Residential radon, EGFR mutations and ALK alterations in never-smoking lung cancer cases.

The aim of this study was to assess if residential radon exposure might cause EGFR mutations or ALK rearrangements in never-smokers.We designed a multicentre case-control study in a radon-prone area (Galicia, Spain); only lung cancer cases were included in the study. We obtained residential radon measurements and clinical information for all the participants. We compared the median values of residential radon between patients with EGFR mutations or ALK rearrangements versus those without them.323 patients were included. Median age was 70 years and 19.5% were males. 42 and 15% of patients were EGFR- and ALK-positive, respectively. The most frequent EGFR alterations were exon 19 deletions and exon 21 (L858R) single-point substitution mutations. ALK-positive patients were 10 years younger than ALK-negative patients. Residential radon levels were two-fold higher in patients with exon 19 deletions compared with patients with exon 21 (L858R) single-point substitution mutations (216 versus 118 Bq·m-3; p=0.057). There were no differences in residential radon levels by EGFR mutation status. ALK-positive patients (n=12) essentially had two-fold residential radon levels compared with ALK-negative patients (290 versus 164 Bq·m-3, respectively).Residential radon may have a role in the molecular signature of lung cancer in never-smokers, although more studies with larger sample sizes are needed to support this hypothesis.

Prevalencia de síntomas de asma en los niños y adolescentes de la Comunidad Autónoma de Galicia (España) y sus variaciones geográficas / Prevalence and Geographic Variations in Asthma Symptoms in Children and Adolescents in Galicia (Spain)

Objetivos: Determinar la prevalencia y variaciones geográficas de síntomas relacionados con asma enniños y adolescentes gallegos.Población y métodos: Estudio transversal según la metodología ISAAC (Internacional Study of Asthmaand Allergies in Childhood) mediante cuestionario escrito distribuido en el medio escolar. Se incluyeron10.371 niños de 6-7 años y 10.372 adolescentes de 13-14 años de todas las Áreas Sanitarias de Galicia. Seanalizaron las variaciones geográficas mediante un modelo de regresión logística.Resultados: Las sibilancias en los últimos 12 meses oscilaron en los pequeños, del 11,4 (Santiago) al 15,7%(Vigo) y en los adolescentes del 8,8 (Ourense) al 18,8% (Vigo). Según el género se observó una mayorfrecuencia en varones de 6-7 años (p < 0,001) y con tendencia a la significación estadística en las chicasde 13-14 años (p = 0,08). El riesgo (Odds ratio [OR]) de sibilancias en los últimos 12 meses, en el área demayor prevalencia con respecto a la de menor, fue 1,45 (intervalo de confianza [IC] del 95%: 1,12-1,88)en niños y 2,39 (IC 95%: 1,82-3,13) en adolescentes. La prevalencia de asma estimada para Galicia fue de13,6% en niños y 12,2% en adolescentes.Conclusiones: La prevalencia de sibilancias en los últimos 12 meses en las diferentes áreas gallegas essensiblemente superior al resto de ciudades españolas participantes en el ISAAC en los pequeños, siendomuy similar en los adolescentes, salvo en Vigo donde es sensiblemente superior. Encontramos un patróngeográficomuydefinido en los adolescentes, siendo mayores las prevalencias en la costa que en el interior(AU)

