Aspirin but not statins is inversely related to gastric cancer with a duration-risk effect: Results from the Stomach Cancer Pooling Project Consortium.

BACKGROUND: Aspirin and statins have been suggested to have potential chemopreventive effects against gastric cancer (GC), although the results of previous studies have been inconsistent. This study therefore aimed to investigate the association between the use of aspirin and statins and GC. METHODS: A pooled analysis of seven case-control studies within the Stomach Cancer Pooling Project, including 3220 cases and 9752 controls, was conducted. Two-stage modeling analyses were used to estimate the association between aspirin and statin use and GC after adjusting for potential confounders. RESULTS: The pooled odds ratio (OR) of GC for aspirin users versus nonusers was 0.72 (95% confidence interval [CI], 0.54-0.95). The protective effect of aspirin appeared stronger in individuals without a GC family history (OR, 0.60; 95% CI, 0.37-0.95), albeit with borderline heterogeneity between those with and without a family history (p = .064). The OR of GC decreased with increasing duration of aspirin use, with an OR of 0.41 (95% CI, 0.18-0.95) for durations of ≥15 years. An inverse, nonsignificant association with the risk of GC was observed for the use of statins alone (OR, 0.79; 95% CI, 0.52-1.18). CONCLUSIONS: These findings suggest that aspirin use, particularly long-term use, is associated with a reduced risk of GC, whereas a similar association was not observed with statins, possibly because of the low frequency of use.

Toenail zinc and risk of prostate cancer in the MCC-Spain case-control study.

BACKGROUND: Some researchers have suggested that zinc (Zn) could reduce the risk of prostate cancer (PC). However, research from observational studies on the relationship between PC risk and biomarkers of Zn exposure shows conflicting results. OBJECTIVES: To evaluate the association between toenail Zn and PC, considering tumour extension and aggressiveness, along with a gene-environment approach, exploring the interaction of individual genetic susceptibility to PC in the relationship between toenail Zn and PC. METHODS: In MCC-Spain study we invited all incident PC cases diagnosed in the study period (2008-2013) and recruited randomly selected general population controls. In this report we included 913 cases and 1198 controls with toenail Zn determined by inductively coupled plasma mass spectrometry. To measure individual genetic susceptibility, we constructed a polygenic risk score based on known PC-related single nucleotide polymorphisms. The association between toenail Zn and PC was explored with mixed logistic and multinomial regression models. RESULTS: Men with higher toenail Zn had higher risk of PC (OR quartile 4 vs.1: 1.41; 95% CI: 1.07-1.85). This association was slightly higher in high-grade PC [(ISUP≤2 Relative risk ratio (RRR) quartile 4 vs.1: 1.36; 1.01-1.83) vs. (ISUP3-5 RRR quartile 4 vs.1: 1.64; 1.06-2.54)] and in advanced tumours [(cT1-cT2a RRR quartile 4 vs.1: 1.40; 95% CI: 1.05-1.89) vs. (cT2b-cT4 RRR quartile 4 vs.1: 1.59; 1.00-2.53)]. Men with lower genetic susceptibility to PC were those at higher risk of PC associated with high toenail Zn (OR quartile 4 vs.1: 2.18; 95% CI: 1.08-4.40). DISCUSSION: High toenail Zn levels were related to a higher risk for PC, especially for more aggressive or advanced tumours. This effect was stronger among men with a lower genetic susceptibility to PC.

Association Between Assisted Reproductive Technology and Cerebral Palsy: A Meta-Analysis.

BACKGROUND: Since 1978 many children are born thanks to assisted reproductive technology (ART). However, the long-term effects of these therapies are still not fully known. Our objective is to evaluate the risk of cerebral palsy (CP) after ART compared with that in those spontaneously conceived (SC) and to examine this risk in single, multiple, and preterm births and the evolution of the risk over the years. METHODS: PubMed, Embase, and Web of Science databases were searched until December 2022. Studies were included if they studied CP cases in children born through ART. 16 studies were finally selected. Quality of studies was assessed using Newcastle Ottawa Scale. Pooled OR was estimated by weighting individual OR/RR by the inverse of their variance. A random-effect model was applied. To assess the causes of heterogeneity, we performed meta-regression analyses. RESULTS: A significantly high risk of CP was found (OR = 1.27; 95% CI 1.12 to 1.43) in children born through ART compared with those SC. This risk increased in singletons (OR = 1.48; 95% CI 1.23 to 1.79) but disappeared in multiple (OR = 1.05; 95% CI 0.93 to 1.18) and preterm births (OR = 1.09; 95% CI 0.87 to 1.37). We found a higher risk of CP in children born before the year 2000 (OR = 3.40; 95% CI 2.49 to 4.63). CONCLUSIONS: ARTs slightly increase the risk of CP once the effect of multiple gestation is controlled. Further studies are needed to clarify whether the techniques themselves, fertility problems, or associated maternal comorbidities are responsible for this risk.

