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Páramo-Rodríguez L, Moreno-Marro S, Guardiola-Vilarroig S, Zurriaga O, Cavero-Carbonell C. [Huntington disease in the Valencian Region]. Rev Neurol 2023; 76:343-350. [PMID: 37231547 PMCID: PMC10478134 DOI: 10.33588/rn.7611.2022088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Huntington disease (HD) is a rare neurodegenerative disorder of the central nervous system characterized by unwanted choreatic movements, behavioral and psychiatric disturbances and dementia. OBJECTIVE Describe the geographical, age and sex distribution of HD in the Valencia Region (VR) and determine its prevalence and mortality. MATERIALS AND METHODS Cross-sectional study for the period 2010-2018. Confirmed cases of HD were identified through the Rare Disease Information System of the VR. Sociodemographic characteristics were described, and the prevalence and mortality rate were obtained. RESULTS 225 cases were identified, 50.2% women. 52.0% lived in the province of Alicante. 68.9% were verified by their clinical diagnosis. The median age at diagnosis was 54.1 years, 54.7 years in men and 53.0 years in women. The prevalence in 2018 was 1.97/100,000 inhabitants (95%; CI: 0.39-2.37), showing a no significant increasing trend, overall and by sex. 49.8% died, 51.8% men. The median age at death was 62.7 years, being lower in men than in women. The mortality rate in 2018 was 0.32/100,000 inhabitants (95%; CI: 0.32-2.28), with no statistically significant differences. CONCLUSIONS The prevalence obtained was within the range estimated by Orphanet (1-9/100,000). A difference between sexes was observed in the diagnosis age. Men are the group with the highest mortality and the earliest age of death. It is a disease with high mortality with an average of 6.5 years between diagnosis and death.
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Affiliation(s)
- L Páramo-Rodríguez
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Valencia, España
| | - S Moreno-Marro
- Universitat de València, 46071 Valencia, España
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Valencia, España
| | - S Guardiola-Vilarroig
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Valencia, España
- Conselleria de Sanitat de la Comunitat Valenciana, Valencia, España
| | - O Zurriaga
- Universitat de València, 46071 Valencia, España
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Valencia, España
- CIBER Epidemiología y Salud Pública. Instituto de Salud Carlos III, Madrid, España
| | - C Cavero-Carbonell
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Valencia, España
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Agurto-Ramírez A, García-Villodre L, Ruiz-Palacio A, Arribas-Díaz B, Barrachina-Bonet L, Páramo-Rodríguez L, Zurriaga Ó, Cavero-Carbonell C. Oesophageal Atresia: Prevalence in the Valencian Region (Spain) and Associated Anomalies. Int J Environ Res Public Health 2023; 20:4042. [PMID: 36901053 PMCID: PMC10001480 DOI: 10.3390/ijerph20054042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
The objective was to determine the prevalence of oesophageal atresia (OA) and describe the characteristics of OA cases diagnosed before the first year of life, born between 2007 and 2019, and residents in the Valencian Region (VR), Spain. Live births (LB), stillbirths (SB), and termination of pregnancy for fetal anomaly (TOPFA) diagnosed with OA were selected from the Congenital Anomalies population-based Registry of VR (RPAC-CV). The prevalence of OA per 10,000 births with 95% confidence interval was calculated, and socio-demographic and clinical variables were analyzed. A total of 146 OA cases were identified. The overall prevalence was 2.4/10,000 births, and prevalence by type of pregnancy ending was 2.3 in LB and 0.03 in both SB and TOPFA. A mortality rate of 0.03/1000 LB was observed. A relationship was found between case mortality and birth weight (p-value < 0.05). OA was primarily diagnosed at birth (58.2%) and 71.2% of the cases were associated with another congenital anomaly, mainly congenital heart defects. Significant variations in the prevalence of OA in the VR were detected throughout the study period. In conclusion, a lower prevalence in SB and TOPFA was identified compared to EUROCAT data. As several studies have identified, an association between OA cases and birth weight was found.
