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Pintos-Rodríguez S, Visos-Varela I, Rodríguez-Fernández A, Zapata-Cachafeiro M, Piñeiro-Lamas M, Herdeiro MT, García-Álvarez RM, Figueiras A, Salgado-Barreira Á. Outpatient Antipsychotic Use and Severe COVID-19: Avoiding the Impact of Age in a Real-World Data Study. Int J Neuropsychopharmacol 2024; 27:pyae020. [PMID: 38600711 DOI: 10.1093/ijnp/pyae020] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/10/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND The association between use of antipsychotics and COVID-19 outcomes is inconsistent, which may be linked to use of these drugs in age-related diseases. Furthermore, there is little evidence regarding their effect in the nongeriatric population. We aim to assess the association between antipsychotic use and risk of disease progression and hospitalization due to COVID-19 among the general population, stratifying by age. METHODS We conducted a population-based, multiple case-control study to assess risk of hospitalization, with cases being patients with a PCR(+) test who required hospitalization and controls being individuals without a PCR(+) test; and risk of progression to hospitalization, with cases being the same as those used in the hospitalization substudy and controls being nonhospitalized PCR(+) patients. We calculated adjusted odds-ratios (aOR) and 95% confidence intervals (CI), both overall and stratified by age. RESULTS Antipsychotic treatment in patients younger than 65 years was not associated with a higher risk of hospitalization due to COVID-19 (aOR 0.94 [95%CI = 0.69-1.27]) and disease progression among PCR(+) patients (aOR 0.96 [95%CI = 0.70-1.33]). For patients aged 65 years or older, however, there was a significant, increased risk of hospitalization (aOR 1.58 [95% CI = 1.38-1.80]) and disease progression (aOR 1.31 [95% CI = 1.12-1.55]). CONCLUSIONS The results of our large-scale real-world data study suggest that antipsychotic use is not associated with a greater risk of hospitalization due to COVID-19 and progression to hospitalization among patients younger than 65 years. The effect found in the group aged 65 years or older might be associated with off-label use of antipsychotics.
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Affiliation(s)
- Samuel Pintos-Rodríguez
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Irene Visos-Varela
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Almudena Rodríguez-Fernández
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maruxa Zapata-Cachafeiro
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - María Teresa Herdeiro
- Department of Medical Sciences, iBiMED-Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Rosa María García-Álvarez
- Santiago de Compostela Health Area, Galician Health Service (Servizo Galego de Saúde - SERGAS), Santiago de Compostela, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Adolfo Figueiras
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ángel Salgado-Barreira
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain
- Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
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Prieto-Campo Á, Zapata-Cachafeiro M, Portela-Romero M, Piñeiro-Lamas M, Figueiras A, Salgado-Barreira Á. Impact of prior use of antiplatelets on COVID-19 susceptibility, progression, and severity: a population-based study. Rev Esp Cardiol (Engl Ed) 2024:S1885-5857(24)00014-8. [PMID: 38191054 DOI: 10.1016/j.rec.2023.12.004] [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: 08/11/2023] [Accepted: 12/19/2023] [Indexed: 01/10/2024]
Abstract
INTRODUCTION AND OBJECTIVES Hypercoagulability and thromboembolism are processes that arise from severe acute respiratory syndrome coronavirus 2 infection and are responsible for a high degree of coronavirus disease 2019 (COVID-19)-related morbidity and mortality. This study sought to assess the effect of antiplatelet drugs on COVID-19 severity (risk of hospitalization and mortality), susceptibility to severe acute respiratory syndrome coronavirus 2 infection, and progression to severe COVID-19. METHODS We conducted a population-based case-control study in a northwestern region of Spain in 2020. The study involved 3060 participants with a positive polymerase chain reaction test who were hospitalized, 26 757 participants with a positive polymerase chain reaction test who were not hospitalized, and 56 785 healthy controls. RESULTS Triflusal seemed to be associated with a significant increase in risk of hospitalization (aOR, 1.97; 95%CI, 1.27-3.04) and susceptibility to infection (OR, 1.45; 95%CI, 1.07-1.96). It also appeared to lead to a nonsignificant increase in the risk of mortality (OR, 2.23; 95%CI, 0.89-5.55) and/or progression to more severe disease stages (OR, 1.42; 95%CI, 0.8-2.51). Aspirin seemed to be associated with a statistically significant decrease in susceptibility to severe acute respiratory syndrome coronavirus 2 infection (OR, 0.92; 95%CI, 0.86-0.98). CONCLUSIONS Triflusal use appears to increase the risk of susceptibility to COVID-19 infection and an even higher risk of hospitalization, whereas the other antiplatelets could be associated with a reduction in the risk of the various outcomes or have no effect on risk. These findings could support reconsideration of triflusal prescription in COVID-19 pandemic situations.
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Affiliation(s)
- Ángela Prieto-Campo
- Departamento de Salud Pública, Facultad de Farmacia, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Maruxa Zapata-Cachafeiro
- Departamento de Salud Pública, Facultad de Farmacia, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain.
| | - Manuel Portela-Romero
- Centro de Salud Concepción Arenal, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - María Piñeiro-Lamas
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain
| | - Adolfo Figueiras
- Departamento de Salud Pública, Facultad de Farmacia, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain
| | - Ángel Salgado-Barreira
- Departamento de Salud Pública, Facultad de Farmacia, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain
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Salgado-Barreira A, Seijas-Amigo J, Rodriguez-Mañero M, Piñeiro-Lamas M, Eiras S, Cordero A, Gonzalez-Juanatey JR, Figueiras A. Effect of dapagliflozin on COVID-19 infection and risk of hospitalization. J Antimicrob Chemother 2023; 78:2335-2342. [PMID: 37549309 PMCID: PMC10477113 DOI: 10.1093/jac/dkad241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/19/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Dapagliflozin has been proposed as a potential treatment for coronavirus disease 2019 (COVID-19) by reducing cytokine production and inflammation. However, there are limited data on its effectiveness. We aimed to evaluate the impact of dapagliflozin on COVID-19 severity (including hospitalization risk, ICU admission, in-hospital death and progression to severe COVID-19) and its potential on susceptibility to COVID-19 infection. METHODS We conducted a population-based case-control study. For aim 1, we assessed COVID-19 severity in cases (positive PCR patients requiring hospitalization) and matched controls (negative PCR patients or positive PCR patients not requiring hospitalization). For aim 2, we compared positive PCR cases (hospitalized and non-hospitalized) with controls. Adjusted odds ratios (aORs) were calculated using a generalized linear mixed model. RESULTS We analysed 86 602 subjects: 3060 were hospitalized cases, 26 757 were non-hospitalized cases and 56 785 were controls. Among the hospitalized COVID-19 patients, 228 were admitted to the ICU and 413 died. Dapagliflozin had no effect on the risk of hospitalization (aOR 0.98; 95% CI 0.65-1.48; P = 0.915), ICU admissions (aOR 1.21; 95% CI 0.34-4.25; P = 0.767) or in-hospital death (aOR 1.33; 95% CI 0.53-3.30; P = 0.543). Dapagliflozin reduced the risk of progression to severe COVID-19 by 35%, but this was not statistically significant (aOR 0.65; 95% CI 0.40-1.06; P = 0.086). Dapagliflozin was associated with a 30% increased risk of susceptibility to COVID-19 infection (aOR 1.31; 95% CI 1.05-1.62; P = 0.015). CONCLUSIONS Use of dapagliflozin prior to SARS-CoV-2 infection was not associated with an increased risk of hospitalization, ICU admission, mortality or progression to severe COVID-19. However, it was associated with an increased risk of susceptibility to COVID-19 infection.
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Affiliation(s)
- Angel Salgado-Barreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Jose Seijas-Amigo
- Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain
- Cardiology Department, Complejo Hospitalario Universidad de Santiago de Compostela, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Moises Rodriguez-Mañero
- Cardiology Department, Complejo Hospitalario Universidad de Santiago de Compostela, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Sonia Eiras
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
- Translational Cardiology Group, Institute of Biomedical Research of Santiago de Compostela (IDIS-SERGAS), Santiago de Compostela, Spain
| | - Alberto Cordero
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
- Cardiology Department, Hospital Universitario de San Juan, Alicante, Spain
- Unidad de Investigación en Cardiología, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
| | - Jose Ramon Gonzalez-Juanatey
- Cardiology Department, Complejo Hospitalario Universidad de Santiago de Compostela, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Carlos III Health Institute, Madrid, Spain
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Visos-Varela I, Zapata-Cachafeiro M, Pintos-Rodríguez S, Bugarín-González R, González-Barcala FJ, Herdeiro MT, Piñeiro-Lamas M, Figueiras A, Salgado-Barreira Á. Outpatient atorvastatin use and severe COVID-19 outcomes: A population-based study. J Med Virol 2023; 95:e28971. [PMID: 37486310 DOI: 10.1002/jmv.28971] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/09/2023] [Accepted: 07/05/2023] [Indexed: 07/25/2023]
Abstract
Evidence of the effect of statins on patients with coronavirus disease (2019) COVID-19 is inconsistent. The aim of this study was to evaluate the association between chronic use of statins-both overall and by active ingredient-and severe outcomes of COVID-19 (risk of hospitalization and mortality), progression to severe outcomes, and susceptibility to the virus. We conducted a population-based case-control study with data from electronic records to assess the risk of (1) hospitalization: cases were patients admitted due to COVID-19 and controls were subjects without COVID-19; (2) mortality: cases were hospitalized patients who died due to COVID-19 and controls were subjects without COVID-19; (3) progression: cases were hospitalized COVID-19 subjects and controls were nonhospitalized COVID-19 patients; and (4) susceptibility: cases were patients with COVID-19 (both hospitalized and nonhospitalized) and controls were subjects without COVID-19. We collected data on 2821 hospitalized cases, 26 996 nonhospitalized cases, and 52 318 controls. Chronic use of atorvastatin was associated with a decreased risk of hospitalization (adjusted odds ratios [aOR] = 0.83; 95% confidence interval [CI]: 0.74-0.92) and mortality (aOR = 0.70; 95% CI: 0.53-0.93), attributable in part to a lower risk of susceptibility to the virus (aOR = 0.91; 95% CI: 0.86-0.96). Simvastatin was associated with a reduced risk of mortality (aOR = 0.59; 95% CI: 0.40-0.87). The wide degree of heterogeneity observed in the estimated odds ratios (ORs) of the different statins suggests that there is no class effect. The results of this real-world study suggest that chronic use of atorvastatin (and to a lesser degree, of simvastatin) is associated with a decrease in risk of severe COVID-19 outcomes.
