Alcohol drinking and head and neck cancer risk: the joint effect of intensity and duration.

Background: Alcohol is a well-established risk factor for head and neck cancer (HNC). This study aims to explore the effect of alcohol intensity and duration, as joint continuous exposures, on HNC risk.

Methods: Data from 26 case-control studies in the INHANCE Consortium were used, including never and current drinkers who drunk ≤10 drinks/day for ≤54 years (24234 controls, 4085 oral cavity, 3359 oropharyngeal, 983 hypopharyngeal and 3340 laryngeal cancers).

Joint effects of intensity and duration of cigarette smoking on the risk of head and neck cancer: A bivariate spline model approach.

Objectives: This study aimed at re-evaluating the strength and shape of the dose-response relationship between the combined (or joint) effect of intensity and duration of cigarette smoking and the risk of head and neck cancer (HNC). We explored this issue considering bivariate spline models, where smoking intensity and duration were treated as interacting continuous exposures.

Materials And Methods: We pooled individual-level data from 33 case-control studies (18,260 HNC cases and 29,844 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium.

[Oncology trajectories of elderly patients in a palliative situation : « The long and winding road »].

This paper focuses on trajectories of elderly patients with metastatic cancer who experience several lines of systemic palliative cancer treatments. Based on photographs representing paths, the representations between patients and professional caregivers vary. Where the latter see wearisome treatments and spaces of negotiation, the patients wish to be seen as fighters, a figure that ought to be adopted to face cancer and its treatments, day after day, to meet medical and social expectations.

[Clinical decision making : from theory to practice… and backward].

Being able to analyze all the successive steps of decision making from the first contact with the patient to the final diagnosis is complex because it refers sometimes to intuitive elements proper to each clinician. However, understanding how they integrate probabilities of diseases into their clinical practice and manage diagnostic uncertainties is crucial. This allows a more rational practice of medicine and identifying factors related to the patient, physician or context that may modify the clinical decision making.

Adding non-randomised studies to a Cochrane review brings complementary information for healthcare stakeholders: an augmented systematic review and meta-analysis.

Background: To reduce the burden of asthma, chronic disease management (CDM) programmes have been widely implemented and evaluated. Reviews including randomised controlled trials (RCTs) suggest that CDM programmes for asthma are effective. Other study designs are however often used for pragmatic reasons, but excluded from these reviews because of their design.

Relation of allium vegetables intake with head and neck cancers: evidence from the INHANCE consortium.

Scope: Only a few studies analyzed the role of allium vegetables with reference to head and neck cancers (HNC), with mixed results. We investigated the potential favorable role of garlic and onion within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium.

Methods And Results: We analyzed pooled individual-level data from eight case-control studies, including 4590 cases and 7082 controls.

Carotenoid intake and head and neck cancer: a pooled analysis in the International Head and Neck Cancer Epidemiology Consortium.

Food and nutrition play an important role in head and neck cancer (HNC) etiology; however, the role of carotenoids remains largely undefined. We explored the relation of HNC risk with the intake of carotenoids within the International Head and Neck Cancer Epidemiology Consortium. We pooled individual-level data from 10 case-control studies conducted in Europe, North America, and Japan.

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration.

Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results.

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study.

Health situation and issues in the Seychelles in 2012.

Located off the coast of Kenya, the Republic of the Seychelles is an island archipelago nation whose citizens are mostly of African origin. The population, independent from the United Kingdom since 1976, has largely completed its demographic and epidemiological transitions. Major investments in infrastructure and social services have fostered a steady economic growth.

[Implementation of a diabetes disease management program in Switzerland: patients' and healthcare professionals' point of view].

Background: A reorganization of healthcare systems is required to meet the challenge of the increasing prevalence of chronic diseases, e.g. diabetes.

[Quality of life in patients traited for primary superficial venous insufficiency].

