Alcohol consumption and the risk of renal cancers in the European Prospective Investigation into Cancer and Nutrition (EPIC). Wozniak MB, Brennan P, Brenner DR, Overvad K, Olsen A, Tjønneland A, Boutron-Ruault MC, Clavel-Chapelon F, Fagherazzi G, Katzke V, Kühn T, Boeing H, Bergmann MM, Steffen A, Naska A, Trichopoulou A, Trichopoulos D, Saieva C, Grioni S, Panico S, Tumino R, Vineis P, Bueno-de-Mesquita HB, Peeters PH, Hjartåker A, Weiderpass E, Arriola L, Molina-Montes E, Duell EJ, Santiuste C, Alonso de la Torre R, Barricarte Gurrea A, Stocks T, Johansson M, Ljungberg B, Wareham N, Khaw KT, Travis RC, Cross AJ, Murphy N, Riboli E, Scelo G.Int J Cancer. 2015 Oct 15;137(8):1953-66. [Epub 2015 Apr 28]. doi: 10.1002/ijc.29559.

Epidemiologic studies have reported that moderate alcohol consumption is inversely associated with the risk of renal cancer. However, there is no information available on the associations in renal cancer subsites. From 1992 to 2010, 477,325 men and women in the European Prospective Investigation into Cancer and Nutrition cohort were followed for incident renal cancers (n = 931). Baseline and lifetime alcohol consumption was assessed by country-specific, validated dietary questionnaires. Information on past alcohol consumption was collected by lifestyle questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from Cox proportional hazard models. In multivariate analysis, total alcohol consumption at baseline was inversely associated with renal cancer; the HR and 95% CI for the increasing categories of total alcohol consumption at recruitment vs. the light drinkers category were 0.78 (0.62-0.99), 0.82 (0.64-1.04), 0.70 (0.55-0.90), and 0.91 (0.63-1.30), respectively, (ptrend = 0.001). A similar relationship was observed for average lifetime alcohol consumption and for all renal cancer subsites combined or for renal parenchyma subsite. The trend was not observed in hypertensive individuals and not significant in smokers. In conclusion, moderate alcohol consumption was associated with a decreased risk of renal cancer.

Dietary folate intake and breast cancer risk: European prospective investigation into cancer and nutrition.

BACKGROUND: There is limited evidence on the association between dietary folate intake and the risk of breast cancer (BC) by hormone receptor expression in the tumors. We investigated the relationship between dietary folate and BC risk using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: A total of 367993 women age 35 to 70 years were recruited in 10 European countries. During a median follow-up of 11.5 years, 11575 women with BC were identified. Dietary folate intake was estimated from country-specific dietary questionnaires. Cox proportional hazards regression models were used to quantify the association between dietary variables and BC risk. BC tumors were classified by receptor status. Subgroup analyses were performed by menopausal status and alcohol intake. Intake of other B vitamins was considered. All statistical tests were two-sided. RESULTS: A borderline inverse association was observed between dietary folate and BC risk (hazard ratio comparing top vs bottom quintile [HRQ5-Q1] = 0.92, 95% CI = 0.83 to 1.01, P trend = .037). In premenopausal women, we observed a statistically significant trend towards lower risk in estrogen receptor-negative BC (HRQ5-Q1 = 0.66, 95% CI = 0.45 to 0.96, P trend = .042) and progesterone receptor-negative BC (HRQ5-Q1 = 0.70, 95% CI = 0.51 to 0.97, P trend = .021). No associations were found in postmenopausal women. A 14% reduction in BC risk was observed when comparing the highest with the lowest dietary folate tertiles in women having a high (>12 alcoholic drinks/week) alcohol intake (HRT3-T1 = 0.86, 95% CI = 0.75 to 0.98, P interaction = .035). CONCLUSIONS: Higher dietary folate intake may be associated with a lower risk of sex hormone receptor-negative BC in premenopausal women.

