Cancer diagnosis in Catalonia (Spain) after two years of COVID-19 pandemic: an incomplete recovery.

BACKGROUND: This study aimed to estimate potential undetected cancers over the first 2 years of the COVID-19 pandemic in Catalonia. METHODS: Cancer incidence was compared between pre-pandemic (2019) and pandemic (March 2020-January 2022) periods in the Catalan Pathology Registry (CPR) according to sex, age, and tumor site. The correlation between cancer diagnosis and COVID-19 health care workload was also evaluated by means of the Pearson's correlation coefficient (R). The expected incident cancers (E) during the pandemic were estimated by applying 2019 CPR cancer incidence specific rates by sex and 5-year age groups to the 2020 and 2021 Catalan population pyramids. CPR incident cancers were considered observed (O). Standardized incidence ratios (SIR) and 95% confidence intervals (CIs) were calculated using the O/E ratio. RESULTS: After two pandemic years, cancer diagnosis decreased by 12% (SIR 0.88, 95% CI 0.87-0.89), or ∼7700 undetected cancers (13 000 with nonmelanoma skin cancer). Without nonmelanoma skin cancer, 72% of the cancer underdiagnosis was generated in 2020. Diagnoses decreased more in men (whole pandemic -14%; 2020 -21%; 2021 -8%) than in women (-9%, -19%, -3%, respectively), dropping significantly overall in all pandemic waves but the fifth (first -37%, second -16%, third -8%, fourth -6%, fifth -2%, sixth -6%), and across all adult age groups. In the first wave, CPR cancer diagnosis was inversely correlated with COVID-19 caseload in primary care (R -0.91, 95% CI -0.97 to -0.75) and occupancy in conventional hospital wards (R -0.91, 95% CI -0.99 to -0.48) and intensive care (R -0.91, 95% CI 95% -0.98 to -0.70). CONCLUSIONS: Our study evaluated the overall pandemic impact on cancer diagnosis on a large scale and with minimal selection bias, showing that as of February 2022, cancer detection in Catalonia had not yet recovered to pre-pandemic levels. Pending cancer incidence data from population-based cancer registries, early CPR data could inform the development of Spanish cancer control plans.

Detection of incident breast and colorectal cancer cases from an administrative healthcare database in Catalonia, Spain.

OBJECTIVE: To validate the Catalan minimum basic data set (MBDS) of hospital discharges as an information source for detecting incident breast (BC) and colorectal cancer (CRC), against the Hospital del Mar Cancer Registry (RTHMar) in Barcelona (Spain) as the gold standard. METHODS: Using ASEDAT software (Analysis, Selection and Extraction of Tumour Data), we identified Catalan public hospital discharge abstracts in patients with a first-time diagnosis of BC and CRC in the years 2005, 2008, and 2011, aggregated by unique patient identifiers and sorted by date. Once merged with the RTHMar database and anonymized, tumour-specific algorithms were validated to extract data on incident cases, tumour stage, surgical treatment, and date of incidence. RESULTS: MBDS had a respective sensitivity and positive predictive value (PPV) of 78.0% (564/723) and 90.5% (564/623) for BC case detection; and 83.9% (387/461) and 94.9% (387/408) for CRC case detection. The staging algorithms overestimated the proportion of local-stage cases and underestimated the regional-stage cases in both cancers. When loco-regional stage and surgery were combined, sensitivity and PPV reached 98.3% and 99.8%, respectively, for BC and 96.4% and 98.4% for CRC. The differences between dates of incidence between RTHMar and MBDS were greater for BC cases without initial surgery, whereas they were generally smaller and homogeneous for CRC cases. CONCLUSIONS: The MBDS is a valid and efficient instrument to improve the completeness of a hospital-based cancer registry (HBCR), particularly in BC and CRC, which require hospitalization and are predominantly surgical.

Post-operative morbidity and mortality of a cohort of steroid refractory acute severe ulcerative colitis: Nationwide multicenter study of the GETECCU ENEIDA Registry.

