Breast cancer risk for the joint exposure to metals and metalloids in women: Results from the EPIC-Spain cohort.

Environmental factors play a role in breast cancer development. While metals and metalloids (MMs) include some carcinogens, their association with breast cancer depends on the element studied. Most studies focus on individual MMs, but the combined effects of metal mixtures remain unclear. The aim of this study was to analyze the relationship between the joint exposure to MMs and the risk of developing female breast cancer. We conducted a case-control study within the multicenter prospective EPIC-Spain cohort. Study population comprised 292 incident cases and 286 controls. Plasma concentrations of 16 MMs were quantified at recruitment. Potential confounders were collected using a questionnaire and anthropometric measurements. Mixed-effects logistic regression models were built to explore the effect of individual MMs. Quantile-based g computation models were applied to identify the main mixture components and to estimate the joint effect of the metal mixture. The geometric means were highest for Cu (845.6 ng/ml) and Zn (604.8 ng/ml). Cases had significantly higher Cu concentrations (p = 0.010) and significantly lower Zn concentrations (p < 0.001). Cu (+0.42) and Mn (+0.13) showed the highest positive weights, whereas Zn (-0.61) and W (-0.16) showed the highest negative weights. The joint effect of the metal mixture was estimated at an OR = 4.51 (95%CI = 2.32-8.79), suggesting a dose-response relationship. No evidence of non-linearity or non-additivity was found. An unfavorable exposure profile, primarily characterized by high Cu and low Zn levels, could lead to a significant increase in the risk of developing female breast cancer. Further studies are warranted to confirm these findings.

Relationship between exposure to parabens and benzophenones and prostate cancer risk in the EPIC-Spain cohort.

The etiology of prostate cancer is not fully elucidated. Among environmental risk factors, endocrine-disrupting chemicals (EDCs) deserve special mention, as they alter metabolic pathways involved in hormone-dependent cancers. Epidemiological evidence assessing the carcinogenicity of EDCs is scarce. The aim of this study was to analyze the relationship between exposure to parabens and benzophenones and prostate cancer risk. We conducted a case-cohort study nested within the EPIC-Spain prospective multi-center cohort. Study population comprised 1,838 sub-cohort participants and 467 non-sub-cohort prostate cancer cases. Serum concentrations of four parabens and two benzophenones were assessed at recruitment. Covariates included age, physical activity, tobacco smoking, alcohol consumption, body mass index, educational level and diabetes. Borgan II weighted Cox proportional hazard models stratified by study center were applied. Median follow-up time was 18.6 years (range = 1.0-21.7 years). Most sub-cohort participants reached primary education at most (65.5%), were overweight (57.7%) and had a low level of physical activity (51.3%). Detection percentages varied widely, being lowest for butyl-paraben (11.3%) and highest for methyl-paraben (80.7%), which also showed the highest geometric mean (0.95 ng/ml). Cases showed significantly higher concentrations of methyl-paraben (p = 0.041) and propyl-paraben (p < 0.001). In the multivariable analysis, methyl-paraben - log-transformed (HR = 1.07; 95%CI = 1.01-1.12) and categorized into tertiles (HR = 1.60 for T3; 95%CI = 1.16-2.20) -, butyl-paraben - linear (HR = 1.19; 95%CI = 1.14-1.23) and log-transformed (HR = 1.17; 95%CI = 1.01-1.35) - and total parabens - log-transformed (HR = 1.09; 95%CI = 1.02-1.17) and categorized into tertiles (HR = 1.62 for T3; 95%CI = 1.10-2.40) - were associated with an increased prostate cancer risk. In this study, higher concentrations of methyl-, butyl-, and total parabens were positively associated with prostate cancer risk. Further research is warranted to confirm these findings.

Pre-Diagnostic Circulating Resistin Concentrations Are Not Associated with Colorectal Cancer Risk in the European Prospective Investigation into Cancer and Nutrition Study.