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Affiliation(s)
- Adriana Agurto-Ramírez
- Service of Preventive Medicine, Valencia General University Hospital Consortium, 46014 Valencia, Spain
| | - Laura García-Villodre
- Rare Diseases Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region-Valencia University (FISABIO-UVEG), 46020 Valencia, Spain
| | - Ana Ruiz-Palacio
- Rare Diseases Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region-Valencia University (FISABIO-UVEG), 46020 Valencia, Spain
| | - Berta Arribas-Díaz
- Rare Diseases Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region-Valencia University (FISABIO-UVEG), 46020 Valencia, Spain
| | - Laia Barrachina-Bonet
- Rare Diseases Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region-Valencia University (FISABIO-UVEG), 46020 Valencia, Spain
| | - Lucía Páramo-Rodríguez
- Rare Diseases Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region-Valencia University (FISABIO-UVEG), 46020 Valencia, Spain
| | - Óscar Zurriaga
- Rare Diseases Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region-Valencia University (FISABIO-UVEG), 46020 Valencia, Spain
- Public Health Regional Health Administration, Generalitat Valenciana, 46020 Valencia, Spain
- Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Legal Medicine, University of Valencia, 46010 Valencia, Spain
| | - Clara Cavero-Carbonell
- Rare Diseases Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region-Valencia University (FISABIO-UVEG), 46020 Valencia, Spain
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Páramo-Rodríguez L, Cavero-Carbonell C, Guardiola-Vilarroig S, López-Maside A, González Sanjuán ME, Zurriaga Ó. [Diagnostic delay in rare diseases: between fear and resilience]. Gac Sanit 2022; 37:102272. [PMID: 36542890 DOI: 10.1016/j.gaceta.2022.102272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To describe the impact of diagnosis delay in rare diseases and analyze psychosocial needs related to this delay in patients. METHOD The qualitative approach has been used by conducting online group interviews with patients and family members in the Valencian Region (Spain) and a content analysis has been carried out. Two categories were differentiated: with diagnostic delay of 1 year or more and without diagnostic delay. Five interviews were conducted with a total of 25 participants. RESULTS The content analysis showed unequal aspects vs. common aspects, in persons with or without diagnostic delay. People with delay expressed the need to feel supported in order to live with continuous uncertainty. People without delay verbalized the importance of adequate communication between patients and professionals. The problems by the COVID-19 were common in both groups; the participants expressed that they did not feel unattended in their disease by the health services. CONCLUSIONS High resilience and coping capacity has been identified in people with rare disease, regardless of whether they have suffered diagnostic delay or not. The professional psychosocial support during the diagnostic process of these rare diseases is essential.
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Affiliation(s)
- Lucía Páramo-Rodríguez
- Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana-Universitat de València (FISABIO-UVEG), Valencia, España
| | - Clara Cavero-Carbonell
- Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana-Universitat de València (FISABIO-UVEG), Valencia, España.
| | | | - Aurora López-Maside
- Dirección General de Salud Pública y Adicciones, Generalitat Valenciana, Valencia, España
| | | | - Óscar Zurriaga
- Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana-Universitat de València (FISABIO-UVEG), Valencia, España; Dirección General de Salud Pública y Adicciones, Generalitat Valenciana, Valencia, España; Departamento de Medicina Preventiva y Salud Pública, Ciencias de la Alimentación, Toxicología y Medicina Legal, Universitat de València, Valencia, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
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Gimenez-Lozano C, Páramo-Rodríguez L, Cavero-Carbonell C, Corpas-Burgos F, López-Maside A, Guardiola-Vilarroig S, Zurriaga O. Rare Diseases: Needs and Impact for Patients and Families: A Cross-Sectional Study in the Valencian Region, Spain. Int J Environ Res Public Health 2022; 19:ijerph191610366. [PMID: 36012000 PMCID: PMC9408677 DOI: 10.3390/ijerph191610366] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/12/2023]
Abstract
Families with rare diseases (RDs) have unmet needs that are often overlooked by health professionals. Describing these needs and the impact of the disease could improve their medical care. A total of 163 surveys were obtained from patients visiting primary care centres in the Valencian Region (Spain), during 2015-2017, with a confirmed or suspected diagnosis of RD. Of the 84.7% with a confirmed diagnosis, 50.4% had a diagnostic delay exceeding one year, and it was more prevalent among adults (62.2%). Families with paediatric patients were in a worse economic situation, with lower incomes and higher monthly disease-related expenses (€300 on average). These expenses were incurred by 66.5% of families and were mainly for medication (40.3%). Among them, 58.5% reported not being able to afford adjuvant therapies. The disease had an impact on 73.1% of families, especially on their routine and emotional state. Expenses, needs, and impacts were more frequent among families of patients with a history of hospitalisation or deterioration. Patients with delayed diagnosis had a higher consumption of drugs prior to diagnosis. People affected by RDs in the Valencian Region need therapies to improve their autonomy and emotional state. Health professionals should be aware of these needs.