The impact of the COVID-19 pandemic on childhood vaccination rates and the role of sociodemographic factors: A cohort study.

OBJECTIVE: This study examines the impact of the COVID-19 pandemic on both routine and non-routine vaccinations in infants during their initial 18 months of life, concurrently exploring the complex influence of sociodemographic factors. METHODS: A cohort study was conducted, involving 2007 children in two distinct periods: pre-pandemic (January-June 2018) and pandemic (March 2020-May 2021). Participants were classified into two cohorts: 962 children in the 2018 group and 1045 children in the 2020-21 group. Utilizing unconditional logistic regression, the association between vaccination (complete or non-routine) and socioeconomic factors was examined, with adjustments for potential confounding variables such as age, breastfeeding, gestational age, and twins. RESULTS: The study's analysis reveals that in the post-pandemic period, mothers were three times more likely to opt for non-routine vaccines (95% CI 2.25-4.23). However, no significant alterations were observed in routine vaccination rates. Protective factors for complete vaccination included having an employed mother, higher education, and a medium-to-high income. Conversely, a higher income was associated with a reduced likelihood of complete vaccination (OR 0.34, 95% CI 0.20-0.59). CONCLUSION: Contrary to initial expectations, this study concludes that the COVID-19 pandemic did not have a substantial impact on childhood complete vaccination rates. Nevertheless, a noticeable increase in the choice of non-routine vaccination was observed. Sociodemographic factors, such as maternal education, income, and employment status, emerged as key influencers, particularly in the context of deciding on non-routine vaccinations.

Characteristics of patients who died in the hospital emergency service during the SARS-CoV-2 pandemic: a retrospective cohort study in a tertiary hospital in Spain.

The objective of this study is to analyze the characteristics of patients who died in the Hospital Emergency Department (HED) of a Spanish third-level hospital, with a special focus on those who died due to SARS-CoV-2. A retrospective cohort study was conducted, including all patients over 18 years old who died in the Hospital Emergency Department (HED) of a Spanish third-level hospital located in Badalona, Spain, from Jun 2019 to Dec 2020. Various sociodemographic, clinical, and diagnostic variables of the patients were analyzed to identify potential risk factors associated with mortality. During the first wave of the COVID-19 pandemic, a total of 72 patients died in the HED, representing a 42% increase compared to the pre-pandemic period. Of the deceased patients, 11% were attributed to SARS-CoV-2. Furthermore, it was found that patients who died from SARS-CoV-2 during the first wave were significantly younger than those in the second wave, with an average age of 78.6 ± 3.1 years in the first wave and 91.8 ± 4.8 years in the second wave. No significant differences were found regarding gender or associated comorbidities. Overall, the mortality rate at the HED in relation to COVID-19 was low, and infected patients died at younger ages during the first wave compared to the second wave.

Drug use, family support and related factors in university students. A cross-sectional study based on the uniHcos Project data / Consumo de drogas ilegales, apoyo familiar y factores relacionados en estudiantes universitarios. Un estudio transversal basado en datos del Proyecto uniHcos

Objective: To assess the prevalence of illegal drug use in college students on any previous occasion, during the previous year and the previous month, and to analyze the relationship between illegal drug use and family support and other factors. Methods: A cross-sectional study using data from students participating in the uniHcos project (n = 3767) was conducted. The prevalence and age of onset of consumption of cannabis, non-prescription sedatives, stimulants and depressants was evaluated. Polyconsumption was also assessed. The independent variables were: family support, age, residence, and employment status. To determine the factors related to drug use multivariate logistic regression models stratified by gender were fitted. Results: Differences between men and women in prevalence of illegal drug use except non-prescription sedatives were observed. In both genders, less family support was associated with higher consumption of all drugs, except depressants, and with polyconsumption. To be studying and looking for work was related to cannabis and stimulant use and to polyconsumption among women, but only to cannabis use among men. Conclusions: These results support the notion that the start of university studies is a particularly relevant stage in the onset of illegal drug use and its prevention, and that consumption may be especially associated with family support

