Incidence of Kidney Replacement Therapy and Subsequent Outcomes Among Patients With Systemic Lupus Erythematosus: Findings From the ERA Registry.

RATIONALE AND OBJECTIVE: There is a dearth of data characterizing patients requiring kidney replacement therapy (KRT) for kidney failure due to systemic lupus erythematosus (SLE) and their clinical outcomes. The aim of this study was to describe trends in incidence and prevalence of KRT among these patients as well as to compare their outcomes to patients treated with KRT for diseases other than SLE.STUDY DESIGN: Retrospective cohort study based on kidney registry data.SETTING & PARTICIPANTS: Patients recorded in 14 registries of patients receiving kidney replacement therapy that provided data to the European Renal Association (ERA) Registry between 1992 and 2016.PREDICTOR: SLE as cause…

Congenital heart defects in the East of Spain

The spatial distribution of population exposure to outdoor air pollution in Valencia (Spain) and its association with a privation index

Objetivo: Evaluar la variación espacial de la exposición a dióxido de nitrógeno (NO2) en la ciudad de Valencia y su relación con la privación socioeconómica y la edad. Métodos: La población por sección censal (SC) procede del Instituto Nacional de Estadística. Los niveles de NO2 se midieron en 100 puntos del área de estudio, mediante captadores pasivos, en tres campañas entre 2002 y 2004. Se utilizó regresión por usos del suelo (LUR) para obtener el mapa de los niveles de NO2. Las predicciones del LUR se compararon con las proporcionadas por: a) el captador más cercano de la red de vigilancia, b) el captador pasivo más cercano, c) el conjunto de captadores en un entorno y d) kriging. Se asi…

Stroke mortality and trends from 1990 to 2006 in 39 countries from Europe and Central Asia: implications for control of high blood pressure

Aims The aim of the present study was to extend our understanding of international trends in stroke and major sequelae in Europe and countries peripheral to Europe by assessing: (1) current mortality rates, (2) the most recent 15-year prevalence trends, and (3) the relationship between systolic blood pressure in community surveys and national stroke mortality. Methods and results Data were obtained from the World Health Organization (WHO [www.who.int/whosis/database/mort/table.cfm][1]), and represent national vital statistics as reported by 39 countries (European and Central Asian countries) using a standard format and population-based cardiovascular surveys. Total numbers of deaths by stro…

Supplemented ERA-EDTA Registry data evaluated the frequency of dialysis, kidney transplantation, and comprehensive conservative management for patients with kidney failure in Europe.

The aims of this study were to determine the frequency of dialysis and kidney transplantation and to estimate the regularity of comprehensive conservative management (CCM) for patients with kidney failure in Europe. This study uses data from the ERA-EDTA Registry. Additionally, our study included supplemental data from Armenia, Germany, Hungary, Ireland, Kosovo, Luxembourg, Malta, Moldova, Montenegro, Slovenia and additional data from Israel, Italy, Slovakia using other information sources. Through an online survey, responding nephrologists estimated the frequency of CCM (i.e. planned holistic care instead of kidney replacement therapy) in 33 countries. In 2016, the overall incidence of rep…

Survival and cure trends for European children, adolescents and young adults diagnosed with acute lymphoblastic leukemia from 1982 to 2002

Proportion cured is a potentially more informative cancer outcome measurement than 5-year survival. We present population-based estimates of cure for young patients diagnosed with acute lymphoblastic leukemia in Europe from 1982 to 2002. Thirty-five European cancer registries provided data. Survival was estimated by age, period of diagnosis and European region, and used as input for parametric cure models, which assume cured patients have the same mortality as the general population. For acute lymphoblastic leukemia diagnosed in 1–14 year olds in 2000–2002, over 77% were estimated cured. The proportion cured improved significantly over the study period: an impressive 26–58% in infants (up t…

Anomalías congénitas cardíacas en la Comunitat Valenciana 2007-2014, el registro poblacional de anomalías congénitas

