Long-term protection of HPV test in women at risk of cervical cancer.

OBJECTIVE: To evaluate the 9-year incidence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and cumulative adherence to perform a next test in a cohort of women aged 40+ years with no cervical screening cytology within a window of 5 years (underscreened women), after baseline cervical cytology and HPV tests. METHODS: In Catalonia, Spain, co-testing with cytology and HPV test has been recommended in the Public Health system since 2006 for underscreened women. In 2007, 1,594 women with underscreened criteria were identified and followed through medical records form Pathological Department. 9-year cumulative incidence of histologically confirmed CIN2+ and cumulative adherence to perform a next test were estimated using Kaplan-Meier statistics. RESULTS: Follow-up was available for 1,009 women (63.3%) resulting in 23 women with. CIN2+ (2.3%). Of them, 4 women (17%) had both tests negative at baseline (3CIN2 and 1CIN3) with cumulative incidence of CIN2+ of 0.4% (95% CI: 0.1-1.4) at 5-years and 1.3% (95% CI: 0.4-3.7) at 9-years. During the first year, the prevalence among women with both tests positive was 27.0% (95% CI: 13.0-50.6) for CIN2+. Lost to follow-up was higher among women with both tests negative compared to those with both positive tests (38.7% vs 4.2%, p-value <0.001). 40.5% of the women HPV-/cyto- had a re-screening test during the 4 years following the baseline, increasing until 53.5% during the 6 years of follow-up. CONCLUSIONS: HPV detection shows a high longitudinal predictive value at 9-year to identify women at risk to develop CIN2+. The data validate a safe extension of the 3-year screening intervals (current screening interval) to 5-year intervals in underscreened women that had negative HPV result at baseline. It is necessary to establish mechanisms to ensure screening participation and adequate follow-up for these women.

Effects of prescribed burning for pasture reclamation on soil chemical properties in subalpine shrublands of the Central Pyrenees (NE-Spain).

The abandonment of the traditional pastoral activities in the subalpine grasslands of the Central Pyrenees (NE-Spain) has resulted in shrub encroachment processes that are dominated by species such as the Echinospartum horridum. Therefore, prescribed burning has been recently readopted in this region as a management tool to stop the spread of shrubs and recover grasslands. We aimed to assess the effect that this practice may have on soil chemical properties such as SOC, N, pH, EC, water-extractable and exchangeable cations (Ca2+, Mg2+ and K+), cation exchange capacity, inorganic N forms (N-NH4+ and N-NO3-) and available P. We studied two prescribed burnings conducted at the subalpine level of the Central Pyrenees in the municipalities of Tella-Sin (April 2015) and Buisán (November 2015). At each site, the topsoil was sampled in triplicate at soil depths of 0-1, 1-2 and 2-3 cm immediately before (U), immediately after (B0) and one year after (B12) burning, and litter and/or ashes were removed prior to sampling. The results indicate that in the B0 samples, burning significantly reduced the SOC and N contents as well as the exchangeable Ca2+ and Mg2+ at 0-1 cm, whereas the rest of the studied properties remained virtually unchanged. However, in the B12 samples we detected a decrease of nutrient content that was probably related to leaching and/or erosion processes.

Burn effects on soil properties associated to heat transfer under contrasting moisture content.

The aim of this work is to investigate the topsoil thickness affected by burning under contrasting soil moisture content (field capacity versus air-dried conditions). A mollic horizon of an Aleppo pine forest was sampled and burned in the laboratory, recording the temperature continuously at the topsoil surface and at soil depths of 1, 2, and 3cm. Changes in soil properties were measured at 0-1, 1-2, 2-3, and 3-4cm. Both the maximum temperature and the charring intensities were significantly lower in wet soils than in air-dried soils up to 3cm in depth. Moreover, soil heating was slower and cooling faster in wet soils as compared to dry soils. Therefore, the heat capacity increase of the soil moistened at field capacity plays a more important role than the thermal conductivity increase on heat transfer on burned soils. Burning did not significantly modify the pH, the carbonate content and the chroma, for either wet or dry soil. Fire caused an immediate and significant decrease in water repellency in the air-dried soil, even at 3cm depth, whereas the wet soil remained hydrophilic throughout its thickness, without being affected by burning. Burning depleted 50% of the soil organic C (OC) content in the air-dried soil and 25% in the wet soil at the upper centimeter, which was blackened. Burning significantly decreased the total N (TN) content only in the dry soil (to one-third of the original value) through the first centimeter of soil depth. Soluble ions, measured by electrical conductivity (EC), increased after burning, although only significantly in the first centimeter of air-dried soils. Below 2cm, burning had no significant effects on the brightness, OC, TN, or EC, for either wet or dry soil.

