113 results on '"Rué, Montserrat"'
Search Results
2. Publisher Correction: Development and validation of a sample entropy-based method to identify complex patient-ventilator interactions during mechanical ventilation
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Sarlabous, Leonardo, Aquino‑Esperanza, José, Magrans, Rudys, de Haro, Candelaria, López‑Aguilar, Josefina, Subirà, Carles, Batlle, Montserrat, Rué, Montserrat, Gomà, Gemma, Ochagavia, Ana, Fernández, Rafael, and Blanch, Lluís
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- 2020
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3. Development and validation of a sample entropy-based method to identify complex patient-ventilator interactions during mechanical ventilation
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Sarlabous, Leonardo, Aquino-Esperanza, José, Magrans, Rudys, de Haro, Candelaria, López-Aguilar, Josefina, Subirà, Carles, Batlle, Montserrat, Rué, Montserrat, Gomà, Gemma, Ochagavia, Ana, Fernández, Rafael, and Blanch, Lluís
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- 2020
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4. Double Cycling During Mechanical Ventilation: Frequency, Mechanisms, and Physiologic Implications
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de Haro, Candelaria, López-Aguilar, Josefina, Magrans, Rudys, Montanya, Jaume, Fernández-Gonzalo, Sol, Turon, Marc, Gomà, Gemma, Chacón, Encarna, Albaiceta, Guillermo M., Fernández, Rafael, Subirà, Carles, Lucangelo, Umberto, Murias, Gastón, Rué, Montserrat, Kacmarek, Robert M., and Blanch, Lluís
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- 2018
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5. Prognostic relevance of integrated genetic profiling in adult T-cell acute lymphoblastic leukemia
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Van Vlierberghe, Pieter, Ambesi-Impiombato, Alberto, De Keersmaecker, Kim, Hadler, Michael, Paietta, Elisabeth, Tallman, Martin S., Rowe, Jacob M., Forne, Carles, Rue, Montserrat, and Ferrando, Adolfo A.
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- 2013
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6. Sixty years old is the breakpoint of human frontal cortex aging
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Cabré, Rosanna, Naudí, Alba, Dominguez-Gonzalez, Mayelin, Ayala, Victòria, Jové, Mariona, Mota-Martorell, Natalia, Piñol-Ripoll, Gerard, Gil-Villar, Maria Pilar, Rué, Montserrat, Portero-Otín, Manuel, Ferrer, Isidre, and Pamplona, Reinald
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- 2017
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7. Factors influencing intention to participate in breast cancer screening. An exploratory structural model.
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López-Panisello, María Belén, Pérez-Lacasta, María José, Rué, Montserrat, and Carles-Lavila, Misericòrdia
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EARLY detection of cancer ,BREAST cancer ,PLANNED behavior theory ,STRUCTURAL models ,INTENTION - Abstract
Objectives: The paper has two objectives. The first one examines whether informing women about the benefits and adverse effects of breast cancer screening could have an effect on three variables: their knowledge, the importance women attach to the future consequences of their current decisions (time perspective), and the degree to which women are worried about developing breast cancer (worry). The second one examines whether these three variables affect their intention to participate in the screening, either directly or indirectly through their feeling of regret if they do not attend the screening (anticipated regret); through their values and the support they receive in making their decisions (decisional conflict); and, through the perceived acceptability and benefits of the screening programme (attitude). Methods: Partial least squares-structural equation modelling (PLS-SEM) is used to analyse both objectives and to differentiate between direct, indirect, and moderating effects, due to the incorporation in the model of the three mediating variables (anticipated regret, decisional conflict, and attitude) and a moderating variable (educational level). Results: Information affects knowledge (objective variable), but not the behavioural variables (time perspective and worry). On the other hand, the level of knowledge has no direct or indirect effect on intention, but behavioural variables do affect it through the mediating variables. Conclusions: The variables of the planned behaviour theory are relevant to understand women's decisions and to be able to take appropriate health policy measures. Doing so, the processes of personalised screening would improve, or there would be the incorporation of shared decision-making in this context; these being demands associated with the most recent goals achieved in health programmes in many countries. [ABSTRACT FROM AUTHOR]
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- 2023
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8. Disease-Specific Health-Related Quality of Life Questionnaires for Heart Failure: A Systematic Review with Meta-Analyses
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Garin, Olatz, Ferrer, Montse, Pont, Àngels, Rué, Montserrat, Kotzeva, Anna, Wiklund, Ingela, Van Ganse, Eric, and Alonso, Jordi
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- 2009
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9. Sick leave among native and immigrant workers in Spain—a 6-month follow-up study
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Soler-González, Jorge, Serna, Maria-Catalina, Bosch, Anna, Ruiz, Maria-Cristina, Huertas, Elisard, and Rué, Montserrat
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- 2008
10. Feasibility and Acceptability of Personalized Breast Cancer Screening (DECIDO Study): A Single-Arm Proof-of-Concept Trial.
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Laza-Vásquez, Celmira, Martínez-Alonso, Montserrat, Forné-Izquierdo, Carles, Vilaplana-Mayoral, Jordi, Cruz-Esteve, Inés, Sánchez-López, Isabel, Reñé-Reñé, Mercè, Cazorla-Sánchez, Cristina, Hernández-Andreu, Marta, Galindo-Ortego, Gisela, Llorens-Gabandé, Montserrat, Pons-Rodríguez, Anna, and Rué, Montserrat
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- 2022
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11. Comparison of Immigrant and Native-Born Population Adherence to Antipsychotic Treatment in a Spanish Health Region
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Forcada, Irene, Pera, Vanessa, Cruz, Inés, Josep, Pifarré, Serna, Catalina, Rué, Montserrat, and Galván, Leonardo
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- 2013
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12. The Effect of Clusters of Double Triggering and Ineffective Efforts in Critically Ill Patients.
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Magrans, Rudys, Ferreira, Francini, Sarlabous, Leonardo, López-Aguilar, Josefina, Gomà, Gemma, Fernandez-Gonzalo, Sol, Navarra-Ventura, Guillem, Fernández, Rafael, Montanyà, Jaume, Kacmarek, Robert, Rué, Montserrat, Forné, Carles, Blanch, Lluís, de Haro, Candelaria, Aquino-Esperanza, José, Esteva, Julia, Fernández-Gonzalo, Sol, Chacón, Encarna, Estruga, Anna, and Ochagavia, Ana
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- 2022
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13. Views of health professionals on risk-based breast cancer screening and its implementation in the Spanish National Health System: A qualitative discussion group study.