Resumen: Introducción: Las anomalías congénitas cardíacas (ACC) son el tipo de anomalías congénitas (AC) mayores de más prevalencia y gravedad. El objetivo fue determinar la frecuencia y distribución de las ACC en la Comunitat Valenciana desde 2007 hasta 2014, describiendo las características comunes de los pacientes y sus madres. Material y Métodos: Se seleccionaron del Registro poblacional de AC de la Comunitat Valenciana los pacientes con ACC nacidos vivos, nacidos muertos e interrupciones voluntarias del embarazo entre 2007-2014 (códigos Q20-Q26 de la Clasificación Internacional de Enfermedades 10.ª Revisión, Asociación Pediátrica Británica). Se calculó la prevalencia por 10.000 nacidos…

Industrial Pollution and Congenital Heart Anomalies in the Valencia Region, Spain

Background Congenital heart anomalies (CHA) are the most common type of birth defects, accounting for nearly one third of major congenital anomalies diagnosed prenatally or in infancy in Europe. In the majority of cases, the etiology is unknown, but an interaction of genetic and environmental factors such as industrial pollution may play a role in CHA development. The aim is to identify the relationship between CHA and the industrial pollution in the municipalities of …

[Drugs use in pregnancy in the Valencia Region and the risk of congenital anomalies].

Background Despite the potential risks of drug use during pregnancy, consumption has increased in recent decades. Objective To identify the risk of congenital anomalies (CA) associated with the use of drugs in primary care in pregnant women resident in the Valencia Region. Methods A case-control study, considering a case as a less than one year old live birth in 2009–2010, diagnosed with a CA and resident in the Valencia Region, obtained from the CA population-based registry. Controls were selected from the Metabolic Disease Registry, and the drugs prescribed and dispensed from the Integral Management of Pharmaceutical Services. Crude odds ratio (OR) was calculated with its 95% confidence i…

Procesos puntuales como herramienta para el análisis de posibles fuentes de contaminación

El análisis de un patrón puntual engloba una serie de técnicas que permiten estudiar la distribución de un conjunto de eventos ocurridos sobre una región del plano. Este problema surge en epidemiología cuando se investiga una potencial fuente de contaminación ambiental alrededor de la cual se sospecha que surgen casos de una determinada enfermedad. En el presente trabajo, se explica brevemente en qué consiste el análisis de un patrón puntual y se ilustra con una aplicación a la determinación del origen medioambiental y al estudio de las zonas de mayor riesgo de incidencia en un brote de neumonía por Legionella ocurrido entre mediados de septiembre y principios de octubre en la ciudad de Alc…

Spatial analysis of the relationship between mortality from cardiovascular and cerebrovascular disease and drinking water hardness

Journal Article; Research Support, Non-U.S. Gov't; Reproduced with permission from Environmental Health Perspectives. Previously published scientific papers have reported a negative correlation between drinking water hardness and cardiovascular mortality. Some ecologic and case-control studies suggest the protective effect of calcium and magnesium concentration in drinking water. In this article we present an analysis of this protective relationship in 538 municipalities of Comunidad Valenciana (Spain) from 1991-1998. We used the Spanish version of the Rapid Inquiry Facility (RIF) developed under the European Environment and Health Information System (EUROHEIS) research project. The strateg…

Analysis of the renal transplant waiting list in the País Valencià (Spain).

In this paper we analyse the renal transplant waiting list of the Pais Valencia in Spain, using Queueing theory. The customers of this queue are patients with end-stage renal failure waiting for a kidney transplant. We set up a simplified model to represent the flow of the customers through the system, and perform Bayesian inference to estimate parameters in the model. Finally, we consider several scenarios by tuning the estimations achieved and computationally simulate the behaviour of the queue under each one. The results indicate that the system could reach equilibrium at some point in the future and the model forecasts a slow decrease in the size of the waiting list in the short and mid…

Geographical Distribution of Cardiovascular Mortality in Comunidad Valenciana (Spain)

Comunidad Valenciana is one of the seventeen autonomous regions into which Spain is divided. It is located on the east coast of Spain, next to the Mediterranean sea, with an area of 23,255 km2 and with 4,009,329 inhabitants in 1996. From an administrative point of view there are three levels of aggregation: provinces (3 units), health areas (20 units) and municipalities (541 units).