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Affiliation(s)
- Cristina Gimenez-Lozano
- Preventive Medicine and Public Health, Hospital Universitario Doctor Peset, 46017 Valencia, Spain
| | - Lucía Páramo-Rodríguez
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, 46020 Valencia, Spain
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, 46020 Valencia, Spain
| | - Francisca Corpas-Burgos
- Economic, Demographic and Social Statistics Service, Valencian Institute of Statistics, Valencian Region, 46020 Valencia, Spain
| | - Aurora López-Maside
- Directorate General for Public Health and Addictions, Regional Ministry of Health, Valencian Region, 46020 Valencia, Spain
| | - Sandra Guardiola-Vilarroig
- Directorate General for Public Health and Addictions, Regional Ministry of Health, Valencian Region, 46020 Valencia, Spain
| | - Oscar Zurriaga
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, 46020 Valencia, Spain
- Directorate General for Public Health and Addictions, Regional Ministry of Health, Valencian Region, 46020 Valencia, Spain
- Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, 46010 Valencia, Spain
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Sinclair M, McCullough JEM, Elliott D, Braz P, Cavero-Carbonell C, Dornan L, Jamry-Dziurla A, João Santos A, Latos-Bieleńska A, Machado A, Páramo-Rodríguez L. Using Social Media as a Research Tool for a Bespoke Web-Based Platform for Stakeholders of Children With Congenital Anomalies: Development Study. JMIR Pediatr Parent 2021; 4:e18483. [PMID: 34779778 PMCID: PMC8663440 DOI: 10.2196/18483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 02/12/2021] [Accepted: 08/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Limited research evidence exists on the development of web-based platforms for reciprocal communication, coproduction research, and dissemination of information among parents, professionals, and researchers. This paper provides learning and the outcomes of setting up a bespoke web-based platform using social media. OBJECTIVE This study aims to explore the establishment of a web-based, multicontextual research communication platform for parents and stakeholders of children with congenital anomalies using social media and to identify associated research and ethical and technical challenges. METHODS The ConnectEpeople e-forum was developed using social media platforms with a stakeholder engagement process. A multilevel approach was implemented for reciprocal engagement between parents of children with congenital anomalies, researchers, health care professionals, and other stakeholders using private and invisible and public Facebook groups, closed Twitter groups, and YouTube. Ethical approval was obtained from Ulster University. RESULTS Nonprofit organizations (N=128) were invited to engage with an initial response rate of 16.4% (21/128). Of the 105 parents contacted, 32 entered the private and invisible Facebook groups to participate in the coproduction research. Public Facebook page followers rose to 215, a total of 22 posts had an engagement of >10%, and 34 posts had a reach of over 100. Webinars included requested information on childhood milestones and behavior. YouTube coverage included 106 ConnectEpeople videos with 28,708 impressions. Project information was obtained from 35 countries. The highest Facebook activity occurred during the early morning hours. Achievement of these results required dedicated time management, social media expertise, creativity, and sharing knowledge to curate valuable content. CONCLUSIONS Building and maintaining a multilayered online forum for coproduction and information sharing is challenging. Technical considerations include understanding the functionality and versatility of social media metrics. Social media offers valuable, easily accessible, quantitative, and qualitative data that can drive the reciprocal process of forum development. The identification and integration of the needs of the ConnectEpeople e-forum was a key driver in the dissemination of useful, meaningful, and accessible information. The necessary dedicated administration to respond to requests and posts and collate data required significant time and effort. Participant safety, the development of trust, and the maintenance of confidentiality were major ethical considerations. Discussions on social media platforms enabled parents to support each other and their children. Social media platforms are particularly useful in identifying common family needs related to early childhood development. This research approach was challenging but resulted in valuable outputs requiring further application and testing. This may be of particular importance in response to COVID-19 or future pandemics. Incorporating flexible, adaptable social media strategies into research projects is recommended to develop effective platforms for collaborative and impactful research and dissemination.
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Affiliation(s)
- Marlene Sinclair
- Institute of Nursing and Health Research, Ulster University, Northern Ireland, United Kingdom
| | - Julie E M McCullough
- Institute of Nursing and Health Research, Ulster University, Northern Ireland, United Kingdom
| | | | - Paula Braz
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisbon, Portugal
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Lesley Dornan
- Institute of Nursing and Health Research, Ulster University, Northern Ireland, United Kingdom
| | - Anna Jamry-Dziurla
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Ana João Santos
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisbon, Portugal.,Public Health Research Centre, National School of Public Health, Nova University Lisbon, Lisbon, Portugal
| | - Anna Latos-Bieleńska
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Ausenda Machado
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisbon, Portugal
| | - Lucía Páramo-Rodríguez
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
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Cavero-Carbonell C, Barrachina-Bonet L, García-Villodre L, Páramo-Rodríguez L, Guardiola-Vilarroig S, Zurriaga O. Folic acid supplementation in the Congenital Anomalies population-based registry in a Spanish Region. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The Congenital Anomalies (CA) population-based registry of Valencian Region (RPACCV) has identified 11376 cases, live births (LB) and stillbirths (SB), between 2007-2018 with at least 1 major CA, diagnosed prenatally or up to 1 year old. The Folic acid supplementation (FAS) during the pregnancy is also registered.