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Laza-Vásquez, Celmira, Codern-Bové, Núria, Cardona-Cardona, Àngels, Hernández-Leal, Maria José, Pérez-Lacasta, Maria José, Carles-Lavila, Misericòrdia, and Rué, Montserrat
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MEDICAL personnel ,EARLY detection of cancer ,BREAST cancer ,WOMEN'S roles ,MEDICAL screening ,PRIMARY care - Abstract
Background: With the aim of increasing benefits and decreasing harms, risk-based breast cancer screening has been proposed as an alternative to age-based screening. This study explores barriers and facilitators to implementing a risk-based breast cancer screening program from the perspective of health professionals, in the context of a National Health Service. Methods: Socio-constructivist qualitative research carried out in Catalonia (Spain), in the year 2019. Four discussion groups were conducted, with a total of 29 health professionals from primary care, breast cancer screening programs, hospital breast units, epidemiology units, and clinical specialties. A descriptive-interpretive thematic analysis was performed. Results: Identified barriers included resistance to reducing the number of screening exams for low-risk women; resistance to change for health professionals; difficulties in risk communication; lack of conclusive evidence of the benefits of risk-based screening; limited economic resources; and organizational transformation. Facilitators include benefits of risk-based strategies for high and low-risk women; women's active role in their health care; proximity of women and primary care professionals; experience of health professionals in other screening programs; and greater efficiency of a risk-based screening program. Organizational and administrative changes in the health system, commitment by policy makers, training of health professionals, and educational interventions addressed to the general population will be required. Conclusions: Despite the expressed difficulties, participants supported the implementation of risk-based screening. They highlighted its benefits, especially for women at high risk of breast cancer and those under 50 years of age, and assumed a greater efficiency of the risk-based program compared to the aged-based one. Future studies should assess the efficiency and feasibility of risk-based breast cancer screening for its transfer to clinical practice. [ABSTRACT FROM AUTHOR]
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- 2022
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14. FLIP is frequently expressed in endometrial carcinoma and has a role in resistance to TRAIL-induced apoptosis
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Dolcet, Xavier, Llobet, David, Pallares, Judit, Rue, Montserrat, Comella, Joan X, and Matias-Guiu, Xavier
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- 2005
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15. Immunohistochemical analysis of PTEN in endometrial carcinoma: a tissue microarray study with a comparison of four commercial antibodies in correlation with molecular abnormalities
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Pallares, Judit, Bussaglia, Elena, Martínez-Guitarte, Jose Luis, Dolcet, Xavier, Llobet, David, Rue, Montserrat, Sanchez-Verde, Lidia, Palacios, Jose, Prat, Jaime, and Matias-Guiu, Xavier
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- 2005
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16. Effect of information about the benefits and harms of mammography on women's decision making : The InforMa randomised controlled trial
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Sala Serra, Maria, Pérez-Lacasta, Maria José, Martínez-Alonso, Montserrat, García, Montse, Perestelo-Pérez, Lilisbeth, Vidal, Carmen, Codern Bové, Núria, Feijoo-Cid, Maria, Toledo-Chávarri, Ana, Cardona, Àngels, Pons, Anna, Carles, Misericòrdia, Rué, Montserrat, and InforMa Group
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Questionnaires ,Health Screening ,Health Knowledge, Attitudes, Practice ,Mama--Radiografia ,Social Sciences ,Decisional conflict ,Choice Behavior ,Geographical locations ,law.invention ,Diagnostic Radiology ,Breast cancer screening ,0302 clinical medicine ,Clinical trials ,Cognition ,Randomized controlled trial ,law ,Cancer screening ,Breast Tumors ,Outcome Assessment, Health Care ,Medicine and Health Sciences ,Psychology ,Mass Screening ,Public and Occupational Health ,030212 general & internal medicine ,Early Detection of Cancer ,Multidisciplinary ,medicine.diagnostic_test ,Radiology and Imaging ,Mama -- Radiografia ,Middle Aged ,Europe ,Oncology ,Research Design ,030220 oncology & carcinogenesis ,Anxiety ,Medicine ,Female ,medicine.symptom ,Cancer Screening ,Research Article ,Mammography ,medicine.medical_specialty ,Psychometrics ,Imaging Techniques ,Science ,Decision Making ,Breast Neoplasms ,Research and Analysis Methods ,Risk Assessment ,Decision Support Techniques ,03 medical and health sciences ,Breast cancer ,Diagnostic Medicine ,Intervention (counseling) ,Breast Cancer ,medicine ,Cancer Detection and Diagnosis ,Humans ,European Union ,Survey Research ,business.industry ,Cognitive Psychology ,Cancers and Neoplasms ,Biology and Life Sciences ,medicine.disease ,Mamografia ,Spain ,Family medicine ,Mama -- Càncer ,Cognitive Science ,People and places ,Patient Participation ,business ,Assaigs clínics ,Neuroscience - Abstract
BACKGROUND: In Spain, women invited to breast screening are not usually informed about potential harms of screening. The objective of the InforMa study is to assess the effect of receiving information about the benefits and harms of breast screening on informed choice and other decision-making outcomes, in women approaching the age of invitation to mammography screening. METHODS: Two-stage randomised controlled trial. In the first stage, 40 elementary territorial units of the public healthcare system were selected and randomised to intervention or control. In the second stage, women aged 49-50 years were randomly selected. The target sample size was 400 women. Women in the intervention arm received a decision aid (DA) with detailed information on the benefits and harms of screening. Women in the control arm received a standard leaflet that did not mention harms and recommended accepting the invitation to participate in the Breast Cancer Screening Program (BCSP). The primary outcome was informed choice, defined as adequate knowledge and intentions consistent with attitudes. Secondary outcomes included decisional conflict, worry about breast cancer, time perspective, opinions about the DA or the leaflet, and participation in the BCSP. RESULTS: In the intervention group, 23.2% of 203 women made an informed choice compared to only 0.5% of 197 women in the control group (p < 0.001). Attitudes and intentions were similar in both study groups with a high frequency of women intending to be screened, 82.8% vs 82.2% (p = 0.893). Decisional conflict was significantly lower in the intervention group. No differences were observed in confidence in the decision, anxiety, and participation in BCSP. CONCLUSIONS: Women in Spain lack knowledge on the benefits and harms of breast screening. Providing quantitative information on benefits and harms has produced a considerable increase in knowledge and informed choice, with a high acceptance of the informative materials. TRIAL REGISTRATION: Trial identifier NCT03046004 at ClinicalTrials.gov registry. Registered on February 4 2017. Trial name: InforMa study. This study was supported by the research grant “Women participation in decisions and strategies on early detection of breast cancer” (PI14/00113) from the Instituto de Salud Carlos III and cofunded by Fondo Europeo de Desarrollo Regional (FEDER) “Una manera de hacer Europa.” Anna Pons received a grant for PhD students from the Lleida Biomedical Research Institute (IRBLleida). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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- 2019
17. High tumor incidence and activation of the PI3K/AKT pathway in transgenic mice define AIB1 as an oncogene
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Torres-Arzayus, Maria I., de Mora, Jaime Font, Yuan, Jing, Vazquez, Francisca, Bronson, Roderick, Rue, Montserrat, Sellers, William R., and Brown, Myles
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- 2004
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18. Longitudinal Changes in Patient-Ventilator Asynchronies and Respiratory System Mechanics Before and After Tracheostomy.
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Lena, Enrico, Aquino-Esperanza, José, López-Aguilar, Josefina, Magrans, Rudys, de Haro, Candelaria, Sarlabous, Leonardo, López, Neus, Montanyà, Jaume, Rué, Montserrat, Kacmarek, Robert M., Lucangelo, Umberto, Fernández, Rafael, Pelosi, Paolo, and Blanch, Lluís
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TRACHEOTOMY ,PILOT projects ,CONFIDENCE intervals ,AIRWAY (Anatomy) ,CONTINUING education units ,RESPIRATORY measurements ,ARTIFICIAL respiration ,RESEARCH funding ,DESCRIPTIVE statistics ,REPEATED measures design ,RESPIRATORY mechanics - Abstract
BACKGROUND: This was a pilot study to analyze the effects of tracheostomy on patient-ventilator asynchronies and respiratory system mechanics. Data were extracted from an ongoing prospective, real-world database that stores continuous output from ventilators and bedside monitors. Twenty adult subjects were on mechanical ventilation and were tracheostomized during an ICU stay: 55% were admitted to the ICU for respiratory failure and 35% for neurologic conditions; the median duration of mechanical ventilation before tracheostomy was 12 d; and the median duration of mechanical ventilation was 16 d. METHODS: We compared patient-ventilator asynchronies (the overall asynchrony index and the rates of specific asynchronies) and respiratory system mechanics (respiratory-system compliance and airway resistance) during the 24 h before tracheostomy versus the 24 h after tracheostomy. We analyzed possible differences in these variables among the subjects who underwent surgical versus percutaneous tracheostomy. To compare longitudinal changes in the variables, we used linear mixed-effects models for repeated measures along time in different observation periods. A total of 920 h of mechanical ventilation were analyzed. RESULTS: Respiratory mechanics and asynchronies did not differ significantly between the 24-h periods before and after tracheostomy: compliance of the respiratory system median (IQR) (47.9 [41.3 -- 54.6] mL/cm H2O vs 47.6 [40.9 -- 54.3] mL/cm H
2 O; P = .94), airway resistance (9.3 [7.5 -- 11.1] cm H2O/L/s vs 7.0 [5.2 -- 8.8] cm H2 O/L/s; P = .07), asynchrony index (2.0% [1.1 -- 3.6%] vs 4.1% [2.3 -- 7.6%]; P = .09), ineffective expiratory efforts (0.9% [0.4 -- 1.8%] vs 2.2% [1.0 -- 4.4%]; P = .08), double cycling (0.5% [0.3 -- 1.0%] vs 0.9% [0.5 -- 1.9%]; P = .24), and percentage of air trapping (7.6% [4.2 -- 13.8%] vs 10.6% [5.9 -- 19.2%]; P = .43). No differences in respiratory mechanics or patient-ventilator asynchronies were observed between percutaneous and surgical procedures. CONCLUSIONS: Tracheostomy did not affect patient-ventilator asynchronies or respiratory mechanics within 24 h before and after the procedure [ABSTRACT FROM AUTHOR]- Published
- 2021
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19. Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data
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Marcos-Gragera Rafael, Rué Montserrat, Vilaprinyo Ester, and Martínez-Alonso Montserrat
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background During the last part of the 1990s the chance of surviving breast cancer increased. Changes in survival functions reflect a mixture of effects. Both, the introduction of adjuvant treatments and early screening with mammography played a role in the decline in mortality. Evaluating the contribution of these interventions using mathematical models requires survival functions before and after their introduction. Furthermore, required survival functions may be different by age groups and are related to disease stage at diagnosis. Sometimes detailed information is not available, as was the case for the region of Catalonia (Spain). Then one may derive the functions using information from other geographical areas. This work presents the methodology used to estimate age- and stage-specific Catalan breast cancer survival functions from scarce Catalan survival data by adapting the age- and stage-specific US functions. Methods Cubic splines were used to smooth data and obtain continuous hazard rate functions. After, we fitted a Poisson model to derive hazard ratios. The model included time as a covariate. Then the hazard ratios were applied to US survival functions detailed by age and stage to obtain Catalan estimations. Results We started estimating the hazard ratios for Catalonia versus the USA before and after the introduction of screening. The hazard ratios were then multiplied by the age- and stage-specific breast cancer hazard rates from the USA to obtain the Catalan hazard rates. We also compared breast cancer survival in Catalonia and the USA in two time periods, before cancer control interventions (USA 1975–79, Catalonia 1980–89) and after (USA and Catalonia 1990–2001). Survival in Catalonia in the 1980–89 period was worse than in the USA during 1975–79, but the differences disappeared in 1990–2001. Conclusion Our results suggest that access to better treatments and quality of care contributed to large improvements in survival in Catalonia. On the other hand, we obtained detailed breast cancer survival functions that will be used for modeling the effect of screening and adjuvant treatments in Catalonia.