BACKGROUND: Despite the increased use of rescue medical therapies for steroid refractory acute severe ulcerative colitis, mortality related to this entity still remains high. We aimed to assess the mortality and morbidity related to colectomy and their predictive factors in steroid refractory acute severe ulcerative colitis, and to evaluate the changes in mortality rates, complications, indications of colectomy, and the use of rescue therapy over time. METHODS: We performed a multicenter observational study of patients with steroid refractory acute severe ulcerative colitis requiring colectomy, admitted to 23 Spanish hospitals included in the ENEIDA registry (GETECCU) from 1989 to 2014. Independent predictive factors of mortality were assessed by binary logistic regression analysis. Mortality along the study was calculated using the age-standardized rate. RESULTS: During the study period, 429 patients underwent colectomy, presenting an overall mortality rate of 6.3% (range, 0-30%). The main causes of death were infections and post-operative complications. Independent predictive factors of mortality were: age ≥50 years (OR 23.34; 95% CI: 6.46-84.311; p < 0.0001), undergoing surgery in a secondary care hospital (OR 3.07; 95% CI: 1.01-9.35; p = 0.047), and in an emergency setting (OR 10.47; 95% CI: 1.26-86.55; p = 0.029). Neither the use of rescue medical treatment nor the type of surgical technique used (laparoscopy vs. open laparotomy) influenced mortality. The proportion of patients undergoing surgery in an emergency setting decreased over time (p < 0.0001), whereas the use of rescue medical therapy prior to colectomy progressively increased (p > 0.001). CONCLUSIONS: The mortality rate related to colectomy in steroid refractory acute severe ulcerative colitis varies greatly among hospitals, reinforcing the need for a continuous audit to achieve quality standards. The increasing use of rescue therapy is not associated with a worse outcome and may contribute to reducing emergency surgical interventions and improve outcomes.

Predicting the cancer burden in Catalonia between 2015 and 2025: the challenge of cancer management in the elderly

Background. Developing effective cancer control programmes requires information on the future cancer burden in an ageing population. In our study we predicted the burden of cancer in Catalonia from 2015 to 2025. Methods. Bayesian age-period-cohort models were used to predict the burden of cancer from 2015 to 2025 using incidence data from the Girona and Tarragona cancer registries and cancer mortality data from the Catalan mortality registry. Using the Bashir-Estève method, we divided the net change in the number of cases between 2015 and 2025 into changes due to population size (S), cancer risk (R) and age (A) distribution. Results. By 2025, there will be 21,743 new cancer cases in men (40% aged > 74 years) and 17,268 in women (37% aged > 74 years). More than 40% of the new cases will be diagnosed among population aged 74 and older in prostate, colorectal, lung, bladder, pancreatic and stomach cancers in men, and in colorectal, pancreatic and bladder cancers and leukaemia in women. During 2015-2025, the number of new diagnoses will increase by 5.5% in men (A + R + S = 18.1% − 13.3% + 0.7% = 5.5%) and 11.9% in women (A + R + S = 12.4% − 1.1% + 0.6% = 11.9%). Overall cancer mortality rates will continue to decrease during 2015-2025. Lung cancer will be the most lethal cancer among men (N = 2705) and women (N = 1174). Conclusions. The increase in the number of cancer cases in Catalonia from 2015 to 2025 will mostly affect the elderly, prompting the need for increased collaboration between geriatricians and oncologists

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Predicting the cancer burden in Catalonia between 2015 and 2025: the challenge of cancer management in the elderly.

