Leonor Poletto

Variation in smoking-related lung cancer risk factors by cell type among men in Argentina: a case-control study

A high mortality rate for lung cancer (62.7 per 100,000) is found in Rosario, Argentina. To investigate the reasons for this high rate, a case-control study was carried out among 215 male cases with histologically confirmed lung cancer and 433 hospitalized controls for conditions unrelated to tobacco consumption. Odds ratios (OR) of squamous cell (SQ), adenocarcinoma (AD), and small cell (SM) carcinoma of the lung associated with different characteristics of the smoking habit were quantified. Ninety-eight percent of the cases had smoked regularly. Smokers were significantly younger at diagnosis than ex-smokers (P<0.0001), a pattern consistent for all cell types. The ORs for the heaviest cf the lowest consumption categories were 15.3 for SQ, 11.6 for AD, and 11.6 for all lung cancer (P<0.0001). Risks associated with the use of unfiltered cigarettes were three to five times higher than those for filtered cigarettes, depending on cell types. For ex-smokers, risks after 10 years of nonsmoking were about 12 times lower than those of current smokers (P<0.001). To halt further increases in lung cancer, preventive measures in Argentina should be directed primarily towards smoking control.

Prevalencia del habito de fumar en jóvenes y sus padres: asociaciones relevantes con educacion y ocupación

Com o objetivo de conhecer a prevalencia de habito de fumar cigarros entre os jovens, estudaram-se amostras aleatorias de homens de 18 anos e de estudantes universitarios de medicina e de economia, que responderam um questionario sobre o habito, escolaridade e ocupacao, proprios e de seus pais. A prevalencia do habito de fumar foi maior nos homens de ambas as geracoes, nos estudantes de medicina, que nos de economia, e nos pais com educacao universitaria. Achou-se associacao entre o habito dos jovens representativos da populacao geral (p < 0,001), mas nao entre o dos progenitores e de seus filhos universitarios. Visto a participacao fundamental que os universitarios, em especial os medicos, deveriam ter na comunidade, surge a necessidade de programas educativos, nao so nas escolas mas tambem nas universidades.Rosario, with a million inhabitants, is the second major urban concentration in Argentina and serves as the commercial and industrial center for a large area. In view of the lack of information on the present prevalence of smoking in this area as for the country as a whole, a study was performed on random samples of young people and university students of medicine and economics, as well as on their parents. Information was obtained on their life smoking habits, education and occupation. The prevalence of the habit was higher: a) in men, both in the youngsters and their parents; b) in medical students than in those of the economic sciences; c) in parents with university education. The smoking habit of these subjects and parents was highly associated (p less than 0.001) in the sample of young people, although no association was found between the prevalence of smoking among university students and their parents. Peer smoking was the main factor influencing the onset of cigarette smoking given by 69% of the subjects. Knowledge of specific adverse health effects of smoking was poor. Attitudes toward restrictive measures were highly associated (p less than 0.001) with the non-smoker category. Based on these findings, we conclude that while there is a need for educational programs for the population in general, the university as a whole and specifically the school of medicine should implement a program to increase knowledge and awareness on this public health problem.

CLUSTER ANALYSIS WITH CONSTRAINTS: ITS USE WITH BREAST CANCER MORTALITY RATES IN ARGENTINA

One approach to analyse geographic variations of a disease within a country is through mortality rates in administrative areas. In some geographical areas the rates can be unstable due to their low population. Thus, the statistical analysis of the rate could be not significant due to low population, not because of the real value. An alternative approach to this problem is to set a minimum level of population that enables valid statistical comparisons with the national rate to be made. It is decided to apply an algorithm that groups neighbouring geographical units that reach the minimum population. In the resulting regions, mortality rates are calculated, and the geographic patterns are analysed through the Morans I coefficient of spatial clustering. This paper presents an application of this approach to mortality rates from breast cancer by Argentine departments, political administrative units into which a province is divided. Applying this procedure, 217 regions were obtained. In two of the regions the rates were significantly higher than the national rate, while in 40 regions they were significantly lower. Significant spatial grouping, reflected by a Moran I coefficient of O-47, was observed.

