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1. Indicadores clínicos e pré-hospitalares de sobrevivência no trauma fechado: uma análise multivariada Indicadores clínicos y prehospitalarios de supervivencia al trauma cerrado: un análisis multivariado Clinical and prehospital survival indicators in blunt trauma: a multivariate analysis

Author: Marisa Aparecida Amaro Malvestio and Regina Marcia Cardoso de Sousa
Subjects: Traumatismo múltiple, Supervivencia, Modelos de riesgos proporcionales, Accidentes de tráfico, Traumatismo múltiplo, Sobrevivência, Modelos de riscos proporcionais, Acidentes de trânsito, Multiple trauma, Survival, Proportional hazards models, Accidents, traffic, Public aspects of medicine, RA1-1270, Nursing, RT1-120, Mental healing, RZ400-408, Education (General), L7-991
Abstract: O objetivo do estudo foi identificar os indicadores clínicos e pré-hospitalares associados à sobrevivência de vítimas de trauma fechado. Foram utilizadas a análise de sobrevivência de Kaplan Meier, e de Riscos Proporcionais de Cox, para analisar a associação de 33 variáveis ao óbito precoce e tardio, propondo modelos multivariados. Os modelos finais até 48h pós-trauma evidenciaram altos coeficientes de risco promovidos pelas lesões abdominais, Injury Severity Score >25, procedimentos respiratórios avançados e compressões torácicas pré-hospitalares. No modelo até 7 dias, a pressão arterial sistólica na cena do acidente, se menor de 75mmHg, foi associada a maior risco de óbito e se ausente, foi associada ao mais elevado risco de óbito após 7 dias. A reposição de volume pré-hospitalar apresentou efeito protetor em todos os períodos. Os resultados sugerem que a magnitude da hipoxemia e da instabilidade hemodinâmica diante da hemorragia, influenciaram de forma significante o óbito precoce e tardio desse grupo de vítimas.El objetivo del estudio fue identificar los indicadores clínicos y prehospitalarios asociados a la supervivencia de víctimas de trauma cerrado. Fueron utilizados el Análisis de Supervivencia de Kaplan-Meier y de Riesgos Proporcionales de Cox para examinar la asociación de 33 variables respecto de la muerte temprana y tardía, proponiéndose modelos multivariados. Los modelos finales hasta 48 horas post trauma mostraron altos coeficientes de riesgo promovidos por las lesiones abdominales, Injury Severity Score > 25, procesos respiratorias avanzados y compresiones torácicas prehospitalarias. En el modelo hasta 7 días, la presión arterial sistólica en la escena del accidente, cuando resultó inferior a 75mmHg, se asoció con mayor riesgo de muerte y, en caso de ausencia, se asoció con el mayor riesgo de muerte posterior a 7 días. La reposición de volumen prehospitalario mostró un efecto protector en todos los períodos. Los resultados sugieren que la magnitud de la hipoxemia y la inestabilidad hemodinámica debida a la hemorragia influyeron de manera significativa en la muerte temprana y tardía en este grupo de víctimas.The aim of the study was to identify the clinical and prehospital indicators associated to the survival of blunt trauma victims. The Kaplan Meier survival analysis and the Cox proportional hazards model were used to analyze the association of 33 variables to early and late death, proposing multivariate models. The final models until 48 hours post-trauma showed high rates of risk promoted by abdominal injuries, Injury Severity Score > 25, advanced respiratory procedures and prehospital chest compressions. In the model up to 7 days, a systolic blood pressure in accident site lower than 75mmHg was associated with increased risk of death, and if absent it was associated with higher risk of death after 7 days. The prehospital volume replacement showed a protective effect in all periods. Results suggest that the magnitude of hypoxemia and hemodynamic instability due to bleeding had a significant influence on early and late death in this group of victims.
Published: 2010
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2. Predetermining value analysis of the prehospital phase procedures in trauma victims survival Análisis del valor predeterminante de los procedimientos de la fase prehospitalaria en la sobrevivencia de las víctimas de trauma Análise do valor predeterminante dos procedimentos da fase pré-hospitalar na sobrevivência das vítimas de trauma

Author: Marisa Aparecida Amaro Malvestio and Regina Marcia Cardoso de Sousa
Subjects: assistencia prehospitalaria, accidentes de tránsito, modelos de riesgos proporcionales, assistência pré-hospitalar, acidentes de trânsito, modelos de riscos proporcionais, prehospitalcare, accidents, traffic, proportional hazards model, Nursing, RT1-120
Abstract: The aim of this study was to analyze the determining value of the procedures carried out during prehospital care in the survival time of traffic accident victims. Data of 175 victims with Revised Trauma Score £ 11, cared for and transported by advanced life support to tertiary referral hospitals, were submitted to Kaplan-Meier Survival Analysis and to Cox proportional hazards model. Four procedure groups associated with survival were identified: basic circulatory; advanced respiratory; volume replaced and medication. Until hospital discharge, the victims who underwent orotracheal intubation and chest compressions showed 3.6 and 6.4 times higher death hazards, respectively. The need for definitive airway and cardiopulmonary resuscitation in the prehospital phase was predetermining with higher death hazard. The less than 1000ml intravenous fluid replacement was the only predetermining factor with protective power against death hazard.La propuesta de este estudio fue analizar el valor determinante de los procedimientos realizados durante la atención prehospitalaria en el tiempo de sobrevivencia de víctimas de accidentes de tránsito. Datos de 175 víctimas con Revised Trauma Score < 11, atendidas y transportadas por el soporte avanzado a la vida a hospitales terciarios, fueron sometidos al análisis de sobrevivencia de Kaplan Méier y al análisis de Riesgos Proporcionales de Cox. Se identificaron 4 grupos de procedimientos asociados a la sobrevivencia: circulatorios básicos; respiratorios avanzados; volumen repuesto y medicamentos. Hasta el alta hospitalaria, las víctimas sometidas a la intubación orotraqueal y compresiones toráxicas presentaron 3,6 y 6,4 veces mayor riesgo de muerte, respectivamente. La necesidad de mantener la vía aérea definitiva permeable y hacer reanimación cardiorrespiratoria en la fase prehospitalaria fue predeterminante de un mayor riesgo de muerte. La reposición de volumen inferior a 1000ml fue el único factor predeterminante con fuerza protectora para el riesgo de muerte.A proposta deste estudo foi analisar o valor predeterminante dos procedimentos realizados, durante o atendimento pré-hospitalar no tempo de sobrevivência de vítimas de acidentes de trânsito. Dados de 175 vítimas com Revised Trauma Score < 11, atendidas e transportadas pelo suporte avançado à vida a hospitais terciários, foram submetidas à Análise de Sobrevivência de Kaplan Méier e à Análise de Riscos Proporcionais de Cox. Identificou-se 4 grupos de procedimentos associados à sobrevivência: circulatórios básicos; respiratórios avançados; volume reposto e medicamentos. Até a alta hospitalar, as vítimas, submetidas à entubação orotraqueal e compressões torácicas, apresentaram 3,6 e 6,4 vezes maior risco para o óbito, respectivamente. A necessidade de realização de via aérea definitiva e de reanimação cardiorrespiratória na fase pré-hospitalar foi predeterminante de maior risco para o óbito. A reposição de volume inferior a 1000ml foi o único fator predeterminante com força protetora para o risco de óbito.
Published: 2008
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3. Expresiones y criterios mejorables en la redacción de informes de evaluación y posicionamiento terapéutico

Author: Alegre del Rey,EJ, Ortega Eslava,A, Fénix-Caballero,S, Fraga Fuentes,D, Martínez López,I, and Hoyo Gil,L
Subjects: metaanálisis en red, modelos de riesgos proporcionales, medición de riesgo, Evaluación de medicamentos, escritura médica
Abstract: Resumen En la revisión de borradores de informes para evaluación y posicionamiento de nuevos fármacos en un entorno multidisciplinar, se observan determinados errores de expresión o criterio que se repiten con frecuencia. Principalmente, están relacionados con la consideración de “diferencias” o tendencias no significativas, abuso de la reducción relativa del riesgo, errores en la valoración de resultados por subgrupos sin calcular la interacción estadística, confusiones en la interpretación de las comparaciones indirectas, sobrevaloración de la relevancia clínica con variables subclínicas y afirmaciones sesgadas en el apartado de seguridad, entre otros. También se observa a menudo ambigüedad o inhibición en el posicionamiento, especialmente en situaciones de precariedad en la evidencia disponible. El presente trabajo expone de forma sintética tales errores, aclara algunos términos comunes y propone expresiones o criterios alternativos que se consideran preferibles, con el fin de ofrecer una evaluación para la toma de decisiones en beneficio de los pacientes.
Published: 2021

4. Efficacy and safety of abiraterone acetate plus prednisone vs. cabazitaxel as a subsequent treatment after first-line docetaxel in metastatic castration-resistant prostate cancer: results from a prospective observational study (CAPRO)

Author: Sergio Vázquez, Jose Miguel Cuevas Sanz, A. González-del-Alba, Alvaro Pinto, Jacobo Muñoz del Toro, Ángela García García-Porrero, Ángel Francisco Zazo Rodríguez, Javier Puente, Eduardo Useros Rodríguez, Núria Sala-González, María José Méndez-Vidal, [Puente,J] Medical Oncology, Hospital Clínico San Carlos. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC. Madrid, Spain. [González-del-Alba,A] Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain. [Sala-Gonzalez,N] Medical Oncology, ICO Girona, Hospital Josep Trueta, Girona, Spain. [Méndez-Vidal,MJ] Oncology Department, Maimonides Institute of Biomedical Research (IMIBIC). Reina Sofía Hospital. University of Córdoba, Cordoba, Spain. [Pinto,A] Medical Oncology, University Hospital La Paz - IdiPAZ, Madrid, Spain. [Rodríguez,A] Medical Oncology, Hospital Universitario de León, León, Spain. [Cuevas Sanz,JM] Medical Oncology, Hospital Universitario de la Ribera, Alcira, Spain. [Muñoz del Toro,JR, Useros Rodríguez,E, García García-Porrero,A] Medical Department, Janssen-Cilag S.A., Madrid, Spain. [Vázquez,S] Medical Oncology, Hospital Universitario Lucus Augusti, Lugo, Spain., and This study was funded by Janssen Cilag S.A.
Subjects: Oncology, Male, Neoplasias de la próstata, astenia, medicine.medical_treatment, Docetaxel, law.invention, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 0302 clinical medicine, estudios prospectivos, Antineoplastic Combined Chemotherapy Protocols, dolor, Prospective Studies, mediana edad, Aged, 80 and over, anciano, Cabazitaxel, protocolos de quimioterapia antineoplásica combinada, Hazard ratio, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Progression-Free Survival, Prostatic Neoplasms, Castration-Resistant, 030220 oncology & carcinogenesis, Taxoids, Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Asthenia [Medical Subject Headings], medicine.medical_specialty, Antineoplastic Agents, Hormonal, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Analysis of Variance::Multivariate Analysis [Medical Subject Headings], Antineoplastic Agents, Adenocarcinoma, lcsh:RC254-282, 03 medical and health sciences, Sequence, Genetics, Humans, Aged, Diseases::Male Urogenital Diseases::Genital Diseases, Male::Genital Neoplasms, Male [Medical Subject Headings], Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Pain [Medical Subject Headings], medicine.disease, Chemicals and Drugs::Polycyclic Compounds::Steroids::Pregnanes::Pregnadienes::Pregnadienediols::Prednisone [Medical Subject Headings], Regimen, 030104 developmental biology, chemistry, Persons::Persons::Age Groups::Adult::Aged::Aged, 80 and over [Medical Subject Headings], Asthenia, Quimioterapia, l-lactato deshidrogenasa, 0301 basic medicine, Cancer Research, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings], modelos de riesgos proporcionales, humanos, Abiraterone Acetate, Kaplan-Meier Estimate, Diseases::Neoplasms::Neoplasms by Site::Urogenital Neoplasms::Genital Neoplasms, Male::Prostatic Neoplasms::Prostatic Neoplasms, Castration-Resistant [Medical Subject Headings], Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Oxidoreductases::Alcohol Oxidoreductases::Lactate Dehydrogenases::L-Lactate Dehydrogenase [Medical Subject Headings], Prostate cancer, chemistry.chemical_compound, Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Alicyclic::Cycloparaffins::Cyclodecanes::Taxoids [Medical Subject Headings], Randomized controlled trial, law, Diseases::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Glandular and Epithelial::Carcinoma::Adenocarcinoma [Medical Subject Headings], antineoplásicos, Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings], resultado del tratamiento, Abiraterone acetate, Age Factors, Anemia, Middle Aged, Treatment Outcome, Drug therapy, Prostatic neoplasms, Health Care::Environment and Public Health::Public Health::Epidemiologic Factors::Age Factors [Medical Subject Headings], Diseases::Hemic and Lymphatic Diseases::Hematologic Diseases::Anemia [Medical Subject Headings], taxoides, medicine.drug, Research Article, estimación de Kaplan-Meier, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings], Pain, Acetato de abiraterona, Internal medicine, medicine, Chemotherapy, análisis multifactorial, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome [Medical Subject Headings], Proportional Hazards Models, Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Survival Analysis::Kaplan-Meier Estimate [Medical Subject Headings], L-Lactate Dehydrogenase, business.industry, Prostatic Neoplasms, Metastatic castration-resistant prostate cancer, Spain, Multivariate Analysis, neoplasias de la próstata, Prednisone, prednisona, business
Abstract: Background To describe the patterns of second-line treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) after docetaxel treatment in a Spanish population, to identify the factors associated with those patterns, and to compare the efficacy and safety of the treatments most frequently administered. Methods Observational, prospective study conducted in patients with histologically or cytologically confirmed prostate adenocarcinoma; documented metastatic castration-resistant disease; progression after first-line, docetaxel-based chemotherapy with or without other agents. Results Of the 150 patients recruited into the study, 100 patients were prescribed abiraterone acetate plus prednisone (AAP), 44 patients received cabazitaxel plus prednisone (CP), and 6 patients received other treatments. Age (odds ratio [OR] 1.06, 95% [confidence interval] CI 1.01 to 1.11) and not elevated lactate dehydrogenase (LDH) levels (OR 0.33, 95% CI 0.14 to 0.76) were independently associated with the administration of AAP. Treatment with AAP was associated with significantly longer clinical/radiographic progression-free survival (hazard ratio [HR] 0.57, 95% CI 0.38 to 0.85) and overall survival (OS; HR 0.40, 95% CI 0.21 to 0.76) compared to CP, while no significant differences between the treatments were found regarding biochemical progression-free survival (PFS; HR 0.78 [95% CI 0.49 to 1.24]). However, in a post-hoc Cox regression analysis adjusted for potential confounders there were not differences between AAP and CP in any of the time-to-event outcomes, including overall survival. We observed no new safety signals related to either regimen. Conclusion Second-line AAP for patients with mCRPC is the most common treatment strategy after progression with a docetaxel-based regimen. When controlling for potential confounders, patients receiving this treatment showed no differences in PFS and OS in comparison to those receiving CP, although these latter results should be confirmed in randomized controlled trials., This study was funded by Janssen Cilag S.A. Janssen-Cilag S.A. was involved in the design of the study, interpretation of data, and in writing the manuscript. Quality control and statistical analyses were performed by a contract research organization that was funded by Janssen-Cilag S.A.
Published: 2019

5. Albuminuria and polyvascular disease improve multivariate predictive models after an acute cardiovascular event. The AIRVAG cohort.