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- 2009
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20. Competing risks to breast cancer mortality in Catalonia
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Espinàs Josep-Alfons, Pla Roger, Carles Misericòrdia, Martínez-Alonso Montserrat, Gispert Rosa, Vilaprinyo Ester, and Rué Montserrat
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Breast cancer mortality has experienced important changes over the last century. Breast cancer occurs in the presence of other competing risks which can influence breast cancer incidence and mortality trends. The aim of the present work is: 1) to assess the impact of breast cancer deaths among mortality from all causes in Catalonia (Spain), by age and birth cohort and 2) to estimate the risk of death from other causes than breast cancer, one of the inputs needed to model breast cancer mortality reduction due to screening or therapeutic interventions. Methods The multi-decrement life table methodology was used. First, all-cause mortality probabilities were obtained by age and cohort. Then mortality probability for breast cancer was subtracted from the all-cause mortality probabilities to obtain cohort life tables for causes other than breast cancer. These life tables, on one hand, provide an estimate of the risk of dying from competing risks, and on the other hand, permit to assess the impact of breast cancer deaths on all-cause mortality using the ratio of the probability of death for causes other than breast cancer by the all-cause probability of death. Results There was an increasing impact of breast cancer on mortality in the first part of the 20th century, with a peak for cohorts born in 1945–54 in the 40–49 age groups (for which approximately 24% of mortality was due to breast cancer). Even though for cohorts born after 1955 there was only information for women under 50, it is also important to note that the impact of breast cancer on all-cause mortality decreased for those cohorts. Conclusion We have quantified the effect of removing breast cancer mortality in different age groups and birth cohorts. Our results are consistent with US findings. We also have obtained an estimate of the risk of dying from competing-causes mortality, which will be used in the assessment of the effect of mammography screening on breast cancer mortality in Catalonia.
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- 2008
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21. Emergency hospital services utilization in Lleida (Spain): A cross-sectional study of immigrant and Spanish-born populations
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Soler-González Jorge, Cabré Xavier, Rué Montserrat, Bosch Anna, Almirall Mercè, and Serna Maria
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Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background The use of emergency hospital services (EHS) has increased steadily in Spain in the last decade while the number of immigrants has increased dramatically. Studies show that immigrants use EHS differently than native-born individuals, and this work investigates demographics, diagnoses and utilization rates of EHS in Lleida (Spain). Methods Cross-sectional study of all the 96,916 EHS visits by patients 15 to 64 years old, attended during the years 2004 and 2005 in a public teaching hospital. Demographic data, diagnoses of the EHS visits, frequency of hospital admissions, mortality and diagnoses at hospital discharge were obtained. Utilization rates were estimated by group of origin. Poisson regression was used to estimate the rate ratios of being visited in the EHS with respect to the Spanish-born population. Results Immigrants from low-income countries use EHS services more than the Spanish-born population. Differences in utilization patterns are particularly marked for Maghrebi men and women and sub-Saharan women. Immigrant males are at lower risk of being admitted to the hospital, as compared with Spanish-born males. On the other hand, immigrant women are at higher risk of being admitted. After excluding the visits with gynecologic and obstetric diagnoses, women from sub-Saharan Africa and the Maghreb are still at a higher risk of being admitted than their Spanish-born counterparts. Conclusion In Lleida (Spain), immigrants use more EHS than the Spanish born population. Future research should indicate whether the same pattern is found in other areas of Spain and whether EHS use is attributable to health needs, barriers to access to the primary care services or similarities in the way immigrants access health care in their countries of origin.
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- 2008
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22. The effect of information about the benefits and harms of mammography on women's decision-making: study protocol for a randomized controlled trial
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Carles, Misericòrdia, Martínez-Alonso, Montserrat, Pons, Anna, Pérez-Lacasta, Maria José, Perestelo-Pérez, Lilisbeth, Sala Serra, Maria, Vidal, Carmen, García, Montse, Toledo-Chávarri, Ana, Codern Bové, Núria, Feijoo-Cid, Maria, Romero, Anabel, Pla, Roger, Soler-González, Jorge, Castells, Xavier, Rué, Montserrat, and InforMa Group
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Research design ,Health Knowledge, Attitudes, Practice ,Mama -- Càncer -- Prevenció ,Medicine (miscellaneous) ,Choice Behavior ,law.invention ,Study Protocol ,Breast cancer screening ,0302 clinical medicine ,Breast cancer ,Randomized controlled trial ,Risk Factors ,law ,Mass Screening ,Medicine ,Pharmacology (medical) ,030212 general & internal medicine ,Overdiagnosis ,lcsh:R5-920 ,medicine.diagnostic_test ,Mama -- Radiografia ,Early detection ,Middle Aged ,Radiation Exposure ,Cribratge ,Research Design ,030220 oncology & carcinogenesis ,Screening ,Female ,lcsh:Medicine (General) ,Mammography ,medicine.medical_specialty ,Medical screening ,Decision Making ,education ,Breast Neoplasms ,Radiation Dosage ,Risk Assessment ,Càncer de mama ,Access to Information ,03 medical and health sciences ,Patient Education as Topic ,Predictive Value of Tests ,Humans ,Patient participation ,Mass screening ,Gynecology ,business.industry ,medicine.disease ,Informed choice ,Spain ,Family medicine ,Decision aids ,Pamphlets ,Patient Participation ,business - Abstract
Background The decision to participate or not in breast cancer screening is complex due to the trade-off between the expected benefit of breast cancer mortality reduction and the major harm of overdiagnosis. It seems ethically necessary to inform women so that they can actively participate in decision-making and make an informed choice based on their values and preferences. The objective of this study is to assess the effects of receiving information about the benefits and harms of screening on decision-making, in women approaching the age of invitation to mammography screening. Methods A two-stage, randomized controlled trial (RCT). In the first stage, 40 Basic Health Areas (BHAs) will be selected and randomized to intervention or control. In the second stage, women within each BHA will be randomly selected (n = 400). Four breast cancer screening programs (BCSPs) of the Spanish public health system, three in Catalonia and one in the Canary Islands will participate in the study. Women in the intervention arm will receive a leaflet with detailed information on the benefits and harms of screening using mammography. Women in the control arm will receive a standard leaflet that does not mention harms and recommends accepting the invitation to participate in the biennial examinations of the BCSP. The primary outcome is informed choice, a dichotomous variable that combines knowledge, attitudes, and intentions. Secondary outcomes include decisional conflict; confidence in the decision made; anxiety about screening participation; worry about breast cancer; anticipated regret; time perspective; perceived importance of benefits/harms of screening; perceived risk of breast cancer; and leaflet acceptability. Primary and secondary outcomes are assessed 2–3 weeks after the intervention. Discussion This is the first RCT that assesses the effect of informing about the benefits and harms of breast cancer screening in Spain in women facing the decision to be screened using mammography. It aims to assess the impact of information on several decisional outcomes and to contribute to paving the road towards shared decision-making in breast cancer screening in our country. Trial registration ClinicalTrials.gov registry, ID: NCT03046004. Retrospectively registered on 4 February 2017. Trial name: InforMa study. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2161-7) contains supplementary material, which is available to authorized users.