Aim
To identify differences in sociodemographic and clinical characteristics and in CA presentation, in cases from RPACCV according to prenatal FAS.
Methods
A cross-sectional study was performed using the RPACCV to identify exposure to FAS (yes/no) in pregnancies with a born (LB and SB) with CA between 2007-2018. Pregnancies with unknown exposure were excluded. Percentages and their 95% confidence intervals (95%CI) of the sociodemographic and clinical characteristics of the cases were determined and compared according to pregnant exposure to FAS. Frequency and its 95%CI of the different CA groups were identified by exposure.
Results
14.1% of pregnancies (1602) were exposed to FAS and 10.4% (1182) were not, 75.5% were excluded. Statistically significant differences weren't found for sociodemographic and clinical characteristics according to exposure. In children of women exposed 1777 CA were identified and 2019 CA in those unexposed. Statistically significant differences were found in these CA groups (shown as % in the exposed/% in the unexposed): Heart defects (7.1%/52.7%), Respiratory (0.2%/1.2%), Digestive (2.3%/5.3%), Genital (2.5%/4.8%), Urinary (3.9%/9.3%), Limb (6.8%/9.4%), Oro-facial clefts (25.4%/2.8%), Eyes, Ears, Face and Neck (3.8%/1.2%).
Conclusions
Several studies identified that FAS prevents from some CA. The fact that in only 25% of pregnant women there is information about FAS, highlight the difficulties of its registration in the clinical documentation. However, with the available information, it was identified that children of unexposed pregnant women presented more CA and from groups with a higher impact on morbidity and mortality.
Key messages
In Spain, Folic acid supplementation doesn’t require a prescription and, as its use is customary prior and during pregnancy, it doesn’t seem to be considered as significant drug exposure in pregnancy. Differences between pregnancies exposed and unexposed to folic acid supplementation were found regarding the number of congenital anomalies presented in their children and its severity.
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Affiliation(s)
| | | | | | | | - S Guardiola-Vilarroig
- Public Health Regional Health Administration, Generalitat Valenciana, Valencia, Spain
| | - O Zurriaga
- Rare Diseases Research Unit, FISABIO, Valencia, Spain
- Public Health Regional Health Administration, Generalitat Valenciana, Valencia, Spain
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Cavero Carbonell C, Páramo-Rodríguez L, Moreno-Marro S, Barrachina-Bonet L, De la Natividad M, Guardiola-Vilarroig S, Zurriaga O. Portrait of Hungtinton’s Disease in the Valencian Region: a cross-sectional study. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Huntington Disease (HD) is a rare neurodegenerative disorder of the central nervous system characterized by involuntary choreic movements and behavioural/psychiatric disorders, which compromises the quality of life.
Objective
To identify the distribution of HD by sex, age and province in the Valencian Region (VR) and to determine its prevalence and mortality rate.
Methods
A cross-sectional epidemiological study was performed. HD's cases between 2010-2018 were identified from the Rare Disease Information System of the VR by selecting codes 333.4 (ICD9) and G10 (ICD10). A descriptive analysis was performed by country of birth, province of residence and sex. Median ages at diagnosis and at death, with interquartile range (IQR), and prevalence and mortality rate, with 95% confidence intervals (95%CI), were obtained.
Results
225 cases were identified: 50.2% women, 52.0% residents in the southernmost province, 92.9% born in Spain and 68.9% confirmed by clinical manifestations. Median age at diagnosis was 54.1 years (IQR:41.1-66.1): 54.7 (IQR:41.2-66.1) in men and 53.0 (IQR:40.5-65.8) in women. Prevalence in 2018 was 2.0/100000 inhabitants (95%CI:0.4-2.4), being higher in women [2.2 (95%CI:0.3-2.8)] than in men [1.8 (95%CI:0.3-2.3)]. Even an increasing trend was observed, significant differences weren't found. 49.8% of cases died during the study, being 51.8% men. The median age at death was 62.7 years (IQR:51.1-74.2), 61.1 (IQR:48.7-72.5) in men and 66.6 (IQR:53.3-76.8) in women. The mortality rate in 2018 in both sexes was 0.3/100000 inhabitants (95%CI:0.3-2.3), significant differences weren't found.
