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León-Muñoz LM, Duarte-Salles T, Llorente A, Díaz Y, Puente D, Pottegård A, Montero-Corominas D, Huerta C. Use of hydrochlorothiazide and risk of skin cancer in a large nested case-control study in Spain. Pharmacoepidemiol Drug Saf 2021; 30:1269-1278. [PMID: 34015159 DOI: 10.1002/pds.5295] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/08/2021] [Accepted: 05/02/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Hydrochlorothiazide (HCTZ) use has been linked to skin cancer in northern European countries. We assessed the association between HCTZ exposure and risk of malignant melanoma (MM) and keratinocyte carcinoma (KC) in a European Mediterranean population. METHODS Two parallel nested case-control studies were conducted in Spain using two electronic primary healthcare databases, each one providing data on both exposure and outcomes: SIDIAP and BIFAP. Cancer cases were matched to 10 controls by age and gender through risk-set sampling. The ORs and 95% CI for MM and KC associated with previous HCTZ use were estimated using conditional logistic regression. In BIFAP, KC cases were further identified as basal cell carcinoma (BCC) or squamous cell carcinoma (SCC). RESULTS In adjusted analyses, both ever and cumulative high (≥50,000 mg) use of HCTZ were associated with an increased risk of KC. The risk estimates for high use were 1.30 (1.26-1.34) in SIDIAP and 1.20 (1.12-1.30) in BIFAP, with a lower risk for BCC (1.11 [1.02-1.21]) than for SCC (1.71 [1.45-2.02]). A dose-response relationship was observed between cumulative doses of HCTZ and KC risk. Inconsistent results were found for high use of HCTZ and risk of MM: 1.25 (1.09-1.43) in SIDIAP and 0.85 (0.64-1.13) in BIFAP. CONCLUSIONS In this European Mediterranean population, a high cumulative use of HCTZ was related to an increased risk of KC with a clear dose-response pattern.
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Affiliation(s)
- Luz M León-Muñoz
- División de Farmacoepidemiología y Farmacovigilancia. Departamento de Medicamentos de Uso Humano, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS)
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Ana Llorente
- División de Farmacoepidemiología y Farmacovigilancia. Departamento de Medicamentos de Uso Humano, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS)
| | - Yesika Díaz
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Diana Puente
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Anton Pottegård
- Clinical Pharmacology and Pharmacy, Department of Public health, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Dolores Montero-Corominas
- División de Farmacoepidemiología y Farmacovigilancia. Departamento de Medicamentos de Uso Humano, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS)
| | - Consuelo Huerta
- División de Farmacoepidemiología y Farmacovigilancia. Departamento de Medicamentos de Uso Humano, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS)
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Solar Climate Features Taking into Account the Morphometric Conditions of the Area and the Possibility of Using Them in Heliotherapy on the Example of the Cieplice and Kołobrzeg Health Resorts (Poland). ATMOSPHERE 2021. [DOI: 10.3390/atmos12030383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Global solar radiation is an important atmospheric stimulus affecting the human body and has been used in heliotherapy for years. In addition to environmental factors, the effectiveness of global solar radiation is increasingly influenced by human activity. This research was based on the use of heliographic and actinometric data (1996–2015) and the model distribution of global solar radiation to determine the possibility of heliotherapy with the example of two health resorts: Cieplice and Kołobrzeg (Poland). The solar features of health resorts (sunshine duration and global solar radiation) were characterized, and they were correlated with the spatial distribution of global solar radiation data obtained with the use of remote sensing techniques (System for Automated Geoscientific Analyzes-SAGA), including COoRdination and INformation on the Environment (CORINE) land cover (CLC) data. Using the maximum entropy model (MaxEnt), a qualitative and quantitative relationship between morphometric parameters and solar climate features was demonstrated for individual land cover types. Studies have shown that the period of late spring and summer, due to the climate’s solar features, is advisable for the use of heliotherapy. The human activity that determines the land cover is the main element influencing the spatial differentiation of the possibilities of using this form of health treatment. It also affects topographic indicators shown as significant in the MaxEnt predictive model. In general, areas with high openness were shown as predisposed for health treatment using global solar radiation, which is not consistent with areas commonly used for heliotherapy. The conducted research has shown the need for an interdisciplinary approach to the issue of heliotherapy, which will contribute to the optimization of the use of this form of health treatment from the perspective of climate change and human pressure.
