Position paper on nasal obstruction: evaluation and treatment.

Nasal obstruction (NO) is defined as the subjective perception of discomfort or difficulty in the passage of air through the nostrils. It is a common reason for consultation in primary and specialized care and may affect up to 30%-40% of the population. It affects quality of life (especially sleep) and lowers work efficiency. The aim of this document is to agree on how to treat NO, establish a methodology for evaluating and diagnosing it, and define an individualized approach to its treatment. NO can be unilateral or bilateral, intermittent or persistent and may be caused by local or systemic factors, which may be anatomical, inflammatory, neurological, hormonal, functional, environmental, or pharmacological in origin. Directed study of the medical history and physical examination are key for diagnosing the specific cause. NO may be evaluated using subjective assessment tools (visual analog scale, symptom score, standardized questionnaires) or by objective estimation (active anterior rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow). Although there is little correlation between the results, they may be considered complementary and not exclusive. Assessing the impact on quality of life through questionnaires standardized according to the underlying disease is also advisable. NO is treated according to its cause. Treatment is fundamentally pharmacological (topical and/or systemic) when the etiology is inflammatory or functional. Surgery may be necessary when medical treatment fails to complement or improve medical treatment or when other therapeutic approaches are not possible. Combinations of surgical techniques and medical treatment may be necessary.

What is the future burden of HPV-related cancers in Spain?

PURPOSE: The aim of this study is to analyze mortality trends of HPV-related cancers in Spain by gender, during the period 1996-2010, and make predictions until the year 2025. METHODS: All deaths registered as cervical cancer were registered (ICD-10 code: C53), as well as vulvar and vaginal (C51 and C52), anal (C21), penile (C60), and oropharyngeal (C02, C09, C10). Adjusted rate calculations for each year were used to study the trends through the regression program Joinpoint. Predictions were made using the Nordpred program, utilizing the age-period-cohort model. RESULTS: In men, a statistically significant increase was observed in mortality by anal cancer, a reduction was observed in oropharyngeal cancer mortality and penile cancer rates were stable. In women, a statistically significant decreasing trend was observed for cervical, vulvar and vaginal cancers. In the predictions, the annual change relative to risk or population changes (size and structure) revealed a reduction in death risk by oropharyngeal cancer in men, and a reduction in death risk by anal cancer in women, although stable adjusted rates were verified for anal cancer in women. CONCLUSIONS: Although an increase was identified in the number of deaths for both genders, rates indicate gender differences in the trends, with increased rates for anal cancer and reduced rates for oropharyngeal cancer in men. Women presented reduced rates for cervical, vulvar, and vaginal cancers. For penile cancer and anal cancer in women, stable trends were verified.

Predictions and estimations of colorectal cancer mortality, prevalence and incidence in Aragon, Spain, for the period 1998-2022.

OBJECTIVE: estimate colorectal cancer incidence and prevalence in, based on mortality and survival data from the period 1998-2007, and provide projections of incidence, prevalence and mortality until the year 2022. METHODS: general and colorectal cancer mortality rates were obtained from the National Statistics Institute and survival data was obtained from the EUROCARE study. Estimations were carried out through the program MIAMOD. The joinpoint program was used to quantify the annual change expected in the projections. RESULTS: in men, an increase in prevalence is expected, from 237.2 (Crude Rate - CR = 303.5) to 237.7 (CR = 412.7) per 100.000 inhabitants/year in 2022. Incidence rates would increase from 48.2 (CR = 61.6) in 2007 to 55.2 (CR = 83.1), and mortality would increase from 22.7 (CR = 29.4) to 26.0 (CR = 39.6) when comparing 2007 and women, a reduction in prevalence is expected from 181.5 (CR = 268.3) to 167.9 (CR = 286.2) cases per 100,000 inhabitants/year. Incidence would change from 25.0 (CR = 38.0) in 2007 to 22.7 (CR = 39.2), and for mortality there is also an expected decrease, from 11.3 (CR =18.0) to 10.3 (CR = 18.5). CONCLUSION: the projections indicate that colorectal cancer in follows an increasing trend in incidence, mortality and prevalencein men, in opposition to corresponding decreasing trends in women.These projections must be considered in order to plan more effective prevention and treatment measures.

Incidencia, prevalencia y mortalidad del cáncer renal en España: estimaciones y proyecciones para el período 1998-2022 / Incidence, Prevalence and Mortality of Kidney Cancer in Spain: Estimates and Projections for the 1998-2022 Period

Objetivos: Estimar la incidencia y la prevalencia del cáncer de riñón en España basándose en datos de mortalidad y supervivencia del período de 1998 a 2007 y proporcionar proyecciones de incidencia, prevalencia y mortalidad hasta el año 2022. Material y métodos: La mortalidad por todas las causas y por el cáncer de riñón se obtuvo del Instituto Nacional de Estadística y los datos de supervivencia del estudio EUROCARE. Las estimaciones han sido realizadas utilizando el programa MIAMOD. El programa Joinpoint ha sido utilizado para cuantificar el cambio anual que se espera en las proyecciones. Resultados: En hombres se espera un aumento de la tasa de incidencia de 11,92 (tasa ajustada [TA]=8,66) casos por 100.000 habitantes/año a 15,7 (TA=9,55). La prevalencia aumentaría de 72,84 (TA=51,62) a 94,47 (TA=59,57) y la mortalidad de 5,77 (TA=7,29) a 7,29 (TA=4,56). En mujeres la tasa de incidencia cambiaría de 5,56 (TA=3,86) a 26,77 (TA=16,4). La prevalencia de un 24,6 (TA=17,28) a 133,69 (TA=81,37) y para la mortalidad el aumento esperado sería de 2,46 (TA=1,54) a 11,65 (TA=6,56) casos por 100.000 habitantes/año. Conclusiones: Las proyecciones indican que el cáncer renal en España sigue una tendencia de aumento en la incidencia, mortalidad y prevalencia, que necesitan ser consideradas para planificar medidas de prevención y tratamiento más efectivas (AU)