Objectives: To determine the prevalence and geographic variations of the symptoms associated withasthma in Galician children and adolescents.Population and methods: A cross-sectional epidemiological study following ISAAC (International Studyof Asthma and Allergies in Childhood) methodology, and using a written questionnaire distributed inschools. The study sample included 10,371 6-7 year-old children and 10,372 13-14 year-old adolescents,all of them from Galician Health Areas. A logistic regression model was used to analyse geographic variations. Results: In the 6-7 year-old group, wheezing in the last 12 months varied from 11.4% (Santiago) to 15.7%(Vigo) and in the adolescents varied from 8.8% (Ourense) to 18.8% (Vigo). The distribution by gender showeda predominant significance in 6-7 year-old males (P < .001), and near to be statistically significant in 13-14year-old females (P = .08). The risk (odds ratio [OR]) of wheezing in the last 12 months in the area withhighest prevalence in comparison with the area of lowest prevalence was 1.45 (95% Confidence Interval[CI], 1.12-1.88) for children and 2.39 (95% CI, 1.82-3.13) for adolescents. The estimated prevalence of asthmain the Autonomous Community of Galicia was 13.6% in younger children and 12.2% in adolescents.Conclusions: The prevalence of wheezing in the last 12 months in the different areas of Galicia is considerablyhigher than the rest of Spanish ISAAC cities in the 6-7 years group and very similar in the 13-14 yearsgroup, except in Vigo where it is considerably higher. We found a clearly defined geographic pattern inthe adolescent group, with higher prevalences in coastal areas than in the interior(AU)

Prevalence and geographic variations in asthma symptoms in children and adolescents in Galicia (Spain).

OBJECTIVES: To determine the prevalence and geographic variations of the symptoms associated with asthma in Galician children and adolescents. POPULATION AND METHODS: A cross-sectional epidemiological study following ISAAC (International Study of Asthma and Allergies in Childhood) methodology, and using a written questionnaire distributed in schools. The study sample included 10,371 6-7 year-old children and 10,372 13-14 year-old adolescents, all of them from Galician Health Areas. A logistic regression model was used to analyse geographic variations. RESULTS: In the 6-7 year-old group, wheezing in the last 12 months varied from 11.4% (Santiago) to 15.7% (Vigo) and in the adolescents varied from 8.8% (Ourense) to 18.8% (Vigo). The distribution by gender showed a predominant significance in 6-7 year-old males (P<.001), and near to be statistically significant in 13-14 year-old females (P=.08). The risk (odds ratio [OR]) of wheezing in the last 12 months in the area with highest prevalence in comparison with the area of lowest prevalence was 1.45 (95% Confidence Interval [CI], 1.12-1.88) for children and 2.39 (95% CI, 1.82-3.13) for adolescents. The estimated prevalence of asthma in the Autonomous Community of Galicia was 13.6% in younger children and 12.2% in adolescents. CONCLUSIONS: The prevalence of wheezing in the last 12 months in the different areas of Galicia is considerably higher than the rest of Spanish ISAAC cities in the 6-7 years group and very similar in the 13-14 years group, except in Vigo where it is considerably higher. We found a clearly defined geographic pattern in the adolescent group, with higher prevalences in coastal areas than in the interior.

Exposición a contaminantes ambientales y enfermedad respiratoria. Un foco de atención en el año 2009 / Exposure to Environmental Contaminants and Respiratory Disease. Spotlight on the Year 2009

La inhalación mantenida de agentes contaminantes presentes en el aire que respiramos es una causa frecuentede enfermedad respiratoria. De forma clásica, esta relación exposición-enfermedad se ha concretadoen el lugar de trabajo y como causa de enfermedades específi cas, como la neumoconiosis y el asmaocupacional. Sin embargo, cada vez es mayor la evidencia que indica la asociación entre exposición laboraly otras afecciones respiratorias tan prevalentes como la enfermedad pulmonar obstructiva crónica y elcáncer de pulmón. Además, el efecto de la contaminación también se observa fuera del lugar de trabajo, elaire de las ciudades puede contribuir a aumentar la morbilidad y la mortalidad por enfermedades respiratoriascrónicas. A continuación, se revisan algunos de los artículos publicados durante el año 2009 que incidenen algunos aspectos relacionados con las enfermedades respiratorias de origen laboral y medioambiental(AU)