BACKGROUND: Developing effective cancer control programmes requires information on the future cancer burden in an ageing population. In our study we predicted the burden of cancer in Catalonia from 2015 to 2025. METHODS: Bayesian age-period-cohort models were used to predict the burden of cancer from 2015 to 2025 using incidence data from the Girona and Tarragona cancer registries and cancer mortality data from the Catalan mortality registry. Using the Bashir-Estève method, we divided the net change in the number of cases between 2015 and 2025 into changes due to population size (S), cancer risk (R) and age (A) distribution. RESULTS: By 2025, there will be 21,743 new cancer cases in men (40% aged > 74 years) and 17,268 in women (37% aged > 74 years). More than 40% of the new cases will be diagnosed among population aged 74 and older in prostate, colorectal, lung, bladder, pancreatic and stomach cancers in men, and in colorectal, pancreatic and bladder cancers and leukaemia in women. During 2015-2025, the number of new diagnoses will increase by 5.5% in men (A + R + S = 18.1% - 13.3% + 0.7% = 5.5%) and 11.9% in women (A + R + S = 12.4% - 1.1% + 0.6% = 11.9%). Overall cancer mortality rates will continue to decrease during 2015-2025. Lung cancer will be the most lethal cancer among men (N = 2705) and women (N = 1174). CONCLUSIONS: The increase in the number of cancer cases in Catalonia from 2015 to 2025 will mostly affect the elderly, prompting the need for increased collaboration between geriatricians and oncologists.

Reconstrucción de la vía aérea principal mediante el uso de prótesis sintéticas integrables / Reconstruction of the main airway through the use of integrable synthetic prosthesis

Uno de los principales problemas que plantea el tratamiento quirúrgico de las lesiones traqueales es la limitación existente en la longitud del segmento que es posible resecar. Actualmente, se puede extirpar con seguridad el 50% de la tráquea como máximo. Lesiones más extensas no se pueden beneficiar de este tratamiento y es necesario utilizar técnicas alternativas, en la mayoría de los casos paliativas. Una posible solución a este problema es la interposición de algún elemento que sustituya el segmento traqueal resecado. Se ha realizado un estudio experimental en animales, sustituyendo segmentos traqueales de distinta longitud por prótesis cilíndricas de politetrafluoroetileno. Posteriormente, se ha realizado un seguimiento y sacrificio de los animales estudiando los cambios histológicos. Los resultados obtenidos muestran la posibilidad técnica de la sustitución de la vía aérea por segmentos de material protésico. En el seguimiento evolutivo de los animales, parece existir una relación directa entre la longitud del implante y la aparición de estenosis traqueal a dicho nivel, tanto en los estudios morfológicos macroscópicos como en los estudios realizados con microscopía óptica. Sin embargo, por el momento, la mortalidad perioperatoria es elevada y, si bien se puede atribuir a la curva de aprendizaje, la traslación de los resultados a una posible práctica clínica no es recomendable

One of the main problems arising from the surgical treatment of tracheal lesions is the existing limitation in the length of segment that can be resected. Currently, a maximum of 50% of the trachea can be safely removed. More extensive lesions cannot benefit from this treatment and alternative techniques must be used, which are palliative in most cases. The interposition of an element which substitutes the segment of resected trachea is a possible solution for this problem. An experimental animal study has been conducted, substituting tracheal segments varying in length with cylindrical polytetrafluoroethylene prostheses. Later, a follow-up was done and the animals were sacrificed to study histological changes. The results show the technical possibility of substituting the airway with segments of prosthetic material. In the monitoring of the animals, there seems to be a direct relationship between the length of the implant and the appearance of tracheal stenosis at the implant site, both in the macroscopic morphological studies and the studies completed with optical microscopy. However, for the time being, perioperative mortality is high and, although it can be attributed to the learning curve, applying the results to possible clinical practice is not recommended

Reoperations after primary breast conserving surgery in women with invasive breast cancer in Catalonia, Spain: a retrospective study