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- 2017
23. Erratum to: Comparison of Immigrant and Native-Born Population Adherence to Antipsychotic Treatment in a Spanish Health Region
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Forcada, Irene, Pera, Vanessa, Cruz, Inés, Pifarré, Josep, Serna, Catalina, Rué, Montserrat, and Galván, Leonardo
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- 2013
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24. A shared-parameter joint model for prostate cancer risk and psa longitudinal profiles
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Serrat Piè, Carles|||0000-0002-1504-5354, Rué, Montserrat, Perpiñán Fabuel, Hèctor, Forte, Anabel, Armero, Carmen, Piulachs, Xavier, Páez, Álvaro, Gómez Melis, Guadalupe|||0000-0003-4252-4884, Universitat Politècnica de Catalunya. Departament de Matemàtiques, Universitat Politècnica de Catalunya. Departament d'Estadística i Investigació Operativa, and Universitat Politècnica de Catalunya. GRBIO - Grup de Recerca en Bioestadística i Bioinformàtica
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Matemàtiques i estadística::Estadística aplicada::Estadística biosanitària [Àrees temàtiques de la UPC] ,Estadística bayesiana ,Bayesian statistical decision theory ,urologic and male genital diseases - Abstract
The paper describes the use of frequentist and Bayesian shared-parameter joint models of longitudinal measurements of prostate specific antigen (PSA) and the risk of prostate cancer (PCa). The motivating dataset corresponds to the screening arm of the Spanish branch of the European Randomized Screening for Prostate Cancer (ERSPC) study. The results show that PSA is highly associated with the risk of being diagnosed with PCa and that there is an age-varying effect of PSA on PCa risk. Both the frequentist and Bayesian paradigms produced very close parameter estimates and subsequent 95% confidence and credibility intervals. Dynamic estimations of disease-free probabilities obtained using Bayesian inference highlight the potential of joint models to guide personalized risk-based screening strategies.
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- 2015
25. Lipid Profile in Human Frontal Cortex Is Sustained Throughout Healthy Adult Life Span to Decay at Advanced Ages.
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Cabré, Rosanna, Naudí, Alba, Dominguez-Gonzalez, Mayelin, Jové, Mariona, Ayala, Victòria, Mota-Martorell, Natalia, Pradas, Irene, Nogueras, Lara, Rué, Montserrat, Portero-Otín, Manuel, Ferrer, Isidro, and Pamplona, Reinald
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LIPID metabolism ,FATTY acids ,BIOSYNTHESIS ,CELL membranes ,INFLAMMATION - Abstract
Fatty acids are key components in the structural diversity of lipids and play a strategic role in the functional properties of lipids which determine the structural and functional integrity of neural cell membranes, the generation of lipid signaling mediators, and the chemical reactivity of acyl chains. The present study analyzes the profile of lipid fatty acid composition of membranes of human frontal cortex area 8 in individuals ranging from 40 to 90 years old. Different components involved in polyunsaturated fatty acid biosynthesis pathways, as well as adaptive defense mechanisms involved in the lipid-mediated modulation of inflammation, are also assessed. Our results show that the lipid profile in human frontal cortex is basically preserved through the adult life span to decay at advanced ages, which is accompanied by an adaptive proactive anti-inflammatory response possibly geared to ensuring cell survival and function. [ABSTRACT FROM AUTHOR]
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- 2018
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26. Bayesian joint modeling of bivariate longitudinal and competing risks data: An application to study patient-ventilator asynchronies in critical care patients.
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Rué, Montserrat, Andrinopoulou, Eleni‐Rosalina, Alvares, Danilo, Armero, Carmen, Forte, Anabel, and Blanch, Lluis
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Mechanical ventilation is a common procedure of life support in intensive care. Patient-ventilator asynchronies (PVAs) occur when the timing of the ventilator cycle is not simultaneous with the timing of the patient respiratory cycle. The association between severity markers and the events death or alive discharge has been acknowledged before, however, little is known about the addition of PVAs data to the analyses. We used an index of asynchronies (AI) to measure PVAs and the SOFA (sequential organ failure assessment) score to assess overall severity. To investigate the added value of including the AI, we propose a Bayesian joint model of bivariate longitudinal and competing risks data. The longitudinal process includes a mixed effects model for the SOFA score and a mixed effects beta regression model for the AI. The survival process is defined in terms of a cause-specific hazards model for the competing risks death or alive discharge. Our model indicates that the SOFA score is strongly related to vital status. PVAs are positively associated with alive discharge but there is not enough evidence that PVAs provide a more accurate indication of death prognosis than the SOFA score alone. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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27. Statistical Methods for the Analysis of Biomedical Data Robert F. Woolson William R. Clarke
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Rue, Montserrat
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- 2004
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28. Assessment of the effects of decision aids about breast cancer screening: a systematic review and meta-analysis.
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Martínez-Alonso, Montserrat, Carles-Lavila, Misericòrdia, Pérez-Lacasta, Maria José, Pons-Rodríguez, Anna, Garcia, Montse, and Rué, Montserrat
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Objective The aim of this systematic review and metaanalysis of randomised controlled trials (RCTs) and observational studies is to assess the effect of decision aids (DAs) in women aged 50 and below facing the decision to be screened for breast cancer. Setting Screening for breast cancer. Intervention DAs aimed to help women make a deliberative choice regarding participation in mammography screening by providing information on the options and outcomes. Eligible studies We included published original, non-pilot, studies that assess the effect of DAs for breast cancer screening. We excluded the studies that evaluated only participation intention or actual uptake. The studies' risk of bias was assessed with the Cochrane Collaboration's tool for RCTs and the National Institutes of Health Quality Assessment Tool for non-RCTs. Primary and secondary outcomes The main outcome measures were informed choice, decisional conflict and/or confidence, and knowledge. Secondary outcomes were values, attitudes, uncertainty and intention to be screened. Results A total of 607 studies were identified, but only 3 RCTs and 1 before-after study were selected. The use of DAs increased the proportion of women making an informed decision by 14%, 95% CI (2% to 27%) and the proportion of women with adequate knowledge by 12%, 95% CI (7% to 16%). We observed heterogeneity among the studies in confidence in the decision. The metaanalysis of the RCTs showed a significant decrease in confidence in the decision and in intention to be screened. Conclusions Tools to aid decision making in screening for breast cancer improve knowledge and promote informed decision; however, we found divergent results on decisional conflict and confidence in the decision. Under the current paradigm change, which favours informed choice rather than maximising uptake, more research is necessary for the improvement of DAs. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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29. Characterization of the CPAP-treated patient population in Catalonia.
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Turino, Cecilia, Bertran, Sandra, Gavaldá, Ricard, Teixidó, Ivan, Woehrle, Holger, Rué, Montserrat, Solsona, Francesc, Escarrabill, Joan, Colls, Cristina, García-Altés, Anna, de Batlle, Jordi, Sánchez de-la-Torre, Manuel, and Barbé, Ferran
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CONTINUOUS positive airway pressure ,PUBLIC health ,SLEEP apnea syndrome treatment ,DEATH rate ,CLUSTER analysis (Statistics) - Abstract
There are different phenotypes of obstructive sleep apnoea (OSA), many of which have not been characterised. Identification of these different phenotypes is important in defining prognosis and guiding the therapeutic strategy. The aim of this study was to characterise the entire population of continuous positive airway pressure (CPAP)-treated patients in Catalonia and identify specific patient profiles using cluster analysis. A total of 72,217 CPAP-treated patients who contacted the Catalan Health System (CatSalut) during the years 2012 and 2013 were included. Six clusters were identified, classified as “Neoplastic patients” (Cluster 1, 10.4%), “Metabolic syndrome patients” (Cluster 2, 27.7%), “Asthmatic patients” (Cluster 3, 5.8%), “Musculoskeletal and joint disorder patients” (Cluster 4, 10.3%), “Patients with few comorbidities” (Cluster 5, 35.6%) and “Oldest and cardiac disease patients” (Cluster 6, 10.2%). Healthcare facility use and mortality were highest in patients from Cluster 1 and 6. Conversely, patients in Clusters 2 and 4 had low morbidity, mortality and healthcare resource use. Our findings highlight the heterogeneity of CPAP-treated patients, and suggest that OSA is associated with a different prognosis in the clusters identified. These results suggest the need for a comprehensive and individualised approach to CPAP treatment of OSA. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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30. Cost-Effectiveness of Double Reading versus Single Reading of Mammograms in a Breast Cancer Screening Programme.