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Affiliation(s)
- Irene Visos-Varela
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
| | - Samuel Pintos-Rodríguez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Rosendo Bugarín-González
- Monforte de Lemos Health Center, Health Area of Lugo, A Mariña and Monforte de Lemos, SERGAS, Monforte de Lemos, Lugo, Spain
| | - Francisco Javier González-Barcala
- Spanish Biomedical Research Networking Centre-CIBERES, Santiago de Compostela, Spain
- Pneumoloxy Department, Santiago de Compostela University Hospital Complex, Santiago de Compostela, Spain
| | - Maria T Herdeiro
- Department of Medical Sciences, iBiMED-Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
| | - Ángel Salgado-Barreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
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Sáenz-Aldea M, Salgado-Barreira Á, Taracido-Trunk M, Piñeiro-Lamas M, Herdeiro MT, Portela-Romero M, Saez M, Figueiras A. RE: Colchicine and risk of hospitalization due to COVID-19: A population-based study. J Med Virol 2023; 95:e28741. [PMID: 37185845 DOI: 10.1002/jmv.28741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023]
Affiliation(s)
| | - Ángel Salgado-Barreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain
| | - Margarita Taracido-Trunk
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maria T Herdeiro
- Department of Medical Sciences, iBiMED-Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Manuel Portela-Romero
- Centro de Salud Concepción Arenal, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, Spain
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), University of Santiago de Compostela, Santiago de Compostela, Spain
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García TC, Ruano-Ravina A, Candal-Pedreira C, López-López R, Torres-Durán M, Enjo-Barreiro JR, Provencio M, Parente-Lamelas I, Vidal-García I, Martínez C, Hernández-Hernández J, Abdulkader-Nallib I, Castro-Añón O, Piñeiro-Lamas M, Varela-Lema L, Fernández-Villar A, Barros-Dios J, Pérez-Ríos M. Occupation as a risk factor of small cell lung cancer. Sci Rep 2023; 13:4727. [PMID: 36959236 PMCID: PMC10036470 DOI: 10.1038/s41598-023-31991-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/21/2023] [Indexed: 03/25/2023] Open
Abstract
Small cell lung cancer (SCLC) comprises approximately 10% of all lung cancer cases. Tobacco is its main risk factor; however, occupation might play a role in this specific lung cancer subtype. The effect of occupation on SCLC risk has been hardly studied and therefore we aim to assess the role of occupation on the risk of SCLC. To do this, we designed a multicentric, hospital-based, case-control study. Cases consisted exclusively in SCLC patients and controls were recruited from patients having minor surgery at the participating hospitals. Face to face interviews emphasizing occupation and tobacco consumption were held and residential radon was also measured. Logistic regression models were adjusted with odds ratios with 95%CI as estimations of the effect. 423 cases and 905 controls were included. Smoking prevalence was higher in cases compared to controls. Those who worked in known-risk occupations for lung cancer showed an OR of 2.17 (95%CI 1.33; 3.52), with a similar risk when men were analysed separately. The results were adjusted by age, sex, smoking and indoor radon exposure. Those who worked in known-risk occupations and were moderate or heavy smokers had a SCLC risk of 12.19 (95%CI 5.68-26.38) compared with never or moderate smokers who had not worked in such occupations. Occupation is a relevant risk factor of SCLC, and it seems that its effect is boosted when tobacco smoking is present.
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Affiliation(s)
- Teresa Curiel García
- Service of Medical Oncology, Santiago de Compostela University Hospital, Santiago de Compostela, Spain
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Medicina, Universidad de Santiago de Compostela, C/ San Francisco s/n., 15782, Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Medicina, Universidad de Santiago de Compostela, C/ San Francisco s/n., 15782, Santiago de Compostela, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Spain.
| | - Cristina Candal-Pedreira
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Medicina, Universidad de Santiago de Compostela, C/ San Francisco s/n., 15782, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Spain
| | - Rafael López-López
- Service of Medical Oncology, Santiago de Compostela University Hospital, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Spain
- Translational Medical Oncology Group (Oncomet), Roche-Chus Joint Unit, Santiago de Compostela, Spain
| | - María Torres-Durán
- NeumoVigo I+i Research Group, Department of Pneumology, Alvaro Cunqueiro University Teaching Hospital, Southern Galician Institute of Health Research (Instituto de Investigación Sanitaria Galicia Sur-IISGS), Vigo, Spain
| | - José Ramón Enjo-Barreiro
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Medicina, Universidad de Santiago de Compostela, C/ San Francisco s/n., 15782, Santiago de Compostela, Spain
| | - Mariano Provencio
- Service of Medical Oncology, Puerta del Hierro University Hospital of Madrid, Madrid, Spain
| | | | - Iria Vidal-García
- Service of Neumology, University Hospital Complex of A Coruña, A Coruña, Spain
| | - Cristina Martínez
- National Institute of Silicosis, University Hospital of Asturias, Oviedo, Spain
| | | | - Ihab Abdulkader-Nallib
- Service of Pathological Anatomy, University Hospital of Santiago de Compostela, A Coruña, Spain
| | - Olalla Castro-Añón
- Department of Pneumology, Lucus Augusti University Teaching Hospital, Lugo, Spain
- Grupo C039 Biodiscovery HULA-USC, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
| | - Leonor Varela-Lema
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Medicina, Universidad de Santiago de Compostela, C/ San Francisco s/n., 15782, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Spain
| | - Alberto Fernández-Villar
- NeumoVigo I+i Research Group, Department of Pneumology, Alvaro Cunqueiro University Teaching Hospital, Southern Galician Institute of Health Research (Instituto de Investigación Sanitaria Galicia Sur-IISGS), Vigo, Spain
| | - Juan Barros-Dios
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Medicina, Universidad de Santiago de Compostela, C/ San Francisco s/n., 15782, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Spain
| | - Mónica Pérez-Ríos
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Medicina, Universidad de Santiago de Compostela, C/ San Francisco s/n., 15782, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Spain
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Rodríguez-Fernández A, Vázquez-Cancela O, Piñeiro-Lamas M, Herdeiro MT, Figueiras A, Zapata-Cachafeiro M. Magnitude and determinants of inappropriate prescribing of antibiotics in dentistry: a nation-wide study. Antimicrob Resist Infect Control 2023; 12:20. [PMID: 36941734 PMCID: PMC10026418 DOI: 10.1186/s13756-023-01225-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 02/26/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Dentist play an important role in misuse of antibiotics. Identification of the dental activities linked to the misuse of antibiotics is important for improving dentists' prescribing quality. The aim of the study was to quantify the magnitude of inappropriate antibiotic prescribing by dentists in Spain and identify the characteristics, knowledge and attitudes that influence prescribing quality. MATERIAL AND METHODS We conducted a cross-sectional, questionnaire-based study on dentists in Spain, assessing prescribing quality (dependent variable) on the basis of their responses about the prescription of antibiotics in 14 clinical situations. As the independent variables, we assessed professional characteristics and attitudes (lack of knowledge, fear, complacency, scheduling problems, and economic benefit) measured on a Likert scale. Odds Ratios (OR) (95%CI) were calculated using logistic regression. RESULTS A total of 878 participants were included in the analysis. Half of all dentists displayed inappropriate antibiotic prescribing habits in more than 28.6% (10/14) of the clinical situations posed (interquartile range 57-79%). Prescribing quality increased when resistance was perceived as a public health problem (OR 0.88, 95% CI: 0.79-0.97), and decreased in response to fear (OR 1.12, 95% CI:1.07-1.18) or the pursuit of economic benefit (OR 1.07, 95% CI 1.01-1.14). Having over 30 years' experience (OR 4.58, 95% CI:1.80-12.48) and/or practising in the field of prosthodontics as opposed to endodontics (OR 2.65, 95% CI:1.26-5.71) were associated with worse prescribing quality. CONCLUSIONS Antibiotics are the most commonly prescribed drugs in dentistry, and in many cases this prescription is inappropriate. Our findings shows that modifiable factors influence prescribing quality among dentists in Spain. These may be use for designing educational and training programmes for dentists.
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Affiliation(s)
- Almudena Rodríguez-Fernández
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15706, Santiago de Compostela, A Coruña, Spain
| | - Olalla Vázquez-Cancela
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15706, Santiago de Compostela, A Coruña, Spain.
- Department of Preventive Medicine, Santiago de Compostela University Teaching Hospital, Santiago de Compostela, Spain.
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Teresa Herdeiro
- Department of Medical Sciences, Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15706, Santiago de Compostela, A Coruña, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15706, Santiago de Compostela, A Coruña, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain
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8
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Zapata-Cachafeiro M, Prieto-Campo Á, Portela-Romero M, Carracedo-Martínez E, Lema-Oreiro M, Piñeiro-Lamas M, Chaudhuri S, Salgado-Barreira Á, Figueiras A. Effect of Previous Anticoagulant Treatment on Risk of COVID-19. Drug Saf 2023; 46:273-281. [PMID: 36562942 PMCID: PMC9782265 DOI: 10.1007/s40264-022-01266-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Little is known about the role played by anticoagulants in COVID-19. OBJECTIVE The aim of this study was to assess the impact of previous anticoagulant treatment on risk of hospitalization due to COVID-19, progression to severe COVID-19 and susceptibility to COVID-19 infection. METHODS We conducted a multiple population-based case-control study in northwest Spain, in 2020, to assess (1) risk of hospitalization: cases were all patients admitted due to COVID-19 with PCR confirmation, and controls were a random matched sample of subjects without a positive PCR; (2) progression: cases were hospitalized COVID-19 subjects, and controls were all non-hospitalized COVID-19 patients; and (3) susceptibility: cases were patients with a positive PCR (hospitalized and non-hospitalized), and the controls were the same as for the hospitalization model. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using a generalized linear mixed model. RESULTS The consumption of antivitamin K and direct-acting anticoagulants apparently was not associated with the risk of progression to severe COVID-19 (OR 0.93 [95% CI 0.74-1.17] and OR 1.04 [95% CI 0.79-1.36], respectively). Antivitamin K anticoagulants were associated with a significantly lower risk of hospitalization (OR 0.77 [95% CI 0.64-0.93]), which, in part, can be explained by a decreased risk of susceptibility to infection (OR 0.83 [95% CI 0.74-0.92]). The use of direct-acting anticoagulants was not associated with the risk of hospitalization, although it also seems to decrease susceptibility (OR 0.85 [95% CI 0.74-0.98]). It has also been observed that low-molecular-weight heparins were associated with an increased risk of progression to severe COVID-19 (OR 1.25 [95% CI 1.01-1.55]). CONCLUSION The results of this study have shown that antivitamin K anticoagulants and direct-acting anticoagulants do not increase the risk of progression to more severe stages. Antivitamin K consumption was associated with a lower risk of hospitalization and susceptibility to infection.
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Affiliation(s)
- Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Ángela Prieto-Campo
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Manuel Portela-Romero
- Centro de Salud Concepción Arenal, Santiago de Compostela, A Coruña, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, Spain
| | - Eduardo Carracedo-Martínez
- Santiago de Compostela Health Area, Galician Health Service (Servizo Galego de Saúde-SERGAS), Santiago de Compostela, Spain
| | - Martina Lema-Oreiro
- Pharmaceutical Provision Management Service, Galician Health Service, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health, (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Somnath Chaudhuri
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ángel Salgado-Barreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health, (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain.
- Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
- Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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9
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Rodríguez-García C, Rodríguez-Ruiz E, Ruano-Raviña A, Cruz R, Piñeiro-Lamas M, Casal A, Lapunzina P, Carracedo Á, Valdés L, Valdés L. Is SARS-COV-2 associated with alpha-1 antitrypsin deficiency? J Thorac Dis 2023; 15:711-717. [PMID: 36910046 PMCID: PMC9992632 DOI: 10.21037/jtd-22-1062] [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] [Received: 09/02/2022] [Accepted: 12/23/2022] [Indexed: 01/31/2023]
Affiliation(s)
| | - Emilio Rodríguez-Ruiz
- Clinical University Hospital of Santiago, Santiago de Compostela, Spain.,Simulation, Life Support and Intensive Care Research Unit of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alberto Ruano-Raviña
- Preventive Medicine and Public Health Unit, University of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain.,Health Research Institute (IDIS), Santiago de Compostela, Spain
| | - Raquel Cruz
- Health Research Institute (IDIS), Santiago de Compostela, Spain.,Centre for Biomedical Network Research on Rare Diseases (CIBERER), Carlos III Health Institute, Madrid, Spain.,Genomic Medicine Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain.,Health Research Institute (IDIS), Santiago de Compostela, Spain
| | - Ana Casal
- Pulmonology Department, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
| | - Pablo Lapunzina
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Carlos III Health Institute, Madrid, Spain.,Institute of Medical and Molecular Genetics (INGEMM), University Hospital La Paz - IDIPAZ, Madrid, Spain
| | - Ángel Carracedo
- Health Research Institute (IDIS), Santiago de Compostela, Spain.,Centre for Biomedical Network Research on Rare Diseases (CIBERER), Carlos III Health Institute, Madrid, Spain.,Genomic Medicine Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela, Santiago de Compostela, Spain.,Galician Public Foundation for Genomic Medicine, Galician Health Service (SERGAS), Santiago de Compostela, Spain
| | - Luis Valdés
- Pulmonology Department, Clinical University Hospital of Santiago, Santiago de Compostela, Spain.,Health Research Institute (IDIS), Santiago de Compostela, Spain.,Medicine Department, University of Santiago, Santiago de Compostela, Spain
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10
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Sáenz-Aldea M, Salgado-Barreira Á, Taracido Trunk M, Piñeiro-Lamas M, Herdeiro MT, Portela-Romero M, Saez M, Figueiras A. Colchicine and risk of hospitalization due to COVID-19: A population-based study. J Med Virol 2023; 95:e28496. [PMID: 36639903 PMCID: PMC10107154 DOI: 10.1002/jmv.28496] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/23/2022] [Accepted: 01/11/2023] [Indexed: 01/15/2023]
Abstract
Colchicine is one of the most widely studied and best-known anti-inflammatory treatments. This study aimed to assess the effect of colchicine on risk of hospitalization due to COVID-19; and its effect on susceptibility to and severity of the virus in patients with COVID-19. We carried out a population-based case-control study. The following groups were applied: (1) to assess risk of hospitalization, cases were patients with a positive PCR who were hospitalized due to COVID-19, and controls without a positive PCR; (2) to assess susceptibility to COVID-19, cases were patients with a positive PCR (hospitalized and non-hospitalized), and the same controls; (3) to determine potential severity, cases were subjects with COVID-19 hospitalized, and controls patients with COVID-19 nonhospitalised. Different electronic, linked, administrative health and clinical databases were used to extract data on sociodemographic variables, comorbidities, and medications dispensed. The study covered 3060 subjects with a positive PCR who were hospitalized, 26 757 with a positive PCR who were not hospitalized, and 56 785 healthy controls. After adjustment for sociodemographic variables, comorbidities and other treatments, colchicine did not modify risk of hospitalization due to COVID-19 (adjusted odd ratio [OR] 1.08 [95% confidence interval (CI) 0.76-1.53]), patients' susceptibility to contracting the disease (adjusted OR 1.12 (95% CI 0.91-1.37)) or the severity of the infection (adjusted OR 1.03 [95% CI 0.67-1.59]). Our results would neither support the prophylactic use of colchicine for prevention of the infection or hospitalization in any type of patient, nor justify the withdrawal of colchicine treatment due to a higher risk of contracting COVID-19.
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Affiliation(s)
| | - Ángel Salgado-Barreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.,Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Margarita Taracido Trunk
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.,Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maria T Herdeiro
- Department of Medical Sciences, iBiMED-Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Manuel Portela-Romero
- Centro de Salud Concepción Arenal, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, Spain
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.,Institute of Health Research of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), University of Santiago de Compostela, Santiago de Compostela, Spain
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11
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Mallah N, Zapata-Cachafeiro M, Aguirre C, Ibarra-García E, Palacios-Zabalza I, Macías-García F, Piñeiro-Lamas M, Ibáñez L, Vidal X, Vendrell L, Martin-Arias L, Sáinz-Gil M, Velasco-González V, Bacariza-Cortiñas M, Salgado A, Estany-Gestal A, Figueiras A. Synergism interaction between genetic polymorphisms in drug metabolizing enzymes and NSAIDs on upper gastrointestinal haemorrhage: a multicenter case-control study. Ann Med 2022; 54:379-392. [PMID: 35114859 PMCID: PMC8820810 DOI: 10.1080/07853890.2021.2016940] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Interindividual genetic variations contribute to differences in patients' response to drugs as well as to the development of certain disorders. Patients who use non-steroidal anti-inflammatory drugs (NSAIDs) may develop serious gastrointestinal disorders, mainly upper gastrointestinal haemorrhage (UGIH). Studies about the interaction between NSAIDs and genetic variations on the risk of UGIH are scarce. Therefore, we investigated the effect of 16 single nucleotide polymorphisms (SNPs) involved in drug metabolism on the risk of NSAIDs-induced UGIH. MATERIALS AND METHODS We conducted a multicenter case-control study of 326 cases and 748 controls. Participants were sub-grouped into four categories according to NSAID exposure and genetic profile. We estimated odds ratios (ORs) and their 95% confidence intervals (CI) using generalized linear mixed models for dependent binomial variables and then calculated the measures of interaction, synergism index (S), and relative excess risk due to interaction (RERI). We undertook stratified analyses by the type of NSAID (aspirin, non-aspirin). RESULTS We observed an excess risk of UGIH due to an interaction between any NSAID, non-aspirin NSAIDs or aspirin and carrying certain SNPs. The greatest excess risk was observed for carriers of: rs2180314:C>G [any NSAID: S = 3.30 (95%CI: 1.24-8.80), RERI = 4.39 (95%CI: 0.70-8.07); non-aspirin NSAIDs: S = 3.42 (95%CI: 1.12-10.47), RERI = 3.97 (95%CI: 0.44-7.50)], and rs4809957:A>G [any NSAID: S = 2.11 (95%CI: 0.90-4.97), RERI = 3.46 (95%CI: -0.40-7.31)]. Aspirin use by carriers of rs6664:C>T is also associated with increased risk of UGIH [ORaspirin(+),wild-type: 2.22 (95%CI: 0.69-7.17) vs. ORaspirin(+),genetic-variation: 7.72 (95%CI: 2.75-21.68)], yet larger sample size is needed to confirm this observation. CONCLUSIONS The joint effect of the SNPs s2180314:C>G and rs4809957:A>G and NSAIDs are more than three times higher than the sum of their individual effects. Personalized prescriptions based on genotyping would permit a better weighing of risks and benefits from NSAID consumption.KEY MESSAGESMulticenter case-control study of the effect of genetic variations involved in drug metabolism on upper gastrointestinal haemorrhage (UGIH) induced by NSAIDs (aspirin and non-aspirin).There is a statistically significant additive synergism interaction between certain genetic polymorphisms and NSAIDs on UGIH: rs2180314:C>G and rs4809957:A>G. The joint effect of each of these single nucleotide polymorphisms and NSAIDs on UGIH is more than three times higher than the sum of their individual effects.Genetic profiling and personalized prescriptions would be useful in managing the risks and benefits associated with NSAIDs.
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Affiliation(s)
- Narmeen Mallah
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain.,Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Carlos III Health Institute, Madrid, Spain
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Carmelo Aguirre
- Pharmacotherapy Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Basque Country Pharmacovigilance Unit, University Hospital of Galdakao-Usansolo, Osakidetza, Spain.,Pharmacology Department, Medicine and Nursing Faculty, University of the Basque Country, Barakaldo, Spain
| | - Eguzkiñe Ibarra-García
- Pharmacotherapy Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Osakidetza Basque Health Service, Pharmacy Department, Urduliz Hospital, Urduliz, Spain
| | - Itziar Palacios-Zabalza
- Pharmacotherapy Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Basque Country Pharmacovigilance Unit, University Hospital of Galdakao-Usansolo, Osakidetza, Spain
| | - Fernando Macías-García
- Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Carlos III Health Institute, Madrid, Spain.,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Luisa Ibáñez
- Department of Pharmacology, Therapeutics and Toxicology, Catalonian Institute of Pharmacology, Clinical Pharmacology Service, Vall d'Hebron University Teaching Hospital, Autonomous University, Barcelona, Spain
| | - Xavier Vidal
- Department of Pharmacology, Therapeutics and Toxicology, Catalonian Institute of Pharmacology, Clinical Pharmacology Service, Vall d'Hebron University Teaching Hospital, Autonomous University, Barcelona, Spain
| | - Lourdes Vendrell
- Department of Pharmacology, Therapeutics and Toxicology, Catalonian Institute of Pharmacology, Clinical Pharmacology Service, Vall d'Hebron University Teaching Hospital, Autonomous University, Barcelona, Spain
| | - Luis Martin-Arias
- Centre for Research on Drug Safety (CESME), Valladolid University, Valladolid, Spain
| | - María Sáinz-Gil
- Centre for Research on Drug Safety (CESME), Valladolid University, Valladolid, Spain
| | | | | | - Angel Salgado
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ana Estany-Gestal
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Carlos III Health Institute, Madrid, Spain.,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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12
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Plácido AI, Aguiar A, Piñeiro-Lamas M, Varallo F, Figueiras A, Herdeiro MT, Roque F. Assessment of Potentially Inappropriate Medications Using the EU (7)-PIM List, in a Sample of Portuguese Older Adults' Residents in Nursing Homes. Risk Manag Healthc Policy 2022; 15:1343-1352. [PMID: 35860675 PMCID: PMC9289568 DOI: 10.2147/rmhp.s346300] [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] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 07/05/2022] [Indexed: 11/23/2022] Open
Abstract
Abstract Prescription of potentially inappropriate medication (PIM) in older adults is associated with poor clinical outcomes. The EU (7)-PIM list was created for the European market to improve pharmacotherapy in older adults. Purpose This work aims to characterize the medication profile and assess the presence of PIM, using the EU (7)-PIM list in older adults’ residents at nursing homes. Methods Retrospective data were collected from the anonymized nursing home records. After PIM identification, a descriptive analysis was performed, and a generalized linear model for dependent negative binomial-type variables was constructed to assess the risk of PIM. Results Of the 210 participants (mean age 85.10), 82.40% were polymedicated. PIM was observed in 86.4% participants (mean per patient = 2.30± 0.10). The most common PIM were proton pump inhibitors (n = 121, 57.62%), followed by anxiolytics (n = 96, 45.71%). 64.30% of all patients take 2–4 PIM and 5.80% take five or more PIM. The occurrence of PIM is influenced by the number of prescribed medicines (RR 1.14; 95% CI 1.1.-1.17) and the presence of digestive system diseases (RR 1.05; 95% CI 1.0–1.09). Conclusion The high prevalence of PIM observations highlights the necessity of the implementation of guidelines to prevent PIM.
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Affiliation(s)
- Ana Isabel Plácido
- Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), Guarda, Portugal
| | - Ana Aguiar
- Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), Guarda, Portugal
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.,Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Fabiana Varallo
- Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Adolfo Figueiras
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.,Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maria Teresa Herdeiro
- Institute of Biomedicine (iBiMED-UA), Department of Medical Sciences, University of Aveiro, Aveiro, 3810-193, Portugal
| | - Fátima Roque
- Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), Guarda, Portugal.,Health Sciences Research Centre, University of Beira Interior (CICS-UBI) Covilhã, Covilhã, Portugal
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13
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Enjo-Barreiro JR, Ruano-Ravina A, Pérez-Ríos M, Kelsey K, Varela-Lema L, Torres-Durán M, Parente-Lamelas I, Provencio-Pulla M, Vidal-García I, Piñeiro-Lamas M, Fernández-Villar JA, Barros-Dios JM. Radon, Tobacco Exposure and Non-Small Cell Lung Cancer Risk Related to BER and NER Genetic Polymorphisms. Arch Bronconeumol 2022; 58:311-322. [PMID: 35312585 DOI: 10.1016/j.arbres.2021.07.006] [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: 04/22/2021] [Revised: 07/06/2021] [Accepted: 07/14/2021] [Indexed: 11/02/2022]
Abstract
INTRODUCTION Tobacco consumption and radon exposure are considered the first and second most common causes of lung cancer, respectively. The aim of this study was to analyze both whether selected genetic polymorphisms in loci that are in DNA repair pathways, are related to non-small-cell lung cancer (NSCLC) and whether they may modulate the association between residential radon exposure and lung cancer in both smokers and never smokers. METHODS A multicentre, hospital-based, case-control study with 826 cases and 1201 controls was designed in a radon-prone area. Genotyping was determined in whole blood and residential radon exposure was measured in participants' dwellings. RESULTS Attending to tobacco exposure, the variant in the gene NBN (rs1805794) was associated with lung cancer in never smokers (OR 2.72; 95%1.44-5.2) and heavy smokers (OR 3.04; 95%CI 1.21-7.69). The polymorphism with the highest lung cancer association was OGG1 (rs125701), showing an OR of 8.04 (95%CI 1.64-58.29) for its homozygous variant genotype in heavy smokers. Attending to indoor radon exposure (>200Bq/m3), rs1452584, for its homozygous variant genotype, showed the highest association (OR 3.04 (95%CI 1.15-8.48). CONCLUSION The genes analyzed seem to have no association with the fully adjusted model, but they might modulate lung cancer association when different categories of tobacco consumption are considered (i.e. heavy smokers). This association may similarly be elevated for those individuals having high indoor radon exposures, though at a minor extent.
