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PURPOSE: The third most frequently diagnosed cancer in Europe in 2018 was lung cancer; it is also the leading cause of cancer death in Europe. We studied patient and tumor characteristics, and patterns of healthcare provision explaining regional variability in lung cancer survival in southern Spain. METHODS: A population-based cohort study included all 1196 incident first invasive primary lung cancer (C33-C34 according to ICD-10) cases diagnosed between 2010 and 2011 with follow-up until April 2015. Data were drawn from local population-based cancer registries and patients' hospital medical records from all public and private hospitals from two regions in southern Spain. RESULTS: There was evidence of regional differences in lung cancer late diagnosis (58% stage IV in Granada vs. 65% in Huelva, p value < 0.001). Among patients with stage I, only 67% received surgery compared with 0.6% of patients with stage IV. Patients treated with a combination of radiotherapy, chemotherapy, and surgery had a 2-year mortality risk reduction of 94% compared with patients who did not receive any treatment (excess mortality risk 0.06; 95% CI 0.02-0.16). Geographical differences in survival were observed between the two regions: 35% vs. 26% at 1-year since diagnosis. CONCLUSIONS: The observed geographic differences in survival between regions are due in part to the late cancer diagnosis which determines the use of less effective therapeutic options. Results from our study justify the need for promoting lung cancer early detection strategies and the harmonization of the best practice in lung cancer management and treatment.
Assuntos
Detecção Precoce de Câncer/mortalidade , Serviços de Saúde , Disparidades em Assistência à Saúde , Neoplasias Pulmonares/mortalidade , Sistema de Registros/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos de Coortes , Terapia Combinada , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Espanha/epidemiologia , Taxa de Sobrevida , Adulto JovemRESUMO
Golf courses represent an agricultural activity wherein grass is intensively cultivated using large quantities of fertilizers. In the present study, nitrogen and phosphorus leaching was analyzed over two years in an experimental green under actual field conditions. The green contained four plots with distinct amendments (P1: hydrogelâ¯+â¯peat, P2: peat, P3: hydrogel, and P4: no amendment). The applied doses of nitrogen ranged from 5 to 103â¯kg/ha and of phosphorus from 9 to 31â¯kg/ha. The irrigation level varied as a function of the rainfall regime and the water requirements of grass; overall water intake varied from 1550 to 2080â¯mm/year. Daily, leached water volume was calculated, and samples were taken for chemical analysis. Nitrogen and phosphorus mass balances were calculated for different periods based on the collected data. The plot amended with peat and hydrogel (P1) had reduced water flow; the percentage of drainage water varied from 8.4 to 29%. As a result, the dissolution and leaching of nitrogen (N) and phosphorus (P) were the lowest in comparison to the other plots. According to the calculated mass balances, the lowest leaching values were also recorded in this plot (P1), ranging from 0.5 to 6.3% for N and from 0.8 to 20.9% for P. The plot without amendment (P4) drained the most water (25.9-44.8%) and leached the highest quantities of N and P, ranging from 9.1-45.7%, and 6-35.9%, respectively. The use of double amendments (hydrogel and peat) therefore represented optimal operating conditions for the green. Moreover, a relationship was found between increasing rates of fertilization and increasing percentages of N and P leaching as well as between higher irrigation levels and greater leaching.
RESUMO
PURPOSE: To analyze and interpret age- and sex-specific incidence trends of lung cancer in Granada over the period 1985-2012 and to further analyze these trends by histologic subtype. METHODS: Incidence data were obtained from the population-based cancer registry located in Granada (Southern Spain). All cases with newly diagnosed primary lung cancer over the period 1985-2012 (n = 8658) and defined by International Classification of Diseases 10th Revision (codes C33-C34) were included. Joinpoint regression analysis of age-standardized incidence rates was used to estimate the annual percent change (APC) and 95% confidence intervals. Results are presented overall and by sex, age groups (0-34, 35-54, 55-64, 65-74, ≥75 years) and histologic subtypes. RESULTS: Temporal trends of incidence rates by sex, over the period 1985-2012, showed a distinct pattern. A significant change point of the trend was observed in males in 1994 (APC: +2.5%; 95% CI 0.7-4.4 from 1985 to 1994 and -1.4%; 95% CI -2.0 to -0.7 from 1994 onward). This general change was mainly caused by the age group 65-74 years and by the higher incidence of squamous cell carcinoma histologic subtype. In females, lung cancer incidence increased over the entire study period by +4.2% per year (95% CI 3.1-5.4); this trend was mainly caused by the age group 55-64 years (APC = +7%) and by adenocarcinoma incidence between women (APC = +6.8%). CONCLUSION: Male lung cancer incidence rates have decreased in Granada, while female rates have increased overall especially in younger women. These trends may reflect the increased consumption of cigarettes in women, especially during younger ages. Lung cancer prevention through tobacco control policies are therefore of utmost importance.