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Posso, Margarita, Carles, Misericòrdia, Rué, Montserrat, Puig, Teresa, and Bonfill, Xavier
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BREAST cancer diagnosis ,DIGITAL mammography ,COST effectiveness ,MEDICAL care costs ,QUALITY-adjusted life years - Abstract
Objectives: The usual practice in breast cancer screening programmes for mammogram interpretation is to perform double reading. However, little is known about its cost-effectiveness in the context of digital mammography. Our purpose was to evaluate the cost-effectiveness of double reading versus single reading of digital mammograms in a population-based breast cancer screening programme. Methods: Data from 28,636 screened women was used to establish a decision-tree model and to compare three strategies: 1) double reading; 2) double reading for women in their first participation and single reading for women in their subsequent participations; and 3) single reading. We calculated the incremental cost-effectiveness ratio (ICER), which was defined as the expected cost per one additionally detected cancer. We performed a deterministic sensitivity analysis to test the robustness of the ICER. Results: The detection rate of double reading (5.17‰) was similar to that of single reading (4.78‰; P = .768). The mean cost of each detected cancer was €8,912 for double reading and €8,287 for single reading. The ICER of double reading versus single reading was €16,684. The sensitivity analysis showed variations in the ICER according to the sensitivity of reading strategies. The strategy that combines double reading in first participation with single reading in subsequent participations was ruled out due to extended dominance. Conclusions: From our results, double reading appears not to be a cost-effective strategy in the context of digital mammography. Double reading would eventually be challenged in screening programmes, as single reading might entail important net savings without significantly changing the cancer detection rate. These results are not conclusive and should be confirmed in prospective studies that investigate long-term outcomes like quality adjusted life years (QALYs). [ABSTRACT FROM AUTHOR]
- Published
- 2016
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31. Frequentist and Bayesian approaches for a joint model for prostate cancer risk and longitudinal prostate-specific antigen data.
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Serrat, Carles, Rué, Montserrat, Armero, Carmen, Piulachs, Xavier, Perpiñán, Hèctor, Forte, Anabel, Páez, Álvaro, and Gómez, Guadalupe
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- *
BAYESIAN analysis , *PROSTATE cancer , *DIAGNOSIS , *MEDICAL screening , *RELATIVE medical risk , *BAYES' theorem , *ANTIGENS - Abstract
The paper describes the use of frequentist and Bayesian shared-parameter joint models of longitudinal measurements of prostate-specific antigen (PSA) and the risk of prostate cancer (PCa). The motivating dataset corresponds to the screening arm of the Spanish branch of the European Randomized Screening for Prostate Cancer study. The results show that PSA is highly associated with the risk of being diagnosed with PCa and that there is an age-varying effect of PSA on PCa risk. Both the frequentist and Bayesian paradigms produced very close parameter estimates and subsequent 95% confidence and credibility intervals. Dynamic estimations of disease-free probabilities obtained using Bayesian inference highlight the potential of joint models to guide personalized risk-based screening strategies. [ABSTRACT FROM PUBLISHER]
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- 2015
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32. Impact of Risk Factors on Different Interval Cancer Subtypes in a Population-Based Breast Cancer Screening Programme.
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Blanch, Jordi, Sala, Maria, Ibáñez, Josefa, Domingo, Laia, Fernandez, Belén, Otegi, Arantza, Barata, Teresa, Zubizarreta, Raquel, Ferrer, Joana, Castells, Xavier, Rué, Montserrat, and Salas, Dolores
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MAMMOGRAMS ,BREAST cancer diagnosis ,CANCER in women ,CARCINOGENS ,DIAGNOSIS - Abstract
Background: Interval cancers are primary breast cancers diagnosed in women after a negative screening test and before the next screening invitation. Our aim was to evaluate risk factors for interval cancer and their subtypes and to compare the risk factors identified with those associated with incident screen-detected cancers. Methods: We analyzed data from 645,764 women participating in the Spanish breast cancer screening program from 2000–2006 and followed-up until 2009. A total of 5,309 screen-detected and 1,653 interval cancers were diagnosed. Among the latter, 1,012 could be classified on the basis of findings in screening and diagnostic mammograms, consisting of 489 true interval cancers (48.2%), 235 false-negatives (23.2%), 172 minimal-signs (17.2%) and 114 occult tumors (11.3%). Information on the screening protocol and women's characteristics were obtained from the screening program registry. Cause-specific Cox regression models were used to estimate the hazard ratios (HR) of risks factors for interval cancer and incident screen-detected cancer. A multinomial regression model, using screen-detected tumors as a reference group, was used to assess the effect of breast density and other factors on the occurrence of interval cancer subtypes. Results: A previous false-positive was the main risk factor for interval cancer (HR = 2.71, 95%CI: 2.28–3.23); this risk was higher for false-negatives (HR = 8.79, 95%CI: 6.24–12.40) than for true interval cancer (HR = 2.26, 95%CI: 1.59–3.21). A family history of breast cancer was associated with true intervals (HR = 2.11, 95%CI: 1.60–2.78), previous benign biopsy with a false-negatives (HR = 1.83, 95%CI: 1.23–2.71). High breast density was mainly associated with occult tumors (RRR = 4.92, 95%CI: 2.58–9.38), followed by true intervals (RRR = 1.67, 95%CI: 1.18–2.36) and false-negatives (RRR = 1.58, 95%CI: 1.00–2.49). Conclusion: The role of women's characteristics differs among interval cancer subtypes. This information could be useful to improve effectiveness of breast cancer screening programmes and to better classify subgroups of women with different risks of developing cancer. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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33. Barriers and Facilitators to the Implementation of a Personalized Breast Cancer Screening Program: Views of Spanish Health Professionals.
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Laza-Vásquez, Celmira, Hernández-Leal, María José, Carles-Lavila, Misericòrdia, Pérez-Lacasta, Maria José, Cruz-Esteve, Inés, and Rué, Montserrat
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- 2022
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34. Prognostic Relevance of Integrated Genetic Profiling in Adult T-Cell Acute Lymphoblastic Leukemia
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Van Vlierberghe, Pieter, Ambesi-Impiombato, Alberto, Rigo, Isaura, Hadler, Michael, Paietta, Elisabeth, Wiernik, Peter H., Rowe, Jacob M, Rue, Montserrat, and Ferrando, Adolfo A.
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- 2012
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35. Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data.
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Vilaprinyo, Ester, Rué, Montserrat, Marcos-Gragera, Rafael, and Martínez-Alonso, Montserrat
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BREAST cancer research , *ADJUVANT treatment of cancer , *MAMMOGRAMS , *MATHEMATICAL models , *CANCER-related mortality - Abstract
Background: During the last part of the 1990s the chance of surviving breast cancer increased. Changes in survival functions reflect a mixture of effects. Both, the introduction of adjuvant treatments and early screening with mammography played a role in the decline in mortality. Evaluating the contribution of these interventions using mathematical models requires survival functions before and after their introduction. Furthermore, required survival functions may be different by age groups and are related to disease stage at diagnosis. Sometimes detailed information is not available, as was the case for the region of Catalonia (Spain). Then one may derive the functions using information from other geographical areas. This work presents the methodology used to estimate age- and stage-specific Catalan breast cancer survival functions from scarce Catalan survival data by adapting the age- and stage-specific US functions. Methods: Cubic splines were used to smooth data and obtain continuous hazard rate functions. After, we fitted a Poisson model to derive hazard ratios. The model included time as a covariate. Then the hazard ratios were applied to US survival functions detailed by age and stage to obtain Catalan estimations. Results: We started estimating the hazard ratios for Catalonia versus the USA before and after the introduction of screening. The hazard ratios were then multiplied by the age- and stage-specific breast cancer hazard rates from the USA to obtain the Catalan hazard rates. We also compared breast cancer survival in Catalonia and the USA in two time periods, before cancer control interventions (USA 1975-79, Catalonia 1980-89) and after (USA and Catalonia 1990-2001). Survival in Catalonia in the 1980-89 period was worse than in the USA during 1975-79, but the differences disappeared in 1990-2001. Conclusion: Our results suggest that access to better treatments and quality of care contributed to large improvements in survival in Catalonia. On the other hand, we obtained detailed breast cancer survival functions that will be used for modeling the effect of screening and adjuvant treatments in Catalonia. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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36. Emergency hospital services utilization in Lleida (Spain): A cross-sectional study of immigrant and Spanish-born populations.
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Rué, Montserrat, Cabré, Xavier, Soler-González, Jorge, Bosch, Anna, Almirall, Mercè, and Serna, Maria Catalina
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UTILIZATION of emergency medical services , *IMMIGRANTS , *UTILIZATION review (Medical care) , *HEALTH services accessibility , *PRIMARY care - Abstract
Background: The use of emergency hospital services (EHS) has increased steadily in Spain in the last decade while the number of immigrants has increased dramatically. Studies show that immigrants use EHS differently than native-born individuals, and this work investigates demographics, diagnoses and utilization rates of EHS in Lleida (Spain). Methods: Cross-sectional study of all the 96,916 EHS visits by patients 15 to 64 years old, attended during the years 2004 and 2005 in a public teaching hospital. Demographic data, diagnoses of the EHS visits, frequency of hospital admissions, mortality and diagnoses at hospital discharge were obtained. Utilization rates were estimated by group of origin. Poisson regression was used to estimate the rate ratios of being visited in the EHS with respect to the Spanish-born population. Results: Immigrants from low-income countries use EHS services more than the Spanish-born population. Differences in utilization patterns are particularly marked for Maghrebi men and women and sub-Saharan women. Immigrant males are at lower risk of being admitted to the hospital, as compared with Spanish-born males. On the other hand, immigrant women are at higher risk of being admitted. After excluding the visits with gynecologic and obstetric diagnoses, women from sub-Saharan Africa and the Maghreb are still at a higher risk of being admitted than their Spanish-born counterparts. Conclusion: In Lleida (Spain), immigrants use more EHS than the Spanish born population. Future research should indicate whether the same pattern is found in other areas of Spain and whether EHS use is attributable to health needs, barriers to access to the primary care services or similarities in the way immigrants access health care in their countries of origin. [ABSTRACT FROM AUTHOR]
- Published
- 2008
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37. Benefits of low weekly doses of methotrexate in steroid-dependent asthmatic patients. A double-blind, randomized, placebo-controlled study.