Background. Although complete tumor resection is accepted as the best means to reduce recurrence, reoperations after lumpectomy are a common problem in breast cancer. The aim of this study was to assess the reoperation rates after primary breast conserving surgery in invasive breast cancer cases diagnosed in Catalonia, Spain, between 2005 and 2011 and to identify variations based on patient and tumour characteristics. Methods. Women with invasive incident breast cancer identified from the Patient’s Hospital Discharge Database [174.0-174.9 codes of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) as the primary diagnosis] and receiving primary breast conserving surgery were included in the study and were followed up to 3 and 12 months by collecting information about repeat breast cancer surgery. Results. Reoperation rates after primary breast conserving surgery decreased from 13.0 % in 2005 to 11.7 % in 2011 at 3 months and from 14.2 % in 2005 to 12.9 % in 2011 at 12 months’ follow-up. While breast conservation reoperations saw a slight, non-significant increase in the same period (from 5.7 to 7.3 % at 3 months, and from 6.0 to 7.5 % at 12 months), there was a significant decrease in radical reoperation (from 7.3 to 4.4 % at 3 months and from 8.2 to 5.4 % at 12 months). Overall, additional breast surgeries decreased among younger women. Conclusions. Despite the rise of breast conserving surgery, reoperation rates following initial lumpectomy in Catalonia decreased by 10 % at 3 and 12 months’ follow-up, remaining low and almost unchanged. Ultimately, there was also a significant decrease in mastectomies (AU)

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Reoperations after primary breast conserving surgery in women with invasive breast cancer in Catalonia, Spain: a retrospective study.

BACKGROUND: Although complete tumor resection is accepted as the best means to reduce recurrence, reoperations after lumpectomy are a common problem in breast cancer. The aim of this study was to assess the reoperation rates after primary breast conserving surgery in invasive breast cancer cases diagnosed in Catalonia, Spain, between 2005 and 2011 and to identify variations based on patient and tumour characteristics. METHODS: Women with invasive incident breast cancer identified from the Patient's Hospital Discharge Database [174.0-174.9 codes of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) as the primary diagnosis] and receiving primary breast conserving surgery were included in the study and were followed up to 3 and 12 months by collecting information about repeat breast cancer surgery. RESULTS: Reoperation rates after primary breast conserving surgery decreased from 13.0 % in 2005 to 11.7 % in 2011 at 3 months and from 14.2 % in 2005 to 12.9 % in 2011 at 12 months' follow-up. While breast conservation reoperations saw a slight, non-significant increase in the same period (from 5.7 to 7.3 % at 3 months, and from 6.0 to 7.5 % at 12 months), there was a significant decrease in radical reoperation (from 7.3 to 4.4 % at 3 months and from 8.2 to 5.4 % at 12 months). Overall, additional breast surgeries decreased among younger women. CONCLUSIONS: Despite the rise of breast conserving surgery, reoperation rates following initial lumpectomy in Catalonia decreased by 10 % at 3 and 12 months' follow-up, remaining low and almost unchanged. Ultimately, there was also a significant decrease in mastectomies.

Method development and validation for determination of thiosultap sodium, thiocyclam, and nereistoxin in pepper matrix.

This work reports a method for extraction and analysis of thiosultap sodium, thiocyclam, and nereistoxin in pepper. Different extraction methods were tested to attain the best recoveries. The final extraction method combines acetonitrile extraction in an acidic medium with ultrasonic extraction followed by a cleanup step with anhydrous MgSO(4). The analyses were performed on a Linear Ion Trap Quadrupole LC-MS/MS in negative mode for thiosultap sodium and in positive mode for thiocyclam and nereistoxin. Recovery studies carried out on peppers spiked at different fortification levels (20 and 200 µg∙kg(-1)) yielded average recoveries in the range 58-87% with RSD (%) values below 20%. Calibration curves covering two orders of magnitude were performed and they were linear over the concentration range studied (0.001-0.5 mg∙l(-1)). Instrumental detection limits were in the low µg∙kg(-1) range. Stability studies of thiosultap sodium in water were performed by evaluating a 100-µg∙l(-1) solution of this compound in water. It was analyzed over 7 days, after which more than 80% degradation of thiosultap sodium could be observed.

Comparison of extraction solvents and conditions for herbicide residues in milled rice with liquid chromatography-diode array detection analysis (LC-DAD).