Author: Sáez-Jiménez R, Esteban-Hernández J, Herreros B, Huelmos A, and Guijarro C
Subjects: Albuminuria complications, Cohort Studies, Humans, Proportional Hazards Models, Risk Assessment, Risk Factors, Cardiovascular Diseases epidemiology, Cardiovascular Diseases prevention & control, Hypertension complications
Abstract: Background and Aims: There is no consensus regarding risk stratification tools for secondary prevention in atherosclerotic cardiovascular disease. Our aim was to compare the discriminative performance of the Framingham, REGICOR, SCORE, and REACH risk functions and the Bohula-TIMI and SMART risk scores, as well as to assess the potential added value of other clinical variables for the prediction of recurrent events in patients with established vascular disease., Methods: A cohort of 269 patients with established vascular disease (52.8% coronary, 32% cerebrovascular, 15.2% PAD) was included. The survival functions of risk groups (low/medium/high) according to commonly used cutoff points for each function/score were compared, and hazard ratios for each were estimated using Cox regression. We calculated Δ Harrell's C statistic, cat-NRI, and cNRI after adding new predictors to a base model including age, sex, total cholesterol, current smoking status, hypertension, and diabetes., Results: After six years of follow-up (median 4.82 years), 61 events occurred (23%). High-risk groups had a higher risk of recurrent event: SMART (HR: 3.17 [1.55-6.5]), Framingham (HR: 3.08 [1.65-5.75]), REGICOR (HR: 2.71 [1.39-5.27]), SCORE (HR: 2.14 [1.01-4.5], REACH (HR: 5.74 [2.83-11.7]), B-TIMI (HR: 3.68 [0.88-15.3]). Polyvascular disease (three territories HR: 5.6 [2.2-14.25]), albuminuria (HR: 3.55 [2.06-6.11]), and heart failure (HR: 3.11 [1.34-7.25]) also increased risk. Discrimination (Harrell's C) was low but improved after adding albuminuria and polyvascular disease. Both variables also improved the performance of the base model (cNRI.326 [.036; .607])., Conclusions: The Framingham, REGICOR, SCORE, and REACH functions and the B-TIMI and SMART scores showed low yet similar performance in secondary prevention. Albuminuria and polyvascular disease improved the predictive performance of major classical cardiovascular risk factors., (Copyright © 2021 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.)
Published: 2022
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6. Cost-effectiveness of everolimus-eluting versus bare-metal stents in ST-segment elevation myocardial infarction: An analysis from the EXAMINATION randomized controlled trial

Author: Salvatore Brugaletta, Matthias Schwenkglenks, Peter den Heijer, Maurizio Tespili, Andrés Iñiguez, Patrick W. Serruys, Pilar Jiménez-Quevedo, Nicolás Vázquez, Nadine Schur, Gianluca Campo, Vicente Mainar, Angel Cequier, Armando Bethencourt, Marco Valgimigli, Manel Sabaté, Antonio Serra, Zanfina Ademi, Universitat de Barcelona, Cardiology, University of Zurich, Voskuil, Michiel, and Schur, Nadine
Subjects: Genetics and Molecular Biology (all), evaluación del desenlace del paciente, Economics, Cardiovascular Procedures, modelos de riesgos proporcionales, Cost effectiveness, Cost-Benefit Analysis, humanos, Myocardial Infarction, lcsh:Medicine, Social Sciences, costos de la atención de salud, Cardiovascular Medicine, 030204 cardiovascular system & hematology, Antiplatelet Therapy, estudios de seguimiento, Vascular Medicine, Biochemistry, Geographical locations, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Medicine and Health Sciences, 030212 general & internal medicine, Myocardial infarction, 610 Medicine & health, lcsh:Science, health care economics and organizations, stents liberadores de fármacos, Coronary Artery Bypass Grafting, Multidisciplinary, Cost–benefit analysis, Pharmaceutics, Drug-Eluting Stents, General Medicine, Hematology, Health Care Costs, Cost-effectiveness analysis, Anàlisi cost-benefici, Europe, Cardiovascular Diseases, Cardiology, Stents, General Agricultural and Biological Sciences, Research Article, medicine.drug, medicine.medical_specialty, Coronary Stenting, Cost-Effectiveness Analysis, Genetics and Molecular Biology, Surgical and Invasive Medical Procedures, 1100 General Agricultural and Biological Sciences, Therapeutics, NO, 03 medical and health sciences, Drug Therapy, 1300 General Biochemistry, Genetics and Molecular Biology, Internal medicine, medicine, Humans, European Union, Everolimus, Espanya, Follow-Up Studies, Patient Outcome Assessment, Proportional Hazards Models, ST Elevation Myocardial Infarction, Biochemistry, Genetics and Molecular Biology (all), Agricultural and Biological Sciences (all), Blood Coagulation, 1000 Multidisciplinary, Coagulation Disorders, business.industry, Proportional hazards model, Revascularization, lcsh:R, Thrombosis, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), medicine.disease, Terapèutica, Economic Analysis, Infart de miocardi, Spain, General Biochemistry, Stent Implantation, lcsh:Q, People and places, business, Decision analysis
Abstract: Background Use of everolimus-eluting stents (EES) has proven to be clinically effective and safe in patients with ST-segment elevation myocardial infarction but it remains unclear whether it is cost-effective compared to bare-metal stents (BMS) in the long-term. We sought to assess the cost-effectiveness of EES versus BMS based on the 5-year results of the EXAMINATION trial, from a Spanish health service perspective. Methods Decision analysis of the use of EES versus BMS was based on the patient-level clinical outcome data of the EXAMINATION trial. The analysis adopted a lifelong time horizon, assuming that long-term survival was independent of the initial treatment strategy after the end of follow-up. Life-expectancy, health-state utility scores and unit costs were extracted from published literature and publicly available sources. Non-parametric bootstrapping was combined with probabilistic sensitivity analysis to co-assess the impact of patient-level variation and parameter uncertainty. The main outcomes were total costs and quality-adjusted life-years. The incremental cost-effectiveness ratio was expressed as cost per quality-adjusted life-years gained. Costs and effects were discounted at 3%. Results The model predicted an average survival time in patients receiving EES and BMS of 10.52 and 10.38 undiscounted years, respectively. Over the life-long time horizon, the EES strategy was (sic)430 more costly than BMS ((sic) 8,305 vs. (sic)7,874), but went along with incremental gains of 0.10 quality-adjusted life-years. This resulted in an average incremental cost-effectiveness ratio over all simulations of (sic)3,948 per quality-adjusted life-years gained and was below a willingness-to-pay threshold of (sic)25,000 per quality-adjusted life-years gained in 86.9% of simulation runs. Conclusions Despite higher total costs relative to BMS, EES appeared to be a cost-effective therapy for ST-segment elevation myocardial infarction patients due to their incremental effectiveness. Predicted incremental cost-effectiveness ratios were below generally acceptable threshold values., The EXAMINATION trial (NCT00828087) was funded by the Spanish Heart Foundation. SB has received speakers' fees from Abbott Vascular and St Jude Medical. MV has received an honorarium as a public speaker for Terumo, the Medicines Company, Medtronic, Iroko, Merck, Abbott, Ely Lilly, AstraZeneca, Cordis, Carbostent and Implantable Devices, and Bayer. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The other authors declare no competing interests.
Published: 2018
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7. Dietary Inflammatory Index and Incidence of Cardiovascular Disease in the PREDIMED Study

Author: Emilio Ortega Martinez de Victoria, Montserrat Ferrer, Xavier Pintó Sala, Joaquin Fernández-Crehuet Navajas, ROBERTO ELOSUA, Itziar Salaverría Lete, Rosa Casas, SUSANNA TELLO, Amelia Marti, Helmut Schroder, Monica Domenech, Joan Salvador Vila-Domènech, Juan José Cabré Vila, Miguel Ruiz-Canela, Anna Tresserra-Rimbau, ANA GARCÍA ARELLANO, Antoni Castro, Julia Warnberg, Emilio Ros, Carmen Cabezas, Montserrat Cofan, Emili Corbella, José Manuel Santos Lozano, Pilar Buil-Cosiales, Lluis Serra-Majem, Jordi Salas-Salvadó, Cinta Valls-Pedret, NANCY BABIO SÁNCHEZ, Dora Romaguera, Rafel M. Prieto, Rosa SOLÀ, Gaspar Mestres, Inmaculada Bautista-Castaño, Ernest Vinyoles, Almudena Sanchez Villegas, Rafael De la Torre, Guillermo Sáez, and Universitat de Barcelona
Subjects: Male, Mediterranean diet, modelos de riesgos proporcionales, humanos, Sistema cardiovascular -- Malalties, estudios de seguimiento, Diet, Mediterranean, Dietary inflammatory index, Body Mass Index, cardiovascular disease, Risk Factors, estudios prospectivos, Surveys and Questionnaires, Nuts, Prospective Studies, Prospective cohort study, mediana edad, Aged, 80 and over, anciano, Nutrition and Dietetics, dieta, resultado del tratamiento, Incidence, Incidence (epidemiology), Hazard ratio, Middle Aged, Cardiovascular disease, Inflamació, determinación del punto final, Cardiovascular diseases, Treatment Outcome, Quartile, Cardiovascular Diseases, dietary inflammatory index, Female, lcsh:Nutrition. Foods and food supply, PREDIMED, medicine.medical_specialty, Endpoint Determination, Promoció de la salut, enfermedades cardiovasculares, lcsh:TX341-641, Context (language use), Ciencias de la Salud::Nutrición y dietética [Materias Investigacion], incidencia, Article, Mediterranean cooking, inflamación, Internal medicine, Cuina mediterrània, ingesta energética, medicine, factores de riesgo, Humans, análisis multifactorial, Olive Oil, Aged, Proportional Hazards Models, Inflammation, Malalties cardiovasculars, business.industry, Proportional hazards model, índice de masa corporal, Diet, Surgery, nueces, Multivariate Analysis, Health promotion, Energy Intake, business, Body mass index, Follow-Up Studies, Food Science
Abstract: Previous studies have reported an association between a more pro-inflammatory diet profile and various chronic metabolic diseases. The Dietary Inflammatory Index (DII) was used to assess the inflammatory potential of nutrients and foods in the context of a dietary pattern. We prospectively examined the association between the DII and the incidence of cardiovascular disease (CVD: myocardial infarction, stroke or cardiovascular death) in the PREDIMED (Prevención con Dieta Mediterránea) study including 7216 high-risk participants. The DII was computed based on a validated 137-item food frequency questionnaire. Multivariate-adjusted hazard ratios (HR) and 95% confidence intervals of CVD risk were computed across quartiles of the DII where the lowest (most anti-inflammatory) quartile is the referent. Risk increased across the quartiles (i.e., with increasing inflammatory potential): HRquartile2 = 1.42 (95%CI = 0.97–2.09), HRquartile3 = 1.85 (1.27–2.71), and HRquartile4 = 1.73 (1.15–2.60). When fit as continuous the multiple-adjusted hazard ratio for each additional standard deviation of the DII was 1.22 (1.06–1.40). Our results provide direct prospective evidence that a pro-inflammatory diet is associated with a higher risk of cardiovascular clinical events.
Published: 2015
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8. Coexpression of p-IGF-1R and MMP-7 Modulates Panitumumab and Cetuximab Efficacy in RAS Wild-Type Metastatic Colorectal Cancer Patients

Author: Jose-R. Rodriguez, José-Carlos Méndez, Carlos Fernández-Martos, Hermini Manzano, Marta Martin-Richard, Jaime Feliu, Federico Rojo, Monserrat Zanui, Miguel Cadena Méndez, Antonia Salud, Xabier García-Albéniz, Pilar Escudero, Javier Gallego, Mireia Gil-Raga, Vicente Alonso, E. Falcó, Julen Fernández-Plana, Miriam Cuatrecasas, and Joan Maurel
Subjects: Male, 0301 basic medicine, Oncology, Cancer Research, modelos de riesgos proporcionales, Colorectal cancer, humanos, Cetuximab, Gene Expression, Kaplan-Meier Estimate, medicine.disease_cause, Receptor, IGF Type 1, proteínas protooncogénicas B-raf, 0302 clinical medicine, Clinical endpoint, mediana edad, proteínas ras, anciano, Panitumumab, Antibodies, Monoclonal, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Prognosis, pronóstico, Matrix Metalloproteinase 7, 030220 oncology & carcinogenesis, FOLFIRI, Biomarker (medicine), Female, KRAS, Colorectal Neoplasms, medicine.drug, Proto-Oncogene Proteins B-raf, estimación de Kaplan-Meier, Original article, medicine.medical_specialty, neoplasias colorrectales, lcsh:RC254-282, Antibodies, 03 medical and health sciences, expresión génica, Internal medicine, medicine, Humans, metaloproteinasa 7 de la matriz, neoplasms, mutación, Aged, Proportional Hazards Models, Proportional hazards model, business.industry, medicine.disease, digestive system diseases, 030104 developmental biology, anticuerpos, Mutation, ras Proteins, business
Abstract: INTRODUCTION: The coexpression of pIGF-1R and MMP-7 (double-positive phenotype, DP) correlates with poor overall survival (OS) in KRAS wild-type (WT) (exon 2) metastatic colorectal cancer (mCRC) patients treated with irinotecan-cetuximab in second/third line. METHODS: We analyzed two prospective biomarker design trials of newly diagnosed RAS-WT mCRC patients treated with panitumumab-FOLFOX6 (PULSE trial; NCT01288339) or cetuximab plus either FOLFOX6/FOLFIRI (POSIBA trial; NCT01276379). The main exposure was DP phenotype (DP/ non-DP), as assessed by two independent pathologists. DP cases were defined by immunohistochemistry as N70% expression of moderate or strong intensity for both MMP-7 and pIGF-1R. Primary endpoint: progression-free survival (PFS); secondary endpoints: OS and response rate. PFS and OS were adjusted by baseline characteristics using multivariate Cox models. RESULTS: We analyzed 67 patients (30 non-DP, 37 DP) in the PULSE trial and 181 patients in the POSIBA trial (158 non-DP, 23 DP). Response rates and PFS were similar between groups in both studies. DP was associated with prolonged OS in PULSE (adjusted HR: 0.23; 95% CI: 0.11-0.52; P =. 0004) and with shorter OS in POSIBA (adjusted HR: 1 .67; 95% CI: 0.96-2.90; P =. 07). CONCLUSION: A differential effect of anti-EGFRs on survival by DP phenotype was observed. Panitumumab might be more beneficial for RAS-WT mCRC patients with DP phenotype, whereas cetuximab might improve OS in non-DP., Amgen supported the PULSE trial and Merck supported the POSIBA trial. Neither Amgen nor Merck had any role in the present analysis design, analysis and interpretation of data, writing the report, and the decision to submit the report for publication.
Published: 2018

9. Plasma Metabolites From Choline Pathway and Risk of Cardiovascular Disease in the PREDIMED (Prevention With Mediterranean Diet) Study