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Comet, Ricard, Domingo, Christian, Larrosa, Marta, Morón, Anisi, Rué, Montserrat, Amengual, Maria-Jose, and Marín, Albert
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Summary: Background: Though several drugs have been tested, the choice of the ideal steroid-sparing agent in steroid-dependent asthmatic patients remains unclear. Our objective was to evaluate the efficacy and tolerance of methotrexate in low weekly doses in order to decrease chronic oral steroid requirements in asthmatic patients. Methods: Design: double blind randomized placebo-controlled study. Setting: The study was performed in a 760-bed teaching hospital. Patients: 46 steroid-dependent asthmatic patients were randomized. Interventions: Patients received 10mg of methotrexate or placebo once weekly for a year. The 6-methylprednisolone was progressively tapered (2mg/day every two weeks) until FEV
1 diminished by 5% or more; 6-methylprednisolone was then increased until the previous FEV1 was reached, and the procedure was repeated throughout follow-up. Measurements: Blood and urine analyses and bone densitometry were performed at entry and at the end of the study. Pulmonary function was tested monthly during the first three months and then every three months until the end. Results: Thirty-nine patients were evaluated at interim analysis. A 54.8% decrease (9.5±4.9mg/day) in 6-methylprednisolone dose was observed in the methotrexate group and a 4.4% decrease (0.5±7.2mg/day) in the placebo group (). There was no significant decrease of FEV1 in either group. No changes in bone metabolism were observed except for a non-statistically significant increase in osteocalcin levels in the treated group compared to a decrease in the placebo group. Toxicity was mild. Conclusions: (1) Methotrexate is an effective steroid-sparing agent. (2) A dosage lower than the one recommended in the literature is effective. (3) Tolerance is good. (4) No benefit or detrimental effects in bone metabolism were observed after one year. [Copyright &y& Elsevier]- Published
- 2006
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38. A predictive index for the diagnosis of cirrhosis in hepatitis C based on clinical, laboratory, and ultrasound findings.
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Obrador BD, Prades MG, Gómez MV, Domingo JP, Cueto RB, Rué M, Real J, Guiteras PM, Obrador, Blai Dalmau, Prades, Montserrat Gil, Gómez, Mercedes Vergara, Domingo, Jordi Puig, Cueto, Rosa Bella, Rué, Montserrat, Real, Jordi, and Guiteras, Pere Mas
- Published
- 2006
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39. ETV6 Is An Early T-Cell Progenitor (ETP) Specific Tumor Suppressor Gene in Adult T-ALL
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Van Vlierberghe, Pieter, Ambesi, Alberto, Rigo, Isaura, Paietta, Elisabeth, Racevskis, Janis, Wiernik, Peter H., Rowe, Jacob M., Rue, Montserrat, and Ferrando, Adolfo A.
- Published
- 2011
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40. Identification of factors that influence tolerance of upper gastrointestinal endoscopy.
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Campo, Rafel, Brullet, Enric, Montserrat, Antonia, Calvet, Xavier, Moix, Jenny, Rué, Montserrat, Roqué, Marta, Donoso, Lluis, Bordas, Josep M., Campo, R, Brullet, E, Montserrat, A, Calvet, X, Moix, J, Rué, M, Roqué, M, Donoso, L, and Bordas, J M
- Published
- 1999
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41. Comparison of In-Phase and Opposed-Phase GRE and Conventional SE MR Pulse Sequences in T1-Weighted Imaging of Liver Lesions.
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Martín, Julio, Sentis, Melcior, Puig, Jordi, Rué, Montserrat, Falcó, Joan, Donoso, Lluis, and Zidan, Ahmed
- Published
- 1996
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42. Lung cancer mortality among males of Catalonia and Spain compared with other European countries between 1975-1977 and 1987-1989.
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Bonfill, Xavier, Moreno, Coloma, Prada, Gonzalo, Rivero, Elena, and Rué, Montserrat
- Published
- 1996
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43. Economic evaluations of screening strategies for the early detection of colorectal cancer in the average-risk population: A systematic literature review.
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Mendivil, Joan, Appierto, Marilena, Aceituno, Susana, Comas, Mercè, and Rué, Montserrat
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EARLY detection of cancer ,FECAL occult blood tests ,COST estimates ,FAILURE mode & effects analysis ,COST effectiveness ,NATIONAL health services ,DIVERTICULOSIS - Abstract
Background: Colorectal cancer (CRC) screening has proven effective in reducing CRC mortality. This study aimed to systematically review, and evaluate the reporting quality, of the economic evidence regarding CRC screening in average-risk individuals. Methods: Databases searched included Medline, EMBASE, National Health Service Economic Evaluation, Database of Abstracts of Reviews of Effects, Cost-Effectiveness Analysis registry, EconLit, and Health Technology Assessment database. Eligible studies were cost-effectiveness and cost-utility analyses comparing CRC screening strategies in average-risk individuals, published in English or Spanish, between January 2012 and November 2018. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results: Of 1,993 publications initially retrieved, 477 were excluded by duplicate review, 1,449 by title/abstract review, and 34 by full-text review. Finally, 33 publications were included in the qualitative synthesis. Most studies were conducted in Europe (36,4%), followed by United States (24,2%) and Asia (24,2%). The main screening modalities considered were fecal immunochemical tests (70%), colonoscopy (67%), guaiac fecal occult blood test (42%) and flexible sigmoidoscopy (30%). In most studies, CRC screening was deemed cost-effective compared to no screening. Sensitivity analyses indicated that cost of CRC screening tests, adherence to screening, screening test sensitivity, and cost of CRC treatment had the greatest impact on cost-effectiveness results across studies. The majority of studies (73%) adequately reported at least 50% of the items included in the CHEERS checklist. Least well reported items included setting, study perspective, discount rate, model choice, and methods to identify effectiveness data or to estimate resource use and costs. Conclusions: CRC screening is an efficient alternative to no screening. Nevertheless, it is not possible to conclude which strategy should be preferred for population-based screening programs. Although we observed an overall good adherence to CHEERS recommendations, there is still room for improvement in economic evaluations reporting in this field. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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44. Competing risks to breast cancer mortality in Catalonia.
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Vilaprinyo E, Gispert R, Martínez-Alonso M, Carles M, Pla R, Espinàs JA, Rué M, Vilaprinyo, Ester, Gispert, Rosa, Martínez-Alonso, Montserrat, Carles, Misericòrdia, Pla, Roger, Espinàs, Josep-Alfons, and Rué, Montserrat
- Abstract
Background: Breast cancer mortality has experienced important changes over the last century. Breast cancer occurs in the presence of other competing risks which can influence breast cancer incidence and mortality trends. The aim of the present work is: 1) to assess the impact of breast cancer deaths among mortality from all causes in Catalonia (Spain), by age and birth cohort and 2) to estimate the risk of death from other causes than breast cancer, one of the inputs needed to model breast cancer mortality reduction due to screening or therapeutic interventions.Methods: The multi-decrement life table methodology was used. First, all-cause mortality probabilities were obtained by age and cohort. Then mortality probability for breast cancer was subtracted from the all-cause mortality probabilities to obtain cohort life tables for causes other than breast cancer. These life tables, on one hand, provide an estimate of the risk of dying from competing risks, and on the other hand, permit to assess the impact of breast cancer deaths on all-cause mortality using the ratio of the probability of death for causes other than breast cancer by the all-cause probability of death.Results: There was an increasing impact of breast cancer on mortality in the first part of the 20th century, with a peak for cohorts born in 1945-54 in the 40-49 age groups (for which approximately 24% of mortality was due to breast cancer). Even though for cohorts born after 1955 there was only information for women under 50, it is also important to note that the impact of breast cancer on all-cause mortality decreased for those cohorts.Conclusion: We have quantified the effect of removing breast cancer mortality in different age groups and birth cohorts. Our results are consistent with US findings. We also have obtained an estimate of the risk of dying from competing-causes mortality, which will be used in the assessment of the effect of mammography screening on breast cancer mortality in Catalonia. [ABSTRACT FROM AUTHOR]- Published
- 2008
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45. Effectiveness and cost-effectiveness of double reading in digital mammography screening: A systematic review and meta-analysis.
