Consecuencias neuroendocrinas de la disrupción génica de los Receptores de Estrógenos

[ES] La introducción de animales genéticamente modificados ha supuesto una pequeña revolución en el estudio de la endocrinología. Éste es un ejemplo de cómo dicha alteración puede cambiar radicalmente algunos de los conceptos básicos.

Programa de sensibilización contra las infecciones de transmisión sexual

[ES] Las infecciones de transmisiónn sexual (ITS) siguen siendo un problema de salud importante en la actualidad tanto a nivel nacional como local. En algunos casos, la comunidad canaria soporta las tasas más altas del país. Es bien sabido que la adolescencia es una etapa de cambios a todos los niveles y expuesta a multitud de influencias, por lo que se considera que la educación para la salud (EpS) de temática sexual debe ser una prioridad en este rango de edad. La población diana de este programa de sensibilización son los alumnos de primero de bachillerato de la Escuela de Arte y Superior de Dise˜no Gran Canaria, cuya edad media es de diecisite años. Asimismo, heredamos las experiencias de intervenciones similares hechas en años anteriores. Inspirados por las bases propuestas por el modelo PRECEDE y otros modelos de EpS, llevamos a cabo una intervenci´on comunitaria participativa, constructivista e interactiva, procurando identificar e involucrar a los agentes de salud de la población. El programa se caracteriza también por el uso de gran cantidad de recursos TIC gratuitos, tales como la elaboración de un blog, vídeos e incluso juegos interactivos. A pesar de no haberse llevado a cabo todas las intervenciones planificadas, se cuantifican resultados positivos tanto a nivel cognitivo como a nivel aptitudinal y actitudinal, por lo que la aplicaciónn del modelo parece pertinente.

Complex organochlorine pesticide mixtures as determinant factor for breast cancer risk: a population-based case-control study in the Canary Islands (Spain)

[EN] Background: All the relevant risk factors contributing to breast cancer etiology are not fully known. Exposure to organochlorine pesticides has been linked to an increased incidence of the disease, although not all data have been consistent. Most published studies evaluated the exposure to organochlorines individually, ignoring the potential effects exerted by the mixtures of chemicals. Methods: This population-based study was designed to evaluate the profile of mixtures of organochlorines detected in 103 healthy women and 121 women diagnosed with breast cancer from Gran Canaria Island, and the relation between the exposure to these compounds and breast cancer risk.Results: The most prevalent mixture of organochlorines among healthy women was the combination of lindane and endrin, and this mixture was not detected in any affected women. Breast cancer patients presented more frequently a combination of aldrin, dichlorodiphenyldichloroethylene (DDE) and dichlorodiphenyldichloroethane (DDD), and this mixture was not found in any healthy woman. After adjusting for covariables, the risk of breast cancer was moderately associated with DDD (OR = 1.008, confidence interval 95% 1.001-1.015, p = 0.024).Conclusions: This study indicates that healthy women show a very different profile of organochlorine pesticide mixtures than breast cancer patients, suggesting that organochlorine pesticide mixtures could play a relevant role in breast cancer risk.

Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis

[EN] Introduction: Candidemia in critically ill patients is usually a severe and life-threatening condition with a high crude mortality. Very few studies have focused on the impact of candidemia on ICU patient outcome and attributable mortality still remains controversial. This study was carried out to determine the attributable mortality of ICU-acquired candidemia in critically ill patients using propensity score matching analysis. Methods: A prospective observational study was conducted of all consecutive non-neutropenic adult patients admitted for at least seven days to 36 ICUs in Spain, France, and Argentina between April 2006 and June 2007. The probability of developing candidemia was estimated using a multivariate logistic regression model. Each patient with ICU-acquired candidemia was matched with two control patients with the nearest available Mahalanobis metric matching within the calipers defined by the propensity score. Standardized differences tests (SDT) for each variable before and after matching were calculated. Attributable mortality was determined by a modified Poisson regression model adjusted by those variables that still presented certain misalignments defined as a SDT > 10%. Results: Thirty-eight candidemias were diagnosed in 1,107 patients (34.3 episodes/1,000 ICU patients). Patients with and without candidemia had an ICU crude mortality of 52.6% versus 20.6% (P < 0.001) and a crude hospital mortality of 55.3% versus 29.6% (P = 0.01), respectively. In the propensity matched analysis, the corresponding figures were 51.4% versus 37.1% (P = 0.222) and 54.3% versus 50% (P = 0.680). After controlling residual confusion by the Poisson regression model, the relative risk (RR) of ICU- and hospital-attributable mortality from candidemia was RR 1.298 (95% confidence interval (CI) 0.88 to 1.98) and RR 1.096 (95% CI 0.68 to 1.69), respectively. Conclusions: ICU-acquired candidemia in critically ill patients is not associated with an increase in either ICU or hospital mortality.