Different extraction procedures and clean-up methods were compared in order to develop a sample preparation procedure for the multi-residue analysis of six post-emergence herbicides (metsulfuron methyl, bensulfuron methyl, pyrazosulfuron ethyl, bentazone, bispyribac sodium and cyhalofop butyl) in rice grains followed by liquid chromatography-diode array detection (LC-DAD). Optimum results were obtained dispersing milled rice grain in water, followed by the addition of 1% acetic acid in acetonitrile, MgSO(4) and sodium acetate as a modification of the quick, easy, cheap, effective, rugged and safe (QuEChERS) method but no primary and secondary amine (PSA) sorbent was added due to the acidic nature of the herbicides. The method was further expanded to other post-emergence herbicides (quinclorac, clomazone and propanil). Except for quinclorac, which cannot be analysed with this method, the recoveries of the other eight herbicides were in the range 73-111%, with relative standard deviations lower than 12%. Limits of detection (LODs) ranged from 0.03 to 0.08 mg kg(-1). A single analyst can extract twelve samples in 4 h. The method presented here allows the simultaneous residue determination of the most common post-emergence herbicides employed in cultivating rice. It is simple, rapid, sensitive, and can be applied routinely to polished rice grain herbicide residue analysis.

Life expectancy and age-period-cohort effects: analysis and projections of mortality in Spain between 1977 and 2016.

OBJECTIVES: This study aimed to: (1) assess Spanish mortality trends between 1977 and 2001 and their impact on life expectancy; and (2) assess the differences in life expectancy between men and women for the period 2002-2016. STUDY DESIGN: Time trends study using age-period-cohort (APC) analysis. METHODS: A Bayesian APC model was fitted to describe Spanish mortality rates for the period 1977-2001 and to project Spanish mortality rates for 2002-2016. Life expectancy was predicted through Chiang's method using projected mortality rates. RESULTS: There was a significant cohort effect for Spanish mortality, showing a slight increase in mortality among men aged 20-39 years between 1986 and 1997 (birth cohorts 1940-1970). Life expectancy is expected to increase by approximately 0.5% in men and women between 1977 and 2016 (1 year per 5-year period). Life expectancy for males born between 2012 and 2016 will be 77.15 years, compared with 84.95 years for females born during the same period. CONCLUSIONS: The rising trend in mortality among the 1940-1970 cohorts may be due to the increased risk of avoidable causes of death related to acquired immunodeficiency syndrome, traffic accidents, and drug and alcohol abuse during the mid 1980s. The decline in mortality rates in recent years could lead to a mean increase in life expectancy of 1 year per 5-year period in both genders between 2002 and 2016. An increase in life expectancy for women and a levelling off for men is expected for age groups older than 79 years.

[Cancer survival trends in Catalonia and comparison with Europe]. / Evolución de la supervivencia del cáncer en Cataluña y comparación con Europa.

OBJECTIVE: To analyze survival in cancer patients in Catalonia for the diagnostic cohort for the period 1995-1999 and the survival trend for the period 1985-1999 and to compare this trend with that observed in the rest of Europe. MATERIAL AND METHOD: We present the observed and relative 5-year survival rates for adult cancer patients resident in Tarragona and Gerona diagnosed between 1995 and 1999. To analyze the trend in survival, rates for the periods 1985-1989, 1990-1994 and 1995-1999 for patients living in Tarragona were analyzed. Relative survival rates for the 1995-1999 Tarragona and Gerona diagnosis cohort as a whole were compared with the European mean obtained in the EUROCARE- 4 project. RESULTS: From 1995-1999, relative survival rates were 46.0% in males and 56.4% in females. For the most frequent types of cancer in males the rates were as follows: 76.5% prostate, 9.2% lung, 53.5% colon and rectum, 69.7% urinary bladder and 25.7% stomach. In females, the rates were 80.9% breast, 50.7% colon and rectum, 76.1% corpus uterine, 24.9% stomach and 36.9% ovary. For quinquenniums and for all cancers as a whole, the rates were 35.1%, 40.8% and 47.5% in males and 49.0%, 55.7% and 57.3% in females. The rate for all people combined in the period 1995-1999 was 50.2% in Tarragona- Gerona and was 51.9% in Europe. CONCLUSIONS: Between the periods 1985-1989 and 1995-1999, relative survival rates increased 12 points in males and eight points in females. Similar values to the European mean were maintained throughout the 15 years of the study.