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Affiliation(s)
- José Ramón Enjo-Barreiro
- Service of Preventive Medicine, University Complex of Santiago de Compostela, Spain; Department of Preventive Medicine, Santiago de Compostela University Teaching Hospital Complex, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine, Santiago de Compostela University Teaching Hospital Complex, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Spain.
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine, Santiago de Compostela University Teaching Hospital Complex, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Spain
| | - Karl Kelsey
- Department of Epidemiology, Brown School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Leonor Varela-Lema
- Department of Preventive Medicine, Santiago de Compostela University Teaching Hospital Complex, Santiago de Compostela, Spain
| | | | | | | | - Iria Vidal-García
- Service of Neumology, University Hospital Complex of A Coruña, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain
| | | | - Juan M Barros-Dios
- Service of Preventive Medicine, University Complex of Santiago de Compostela, Spain; Department of Preventive Medicine, Santiago de Compostela University Teaching Hospital Complex, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain
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Carracedo-Martínez E, Vázquez-Mourelle R, Figueiras A, Piñeiro-Lamas M. Impact on In- and Outpatient Hospital Drug Prescriptions of Including a More Expensive Me-Too Antidepressant in a Hospital Drug Formulary: a Controlled Longitudinal Study. Pharmacoepidemiol Drug Saf 2021; 31:556-565. [PMID: 34965012 DOI: 10.1002/pds.5405] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 11/08/2021] [Accepted: 12/23/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND The effect of the inclusion of a more expensive me-too medicine in a hospital drug formulary (HDF) on both in- and out-of-hospital utilization, and the contextual factors which influence this type of induction is rarely studied. Accordingly, this work aimed to quantify the effect of the decision of a hospital of including a more expensive me-too antidepressant in its HDF. METHODS A controlled longitudinal study was carried out in a Regional Health Service of Spain. We performed a segmented regression analysis with control group. We used the following dependent variables: defined daily doses (DDD) per 1000 inhabitants per day, DDD per 100 bed days, and cost per DDD. RESULTS At a hospital level, the modification in the formulary led to utilization changes: (1) an increase in immediate consumption of the newly included me-too drug; and, (2) an annual 25.96% [95%CI: 2.96%-48.95%] decrease in the adjusted trend of the already existing parent antidepressant. The adjusted trend of the cost per DDD of the sum of all medications in the therapeutic group increased by 20.03% annually [95%CI:3.24%-36.82%]. In the out-of-hospital setting utilization changes were: (1) the adjusted trend of the newly included me-too drug rose by 12.14% annually [95%CI:4.97%-19.30%]; and, (2) that of the parent drug underwent a negative change in trend of 4.18% annually [95%CI: 0.00%-8.36%]. CONCLUSIONS The inclusion of a more expensive me-too drug in the HDF led to increased consumption of this more expensive me-too drug both in- and out-of-hospital. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Eduardo Carracedo-Martínez
- Santiago de Compostela Health Area. Galician Health Service (Servizo Galego de Saúde - SERGAS). Spanish National Health System, Spain
| | - Raquel Vázquez-Mourelle
- Deputy Directorate-General Galician Health Service (Servicio Gallego de Salud SERGAS), Galicia Regional Authority, Santiago de Compostela, Galicia, Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP).,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Galicia, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP).,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Galicia, Spain
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15
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Fernández-Riveiro P, Obregón-Rodríguez N, Piñeiro-Lamas M, Rodríguez-Fernández A, Smyth-Chamosa E, Suárez-Cunqueiro MM. The Dental Aesthetic Index and Its Association with Dental Caries, Dental Plaque and Socio-Demographic Variables in Schoolchildren Aged 12 and 15 Years. Int J Environ Res Public Health 2021; 18:ijerph18189741. [PMID: 34574666 PMCID: PMC8468568 DOI: 10.3390/ijerph18189741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/01/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022]
Abstract
The Dental Aesthetic Index (DAI) was determined in 12- and 15-year-old schoolchildren to ascertain the prevalence of malocclusion and to assess its association with dental caries experience, dental plaque accumulation, and socio-demographic variables. We performed a cross-sectional study with a stratified two-stage sampling design. An oral health survey and oral examination were conducted, and socio-demographic data were recorded. The sample comprised 1453 schoolchildren aged 12 (868) and 15 (585). These two samples were analyzed separately because statistically significant differences were found: the 12-year-old age group displayed a higher frequency of schoolchildren who attended state-run public schools (p = 0.004) and belonged to a lower social class (p = 0.001); the 15-year-old age group registered higher levels of caries (p = 0.001) and lower levels of dental plaque (p < 0.001). The malocclusion was 9.5% higher (p = 0.001), and the global mean DAI score was likewise higher among the 12-year-olds (p < 0.001). The multivariate regression analysis not only showed that caries and dental plaque were the variables that were the most strongly associated with malocclusion, but that caries (OR = 1.5) and dental plaque (OR > 2) were also risk factors for malocclusion in both groups. In conclusion, this study revealed a higher prevalence of malocclusion and dental plaque at age 12. A higher risk of caries and dental plaque was found to be related to the presence of malocclusion in both age groups.
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Affiliation(s)
- Paula Fernández-Riveiro
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Medicine and Dentistry School, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (P.F.-R.); (E.S.-C.)
| | - Nerea Obregón-Rodríguez
- Department of Surgery and Medical Surgical Specialties, Medicine and Dentistry School, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain;
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER of Epidemiology and Public Health, CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Almudena Rodríguez-Fernández
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Medicine and Dentistry School, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (P.F.-R.); (E.S.-C.)
- Correspondence: (A.R.-F.); (M.M.S.-C.); Tel.: +34-881812437 (A.R.-F.); +34-881812437 (M.M.S.-C.)
| | - Ernesto Smyth-Chamosa
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Medicine and Dentistry School, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (P.F.-R.); (E.S.-C.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER of Epidemiology and Public Health, CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - María Mercedes Suárez-Cunqueiro
- Department of Surgery and Medical Surgical Specialties, Medicine and Dentistry School, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain;
- Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital of Santiago de Compostela (CHUS/SERGAS), 15782 Santiago de Compostela, Spain
- Correspondence: (A.R.-F.); (M.M.S.-C.); Tel.: +34-881812437 (A.R.-F.); +34-881812437 (M.M.S.-C.)
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16
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Ferreiro L, Ruano-Raviña A, Otero-Mallo R, Pou-Álvarez C, Riveiro-Blanco V, Casal A, Suárez-Antelo J, Toubes ME, Cruz-Ferro E, Rodríguez-Núñez N, Ursúa-Díaz MI, Lama A, Piñeiro-Lamas M, Rábade C, Zamarrón C, González-Barcala FJ, Valiño-López P, Anibarro L, Taboada-Rodríguez JA, Valdés L. Recent epidemiological trends in extrapulmonary TB in Galicia, Spain. Int J Tuberc Lung Dis 2021; 25:373-381. [PMID: 33977905 DOI: 10.5588/ijtld.20.0910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE: To describe the epidemiological trends and characteristics of extrapulmonary tuberculosis (EPTB) in Galicia, Spain, from 2000 to 2019.METHODS: This was a retrospective cohort study based on data from the Galician TB information system.RESULTS: Of the total number of TB cases (n = 15,871), 5,428 (34.2%) had EPTB. The absolute number of cases and incidence of EPTB decreased dramatically (from 480 cases and 17.8 cases/100,000 in 2000, to 172 and 6.4 cases/100,000 in 2019, respectively), with a mean annual decrease of respectively 64% and 4.7% for absolute cases and incidence rates. The risk for EPTB was higher in men than in women (RR 3.86, 95% CI 3.66-4.07). The most frequent age group was 15-44 years (2,234 patients, 41.2%); overall reductions per age group were 82% (0-14 years), 75% (15-44 years), 44% (45-64 years) and 63% (≥65 years), with statistically significant differences. The most frequently locations were the pleura (1,916 cases; 35.3%) and the lymph nodes (1,504; 27.7%).CONCLUSION: The incidence of EPTB in Galicia has decreased significantly in the last 20 years. The epidemiological characteristics have not changed, except for the number of patients with risk factors. This improvement of EPTB epidemiological trends coincides with the implementation of the programme for the prevention and control of TB, which suggests that it has been very effective in the control of the EPTB.
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Affiliation(s)
- L Ferreiro
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago de Compostela, Santiago de Compostela, Spain
| | - A Ruano-Raviña
- Departamento de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - R Otero-Mallo
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - C Pou-Álvarez
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - V Riveiro-Blanco
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - A Casal
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - J Suárez-Antelo
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - M E Toubes
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - E Cruz-Ferro
- Programa Gallego de Prevención y Control de la Tuberculosis, Dirección General de Innovación y Gestión de la Salud Pública, Consellería de Sanidad, Xunta de Galicia, Santiago de Compostela, Spain
| | - N Rodríguez-Núñez
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - M I Ursúa-Díaz
- Programa Gallego de Prevención y Control de la Tuberculosis, Dirección General de Innovación y Gestión de la Salud Pública, Consellería de Sanidad, Xunta de Galicia, Santiago de Compostela, Spain
| | - A Lama
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - M Piñeiro-Lamas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - C Rábade
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - C Zamarrón
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain
| | - F J González-Barcala
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago de Compostela, Santiago de Compostela, Spain
| | - P Valiño-López
- Servicio de Neumología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - L Anibarro
- Unidad de Tuberculosis, Enfermedades Infecciosas, Servicio de Medicina Interna, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - J A Taboada-Rodríguez
- Programa Gallego de Prevención y Control de la Tuberculosis, Dirección General de Innovación y Gestión de la Salud Pública, Consellería de Sanidad, Xunta de Galicia, Santiago de Compostela, Spain
| | - L Valdés
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago de Compostela, Santiago de Compostela, Spain
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Rodríguez-Martínez Á, Ruano-Ravina A, Torres-Durán M, Provencio M, Parente-Lamelas I, Vidal-García I, Martínez C, Hernández-Hernández J, Abdulkader-Nallib I, Castro-Añón O, Varela-Lema L, Piñeiro-Lamas M, Fidalgo PS, Fernández-Villar A, Barros-Dios J, Pérez-Ríos M. Residential Radon and Small Cell Lung Cancer. Final Results of the Small Cell Study. Arch Bronconeumol 2021; 58:S0300-2896(21)00052-1. [PMID: 33744027 DOI: 10.1016/j.arbres.2021.01.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/06/2021] [Accepted: 01/26/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Residential radon is considered the second cause of lung cancer and the first in never smokers. Nevertheless, there is little information regarding the association between elevated radon levels and small cell lung cancer (SCLC). We aimed to assess the effect of residential radon exposure on the risk of SCLC in general population through a multicentric case-control study. METHODS A multicentric hospital-based case-control study was designed including 9 hospitals from Spain and Portugal, mostly including radon-prone areas. Indoor radon was measured using Solid State Nuclear Track Detectors at the Galician Radon Laboratory. RESULTS A total of 375 cases and 902 controls were included, with 24.5% of cases being women. The median number of years living in the measured dwelling was higher than 25 years for both cases and controls. There was a statistically significant association for those exposed to concentrations higher than the EPA action level of 148Bq/m3, with an Odds Ratio of 2.08 (95%CI: 1.03-4.39) compared to those exposed to concentrations lower than 50Bq/m3. When using a dose-response model with 100Bq/m3 as a reference, it can be observed a linear effect for small cell lung cancer risk. Smokers exposed to higher radon concentrations pose a much higher risk of SCLC compared to smokers exposed to lower indoor radon concentrations. CONCLUSIONS Radon exposure seems to increase the risk of small cell lung cancer with a linear dose-response pattern. Tobacco consumption may also produce an important effect modification for radon exposure.