Resistin is a polypeptide implicated in inflammatory processes, and as such could be linked to colorectal carcinogenesis. In case-control studies, higher resistin levels have been found in colorectal cancer (CRC) patients compared to healthy individuals. However, evidence for the association between pre-diagnostic resistin and CRC risk is scarce. We investigated pre-diagnostic resistin concentrations and CRC risk within the European Prospective Investigation into Cancer and Nutrition using a nested case-control study among 1293 incident CRC-diagnosed cases and 1293 incidence density-matched controls. Conditional logistic regression models controlled for matching factors (age, sex, study center, fasting status, and women-related factors in women) and potential confounders (education, dietary and lifestyle factors, body mass index (BMI), BMI-adjusted waist circumference residuals) were used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for CRC. Higher circulating resistin concentrations were not associated with CRC (RR per doubling resistin, 1.11; 95% CI 0.94-1.30; p = 0.22). There were also no associations with CRC subgroups defined by tumor subsite or sex. However, resistin was marginally associated with a higher CRC risk among participants followed-up maximally two years, but not among those followed-up after more than two years. We observed no substantial correlation between baseline circulating resistin concentrations and adiposity measures (BMI, waist circumference), adipokines (adiponectin, leptin), or metabolic and inflammatory biomarkers (C-reactive protein, C-peptide, high-density lipoprotein cholesterol, reactive oxygen metabolites) among controls. In this large-scale prospective cohort, there was little evidence of an association between baseline circulating resistin concentrations and CRC risk in European men and women.

Intimate Partner Violence and Its Associated Factors in a Sample of Colombian Immigrant Population in Spain.

Immigrants are vulnerable to Intimate partner violence (IPV). This study aims at characterising IPV among Colombian immigrants, and to identify its associated factors. Cross-sectional study on 336 Colombian immigrants (46 % women), aged 15-70 years, living in Spain. Self-reported questionnaire information on IPV suffered throughout the last year was collected face-to-face. Multivariable logistic regression was used to identify factors associated with IPV. Almost 30 % of participants reported IPV, without differences by gender (p = 0.339). Partner's alcohol consumption was associated with a higher frequency of being victim of IPV in both sexes. In women, low educational level, and discrimination were further associated to IPV. Younger age, and poorer self-perceived health in Spain as compared to Colombia were factors associated in men. Results showed similarly high levels of IPV among immigrant men and women. Alcohol consumption, education, discrimination, age, and poor self-perceived health were factors associated to IPV.

Factores de riesgo de infección intervenibles en el cuidado médico y de enfermería de pacientes con trauma en un hospital de tercer nivel de atención, Medellín 1999 / Risk factors of preventible infection to trauma patients from physician and nursing care in a tertiary care hospital, Medellín 1999

Se presenta un estudio de seguimiento de una cohorte de pacientes que ingresaron al servicio de urgencias, con una estancia hospitalaria superior a 24 horas. La información recolectada fue de tres tipos: La incial relacionada con las variables de persona, y asociada con el trauma y las primeras horas, la segunda asociada con la intervención quirúrgica y la tercera asociada con la evolución y seguimiento del paciente.La mayoría de los pacientes fueron hombres con una edad promedio de 31 años, principalmente con trauma penetrante por arma de fuego y arma blanca. El índice global de infección fue de 24 por ciento. Los factores de riesgo asociados en el modelo de regresión logística para todas las fases de atención fueron trauma score (TS) <14 y riesgo relativo (RR)=2,43; la aplicación de sonda vesical RR=5,43, la transfusión sanguínea RR=4,35, el tiempo preoperatorio mayor de 6 horas RR=1,91, y el uso de antibióticos RR=8,16. El trauma penetrante RR=0,57 y el ingreso día festivo RR=0,43 fueron factores protectores para la infección intrahospitalaria. Se concluye que es factible intervenir algunos factores de riesgo mediante cambios en la atención y la administración de los servicios.Además se sugiere promover un Sistema Regionalizado del Trauma en el Valle de Aburrá.