Validation and uncertainty study of a comprehensive list of 160 pesticide residues in multi-class vegetables by liquid chromatography-tandem mass spectrometry.

A rapid and sensitive liquid chromatography-tandem mass spectrometry method, in electrospray ionization positive mode, has been developed for the determination of 160 selected multi-class pesticides over a 33-min run time. Extracts were obtained using the acetonitrile-based QuEChERS (quick, easy, cheap, effective, rugged and safe) sample preparation technique. The validation study was carried out on tomato, pear and orange matrices following DG SANCO/2007/3131 of the European Quality Control Guidelines. These matrices represent high water, high sugar and high acidic content commodities, respectively. Matrix influence on recoveries and its effects on ionization were evaluated for the three matrices. Ten out of the 160 pesticides showed very low intensity, linearity and/or sensitivity problems. Linearity was studied in the 5-500 microg kg(-1) concentration range. Soft (<20%), medium (20-50%), and strong (>50%) matrix effects were obtained for 69%, 20%, and 11% of the studied compounds, respectively. Recoveries were investigated at the 10 and 100 microg kg(-1) levels, and depending on the commodity, 97%, 98% and 97% of the compounds in tomato, pear and orange, respectively, were in the 70-120% range. More than 90% of the investigated compounds had less or equal to a 5 microg kg(-1) limit of detection in the studied matrices. The relative standard deviations obtained exceeded 20% in only very few cases. The overall standard deviation obtained in the survey study (0.1551) was used for the method's uncertainty estimation. The expanded uncertainty resulted as being 0.3002 (coverage factor K=2, confidence level 95%). The method was applied on 59 real samples from 14 different kinds of fruits and vegetables. Thirty-three compounds were detected in 50 positive samples.

Análisis de la incidencia, la supervivencia y la mortalidad según las principales localizaciones tumorales, 1985-2019: cáncer colorrectal / No disponible

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Análisis de la incidencia, la supervivencia y la mortalidad según las principales localizaciones tumorales, 1985-2019: cáncer hepático / No disponible

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Evolución de la supervivencia del cáncer en Cataluña y comparación con Europa / Cancer survival trends in Catalonia and comparison

OBJETIVO: Presentar la supervivencia de los pacientes con cáncer en Cataluña en la cohorte diagnóstica del período 1995-1999, su evolución a lo largo del período 1985-1999 y su comparación con la del resto de Europa. MATERIAL Y MÉTODO: Se presentan las tasas de supervivencia observada y relativa a 5 años de los pacientes adultos con cáncer diagnosticados entre 1995 y 1999 residentes en Tarragona y Girona. Para el análisis de la evolución de la supervivencia se presentan las tasas de los períodos 1985-1989, 1990-1994 y 1995-1999 de los pacientes residentes en Tarragona. Las tasas de supervivencia relativa del conjunto Tarragona/ Girona de la cohorte diagnosticada durante el período 1995-1999 se comparan con las de la media europea obtenidas en el proyecto EUROCARE-4. RESULTADOS: En el período 1995-1999, la supervivencia relativa fue del 46% en varones y el 56,4% en mujeres. Para los principales tipos tumorales en el varón las tasas fueron: el 76,5%, próstata; el 9,2%,pulmón; el 53,5%, colorrectal; el 69,7%, vejiga urinaria, y el 25,7%, estómago. En las mujeres fueron: el 80,9%, mama; el 50,7%, colorrectal; el 76,1%, cuerpo uterino; el 24,9%, estómago, y el 36,9%, ovario. Por quinquenios y para el conjunto de tipos tumorales, los valores fueron del 35,1, el 40,8 y el 47,5% en varones y el 49, el 55,7 y el 57,3% en mujeres. La tasa global del período 1995-1999 fue del 50,2% en Tarragona-Girona y el 51,9% en Europa. CONCLUSIONES: Entre los quinquenios 1985-1989 y 1995-1999, la supervivencia relativa aumentó 12 puntos en varones y 8 en mujeres, y mantuvo durante los 15 años del estudio unos valores similares a la media europea