Author: Dong D. Wang, Jordi Salas-Salvadó, Emilio Ros, José Lapetra, Fernando Arós, Courtney Dennis, Liming Liang, Miguel Ruiz-Canela, Mònica Bulló, Enrique Gómez-Gracia, Clary B. Clish, Ramon Estruch, Dolores Corella, Marta Guasch-Ferré, Frank B. Hu, Montserrat Fitó, Miguel Ángel Martínez-González, Miquel Fiol, Lluis Serra-Majem, Estefanía Toledo, [Guasch-Ferre, Marta] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA, [Hu, Frank B.] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA, [Wang, Dong D.] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA, [Martinez-Gonzalez, Miguel A.] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA, [Hu, Frank B.] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA, [Liang, Liming] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA, [Liang, Liming] Harvard TH Chan Sch Publ Hlth, Dept Biostat, Boston, MA USA, [Guasch-Ferre, Marta] Rovira & Virgili Univ, Inst Invest Sanit Pere Virgili, Fac Med & Hlth Sci, Human Nutr Unit, Reus, Spain, [Bullo, Monica] Rovira & Virgili Univ, Inst Invest Sanit Pere Virgili, Fac Med & Hlth Sci, Human Nutr Unit, Reus, Spain, [Salas-Salvado, Jordi] Rovira & Virgili Univ, Inst Invest Sanit Pere Virgili, Fac Med & Hlth Sci, Human Nutr Unit, Reus, Spain, [Guasch-Ferre, Marta] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Ruiz-Canela, Miguel] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Bullo, Monica] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Toledo, Estefania] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Corella, Dolores] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Gomez-Gracia, Enrique] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Fiol, Miquel] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Estruch, Ramon] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Lapetra, Jose] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Fito, Montserrat] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Aros, Fernando] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Serra-Majem, Lluis] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Ros, Emilio] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Martinez-Gonzalez, Miguel A.] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Salas-Salvado, Jordi] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid, Spain, [Hu, Frank B.] Brigham & Womens Hosp, Dept Med, Charming Div Network Med, 75 Francis St, Boston, MA 02115 USA, [Hu, Frank B.] Harvard Med Sch, Boston, MA USA, [Ruiz-Canela, Miguel] Univ Navarra, Inst Invest Sanit Navarra, Dept Prevent Med & Publ Hlth, Pamplona, Spain, [Toledo, Estefania] Univ Navarra, Inst Invest Sanit Navarra, Dept Prevent Med & Publ Hlth, Pamplona, Spain, [Martinez-Gonzalez, Miguel A.] Univ Navarra, Inst Invest Sanit Navarra, Dept Prevent Med & Publ Hlth, Pamplona, Spain, [Corella, Dolores] Univ Valencia, Dept Prevent Med, Valencia, Spain, [Gomez-Gracia, Enrique] Univ Malaga, Dept Prevent Med, Malaga, Spain, [Fiol, Miquel] Univ Balearic Isl, Inst Hlth Sci IUNICS, Palma De Mallorca, Spain, [Fiol, Miquel] Hosp Son Espases, Palma De Mallorca, Spain, [Estruch, Ramon] Univ Barcelona, Dept Internal Med, Hosp Clin, Inst Invest Biomed August Pi Sunyer, Barcelona, Spain, [Ros, Emilio] Univ Barcelona, Lipid Clin, Hosp Clin, Inst Invest Biomed August Pi Sunyer,Dept Endocrin, Barcelona, Spain, [Lapetra, Jose] Primary Care Div Sevilla, Dept Family Med, Res Unit, Seville, Spain, [Fito, Montserrat] Hosp del Mar, Inst Recerca, Cardiovasc & Nutr Res Grp, Regicor Study Grp, Barcelona, Spain, [Aros, Fernando] Univ Hosp Alava, Dept Cardiol, Vitoria, Spain, [Serra-Majem, Lluis] Univ Las Palmas Gran Canaria, Dept Clin Sci, Las Palmas Gran Canaria, Spain, [Dennis, Courtney] Broad Inst MIT & Harvard Univ, Cambridge, MA USA, [Clish, Clary B.] Broad Inst MIT & Harvard Univ, Cambridge, MA USA, NIH, Spanish Government, Instituto de Salud Carlos III, Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion, Centro Nacional de Investigaciones Cardiovasculares, Fondo de Investigacion Sanitaria-Fondo Europeo de Desarrollo Regional, Ministerio de Ciencia e Innovacion, Fundacion Mapfre, Consejeria de Salud de la Junta de Andalucia, Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana, Regional Government of Navarra, Agency for Administration of University and Research Grants of the Autonomous Government of Catalonia, Agency for Administration of University, Research Grants of the Autonomous Government of Catalonia, European Foundation for the Study of Diabetes, and NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
Subjects: 0301 basic medicine, Male, Time Factors, Mediterranean diet, Epidemiology, modelos de riesgos proporcionales, humanos, Sistema cardiovascular -- Malalties, éteres de fosfolípidos, Disease, 030204 cardiovascular system & hematology, Gut flora, Diet, Mediterranean, Choline, chemistry.chemical_compound, 0302 clinical medicine, Betaine, cardiovascular disease, Risk Factors, Tandem Mass Spectrometry, estudios prospectivos, metabolómica, Prospective Studies, Trimethylamine-n-oxide, mediana edad, Original Research, Diet and Nutrition, metilaminas, 2. Zero hunger, Aged, 80 and over, Chromatography, anciano, Choline metabolism, biology, dieta, resultado del tratamiento, Incidence, Phospholipid Ethers, distribución de la ji al cuadrado, Middle Aged, Cardiovascular disease, 3. Good health, Primary Prevention, colina, Treatment Outcome, Cardiovascular Diseases, espectrometría de masas en tándem, Plasma concentration, Profile, Female, Cardiology and Cardiovascular Medicine, fosforilcolina, medicine.medical_specialty, Phosphorylcholine, estudios de casos y controles, enfermedades cardiovasculares, Gut microbiota, incidencia, 03 medical and health sciences, Methylamines, factores de tiempo, Internal medicine, Oxidation, medicine, factores de riesgo, Humans, Metabolomics, análisis multifactorial, Dieta -- Mediterrània, Regió de la, cromatografía, Aged, Proportional Hazards Models, Chi-Square Distribution, gut microbiota, business.industry, betaína, Plasma sanguini, Lifestyle, biology.organism_classification, Predimed, Diet, Phosphatidylcholine, 030104 developmental biology, Endocrinology, chemistry, Spain, Case-Control Studies, Multivariate Analysis, business, Biomarkers, Chromatography, Liquid
Abstract: Background-The relationship between plasma concentrations of betaine and choline metabolism and major cardiovascular disease (CVD) end points remains unclear. We have evaluated the association between metabolites from the choline pathway and risk of incident CVD and the potential modifying effect of Mediterranean diet interventions. Methods and Results-We designed a case-cohort study nested within the PREDIMED (Prevention With Mediterranean Diet) trial, including 229 incident CVD cases and 751 randomly selected participants at baseline, followed up for 4.8 years. We used liquid chromatography-tandem mass spectrometry to measure, at baseline and at 1 year of follow-up, plasma concentrations of 5 metabolites in the choline pathway: trimethylamine N-oxide, betaine, choline, phosphocholine, and a-glycerophosphocholine. We have calculated a choline metabolite score using a weighted sum of these 5 metabolites. We used weighted Cox regression models to estimate CVD risk. The multivariable hazard ratios (95% confidence intervals) per 1-SD increase in choline and alpha-glycerophosphocholine metabolites were 1.24 (1.05-1.46) and 1.24 (1.03-1.50), respectively. The baseline betaine/choline ratio was inversely associated with CVD. The baseline choline metabolite score was associated with a 2.21-fold higher risk of CVD across extreme quartiles (95% confidence interval, 1.36-3.59; P, This work was supported by NIH research grant HL118264. The PREDIMED trial was supported by the official funding agency for biomedical research of the Spanish Government, Instituto de Salud Carlos III, through grants provided to research networks specifically developed for the trial (RTIC G03/140 to Estruch; RTIC RD 06/0045 to Martinez-Gonzalez) and through Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion; and by grants from Centro Nacional de Investigaciones Cardiovasculares (06/2007), Fondo de Investigacion Sanitaria-Fondo Europeo de Desarrollo Regional (PI04-2239, PI05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI10/01407, PI10/02658, PI11/01647, P11/02505, and PI13/00462), Ministerio de Ciencia e Innovacion (AGL-2009-13906-C02 and AGL2010-22319-C03), Fundacion Mapfre 2010, Consejeria de Salud de la Junta de Andalucia (PI0105/2007), Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana (ACOMP06109, GVA-COMP2010-181, GVACOMP2011-151, CS2010-AP-111, and CS2011-AP-042), and Regional Government of Navarra (P27/2011). Guasch-Ferre was supported by a postdoctoral fellowship granted by the Agency for Administration of University and Research Grants of the Autonomous Government of Catalonia (2014-BP-A 00017). None of the funding sources played a role in the design, collection, analysis, or interpretation of the data or in the decision to submit the article for publication.
Published: 2017

10. Androgen receptor gene status in plasma DNA associates with worse outcome on enzalutamide or abiraterone for castration-resistant prostate cancer: a multi-institution correlative biomarker study

Author: Conteduca, Vincenza, Wetterskog, Daniel, Sharabiani, Grande, Enrique, Fernandez Perez, M. P., Jayaram, Anuradha, Salvi, S., Castellano, Daniel, Romanel, A., Lolli, C., Casadio, Valentina, Gurioli, G., Amadori, D., Font, A., Vazquez Estevez, S., González del Alba, A., Mellado, B., Fernandez Calvo, O., Méndez Vidal, M. J., Climent, M. A., Durán, I, Gallardo, E., Rodríguez Sánchez, Ángel, Santander, C., Sáez, M. I., Puente, J., Gasi Tandefelt, D., Wingate, Anna, Dearnaley, D., Demichelis, F., De Giorgi, Ugo, Gonzalez Billalabeitia, E., Attard, Gerhardt, Spanish Oncology Genitourinary Group, and Universitat Autònoma de Barcelona
Subjects: Male, Time Factors, plasma DNA, modelos de riesgos proporcionales, DNA Mutational Analysis, humanos, Kaplan-Meier Estimate, Circulating Tumor DNA, Risk Factors, estudios prospectivos, androgen receptor, abiraterone, Odds Ratio, castration-resistant prostate cancer, Prospective Studies, supervivencia sin enfermedad, antineoplásicos, Precision Medicine, Abiraterone, mediana edad, Castration-resistant prostate cancer, Aged, 80 and over, anciano, enzalutamide, resultado del tratamiento, Middle Aged, adulto, cociente de probabilidades relativas, feniltiohidantoína, Europe, Prostatic Neoplasms, Castration-Resistant, Androgen receptor, Treatment Outcome, Receptors, Androgen, Benzamides, Disease Progression, biomarker, Androstenes, Adult, estimación de Kaplan-Meier, Antineoplastic Agents, Hormonal, androstenos, Antineoplastic Agents, selección de los pacientes, Disease-Free Survival, factores de tiempo, Predictive Value of Tests, progresión de la enfermedad, Nitriles, Phenylthiohydantoin, Biomarkers, Tumor, Enzalutamide, Humans, factores de riesgo, análisis multifactorial, reacción en cadena de la polimerasa múltiple, mutación, Aged, Proportional Hazards Models, pruebas de valores predictivos, Patient Selection, Prostatic Neoplasms, Biomarker, análisis de mutaciones del ADN, Plasma DNA, Multivariate Analysis, Mutation, neoplasias de la próstata, Multiplex Polymerase Chain Reaction
Abstract: Background: There is an urgent need to identify biomarkers to guide personalized therapy in castration-resistant prostate cancer (CRPC). We aimed to clinically qualify androgen receptor (AR) gene status measurement in plasma DNA using multiplex droplet digital PCR (ddPCR) in pre- and post-chemotherapy CRPC. Methods: We optimized ddPCR assays for AR copy number and mutations and retrospectively analyzed plasma DNA from patients recruited to one of the three biomarker protocols with prospectively collected clinical data. We evaluated associations between plasma AR and overall survival (OS) and progression-free survival (PFS) in 73 chemotherapy-naive and 98 postdocetaxel CRPC patients treated with enzalutamide or abiraterone (Primary cohort) and 94 chemotherapy-naive patients treated with enzalutamide (Secondary cohort; PREMIERE trial). Results: In the primary cohort, AR gain was observed in 10 (14%) chemotherapy-naive and 33 (34%) post-docetaxel patients and associated with worse OS [hazard ratio (HR), 3.98; 95% CI 1.74-9.10; P= 50% [odds ratio (OR), 4.7; 95% CI 1.17-19.17; P = 0.035 and OR, 5.0; 95% CI 1.70-14.91; P = 0.003, respectively]. ARmutations [2105T>A (p.L702H) and 2632A>G (p.T878A)] were observed in eight (11%) post-docetaxel but no chemotherapy-naive abiraterone-treated patients and were also associated with worse OS (HR 3.26; 95% CI 1.47-not reached; P = 0.004). There was no interaction between AR and docetaxel status (P = 0.83 for OS, P = 0.99 for PFS). In the PREMIERE trial, 11 patients (12%) with AR gain had worse PSA-PFS (sPFS) (HR 4.33; 95% CI 1.94-9.68; P, This work was funded by Prostate Cancer UK (PG12-49) and Cancer Research UK (A13239) and was supported by the NIHR Royal Marsden and the Institute of Cancer Research (ICR) Biomedical Research Centre. VC was funded by a European Society of Medical Oncology Translational Clinical Research Fellowship, AJ by an Irish Health Research Board Clinical Research Fellowship and a Medical Research Council Clinical Research Fellowship, DGT by a European Union Marie Curie Intra-European Postdoctoral Fellowship, EG by Instituto de Salud Carlos III and the Spanish Society of Medical Oncology (SEOM)/Chris Foundation (no grant numbers apply) and GA by a Cancer Research UK Advanced Clinician Scientist Fellowship. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The PREMIERE trial was sponsored by Spanish Genito-Urinary oncology Group that received a grant from Astellas to support the conduct of the trial.
Published: 2017

11. Clinical outcomes of 217 patients with acute erythroleukemia according to treatment type and line

Author: Antonio Almeida, Haifa Kathrin Al-Ali, Dietmar Geissler, Joan Bargay, Arjan A. van de Loosdrecht, Peter Krippl, Guillermo Deben, Sylvain Thepot, Raphael Itzykson, Ana Garrido, Richard Greil, Alois Lang, Eva Maria Autzinger, Jaime L. Wetzel, Lisa Pleyer, Pierre Fenaux, Reinhard Stauder, Ricardo Pinto, Peter Valent, Fernando Ramos, Mikkael A. Sekeres, Wolfgang R. Sperr, Jose F Falantes, Lionel Ades, María Díez-Campelo, Pellegrino Musto, Santiago Bonanad, Jamile M. Shammo, Thomas Prebet, Luca Maurillo, Maria Joao Costa, Sonja Burgstaller, Susana Esteves, Carmen Pedro, [Almeida, Antonio M.] IPOL, P-1200795 Lisbon, Portugal, [Esteves, Susana] IPOL, P-1200795 Lisbon, Portugal, [Prebet, Thomas] Inst Paoli Calmettes, Marseille, France, [Prebet, Thomas] Yale New Haven Med Ctr, New Haven, CT 06512 USA, [Itzykson, Raphael] Paris Diderot Univ, Hop St Louis, AP HP, F-75010 Paris, France, [Ades, Lionel] Paris Diderot Univ, Hop St Louis, AP HP, F-75010 Paris, France, [Fenaux, Pierre] Paris Diderot Univ, Hop St Louis, AP HP, F-75010 Paris, France, [Ramos, Fernando] Hosp Univ Leon, Leon 24071, Spain, [Al-Ali, Haifa] Univ Hosp Halle, D-06120 Halle, Germany, [Shammo, Jamile] Rush Univ, Med Ctr, Chicago, IN 60612 USA, [Pinto, Ricardo] Hosp Sao Joao, P-4200319 Oporto, Portugal, [Maurillo, Luca] Univ Tor Vergata, I-00173 Rome, Italy, [Wetzel, Jaime] Cleveland Clin, Taussig Canc Inst, Cleveland, OH 44195 USA, [Sekeres, Mikkael A.] Cleveland Clin, Taussig Canc Inst, Cleveland, OH 44195 USA, [Musto, Pellegrino] Referral Canc Ctr Basilicata, RCCS CROB, I-85028 Rionero In Vulture, Pz, Italy, [Van De Loosdrecht, Arjan A.] Vrije Univ Amsterdam, Med Ctr, Dept Hematol, NL-1081 HV Amsterdam, Netherlands, [Costa, Maria Joao] Hosp Santa Maria, Ctr Hosp Lisboa Norte, P-1649035 Lisbon, Portugal, [Burgstaller, Sonja] Hosp Wels Grieskirchen, Dept Internal Med 4, A-4600 Wels, Austria, [Stauder, Reinhard] Innsbruck Med Univ, Dept Internal Med Haematol & Oncol 5, A-6020 Innsbruck, Austria, [Autzinger, Eva M.] Wilhelminenspital Stadt Wien, Ctr Oncol & Hematol, Dept Internal Med 1, A-1160 Vienna, Austria, [Lang, Alois] Hosp Feldkirch, Internal Med, A-6800 Feldkirch, Austria, [Krippl, Peter] Hosp Furstenfeld, Dept Internal Med, A-8280 Furstenfeld, Austria, [Geissler, Dietmar] Klinikum Klagenfurt Worthersee, Dept Internal Med, A-9020 Portschach Am Worthersee, Austria, [Francisco Falantes, Jose] Hosp Univ Virgen Rocio, Seville 41013, Spain, [Pedro, Carmen] Hosp Mar, Barcelona 08003, Spain, [Bargay, Joan] Hosp Son Llatzer, Palma De Mallorca 07198, Spain, [Deben, Guillermo] Hosp Univ, La Coruna 15006, Spain, [Garrido, Ana] Hosp Santa Creu & Sant Pau, Barcelona 08026, Spain, [Bonanad, Santiago] Hosp Univ Ribera, Alzira 46600, Spain, [Diez-Campelo, Maria] Hosp Univ Salamanca, Salamanca 37007, Spain, [Thepot, Sylvain] CHU, F-49100 Angers, France, [Sperr, Wolfgang R.] Med Univ Vienna, Dept Internal Med 1, Div Hematol & Hemostaseol, A-1090 Vienna, Austria, [Valent, Peter] Med Univ Vienna, Dept Internal Med 1, Div Hematol & Hemostaseol, A-1090 Vienna, Austria, [Sperr, Wolfgang R.] Med Univ Vienna, Ludwig Boltzmann Cluster Oncol, A-1090 Vienna, Austria, [Valent, Peter] Med Univ Vienna, Ludwig Boltzmann Cluster Oncol, A-1090 Vienna, Austria, [Greil, Richard] Paracelsus Med Univ, Med Dept 3, A-5020 Salzburg, Austria, [Pleyer, Lisa] Paracelsus Med Univ, Med Dept 3, A-5020 Salzburg, Austria, [Greil, Richard] Salzburg Canc Res Inst, A-5020 Salzburg, Austria, [Pleyer, Lisa] Salzburg Canc Res Inst, A-5020 Salzburg, Austria, [Greil, Richard] Canc Cluster Salzburg, A-5020 Salzburg, Austria, [Pleyer, Lisa] Canc Cluster Salzburg, A-5020 Salzburg, Austria, [Greil, Richard] Arbeitsgemeinschaft Medikamentose Tumortherapie A, A-5020 Salzburg, Austria, [Pleyer, Lisa] Arbeitsgemeinschaft Medikamentose Tumortherapie A, A-5020 Salzburg, Austria, University of Salzburg, NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES, CCA - Cancer Treatment and quality of life, and Hematology
Subjects: Oncology, Male, modelos de riesgos proporcionales, humanos, Chronic myelomonocytic leukemia, 0302 clinical medicine, Bone Marrow, Antineoplastic Combined Chemotherapy Protocols, Conventional care regimens, Complete remission, Open-label, Spectroscopy, mediana edad, leucemia, Aged, 80 and over, anciano, Leukemia, análisis citogenético, resultado del tratamiento, protocolos de quimioterapia antineoplásica combinada, General Medicine, Middle Aged, adulto, análisis de supervivencia, 3. Good health, Computer Science Applications, Treatment Outcome, 030220 oncology & carcinogenesis, Cytogenetic Analysis, Acute erythroleukemia, Female, Median survival, acute erythroleukemia, azacitidine, decitabine, Adult, medicine.medical_specialty, Poor prognosis, azacitidina, Myelodysplastic syndromes, Catalysis, Article, Leucèmia -- Tractament, Inorganic Chemistry, 03 medical and health sciences, Acute myeloid-leukemia, Health-organization classification, Internal medicine, Cox proportional hazards regression, medicine, Overall survival, Older patients, Humans, In patient, Physical and Theoretical Chemistry, Molecular Biology, acute erythroleukemia, azacitidine, decitabine, Aged, Proportional Hazards Models, Retrospective Studies, business.industry, Stem-cell transplantation, Organic Chemistry, estudios retrospectivos, medicine.disease, Survival Analysis, Surgery, Acute erythroid leukemia, Leukemia, Erythroblastic, Acute, business, médula ósea, Biomarkers, 030215 immunology, Rare disease
Abstract: Acute erythroleukemia (AEL) is a rare disease typically associated with a poor prognosis. The median survival ranges between 3-9 months from initial diagnosis. Hypomethylating agents (HMAs) have been shown to prolong survival in patients with myelodysplastic syndromes (MDS) and AML, but there is limited data of their efficacy in AEL. We collected data from 210 AEL patients treated at 28 international sites. Overall survival (OS) and PFS were estimated using the Kaplan-Meier method and the log-rank test was used for subgroup comparisons. Survival between treatment groups was compared using the Cox proportional hazards regression model. Eighty-eight patients were treated with HMAs, 44 front line, and 122 with intensive chemotherapy (ICT). ICT led to a higher overall response rate (complete or partial) compared to first-line HMA (72% vs. 46.2%, respectively; p, Publication costs were supported by the University of Salzburg.
Published: 2017
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12. Neurological Complications of Infective Endocarditis

