objective of our study is to evaluate the concentration of pesticides in blood samples-in addition to the sperm count and semen quality parameters (according to criteria set out by the W.H.O.) in a population of 273 healthy men with an average age of 20.7 years; all from Southern Spain and recruited in collaboration with the University of Almeria. Results. Out of the total of 224 serum samples available, at least one pesticide was quantified per sample, with an average of 11 pesticides per sample; the most frequent being p,p’-DDE, present in 95.98% of the samples. Only in the case of endosulfan sulphate (present in 45.1% of the volunteers) was there a strong reduction tendency in the number of spermatozoa of more than 1.23 million, reaching statistical significance(P=0.009), with a 95% confidence interval of −1.43 to −1.05. As far as the number of motile spermatozoa were concerned, it was also only with endosulfan sulphate that a statistically significant reduction of 1.23 million (P=0.02) in the total number appeared, with a 95% confidence interval of −1.47 to −1.04) (AU)

[Breast cancer survival after 10 years of follow up, in Granada and Almeria Spanish Provinces]. / Supervivencia en cáncer de mama tras 10 años de seguimiento en las provincias de Granada y Almería.

BACKGROUND: To describe the overall and disease-free survival at five and ten years after breast cancer diagnosis in women from a previous case-control study, and establish related prognostic factors. METHODS: We followed up 202 patients diagnosed between 1996 and 1998 in three public hospitals in Granada and Almeria provinces in Spain. Survival rates were calculated using the Kaplan and Meier method, and the Cox proportional hazards model was applied to identify the most significant variables contributing to survival. RESULTS: Mean age at diagnosis was 54.27 ± 10.4 years. Mean follow-up for overall survival was 119.91 months (95%CI 113.65-126.17); the five-year survival rate was 83.9% (95%CI: 78.13-89.66) and the ten-year rate was 71% (95% CI: 63.25-78.74). Mean follow-up for disease-free survival was 118.75 months (95%CI 111.86-125.65); the five-year disease-free survival rate was 81% (95% CI: 74.52-87.47) and the ten-year rate was 71.3% (95% CI: 63.33-79.26). The mortality rate of the study population was 33.17%. CONCLUSIONS: Disease characteristics are similar in our population to those in other Spanish and European regions, while the overall survival is higher than the mean rate during the same period in Europe (5-yr rate of 79%) and similar to that in Spain (83%).

Endocrine disrupting chemicals: harmful substances and how to test them

Este artigo apresenta uma análise das opiniões de diferentes grupos, inclusive de cientistas, agências regulatórias internacionais, organizações não-governamentais e indústrias, interessados na questão da identificação de substâncias químicas com atividade desreguladora endócrina. Os autores discutem também o impacto da exposição aos desreguladores endócrinos sobre a saúde humana, considerando as seguintes questões: estimativa de risco; testes utilizados para detectar distúrbios endócrinos; dificuldades na identificação de uma associação entre dose, tempo de exposição, suscetibilidade individual e efeito e tentativas no sentido de mapear os desreguladores endócrinos. Finalmente, os autores argumentam que nem todos os agonistas hormonais devem ser incluídos sob a denominação genérica de desreguladores endócrinos.

Endocrine disrupting chemicals: harmful substances and how to test them.

This paper presents an analysis of the opinions of different groups from: scientists, international regulatory bodies, non-governmental organizations and industry; with an interest in the problem of identifying chemical substances with endocrine disrupting activity. There is also discussion of the consequences that exposure to endocrine disruptors may have for human health, considering concrete issues related to: the estimation of risk; the tests that must be used to detect endocrine disruption; the difficulties to establish an association between dose, time of exposure, individual susceptibility, and effect; and the attempts to create a census of endocrine disruptors. Finally, it is proposed that not all hormonal mimics should be included under the single generic denomination of endocrine disruptors.