Objetivo: Evaluar la prevalencia del consumo de drogas ilegales en estudiantes universitarios y analizar la relación entre dicho consumo, el apoyo familiar y otros factores. Método: Se realizó un diseño transversal basado en datos de participantes en el proyecto uniHcos (n = 3767). Se evaluaron la prevalencia y la edad de inicio del consumo de cannabis, tranquilizantes sin receta, estimulantes y depresores, y el policonsumo. Como variables independientes se consideraron el apoyo familiar, la edad, la residencia y la situación laboral. Para la determinación de los factores asociados al consumo de drogas se ajustaron modelos de regresión logística estratificados por sexo. Resultados: Se observaron diferencias entre hombres y mujeres en la prevalencia del consumo de todas las drogas ilegales, excepto tranquilizantes sin receta. En ambos sexos, cuanto peor apoyo familiar, mayor consumo de todas las drogas, excepto depresores y policonsumo. Encontrarse estudiando y buscando trabajo se relacionó con el consumo de cannabis, estimulantes y policonsumo en las mujeres, y solo con cannabis en los hombres. Conclusiones: Los resultados de este estudio aportan nueva evidencia a favor de que el inicio de la etapa universitaria es un momento de especial relevancia en el inicio del consumo de drogas ilegales y su prevención, pudiendo este consumo estar especialmente relacionado con el apoyo familiar

Nitrate and trace elements in municipal and bottled water in Spain / Nitrato y elementos traza en agua embotellada y municipal en España

Objectives: To describe levels of nitrate and trace elements in drinking water from the study areas of a multicase-control study of cancer in Spain (MCC-Spain). Methods: A total of 227 tap water samples were randomly collected from 67 municipalities in 11 provinces and the nine most frequently consumed bottled water brands were sampled to measure levels of nitrate, arsenic, nickel, chromium, cadmium, lead, selenium and zinc. Results: The median nitrate level was 4.2mg/l (range<1-29.0), with similar levels in rural and urban municipalities (p=0.86). Trace elements were unquantifiable in 94% of tap water samples. Differences between areas were significant for nitrate (p<0.001) and arsenic (p=0.03). Only nitrate was quantifiable in bottled water (range 2.3-15.6mg/l). Conclusions: Nitrate levels in municipal water differed between regions and were below the regulatory limit in all samples, including bottled water. Trace element levels were low and mainly unquantifiable in tap and bottled water (AU)

Objetivos: Determinar las concentraciones de nitrato y de elementos traza en el agua de consumo de las áreas del estudio Multicaso-Control de Cáncer en España (MCC-Spain). Métodos: Se tomaron al azar 227 muestras de agua municipal en 67 municipios de 11 provincias, y 9 muestras de las aguas embotelladas más consumidas, para cuantificar la cantidad presente de nitrato, arsénico, níquel, cromo, cadmio, plomo y zinc. Resultados: La mediana de las cifras de nitrato fue 4,2mg/l (rango<1-29,0), con similares resultados en municipios urbanos y rurales (p=0,86). Los elementos traza fueron incuantificables en el 94% de las muestras de agua municipal. Se observaron diferencias entre áreas para nitrato (p<0,001) y arsénico (p=0,03). Solo el nitrato fue cuantificable en el agua embotellada (rango 2,3-15,6mg/l). Conclusiones: La cantidad de nitrato en el agua municipal difiere entre regiones y es menor que el límite regulatorio en todas las muestras. Los elementos traza son mayormente incuantificables tanto en el agua municipal como en la embotellada (AU)

Respuesta: Análisis coste-efectividad de los tratamientos utilizando el «número de pacientes necesario a tratar» / Reply: Cost-effectiveness analysis of treatment options using the «number-needed-to-treat»

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Número necesario de tratamientos: interpretación y estimación en análisis multivariables y con datos censurados / Number needed to treat: Interpretation and estimation in multivariable analyses and censored data

El número necesario de tratamientos se ha recomendado como una forma sencilla de transmitir los resultados de un estudio, especialmente de un ensayo clínico. La mayor parte de las publicaciones lo estiman a partir de una tabla 2 × 2, como el inverso de la reducción absoluta de riesgos. No obstante, se ha llamado la atención sobre algunas limitaciones: la interpretación no resulta tan sencilla como se había pretendido, frecuentemente se ignora la estimación del intervalo de confianza, y los estudios en los que se estima una medida de efecto ajustado por factores de confusión no pueden utilizar las tablas 2 × 2 en el cálculo del número necesario de tratamientos. En este trabajo revisamos la forma de obtener la estimación puntual y el intervalo confianza en 4 situaciones: tablas 2 × 2, regresión logística, método de Kaplan-Meier y regresión de Cox (AU)

Number needed to treat has been recommended as an easy way to transmit results from a trial, especially controlled clinical trials. Most articles estimate it from a 2 × 2 table, as the inverse of the absolute risk reduction. However, some limitations have been pointed out: The interpretation is not as easy as claimed, confidence intervals are frequently not estimated, and the estimation from 2 × 2 tables is inadequate when the main effect measure has been estimated adjusting for confounding factors. In this paper, we revise how to obtain point estimations and confidence intervals of number needed to treat in 4 situations: 2 ×2 tables, logistic regression, Kaplan-Meier method, and Cox regression (AU)