Protecting the underscreened women in developed countries: the value of HPV test.

BACKGROUND: Poor attendance to cervical cancer (CC) screening is a major risk factor for CC. Efforts to capture underscreened women are considerable and once women agree to participate, the provision of longitudinal validity of the screening test is of paramount relevance. We evaluate the addition of high risk HPV test (HPV) to cervical cytology as a primary screening test among underscreened women in the longitudinal prediction of intraepithelial lesions grade 2 or worse (CIN2+). METHODS: Women were included in the study if they were older than 39 years and with no evidence of cervical cytology in the previous five years within the Public Primary Health Care System in Catalonia (Spain). 1,832 underscreened women from eight public primary health areas were identified during 2007-2008 and followed-up for over three years to estimate longitudinal detection of CIN2+. Accuracy of each screening test and the combination of both to detect CIN2+ was estimated. The risk of developing CIN2+ lesions according to histology data by cytology and HPV test results at baseline was estimated using the Kaplan-Meier method. RESULTS: At baseline, 6.7% of participants were HPV positive, 2.2% had an abnormal cytology and 1.3% had both tests positive. At the end of follow-up, 18 out of 767 (2.3%) underscreened women had a CIN2+, two of which were invasive CC. The three-year longitudinal sensitivity and specificity estimates to detect CIN2+ were 90.5% and 93.0% for HPV test and 38.2% and 97.8% for cytology. The negative predictive value was >99.0% for each test. No additional gains in validity parameters of HPV test were observed when adding cytology as co-test. The referral to colposcopy was higher for HPV but generated 53% higher detection of CIN2+ compared to cytology. CONCLUSIONS: Underscreened women had high burden of cervical disease. Primary HPV screening followed by cytology triage could be the optimal strategy to identify CIN2+ leading to longer and safe screen intervals.

Straw management effects on CO2 efflux and C storage in different Mediterranean agricultural soils.

The crop residues buried in semiarid soils as a carbon sink are evaluated. Both C-CO2 evolved and C sequestered from agricultural soils amended with barley straw were measured seasonally over 2 farming seasons in a semiarid environment (NE Spain). Six experimental soils with low organic matter content and contrasted properties were selected. The CO2 efflux, as a result of soil microbial activity, showed a significant seasonal variation according to changes in both soil moisture and temperature being the spring and early summer when respiration rates get higher. On annual average, more organic, calcareous soils, evolved higher carbon dioxide efflux (up to 53 mg CO2/kg and day) than soils with high levels of gypsum or more soluble salts (up to 25 mg CO2/kg and day), which have a lower percentage of organic carbon. Straw residue incorporation increases these CO2 emissions significantly for each soil type. Although CO2 emissions are significantly and negatively correlated with the C storage, straw addition increases soil organic C content, at the end of the period of study. In calcareous soils were stored up to 550 kgC/ha and year, gypseous soils up to 1135 kgC/ha and year and saline soils up to 1450 kgC/ha and year. According to the amount of stored C in the different soil types, the isohumic coefficient of barley straw ranges from 0.087 to 0.259 (kg of humus formed from 1 kg of dry straw).

[Alcohol, drug and tobacco use amongst adolescents in Barcelona region]. / Hábitos tóxicos de los adolescentes.