Author: Josefa Ruiz-Morales, José Manuel Lomas, Mariam Noureddine, Javier de la Torre-Lima, Francisco Javier Martínez-Marcos, Carmen Hidalgo-Tenorio, Antonio Plata, Radka Ivanova-Georgieva, Juan Gálvez-Acebal, Nuria Fernández-Hidalgo, J.M. Reguera, Benito Almirante, Arístides de Alarcón González, Emilio García-Cabrera, The Group for the Study of Cardiovascular Infections of the Andalusian Society of Infectious Diseases (SAEI) and the Spanish Network for Research in Infectious Diseases (REIPI), [García-Cabrera,E, Fernández-Hidalgo,N, Almirante,B, Ivanova-Georgieva,R, Noureddine,M, Plata,A, Lomas,ML, Gálvez-Acebal,J, Hidalgo-Tenorio,C, Ruíz-Morales,J, Martínez-Marcos,FJ, Reguera,JM, Torre-Lima,J De La, Alarcón González,A De] Spanish Network for Research in Infectious Diseases (REIPI), Seville, Spain. [García-Cabrera,E, Alarcón González,A De] Instituto de Biomedicina de Sevilla (IBIS) Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain. [Ivanova-Georgieva,R] Internal Medicine Unit, Hospital Universitario Virgen de la Victoria, Málaga, Spain. [Fernández-Hidalgo,N, Almirante,B] Diseases Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Medicine Department, Barcelona. [Ruíz-Morales,J] Infectious Diseases Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain. [Noureddine,M] Infectious Diseases Unit Hospital Costa del Sol, Marbella, Malaga, Spain. [Plata,A, Ruíz-Morales,J] Infectious Diseases Service, Hospital Universitario Carlos Haya Malaga. [Lomas,JM, Martínez-Marcos,FJ] Infectious Diseases Unit Hospital Juan Ramón Jiménez, Huelva, Spain. [Gálvez-Acebal,J] Clinical Service of Infectious Disease and Clinical Microbiology, Hospital Universitario Virgen Macarena, Seville, Spain. [Hidalgo-Tenorio,C] Infectious Diseases Service, Hospital Universitario Virgen de las Nieves, Granada, Spain. [Alarcón González,A De] Infectious Diseases, Microbiology and Preventive Medicine Department, Hospital Universitario Virgen del Rocío, Seville, Spain., and This study was funded by the Ministerio de Ciencia e Innovación, Instituto de Salud Carlos III, and cofinanced by the European Development Regional Fund 'A way to achieve Europe', Spanish Network for the Research in Infectious Diseases (REIPI RD06/0008).
Subjects: Male, Complications, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings], Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies [Medical Subject Headings], Hemorragia cerebral, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Comorbidity, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings], Brain Ischemia, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Intracranial Arterial Diseases::Intracranial Aneurysm [Medical Subject Headings], Postoperative Complications, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Clinical Trials as Topic::Multicenter Studies as Topic [Medical Subject Headings], Anti-Infective Agents, Risk Factors, Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Comorbidity [Medical Subject Headings], Diseases::Cardiovascular Diseases::Heart Diseases::Endocarditis [Medical Subject Headings], Infecciones estafilocócicas, Diseases::Nervous System Diseases::Central Nervous System Diseases::Meningitis [Medical Subject Headings], Multicenter Studies as Topic, Medicine, Antiinfecciosos, Absceso encefálico, Ultrasonography, Heart Valve Prosthesis Implantation, Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Hematologic Agents::Anticoagulants [Medical Subject Headings], Diseases::Virus Diseases::Central Nervous System Viral Diseases::Encephalitis [Medical Subject Headings], Endocarditis, Incidence, Incidence (epidemiology), Hazard ratio, Pronóstico, Middle Aged, Staphylococcal Infections, Comorbilidad, Prognosis, Combined Modality Therapy, Cardiac surgery, Diseases::Bacterial Infections and Mycoses::Brain Abscess [Medical Subject Headings], Treatment Outcome, Infective endocarditis, Cohort, Encephalitis, Female, Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents [Medical Subject Headings], Estudios de seguimiento, Aneurisma Intracraneal, Infection, Incidencia, Cardiology and Cardiovascular Medicine, Meningitis, Factores de riesgo, Nervous system, Adult, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Combined Modality Therapy [Medical Subject Headings], medicine.medical_specialty, Encephalopathy, Check Tags::Male [Medical Subject Headings], Brain Abscess, Estudios retrospectivos, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Incidence [Medical Subject Headings], Modelos de riesgos Proporcionales, Physiology (medical), Internal medicine, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies [Medical Subject Headings], Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], Humans, Estudios multicéntricos como Asunto, Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Staphylococcal Infections [Medical Subject Headings], Isquemia encefálica, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome [Medical Subject Headings], Aged, Cerebral Hemorrhage, Proportional Hazards Models, Retrospective Studies, Terapia combinada, business.industry, Proportional hazards model, Diseases::Cardiovascular Diseases::Vascular Diseases::Cerebrovascular Disorders::Intracranial Hemorrhages::Cerebral Hemorrhage [Medical Subject Headings], Anticoagulants, Encefalitis, Intracranial Aneurysm, Complicaciones postoperatorias, medicine.disease, Surgery, Check Tags::Female [Medical Subject Headings], Spain, Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Brain Ischemia [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis [Medical Subject Headings], Resultado del tratamiento, business, Endocardium, Follow-Up Studies
Abstract: Background— The purpose of this study was to assess the incidence of neurological complications in patients with infective endocarditis, the risk factors for their development, their influence on the clinical outcome, and the impact of cardiac surgery. Methods and Results— This was a retrospective analysis of prospectively collected data on a multicenter cohort of 1345 consecutive episodes of left-sided infective endocarditis from 8 centers in Spain. Cox regression models were developed to analyze variables predictive of neurological complications and associated mortality. Three hundred forty patients (25%) experienced such complications: 192 patients (14%) had ischemic events, 86 (6%) had encephalopathy/meningitis, 60 (4%) had hemorrhages, and 2 (1%) had brain abscesses. Independent risk factors associated with all neurological complications were vegetation size ≥3 cm (hazard ratio [HR] 1.91), Staphylococcus aureus as a cause (HR 2.47), mitral valve involvement (HR 1.29), and anticoagulant therapy (HR 1.31). This last variable was particularly related to a greater incidence of hemorrhagic events (HR 2.71). Overall mortality was 30%, and neurological complications had a negative impact on outcome (45% of deaths versus 24% in patients without these complications; P Conclusions— Moderate to severe ischemic stroke and brain hemorrhage were found to have a significant negative impact on the outcome of infective endocarditis. Early appropriate antimicrobial treatment is critical, and transitory discontinuation of anticoagulant therapy should be considered.
Published: 2013
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13. Characterization and risk estimate of cancer in patients with primary Sjögren syndrome

Author: Brito-Zerón, Pilar, Kostov, Belchin, Fraile, Guadalupe, Caravia-Durán, Daniel, Maure, Brenda, Rascón, Francisco-Javier, Zamora, Mónica, Casanovas, Arnau, Lopez-Dupla, Miguel, Ripoll, Mar, Pinilla, Blanca, Fonseca, Eva, Akasbi, Miriam, de la Red, Gloria, Duarte-Millán, Miguel-Angel, Fanlo, Patricia, Guisado-Vasco, Pablo, Pérez-Alvarez, Roberto, Chamorro, Antonio J, Morcillo, César, Jiménez-Heredia, Iratxe, Sánchez-Berná, Isabel, López-Guillermo, Armando, Ramos-Casals, Manuel, SS Study Group GEAS-SEMI, The SS Study Group GEAS-SEMI, [Morcillo,C, Brito-Zerón,P] Autoimmune Diseases Unit, Department of Internal Medicine, Hospital CIMA-Sanitas, Barcelona, Spain. [Brito-Zerón, P: Sánchez-Berná,I, Ramos-Casals,M] Laboratory of Autoimmune Diseases Josep Font, IDIBAPS, Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain. [Kostov,B] Transversal group for research in primary care, IDIBAPS, Consorci d’Atenció Primària de Salut Barcelona Esquerre (CAPSBE), Barcelona, Spain. [Fraile,G] Department of Internal Medicine, Hospital Ramón y Cajal, Madrid, Spain. [Caravia-Durán,D] Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain. [Maure,B] Department of Internal Medicine, Complejo Hospitalario Universitario, Vigo, Spain. [Rascón,FJ] Department of Internal Medicine, Hospital Son Espases, Palma de Mallorca, Spain. [Zamora,M, and Sánchez-Berná,I] Department of Internal Medicine, Hospital Virgen de las Nieves, Granada, Spain. [Casanovas,A] Department of Internal Medicine, Hospital Parc Taulí, Sabadell, Spain. [ Lopez-Dupla,M] Department of Internal Medicine, Hospital Joan XXIII, Tarragona, Spain. [Ripoll,M] Department of Internal Medicine, Hospital Infanta Sofía, Madrid, Spain. [Pinilla,B] Department of Internal Medicine, Hospital Gregorio Marañón, Madrid, Spain. [Fonseca,E] Department of Internal Medicine, Hospital de Cabueñes, Gijón, Spain. [Akasbi,M] Department of Internal Medicine, Hospital Infanta Leonor, Madrid, Spain. [de la Red,G] Department of Internal Medicine, Hospital Esperit Sant, Santa Coloma de Gramenet, Spain. [Duarte-Millán,MA] Department of Internal Medicine, Hospital de Fuenlabrada, Fuenlabrada, Spain. [Fanlo,P] Department of Internal Medicine, Hospital Virgen del Camino, Pamplona, Spain. [Guisado-Vasco,P] Department of Internal Medicine, Complejo Hospitalario Ruber Juan Bravo, Madrid, Spain. [Pérez-Alvarez,R] Department of Internal Medicine, Hospital Alvaro Cunqueiro, Vigo, Spain. [Chamorro,AJ] Department of Internal Medicine, Hospital de Salamanca, Salamanca, Spain. [ Jiménez-Heredia,i] Department of Internal Medicine, Hospital de Sagunto, Valencia, Spain. [López-Guillermo,A] Department of Hematology, ICMHO, Hospital Clinic, Barcelona, Spain. [Ramos-Casals,M] Department of Medicine, University of Barcelona, Barcelona, Spain.
Subjects: Oncology, Male, Cancer Research, Pathology, Lymphoma, Databases, Factual, modelos de riesgos proporcionales, humanos, Diseases::Neoplasms::Neoplasms by Site::Endocrine Gland Neoplasms::Thyroid Neoplasms [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Cohort Studies, Enfermedad de hodgkin, 0302 clinical medicine, immune system diseases, hemic and lymphatic diseases, Neoplasms, Análisis de regresión, evaluación de riesgos, Gammopatía monoclonal de relevancia indeterminada, Diseases::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Plasma Cell::Multiple Myeloma [Medical Subject Headings], Sjogren syndrome, Stomach cancer, estudios de cohortes, Thyroid cancer, Neoplasias de la tiroides, Multiple myeloma, mediana edad, Síndrome de sjögren, Cancer, Labio, neoplasias, anciano, Hematology, Incidence, Pronóstico, Diseases::Neoplasms::Neoplasms by Histologic Type::Lymphoma::Hodgkin Disease [Medical Subject Headings], Diseases::Hemic and Lymphatic Diseases::Hematologic Diseases::Blood Protein Disorders::Hypergammaglobulinemia::Monoclonal Gammopathy of Undetermined Significance [Medical Subject Headings], lcsh:Diseases of the blood and blood-forming organs, adulto, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Prognosis, humanities, pronóstico, Sjogren's Syndrome, 030220 oncology & carcinogenesis, Hematologic Neoplasms, Linfoma de células b de la zona marginal, Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Globulins::Serum Globulins::Immunoglobulins::Paraproteins::Cryoglobulins [Medical Subject Headings], Female, Estudios de seguimiento, Incidencia, Anatomy::Stomatognathic System::Mouth::Lip [Medical Subject Headings], Adult, medicine.medical_specialty, Neoplasias gástricas, Lymphoma, B-Cell, lcsh:RC254-282, Risk Assessment, incidencia, 03 medical and health sciences, Crioglobulinas, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Incidence [Medical Subject Headings], Internal medicine, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies [Medical Subject Headings], medicine, Diseases::Immune System Diseases::Autoimmune Diseases::Arthritis, Rheumatoid::Sjogren's Syndrome [Medical Subject Headings], Humans, linfoma, Molecular Biology, Aged, Proportional Hazards Models, 030203 arthritis & rheumatology, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Regression Analysis [Medical Subject Headings], Proportional hazards model, business.industry, lcsh:RC633-647.5, Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Stomach Neoplasms [Medical Subject Headings], Research, Mieloma múltiple, medicine.disease, neoplasias hematológicas, Diseases::Neoplasms::Neoplasms by Histologic Type::Lymphoma::Lymphoma, Non-Hodgkin::Lymphoma, B-Cell::Lymphoma, B-Cell, Marginal Zone [Medical Subject Headings], Sjögren syndrome, stomatognathic diseases, Risk Estimate, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis [Medical Subject Headings], business
Abstract: Background: The purpose of this study is to characterize the risk of cancer in a large cohort of patients with primary Sjogren syndrome (SjS). Methods: We had analyzed the development of cancer in 1300 consecutive patients fulfilling the 2002 SjS classification criteria. The baseline clinical and immunological characteristics and systemic activity (ESSDAI scores) were assessed at diagnosis as predictors of cancer using Cox proportional hazards regression analysis adjusted for age at diagnosis and gender. The sex-and age-specific standardized incidence ratios (SIR) of cancer were estimated from 2012 Spanish mortality data. Results: After a mean follow-up of 91 months, 127 (9.8%) patients developed 133 cancers. The most frequent type of cancer was B-cell lymphoma (including 27 MALT and 19 non-MALT B-cell lymphomas). Systemic activity at diagnosis of primary SjS correlated with the risk of hematological neoplasia and cryoglobulins with a high risk of either B-cell or non-B-cell lymphoma subtypes. Patients with cytopenias had a high risk of non-MALT B-cell and non-B-cell cancer, while those with low C3 levels had a high risk of MALT lymphomas and those with monoclonal gammopathy and low C4 levels had a high risk of non-MALT lymphomas. The estimated SIR for solid cancer was 1. 13 and 11.02 for hematological cancer. SIRs for specific cancers were 36.17 for multiple myeloma and immunoproliferative diseases, 19.41 for Hodgkin lymphoma, 6.04 for other non-Hodgkin lymphomas, 5.17 for thyroid cancer, 4.81 for cancers of the lip and oral cavity, and 2.53 for stomach cancer. Conclusions: One third of cancers developed by patients with primary SjS are B-cell lymphomas. The prognostic factors identified at SjS diagnosis differed according to the subtype of B-cell lymphoma developed. Primary SjS is also associated with the development of some non-hematological cancers (thyroid, oral cavity, and stomach)., This work is supported by the Grant Fondo de Investigaciones Sanitarias (MRC, INT15/00085) and by the CERCA Programme/Generalitat de Catalunya.
Published: 2017

