RESUMEN
BACKGROUND: While higher intake of fish and lower consumption of red/processed meats have been suggested to play a protective role in the etiology of several cancers, prospective evidence for hepatocellular carcinoma (HCC) is limited, particularly in Western European populations. METHODS: The associations of fish and meats with HCC risk were analyzed in the EPIC cohort. Between 1992 and 2010, 191 incident HCC were identified among 477 206 participants. Baseline diet was assessed using validated dietary questionnaires. A single 24-h diet recall from a cohort subsample was used for calibration. Multivariable proportional hazard regression was utilized to estimate hazard ratios (HR) and 95% confidence intervals (CI). In a nested case-control subset (HCC = 122), HBV/HCV status and liver function biomarkers were measured. RESULTS: HCC risk was inversely associated with intake of total fish (per 20 g/day increase, HR = 0.83, 95% CI 0.74-0.95 and HR = 0.80, 95% CI 0.69-0.97 before and after calibration, respectively). This inverse association was also suggested after adjusting for HBV/HCV status and liver function score (per 20-g/day increase, RR = 0.86, 95% CI 0.66-1.11 and RR = 0.74, 95% CI 0.50-1.09, respectively) in a nested case-control subset. Intakes of total meats or subgroups of red/processed meats, and poultry were not associated with HCC risk. CONCLUSIONS: In this large European cohort, total fish intake is associated with lower HCC risk.
Asunto(s)
Carcinoma Hepatocelular/epidemiología , Conducta Alimentaria , Peces , Neoplasias Hepáticas/epidemiología , Carne , Adulto , Anciano , Anciano de 80 o más Años , Animales , Estudios de Casos y Controles , Estudios de Cohortes , Dieta , Europa (Continente)/epidemiología , Femenino , Humanos , Incidencia , Pruebas de Función Hepática , Masculino , Persona de Mediana Edad , Estado Nutricional , Estudios Prospectivos , Riesgo , Factores de Riesgo , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: Promontory fixation is a reliable technique for genitourinary prolapsus. Results obtained with Mersurtures are good, but infectious episodes have been described and the fixation is rigid. The pelvic organs loose their mobility with possible functional impairment. To avoid these problems, we tested a composite implant composed of 60% absorbable polyglactine 910 (Vicryl) and 40% non-absorbable terephthalic polyester (Dacron). SUBJECTS AND METHODS: A series of 32 patients with genito-urinary prolapsus were treated by one operator using the new material. Promontory fixation was performed in all cases, with at least one implant. The patients were followed for mean 24.2 months for evaluation of tolerance to the new material and the functional impact. These parameters were compared retrospectively with former experience with Mersutures. RESULTS: The new material was perfectly tolerated and no infectious complication was observed. The anatomic results were identical to those obtained with the Mersutures, giving 93.4% good anatomic results, 68% cure rate for urinary incontinence and 20% major improvement in urinary incontinence. It was difficult to analyse results for sexual activity and digestive tract function. CONCLUSION: The Vicryl composite is useful for promontory fixation in patients with prolapsus. This material which reduces the amount of inert material remaining in the form of a thin lattice of highly flexible Dacron, should be tested prospectively to determine the functional benefit of prolapsus care.