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Posso, Margarita, Puig, Teresa, Carles, Misericòrdia, Rué, Montserrat, Canelo-Aybar, Carlos, and Bonfill, Xavier
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MAMMOGRAMS , *COST effectiveness , *EARLY detection of cancer , *DIAGNOSTIC imaging , *SYSTEMATIC reviews , *META-analysis - Abstract
Purpose: Double reading is the strategy of choice for mammogram interpretation in screening programmes. It remains, however, unknown whether double reading is still the strategy of choice in the context of digital mammography. Our aim was to determine the effectiveness and cost-effectiveness of double reading versus single reading of digital mammograms in screening programmes.Methods: We performed a systematic review by searching the PubMed, Embase, and Cochrane Library databases up to April 2017. We used the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) tool and CHEERS (Consolidated Health Economic Evaluation Reporting Standards) checklist to assess the methodological quality of the diagnostic studies and economic evaluations, respectively. A proportion's meta-analysis approach, 95% Confidence Intervals (95% CI) and test of heterogeneity (P values) were used for pooled results. Costs are expressed US$ PPP (United States Dollar purchasing power parities). The PROSPERO ID of this Systematic Review's protocol is CRD42014013804.Results: Of 1473 potentially relevant hits, four high-quality studies were included. The pooled cancer detection rate of double reading was 6.01 per 1000 screens (CI: 4.47‰-7.77‰), and it was 5.65 per 1000 screens (CI: 3.95‰-7.65‰) for single reading (P=0.76). The pooled proportion of false-positives of double reading was 47.03 per 1000 screens (CI: 39.13‰-55.62‰) and it was 40.60 per 1000 screens (CI: 38.58‰-42.67‰) for single reading (P=0.12). One study reported, for double reading, an ICER (Incremental Cost-Effectiveness Ratio) of 16,684 Euros (24,717 US$ PPP; 2015 value) per detected cancer. Single reading+CAD (computer-aided-detection) was cost-effective in Japan.Conclusion: The evidence of benefit for double reading compared to single reading for digital mammography interpretation is scarce. Double reading seems to increase operational costs, have a not significantly higher false-positive rate, and a similar cancer detection rate. [ABSTRACT FROM AUTHOR]- Published
- 2017
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46. Region-specific vulnerability to lipid peroxidation and evidence of neuronal mechanisms for polyunsaturated fatty acid biosynthesis in the healthy adult human central nervous system.
- Author
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Naudí, Alba, Cabré, Rosanna, Dominguez-Gonzalez, Mayelin, Ayala, Victoria, Jové, Mariona, Mota-Martorell, Natalia, Piñol-Ripoll, Gerard, Gil-Villar, Maria Pilar, Rué, Montserrat, Portero-Otín, Manuel, Ferrer, Isidre, and Pamplona, Reinald
- Subjects
- *
LIPID peroxidation (Biology) , *UNSATURATED fatty acids , *BIOSYNTHESIS , *GAS chromatography/Mass spectrometry (GC-MS) , *CENTRAL nervous system physiology - Abstract
Lipids played a determinant role in the evolution of the brain. It is postulated that the morphological and functional diversity among neural cells of the human central nervous system (CNS) is projected and achieved through the expression of particular lipid profiles. The present study was designed to evaluate the differential vulnerability to oxidative stress mediated by lipids through a cross-regional comparative approach. To this end, we compared 12 different regions of CNS of healthy adult subjects, and the fatty acid profile and vulnerability to lipid peroxidation, were determined by gas chromatography (GC) and gas chromatography/mass spectrometry (GC/MS), respectively. In addition, different components involved in PUFA biosynthesis, as well as adaptive defense mechanisms against lipid peroxidation, were also measured by western blot and immunohistochemistry, respectively. We found that: i) four fatty acids (18.1n-9, 22:6n-3, 20:1n-9, and 18:0) are significant discriminators among CNS regions; ii) these differential fatty acid profiles generate a differential selective neural vulnerability (expressed by the peroxidizability index); iii) the cross-regional differences for the fatty acid profiles follow a caudal-cranial gradient which is directly related to changes in the biosynthesis pathways which can be ascribed to neuronal cells; and iv) the higher the peroxidizability index for a given human brain region, the lower concentration of the protein damage markers, likely supported by the presence of adaptive antioxidant mechanisms. In conclusion, our results suggest that there is a region-specific vulnerability to lipid peroxidation and offer evidence of neuronal mechanisms for polyunsaturated fatty acid biosynthesis in the human central nervous system. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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47. Longitudinal Changes in Patient-Ventilator Asynchronies and Respiratory System Mechanics Before and After Tracheostomy
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Umberto Lucangelo, Paolo Pelosi, José Aquino-Esperanza, Lluís Blanch, Rafael Fernandez, Enrico Lena, Jaume Montanya, Candelaria de Haro, Josefina López-Aguilar, Rudys Magrans, Leonardo Sarlabous, Robert M. Kacmarek, Neus López, Montserrat Rué, Lena, Enrico, Aquino-Esperanza, José, López-Aguilar, Josefina, Magrans, Rudy, de Haro, Candelaria, Sarlabous, Leonardo, López, Neu, Montanyà, Jaume, Rué, Montserrat, M Kacmarek, Robert, Lucangelo, Umberto, Fernández, Rafael, Pelosi, Paolo, and Blanch, Lluís
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Pulmonary and Respiratory Medicine ,Adult ,medicine.medical_treatment ,Ventilators ,Pilot Projects ,Respiratory physiology ,Critical Care and Intensive Care Medicine ,Air trapping ,Airway resistance ,Tracheostomy ,Medicine ,Humans ,Pilot Project ,Prospective Studies ,Respiratory system ,Prospective cohort study ,Lung ,Respiration, Artificial ,Respiratory Mechanics ,Ventilators, Mechanical ,Original Research ,Mechanical ventilation ,Respiratory Mechanic ,business.industry ,Respiration ,Repeated measures design ,General Medicine ,Mechanical ,Prospective Studie ,Editorial ,Respiratory failure ,Anesthesia ,Artificial ,medicine.symptom ,business ,Human - Abstract
BACKGROUND: This was a pilot study to analyze the effects of tracheostomy on patient-ventilator asynchronies and respiratory system mechanics. Data were extracted from an ongoing prospective, real-world database that stores continuous output from ventilators and bedside monitors. Twenty adult subjects were on mechanical ventilation and were tracheostomized during an ICU stay: 55% were admitted to the ICU for respiratory failure and 35% for neurologic conditions; the median duration of mechanical ventilation before tracheostomy was 12 d; and the median duration of mechanical ventilation was 16 d. METHODS: We compared patient-ventilator asynchronies (the overall asynchrony index and the rates of specific asynchronies) and respiratory system mechanics (respiratory-system compliance and airway resistance) during the 24 h before tracheostomy versus the 24 h after tracheostomy. We analyzed possible differences in these variables among the subjects who underwent surgical versus percutaneous tracheostomy. To compare longitudinal changes in the variables, we used linear mixed-effects models for repeated measures along time in different observation periods. A total of 920 h of mechanical ventilation were analyzed. RESULTS: Respiratory mechanics and asynchronies did not differ significantly between the 24-h periods before and after tracheostomy: compliance of the respiratory system median (IQR) (47.9 [41.3 – 54.6] mL/cm H(2)O vs 47.6 [40.9 – 54.3] mL/cm H(2)O; P = .94), airway resistance (9.3 [7.5 – 11.1] cm H(2)O/L/s vs 7.0 [5.2 – 8.8] cm H(2)O/L/s; P = .07), asynchrony index (2.0% [1.1 – 3.6%] vs 4.1% [2.3 – 7.6%]; P = .09), ineffective expiratory efforts (0.9% [0.4 – 1.8%] vs 2.2% [1.0 – 4.4%]; P = .08), double cycling (0.5% [0.3 – 1.0%] vs 0.9% [0.5 – 1.9%]; P = .24), and percentage of air trapping (7.6% [4.2 – 13.8%] vs 10.6% [5.9 – 19.2%]; P = .43). No differences in respiratory mechanics or patient-ventilator asynchronies were observed between percutaneous and surgical procedures. CONCLUSIONS: Tracheostomy did not affect patient-ventilator asynchronies or respiratory mechanics within 24 h before and after the procedure
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- 2021
48. Double cycling during mechanical ventilation: Frequency, mechanisms, and physiologic implications*
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Sol Fernandez-Gonzalo, Robert M. Kacmarek, Rafael Fernandez, Umberto Lucangelo, Josefina López-Aguilar, Guillermo M. Albaiceta, Rudys Magrans, Encarna Chacón, Jaume Montanya, Marc Turon, Carles Subirà, Gemma Gomà, Candelaria de Haro, Montserrat Rué, Gastón Murias, Lluis Blanch, Haro, Candelaria de, López-Aguilar, Josefina, Magrans, Rudy, Montanya, Jaume, Fernández-Gonzalo, Sol, Turon, Marc, Gomà, Gemma, Chacón, Encarna, Albaiceta, Guillermo M., Fernández, Rafael, Subirà, Carle, Lucangelo, Umberto, Murias, Gastón, Rué, Montserrat, Kacmarek, Robert M., and Blanch, Lluís