Brote epidémico de tuberculosis / Epidemic outbreak of tuberculosis

Objetivo: Comunicar que la colaboración entre Vigilancia Epidemiológica y los Centros Asistenciales de Atención Primaria y Especializada permitió una rápida actuación en un brote de tuberculosis que se produjo en una guardería. Material y métodos: Se diagnosticó a una cuidadora de guardería de tuberculosis bacilífera. Se identificaron las personas expuestas que fueron 4 adultos (cuidadoras) y 58 niños con edades inferiores a los 4 años. Por medio de los respectivos pediatras de atención primaria, se realizó la prueba de la tuberculina en todos los niños. A los niños con tuberculina positiva se les practicó estudio radiológico y microbiológico para descartar la enfermedad. La misma actuación se tuvo con los adultos. Resultados: La localización de los niños fue rápida. El 32,8% de los alumnos estaban infectados y seis de ellos tenían alteraciones en la radiografía de tórax y se consideraron enfermos. En 3 niños se aisló Mycobacterium tuberculosis que fue similar genéticamente al del caso índice. Se realizó quimioprofilaxis primaria en todos los niños con tuberculina negativa; quimioprofilaxis secundaria en los infectados y tratamiento específico en los enfermos. La evolución de todos los niños fue satisfactoria. Conclusiones: Es necesario llevar a cabo vigilancia periódica de tuberculosis en las personas adultas que trabajan con niños. Es importante la rapidez en el estudio de contactos de los adultos diagnosticados de tuberculosis, en especial si trabajan con personas especialmente susceptibles. El estudio genético de las cepas aisladas facilita y aclara las conclusiones epidemiológicas en estos brotes (AU)

[Epidemic outbreak of tuberculosis]. / Brote epidémico de tuberculosis.

OBJECTIVE: To describe how collaboration between epidemiological surveillance and primary and specialist health care centres enabled rapid intervention during an outbreak of tuberculosis in a nursery school. MATERIAL AND METHODS: A child minder was diagnosed with tuberculosis. The persons exposed were identified. These were four child minders and 58 children under 4 years of age. The respective primary care pediatricians carried out a tuberculin test in all of the children. Children with a positive tuberculin test underwent radiological and microbiological study to rule out the disease. The adults underwent the same procedure. RESULTS: Detection among the children was rapid; 32.8 % were infected and six showed alterations in thoracic x-rays and were considered to be ill. In three children Mycobacterium tuberculosis was isolated and was genetically similar to the index case. Primary chemoprophylaxis was carried out in all children with a negative tuberculin test; secondary chemoprophylaxis was administered to infected children and specific treatment to the ill. In all children, evolution was satisfactory. CONCLUSIONS: Periodic surveillance for tuberculosis should be carried out among adults working with children. Genetic study of the strains isolated facilitates epidemiological analysis of these microepidemics.

[Alcohol level and injury risks in traffic accidents in Tudela (Navarre)]. / Nivel de alcohol y riesgo de lesión por accidente de tráfico en Tudela (Navarra).

OBJECTIVE: A case-control study was carried out with the aim of assessing the association between the levels of blood alcohol in drivers and traffic accident rate. METHODS: 150 cases of drivers injured in traffic accident were obtained, treated at the Emergency Medical Services of the Hospital Comarcal of Tudela (Navarre) and whose alcohol level in blood was determined with the ADX technique and compared to the 648 controls from a representative sample among the drivers from the area, whose alcohol level in exhaled air was assessed with a digital alcoholometer. The research was carried out in the period between 1 May, 1990 and 30 April, 1991. RESULTS: In the injured drivers. (cases) the prevalence of blood alcohol levels equal or over 50 mg/dl was 36.6%, compared to 6.9% in controls. The odds ratio for blood alcohol levels equal or over 50 mg/dl. compared to levels below 50 mg/dl was 7.5.

[Magnitude of human immunodeficiency virus (HIV) infection. Navarre, 1992]. / Magnitud de la infección por el virus de la immunodeficiencia humana (VIH). Navarra 1992.

The information available from public laboratories in Navarra (Spain) on tests for detecting anti-HIV antibodies enabled to find out the number of HIV seropositive subjects from 1985 to June 1992, as well as their demographic characteristics and risk habits. 1205 subjects were found to be HIV seropositive, out of a population of 512,512 inhabitants which means an accumulated incidence of a 2.35 cases per thousand inhabitants. Higher rates were observed in young males (13.57 per thousand), and in urban areas (3.7 per thousand). The most frequent risk habit among HIV seropositive is the use drugs by intravenous injection (93.7%) followed by sexual transmission (3.5%). This methodology provides the minimum number of HIV seropositive cases in Navarra, since it does not include those not diagnosed, on diagnosed in private centres in Navarra and/or in other autonomous regions.