Prevalence of smoking in young people and their parents: important assocations with education and occupation

Com o objetivo de conhecer a prevalencia de habito de fumar cigarros entre os jovens, estudaram-se amostras aleatorias de homens de 18 anos e de estudantes universitarios de medicina e de economia, que responderam um questionario sobre o habito, escolaridade e ocupacao, proprios e de seus pais. A prevalencia do habito de fumar foi maior nos homens de ambas as geracoes, nos estudantes de medicina, que nos de economia, e nos pais com educacao universitaria. Achou-se associacao entre o habito dos jovens representativos da populacao geral (p < 0,001), mas nao entre o dos progenitores e de seus filhos universitarios. Visto a participacao fundamental que os universitarios, em especial os medicos, deveriam ter na comunidade, surge a necessidade de programas educativos, nao so nas escolas mas tambem nas universidades.Rosario, with a million inhabitants, is the second major urban concentration in Argentina and serves as the commercial and industrial center for a large area. In view of the lack of information on the present prevalence of smoking in this area as for the country as a whole, a study was performed on random samples of young people and university students of medicine and economics, as well as on their parents. Information was obtained on their life smoking habits, education and occupation. The prevalence of the habit was higher: a) in men, both in the youngsters and their parents; b) in medical students than in those of the economic sciences; c) in parents with university education. The smoking habit of these subjects and parents was highly associated (p less than 0.001) in the sample of young people, although no association was found between the prevalence of smoking among university students and their parents. Peer smoking was the main factor influencing the onset of cigarette smoking given by 69% of the subjects. Knowledge of specific adverse health effects of smoking was poor. Attitudes toward restrictive measures were highly associated (p less than 0.001) with the non-smoker category. Based on these findings, we conclude that while there is a need for educational programs for the population in general, the university as a whole and specifically the school of medicine should implement a program to increase knowledge and awareness on this public health problem.

Hipercementosis Apicales y No Apicales en Raíces Dentarias Humanas

El cemento secundario del apice radicular se deposita en forma lenta y continua durante toda la vida util del diente, siendo su funcion compensar el desgaste producido por la masticacion. En raras ocasiones podemos hallar en la raiz dental, a posteriori de una extraccion dentaria, excesos de cementos redondeados u ovalados, bien delimitados y duros al tacto, ubicados en un sector radicular diferente al apice. Nuestro objetivo fue comparar las caracteristicas fisicas y radiologicas de raices dentales normales con aquellas que presentan este tipo de formaciones que alteran la anatomia radicular. Fueron incluidos 20 dientes adultos con raices normales y 20 con raices donde se visualizaron estos depositos. Las variables investigadas fueron edad, sexo, patologias generales y periodontales previas, tipo de diente extraido, ubicacion en el arco dental, motivo de extraccion, caracteristicas de consistencia, color, aspecto y textura de todas las raices. La imagen radiologica fue crucial para la inclusion de dientes con exceso de cemento. Se recolecto un total de 40 dientes adultos, cuya edad promedio fue de 61anos (16-79), 42.5% masculinos y 57.5% femeninos. Patologia general presento el 37.5% y periodontal el 55%, los dientes mas extraidos fueron premolares superiores del lado derecho 15%. La caries fue causa principal de extraccion 72.5%. En ambos grupos las raices fueron de consistencia dura y textura lisa. El aspecto nacarado fue de 70% y 60%, los colores claros 45% y 75%, respectivamente. En las radiografias se observo que el cemento no se diferencio de la dentina en el 40% y 85% de cada grupo (p=0.004). Los adultos pueden desarrollar anomalias de cemento ubicadas en otro sector del apice si bien las caracteristicas fisicas de la raiz se consideran dentro de parametros normales.

Exposición ocupacional y cáncer de pulmón en fumadores

High male lung cancer incidence and mortality in Rosario city, Argentina, have been found in previous studies. A project was undertaken for the purpose of evaluating the life-time occupational history as well as the duration and intensity of cigarette smoking as determinants of histologic cell types in 211 male patients with primary lung cancer. Their histologic cell types were: squamous 39%, adenocarcinoma 29%, small cell 18%, and others and not specified 14%. An association was found between histologic cell types and occupations (p < 0.0001), adenocarcinoma being more prevalent in office personnel, teachers, accountants, lawyers, and squamous in the other, supposedly dirtier working environments, mainly in those men who had begun to work in farming and later transferred to mechanics and metallurgy. These latter ones were diagnosed at a younger age than those in other occupations, with a significant difference for squamous and small cell. No differences in the smoking intensity were found between the occupational groups. The mean age these patients began to smoke at was 15 years for those with squamous and small cell, and 17 years for those with adenocarcinoma (p < 0.001). An interesting finding was the difference at their mean-age at diagnosis, 58 years for smokers and 68 for ex-smokers (p < 0.0001). Studies are needed to elucidate the interplay of risk factors in the etiology of histologic subtypes of lung cancer.Las altas tasas de incidencia y mortalidad por cancer de pulmon en hombres en Rosario, Argentina motivaron o estudio de 211 pacientes varones. Se comparon las edades al diagnostico entre los tipos histologicos y ocupaciones, y edad de iniciacion, duracion e intensidad del habito de fumar. La edad promedio al diagnostico fue 61 anos, sin diferencias por tipo histologico pero si por habito de fumar: 58 anos los fumadores y 68 los ex-fumadores (p<0,0001). En estos pacientes se encontro un predominio de tumores epidermoides, lo que podria estar asociado a los contaminantes ocupacionales presentes en esta etapa de industrializacion. La asociacion entre tipo celular y ocupacion fue altamente significativa (p<0,0001), encontrandose el adenocarcinoma con mayor frecuencia en administrativos (oficinistas, docentes, contadores, abogados) y el epidermoide en otras ocupaciones (agricultores, metalurgicos), especialmente en quienes fueron primeramente agricultores y luego metalurgicos.