The continued inhalation of contaminants present in the air that we breathe is a common cause ofrespiratory disease. Classically, this exposure-disease relationship has been proved in the workplace and asa cause of specifi c diseases such as pneumoconiosis and occupational asthma. However, there is increasingevidence indicating an association between occupational exposure and other more prevalent respiratorydiseases such as Chronic Obstructive Pulmonary Disease and lung cancer. The effect of contamination isalso observed outside the workplace. The air in cities can contribute to increasing the morbidity andmortality due to chronic respiratory diseases. Some articles published during the year 2009 that have abearing on aspects associated with respiratory diseases of occupational or environmental origin arereviewed below(AU)

[Relation between changes in retinal microcirculation and other organ damage in hypertension and regression with antihypertensive treatment]. / Relación entre los cambios en la microcirculación retiniana y la lesión de otros órganos diana en pacientes hipertensos y su regresión tras el tratamiento.

BACKGROUND AND OBJECTIVE: The possibility to aplicate a semi-automatic computerized system to evaluate the calibre of retinal blood vessels, has shown very good reproducibility, and have let us measure the calibres of retinal arterioles and veins, and their ratio (AVR). PATIENTS AND METHOD: We have measured the calibres of retinal vessels in a group of 51 hypertensive outpatients before and after 6 months' treatment with losartan or, losartan plus hydrochlorothiazide if the association was required to adequate control of the blood pressure. RESULTS: AVR increased from 0.7530 (0.03) to 0.7563 (0.03) (p = 0.005). We have related these modifications with damage in other target organs and we have found out a inverse relation between AVR and left ventricular mass index. This relation could be confirmed in multiple regression analysis. We have found no relation between AVR and microalbuminuria, probably because of its variability. CONCLUSIONS: These results suggest a relation between retinal microcirculation and hypertensive cardiopathy, but they should be interpreted with caution because the sample is small.

Relación entre los cambios en la microcirculación retiniana y la lesión de otros órganos diana en pacientes hipertensos y su regresión tras el tratamiento / Relation between changes in retinal microcirculation and other organ damage in hypertension and regression with antihypertensive treatment

Fundamento y objetivo: Aunque la evaluación de los cambios iniciales en la microcirculación retiniana es subjetiva y difícilmente reproducible, la posibilidad de disponer de un método semiautomático y reproducible permite cuantificar los cambios iniciales y su modificación con el tratamiento antihipertensivo. Pacientes y método: Hemos cuantificado los cambios en la microcirculación retiniana, medidos con el índice arteriovenoso retiniano, en un grupo de 51 hipertensos, y hemos observado su modificación tras 6 meses de tratamiento antihipertensivo con losartán combinado o no con hidroclorotiazida. Resultados: El índice arteriovenoso (IAV) retiniano aumentó de 0,7530 (0,03) a 0,7563 (0,03) (p = 0,005). Hemos relacionado estas modificaciones con los cambios en la lesión de otros órganos diana, y encontramos una relación inversa entre los cambios en la microcirculación y el índice de masa ventricular izquierda. Dicha relación se confirmó en el análisis multivariable. No se encontró relación entre el IAV y la microalbuminuria, probablemente por la amplia dispersión de sus valores. Conclusiones: Los resultados indican una relación entre microcirculación retiniana y cardiopatía hipertensiva, aunque se debe interpretar con cautela, al tratarse de una muestra pequeña

Background and objective: The possibility to aplicate a semi-automatic computerized system to evaluate the calibre of retinal blood vessels, has shown very good reproducibility, and have let us measure the calibres of retinal arterioles and veins, and their ratio (AVR). Patients and method: We have measured the calibres of retinal vessels in a group of 51 hypertensive outpatients before and after 6 months' treatment with losartan or, losartan plus hydrochlorothiazide if the association was requiered to adequate control of the blood pressure. Results: AVR increased from 0.7530 (0.03) to 0.7563 (0.03) (p = 0.005). We have related these modifications with damage in other target organs and we have found out a inverse relation between AVR and left ventricular mass index. This relation could be confirmed in multiple regression analysis. We have found no relation between AVR and microalbuminuria, probably because of its variability. Conclusions: These results suggest a relation between retinal microcirculation and hypertensive cardiopathy, but they should be interpreted with caution because the sample is small