Ruy Lopez-Ridaura

Effects of non-steroidal anti-inflammatory drugs on cancer sites other than the colon and rectum: a meta-analysis.

BackgroundObservational studies have consistently shown that aspirin and non-steroidal anti-inflammatory drug (NSAID) use is associated with a close to 50% reduced risk of colorectal cancer. Studies assessing the effects of NSAIDs on other cancers have shown conflicting results. Therefore, we conducted a meta-analysis to evaluate the relationship between NSAID use and cancer other than colorectal.MethodsWe performed a search in Medline (from 1966 to 2002) and identified a total of 47 articles (13 cohort and 34 case-control studies). Overall estimates of the relative risk (RR) were calculated for each cancer site using random effects models.ResultsAspirin use was associated with a reduced risk of cancer of the esophagus and the stomach (RR, 0.51; 95%CI (0.38–0.69), and 0.73; 95%CI (0.63–0.84)). Use of NSAIDs was similarly associated with a lower risk of esophageal and gastric cancers (RR,0.65; 95% CI(0.46–0.92) and RR,0.54; 95%CI (0.39–0.75)). Among other cancers, only the results obtained for breast cancer were fairly consistent in showing a slight reduced risk among NSAID and aspirin users (RR, 0.77; 95%CI (0.66–0.88), and RR, 0.77; 95%CI (0.69–0.86) respectively)).ConclusionsThe results of this meta-analysis show that the potential chemopreventive role of NSAIDs in colorectal cancer might be extended to other gastrointestinal cancers such as esophagus and stomach. Further research is required to evaluate the role of NSAIDs at other cancers sites.

Diabetes in Mexico: cost and management of diabetes and its complications and challenges for health policy.

BackgroundMexico has been experiencing some of the most rapid shifts ever recorded in dietary and physical activity patterns leading to obesity. Diabetes mellitus has played a crucial role causing nearly 14% of all deaths. We wanted to make a comprehensive study of the role of diabetes in terms of burden of disease, prevalence, cost of diabetes, cost of complications and health policy.MethodWe review the quantitative data that provides evidence of the extent to which the Mexican health economy is affected by the disease and its complications. We then discuss the current situation of diabetes in Mexico with experts in the field.ResultsThere was a significant increase in the prevalence of diabetes from 1994 to 2006 with rising direct costs (2006: outpatient USD

Association of Gly972Arg polymorphism of IRS1 gene with type 2 diabetes mellitus in lean participants of a national health survey in Mexico: a candidate gene study

717,764,787, inpatient USD

The association between body shape silhouette and dietary pattern among Mexican women

223,581,099) and indirect costs (2005: USD

Knowledge and Adoption of Community Mitigation Efforts in Mexico During the 2009 H1N1 Pandemic

177,220,390), and rising costs of complications (2010: Retinopathy USD

Metabolic Syndrome and Mammographic Density in Mexican Women

10,323,421; Cardiovascular disease USD

Mammographic density and ageing: A collaborative pooled analysis of cross-sectional data from 22 countries worldwide

12,843,134; Nephropathy USD

Circulating concentrations of insulin-like growth factor-I, insulin-like growth factor-binding protein-3, genetic polymorphisms and mammographic density in premenopausal Mexican women: results from the ESMaestras cohort.

81,814,501; Neuropathy USD

Mobile messaging as surveillance tool during pandemic (H1N1) 2009, Mexico

2,760,271; Peripheral vascular disease USD

Restless Legs Syndrome and Hypertension in Mexican Women

2,042,601). The health policy focused on screening and the creation of self-support groups across the country.ConclusionsThe increasing diabetes mortality and lack of control among diagnosed patients make quality of treatment a major concern in Mexico. The growing prevalence of childhood and adult obesity and the metabolic syndrome suggest that the situation could be even worse in the coming years. The government has reacted strongly with national actions to address the growing burden posed by diabetes. However our research suggests that the prevalence and mortality of diabetes will continue to rise in the future.