OBJECTIVE: To analyze survival in cancer patients in Catalonia for the diagnostic cohort for the period 1995-1999 and the survival trend for the period 1985-1999 and to compare this trend with that observedin the rest of Europe. MATERIAL AND METHOD: We present the observed and relative 5-year survival rates for adult cancer patients resident in Tarragona and Gerona diagnosed between 1995 and 1999. To analyze the trend in survival, rates for the periods 1985-1989, 1990-1994 and 1995-1999for patients living in Tarragona were analyzed. Relative survival rates for the 1995-1999 Tarragona and Gerona diagnosis cohort as a whole were compared with the European mean obtained in the EUROCARE- 4 project. RESULTS: From 1995-1999, relative survival rates were 46.0% in males and 56.4% in females. For the most frequent types of cancer in males the rates were as follows: 76.5% prostate, 9.2% lung, 53.5%colon and rectum, 69.7% urinary bladder and 25.7% stomach. In females, the rates were 80.9% breast, 50.7% colon and rectum, 76.1% corpus uterine, 24.9% stomach and 36.9% ovary. For quinquenniums and for all cancers as a whole, the rates were 35.1%, 40.8% and47.5% in males and 49.0%, 55.7% and 57.3% in females. The rate for all people combined in the period 1995-1999 was 50.2% in Tarragona- Gerona and was 51.9% in Europe. CONCLUSIONS: Between the periods 1985-1989 and 1995-1999, relative survival rates increased 12 points in males and eight points in females. Similar values to the European mean were maintained throughout the 15 years of the study

Effect of the addition of vancomycin on the performance of an automated nonradioactive system for detection of mycobacteria.

A recently developed automated, nonradioactive system for the detection of mycobacteria (MB/BacT; Organon Teknika, Belgium) has provided good results, but the contamination rate was found to be higher than that obtained with the radiometric Bactec 460 system (Becton Dickinson, USA). In the present study, the effects of adding vancomycin (1 microg/ml) to the antibiotic mixture of the nonradioactive system were evaluated, and the performance of the system with versus without vancomycin was compared. Three hundred sputum samples were tested, using the radiometric system as the reference method. Mycobacteria were isolated from 47 (15.7%) samples. The nonradioactive system with and without vancomycin detected 42 and 43 strains, respectively; the time to detection was 1 day shorter with the medium without vancomycin (15.7 days vs. 14.3 days). The radiometric system detected 42 strains of mycobacteria in a mean detection time of 13.6 days. Contamination rates with the nonradioactive system were 6.7% in the medium without vancomycin and 2.7% in the medium with vancomycin. The latter figure was approximately the same as the contamination rate found with the radiometric system (2.3%). Our data suggest that the addition of vancomycin considerably reduces the number of contaminants in the MB/BacT medium without affecting the performance of the system.

[Culture media for the detection and the identification of Streptococcus agalactiae]. / Medios de cultivo para la detección e identificación de Streptococcus agalactiae.

Streptococcus agalactiae, a Group B streptococcus, is the main cause of bacterial perinatal infection and is also an important opportunistic pathogen. Detection and identification of S. agalactiae are straight forward with special culture media, where Group B streptococci show a specific, typical pink or red pigment. To quickly and easily detect the pigment, culture media should contain: (i) starch; (ii) an inhibitor of the folate pathway; (iii) animal serum; (iv) a pepsic proteic hydrolysate; and (v) glucose, together with a high-capacity buffer. When selective antibiotics are added to culture media designed in this way, it is possible to detect S. agalactiae directly from clinical samples by observation of its pigment after less than 12 hours of aerobic incubation.