14. External validation of multidimensional prognostic indices (ADO, BODEx and DOSE) in a primary care international cohort (PROEPOC/COPD cohort)

Author: Espantoso-Romero, Maite, Roman Rodriguez, Miguel, Duarte-Perez, Ana, Gonzalvez-Rey, Jaime, Callejas-Cabanillas, Pedro A., Lazic, Durdica Kasuba, Anta-Agudo, Berta, Toran Monserrat, Pere, Magallon-Botaya, Rosa, Kitanovska, Biljana Gerasimovska, Lingner, Heidrun, Assenova, Radost S., Iftode, Claudia, Gude-Sampedro, Francisco, Claveria, Ana, and PROEPOC COPD Study Grp
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, modelos logísticos, modelos de riesgos proporcionales, humanos, Validation studies as topic, pruebas de función respiratoria, Logistic regression, Risk Assessment, Severity of Illness Index, Pulmonary function testing, 03 medical and health sciences, Study Protocol, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, progresión de la enfermedad, Risk Factors, estudios prospectivos, Surveys and Questionnaires, evaluación de riesgos, factores de riesgo, Medicine, Humans, Medical history, índice de gravedad de la enfermedad, análisis multifactorial, 030212 general & internal medicine, Prospective Studies, Intensive care medicine, Prospective cohort study, Proportional Hazards Models, COPD, Primary Health Care, business.industry, Chronic obstructive pulmonary disease, Guideline, medicine.disease, Prognosis, Obstructive lung disease, Respiratory Function Tests, Europe, pronóstico, Logistic Models, 030228 respiratory system, Cohort, Multivariate Analysis, Disease Progression, business
Abstract: Background: Due to the heterogeneous and systemic nature of the chronic obstructive pulmonary disease ( COPD), the new guidelines are oriented toward individualized attention. Multidimensional scales could facilitate its proper clinical and prognostic assessment, but not all of them were validated in an international primary care cohort, different from the original ones used for model development. Therefore, our main aim is to assess the prognostic capacity of the ADO, BODEx and DOSE indices in primary care for predicting mortality in COPD patients and to validate the models obtained in subgroups of patients, classified by revised Global Initiative for Chronic Obstructive Lung Disease ( 2011) and updated Spanish Guideline ( 2014). Besides, we want to confirm that the prognostic capacity of all indices increases if the number of exacerbations is substituted by the interval between them and to assess the impact on health of the patient's lifestyle, social network and adherence to treatment. Methods: Design: External validation of scales, open and prospective cohort study in primary care. Setting: 36 health centres in 6 European high, medium and low income countries. Subjects: 477 patients diagnosed with COPD, captured in clinical visit by their General Practitioner/Nurse. Predictors: Detailed patient history, exacerbations, lung function test and questionnaires at baseline. Outcomes: Exacerbations, all-cause mortality and specific mortality, within 5 years of recruitment. Analysis: Multivariate logistic regression and Cox regression will be used. Possible non-linear effect of the indices will be studied by using Structured Additive Regression models with penalised splines. Subsequently, we will assess different aspects of the regression models: discrimination, calibration and diagnostic precision. Clinical variables modulated in primary care and the interval between exacerbations will be considered and incorporated into the analysis. Discussion: The Research Agenda for General Practice/Family Medicine highlights that the evidence on predictive values of prognostic indices in primary care is scarce. A prospective cohort like that of PROEPOC/COPD provides good opportunities for research into COPD and make communication easier between family practitioners, nursing staff, pneumologists and other professionals, supporting a multi-disciplinary approach to the treatment of these patients., The PROEPOC/COPD study is supported by a grant (PI14/00385) from the Instituto de Salud Carlos III (Carlos III Institute of Health) of the Spanish Ministry of Health, co-financed with European Union ERDF Funds, in peer reviewed public competition.
Published: 2016

15. Metabolites of Glutamate Metabolism Are Associated With Incident Cardiovascular Events in the PREDIMED PREvención con DIeta MEDiterránea (PREDIMED) Trial

Author: Courtney Dennis, Lluis Serra-Majem, José Lapetra, Estefanía Toledo, Enrique Gómez-Gracia, Montserrat Fitó, Fernando Arós, Liming Liang, Emilio Ros, Miguel Ángel Martínez-González, Adela Hruby, Ramon Estruch, Miquel Fiol, Frank B. Hu, Miguel Ruiz-Canela, Dolores Corella, Clary B. Clish, Yan Zheng, Jordi Salas-Salvadó, Alimentació, Nutrició, Creixement i Salut Mental, Bioquímica i Biotecnologia, Universitat Rovira i Virgili, [Zheng, Yan] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA, [Hu, Frank B.] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA, [Hruby, Adela] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA, [Hu, Frank B.] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA, [Liang, Liming] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA, [Liang, Liming] Harvard TH Chan Sch Publ Hlth, Dept Biostat, Boston, MA USA, [Hu, Frank B.] Brigham & Womens Hosp, Dept Med, Channing Lab, Boston, MA USA, [Hu, Frank B.] Harvard Med Sch, Boston, MA USA, [Ruiz-Canela, Miguel] Univ Navarra, Dept Prevent Med & Publ Hlth, Pamplona, Spain, [Toledo, Estefania] Univ Navarra, Dept Prevent Med & Publ Hlth, Pamplona, Spain, [Martinez-Gonzalez, Miguel A.] Univ Navarra, Dept Prevent Med & Publ Hlth, Pamplona, Spain, [Ruiz-Canela, Miguel] IDISNA Inst Invest Sanitaria Navarra, Pamplona, Spain, [Toledo, Estefania] IDISNA Inst Invest Sanitaria Navarra, Pamplona, Spain, [Martinez-Gonzalez, Miguel A.] IDISNA Inst Invest Sanitaria Navarra, Pamplona, Spain, [Ruiz-Canela, Miguel] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Salas-Salvado, Jordi] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Toledo, Estefania] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Corella, Dolores] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Ros, Emilio] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Fito, Montserrat] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Gomez-Gracia, Enrique] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Aros, Fernando] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Fiol, Miquel] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Lapetra, Jose] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Serra-Majem, Lluis] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Estruch, Ramon] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Martinez-Gonzalez, Miguel A.] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Madrid, Spain, [Clish, Clary B.] Broad Inst MIT & Harvard Univ, Cambridge, MA USA, [Dennis, Courtney] Broad Inst MIT & Harvard Univ, Cambridge, MA USA, [Salas-Salvado, Jordi] Univ Rovira & Virgili, Dept Human Nutr, IISPV, Reus, Spain, [Corella, Dolores] Univ Valencia, Dept Prevent Med, Valencia, Spain, [Ros, Emilio] Univ Barcelona, Inst Invest Biomed August Pi Sunyer IDIBAPS, Dept Endocrinol & Nutr, Lipid Clin,Hosp Clin, Barcelona, Spain, [Estruch, Ramon] Univ Barcelona, Inst Invest Biomed August Pi Sunyer IDIBAPS, Dept Internal Med, Hosp Clin, Barcelona, Spain, [Fito, Montserrat] Hosp del Mar, Inst Recerca, Cardiovasc & Nutr Res Grp, Barcelona, Spain, [Gomez-Gracia, Enrique] Univ Malaga, Dept Prevent Med, Malaga, Spain, [Aros, Fernando] Univ Hosp Alava, Dept Cardiol, Vitoria, Spain, [Fiol, Miquel] Hosp Son Espases, Palma Inst Hlth Res IdISPa, Palma De Mallorca, Spain, [Lapetra, Jose] Dist Sanitario Atenc Primaria Sevilla, Res Unit, Dept Family Med, Seville, Spain, [Serra-Majem, Lluis] Univ Las Palmas Gran Canaria, Res Inst Biomed & Hlth Sci IUIBS, Las Palmas Gran Canaria, Spain, National Institutes of Health, Biomedical Research of the Spanish Government, Instituto de Salud Carlos III, Centro Nacional de Investigaciones Cardiovasculares, Fondo de Investigacion Sanitaria-Fondo Europeo de Desarrollo Regional, Consejeria de Salud de la Junta de Andalucia, Ministerio de Ciencia e Innovacion, Fundacion Mapfre, Agencia Canaria de Investigacion, Innovacion y Sociedad de la Informacion-EU FEDER, Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana, Ministerio de Economia, NATIONAL HEART, LUNG, AND BLOOD INSTITUTE, and NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
Subjects: Male, Glutamate Metabolism, lcsh:Diseases of the circulatory (Cardiovascular) system, Mediterranean diet, Epidemiology, Myocardial Infarction, Food-frequency questionnaire, law.invention, 0302 clinical medicine, cardiovascular disease, Mechanisms, Myocardial infarction, mediana edad, Original Research, Aged, 80 and over, anciano, dieta, Incidence, Cardiovascular disease, 3. Good health, Biochemistry and technology, Cholesterol, Cardiovascular Diseases, Cardiology and Cardiovascular Medicine, PREDIMED, medicine.medical_specialty, enfermedades cardiovasculares, glutamate, Sistema cardiovascular malalties, Bioquímica i biotecnologia, incidencia, 03 medical and health sciences, Diabetes Mellitus, Humans, Dieta -- Mediterrània, Regió de la, Aged, Dyslipidemias, Prevention, hábito de fumar, Insulin-resistance, medicine.disease, dietary clinical trial, Clinical trial, Diabetes Mellitus, Type 2, Fat, lcsh:RC666-701, Acute Coronary Syndromes, Etiology, modelos de riesgos proporcionales, Supplementation, Dietary clinical trial, humanos, 030204 cardiovascular system & hematology, Diet, Mediterranean, Dieta mediterrània, Randomized controlled trial, law, Risk Factors, Disease, 030212 general & internal medicine, Cardiovascular Events, Stroke, Randomized Controlled Trials as Topic, Diet and Nutrition, Bioquímica y tecnología, Ciencias de la Salud::Salud pública [Materias Investigacion], ensayos clínicos controlados aleatorizados como asunto, Incidence (epidemiology), Smoking, colesterol, Middle Aged, stroke, glutamina, Hypertension, glutamine, Female, epidemiology, Glutamate, Sistema cardiovascular -- Malalties -- Dietoteràpia, Risk, dislipidemias, Population, 2047-9980, Glutamic Acid, Àcid glutàmic, Internal medicine, medicine, Tobacco Smoking, factores de riesgo, accidente cerebrovascular, cardiovascular diseases, infarto de miocardio, Proportional Hazards Models, business.industry, Cholesterol, HDL, Cholesterol, LDL, Surgery, Diet, Glutamine, Spain, Weight-loss, hipertensión, business, diet, ácido glutámico
Abstract: Background-Glutamate metabolism may play a role in the pathophysiology of cardiometabolic disorders. However, there is limited evidence of an association between glutamate-related metabolites and, moreover, changes in these metabolites, and risk of cardiovascular disease (CVD). Methods and Results-Plasma levels of glutamate and glutamine were measured at baseline and 1-year follow-up in a case-cohort study including 980 participants (mean age 68 years; 46% male) from the PREvencion con DIeta MEDiterranea (PREDIMED) randomized trial, which assessed a Mediterranean diet intervention in the primary prevention of CVD. During median 4.8 years of follow-up, there were 229 incident CVD events (nonfatal stroke, nonfatal myocardial infarction, or CVD death). In fully adjusted models, per 1-SD, baseline glutamate was associated with 43% (95% CI: 16% to 76%) and 81% (39% to 137%) increased risk of composite CVD and stroke alone, respectively, and baseline glutamine-to-glutamate ratio with 25% (6% to 40%) and 44% (25% to 58%) decreased risk of composite CVD and stroke alone, respectively. Associations appeared linear for stroke (both P-linear trend, This work was supported by the National Institutes of Health, 1R01HL118264. The PREDIMED trial was supported by the official funding agency for Biomedical Research of the Spanish Government, Instituto de Salud Carlos III, through grants provided to research networks specifically developed for the trial: RTIC G03/140 (Period 2003-2006, Coordinator: R. Estruch, MD, PhD), and RTIC RD 06/0045 (Period 2007-2013, Coordinator: M. A. Martinez-Gonzalez, MD, PhD). We also acknowledge the grants from Centro Nacional de Investigaciones Cardiovasculares CNIC06/2007, Fondo de Investigacion Sanitaria-Fondo Europeo de Desarrollo Regional (PI04-2239, PI05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI08/1259, PI10/01407, PI11/01647, PI11/01791), and Consejeria de Salud de la Junta de Andalucia (PI0105/2007). Ministerio de Ciencia e Innovacion (AGL-2009-13906-C02, AGL2010-22319-C03), Fundacion Mapfre 2010, Consejeria de Salud de la Junta de Andalucia (PI0105/2007), Agencia Canaria de Investigacion, Innovacion y Sociedad de la Informacion-EU FEDER (PI 2007/050), Public Health Division of the Department of Health of the Autonomous Government of Catalonia and Generalitat Valenciana (ACOMP06109, GVA-COMP2010-181, GVACOMP2011-151, CS2010-AP-111, CS2011-AP-042, AP-042/11 and BEST11-263) and Ministerio de Economia (PI07-0954, CNIC-06, AGL2010-22319-C03-03, PI11/02505). CIBEROBN is an initiative of ISCIII, Spain.
Published: 2016
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16. Low phase angle is associated with the development of hepatic encephalopathy in patients with cirrhosis