Assuntos
Adenocarcinoma/epidemiologia , Carcinoma de Células Grandes/epidemiologia , Carcinoma Pulmonar de Células não Pequenas/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Pulmonares/epidemiologia , Carcinoma de Pequenas Células do Pulmão/epidemiologia , Adenocarcinoma/patologia , Adolescente , Adulto , Idoso , Carcinoma de Células Grandes/patologia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Escamosas/patologia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Sistema de Registros , Carcinoma de Pequenas Células do Pulmão/patologia , Espanha/epidemiologia , Fatores de Tempo , Adulto JovemRESUMO
The Toluca Valley is located on the high plains of Mexico, where there are significant industrial zones and large populations. Water needs are almost exclusively met by groundwater, which has brought about intense exploitation of the aquifer and indication of some contamination. The present study investigates the effect of urbanization, related to industrialization of the region, on groundwater in the central portion of the Toluca Valley aquifer--a zone with high population density and where the largest industrial park is located. A general decline in the groundwater level has been found over the years, at a rate of as much as 2.5 m/year. The appearance of a large drawdown cone was identified, indicating changes in the direction of groundwater flow. Also identified was the presence of several ground fissures, the location of which coincided with the drawdown cone. In hydrochemical terms, the water type is sodium-magnesium bicarbonate and this characteristic has not changed over time, although it has been possible to detect the presence of larger quantities of sulfates (up to 117 mg/L) and nitrates (up to 47 mg/L) in recent years, likely associated with contamination from industrial and urban wastewater. Factor analysis made it possible to identify ions that would characterize natural processes involving the acquisition of salts (HCO3 (-), Na(+), Mg(2+), and Si), as well as anthropic activities (SO4 (2-), NO3 (-), Cl(-), Ca(2+), and K(+)).
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Monitoramento Ambiental , Água Subterrânea/química , Hidrodinâmica , Urbanização , Poluentes Químicos da Água/análise , México , Nitratos/análise , Sais/análise , Sulfatos/análiseRESUMO
BACKGROUND: The Epstein-Barr virus (EBV) is related with nasopharyngeal carcinoma (NPC) in that, in this neoplasm, high levels of antibodies are found vs different EBV antigens. METHODS: The determinations of IgG and IgA type antibodies were evaluated vs capsid antigens (VCA) and early antigen (EA) of the EBV by indirect immunofluorescence in 14 patients diagnosed with NPC, in 12 patients with other tumors of the head and neck and in 61 blood donors. RESULTS: The detection of IgA type antibodies with a sensitivity and specificity of 100% and 92% for the VCA antigen and of 86% and 100% for the EA antigen are the most useful tests in the early diagnosis of nasopharyngeal carcinoma. The determination of IgG type antibodies were of a more limited usefulness with sensitivities and specificities of 86% and 67% for IgG anti-VCA and 100% and 83% of IgG anti-EA. CONCLUSIONS: The detection of antibodies vs VCA and EA antigens is useful in the differential diagnosis of NPC with other tumors of the head and neck.
Assuntos
Anticorpos Antivirais/sangue , Proteínas do Capsídeo , Herpesvirus Humano 4/imunologia , Imunoglobulina A/sangue , Imunoglobulina G/sangue , Neoplasias Nasofaríngeas/diagnóstico , Infecções Tumorais por Vírus/imunologia , Adulto , Idoso , Antígenos Virais/imunologia , Capsídeo/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Nasofaríngeas/microbiologiaRESUMO
The assay of estrogen and progesterone receptors (RE and RP) is used to know the hormone dependency of breast tumors and to predict the response to endocrine therapy. In this study 68 per 100 of the patients were RE(+) within a range of 5 to 180 fmol/mg, and 45 per 200 were RP(+) between 10 and 400 fmol/mg. The frequency and concentration increase with age. Significative variations were not observed in RE(+) for either frequency or concentration between primary and metastatic samples. There is a correlation between phenotypes RE(+) and RE(-) and histopathologic prognostic features.