Conclusions
Most of confirmations at registry level were based on clinical manifestations, reinforcing that HD has a characteristic pattern of symptoms although most are unspecific. The slight difference between sexes in the median age of diagnosis was significantly increased in the age of death, with men being the group with the highest mortality and an earlier death.
Key messages
In the Valencian Region of Spain, men with Huntington Disease have a higher mortality rate and a lower median age at death (5.5 years earlier) than women. There is a pattern of symptoms which is characteristic of Huntington Disease, although most of them are unspecific.
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Affiliation(s)
| | | | | | | | | | - S Guardiola-Vilarroig
- Public Health Regional Health Administration, Generalitat Valenciana, Valencia, Spain
| | - O Zurriaga
- Rare Diseases Research Unit, FISABIO, Valencia, Spain
- Public Health Regional Health Administration, Generalitat Valenciana, Valencia, Spain
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Cavero-Carbonell C, García-Villodre L, Barrachina-Bonet L, Moreno-Marro S, Páramo-Rodríguez L, Guardiola-Vilarroig S, Zurriaga-Llorens Ó. [Epidemiological surveillance of congenital heart defects: the Tetralogy of Fallot in the Valencian Region, 2007-2017.]. Rev Esp Salud Publica 2021; 95:e202101019. [PMID: 33511968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVE Tetralogy of Fallot is characterized by the presence of four congenital heart defects. Objective: to describe the temporal trend and distribution of Tetralogy of Fallot, in children under one year in the Valencian Region. METHODS Cases with Tetralogy of Fallot (code Q21.3 from the ICD10-British Paediatric Association) were selected from the Congenital Anomalies Population-based Registry between 2007-2017. Prevalence per 10,000 births with 95%CI was calculated, and a descriptive analysis of sociodemographic and clinical variables was made. RESULTS 165 cases were identified (43.6% male, 30.9% female and 25.5% unknown). The overall prevalence was 3.1/10,000 births (95%CI:2.6-3.6), being 2015 and 2017 the years with the highest (4.3/10,000 births and 4.7/10,000 births respectively) and 2011 with the lowest (1.8/10,000 births). 72.1% were live births, 24.8% Termination of Pregnancy for Fetal Anomaly (TOPFA) and 3.0% stillbirths. The prevalence in live births was 2.2/10,000 births (95%CI:1.8-2.7) and in TOPFA it was 0.8/10,000 births (95%CI:0.5-1.0), identifying an increasing trend along the period in the last one. 10.1% of live births died during the first year of life and 55.8% were diagnosed prenatally. Mothers younger than 20 years had the highest prevalence (4.8/10,000 births). CONCLUSIONS The prevalence obtained in the Valencian Region was slightly lower than EUROCAT's but coincides with that of the registries that are closer geographically, and in all of them it is noted that their increasing trend specifically affects cases ending in TOPFA.
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Affiliation(s)
| | | | | | - Sandra Moreno-Marro
- Unidad Mixta de Investigación en Enfermedades Raras, FISABIO-UVEG. Valencia. España
| | | | - Sandra Guardiola-Vilarroig
- Unidad Mixta de Investigación en Enfermedades Raras, FISABIO-UVEG. Valencia. España
- Dirección General de Salud Pública y Adicciones. Conselleria Sanitat Comunitat Valenciana. Valencia. España
| | - Óscar Zurriaga-Llorens
- Unidad Mixta de Investigación en Enfermedades Raras, FISABIO-UVEG. Valencia. España
- Dirección General de Salud Pública y Adicciones. Conselleria Sanitat Comunitat Valenciana. Valencia. España
- CIBER Epidemiología y Salud Pública. Instituto de Salud Carlos III. Madrid. España
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9
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Moreno-Marro S, Barrachina-Bonet L, Páramo-Rodríguez L, Alonso-Ferreira V, Guardiola-Vilarroig S, Vicente E, García-López M, Palomar-Rodríguez J, Zoni AC, Zurriaga Ó, Cavero-Carbonell C. [Wilson's disease in Spain: validation of sources of information used by the Rare Diseases Registries]. Gac Sanit 2020; 35:551-558. [PMID: 33010964 DOI: 10.1016/j.gaceta.2020.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To evaluate the sources of information used by the Regional Population-based Registries of Rare Diseases (RRD) for Wilson's Disease identification in Spain; to calculate its prevalence and mortality; and to describe the sociodemographic characteristics of those affected. METHOD Cross-sectional epidemiological study, period 2010-2015. Possible cases were identified by codes 275.1 (ICD-9-CM), E83.0 (ICD-10) and 905 (ORPHAcode) in: 15 participating RRD and the Rare Disease Patients Registry of the Carlos III Health Institute. The diagnoses were confirmed through a clinical documentation review. The positive predictive value (PPV) of the sources of information used by RRD and their combinations were obtained. The prevalence, mortality and the distribution of sociodemographic characteristics were calculated. RESULTS The Hospital Discharge Database (HDD) was the most used source by the RRD (PPV=39.4%), followed by the Orphan Drugs Registry (ODR) (PPV=81.9%). The Clinical History of Primary Care (PC) obtains PPV=55.9%. The combinations with highest PPV were the ODR with HDD (PPV=95.8%) and the ODR with PC (PPV=92.9%). 514 cases were confirmed, 57.2% men, with a median age of diagnosis of 21.3 years. The prevalence was 1.64/100,000 inhabitants in 2015 and mortality rate was 3.0%, being both higher in men. CONCLUSIONS Incorporation of ODR and PC into the RRD is recommended, as its combination and ODR with HDD could be used as an automatic validation criterion for Wilson's disease. The prevalence obtained was similar to that of countries close to Spain.