Author: Ángeles Espinosa-Cuevas, Astrid Ruiz-Margáin, Manuel Romero-Gómez, Andres Duarte-Rojo, Ricardo U Macías-Rodríguez, Javier Ampuero, Francisco Javier Cubero, Luis Alberto Chi-Cervera, Aldo Torre, Silvia L. Ríos-Torres, [Ruiz-Margáin,A, Macías-Rodríguez,RU] Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México. Department of Internal Medicine Ⅲ, University Hospital RWTH Aachen, Aachen, Germany. [Ampuero,J, Romero-Gómez,M] Unit for the Clinical Management of Digestive Diseases, Virgen del Rocio -Virgen Macarena University Hospital, Sevilla, Spain. [Cubero,FJ] Department of Immunology, Complutense University School of Medicine, Madrid, Spain. [Chi-Cervera,L, Ríos-Torres,SL, Torre,A] Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México. [Duarte-Rojo,A] University of Arkansas for Medical Sciences, Little Rock, United States. [Espinosa-Cuevas,A] Department of Nephrology and Mineral Merabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México., [Ruiz-Margain, Astrid] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Gastroenterol, Vasco Quiroga 15, Mexico City 14080, DF, Mexico, [Ulises Macias-Rodriguez, Ricardo] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Gastroenterol, Vasco Quiroga 15, Mexico City 14080, DF, Mexico, [Chi-Cervera, Luis] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Gastroenterol, Vasco Quiroga 15, Mexico City 14080, DF, Mexico, [Rios-Torres, Silvia L.] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Gastroenterol, Vasco Quiroga 15, Mexico City 14080, DF, Mexico, [Torre, Aldo] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Gastroenterol, Vasco Quiroga 15, Mexico City 14080, DF, Mexico, [Ruiz-Margain, Astrid] Univ Hosp RWTH Aachen, Dept Internal Med 3, D-52074 Aachen, Germany, [Ulises Macias-Rodriguez, Ricardo] Univ Hosp RWTH Aachen, Dept Internal Med 3, D-52074 Aachen, Germany, [Ampuero, Javier] Virgen Rocio Virgen Macarena Univ Hosp, Unit Clin Management Digest Dis, Seville 41009, Spain, [Romero-Gomez, Manuel] Virgen Rocio Virgen Macarena Univ Hosp, Unit Clin Management Digest Dis, Seville 41009, Spain, [Javier Cubero, Francisco] Univ Complutense, Sch Med, Dept Immunol, E-28040 Madrid, Spain, [Duarte-Rojo, Andres] Univ Arkansas Med Sci, Little Rock, AR 72205 USA, [Espinosa-Cuevas, Angeles] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Nephrol & Mineral Merab, Mexico City 14080, DF, Mexico, CONACYT/UNAM, and Fundacion para la Salud y Educacion 'Salvador Zubiran'
Subjects: Liver Cirrhosis, Male, Sarcopenia, Cirrhosis, Cachexia, Survival, Diseases::Virus Diseases::Hepatitis, Viral, Human::Hepatitis C::Hepatitis C, Chronic [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings], Cirrosis hepática, Kaplan-Meier Estimate, Gastroenterology, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 0302 clinical medicine, Várices esofágicas y gástricas, Liver Cirrhosis, Alcoholic, Non-alcoholic Fatty Liver Disease, Risk Factors, Liver-cirrhosis, Análisis de regresión, Electric Impedance, Medicine, Responses, Disease, Prospective Studies, Diseases::Digestive System Diseases::Liver Diseases::Hepatic Insufficiency::Liver Failure::Hepatic Encephalopathy [Medical Subject Headings], Hepatic encephalopathy, Liver Cirrhosis, Biliary, Incidence, Phase angle, Brain, General Medicine, Middle Aged, Modelos de riesgos proporcionales, Prognosis, Hepatitis C, 030220 oncology & carcinogenesis, Body-composition, Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 1-Ring::Azoles::Imidazoles::Creatinine [Medical Subject Headings], Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Causality::Precipitating Factors [Medical Subject Headings], Body Composition, 030211 gastroenterology & hepatology, Female, Estudios de seguimiento, Gastrointestinal Hemorrhage, Adult, medicine.medical_specialty, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Analysis of Variance::Multivariate Analysis [Medical Subject Headings], Diseases::Digestive System Diseases::Liver Diseases::Liver Cirrhosis [Medical Subject Headings], Esophageal and Gastric Varices, Infections, 03 medical and health sciences, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Incidence [Medical Subject Headings], Internal medicine, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies [Medical Subject Headings], Humans, In patient, ddc:610, Diseases::Digestive System Diseases::Gastrointestinal Diseases::Gastrointestinal Hemorrhage [Medical Subject Headings], Encefalopatía hepática, Proportional Hazards Models, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Regression Analysis [Medical Subject Headings], Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight::Body Weight Changes::Weight Loss::Emaciation::Cachexia [Medical Subject Headings], business.industry, Malnutrition, Hepatitis C, Chronic, medicine.disease, Diseases::Digestive System Diseases::Gastrointestinal Diseases::Esophageal Diseases::Esophageal and Gastric Varices [Medical Subject Headings], Metabolism, Prospective Study, business
Abstract: World journal of gastroenterology 22(45), 10064-10070 (2016). doi:10.3748/wjg.v22.i45.10064, Published by WJG Press, Beijing
Published: 2016
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17. A Randomized Trial of Factor VIII and Neutralizing Antibodies in Hemophilia A

Author: Kaan Kavakli, Mamta Manglani, Ezio Zanon, Christoph Male, Tarek Owaidah, Johnny Mahlangu, Ramabadran Varadarajan, Veronica Soto Arellano, Flora Peyvandi, Alessandra Nunes Loureiro Prezotti, Monica Martinez, Frits R. Rosendaal, Cecil Ross, Suresh Hanagavadi, Suvankar Majumdar, Bulent Zulfikar, Anupam Sachdeva, Brian M. Wicklund, Amal El-Beshlawy, Marilyn J. Manco-Johnson, M. Cerqueira, Dinesh M Nayak, Pier Mannuccio Mannucci, Santiago Bonanad Boix, Nadia P. Ewing, Klaus Schmitt, Angeles Palomo Bravo, Nathan L Kobrinsky, Maria Elisa Mancuso, Shashikant Apte, Mathew Thomas, Isabella Garagiola, Rogelio Paredes Aguilera, Guy Young, Maria Gabriella Mazzucconi, Esperanza Marzouka, Rosario Perez Garrido, Tulika Seth, Bülent Antmen, Mohsen Saleh Elalfy, Peyman Eshghi, E. Santagostino, Mindy L. Simpson, Vijay Ramanan, Daniela Neme, Mehran Karimi, Adriana C Sandoval Gonzalez, Çukurova Üniversitesi, Ege Üniversitesi, [Peyvandi,F, Mannucci,PM, Santagostino,E, Mancuso,ME] the Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Ospedale Maggiore Policlinico, Italy. [Peyvandi,F, and Garagiola,I] Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Italy. [Zanon,E] Milan, Clinica Medica II, Azienda Ospedaliera di Padova, Centro Emofilia, Padua. Italy. [Mazzucconi,MG] Ematologia, Unità Operativa Diagnostica Speciale e Terapia delle Malattie dell’Emostasi e della Trombosi, Università Sapienza, Policlinico Umberto I, Rome, Italy. [El-Beshlawy,A] The Pediatric Hematology Department, Cairo University Pediatric Hospital, Cairo. [Elalfy,M] Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo. [Ramanan,V] Jehangir Clinical Development Center, Department of Hematology, Jehangir Hospital Premises, India. , [Apte,S] Sahyadri Speciality Hospita, l India. [Hanagavadi,S] Pune, Jagadguru Jayadeva Murugarajendra Medical College, Davangere, India. [Baradajaran,P] Center for Blood Disorders, Chennai, India. [Manglani,MV] Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India. [Ross,C] St. John’s Medical College Hospital, Bangalore India. [Seth,T] India Institute of Medical Sciences, Department of Hematology, India. [Sachdeva,A] Pediatric Hematology Oncology and Bone Marrow Transplantation, Institute for Child Health, Sir Ganga Ram Hospital, India. [Nayak,DM] New Delhi, Melaka-Manipal Medical College, Manipal University, Manipal, India. [Thomas,M] Kerala Institute of Medical Science, Trivandrum, India. [Eshghi,P] The Congenital Pediatric Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. [Karimi,M] Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. [Young,G] Children’s Hospital Los Angeles, Los Angeles,California. [Ewing,NP] City of Hope National Medical Center, Duarte, California. [Sandoval Gonzalez, AC] Hospital de Especialidades Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social, Monterrey, Mexico. [Paredes Aguilera,R] Instituto Nacional de Pediatria, Mexico City, Mexico. [Mahlangu,JN] Faculty of Health Sciences, School of Pathology, University of the Witwatersrand, National Health Laboratory Service and Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg.[Bonanad Boix,S] Hospital Universitario La Fe, Unidad Coagulopatias Congenitas, Valencia, Spain. [Perez Garrido, R] Hospital Universitario Virgen del Rocío, Unidad de Hemofilia, Seville, Spain. [Palomo Bravo,A] Hospital Regional Universitario Carlos Haya, Malaga, Spain. [Cerqueira,M] Centro de Pesquisa Clinica Hemorio–Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti, Rio de Janeiro, Brazil. [Prezotti,A] Centro de Hematologia e Hemoterapia do Espírito Santo, Vitoria, Brazil. [Male,C] Medizinische Universität Wien, Department of Pediatrics, Vienna, Austria. [Schmitt,K] Department of Pediatric and Adolescent Medicine, Kepler University Clinic, Linz, Austria. [Owaidah,T] King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. [Soto Arellano,V] Centro de Hemofílicos del Hospital de Niños Dr. Roberto del Río, Chile. [Marzouka,E] Hospital de Niños Dr. Luis Calvo Mackenna, Centro Hemofílico, Santiago, Chile. [Kobrinsky, NL] Sanford Roger Maris Cancer Center, Fargo, ND. [Majundar,S] University of Mississippi Medical Center, Division of Pediatric Hematology–Oncology, Jackson. [Simpson,M] Rush Hemophilia and Thrombophilia Center, Rush University Medical Center, Chicago. [Antmen,B] Cukurova Universitesi, Tip Fakultesi Pediatrik Hematoloji Bilim Dali, Adana, Turkey. [Kabakli,K] Ege Universitesi Tip Fakultesi Cocuk Sagligi ve Hastalikari Anabilim Dali, Pediatrik Hematoloji Bilim Dali, Turkey. [Zulfikar,B] Istanbul Universitesi Cerrahpasa Tip Fakultesi, Pediatrik Hematoloji Bilim Dali, Istanbul,Turkey. [Manco-Johnson,MJ] Hemophilia and Thrombosis Center, University of Colorado Denver, Aurora. [Martinez,M] Hospital de Niños Sor María Ludovica La Plata, Servicio de Hematología, Buenos Aires. [Neme,D] Fundación de la Hemofilia, Buenos Aires.[Wicklund,BM] Children’s Mercy Hospital, Kansas City, MO, The Netherlands. [Rosendaal,FR] he Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Subjects: Male, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings], Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Adulto joven, 030204 cardiovascular system & hematology, Gastroenterology, law.invention, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 0302 clinical medicine, Randomized controlled trial, Isoantibodies, law, Hemorragia, hemic and lymphatic diseases, Medicine, Child, Masculino, Adolescente, Named Groups::Persons::Age Groups::Child::Child, Preschool [Medical Subject Headings], biology, Adulto, Incidence, Hemofilia A, General Medicine, Middle Aged, Modelos de riesgos proporcionales, Humanos, Diseases::Hemic and Lymphatic Diseases::Hematologic Diseases::Hemorrhagic Disorders::Hemophilia A [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Administration Routes::Injections::Injections, Subcutaneous [Medical Subject Headings], Child, Preschool, Niño, Named Groups::Persons::Age Groups::Adolescent [Medical Subject Headings], Drug Therapy, Combination, Named Groups::Persons::Age Groups::Infant [Medical Subject Headings], Antibody, Incidencia, Niño preescolar, Adult, medicine.medical_specialty, Randomization, Adolescent, Named Groups::Persons::Age Groups::Adult::Young Adult [Medical Subject Headings], Injections, Subcutaneous, Anciano, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Therapy, Combination [Medical Subject Headings], Check Tags::Male [Medical Subject Headings], Hemorrhage, Hemophilia A, Isoanticuerpos, Bethesda unit, Anticuerpos neutralizantes, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Hemorrhage [Medical Subject Headings], Young Adult, 03 medical and health sciences, Pharmacotherapy, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Incidence [Medical Subject Headings], Von Willebrand factor, Internal medicine, von Willebrand Factor, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], Humans, Factor de von Willebrand, Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Named Groups::Persons::Age Groups::Child [Medical Subject Headings], Aged, Proportional Hazards Models, Emicizumab, Mediana edad, Factor VIII, Dose-Response Relationship, Drug, business.industry, Phenomena and Processes::Physiological Phenomena::Pharmacological Phenomena::Dose-Response Relationship, Drug [Medical Subject Headings], Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Globulins::Serum Globulins::Immunoglobulins::Antibodies::Isoantibodies [Medical Subject Headings], Infant, Inyecciones subcutáneas, Lactante, Antibodies, Neutralizing, Relación dosis-respuesta de medicamentos, Chemicals and Drugs::Biological Factors::Blood Coagulation Factors::von Willebrand Factor [Medical Subject Headings], Surgery, Farmacoterapia combinada, Chemicals and Drugs::Biological Factors::Blood Coagulation Factors::Factor VIII [Medical Subject Headings], biology.protein, Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Globulins::Serum Globulins::Immunoglobulins::Antibodies::Antibodies, Neutralizing [Medical Subject Headings], business, 030215 immunology
Abstract: WOS: 000376443500008, PubMed ID: 27223147, BACKGROUND The development of neutralizing anti-factor VIII alloantibodies (inhibitors) in patients with severe hemophilia A may depend on the concentrate used for replacement therapy. METHODS We conducted a randomized trial to assess the incidence of factor VIII inhibitors among patients treated with plasma-derived factor VIII containing von Willebrand factor or recombinant factor VIII. Patients who met the eligibility criteria (male sex, age = 5 Bethesda units). Inhibitors developed in 29 of the 125 patients treated with plasma-derived factor VIII (20 patients had high-titer inhibitors) and in 47 of the 126 patients treated with recombinant factor VIII (30 patients had high-titer inhibitors). The cumulative incidence of all inhibitors was 26.8% (95% confidence interval [CI], 18.4 to 35.2) with plasma-derived factor VIII and 44.5% (95% CI, 34.7 to 54.3) with recombinant factor VIII; the cumulative incidence of high-titer inhibitors was 18.6% (95% CI, 11.2 to 26.0) and 28.4% (95% CI, 19.6 to 37.2), respectively. In Cox regression models for the primary end point of all inhibitors, recombinant factor VIII was associated with an 87% higher incidence than plasma-derived factor VIII (hazard ratio, 1.87; 95% CI, 1.17 to 2.96). This association did not change in multivariable analysis. For high-titer inhibitors, the hazard ratio was 1.69 (95% CI, 0.96 to 2.98). When the analysis was restricted to recombinant factor VIII products other than second-generation full-length recombinant factor VIII, effect estimates remained similar for all inhibitors (hazard ratio, 1.98; 95% CI, 0.99 to 3.97) and high-titer inhibitors (hazard ratio, 2.59; 95% CI, 1.11 to 6.00). CONCLUSIONS Patients treated with plasma-derived factor VIII containing von Willebrand factor had a lower incidence of inhibitors than those treated with recombinant factor VIII. (Funded by the Angelo Bianchi Bonomi Foundation and others; ClinicalTrials.gov number, NCT01064284; EudraCT number, 2009-011186-88.), Angelo Bianchi Bonomi Foundation, Funded by the Angelo Bianchi Bonomi Foundation and others
Published: 2016

18. Preinfarction Angina Prior to First Myocardial Infarction Does not Influence Long-Term Prognosis: A Retrospective Study with Subgroup Analysis in Elderly and Diabetic Patients