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Pottegård A, Pedersen SA, Schmidt SAJ, Lee CN, Hsu CK, Liao TC, Shao SC, Lai ECC. Use of hydrochlorothiazide and risk of skin cancer: a nationwide Taiwanese case-control study. Br J Cancer 2019; 121:973-978. [PMID: 31673105 PMCID: PMC6889460 DOI: 10.1038/s41416-019-0613-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/08/2019] [Indexed: 11/30/2022] Open
Abstract
Background The antihypertensive agent hydrochlorothiazide has been associated with increased risks of non-melanoma skin cancer (NMSC) and possibly some melanoma subtypes. Previous studies were, however, conducted in predominantly Caucasian populations. We therefore examined the association between hydrochlorothiazide and skin cancer risk in an Asian population. Methods By using Taiwan’s National Health Insurance Research Database (NHIRD), we conducted three separate case–control studies of lip cancer, non-lip non-melanoma skin cancer and melanoma. Cases (n = 29,082) with a first-ever skin cancer diagnoses (2008–2015) were matched 1:10 to population controls. We estimated odds ratios (ORs) associating hydrochlorothiazide use with skin cancer risk by using conditional logistic regression. Results Hydrochlorothiazide use showed no overall association with any of the three outcomes: ORs for high cumulative use of HCTZ (≥50,000 mg) were 0.86 (95% CI 0.09–7.81) for lip cancer, 1.16 (95% CI 0.98–1.37) for non-lip NMSC and 1.07 (95% CI 0.65–1.76) for melanoma. There was some evidence of a dose–response pattern for non-lip NMSC, with an OR of 1.66 (95% CI 0.82–3.33) for 100,000–149,999 mg of HCTZ. The null findings were robust across subgroup and sensitivity analyses. Conclusion Use of HCTZ appears safe in terms of skin cancer risk in an Asian population.
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Affiliation(s)
- Anton Pottegård
- Clinical Pharmacology and Pharmacy, Department of Public health, University of Southern Denmark, Odense, Denmark
| | - Sidsel Arnspang Pedersen
- Clinical Pharmacology and Pharmacy, Department of Public health, University of Southern Denmark, Odense, Denmark.,Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Sigrun Alba Johannesdottir Schmidt
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Chaw-Ning Lee
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chao-Kai Hsu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzu-Chi Liao
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shih-Chieh Shao
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Pharmacy, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Edward Chia-Cheng Lai
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. .,Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan.
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Marsakova A, Kudish A, Gkalpakiotis S, Jahn I, Arenberger P, Harari M. Dead Sea climatotherapy versus topical steroid treatment for atopic dermatitis children: long-term follow-up study. J DERMATOL TREAT 2019; 31:711-715. [PMID: 30995135 DOI: 10.1080/09546634.2019.1605138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this study was to compare long-term results of 4 weeks Dead Sea climatotherapy at the Deutsches Medizinisches Zentrum, Israel to those obtained by classical topical treatment for moderate-to-severe atopic dermatitis. Seventy-two children from the Czech Republic were divided into three groups of 24 and treated during three periods (March 2014, October 2014 and March 2015) with gradually increasing sun exposure during 28 consecutive days. Forty-four children were treated with steroid creams at the Department of Dermatovenereology, Third Faculty of Medicine, Charles University and University Hospital of Kralovske Vinohrady, Prague, Czech Republic. The primary outcome was the change in the SCORing Atopic Dermatitis (SCORAD) index, recorded after 1 month of treatment (immediately after DSC) and 3, 6, 9, 12, and 18 months later in Prague. The mean SCORAD improvement was 87.5 ± 13.4% after 4 weeks at the Dead Sea and 86.1 ± 11.3% after 1 month of treatment with steroid creams in the Czech Republic. All 44 patients treated in Prague participated in this 18-month follow-up study, whereas only 47 patients (65.3%) after DSC treatment. Good clinical results were maintained in both groups and mean SCORAD values were stable and low, around 5.
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Affiliation(s)
- Anna Marsakova
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - Avraham Kudish
- Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, E D Bergmann Campus, Beer Sheva 84105, Israel.,Dead Sea & Arava Science Center, Masada, Israel
| | - Spyridon Gkalpakiotis
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - Irmgard Jahn
- DMZ Medical Center, Lot Spa Hotel, Dead Sea, Israel
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - Marco Harari
- Dead Sea & Arava Science Center, Masada, Israel.,DMZ Medical Center, Lot Spa Hotel, Dead Sea, Israel
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