Medición Comparada de Procesos Odontoblásticos y Canalículos Dentinarios

El complejo dentinopulpar comparte el odontoblasto cuyo cuerpo esta ubicado en la parte externa de la pulpa dentaria. De su polo apical se desprende el proceso odontoblastico que se introduce en el canaliculo dentinal atravesando la dentina originando en su recorrido multiples colaterales hasta su finalizacion. Describir el proceso fue ardua tarea de investigadores que combinaron tecnicas histologicas para preservarlo en el interior de los canaliculos utilizando microscopio electronico de transmision o scanning para visualizarlo. En un trabajo previo observamos ambos tejidos unidos por los odontoblastos y los procesos coloreados. El objetivo actual fue medir micrometricamente la longitud de procesos y canaliculos para verificar si ambas son similares tanto en corona como en raiz. Se utilizaron treinta dientes sanos, extraidos por razones ortodoncicas de ambos sexos, cuyas edades oscilaron entre 6 y 18 anos. Se descubrio la pulpa dental, se fijo y se dividieron en partes iguales. Las mitades sin pulpa se prepararon con tecnica por desgaste. Las mitades que conservaron la pulpa se desmineralizaron aplicandoseles Colagenasa tipo II y coloreandolos con la tecnica de Schmorl. Con microscopio optico y una cuadricula calibrada con micrometro objetivo se midio primero el ancho de los campos histologicos y luego la longitud de procesos y canaliculos dentinales. Los resultados fueron analizados con pruebas de chi2, t de Student y test exacto de Fischer con un nivel de significacion del 5%. Observamos que el ancho de los campos histologicos coloreados tuvo una retraccion del 92% respecto al mismo campo en el desgaste y que la longitud de canaliculos siempre fue mayor que la de procesos, si bien se hallaron cuatro coincidencias de longitudes en corona y una en raiz. Estos resultados sugieren que la longitud del proceso aun sigue siendo tema controversial. La precausion profesional en los tratamientos odontologicos es el unico medio para evitar danarlo.

Raíces Dentales Humanas Normales y con Perlas de Cemento: Comparación Histológica de Estructuras

Durante la vida del diente en boca se deposita cemento celular en el apice a fin de compensar el desgaste oclusal considerado normal. Al extraer un diente, en raras ocasiones es posible visualizar excesos de cemento con forma de perlas bien delimitados y duros al tacto, ubicados en otro sector radicular diferente al apice. Nuestro objetivo fue comparar estructuras en ambos tipos de cemento a fin de hallar diferencias histologicas. Se utilizaron 20 dientes permanentes con perlas (G1) y 20 con raices normales (G2). Las raices de G1 se cortaron con disco metalico de grano fino a baja velocidad en sentido transversal, a la altura de la parte mas prominente de la protuberancia, las raices de G2 se marcaron en tercios y se cortaron en sentido transversal aproximadamente a la altura de la mitad del tercio apical y de ambos grupos se obtuvieron un segmento que fue reservado y otro que fue preparado con tecnica por desgaste para visualizacion con MO a menor y mayor aumentos. Los resultados se compararon con prueba t de student, las variables categoricas se compararon con pruebas de Fisher significacion 5%. Se obtuvieron 40 dientes de pacientes adultos, 42,5% masculinos y 57,5% femeninos, edad promedio 61±16 en G1 y 55±18 en G2 (p=0,289). El contorno exterior de las perlas fue liso, conservando su perimetro, la zona granular de Tomes fue visible al igual que las lagunas, que fueron menos abundantes, de mayor tamano y con distribucion desordenada llegando en menor proporcion al borde del tejido comparado con cemento normal.