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Affiliation(s)
- Ángeles Rodríguez-Martínez
- Service of Medical Oncology, University Hospital Complex of Pontevedra, Spain; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain; Instituto de Investigaciones Sanitarias de Santiago de Compostela (IDIS), Spain.
| | | | - Mariano Provencio
- Service of Medical Oncology, Puerta del Hierro University Hospital of Madrid, Spain
| | | | - Iria Vidal-García
- Service of Neumology, University Hospital Complex of A Coruña, Spain
| | - Cristina Martínez
- National Institute of Silicosis, University Hospital of Asturias, Oviedo, Spain
| | | | | | | | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain; Instituto de Investigaciones Sanitarias de Santiago de Compostela (IDIS), Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain
| | | | | | - Juan Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain; Service of Preventive Medicine, University Complex of Santiago de Compostela, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain; Instituto de Investigaciones Sanitarias de Santiago de Compostela (IDIS), Spain
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18
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Figueiras A, López-Vázquez P, Gonzalez-Gonzalez C, Vázquez-Lago JM, Piñeiro-Lamas M, López-Durán A, Sánchez C, Herdeiro MT, Zapata-Cachafeiro M. Impact of a multifaceted intervention to improve antibiotic prescribing: a pragmatic cluster-randomised controlled trial. Antimicrob Resist Infect Control 2020; 9:195. [PMID: 33287881 PMCID: PMC7722452 DOI: 10.1186/s13756-020-00857-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 11/18/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This study sought to assess the effectiveness and return on investment (ROI) of a multifaceted intervention aimed at improving antibiotic prescribing for acute respiratory infections in primary care. DESIGN Large-sized, two-arm, open-label, pragmatic, cluster-randomised controlled trial. SETTING All primary care physicians working for the Spanish National Health Service (NHS) in Galicia (region in north-west Spain). PARTICIPANTS The seven spatial clusters were distributed by unequal randomisation (3:4) of the intervention and control groups. A total of 1217 physicians (1.30 million patients) were recruited from intervention clusters and 1393 physicians (1.46 million patients) from control clusters. INTERVENTIONS One-hour educational outreach visits tailored to training needs identified in a previous study; an online course integrated in practice accreditation; and a clinical decision support system. MAIN OUTCOME MEASURES Changes in the ESAC (European Surveillance of Antimicrobial Consumption) quality indicators for outpatient antibiotic use. We used generalised linear mixed and conducted a ROI analysis to ascertain the overall cost savings. RESULTS Median follow-up was 19 months. The adjusted effect on overall antibiotic prescribing attributable to the intervention was - 4.2% (95% CI: - 5.3% to - 3.2%), with this being more pronounced for penicillins - 6.5 (95% CI: - 7.9% to - 5.2%) and for the ratio of consumption of broad- to narrow-spectrum penicillins, cephalosporins, and macrolides - 9.0% (95% CI: - 14.0 to - 4.1%). The cost of the intervention was €87 per physician. Direct savings per physician attributable to the reduction in antibiotic prescriptions was €311 for the NHS and €573 for patient contributions, with an ROI of €2.57 and €5.59 respectively. CONCLUSIONS Interventions designed on the basis of gaps in physicians' knowledge of and attitudes to misprescription can improve antibiotic prescribing and yield important direct cost savings. TRIAL REGISTRATION Current Controlled Trials ISRCTN24158380 . Registered 5 February 2009.
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Affiliation(s)
- Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública- CIBERESP), Santiago de Compostela, Spain.
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| | - Paula López-Vázquez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain
| | - Cristian Gonzalez-Gonzalez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain
| | - Juan Manuel Vázquez-Lago
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública- CIBERESP), Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Ana López-Durán
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Coro Sánchez
- Pontevedra Primary Care Service, SERGAS Eoxi Pontevedra-Salnés, Pontevedra, Spain
| | - María Teresa Herdeiro
- Department of Medical Sciences & Institute for Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública- CIBERESP), Santiago de Compostela, Spain
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19
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Casal-Mouriño A, Ruano-Ravina A, Torres-Durán M, Parente-Lamelas I, Provencio-Pulla M, Castro-Añón O, Vidal-García I, Abal-Arca J, Piñeiro-Lamas M, Fernández-Villar A, Valdés-Cuadrado L, Barros-Dios JM, Pérez-Ríos M. Polymorphisms in the BER and NER pathways and their influence on survival and toxicity in never-smokers with lung cancer. Sci Rep 2020; 10:21147. [PMID: 33273562 PMCID: PMC7713126 DOI: 10.1038/s41598-020-78051-5] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/11/2020] [Indexed: 01/05/2023] Open
Abstract
Polymorphisms in DNA repair pathways may play a relevant role in lung cancer survival in never-smokers. Furthermore, they could be implicated in the response to chemotherapy and toxicity of platinum agents. The aim of this study was to evaluate the influence of various genetic polymorphisms in the BER and NER DNA repair pathways on survival and toxicity in never-smoker LC patients. The study included never-smokers LC cases diagnosed from 2011 through 2019, belonging to the Lung Cancer Research In Never Smokers study. A total of 356 never-smokers cases participated (79% women; 83% adenocarcinoma and 65% stage IV). Survival at 3 and 5 years from diagnosis was not associated with genetic polymorphisms, except in the subgroup of patients who received radiotherapy or chemo-radiotherapy, and presented with ERCC1 rs3212986 polymorphism. There was greater toxicity in those presenting OGG1 rs1052133 (CG) and ERCC1 rs11615 polymorphisms among patients treated with radiotherapy or chemo-radiotherapy, respectively. In general, polymorphisms in the BER and NER pathways do not seem to play a relevant role in survival and response to treatment among never-smoker LC patients.
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Affiliation(s)
- Ana Casal-Mouriño
- Department of Pneumology, Santiago de Compostela University Clinical Teaching Hospital, Santiago de Compostela, Spain.,Department of Preventive Medicine and Public Health, University of Santiago de Compostela, C/San Francisco s/n, 15782, Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, C/San Francisco s/n, 15782, Santiago de Compostela, Spain. .,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología and Salud Pública-CIBERESP), Madrid, Spain. .,C013 Group-Health Research Institute of Santiago de Compostela (Instituto Investigación Sanitaria de Santiago de Compostela/IDIS), Santiago de Compostela, Spain.
| | - María Torres-Durán
- Department of Pneumology, Vigo University Teaching Hospital Complex, Vigo, Spain
| | | | | | | | - Iria Vidal-García
- Department of Pneumology, A Coruña University Teaching Hospital Complex, Vigo, Spain
| | - José Abal-Arca
- Department of Pneumology, Ourense University Teaching Hospital Complex, Ourense, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología and Salud Pública-CIBERESP), Madrid, Spain
| | | | - Luis Valdés-Cuadrado
- Department of Pneumology, Santiago de Compostela University Clinical Teaching Hospital, Santiago de Compostela, Spain.,Interdisciplinary Neumology Research Group, Health Research Institute of Santiago de Compostela (Instituto Investigación Sanitaria de Santiago de Compostela/IDIS), Santiago de Compostela, Spain
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, C/San Francisco s/n, 15782, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología and Salud Pública-CIBERESP), Madrid, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, C/San Francisco s/n, 15782, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología and Salud Pública-CIBERESP), Madrid, Spain.,C013 Group-Health Research Institute of Santiago de Compostela (Instituto Investigación Sanitaria de Santiago de Compostela/IDIS), Santiago de Compostela, Spain
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Lorenzo-Gonzalez M, Ruano-Ravina A, Torres-Duran M, Kelsey KT, Provencio M, Parente-Lamelas I, Piñeiro-Lamas M, Varela-Lema L, Perez-Rios M, Fernandez-Villar A, Barros-Dios JM. Lung cancer risk and residential radon exposure: A pooling of case-control studies in northwestern Spain. Environ Res 2020; 189:109968. [PMID: 32736146 DOI: 10.1016/j.envres.2020.109968] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 06/09/2020] [Revised: 06/20/2020] [Accepted: 07/16/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Through a pooled case-control study design, we have assessed the relationship between residential radon exposure and lung cancer risk. Other objectives of the study were to evaluate the different risk estimates for the non-small cell lung cancer histological types and to assess the effect modification of the radon exposure on lung cancer risk by tobacco consumption. METHODS We collected individual data from various case-control studies performed in northwest Spain that investigated residential radon and lung cancer. Cases had a confirmed anatomopathological diagnosis of primary lung cancer and controls were selected because they were undergoing ambulatory evaluation or surgical procedures that were unrelated to tobacco use. Residential radon was measured using alpha track detectors. Results were analyzed using logistic regression. RESULTS 3704 participants were enrrolled, 1842 cases and 1862 controls. Data show that lung cancer risk increases with radon exposure, finding a significant association of radon exposure with lung cancer at radon exposures above 50 Bq/m3. The estimated adjusted OR for individuals exposed to concentrations >200 Bq/m3 was 2.06 (95% CI: 1.61-2.64) compared with those exposed to ≤50 Bq/m3. Within a smoking category, lung cancer risk increases markedly as radon concentration increases, reaching an OR of 29.3 (95% CI: 15.4-55.7) for heavy smokers exposed to more than 200 Bq/m.3 CONCLUSIONS: This study confirms that residential radon exposure is a risk factor for lung cancer well below action levels established by international organizations. As expected, there is also an effect modification between radon exposure and tobacco consumption.
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Affiliation(s)
- María Lorenzo-Gonzalez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública- CIBERESP), Spain; Department of Epidemiology, Brown School of Public Health, Brown University, Providence, RI, USA.
| | | | - Karl T Kelsey
- Department of Epidemiology, Brown School of Public Health, Brown University, Providence, RI, USA
| | - Mariano Provencio
- Service of Oncology, Puerta de Hierro University Hospital, Madrid, Spain
| | | | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública- CIBERESP), Spain
| | - Leonor Varela-Lema
- Galician Agency for Health Technology Assessment, Avalia-t. ACIS, SERGAS. Galician Health Service, Spain
| | - Monica Perez-Rios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública- CIBERESP), Spain
| | | | - Juan M Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública- CIBERESP), Spain; Service of Preventive Medicine, University Hospital Complex of Santiago de Compostela, Spain
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21
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Piñeiro-Lamas M, Taracido M, Figueiras A. La ruleta rusa de los análisis estadísticos de estudios clínicos. Una reflexión para lectores y autores. Arch Bronconeumol 2020. [DOI: 10.1016/j.arbres.2019.10.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Piñeiro-Lamas M, Taracido M, Figueiras A. The Russian Roulette of Statistical Analysis in Clinical Trials. Some Considerations for Readers and Authors. Arch Bronconeumol 2020; 56:547-548. [PMID: 35373764 DOI: 10.1016/j.arbr.2019.10.016] [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] [Received: 06/04/2019] [Accepted: 10/22/2019] [Indexed: 06/14/2023]
Affiliation(s)
- María Piñeiro-Lamas
- Consorcio de Investigación Biomédica en Epidemiología y Salud Pública (CIBER en Epidemiología y Salud Pública), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain
| | - Margarita Taracido
- Consorcio de Investigación Biomédica en Epidemiología y Salud Pública (CIBER en Epidemiología y Salud Pública), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Adolfo Figueiras
- Consorcio de Investigación Biomédica en Epidemiología y Salud Pública (CIBER en Epidemiología y Salud Pública), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, Spain.