AIMS: to describe consumption, knowledge and attitudes towards alcohol, tobacco an "illicit drugs" amongst teenagers aged 12-15 years. DESIGN: cross-sectional study. RECRUITMENT: high schools from Barcelona area. PARTICIPANTS: 407 studies of ESO (Secondary education) aged 12-15, academic year 2007-2008. SURVEY MEASURES: demographic characteristics, alcohol, tobacco and drug use, opinion and information about them. It was an ad hoc questionnaire of 22 items, anonymous and filled in by each student. RESULTS: the sample (n = 348) consisted of 50% of women and 50% of men. Mean age: 13.91 years old. The largest group was 14 years old. 35,34% of pupils had tried tobacco, 55,17% alcohol, 9,8% cannabis, 1% cocaine and 0,5% synthetic drugs. 72,41% tried them because they were curious. 40% did not consider alcohol as a drug. Tobacco and alcohol were accessible in more than 85% of the cases. The main source of information comes from the media 49,75%. CONCLUSIONS: adolescents start tobacco consumption between 12-13 years, alcohol at 13, cannabis at 14 synthetic drugs at 13 and cocaine between 14 and 15. The most used substances are alcohol and tobacco and they were not considered drugs by more than half of the surveyed. They believe availability is high. More than half of the sample would like to receive more information about drugs.

Hábitos tóxicos de los adolescentes / Alcohol, Drug and Tobacco use amongst adolescents in Barcelona region

Objetivo: describir el consumo, conocimientos y actitudes sobre sustancias tóxicas en el grupo de edad de 12 a 15 años. Diseño: estudio transversal descriptivo. Emplazamiento: centros de educación secundaria. Nivel de atención sanitaria: Salud Comunitaria. Participantes: 407 estudiantes de ESO, de la provincia de Barcelona entre 12 y 15 años de edad (curso académico 2007-2008). Mediciones principales: variables sociodemográficas, hábitos tóxicos, opinión e información sobre tabaco, alcohol, cannabis, cocaína y drogas de síntesis mediante cuestionario ad hoc de 22 ítems, anónimo y autocumplimentado. Resultados: las encuestas válidas (n=348) procedían en un 50% de mujeres y otro 50% de varones, con edad media de 13’91 años. El grupo más extenso era el de 14 años. Un 35,34% del total de alumnos había probado tabaco; 55,17% alcohol; 9,8% cannabis; 1,1% cocaína; y 0,5% drogas de síntesis. El 72,41% las probó por curiosidad. Un 40% de los alumnos no consideraba el alcohol una droga. Tabaco y alcohol se estiman accesibles en más del 85% de los casos. La principal fuente de información procedía de los medios de comunicación (49,7%). Conclusiones: los adolescentes empiezan a consumir tabaco entre los 12 y 13 años; alcohol con 13; cannabis con 14; drogas de síntesis con 13 y cocaína entre los 14 y 15 años. Las sustancias más consumidas son el alcohol y el tabaco; no siendo consideradas como drogas por más de la mitad de los encuestados. La mayor parte de ellos afirma que la accesibilidad es alta. Más de la mitad de la muestra desearía recibir más información. Nota de las autoras. El estudio que nos ha permitido realizar el artículo, ha sido elaborado como tesina del Máster en Enfermería de Salud Pública y Comunitaria que ofrece bianualmente la Universidad de Barcelona(AU)

Aims: to describe consumption, knowledge and attitudes towards alcohol, tobacco an «illicit drugs» amongst teenagers aged 12-15 years. Design: cross-sectional study. Recruitment: high schools from Barcelona area. Participants: 407 studies of ESO (Secondary education) aged 12-15, academic year 2007-2008. Survey measures: demographic characteristics, alcohol, tobacco and drug use, opinion and information about them. It was an ad hoc questionnaire of 22 items, anonymous and filled in by each student. Results: the sample (n= 348) consisted of 50% of women and 50% of men. Mean age: 13.91 years old. The largest group was 14 years old. 35,34% of pupils had tried tobacco, 55,17% alcohol, 9,8% cannabis, 1% cocaine and 0,5% synthetic drugs. 72,41% tried them because they were curious. 40% did not consider alcohol as a drug. Tobacco and alcohol were accessible in more than 85% of the cases. The main source of information comes from de media 49,75%. Conclusions: adolescents start tobacco consumption between 12-13 years, alcohol at 13, cannabis at 14 synthetic drugs at 13 and cocaine between 14 and 15. The most used substances are alcohol and tobacco and they were not considered drugs by more than half of the surveyed. They believe availability is high. More than half of the sample would like to receive more information about drugs(AU)