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  • 1
    Keywords: CANCER ; INFORMATION ; SUPPORT ; COHORT ; EXPOSURE ; LONG-TERM ; RISK ; ACTIVATION ; DNA ; AIR ; ASSOCIATION ; VARIANTS ; BREAST-CANCER ; NO ; HEALTH ; lifestyle ; MUTATION ; PROSPECTIVE COHORT ; COLORECTAL-CANCER ; bladder cancer ; BLADDER-CANCER ; cancer risk ; acetylation ; METABOLIC-ACTIVATION ; COLON-CANCER ; MUTATIONS ; gene-environment interaction ; CARCINOGENS ; DIET ; DIETARY ; NETHERLANDS ; case-control studies ; CONSUMPTION ; EPIC ; nutrition ; QUESTIONNAIRE ; ONCOLOGY ; case-control study ; REGRESSION ; VARIANT ; prospective studies ; LEVEL ; methods ; GENOTYPE ; prospective ; MEAT INTAKE ; RISK-FACTOR ; VARIABLES ; CANCER-RISK ; ENGLAND ; AMINE ; N-acetyltransferase ; GENE-ENVIRONMENT INTERACTIONS ; N-ACETYLATION
    Abstract: Objective The suspect carcinogens, heterocyclic amines (HAAs), found in well-done meat require host-mediated metabolic activation before inducing DNA mutations. The role of SULT1A1 and of NAT2 on the activation of HAAs suggests that NAT2 rapid acetylator genotype and SULT1A1 allele variants can have an effect on HAA carcinogenicity. Methods Data were collected as part of a case-control study nested within the EPIC cohort, the Gen Air investigation. EPIC is a prospective study designed to investigate the relationship between nutrition and cancer. Information was collected through a non-dietary questionnaire on lifestyle variables and through a dietary questionnaire. The subjects were restricted to non-smokers. We calculated the matched odds ratio for bladder cancer risk using logistic regression, controlling for potential confounders. Results There were 227 bladder cases and 612 controls matched 1:3. Meat intake and NAT2 genotype were not independently associated with bladder cancer risk. A significant relationship was observed between bladder cancer risk and consumption of meat only among subjects with the rapid NAT2 genotype (odds ratios [OR] 2.9, 95% CI 1.0-7.9 for the 2nd quartile of meat intake; 3.6, 95% CI 1.3-9.7 for the 3rd quartile; and 3.5, 95% CI 1.2-9.7 for the 4th quartile), and was not present among subjects with the slow genotype. An interaction between NAT2 and meat intake was found in logistic regression (P = 0.034). No association was observed for SULT1A *1/2 genotype (1.0; 95% CI 0.7-1.5) and for SULT1A1 *2/2 genotype (0.9; 95% CI 0.5-1.7). Conclusions These results are suggestive of a role of meat intake and NAT2 on bladder cancer risk. They support the hypothesis that among subjects with the rapid NAT2 acetylation genotype higher levels of HAAs exposure are a bladder cancer risk factor. We did not observe an effect of SULT1A1 allele variants on this cancer. The present study adds new information on the possible long-term adverse effects of diets with high meat intake
    Type of Publication: Journal article published
    PubMed ID: 18264785
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  • 2
    Publication Date: 2018-03-17
    Description: Objectives To determine the appropriateness of medical imaging examinations involving radiation and to estimate the effective radiation dose and costs associated. Design Cross-sectional retrospective study. Setting Two Spanish public tertiary hospitals. Participants 2022 medical imaging tests were extracted from the radiology information system in February and March of 2014. MRI and ultrasound examinations were excluded. Primary and secondary outcome measures Five outcomes were set independently by at least two researchers according to four guidelines: (1) appropriate; (2) inappropriate; (3) inappropriate due to repetition, if the timing to carry out next diagnostic tests was incorrect according to guidelines; (4) not adequately justified, if the referral form did not include enough clinical information to allow us to understand the patient’s clinical condition; and (5) not included in the guidelines, if the referral could not be matched to a clinical scenario described in the guidelines. We estimated the prevalence of the five categories according to relevant clinical and sociodemographic variables and the effective radiation dose and costs for each category. Results Approximately half of the imaging tests were deemed as appropriate (967, 47.8%) while one-third (634, 31.4%) were considered inappropriate. 19.6% of the effective dose and 25.2% of the cost were associated with inappropriate tests. Women were less likely than men to have an imaging test classified as appropriate (adjusted OR 0.70,95% CI 0.57 to 0.86). Imaging tests requested by general practitioners were less likely to be considered appropriate than those requested by central services (adjusted OR 0.60, 95% CI 0.38 to 0.93). Mammography and CT were more likely to be appropriate than conventional X-rays. Conclusion There was a significant frequency of inappropriateness, which resulted in a high percentage of associated effective radiation dose. Percentage of inappropriateness depends on sociodemographic and clinical characteristics such as sex, age, referral physician and medical imaging test.
    Keywords: Open access, Radiology and imaging
    Electronic ISSN: 2044-6055
    Topics: Medicine
    Published by BMJ Publishing
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  • 3
    Publication Date: 2018-10-31
    Description: BACKGROUND: Despite considerable research investment, moving from biomarker discovery to clinical application has presented unique challenges. We aimed to evaluate progress toward clinical application of a sample of molecular- and "omics"-based diagnostic tests over a 10-year period. METHODS: We used Scopus to locate studies, published before the December 31, 2016, citing 107 original-research articles published in 2006 that assessed the diagnostic value of a molecular- or "omics"-based test. We identified diagnostic studies of the same test and disease and determined whether the article represented progress in the validation of the molecular test. We classified the types of progress: ( a ) clinical validation (measuring diagnostic accuracy in a series of patients similar to the population in which the test will be used in practice), ( b ) technical improvement, ( c ) extended diagnostic application (modification of the diagnostic question attended initially by the test), ( d ) economic evaluation, or ( e ) clinical use or implementation. RESULTS: In the 10-year period analyzed, 4257 articles cited the 107 diagnostic studies; 118 (2.8%) were diagnostic studies of the same test, and of these papers, 25 (21.2%) did not constitute progress toward validation of the test for use in clinical practice (potential research waste). Of the 107 molecular- or "omics"-based tests described in 2006, only 28 (26.2%) appeared to have made progress toward clinical application. Only 4 (9.1%) of 44 proteomics-based tests had made progress toward clinical application. CONCLUSIONS: Articles evaluating molecular- or "omics"-based diagnostic tests are numerous in biomedical journals. Few tests have made progress toward clinical application in the 10 years following their discovery.
    Print ISSN: 0009-9147
    Electronic ISSN: 1530-8561
    Topics: Medicine
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