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23
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Casal-Mouriño A, Ruano-Ravina A, Torres-Durán M, Parente-Lamelas I, Provencio-Pulla M, Castro-Añón O, Vidal-García I, Pena-Álvarez C, Abal-Arca J, Piñeiro-Lamas M, Fuente-Merino I, Fernández-Villar A, Abdulkader I, Valdés-Cuadrado L, Barros-Dios JM, Pérez-Ríos M. Corrigendum to "Lung cancer survival in never-smokers and exposure to residential radon: Results of the LCRINS study" [Canc. Lett. 487 (2020) 21-26]. Cancer Lett 2020; 493:10. [PMID: 32810636 DOI: 10.1016/j.canlet.2020.07.020] [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: 11/18/2022]
Affiliation(s)
- Ana Casal-Mouriño
- Department of Pneumology, Santiago de Compostela University Clinical Teaching Hospital, Santiago de Compostela, Spain; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública - CIBERESP), Spain.
| | - María Torres-Durán
- Department of Pneumology, Vigo University Teaching Hospital Complex, Vigo, Spain
| | | | | | | | - Iria Vidal-García
- Department of Pneumology, A Coruña University Teaching Hospital Complex, Spain
| | | | - José Abal-Arca
- Department of Pneumology, Ourense University Teaching Hospital Complex, Ourense, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública - CIBERESP), Spain
| | - Ismael Fuente-Merino
- Environmental Radioactivity Laboratory (Laboratorio de Radiactividad Ambiental - LARUC), University of Cantabria, Spain
| | | | - Ihab Abdulkader
- Department of Pathology, Clinic University Hospital of Santiago de Compostela, Spain
| | - Luis Valdés-Cuadrado
- Department of Pneumology, Santiago de Compostela University Clinical Teaching Hospital, Santiago de Compostela, Spain; Interdisciplinary Neumology Research Group, Health Research Institute of Santiago de Compostela (Instituto Investigación Sanitaria de Santiago de Compostela/IDIS), Spain
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública - CIBERESP), Spain; Department of Preventive Medicine, Santiago de Compostela University Teaching Hospital Complex, Santiago de Compostela, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública - CIBERESP), Spain
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24
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Mallah N, Zapata-Cachafeiro M, Aguirre C, Ibarra-García E, Palacios-Zabalza I, Macías-García F, Domínguez-Muñoz JE, Piñeiro-Lamas M, Ibáñez L, Vidal X, Vendrell L, Martin-Arias L, Sáinz-Gil M, Velasco-González V, Figueiras A. Corrigendum: Influence of Polymorphisms Involved in Platelet Activation and Inflammatory Response on Aspirin-Related Upper Gastrointestinal Bleeding: A Case-Control Study. Front Pharmacol 2020; 11:1072. [PMID: 32765275 PMCID: PMC7379888 DOI: 10.3389/fphar.2020.01072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 07/01/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Narmeen Mallah
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Carmelo Aguirre
- Biocruces Bizkaia Health Research Institute, Pharmacotherapy Group, Bizkaia, Spain.,University Hospital of Galdakao-Usansolo. Basque Country Pharmacovigilance Unit, Osakidetza, Spain.,Pharmacology Department, Medicine and Nursing Faculty, University of the Basque Country, Barakaldo, Bizkaia, Spain
| | - Eguzkiñe Ibarra-García
- Biocruces Bizkaia Health Research Institute, Pharmacotherapy Group, Bizkaia, Spain.,Osakidetza Basque Health Service, Urduliz Hospital, Pharmacy Department, Urduliz, Spain
| | - Itziar Palacios-Zabalza
- Biocruces Bizkaia Health Research Institute, Pharmacotherapy Group, Bizkaia, Spain.,University Hospital of Galdakao-Usansolo. Basque Country Pharmacovigilance Unit, Osakidetza, Spain
| | - Fernando Macías-García
- Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - J Enrique Domínguez-Muñoz
- Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Carlos III Health Institute, Madrid, Spain.,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Luisa Ibáñez
- Department of Pharmacology, Therapeutics and Toxicology, Catalonian Institute of Pharmacology, Clinical Pharmacology Service, Vall d'Hebron University Teaching Hospital, Autonomous University, Barcelona, Spain
| | - Xavier Vidal
- Department of Pharmacology, Therapeutics and Toxicology, Catalonian Institute of Pharmacology, Clinical Pharmacology Service, Vall d'Hebron University Teaching Hospital, Autonomous University, Barcelona, Spain
| | - Lourdes Vendrell
- Department of Pharmacology, Therapeutics and Toxicology, Catalonian Institute of Pharmacology, Clinical Pharmacology Service, Vall d'Hebron University Teaching Hospital, Autonomous University, Barcelona, Spain
| | - Luis Martin-Arias
- Centre for Research on Drug Safety (CESME), Valladolid University, Valladolid, Spain
| | - María Sáinz-Gil
- Centre for Research on Drug Safety (CESME), Valladolid University, Valladolid, Spain
| | | | - Adolfo Figueiras
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Carlos III Health Institute, Madrid, Spain.,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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25
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Mallah N, Zapata-Cachafeiro M, Aguirre C, Ibarra-García E, Palacios-Zabalza I, Macías-García F, Domínguez-Muñoz JE, Piñeiro-Lamas M, Ibáñez L, Vidal X, Vendrell L, Martin-Arias L, Sáinz-Gil M, Velasco-González V, Figueiras A. Influence of Polymorphisms Involved in Platelet Activation and Inflammatory Response on Aspirin-Related Upper Gastrointestinal Bleeding: A Case-Control Study. Front Pharmacol 2020; 11:860. [PMID: 32655394 PMCID: PMC7325915 DOI: 10.3389/fphar.2020.00860] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/26/2020] [Indexed: 12/13/2022] Open
Abstract
Background Despite the wide benefits of aspirin and its cost-effectiveness, aspirin prescriptions have been reduced due to idiosyncratic responses in susceptible individuals. Low-dose aspirin and single-nucleotide polymorphisms (SNPs) are independently associated with increased risk of gastrointestinal hemorrhage; however, to-date, no studies investigated the SNP-aspirin interaction effect on upper gastrointestinal hemorrhage (UGIH). Therefore, we aimed to evaluate the role of 25 SNPs in multiple genes involved in platelet activation, angiogenesis and inflammatory response in aspirin-related UGIH. Methods A multicenter, full case–control study was conducted in patients exposed and unexposed to aspirin. Three hundred twenty-six cases diagnosed with UGIH were matched with 748 controls (1:3) by age, gender, health center, and recruitment date. Only adults of European origin were included. Participants were stratified by aspirin exposure and genotype [(Aspirin(−), wild-type), (Aspirin(+), wild-type), (Aspirin(+), genetic variation), (Aspirin(−), genetic variation)]. For each SNP, the Odds Ratio of UGIH and their 95% confidence intervals were estimated in each subgroup by using the generalized linear mixed models for dependent binomial variables. SNP-aspirin interaction effect was estimated through Relative Excess Risk due to Interaction (RERI) measures. Results We observed two categories of SNPs that might modify the risk magnitude of UGIH in aspirin consumers. Seven SNPs (rs1387180 A > G, rs2238631 T > C, rs1799964 T > C, rs5050 T > C/T > G, rs689466 T > C, rs1799983 T > A/T > G, and rs7756935 C > A) were “positive modifiers” associated with an excess of risk from aspirin exposure and carrying that genetic variation (1.75 ≤ RERI ≤ 4.95). On the contrary, the following nine SNPs (rs2243086 G > T, rs1131882 G > A, rs4311994 C > T, rs10120688 G > A, rs4251961 T > C, rs3778355 G > C, rs1330344 C > T, rs5275 A > G/A > T, and rs3779647 C > T) were “negative modifiers” and associated with a reduced risk in aspirin users (−2.74 ≤ RERI ≤ −0.95). Conclusion This preliminary study suggests that polymorphisms in genes involved in platelets activity, angiogenesis and inflammatory response might modify the risk of aspirin-related UGIH. Further studies with larger sample size and in different populations are needed to confirm our findings. If confirmed, this might have great impact on public health, thanks to aspirin’s prophylactic properties in diseases of high incidence and severity.
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Affiliation(s)
- Narmeen Mallah
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Carmelo Aguirre
- Biocruces Bizkaia Health Research Institute, Pharmacotherapy Group, Bizkaia, Spain.,University Hospital of Galdakao-Usansolo. Basque Country Pharmacovigilance Unit, Osakidetza, Spain.,Pharmacology Department, Medicine and Nursing Faculty, University of the Basque Country, Barakaldo, Bizkaia, Spain
| | - Eguzkiñe Ibarra-García
- Biocruces Bizkaia Health Research Institute, Pharmacotherapy Group, Bizkaia, Spain.,Osakidetza Basque Health Service, Urduliz Hospital, Pharmacy Department, Urduliz, Spain
| | - Itziar Palacios-Zabalza
- Biocruces Bizkaia Health Research Institute, Pharmacotherapy Group, Bizkaia, Spain.,University Hospital of Galdakao-Usansolo. Basque Country Pharmacovigilance Unit, Osakidetza, Spain
| | - Fernando Macías-García
- Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - J Enrique Domínguez-Muñoz
- Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Carlos III Health Institute, Madrid, Spain.,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Luisa Ibáñez
- Department of Pharmacology, Therapeutics and Toxicology, Catalonian Institute of Pharmacology, Clinical Pharmacology Service, Vall d'Hebron University Teaching Hospital, Autonomous University, Barcelona, Spain
| | - Xavier Vidal
- Department of Pharmacology, Therapeutics and Toxicology, Catalonian Institute of Pharmacology, Clinical Pharmacology Service, Vall d'Hebron University Teaching Hospital, Autonomous University, Barcelona, Spain
| | - Lourdes Vendrell
- Department of Pharmacology, Therapeutics and Toxicology, Catalonian Institute of Pharmacology, Clinical Pharmacology Service, Vall d'Hebron University Teaching Hospital, Autonomous University, Barcelona, Spain
| | - Luis Martin-Arias
- Centre for Research on Drug Safety (CESME), Valladolid University, Valladolid, Spain
| | - María Sáinz-Gil
- Centre for Research on Drug Safety (CESME), Valladolid University, Valladolid, Spain
| | | | - Adolfo Figueiras
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Carlos III Health Institute, Madrid, Spain.,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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26
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Fernández-Álvarez I, Zapata-Cachafeiro M, Vázquez-Lago J, López-Vázquez P, Piñeiro-Lamas M, García Rodríguez R, Figueiras A. Pharmaceutical companies information and antibiotic prescription patterns: A follow-up study in Spanish primary care. PLoS One 2019; 14:e0221326. [PMID: 31437201 PMCID: PMC6706057 DOI: 10.1371/journal.pone.0221326] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 08/06/2019] [Indexed: 11/19/2022] Open
Abstract
Objectives To assess the impact of sources of drug information on antibiotic prescribing patterns (quantity and quality) among primary care physicians. Methods We conducted a cohort study on primary care physicians who were actively engaged in medical practice in 2010 in a region in north-west Spain (Galicia), fulfilling inclusion criteria (n = 2100). As the independent variable, we took the perceived utility of 6 sources of information on antibiotics, as measured by the validated KAAR-11 questionnaire. As dependent variables, we used: (1) a quality indicator (appropriate quality, defined as any case where 6 of the 12 indicators proposed by the European Surveillance of Antimicrobial Consumption Network [ESAC-Net] were better than the mean values for Spain); and, (2) a quantity indicator (high prescribing), defined as any case where defined daily doses (DDD) per 1 000 inhabitants per day of antibacterials for systemic use were higher than the mean values for Spain. The adjusted odds ratio for a change in the interquartile range (IqOR) for each sources of information on antibiotics was calculated using Generalized Linear Mixed Models. Results The questionnaire response rate was 68%. Greater perceived utility of pharmaceutical sales representatives increases the risk of having high prescribing (1/IqOR = 2.50 [95%CI: 1.63–3.66]) and reduces the probability of having appropriate quality (1/IqOR = 2.28 [95%CI: 1.77–3.01]). Greater perceived utility of clinical guidelines increases the probability of having appropriate quality (1/IqOR = 1.25 [95%CI: 1.02–1.54]) and reduces the probability of high prescribing (1/IqOR = 1.25 [95%CI: 1.02–1.54]). Conclusions Sources of information on antibiotics are an important determinant of the quantity and quality of antibiotic prescribing in primary care. Commercial sources of information influence prescribing negatively, and clinical guidelines are associated with better indicators.