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Affiliation(s)
- Sandra Moreno-Marro
- Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana- Universitat de València (FISABIO-UVEG), Valencia, España
| | - Laia Barrachina-Bonet
- Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana- Universitat de València (FISABIO-UVEG), Valencia, España.
| | - Lucía Páramo-Rodríguez
- Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana- Universitat de València (FISABIO-UVEG), Valencia, España
| | | | - Sandra Guardiola-Vilarroig
- Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana- Universitat de València (FISABIO-UVEG), Valencia, España; Dirección General de Salud Pública y Adicciones, Conselleria de Sanitat, Comunitat Valenciana, Valencia, España
| | - Esther Vicente
- Sección del Observatorio de la Salud Comunitaria, Instituto de Salud Pública y Laboral de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, España
| | - María García-López
- Servicio de Información de Salud Pública, Consejería de Sanidad, Junta de Castilla y León, Valladolid, España
| | - Joaquín Palomar-Rodríguez
- Servicio de Planificación y Financiación Sanitaria, Consejería de Salud, Región de Murcia, Murcia, España
| | - Ana Clara Zoni
- Servicio de Informes de Salud y Estudios, Dirección General de Salud Pública, Consejería de Sanidad de la Comunidad de Madrid, Madrid, España
| | - Óscar Zurriaga
- Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana- Universitat de València (FISABIO-UVEG), Valencia, España; Dirección General de Salud Pública y Adicciones, Conselleria de Sanitat, Comunitat Valenciana, Valencia, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Medicina Preventiva y Salud Pública, Ciencias de la Alimentación, Toxicología y Medicina Legal, Universitat de València, Valencia, España
| | - Clara Cavero-Carbonell
- Unidad Mixta de Investigación en Enfermedades Raras, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana- Universitat de València (FISABIO-UVEG), Valencia, España
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10
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Cavero Carbonell C, Barrachina-Bonet L, García-Villodre L, Moreno-Marro S, Páramo-Rodríguez L, Guardiola-Vilarroig S, Zurriaga O. Congenital Anomalies and assisted conception in the Population-based registry from a Spanish Region. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The Congenital Anomalies (CA) population-based Registry of Valencian Region (RPAC-CV) has identified 12917 cases during 2007-2017, confirmed by clinical documentation. The Spanish Fertility Society (SEF) has identified a CA's prevalence per 10000 live births (LB) from assisted conception of 305.2 with a 95% confidence interval (CI) of 296.1-314.2 from 2013 to 2017.
Objective
to identify differences in sociodemographic and clinical characteristics between cases with CA according to the type of conception: natural (N) or assisted (A). To determine the CA's prevalence of LB in the RPAC-CV.
Methods
RPAC-CV cases since 2007 until 2017 were classified in N or A conception, and their sociodemographic and clinical characteristics were compared. Cases with no information about type of conception were excluded. The prevalence per 10000 LB with CI 95% in the RPAC-CV between 2013-2017 was calculated.