Determinants of dental care utilization by the adult population in Buenos Aires

Objective: To establish the frequency with which the general population is seen by a dentist and the variables associated with the lack of regular dental check-ups. Methods: A cross-sectional study with a descriptive and analytical phase conducted in an urban community in Argentina. A sample population was obtained by stratified method. Socioeconomic conditions (measure by UBN index), health, health coverage, level of education and location of the households with respect to the dental clinics were all taken into consideration in selecting the sample. We performed a uni-and multivariate analysis. The statistical software used was SPSS 9.0 for Windows and Epilnfo6 Version 6.0. Results: We obs…

Statistical relationship between hardness of drinking water and cerebrovascular mortality in Valencia: a comparison of spatiotemporal models

The statistical detection of environmental risk factors in public health studies is usually difficult due to the weakness of their effects and their confounding with other covariates. Small area geographical data bring the opportunity of observing health response in a wide variety of exposure values. Temporal sequences of these geographical datasets are crucial to gaining statistical power in detecting factors. The spatiotemporal models required to perform the statistical analysis have to allow for spatial and temporal correlations, which are more easily modelled via hierarchical structures of hidden random factors. These models have produced important research activity during the last deca…

Geographical Variability in Mortality in Urban Areas: A Joint Analysis of 16 Causes of Death.

The authors acknowledge the support of the research grants PI16/00670, PI16/00755, PI16/01004, PI16/01187, PI16/01273, PI16/01281, and PI18/01313 of Instituto de Salud Carlos III, co-funded with FEDER grants.

Survival of European children and young adults with cancer diagnosed 1995-2002

This study analyses survival in 40,392 children (age 0-14 years) and 30,187 adolescents/young adults (age 15-24 years) diagnosed with cancer between 1995 and 2002. The cases were from 83 European population-based cancer registries in 23 countries participating in EUROCARE-4. Five-year survival in countries and in regional groupings of countries was compared for all cancers combined and for major cancers. Survival for 15 rare cancers in children was also analysed. Five-year survival for all cancers combined was 81% in children and 87% in adolescents/young adults. Between-country survival differences narrowed for both children and adolescents/young adults. Relative risk of death reduced signi…

Source Detection in an Outbreak of Legionnaire’s Disease

Spatial statistics have broadly been applied, developed and demanded from the field of epidemiology. The point process theory is an appropriate framework to analyse the spatial variation of risk of disease from information at individual level.

Consumo de medicamentos en el embarazo y riesgo de anomalías congénitas en la Comunitat Valenciana

Resumen: Antecedentes: El consumo de medicamentos durante el embarazo se ha incrementado en las últimas décadas. Objetivo: Identificar el riesgo de anomalías congénitas (AC) asociado a la utilización de medicamentos en atención ambulatoria en embarazadas residentes en la Comunitat Valenciana. Métodos: Estudio de casos-controles, considerando caso a menores de un año nacidos vivos en 2009-2010 diagnosticados de AC y residentes en la Comunitat Valenciana, obtenidos del registro poblacional de AC. Los controles se seleccionaron del Registro de Metabolopatías y la medicación prescrita y dispensada se obtuvo del módulo Gestión Integral de Prestación Farmacéutica. Se calcularon las odds ratio (OR…

Geographical spread of influenza incidence in Spain during the 2009 A(H1N1) pandemic wave and the two succeeding influenza seasons

SUMMARYThe aim of this study was to monitor the spatio-temporal spread of influenza incidence in Spain during the 2009 pandemic and the following two influenza seasons 2010–2011 and 2011–2012 using a Bayesian Poisson mixed regression model; and implement this model of geographical analysis in the Spanish Influenza Surveillance System to obtain maps of influenza incidence for every week. In the pandemic wave the maps showed influenza activity spreading from west to east. The 2010–2011 influenza epidemic wave plotted a north-west/south-east pattern of spread. During the 2011–2012 season the spread of influenza was geographically heterogeneous. The most important source of variability in the m…