Author: Miguel A. Ramírez-Marrero, José M. Hernández-García, Eduardo de Teresa, Juan H. Alonso-Briales, Antonio J. Muñoz-García, Juan José Gómez-Doblas, Dolores Salva, Manuel F. Jiménez-Navarro, Ángel García Alcántara, Antonio J. Domínguez-Franco, Noela Rodriguez-Losada, [Jiménez-Navarro, MF, Muñoz-García, A, Ramírez-Marrero, MA, Domínguez-Franco, A, Gómez-Doblas, JJ, Alonso-Briales, J, Hernández-García, JM, Salva, D, Rodríguez-Losada, N, and de Teresa, E]Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria. Málaga, Spain. [García-Alcántara, A] Intensive Care Unit, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain.
Subjects: Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Recurrence [Medical Subject Headings], Diseases::Cardiovascular Diseases::Heart Diseases::Myocardial Ischemia::Angina Pectoris::Angina, Unstable [Medical Subject Headings], Diseases::Cardiovascular Diseases::Heart Diseases::Myocardial Ischemia::Myocardial Infarction [Medical Subject Headings], Phenomena and Processes::Physical Phenomena::Time::Time Factors [Medical Subject Headings], Hospitalización, First myocardial infarction, Case Reports, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Preinfarction angina, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Angina, Myocardial infarction, Insuficiencia cardíaca, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::Hospitalization::Patient Readmission [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Thrombolytic Therapy [Medical Subject Headings], General Medicine, Modelos de riesgos proporcionales, Humanos, Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Causality::Risk Factors [Medical Subject Headings], Cardiology, Health Care::Health Care Facilities, Manpower, and Services::Health Services::Patient Care::Hospitalization [Medical Subject Headings], Terapia trombolítica, Cardiology and Cardiovascular Medicine, Factores de riesgo, medicine.medical_specialty, Readmisión del paciente, Anciano, Recurrencia, Subgroup analysis, Diseases::Cardiovascular Diseases::Heart Diseases::Myocardial Ischemia::Angina Pectoris [Medical Subject Headings], Estudios retrospectivos, Complicaciones de la diabetes, Infarto del miocardio, Internal medicine, Diabetes mellitus, medicine, Health Care::Health Services Administration::Organization and Administration::Risk Management::Risk Assessment [Medical Subject Headings], Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], business.industry, Angina de pecho, Angina inestable, Diseases::Cardiovascular Diseases::Heart Diseases::Heart Failure [Medical Subject Headings], Retrospective cohort study, medicine.disease, Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings], Factores de tiempo, Diseases::Endocrine System Diseases::Diabetes Mellitus::Diabetes Complications [Medical Subject Headings], Medición de riesgo, Resultado del tratamiento, Health Care::Health Services Administration::Quality of Health Care::Outcome and Process Assessment (Health Care)::Outcome Assessment (Health Care)::Treatment Outcome [Medical Subject Headings], business, Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies [Medical Subject Headings]
Abstract: BACKGROUND AND HYPOTHESIS: Although prodromal angina occurring shortly before an acute myocardial infarction (MI) has protective effects against in‐hospital complications, this effect has not been well documented after initial hospitalization, especially in older or diabetic patients. We examined whether angina 1 week before a first MI provides protection in these patients. METHODS: A total of 290 consecutive patients, 143 elderly (>64 years of age) and 147 adults (
Published: 2009
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19. Randomized Phase 3 Trial of Fluorouracil, Epirubicin, and Cyclophosphamide Alone or Followed by Paclitaxel for Early Breast Cancer

Author: Miguel, Martín, Alvaro, Rodríguez-Lescure, Amparo, Ruiz, Emilio, Alba, Lourdes, Calvo, Manuel, Ruiz-Borrego, Blanca, Munárriz, César A, Rodríguez, Carmen, Crespo, Enrique, de Alava, José Antonio, López García-Asenjo, María Dolores, Guitián, Sergio, Almenar, Jesús Fernando, González-Palacios, Francisco, Vera, José, Palacios, Manuel, Ramos, Jose Manuel, Gracia Marco, Ana, Lluch, Isabel, Alvarez, Miguel Angel, Seguí, José Ignacio, Mayordomo, Antonio, Antón, José Manuel, Baena, Arrate, Plazaola, Alfonso, Modolell, Amadeu, Pelegrí, Jose Ramón, Mel, Enrique, Aranda, Encarna, Adrover, José Valero, Alvarez, José Luis, García Puche, Pedro, Sánchez-Rovira, Sonia, Gonzalez, José Manuel, López-Vega, M Francisca, Garijo, GEICAM 9906 Study Investigators, [Martín,M] Department of Medical Oncology, Hospital Universitario San Carlos, Madrid, Spain. [López García-Asenjo,JA] Department of Pathology, Hospital Universitario San Carlos, Madrid, Spain. [Rodríguez-Lescure,A] Department of Medical Oncology, Hospital Universitario de Elche, Spain. [Ruiz,A] Department of Medical Oncology, Instituto Valenciano de Oncologia, Valencia, Spain. [Almenar,S] Department of Pathology, Instituto Valenciano de Oncologia, Valencia, Spain. [Alba Conejo,E] Department of Medical Oncology, Hospital Virgen de la Victoria, Málaga, Spain. [Calvo,L] Department of Medical Oncology, Complejo Hospitalario Juan Canalejo, La Coruña, Spain. [Guitián,MD] Department of Pathology, Complejo Hospitalario Juan Canalejo, La Coruña, Spain. [Ruiz-Borrego,M] Department of Medical Oncology, Hospital Vírgen del Rocío, Sevilla, Spain [Palacios,J] Department of Pathology, Hospital Vírgen del Rocío, Sevilla, Spain. [Muñárriz,B] Department of Medical Oncology, Hospital La Fe, Valencia, Spain. [Vera,F] Department of Pathology, Hospital La Fe, Valencia, Spain. [Rodríguez, CA] Department of Medical Oncology, Hospital Universitario de Salamanca, Salamanca, Spain. [Crespo,C] Department of Medical Oncology, Hospital Ramón y Cajal, Madrid, Spain. [González-Palacios,JF] Department of Pathology, Hospital Ramón y Cajal, Madrid, Spain. [de Álava,E] Department of Pathology, Centro de Investigación del Cáncer, Salamanca, Spain. [Ramos,M] Department of Medical Oncology, Centro Oncológico de Galicia, La Coruña, Spain. [Gracia Marco,JM] Department of Medical Oncology, Hospital de Cabueñes, Gijón, Spain. [Lluch,A] Department of Medical Oncology, Hospital Clínico Universitario de Valencia, Valencia, Spain. [Álvarez,I] Department of Medical Oncology, Hospital de Donostia, San Sebastián, Spain. [Seguí,MA] Department of Medical Oncology, Hospital Parc Taulí, Sabadell, Spain. [Mayordomo,JI] Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain. [Antón,A] Department of Medical Oncology, Hospital Miguel Servet, Zaragoza, Spain. [Baena,JM] Department of Medical Oncology, Complejo Hospitalario Puerta del Mar, Cádiz, Spain. [Plazaola,A] Department of Medical Oncology, Instituto Oncológico de Guipúzcoa, San Sebastián, Spain. [Modolell,A] Department of Medical Oncology, Clínica Corachan, Barcelona, Spain. [Pelegrí,A] Department of Medical Oncology, Hospital Universitario San Joan de Reus, Tarragona, Spain. [Mel,JR] Department of Medical Oncology, Complejo Hospitalario Xeral Calde, Lugo, Spain. [Aranda,E] Department of Medical Oncology, Hospital Provincial de Córdoba, Córdoba, Spain. [Adrover,E] Department of Medical Oncology, Hospital General de Alicante, Alicante, Spain. [Valero Álvarez,J] Hospital Provincial de Zamora, Spain. [García Puche,JL] Department of Medical Oncology, Hospital San Cecilio de Granada, Granada, Spain. [Sánchez-Rovira,P] Department of Medical Oncology, Hospital Ciudad de Jaén, Jaén, Spain. [González,S] Department of Medical Oncology, Mutua de Terrasa, Terrasa, Spain. [López-Vega,JM] Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain., and Department of Medical Oncology, Hospital Ciudad de Jaén, Jaén, Spain
Subjects: Oncology, medicine.medical_treatment, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Supervivencia sin Enfermedad, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Transferases::Phosphotransferases::Phosphotransferases (Alcohol Group Acceptor)::Protein Kinases::Protein-Tyrosine Kinases::Receptor Protein-Tyrosine Kinases::Receptor, erbB-2 [Medical Subject Headings], Antineoplastic Combined Chemotherapy Protocols, Estimación de Kaplan-Meier, Receptor erbB-2, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Clinical Protocols::Antineoplastic Protocols::Antineoplastic Combined Chemotherapy Protocols [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Administration Schedule [Medical Subject Headings], Hazard ratio, Pronóstico, Epirrubicina, Prognosis, Immunohistochemistry, Diseases::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Glandular and Epithelial::Carcinoma::Adenocarcinoma::Carcinoma, Ductal::Carcinoma, Ductal, Breast [Medical Subject Headings], Receptors, Estrogen, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Neoplasm Staging [Medical Subject Headings], Chemicals and Drugs::Biological Factors::Biological Markers::Tumor Markers, Biological [Medical Subject Headings], Receptors, Progesterone, Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Alicyclic::Cycloparaffins::Cyclodecanes::Taxoids::Paclitaxel [Medical Subject Headings], medicine.medical_specialty, Paclitaxel, Fluorouracilo, Axillary lymph nodes, Resultado del Tratamiento, Anciano, Disease-Free Survival, Drug Administration Schedule, Breast cancer, Carcinoma Lobular, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], Adjuvant therapy, Humans, Cyclophosphamide, Aged, ERBB2 protein, human, medicine.disease, Carcinoma, Lobular, Check Tags::Female [Medical Subject Headings], Modelos de Riesgos Proporcionales, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Cytological Techniques::Histocytological Preparation Techniques::Staining and Labeling::In Situ Hybridization::In Situ Hybridization, Fluorescence [Medical Subject Headings], Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Survival Analysis::Disease-Free Survival [Medical Subject Headings], Cancer Research, Receptor, ErbB-2, Kaplan-Meier Estimate, Antineoplásicos Fitogénicos, Diseases::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Glandular and Epithelial::Carcinoma::Adenocarcinoma::Carcinoma, Lobular [Medical Subject Headings], Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 1-Ring::Pyrimidines::Pyrimidinones::Uracil::Fluorouracil [Medical Subject Headings], Infusions, Intravenous, In Situ Hybridization, Fluorescence, Carcinoma, Ductal, Breast, Neoplasias de la Mama, Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Receptors, Cytoplasmic and Nuclear::Receptors, Steroid::Receptors, Estrogen [Medical Subject Headings], Middle Aged, Chemotherapy regimen, Treatment Outcome, medicine.anatomical_structure, Female, Fluorouracil, Breast disease, Infusiones Intravenosas, Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Antineoplastic Agents::Antineoplastic Agents, Phytogenic [Medical Subject Headings], Epirubicin, medicine.drug, Adult, Protocolos de Quimioterapia Combinada Antineoplásica, Hibridación Fluorescente In Situ, Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Halogenated::Mustard Compounds::Nitrogen Mustard Compounds::Phosphoramide Mustards::Cyclophosphamide [Medical Subject Headings], Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::DNA-Binding Proteins::Receptors, Cytoplasmic and Nuclear::Receptors, Steroid::Receptors, Progesterone [Medical Subject Headings], Breast Neoplasms, Ciclofosfamida, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Models, Theoretical::Models, Statistical::Proportional Hazards Models [Medical Subject Headings], Disciplines and Occupations::Natural Science Disciplines::Biological Science Disciplines::Biochemistry::Immunochemistry [Medical Subject Headings], Predictive Value of Tests, Internal medicine, Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Aromatic::Polycyclic Hydrocarbons, Aromatic::Naphthacenes::Anthracyclines::Daunorubicin::Doxorubicin::Epirubicin [Medical Subject Headings], Biomarkers, Tumor, medicine, Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Diseases::Neoplasms::Neoplasms by Site::Breast Neoplasms [Medical Subject Headings], Neoplasm Staging, Proportional Hazards Models, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome [Medical Subject Headings], Receptores de Progesterona, Chemotherapy, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Survival Analysis::Kaplan-Meier Estimate [Medical Subject Headings], business.industry, Esquema de Medicación, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Administration Routes::Infusions, Parenteral::Infusions, Intravenous [Medical Subject Headings], Antineoplastic Agents, Phytogenic, Estadificación de Neoplasias, Receptores Estrogénicos, Surgery, Marcadores Biológicos de Tumor, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis [Medical Subject Headings], business, Carcinoma Ductal de Mama, Inmunohistoquímica
Abstract: Clinical Trial, Phase III; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; BACKGROUND Taxanes are among the most active drugs for the treatment of metastatic breast cancer, and, as a consequence, they have also been studied in the adjuvant setting. METHODS After breast cancer surgery, women with lymph node-positive disease were randomly assigned to treatment with fluorouracil, epirubicin, and cyclophosphamide (FEC) or with FEC followed by weekly paclitaxel (FEC-P). The primary endpoint of study-5-year disease-free survival (DFS)-was assessed by Kaplan-Meier analysis. Secondary endpoints included overall survival and analysis of the prognostic and predictive value of clinical and molecular (hormone receptors by immunohistochemistry and HER2 by fluorescence in situ hybridization) markers. Associations and interactions were assessed with a multivariable Cox proportional hazards model for DFS for the following covariates: age, menopausal status, tumor size, lymph node status, type of chemotherapy, tumor size, positive lymph nodes, HER2 status, and hormone receptor status. All statistical tests were two-sided. RESULTS Among the 1246 eligible patients, estimated rates of DFS at 5 years were 78.5% in the FEC-P arm and 72.1% in the FEC arm (difference = 6.4%, 95% confidence interval [CI] = 1.6% to 11.2%; P = .006). FEC-P treatment was associated with a 23% reduction in the risk of relapse compared with FEC treatment (146 relapses in the 614 patients in the FEC-P arm vs 193 relapses in the 632 patients in the FEC arm, hazard ratio [HR] = 0.77, 95% CI = 0.62 to 0.95; P = .022) and a 22% reduction in the risk of death (73 and 95 deaths, respectively, HR = 0.78, 95% CI = 0.57 to 1.06; P = .110). Among the 928 patients for whom tumor samples were centrally analyzed, type of chemotherapy (FEC vs FEC-P) (P = .017), number of involved axillary lymph nodes (P < .001), tumor size (P = .020), hormone receptor status (P = .004), and HER2 status (P = .006) were all associated with DFS. We found no statistically significant interaction between HER2 status and paclitaxel treatment or between hormone receptor status and paclitaxel treatment. CONCLUSIONS Among patients with operable breast cancer, FEC-P treatment statistically significantly reduced the risk of relapse compared with FEC as adjuvant therapy. Yes
Published: 2008
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20. Antilymphocyte Globulin for Prevention of Chronic Graft-versus-Host Disease