Results
Conception's information was available in 58.3% of the cases (90.4% N, 9.6% A). Differences were found in the following variables (values are shown by %N/%A) multiple pregnancy (6.5%/47.9%); birth before the 37th gestational week (24.5%/56.8%); weight at birth less than 2500 grams (24.6%/55.2%); dead before one week of age (4.4%/7.9%); mother older than 35 years (31.3%/64.2%). Statistically significant differences were found in the Nervous System CA group, being a higher proportion in A conception cases (12.5% (CI95%:9.8-15.2)) than in N (7.6% (CI95%:6.9-8.3)). The CA prevalence per 10000 LB in RPAC-CV was 194.1 (CI95%:188.3-199.9).
Conclusions
The CA's prevalence in the RPAC-CV was significantly lower compared to SEF's. Partially could be due to SEF includes minor CA and RPAC-CV not, although differences are overly high. Encourage the collection of the conception information in the clinical documentation will increase data quality in cases from assisted conception and allow having interesting information available for the development of health policies and research.
Key messages
CA’s prevalence, identified in a population-based registry from a Spanish region, was significantly lower than the one identified in assisted conception cases at national level for the same period. Analysing natural versus assisted conception, significant differences in cases’ characteristics have been identified in a CA’s population-based registry in Spain.
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Affiliation(s)
| | | | | | - S Moreno-Marro
- Rare Diseases Joint Research Unit, FISABIO-UVEG, Valencia, Spain
| | | | - S Guardiola-Vilarroig
- Rare Diseases Joint Research Unit, FISABIO-UVEG, Valencia, Spain
- Public Health Regional Health Administration, Generalitat Valenciana, Valencia, Spain
| | - O Zurriaga
- Rare Diseases Joint Research Unit, FISABIO-UVEG, Valencia, Spain
- Public Health Regional Health Administration, Generalitat Valenciana, Valencia, Spain
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Sinclair M, McCullough JE, Elliott D, Latos-Bielenska A, Braz P, Cavero-Carbonell C, Jamry-Dziurla A, João Santos A, Páramo-Rodríguez L. Exploring Research Priorities of Parents Who Have Children With Down Syndrome, Cleft Lip With or Without Cleft Palate, Congenital Heart Defects, or Spina Bifida Using ConnectEpeople: A Social Media Coproduction Research Study. J Med Internet Res 2019; 21:e15847. [PMID: 31763986 PMCID: PMC6902131 DOI: 10.2196/15847] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/29/2019] [Accepted: 09/30/2019] [Indexed: 11/13/2022] Open
Abstract
Background Using social media for research purposes is novel and challenging in terms of recruitment, participant knowledge about the research process, and ethical issues. This paper provides insight into the recruitment of European parents of children with specific congenital anomalies to engage in coproduction research by using social media. Secret Facebook groups, providing optimal security, were set up for newly recruited research-aware parents (RAPs) to communicate privately and confidentially with each other and for the research team to generate questions and to interpret findings. Objective This study aimed to use social media for the recruitment and engagement of parents in research and to determine the research priorities of parents who have children with Down syndrome, cleft lip with or without cleft palate, congenital heart defects, and spina bifida. Methods The design was exploratory and descriptive with 3 phases. Phase 1 included the recruitment of RAPs and generation of research questions important to them; phase 2 was a Web-based survey, designed using Qualtrics software, and phase 3 included analysis and ranking of the top 10 research questions using an adapted James Lind Alliance approach. Simple descriptive statistics were used for analysis, and ethical approval was obtained from the Ethics Filter Committee of the Institute of Nursing and Health Research, Ulster University. Results The recruitment of 32 RAPs was a sensitive process, varying in the time taken to consent (mean 51 days). However, parents valued the screening approach using the State-Trait Anxiety Inventory as a measure to ensure their well-being (mean 32.5). In phase 1, RAPs generated 98 research questions. In phase 2, 251 respondents accessed the Web-based survey, 248 consented, and 80 completed the survey, giving a completeness rate of 32.3% (80/248). Most parents used social media (74/80, 92%). Social media, online forums, and meeting in person were ranked the most preferable methods for communication with support groups networks and charities. Most respondents stated that they had a good understanding of research reports (71/80, 89%) and statistics (68/80, 85%) and could differentiate among the different types of research methodologies (62/80, 78%). Phase 3 demonstrated consensus among RAPs and survey respondents, with a need to know the facts about their child’s condition, future health, and psychosocial and educational outcomes for children with similar issues. Conclusions Social media is a valuable facilitator in the coproduction of research between parents and researchers. From a theoretical perspective, ocularcentrism can be an applicable frame of reference for understanding how people favor visual contact.