Objective: To estimate kidney cancer incidence and prevalence in Spain, based on mortality and survival data from the period 1998-2007, and to provide projections of incidence, prevalence and mortality until the year 2022. Material and methods: All-cause and kidney-cancer mortality rates were obtained from the National Statistics Institute and survival data were obtained from the EUROCARE study. Estimations were carried out using the MIAMOD program. The Joinpoint program was used to quantify the expected annual change in the projections. Results: An increase in the incidence rate is expected in men from, this going from 11.92 (Adjusted Rate - AR=8.66) per 100,000 inhabitants/year to 15.7 (AR=9.55). Prevalence would increase from 72.84 (AR=51.62) to 94.47 (AR=59.57), and mortality would increase from 5.77 (AR=7.29) to 7.29 (AR=4.56). The incidence rate in women would increase from 5.56 (AR=3.86) to 26.77 (AR=16.4). Prevalence would increase from 24.6 (AR=17.28) to 133.69 (81.37), and for mortality, the expected increase would be from 2.46 (AR=1.54) to 11.65 (AR=6.56) cases per 100.000 inhabitants/year. Conclusion: The projections indicate that kidney cancer in Spain follows an increasing trend in incidence, mortality and prevalence. This needs to be considered in order to plan more effective prevention and treatment measures (AU)

Laryngeal cancer survival in Zaragoza (Spain): a population-based study

OBJECTIVE: This article aims to study larynx cancer survival from the Population-Based Cancer Registry of Zaragoza, Spain, for the period 1978-2002. METHODS: The survival rates were calculated using the Kaplan-Meier method. The automated calculation of the Catalan Institute of Oncology was utilised to obtain the relative survival. RESULTS: The observed survival rate was 84.6% in the first year and 60.9% in the fifth year. The one-year relative survival in both genders was 86.8% (CI 95%: 85.3-88.4) and 70.1% (CI 95%: 67.8-72.4) after five years. Glottic cancer presented a better survival rate than supraglottic and subglottic cancers, and a better survival rate was also observed in younger ages. There were no statistical differences when comparing survival rates by gender and between the periods 1978-1986, 1987-1994 and 1995-2002. CONCLUSIONS: The data suggest there were no significant changes in laryngeal cancer survival in the province of Zaragoza in the period 1978-2002 and that the tumours located in the glottis presented a better prognosis (AU)

[Incidence, prevalence and mortality of kidney cancer in Spain: estimates and projections for the 1998-2022 period]. / Incidencia, prevalencia y mortalidad del cáncer renal en España: estimaciones y proyecciones para el período 1998-2022.

OBJECTIVE: To estimate kidney cancer incidence and prevalence in Spain, based on mortality and survival data from the period 1998-2007, and to provide projections of incidence, prevalence and mortality until the year 2022. MATERIAL AND METHODS: All-cause and kidney-cancer mortality rates were obtained from the National Statistics Institute and survival data were obtained from the EUROCARE study. Estimations were carried out using the MIAMOD program. The Joinpoint program was used to quantify the expected annual change in the projections. RESULTS: An increase in the incidence rate is expected in men from, this going from 11.92 (Adjusted Rate - AR=8.66) per 100,000 inhabitants/year to 15.7 (AR=9.55). Prevalence would increase from 72.84 (AR=51.62) to 94.47 (AR=59.57), and mortality would increase from 5.77 (AR=7.29) to 7.29 (AR=4.56). The incidence rate in women would increase from 5.56 (AR=3.86) to 26.77 (AR=16.4). Prevalence would increase from 24.6 (AR=17.28) to 133.69 (81.37), and for mortality, the expected increase would be from 2.46 (AR=1.54) to 11.65 (AR=6.56) cases per 100.000 inhabitants/year. CONCLUSION: The projections indicate that kidney cancer in Spain follows an increasing trend in incidence, mortality and prevalence. This needs to be considered in order to plan more effective prevention and treatment measures.

Isolation, characterization, molecular cloning and amplification of a species-specific M. leprae antigen.

A polyclonal serum sample from a lepromatous leprosy (LL) patient, which presented a specific recognition pattern for leprosin, was used to screen a Mycobacterium leprae genomic library constructed with DNA isolated from human lepromas. One clone, designated ML4-1, which expressed a specific antigenic determinant of M. leprae as part of a beta-galactosidase fusion protein, was isolated. The 1.932 bp M. leprae-derived genomic fragment was sequenced, and it had an incomplete open-reading frame shown to code for a 644 amino-acid polypeptide (72.3 kDa). Some partial nucleotide homology to the M. tuberculosis MTCY9C4 cosmid and the M. leprae B1913 cosmid were found. Southern blot assays using the 584 bp Eco RI-Bam HI fragment excised from the ML4-1 clone revealed that this sequence is present only in the M. leprae genome and not in the 24 different mycobacterial DNA tested. Two oligonucleotides based on the genomic sequence were also synthesized and used as amplifiers for a polymerase chain reaction (PCR) test, giving a positive signal exclusively in M. leprae DNA. Furthermore, 32 sequential synthetic peptides, 20 amino-acids long, spanning the entire protein corresponding to the hypothetical ML4-1 clone sequence, were synthesized and evaluated by ELISA. A peptide included in the 221-240 region was significantly recognized by either lepromatous leprosy or healthy tuberculosis contact patient sera. Thus, PCR amplification of this fragment, along with the recognition of its protein sequence by leprosy patient sera, could be a useful tool for a potential diagnostic method in the detection of M. leprae infection in the future.