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Male ,medicine.medical_specialty ,Critical Illness ,medicine.medical_treatment ,Asynchronies ,Diaphragmatic breathing ,Reverse triggering ,Lung injury ,Critical Care and Intensive Care Medicine ,Tidal volume ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Respiration ,medicine ,Respiratory muscle ,Humans ,Prospective Studies ,Aged ,Mechanical ventilation ,Breath stacking ,Asynchronie ,business.industry ,Critically ill ,030208 emergency & critical care medicine ,Middle Aged ,Respiration, Artificial ,030228 respiratory system ,Cardiology ,Female ,business ,Cycling - Abstract
Objectives Double cycling generates larger than expected tidal volumes that contribute to lung injury. We analyzed the incidence, mechanisms, and physiologic implications of double cycling during volume- and pressure-targeted mechanical ventilation in critically ill patients. Design Prospective, observational study. Setting Three general ICUs in Spain. Patients Sixty-seven continuously monitored adult patients undergoing volume control-continuous mandatory ventilation with constant flow, volume control-continuous mandatory ventilation with decelerated flow, or pressure control-continuous mandatory mechanical ventilation for longer than 24 hours. Interventions None. Measurements and main results We analyzed 9,251 hours of mechanical ventilation corresponding to 9,694,573 breaths. Double cycling occurred in 0.6%. All patients had double cycling; however, the distribution of double cycling varied over time. The mean percentage (95% CI) of double cycling was higher in pressure control-continuous mandatory ventilation 0.54 (0.34-0.87) than in volume control-continuous mandatory ventilation with constant flow 0.27 (0.19-0.38) or volume control-continuous mandatory ventilation with decelerated flow 0.11 (0.06-0.20). Tidal volume in double-cycled breaths was higher in volume control-continuous mandatory ventilation with constant flow and volume control-continuous mandatory ventilation with decelerated flow than in pressure control-continuous mandatory ventilation. Double-cycled breaths were patient triggered in 65.4% and reverse triggered (diaphragmatic contraction stimulated by a previous passive ventilator breath) in 34.6% of cases; the difference was largest in volume control-continuous mandatory ventilation with decelerated flow (80.7% patient triggered and 19.3% reverse triggered). Peak pressure of the second stacked breath was highest in volume control-continuous mandatory ventilation with constant flow regardless of trigger type. Various physiologic factors, none mutually exclusive, were associated with double cycling. Conclusions Double cycling is uncommon but occurs in all patients. Periods without double cycling alternate with periods with clusters of double cycling. The volume of the stacked breaths can double the set tidal volume in volume control-continuous mandatory ventilation with constant flow. Gas delivery must be tailored to neuroventilatory demand because interdependent ventilator setting-related physiologic factors can contribute to double cycling. One third of double-cycled breaths were reverse triggered, suggesting that repeated respiratory muscle activation after time-initiated ventilator breaths occurs more often than expected.
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- 2018
49. Feasibility and acceptability of personalised breast cancer screening (DECIDO study): protocol of a single-arm proof-of-concept trial.
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Pons-Rodriguez A, Forné Izquierdo C, Vilaplana-Mayoral J, Cruz-Esteve I, Sánchez-López I, Reñé-Reñé M, Cazorla C, Hernández-Andreu M, Galindo-Ortego G, Llorens Gabandé M, Laza-Vásquez C, Balaguer-Llaquet P, Martínez-Alonso M, and Rué M
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- Adult, Bayes Theorem, Feasibility Studies, Female, Humans, Middle Aged, Spain, Breast Neoplasms diagnosis, Breast Neoplasms genetics, Early Detection of Cancer
- Abstract
Introduction: Personalised cancer screening aims to improve benefits, reduce harms and being more cost-effective than age-based screening. The objective of the DECIDO study is to assess the acceptability and feasibility of offering risk-based personalised breast cancer screening and its integration in regular clinical practice in a National Health System setting., Methods and Analysis: The study is designed as a single-arm proof-of-concept trial. The study sample will include 385 women aged 40-50 years resident in a primary care health area in Spain. The study intervention consists of (1) a baseline visit; (2) breast cancer risk estimation; (3) a second visit for risk communication and screening recommendations based on breast cancer risk and (4) a follow-up to obtain the study outcomes.A polygenic risk score (PRS) will be constructed as a composite likelihood ratio of 83 single nucleotide polymorphisms. The Breast Cancer Surveillance Consortium risk model, including age, race/ethnicity, family history of breast cancer, benign breast disease and breast density will be used to estimate a preliminary 5-year absolute risk of breast cancer. A Bayesian approach will be used to update this risk with the PRS value.The primary outcome measures will be attitude towards, intention to participate in and satisfaction with personalised breast cancer screening. Secondary outcomes will include the proportions of women who accept to participate and who complete the different phases of the study. The exact binomial and the Student's t-test will be used to obtain 95% CIs., Ethics and Dissemination: The study protocol was approved by the Drug Research Ethics Committee of the University Hospital Arnau de Vilanova. The trial will be conducted in compliance with this study protocol, the Declaration of Helsinki and Good Clinical Practice.The results will be published in peer-reviewed scientific journals and disseminated in scientific conferences and media., Trial Registration Number: NCT03791008., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2020
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50. The effect of information about the benefits and harms of mammography on women's decision-making: study protocol for a randomized controlled trial.
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Carles M, Martínez-Alonso M, Pons A, Pérez-Lacasta MJ, Perestelo-Pérez L, Sala M, Vidal C, Garcia M, Toledo-Chávarri A, Codern N, Feijoo-Cid M, Romero A, Pla R, Soler-González J, Castells X, and Rué M
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- Decision Making, Female, Health Knowledge, Attitudes, Practice, Humans, Mass Screening adverse effects, Middle Aged, Patient Participation, Predictive Value of Tests, Research Design, Risk Assessment, Risk Factors, Spain, Access to Information, Breast Neoplasms diagnostic imaging, Choice Behavior, Mammography adverse effects, Mass Screening methods, Pamphlets, Patient Education as Topic methods, Radiation Dosage, Radiation Exposure adverse effects
- Abstract
Background: The decision to participate or not in breast cancer screening is complex due to the trade-off between the expected benefit of breast cancer mortality reduction and the major harm of overdiagnosis. It seems ethically necessary to inform women so that they can actively participate in decision-making and make an informed choice based on their values and preferences. The objective of this study is to assess the effects of receiving information about the benefits and harms of screening on decision-making, in women approaching the age of invitation to mammography screening., Methods: A two-stage, randomized controlled trial (RCT). In the first stage, 40 Basic Health Areas (BHAs) will be selected and randomized to intervention or control. In the second stage, women within each BHA will be randomly selected (n = 400). Four breast cancer screening programs (BCSPs) of the Spanish public health system, three in Catalonia and one in the Canary Islands will participate in the study. Women in the intervention arm will receive a leaflet with detailed information on the benefits and harms of screening using mammography. Women in the control arm will receive a standard leaflet that does not mention harms and recommends accepting the invitation to participate in the biennial examinations of the BCSP. The primary outcome is informed choice, a dichotomous variable that combines knowledge, attitudes, and intentions. Secondary outcomes include decisional conflict; confidence in the decision made; anxiety about screening participation; worry about breast cancer; anticipated regret; time perspective; perceived importance of benefits/harms of screening; perceived risk of breast cancer; and leaflet acceptability. Primary and secondary outcomes are assessed 2-3 weeks after the intervention., Discussion: This is the first RCT that assesses the effect of informing about the benefits and harms of breast cancer screening in Spain in women facing the decision to be screened using mammography. It aims to assess the impact of information on several decisional outcomes and to contribute to paving the road towards shared decision-making in breast cancer screening in our country., Trial Registration: ClinicalTrials.gov registry, ID: NCT03046004 . Retrospectively registered on 4 February 2017. Trial name: InforMa study.
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- 2017
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