Exposição ocupacional e câncer de pulmão em fumantes

High male lung cancer incidence and mortality in Rosario city, Argentina, have been found in previous studies. A project was undertaken for the purpose of evaluating the life-time occupational history as well as the duration and intensity of cigarette smoking as determinants of histologic cell types in 211 male patients with primary lung cancer. Their histologic cell types were: squamous 39%, adenocarcinoma 29%, small cell 18%, and others and not specified 14%. An association was found between histologic cell types and occupations (p < 0.0001), adenocarcinoma being more prevalent in office personnel, teachers, accountants, lawyers, and squamous in the other, supposedly dirtier working environments, mainly in those men who had begun to work in farming and later transferred to mechanics and metallurgy. These latter ones were diagnosed at a younger age than those in other occupations, with a significant difference for squamous and small cell. No differences in the smoking intensity were found between the occupational groups. The mean age these patients began to smoke at was 15 years for those with squamous and small cell, and 17 years for those with adenocarcinoma (p < 0.001). An interesting finding was the difference at their mean-age at diagnosis, 58 years for smokers and 68 for ex-smokers (p < 0.0001). Studies are needed to elucidate the interplay of risk factors in the etiology of histologic subtypes of lung cancer.Las altas tasas de incidencia y mortalidad por cancer de pulmon en hombres en Rosario, Argentina motivaron o estudio de 211 pacientes varones. Se comparon las edades al diagnostico entre los tipos histologicos y ocupaciones, y edad de iniciacion, duracion e intensidad del habito de fumar. La edad promedio al diagnostico fue 61 anos, sin diferencias por tipo histologico pero si por habito de fumar: 58 anos los fumadores y 68 los ex-fumadores (p<0,0001). En estos pacientes se encontro un predominio de tumores epidermoides, lo que podria estar asociado a los contaminantes ocupacionales presentes en esta etapa de industrializacion. La asociacion entre tipo celular y ocupacion fue altamente significativa (p<0,0001), encontrandose el adenocarcinoma con mayor frecuencia en administrativos (oficinistas, docentes, contadores, abogados) y el epidermoide en otras ocupaciones (agricultores, metalurgicos), especialmente en quienes fueron primeramente agricultores y luego metalurgicos.

Occupational exposure and lung cancer in smokers

High male lung cancer incidence and mortality in Rosario city, Argentina, have been found in previous studies. A project was undertaken for the purpose of evaluating the life-time occupational history as well as the duration and intensity of cigarette smoking as determinants of histologic cell types in 211 male patients with primary lung cancer. Their histologic cell types were: squamous 39%, adenocarcinoma 29%, small cell 18%, and others and not specified 14%. An association was found between histologic cell types and occupations (p < 0.0001), adenocarcinoma being more prevalent in office personnel, teachers, accountants, lawyers, and squamous in the other, supposedly dirtier working environments, mainly in those men who had begun to work in farming and later transferred to mechanics and metallurgy. These latter ones were diagnosed at a younger age than those in other occupations, with a significant difference for squamous and small cell. No differences in the smoking intensity were found between the occupational groups. The mean age these patients began to smoke at was 15 years for those with squamous and small cell, and 17 years for those with adenocarcinoma (p < 0.001). An interesting finding was the difference at their mean-age at diagnosis, 58 years for smokers and 68 for ex-smokers (p < 0.0001). Studies are needed to elucidate the interplay of risk factors in the etiology of histologic subtypes of lung cancer.Las altas tasas de incidencia y mortalidad por cancer de pulmon en hombres en Rosario, Argentina motivaron o estudio de 211 pacientes varones. Se comparon las edades al diagnostico entre los tipos histologicos y ocupaciones, y edad de iniciacion, duracion e intensidad del habito de fumar. La edad promedio al diagnostico fue 61 anos, sin diferencias por tipo histologico pero si por habito de fumar: 58 anos los fumadores y 68 los ex-fumadores (p<0,0001). En estos pacientes se encontro un predominio de tumores epidermoides, lo que podria estar asociado a los contaminantes ocupacionales presentes en esta etapa de industrializacion. La asociacion entre tipo celular y ocupacion fue altamente significativa (p<0,0001), encontrandose el adenocarcinoma con mayor frecuencia en administrativos (oficinistas, docentes, contadores, abogados) y el epidermoide en otras ocupaciones (agricultores, metalurgicos), especialmente en quienes fueron primeramente agricultores y luego metalurgicos.