Venous symptoms and quality of life (QOL) of 78 patients (54 women, mean age 49,5±13,3 years) with primary superficial venous insufficiency (PSVI) were compared at one year after treatment with crossectomy and stripping (C/S, 56 patients) or endovenous laser ablation (EVLA, 22 patients) using the VEINES-QOL questionnaire. Both treatments significantly (p<0,001) improved the scores for venous symptoms (difference 10,6±9,9 and 9,9±8,2 score points for C/S and EVLA, respectively) and QOL (difference 10,3±8,7 and 8,4±6,6 score points for C/S and EVLA, respectively). No difference was found between treatments regarding symptoms or QOL improvement (p=0,30).

[Complementary and alternative medicines (CAM): towards an "evidence-based" consensus in the university hospital].

While a popular vote supported a new article on complementary and alternative medicines (CAM) in the Swiss Constitution, this assessment in 14 wards of the University Hospital of Lausanne, Switzerland, attempted at answering the question: How can CAM use be better taken into account and patients informed with more rigor and respect for their choices? Confronted with a review of the literature (> 2000 publications in "Evidence-based complementary medicines" since 1998), respondents declared their ignorance of the clinical data presently available on CAM. All were in favour of more teaching and information on the subject, plus an official statement from the Hospital direction, ensuring production and diffusion of rigorous and clinically significant information on CAM.

Risk of prostate, breast and colorectal cancer after skin cancer diagnosis.

Ultraviolet radiation is the major cause of skin cancer, but promotes vitamin D synthesis, and vitamin D has been inversely related to the risk of several common cancers including prostate, breast and colorectum. We therefore computed the incidence of prostate, breast and colorectal cancer following skin cancer using the datasets of the Swiss cancer Registries of Vaud and Neuchâtel. Between 1974 and 2005, 6,985 histologically confirmed squamous cell skin cancers, 21,046 basal cell carcinomas and 3,346 cutaneous malignant melanomas were registered, and followed up to the end of 2005 for the occurrence of second primary cancer of the prostate, breast and colorectum.

[Epidemiology and prevention of obesity in children and adolescents].

The epidemic of obesity extends to the entire population, including children and adolescents. Obesity is most often assessed based on age- and sex-specific values of body mass index. In Switzerland, the pediatric prevalence of overweight (including obesity) and obesity are, respectively, 15-20% and 2-5%.

[The french school of public health (FSPH): III. Disease prevention and screening].

The ongoing epidemiological transition is characterized by the increasing predominance of degenerative diseases. New responses from the health system are thus needed, reorganizing curative services as well as preventive strategies. The latter have to target risk factors for degenerative disease in order to improve primary prevention.

[Cancer epidemiology and trends in Switzerland].

Trends in cancer mortality in Switzerland over the period 1980-2001 and of incidence in the Swiss Canton of Vaud (640,000 inhabitants) over the period 1974-2003 are reviewed and discussed. Steady declines in cancer mortality were observed, over the last decade, particularly from the mid-1980's, with falls in overall mortality of 11% in men and 8% in women. The fall was of 20 % in male lung, whereas lung cancer has steadily increased in women by 47 %.

[Childhood obesity: definition, consequences, and prevalence].

Since the 1980s, an epidemic of obesity is occurring worldwide among adults and children. The body mass index (BMI) is useful to determine whether a child is overweight or obese because BMI relates strongly to body fat mass. However, contrary to adults, BMI changes with sex and age in children.

[Prevention practices of primary health care physicians in Switzerland in the context of the HIV/Aids epidemic: changes between 1990 and 2002].

Background: Individual preventive counseling offered to the general public by private doctors working in primary health care is an essential component of the Swiss National Aids Prevention strategy. Surveys were conducted to assess to what extent they fulfill this role and how this may have changed over time.

Methods: Three cross-sectional surveys were conducted in 1990, 1995, and 2002 by anonymous mailed questionnaire in a random sample of primary health care physicians.

[CT utilisation in Switzerland: frequency and secular trends].

Purpose: This study analyzes CT examinations in Switzerland.

Materials And Methods: Using different sources (administrative data on the equipment, a 1998 nationwide inquiry into practices, and data provided by the Swiss University Hospitals of Basel, Zurich, and Lausanne), we determined the frequency of CT examinations (hospitals and private radiologists) in 1998 according to different descriptive variables and studied the progression in CT use over time.

Results: CT scanners increased by 7% between 1998 and 2004.