[Hemoglobinopathies and glucose-6-phosphate dehydrogenase deficiency in the sub-Saharan immigrant population of the Center and South Maresme region, Catalonia, Spain]. / Estudio de hemoglobinopatías y del déficit de glucosa-6-fosfato deshidrogenasa en la población inmigrante subsahariana del centro y sur del Maresme (Cataluña).

BACKGROUND AND OBJECTIVE: Prevalence of hemoglobinophaty S and glucose-6-phosphate dehydrogenase (G6PD) deficiency are very increased in certain zones of Western Africa due to the positive pressure exerted by malaria on these congenital defects. In Maresme, a region of East Catalonia, there is a numerous community of African people, coming from areas of Western Africa where sickle cell trait and G6PD deficiency are frequent. The aim of our study was to know the prevalence of both disturbances in this population. POPULATION AND METHOD: We studied 204 individuals of black ethnical background who were migrant Africans. They attended the Immigrant Attention Unit or Outside Surgery Department of Consorcio Sanitario de Mataró for any medical or surgical problems but not for anemia. The G6PD deficiency was determined by a quantitative assay and 2 screening techniques. The identification of abnormal hemoglobins was done by electrophoresis. RESULTS: We studied 141 males (69%) and 63 females (31%). Mean age was 30.8 years (range: 1-70). The studied population came from Gambia, Senegal, Equatorial Guinea, Guinea Bissau, Mali, Somalia, Guinea Conakry, Nigeria, Ghana, Ivory Coast, Sierra Leone, Liberia and Mauritania, and were members of the Sarankhole, Mande, Fulani, Peul, Djola, Bambara, Pare and Ibo ethnic groups (according to the frequency order). We found abnormal hemoglobins in 44 subjects (21.5%): 36 hemoglobin S carriers, 7 hemoglobin C carriers and one hemoglobin C homozygous. Moreover, we identified G6PD deficiency in 31 subjects. According to these results, the prevalence of hemoglobinophaty S in these people is 17.6%; the prevalence of hemoglobinophaty C is 3.9%, and the prevalence of G6PD deficiency is 15.2%. The association of abnormal hemoglobins and G6PD deficiency was found only in a 3% of the cases (2.5% hemoglobinophaty S and 0.5% hemoglobinophaty C). CONCLUSIONS: This results demonstrate a high prevalence of hemoglobinopathies and G6PD deficiency in this population. The morbidity and mortality of sickle cell disease and the complications due to G6PD deficiency, besides the easy detection using electrophoresis and G6PD determination, make it necessary to standardize these tests in areas with high density of black people.

Office-based radiation therapy for cutaneous carcinoma: evaluation of 710 treatments.

Skin cancers are the most common malignancies and, historically, ionizing radiation has played an important role in their treatment. However, less experienced dermatologists generally consider radiation last in the line of therapeutic options. The authors sought to evaluate the effectiveness and safety of office-based elective radiation therapy for cutaneous carcinoma. A retrospective study of 604 basal cell carcinomas (BCCs) and 106 squamous cell carcinomas (SCCs) irradiated between 1971-96 was performed. The percentage of patients who developed tumor recurrence during the follow-up period was calculated using Kaplan-Meier survival curves. Cox's proportional model was used to assess the prognostic factors that might have influenced the recurrences. The recurrence rates for BCC and SCC were 11.5 and 16.5 per 1000 patient-years, respectively. The 5-year cure rates were 94.4% for BCC and 92.7% for SCC, and the 15-year cure rates were 84.8% and 78.6%, respectively. Tumor location on the nasolabial fold (OR 4.4; 95% IC, 1.3-14.7) and tumor size > or = 10 mm (OR 2.14; 95% IC, 1.03-4.45) were independent predictors of BCC recurrence. This study suggested that radiation therapy is an effective treatment for BCC and SCC and should be considered as a first option in many cases.

Prevalencia de uso de fármacos para el tratamiento de la enfermedad de Alzheimer y su evolución temporal: un estudio descriptivo con la base de datos de atención primaria BIFAP / No disponible

Objetivo. Estimar la prevalencia de uso de fármacos antidemencia en el período 2002-2011. Métodos. Se seleccionaron los pacientes registrados en la base de datos BIFAP de historias clínicas de atención primaria mayores de 65 años con al menos un día de seguimiento. Se identificaron los pacientes con un código CIAP «P70 Demencia» en su historia y aquellos que recibieron prescripciones de donepezilo, rivastigmina, galantamina y memantina. De promedio se analizaron 365 787 pacientes por año. Resultados. La prevalencia de registro de demencia aumentó de 2002 a 2011 del 2,97 % al 4,17 %. El uso de fármacos para la demencia aumentó del 0,86 % al 2,4 % en mayores de 65 años y del 23,13 % al 41,12 % en pacientes diagnosticados de demencia. La proporción de pacientes con demencia en terapia combinada aumentó del 1,69% en 2003 al 6,29 % en 2011. El donepezilo fue el fármaco más utilizado. En los varones con demencia a partir de los 75 años, la prevalencia de uso de rivastigmina y galantamina es mayor que en las mujeres. A partir de los 85 años, los pacientes con demencia reciben menos tratamiento farmacológico. Conclusiones. BIFAP es una fuente útil de datos en el estudio de prevalencia de uso de fármacos. Se observa un aumento en el uso de fármacos antidemencia, provocado por un aumento en la prevalencia de diagnóstico de la enfermedad así como de la proporción de pacientes diagnosticados que reciben esos tratamientos. Se detectaron algunas diferencias en el perfil de tratamiento farmacológico de la demencia según el sexo que merecen ser investigadas(AU)

Objective. To estimate the prevalence of use of drugs for the treatment of dementia during 2002-2011 period. Methods. Patients over 65 years old registered in the BIFAP database with at least one day of follow-up were selected. Patients with a diagnostic code «P70 Dementia» or with prescriptions of donepezil, rivastigmine, galantamine and mematin were indentified. In average 365 787 patients per year were analyzed. Results. Prevalence of dementia codification rose up from 2.97% to 4.17 %. Use of antidementia drugs increased from 0.86% to 2.40 % within the general population and from 23.13% al 41.12 % within patients with a diagnosis of dementia. The prevalence of combined therapy rose up from 1.69% in 2003 to 6.29 % in 2011. Donepezil was the most used drug. The use of rivastigmine and galantamine is more frequent within men over 75 years old with a diagnosis of dementia than women. After 85 years old, there is a decrease in the proportion of patients with dementia receiving drug treatment. Conclusions. BIFAP is a useful source of data in the study of medication use prevalence. There is an increase in the use of antidementia drugs, driven by an increase in the prevalence of the disease and in the proportion of patients receiving treatment. Some gender differences in the profile of pharmacological treatment of dementia were found and deserve further research(AU)