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Affiliation(s)
- Iria Fernández-Álvarez
- Preventive Medicine Service, Santiago de Compostela University Teaching Hospital, Santiago de Compostela, Spain
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Santiago de Compostela, Spain
| | - Juan Vázquez-Lago
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Paula López-Vázquez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | | | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- * E-mail:
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27
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Fernández MDM, Montes-Martínez A, Piñeiro-Lamas M, Regueira-Méndez C, Takkouche B. Tobacco consumption and premenstrual syndrome: A case-control study. PLoS One 2019; 14:e0218794. [PMID: 31226148 PMCID: PMC6588233 DOI: 10.1371/journal.pone.0218794] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 06/09/2019] [Indexed: 11/30/2022] Open
Abstract
Objective To assess whether tobacco smoking is associated with Premenstrual Syndrome (PMS) and its most severe form, Premenstrual Dysphoric Disorder (PMDD). Design Case-control study with incident cases using the Spanish public healthcare system. Setting 3 major public hospitals and one family counseling and planning center. Population Women consulting for troubles related to menstruation and for other motives such as screening for uterine cancer, contraception counseling or desire for pregnancy. Methods Logistic regression. Main outcome measures Odds Ratios of PMS and PMDD. Results 285 incident PMS cases and 285 age-matched controls on the one hand, and 88 incident PMDD cases and 176 controls on the other hand participated in the study. The odds of premenstrual disorders was higher in current smokers compared with never smokers: Odds Ratio (OR) = 1.78, 95% Confidence Interval (CI): 1.20–2.63 for PMS and OR = 2.92, 95%CI: 1.55–5.50 for PMDD. For PMS, women who smoke 1 to 5 cigarettes/day presented an OR = 2.82, 95%CI: 1.57–5.06 and those who smoke more than 15 cigarettes/day an OR = 2.52, 95%CI: 0.99–6.40. Compared to non-smokers, current and ex-smokers who smoked < 3 pack-years presented an OR = 1.79, 95%CI: 1.04–3.08 for PMS, and an OR = 3.06, 95%CI: 1.27–7.35 for PMDD. Smokers of 3 to 8 pack-years presented an OR = 2.34, 95%CI: 1.33–4.13 for PMS and OR = 3.56, 95%CI: 1.55–8.17 for PMDD. These results were confirmed by the exposure-effect curve obtained from a cubic spline model. Conclusions This study shows that smokers are more likely to develop PMS and PMDD.
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Affiliation(s)
- María Del Mar Fernández
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Agustín Montes-Martínez
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
| | - María Piñeiro-Lamas
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
| | - Carlos Regueira-Méndez
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
| | - Bahi Takkouche
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
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28
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Lorenzo-González M, Ruano-Ravina A, Torres-Durán M, Kelsey KT, Provencio M, Parente-Lamelas I, Leiro-Fernández V, Vidal-García I, Castro-Añón O, Martínez C, Golpe-Gómez A, Zapata-Cachafeiro M, Piñeiro-Lamas M, Pérez-Ríos M, Abal-Arca J, Montero-Martínez C, Fernández-Villar A, Barros-Dios JM. Lung cancer and residential radon in never-smokers: A pooling study in the Northwest of Spain. Environ Res 2019; 172:713-718. [PMID: 30903971 DOI: 10.1016/j.envres.2019.03.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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: 11/19/2018] [Revised: 01/08/2019] [Accepted: 03/05/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Using a pooled case-control study design, including only never-smokers, we have assessed the association of residential radon exposure with the subsequent occurrence of lung cancer. We also investigated whether residential radon poses a different risk specifically for adenocarcinoma. METHODS We pooled individual data from different case-control studies conducted in recent years in Northwestern Spain which investigated residential radon and lung cancer. All participants were never-smokers. Cases had a confirmed biopsy of primary lung cancer. Hospital controls were selected at pre-surgery units, presenting for non-complex surgical procedures. They were interviewed using a standardized instrument. Residential radon was measured using alpha track detectors at the Galician Radon Laboratory at the University of Santiago de Compostela. RESULTS A total of 1415 individuals, 523 cases and 892 controls were included. We observed an odds ratio of 1.73 (95%CI: 1.27-2.35) for individuals exposed to ≥ 200 Bq/m3 compared with those exposed to ≤100 Bq/m3. Lung cancer risk for adenocarcinoma was 1.52 (95%CI: 1.14-2.02) using the same categories for radon exposure. CONCLUSIONS Residential radon is a clear risk factor for lung cancer in never-smokers. Our data suggest that radon exposure is associated with all histological types of lung cancer and also with adenocarcinoma, which is currently the most frequent histological type for this disease.
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Affiliation(s)
- María Lorenzo-González
- Service of Preventive Medicine, University Hospital Complex of Ourense, Spain; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain; Department of Epidemiology, Brown School of Public Health, Brown University, Providence, RI, USA.
| | | | - Karl T Kelsey
- Department of Epidemiology, Brown School of Public Health, Brown University, Providence, RI, USA
| | - Mariano Provencio
- Service of Oncology, Puerta de Hierro University Hospital, Madrid, Spain
| | | | | | - Iria Vidal-García
- Service of Neumology, University Hospital Complex of A Coruña, Spain
| | | | - Cristina Martínez
- National Institute of Silicosis, University Hospital of Asturias, Oviedo, Spain
| | - Antonio Golpe-Gómez
- Service of Neumology, University Hospital Complex of Santiago de Compostela, Spain
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain
| | - Mónica Pérez-Ríos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain; Department of Epidemiology, Brown School of Public Health, Brown University, Providence, RI, USA
| | - José Abal-Arca
- Service of Neumology, University Hospital Complex of Ourense, Spain
| | | | | | - Juan M Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain; Service of Preventive Medicine, University Hospital Complex of Santiago de Compostela, Spain
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Zapata-Cachafeiro M, Piñeiro-Lamas M, Guinovart MC, López-Vázquez P, Vázquez-Lago JM, Figueiras A. Magnitude and determinants of antibiotic dispensing without prescription in Spain: a simulated patient study. J Antimicrob Chemother 2019; 74:511-514. [PMID: 30395222 PMCID: PMC6337896 DOI: 10.1093/jac/dky440] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/27/2018] [Accepted: 10/01/2018] [Indexed: 01/21/2023] Open
Abstract
Objectives Excessive and inappropriate use of antibiotics increases antimicrobial resistance. The aim of this study was to determine the magnitude and determinants of antibiotic dispensing without prescription in Spain by the simulated patient technique. Methods A cross-sectional study was conducted with all the pharmacies in a region of north-west Spain (n = 977), between December 2016 and January 2017. Four actors visited the pharmacies simulating a respiratory infection. Four incremental levels of pressure were used to obtain an antibiotic. The education and sex of the person who was dispensing and the area where the pharmacy was located were recorded. The effect of these independent variables on the dispensing of an antibiotic without prescription (1 = yes, 0 = no) was modelled by logistic regression. Results An antibiotic was obtained in 18.83% (95% CI = 16.5%-21.41%) of the visits. The area influenced the dispensing of antibiotics without a medical prescription, with a greater likelihood of dispensing in rural (OR = 1.79; 95% CI = 1.20-2.68) or semi-rural (OR = 1.66; 95% CI = 1.13-2.44) areas than in urban areas. No association was found with the sex or the training of the person who dispensed the antibiotic. In the pharmacies in urban areas, a lower level of pressure was needed to obtain the antibiotic. Conclusions This study shows that one-fifth of the pharmacies still dispense antibiotics without prescription, especially under patient pressure. A rural setting has been identified as a risk factor for dispensing without prescription, so it must be taken into account for future interventions.
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Affiliation(s)
- Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - María C Guinovart
- Unitat d'atenció farmacéutica, Regió sanitària Camp de Tarragona, CatSalut, Tarragona, Spain
| | - Paula López-Vázquez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Juan Manuel Vázquez-Lago
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Rodríguez-Castro E, López-Dequit I, Santamaría-Cadavid M, Arias-Rivas S, Rodríguez-Yáñez M, Pumar JM, Hervella P, López-Arias E, da Silva-Candal A, Estany A, Piñeiro-Lamas M, Sobrino T, Campos F, Portela M, Vázquez-Lima M, Castillo J, Iglesias-Rey R. Trends in stroke outcomes in the last ten years in a European tertiary hospital. BMC Neurol 2018; 18:164. [PMID: 30285659 PMCID: PMC6171303 DOI: 10.1186/s12883-018-1164-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 09/24/2018] [Indexed: 12/24/2022] Open
Abstract
Background Studying the impact of demographic changes and progress in the management of stroke patients is necessary in order to organize care structures for the coming years. Consequently, we analyzed the prognostic trends of patients admitted to the Stroke Unit of a tertiary hospital in the last ten years. Methods The University Clinical Hospital of Santiago de Compostela is the referral hospital for stroke in a catchment area that accounts for 16.5% of the population of Galicia. Data from patients admitted to the Stroke Unit were registered prospectively. A multinomial logistic regression was performed to determine the influence of new trends in demographic factors and in the management of patients with acute stroke. For the expected trend of progression, a 2008–2011 and 2012–2017 time series model was made by selecting the most appropriate model. Results In the last 10 years, the age of stroke onset has only increased in women (from 74.4 ± 2.2 years in 2008 to 78.8 ± 2.1 years in 2017; p = 0.037), and the same happens with the severity of neurological symptoms (ischemic stroke (IS), p < 0.0001; from 14 [10, 19] in 2008 to 19 [15, 26] in 2017), with a higher percentage of cardioembolic strokes (40.7% vs. 32.2% of cardioembolic strokes in women vs. men, p < 0.0001). In a multiple linear regression model, hospital improvement was mainly associated with the use of reperfusion treatment (B 53.11, CI 95% 49.87, 56.36, p < 0.0001). A differentiated multinomial logistic regression analysis conducted for the whole sample with ischemic strokes in the two time periods (2008–2011 and 2012–2017) showed no differences in the influence of factors associated with higher morbidity and mortality. The modeling of time series showed a distinct falling trend in mortality, with a slight increase in good outcome as well as morbidity in both ischemic and hemorrhagic stroke. Conclusions Our results showed that mortality decreased in the entire sample; however, although outcome at discharge improved in ischemic stroke, severe disability also increased in these patients. Importantly, this tendency towards increased morbidity seems to be confirmed for the coming years.