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Affiliation(s)
- Marlene Sinclair
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, Northern Ireland, United Kingdom
| | - Julie Em McCullough
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, Northern Ireland, United Kingdom
| | | | - Anna Latos-Bielenska
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Paula Braz
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisbon, Portugal
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Anna Jamry-Dziurla
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Ana João Santos
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisbon, Portugal.,Public Health Research Centre, National School of Public Health, Nova University Lisbon, Lisbon, Portugal
| | - Lucía Páramo-Rodríguez
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
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Canet-Chaqués I, Moreno-Marro S, Páramo-Rodríguez L, Zurriaga Ó, Cavero-Carbonell C. Congenital anomalies of urinary tract in the population-based registry of Valencia region (Spain), 2007-2015. Eur J Med Genet 2018. [DOI: 10.1016/j.ejmg.2018.06.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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13
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Canet-Chaqués I, Páramo-Rodríguez L, Gimeno-Martos S, Pérez-Riera C, Guardiola-Vilarroig S, Cavero-Carbonell C. The Osteogenesis Imperfecta in the Valencia Region (Spain), 2004-2014. Eur J Med Genet 2018. [DOI: 10.1016/j.ejmg.2018.06.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Pastor-García M, Gimeno-Martos S, Páramo-Rodríguez L, Guardiola-Vilarroig S, Sorlí JV, Zurriaga O, Cavero-Carbonell C. Congenital heart defects in the East of Spain. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- M Pastor-García
- Foundation For The Promotion Of Health And Biomedical Research Of The Valencian Region (FISABIO), Valencia, Spain
| | - S Gimeno-Martos
- Foundation For The Promotion Of Health And Biomedical Research Of The Valencian Region (FISABIO), Valencia, Spain
| | - L Páramo-Rodríguez
- Foundation For The Promotion Of Health And Biomedical Research Of The Valencian Region (FISABIO), Valencia, Spain
| | | | - JV Sorlí
- University of Valencia, Valencia, Spain
| | - O Zurriaga
- Directorate General of Public Health, Valencia, Spain
| | - C Cavero-Carbonell
- Foundation For The Promotion Of Health And Biomedical Research Of The Valencian Region (FISABIO), Valencia, Spain
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Gimeno-Martos S, Pérez-Riera C, Páramo-Rodríguez L, Cavero-Carbonell C. The Osteogenesis imperfecta in the Valencia Region, Spain. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- S Gimeno-Martos
- Foundation For The Promotion Of Health And Biomedical Research Of The Valencian Region (FISABIO), Valencia, Spain
| | - C Pérez-Riera
- Foundation For The Promotion Of Health And Biomedical Research Of The Valencian Region (FISABIO), Valencia, Spain
| | - L Páramo-Rodríguez
- Foundation For The Promotion Of Health And Biomedical Research Of The Valencian Region (FISABIO), Valencia, Spain
| | - C Cavero-Carbonell
- Foundation For The Promotion Of Health And Biomedical Research Of The Valencian Region (FISABIO), Valencia, Spain
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Cavero-Carbonell C, Gimeno-Martos S, Páramo-Rodríguez L, Rabanaque-Hernández MJ, Martos-Jiménez C, Zurriaga Ó. Drugs use in pregnancy in the Valencia Region and the risk of congenital anomalies. An Pediatr (Barc) 2017. [DOI: 10.1016/j.anpede.2016.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Cavero-Carbonell C, Gimeno-Martos S, Gras-Colomer E, Páramo-Rodríguez L, Alfaro A, Zurriaga O. Stevens Johnson Syndrome: identification of the risk factors in a rare disease. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw174.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Páramo-Rodríguez L, Mas Pons R, Cavero-Carbonell C, Martos-Jiménez C, Zurriaga Ó, Barona Vilar C. Corrigendum a: A corazón abierto: vivencias de madres y padres de menores con anomalías congénitas cardiacas. Gaceta Sanitaria 2016. [DOI: 10.1016/j.gaceta.2015.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Páramo-Rodríguez L, Mas Pons R, Cavero-Carbonell C, Martos-Jiménez C, Zurriaga Ó, Barona Vilar C. A corazón abierto: vivencias de madres y padres de menores con anomalías congénitas cardiacas. Gaceta Sanitaria 2015; 29:445-50. [DOI: 10.1016/j.gaceta.2015.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 07/17/2015] [Accepted: 07/20/2015] [Indexed: 10/23/2022]
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20
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Cavero-Carbonell C, Gimeno-Martos S, Páramo-Rodríguez L, Rabanaque-Hernández MJ, Martos-Jiménez C, Zurriaga O. Drugs use in pregnancy and congenital anomalies: identifying potential risks in the East of Spain. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv172.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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