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Affiliation(s)
- Emilio Rodríguez-Castro
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Stroke Unit, Department of Neurology, Hospital Clínico Universitario, Santiago de Compostela, Spain
| | - Iria López-Dequit
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Stroke Unit, Department of Neurology, Hospital Clínico Universitario, Santiago de Compostela, Spain
| | - María Santamaría-Cadavid
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Stroke Unit, Department of Neurology, Hospital Clínico Universitario, Santiago de Compostela, Spain
| | - Susana Arias-Rivas
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Stroke Unit, Department of Neurology, Hospital Clínico Universitario, Santiago de Compostela, Spain
| | - Manuel Rodríguez-Yáñez
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Stroke Unit, Department of Neurology, Hospital Clínico Universitario, Santiago de Compostela, Spain
| | - José Manuel Pumar
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Department of Neuroradiology, Hospital Clínico Universitario, Santiago de Compostela, Spain
| | - Pablo Hervella
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Esteban López-Arias
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Andrés da Silva-Candal
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Ana Estany
- Unit of Methodology of the Research, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid. Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Francisco Campos
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Manuel Portela
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Health Area Management of Santiago de Compostela, Servicio Galego de Saúde, Santiago de Compostela, Spain
| | - Manuel Vázquez-Lima
- Emergency Department, Hospital do Salnés, Pontevedra, Vilagarcía de Arousa, Spain
| | - José Castillo
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain. .,Clinical Neuroscience Research Laboratory (Hospital Clínico Universitario), Rúa Travesa da Choupana, s/n, 15706, Santiago de Compostela, Spain.
| | - Ramón Iglesias-Rey
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain. .,Clinical Neuroscience Research Laboratory (Hospital Clínico Universitario), Rúa Travesa da Choupana, s/n, 15706, Santiago de Compostela, Spain.
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Ruano-Ravina A, Aragonés N, Kelsey KT, Pérez-Ríos M, Piñeiro-Lamas M, López-Abente G, Barros-Dios JM. Residential radon exposure and brain cancer: an ecological study in a radon prone area (Galicia, Spain). Sci Rep 2017; 7:3595. [PMID: 28620182 PMCID: PMC5472649 DOI: 10.1038/s41598-017-03938-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 05/05/2017] [Indexed: 12/15/2022] Open
Abstract
We aimed to know if radon concentration is associated with municipal mortality due to brain cancer in Galicia, Spain. We designed an ecological study taking as study unit Galician municipalities. To be included, municipalities had to have at least three radon measurements. We correlated radon concentrations with municipal mortality due to these malignant tumors during the period 1999-2008. We calculated the relative risk of dying of brain cancers for each municipality and correlated this value with municipal radon concentration using Spearman's Rho. 251 municipalities were included, with close to 3,500 radon measurements and an average of 14 radon measurements at each municipality. We observed a significant correlation between residential radon with brain cancer mortality for males and females and the intensity of the correlation was higher for females. These results were reinforced when the analysis was restricted to municipalities with more than 5 radon measurements: Spearman's Rho 0.286 (p-value < 0.001) and Spearman's Rho 0.509 (p-value < 0.001) for males and females, respectively. These results suggest an association between residential radon and brain cancer mortality. More research using more robust epidemiological designs is needed to confirm these findings.
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Affiliation(s)
- Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago, Spain.
- CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago, Spain.
- Department of Epidemiology, Brown School of Public Health, Providence, Rhode, Island, USA.
| | - Nuria Aragonés
- CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago, Spain
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Public Health, Madrid, Spain
| | - Karl T Kelsey
- Department of Epidemiology, Brown School of Public Health, Providence, Rhode, Island, USA
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago, Spain
- CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago, Spain
| | | | - Gonzalo López-Abente
- CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago, Spain
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Public Health, Madrid, Spain
| | - Juan M Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago, Spain
- CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago, Spain
- Preventive Medicine Unit, Santiago de Compostela Clinic University Hospital, Santiago, Spain
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López-Vázquez P, Vázquez-Lago JM, Gonzalez-Gonzalez C, Piñeiro-Lamas M, López-Durán A, Herdeiro MT, Figueiras A. Development and validation of the knowledge and attitudes regarding antibiotics and resistance (KAAR-11) questionnaire for primary care physicians. J Antimicrob Chemother 2016; 71:2972-9. [PMID: 27353468 DOI: 10.1093/jac/dkw238] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 05/17/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The aim of this study was to develop a novel, self-administered questionnaire to identify primary-care physicians' knowledge and attitudes regarding antibiotics and resistance (KAAR). METHODS The study population comprised primary care physicians. The study was conducted in five phases. Phase I consisted of a systematic review and qualitative focus-group study (n = 33 physicians), in which items were formulated so as to be measured on a continuous, visual analogue scale (VAS); in Phase II, content validation and face validity were evaluated by a panel of experts, which reformulated, added and deleted items; Phase III consisted of a pilot study on a population possessing similar characteristics (n = 15); in Phase IV, we analysed reliability by means of a test-retest study (n = 91) and calculated the intraclass correlation coefficients (ICCs); and in Phase V, we assessed construct validity by applying the known-groups technique, measuring the differences between contrasting groups of physicians formed according to antibiotic prescription quality indicators (group 1, n = 156 versus group 2, n = 191). RESULTS Following Phases I and II, the questionnaire contained 16 knowledge and attitude items. Participants in the pilot study (Phase III) reported no difficulty. The test-retest study (Phase IV) showed that 11 of the 16 initial knowledge and attitude items yielded an ICC > 0.5, while analysis of known-groups validity (Phase V) showed that 13 of the 16 initial items which assessed knowledge and attitudes discriminated between physicians with good and bad indicators of antibiotics prescription. CONCLUSION The final 11 item KAAR questionnaire appears to be valid, reliable and responsive.
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Affiliation(s)
- Paula López-Vázquez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Juan Manuel Vázquez-Lago
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Cristian Gonzalez-Gonzalez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
| | - Ana López-Durán
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maria Teresa Herdeiro
- Polytechnic and University Teaching Institute (Cooperativa de Ensino Superior Politécnico e Universitário-CESPU), Porto, Portugal Institute for Advanced Research and Training in Health Sciences and Technologies, Gandra PRD, Portugal Northern Pharmacovigilance Unit, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Santiago de Compostela, Spain
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Villamarín-Bello B, Piñeiro-Lamas M, Barros-Dios JM, Ruano-Ravina A, García-Otero MJ, Fernández-Villanueva JR. Bacteremia nosocomial asociada a catéter vascular central en unidades de cuidados intensivos en 2 hospitales en Galicia (España). Infectio 2016. [DOI: 10.1016/j.infect.2015.07.006] [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] Open
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34
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Gonzalez-Gonzalez C, López-Vázquez P, Vázquez-Lago JM, Piñeiro-Lamas M, Herdeiro MT, Arzamendi PC, Figueiras A. Effect of Physicians' Attitudes and Knowledge on the Quality of Antibiotic Prescription: A Cohort Study. PLoS One 2015; 10:e0141820. [PMID: 26509966 PMCID: PMC4624842 DOI: 10.1371/journal.pone.0141820] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 10/13/2015] [Indexed: 01/21/2023] Open
Abstract
Resistance increases with the use and abuse of antibiotics. Since physicians are primarily responsible for the decision to use antibiotics, ascertaining the attitudes and knowledge that underlie their prescribing habits is thus a prerequisite for improving prescription. Three-year follow-up cohort study (2008-2010) targeting primary-care physicians (n = 2100) in Galicia, a region in NW Spain. We used data obtained from a postal survey to assess knowledge and attitudes. A physician was deemed to have demonstrated Appropriate Quality Prescription of Antibiotics (dependent variable) in any case where half or more of the indicators proposed by the European Surveillance of Antimicrobial Consumption had values that were better than the reference values for Spain. The mail-questionnaire response rate was 68·0% (1428/2100). The adjusted increase in the interquartile OR of displaying good prescribing of antibiotics for each attitude was: 205% for fear ("When in doubt, it is better to ensure that a patient is cured of an infection by using a broad-spectrum antibiotic"; 95%CI: 125% to 321%); 119% for better knowledge ("Amoxicillin is useful for resolving most respiratory infections in primary care"; 95%CI: 67% to 193%); and 21% for complacency with patients' demands ("Antibiotics are often prescribed due to patients' demands"; 95%CI: 0% to 45%). Due to the fact that physicians' knowledge and attitudes are potentially modifiable, the implementation of purpose-designed educational interventions based on the attitudes identified may well serve to improve antibiotic prescription.
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Affiliation(s)
- Cristian Gonzalez-Gonzalez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Paula López-Vázquez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Juan Manuel Vázquez-Lago
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Santiago de Compostela, Spain
| | - Maria Teresa Herdeiro
- Polytechnic and University Teaching Institute (Cooperativa de Ensino Superior Politécnico e Universitário—CESPU), Gandra PRD, Portugal
- Institute for Advanced Research and Training in Health Sciences and Technologies, Gandra PRD, Portugal
- Northern Pharmacovigilance Unit, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Pilar Chávarri Arzamendi
- Subdirectorate-General of Pharmacy, Galician Health Service (Servicio Gallego de Salud—SERGAS), Santiago de Compostela, Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Santiago de Compostela, Spain
- * E-mail:
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Caamano-Isorna F, Figueiras A, Sastre I, Montes-Martínez A, Taracido, M, Piñeiro-Lamas M. Respiratory and mental health effects of wildfires: an ecological study in Galician municipalities (north-west Spain). Environ Health 2011; 10:48. [PMID: 21600035 PMCID: PMC3224540 DOI: 10.1186/1476-069x-10-48] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Accepted: 05/21/2011] [Indexed: 05/20/2023]
Abstract
BACKGROUND During the summer of 2006, a wave of wildfires struck Galicia (north-west Spain), giving rise to a disaster situation in which a great deal of the territory was destroyed. Unlike other occasions, the wildfires in this case also threatened farms, houses and even human lives, with the result that the perception of disaster and helplessness was the most acute experienced in recent years. This study sought to analyse the respiratory and mental health effects of the August-2006 fires, using consumption of anxiolytics-hypnotics and drugs for obstructive airway diseases as indicators. METHODS We conducted an analytical, ecological geographical- and temporal-cluster study, using municipality-month as the study unit. The independent variable was exposure to wildfires in August 2006, with municipalities thus being classified into the following three categories: no exposure; medium exposure; and high exposure. Dependent variables were: (1) anxiolytics-hypnotics; and (2) drugs for obstructive airway diseases consumption. These variables were calculated for the two 12-month periods before and after August 2006. Additive models for time series were used for statistical analysis purposes. RESULTS The results revealed a higher consumption of drugs for obstructive airway diseases among pensioners during the months following the wildfires, in municipalities affected versus those unaffected by fire. In terms of consumption of anxiolytics-hypnotics, the results showed a significant increase among men among men overall -pensioners and non-pensioners- in fire-affected municipalities. CONCLUSIONS Our study indicates that wildfires have a significant effect on population health. The coherence of these results suggests that drug utilisation research is a useful tool for studying morbidity associated with environmental incidents.
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Affiliation(s)
- Francisco Caamano-Isorna
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Department of Preventive Medicine, University of Santiago de Compostela. Spain
| | - Adolfo Figueiras
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Department of Preventive Medicine, University of Santiago de Compostela. Spain
| | - Isabel Sastre
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Department of Preventive Medicine, University of Santiago de Compostela. Spain
- Culleredo Primary Care Centre, A Coruna, Galician Health Service (Servizo Galego de Saúde - SERGAS), Spain
| | - Agustín Montes-Martínez
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Department of Preventive Medicine, University of Santiago de Compostela. Spain
| | - Margarita Taracido,
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Department of Preventive Medicine, University of Santiago de Compostela. Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). Department of Preventive Medicine, University of Santiago de Compostela. Spain
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