Author: Fabio Benedetti, Angelo Michele Carella, Michele Cimminiello, Elisabetta Terruzzi, Jaime Pérez De Oteiza, Kröger N, Francesca Bonifazi, Nicola Mordini, Rafael F. Duarte, Jorge Sierra, Jürgen Finke, Francesca Patriarca, Christine Wolschke, Carlos Solano, Franco Narni, Antonio M. Risitano, Domenico Pastore, Wolfgang Bethge, Francis Ayuk, Mario Petrini, Carmine Selleri, Tapani Ruutu, Giuseppe Messina, Arnon Nagler, Andreas Völp, Christelle Ferra, Marion Heinzelmann, Massimo Pini, Giuseppe Bandini, Manuel Jurado, Giuseppe Milone, Domenico Russo, Stefano Guidi, [Kröge,N, Wolschke ,C, Heinzelmann,M, Ayuk,F ] University Medical Center Hamburg-Eppendorf,Hamburg, Germany. [Finke,J] University Hospital Freiburg, Freiburg ,Germany. [Bethge,W] University Hospital Tübingen, Tübingen, Germany. [Völp,A] Psy Consult, Frankfurt, Germany. [Solano,C] Hospital Clinico Universitario, Valencia, Spain. [Pérez de Oteiza,J] Hospital Ramon y Cajal, Madrid, Spain. [Duarte,R] Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain. [Ferra,C] Servicio de Hematología, Institut Català d’Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. [Sierra,J] Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. [Jurado,M] Hospital Virgen de las Nieves, Granada, Spain. [Bandini,G, Bonifaz,F] Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy. [Patriarca,F] Hematology, DISM, University Udine, Udine. Azienda Ospedaliera SS Antonio e Biagio e C. Arrigo, Alessandria, Italy. [Pini,M] Università Federico II di Napoli, Naples, Italy. [Selleri,C, Risitano,A) A.O. Bianchi-Melacrino-Morelli, Reggio Calabria, Italy. [Messina,G] Ospedale Casa Sollievo della Sofferenza IRCCCS, San Giovanni Rotondo, Italy. [Carella,AM] Azienda Ospedaliera San Carlo, Potenza, Italy. [Cimminiello,M] Azienda Ospedaliera Careggi, Florence, Italy. [Guido,E] Ospedale Santa Croce, e Carle, Cuneo, Italy. [Mordini,N] University of Brescia, Department of Clinical and Experimental Sciences, Brescia, Italy. [Russo,D] University of Pisa, Department of Clinical and Experimental Medicine, Pisa, Italy. [Petrini,M] Programma di Trapianto Emopoietico Metropolitano, Azienda Policlinico-Vittorio Emanuele, Catania, Italy. [Milone,R] Policlinico G.B. Rossi, Verona, Italy. [Benedetti,F] Azienda Ospedaliera, Universitaria Ospedale, Bari, Italy. [Pastore,D] Ospedale San Gerardo, Monza, Italy. [Terruzzi,E] Policlinico Modena, Modena, Italy. [Narni,F] Università di Salerno, Salerno, Italy. [Nagler,A] Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel. [Tapani,R] Helsinki University Hospital, Helsinki., Supported by a research grant from Neovii Biotech and by the European Society for Blood and Marrow Transplantation (EBMT) as an EBMT-labeled-study of the Chronic Malignancies Working Party., Kröger, Nicolau, Solano, Carlo, Wolschke, Christine, Bandini, Giuseppe, Patriarca, Francesca, Pini, Massimo, Nagler, Arnon, Selleri, Carmine, Risitano, ANTONIO MARIA, Messina, Giuseppe, Bethge, Wolfgang, De Oteiza, Jaime Pérez, Duarte, Rafael, Carella, Angelo Michele, Cimminiello, Michele, Guidi, Stefano, Finke, Jürgen, Mordini, Nicola, Ferra, Christelle, Sierra, Jorge, Russo, Domenico, Petrini, Mario, Milone, Giuseppe, Benedetti, Fabio, Heinzelmann, Marion, Pastore, Domenico, Jurado, Manuel, Terruzzi, Elisabetta, Narni, Franco, Völp, Andrea, Ayuk, Franci, Ruutu, Tapani, and Bonifazi, Francesca
Subjects: Male, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings], T-Lymphocytes, Phases of clinical research, Graft vs Host Disease, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Linfocitos t, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Immunosuppressive Agent, 0302 clinical medicine, Trasplante homólogo, Estudios prospectivos, Medicine, Cumulative incidence, Prospective Studies, Prospective cohort study, Child, Transplantation, Homologou, Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Immune Sera::Antilymphocyte Serum [Medical Subject Headings], Acute leukemia, Anatomy::Cells::Blood Cells::Leukocytes::Leukocytes, Mononuclear::Lymphocytes::T-Lymphocytes [Medical Subject Headings], Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Chronic Disease [Medical Subject Headings], Named Groups::Persons::Age Groups::Child::Child, Preschool [Medical Subject Headings], Medicine (all), Incidence, Suero antilinfocítico, General Medicine, Middle Aged, Modelos de riesgos proporcionales, 3. Good health, Humanos, Survival Rate, 030220 oncology & carcinogenesis, Named Groups::Persons::Age Groups::Adolescent [Medical Subject Headings], Child, Preschool, Female, Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Immunologic Factors::Immunosuppressive Agents [Medical Subject Headings], Immunosuppressive Agents, Human, Homologous, Adult, medicine.medical_specialty, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings], Named Groups::Persons::Age Groups::Adult::Young Adult [Medical Subject Headings], Adolescent, Enfermedad injerto contra huésped, Disease-Free Survival, 03 medical and health sciences, Young Adult, Internal medicine, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], Humans, Transplantation, Homologous, Supervivencia sin enfermedad, Preschool, Survival rate, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Disease-Free Survival [Medical Subject Headings], Named Groups::Persons::Age Groups::Child [Medical Subject Headings], Antilymphocyte Serum, Proportional Hazards Models, Transplantation, business.industry, Enfermedad crónica, medicine.disease, Inmunosupresores, Anti-thymocyte globulin, Surgery, Diseases::Immune System Diseases::Graft vs Host Disease [Medical Subject Headings], Prospective Studie, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Transplantation::Transplantation, Homologous [Medical Subject Headings], Graft-versus-host disease, T-Lymphocyte, Check Tags::Female [Medical Subject Headings], Chronic Disease, Proportional Hazards Model, business, 030215 immunology
Abstract: Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; BACKGROUND Chronic graft-versus-host disease (GVHD) is the leading cause of later illness and death after allogeneic hematopoietic stem-cell transplantation. We hypothesized that the inclusion of antihuman T-lymphocyte immune globulin (ATG) in a myeloablative conditioning regimen for patients with acute leukemia would result in a significant reduction in chronic GVHD 2 years after allogeneic peripheral-blood stem-cell transplantation from an HLA-identical sibling. METHODS We conducted a prospective, multicenter, open-label, randomized phase 3 study of ATG as part of a conditioning regimen. A total of 168 patients were enrolled at 27 centers. Patients were randomly assigned in a 1:1 ratio to receive ATG or not receive ATG, with stratification according to center and risk of disease. RESULTS After a median follow-up of 24 months, the cumulative incidence of chronic GVHD was 32.2% (95% confidence interval [CI], 22.1 to 46.7) in the ATG group and 68.7% (95% CI, 58.4 to 80.7) in the non-ATG group (P
Published: 2016

21. CLOCK gene variation is associated with incidence of type‑2 diabetes and cardiovascular diseases in type‑2 diabetic subjects: dietary modulation in the PREDIMED randomized trial

Author: Fernando Arós, José V. Sorlí, Ramon Estruch, Jordi Salas-Salvadó, Miquel Fiol, Javier Díez Espino, Andrés Díaz-López, José Lapetra, Miguel Ángel Martínez-González, Olga Castañer, Montserrat Fitó, Oscar Coltell, Eva M. Asensio, Dolores Corella, Jose M. Ordovas, Emilio Ros, Enrique Gómez-Gracia, Carolina Ortega-Azorín, Lluis Serra-Majem, and Universitat de Barcelona
Subjects: Male, 0301 basic medicine, Time Factors, modelos de riesgos proporcionales, Endocrinology, Diabetes and Metabolism, humanos, CLOCK Proteins, Type 2 diabetes, Kaplan-Meier Estimate, frecuencia génica, 030204 cardiovascular system & hematology, Diet, Mediterranean, 0302 clinical medicine, Gene Frequency, Risk Factors, evaluación de riesgos, Longitudinal Studies, mediana edad, Original Investigation, Aged, 80 and over, anciano, Diabetis, homocigoto, dieta, Incidence, resultado del tratamiento, Homozygote, Diabetes, distribución de la ji al cuadrado, Middle Aged, Circadian Rhythm, CLOCK, Stroke, Phenotype, Treatment Outcome, Cardiovascular diseases, interacción gen-ambiente, diabetes mellitus, fenotipo, Cardiology and Cardiovascular Medicine, estimación de Kaplan-Meier, medicine.medical_specialty, Heterozygote, enfermedades cardiovasculares, Single-nucleotide polymorphism, Ciencias de la Salud::Nutrición y dietética [Materias Investigacion], Polymorphism, Single Nucleotide, Risk Assessment, incidencia, 03 medical and health sciences, Insulin resistance, Mediterranean cooking, factores de tiempo, Ciencias de la Salud::Medicina preventiva [Materias Investigacion], Diabetes mellitus, Internal medicine, Sistema cardiovascular -- Malalties -- Aspectes genètics, Mediterranean diet, Cuina mediterrània, medicine, SNP, Humans, proteínas CLOCK, factores de riesgo, Genetic Predisposition to Disease, Circadian rhythm, análisis multifactorial, Dieta -- Mediterrània, Regió de la, Aged, Proportional Hazards Models, Chi-Square Distribution, CLOCK gene, business.industry, Malalties cardiovasculars, predisposición genética a la enfermedad, Protective Factors, medicine.disease, Obesity, Diet, 030104 developmental biology, Endocrinology, ritmo circadiano, Diabetes Mellitus, Type 2, Spain, Multivariate Analysis, estudios longitudinales, Gene-Environment Interaction, business, Ciencias de la Salud::Endocrinología [Materias Investigacion], heterocigoto
Abstract: Background: Circadian rhythms regulate key biological processes influencing metabolic pathways. Disregulation is associated with type 2 diabetes (T2D) and cardiovascular diseases (CVD). Circadian rhythms are generated by a transcriptional autoregulatory feedback loop involving core clock genes. CLOCK (circadian locomotor output cycles protein kaput), one of those core genes, is known to regulate glucose metabolism in rodent models. Cross-sectional studies in humans have reported associations between this locus and obesity, plasma glucose, hypertension and T2D prevalence, supporting its role in cardiovascular risk. However, no longitudinal study has investigated the association between CLOCK gene variation and T2D or CVD incidence. Moreover, although in a previous work we detected a gene-diet interaction between the CLOCK-rs4580704 (C > G) single nucleotide polymorphism (SNP) and monounsaturated (MUFA) intake on insulin resistance, no interventional study has analyzed gene-diet interactions on T2D or CVD outcomes. Methods: We analyzed the association between the CLOCK-rs4580704 SNP and incidence of T2D and CVD longitudinally in 7098 PREDIMED trial (ISRCTN35739639) participants after a median 4.8-year follow-up. We also examined modulation by Mediterranean diet (MedDiet) intervention (high in MUFA) on these associations. Results: We observed a significant association between the CLOCK-rs4580704 SNP and T2D incidence in n = 3671 non-T2D PREDIMED participants, with variant allele (G) carriers showing decreased incidence (dominant model) compared with CC homozygotes (HR: 0.69; 95 % CI 0.54-0.87; P = 0.002). This protection was more significant in the MedDiet intervention group (HR: 0.58; 95 % CI 0.43-0.78; P < 0.001) than in the control group (HR: 0.95; 95 % CI 0.63-1.44; P = 0.818). Moreover, we detected a statistically significant interaction (P = 0.018) between CLOCK-rs4580704 SNP and T2D status on stroke. Thus, only in T2D subjects was CLOCK-rs4580704 SNP associated with stroke risk, G-carriers having decreased risk (HR: 0.61; 95 % CI 0.40-0.94; P = 0.024 versus CC) in the multivariable-adjusted model. Conclusions: In agreement with our previous results showing a protective effect of the G-allele against hyperglycemia, we extended our findings by reporting a novel association with lower T2D incidence and also suggesting a dietary modulation. Moreover, we report for the first time an association between a CLOCK polymorphism and stroke in T2D subjects, suggesting that core clock genes may significantly contribute to increased CVD risk in T2D., This study was funded, by the Spanish Ministry of Health (Instituto de Salud Carlos III) and the Ministerio de Economia y Competitividad (Projects PI051839, PI070240, PI1001407, G03/140, CIBER 06/03, RD06/0045 PI07-0954, CNIC-06, PI11/02505, SAF2009-12304, AGL2010-22319-C03-03 and PRX14/00527), Fondo Europeo de Desarrollo Regional, by the University Jaume I (Project P1-1B2013-54) and by the Generalitat Valenciana (AP111/10, AP-042/11, BEST/2015/087, GVACOMP2011-151, ACOMP/2011/145, ACOMP/2012/190 and ACOMP/2013/159). This material is based upon work supported by the U.S. Department of Agriculture-Agricultural Research Service (ARS), under Agreement No. 58-1950-4-003.
Published: 2016

22. Safety and efficacy of 5-aminolevulinic acid for high grade glioma inusual clinical practice: a prospective cohort study

Author: Miguel Ángel Arráez, Xavier Vidal, Juan José Pulido González, Gloria Villalba, Jordi Rimbau, Eva Montané, Pilar Teixidor, Roser Garcia, Manel Tardáguila, [Teixidor,P, Garcia,R, Tardáguila,M, Rimbau,J] Department of Neurosurgery, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. [Arraez,MA] Department of Neurosurgery, Hospital Carlos Haya, Málaga, Spain. [Villalba,G] Department of Neurosurgery, Hospital del Mar, Barcelona, Spain. [González,JJ] Department of Neurosurgery, Hospital Clínic I Provincial de Barcelona, Barcelona, Spain. [Vidal,X] Fundació Institut Català de Farmacologia, Hospital Universitari Vall d’Hebron, Barcelona, Spain. [Vidal,X, Montané,E] Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain. [Montané,E] Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain., and Funding for this work was provided by the Spanish Ministry of Health (through two research projects which codes were: TRA-085 [convocatoria de ayudas para el fomento de la traslación de la aplicación de terapéutica de medicamentos de uso humano, huérfanos y terapias avanzadas de la Orden Ministerial SAS 2481/2009] and EC11-040 [convocatoria de ayudas para la investigación clínica independiente de la Orden Ministerial SPI 2885/2011]).
Subjects: Male, Cervell Tumors, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Chemicals and Drugs::Organic Chemicals::Carboxylic Acids::Keto Acids::Levulinic Acids::Aminolevulinic Acid [Medical Subject Headings], Diagnostic Radiology, Diseases::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Germ Cell and Embryonal::Neuroectodermal Tumors::Neoplasms, Neuroepithelial::Glioma [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 0302 clinical medicine, Medicine, Practice Patterns, Physicians', lcsh:Science, Masculino, Neurological Tumors, 5-Aminolevulinic Acid, Brain Neoplasms, Tumor Resection, Humanos, Oncology, Neurology, 030220 oncology & carcinogenesis, Disease Progression, Health Care::Health Services Administration::Patient Care Management::Delivery of Health Care::Practice Patterns, Physicians' [Medical Subject Headings], Cohort study, medicine.medical_specialty, Drug Research and Development, Named Groups::Persons::Age Groups::Adult::Young Adult [Medical Subject Headings], Imaging Techniques, Anciano, Estudios de cohortes, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Analysis of Variance::Multivariate Analysis [Medical Subject Headings], Check Tags::Male [Medical Subject Headings], Surgical and Invasive Medical Procedures, Disease-Free Survival, 03 medical and health sciences, Glioma, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], Humans, Clinical significance, Clinical Trials, 5-ALA, Adverse effect, Aged, Pharmacology, Ácido aminolevulínico, Mediana edad, Surgical Resection, lcsh:R, medicine.disease, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Proportional Hazards Models [Medical Subject Headings], Clinical trial, Check Tags::Female [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], lcsh:Q, Clinical Medicine, Probabilidad, 030217 neurology & neurosurgery, Cancer Treatment, lcsh:Medicine, Adulto joven, Cohort Studies, Epidemiology, Medicine and Health Sciences, Prospective cohort study, Multidisciplinary, Patrones de la práctica médica, Adulto, Radiology and Imaging, Femenino, Middle Aged, Modelos de riesgos proporcionales, Magnetic Resonance Imaging, Análisis multifactorial, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability [Medical Subject Headings], Surgical Oncology, Treatment Outcome, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Survival Analysis::Disease-Free Survival [Medical Subject Headings], Female, Research Article, Adult, Diseases::Neoplasms::Neoplasms by Site::Nervous System Neoplasms::Central Nervous System Neoplasms::Brain Neoplasms [Medical Subject Headings], Research and Analysis Methods, Young Adult, Diagnostic Medicine, Internal medicine, Progresión de la enfermedad, Sistema nerviós--Cirurgia, Supervivencia sin enfermedad, Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Contraindication, Neoplasias cerebrales, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome [Medical Subject Headings], Probability, Proportional Hazards Models, Tumors -- Tractament, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Disease Progression [Medical Subject Headings], business.industry, Cancers and Neoplasms, Aminolevulinic Acid, Surgery, Multivariate Analysis, Resultado del tratamiento, business, Safety Studies
Abstract: BACKGROUND: During the last decade, the use of 5-aminolevulinic acid (5-ALA) has been steadily increasing in neurosurgery. The study's main objectives were to prospectively evaluate the effectiveness and safety of 5-ALA when used in clinical practice setting on high-grade gliomas' patients. METHODS: National, multicenter and prospective observational study. INCLUSION CRITERIA: authorized conditions of use of 5-ALA. EXCLUSION CRITERIA: contraindication to 5-ALA, inoperable or partial resected tumors, pregnancy and children. Epidemiological, clinical, laboratory, radiological, and safety data were collected. Effectiveness was assessed using complete resection of the tumor, and progression-free and overall survival probabilities. RESULTS: Between May 2010 and September 2014, 85 patients treated with 5-ALA were included, and 77 were suitable for the effectiveness analysis. Complete resection was achieved in 41 patients (54%). Surgeons considered suboptimal the fluorescence of 5-ALA in 40% of the patients assessed. The median duration of follow-up was 12.3 months. The progression-free survival probability at 6 months was 58%. The median duration overall survival was 14.2 months. Progression tumor risk factors were grade of glioma, age and resection degree; and death risk factors were grade of glioma and gender. No severe adverse effects were reported. At one month after surgery, new or increased neurological morbidity was 6.5%. Hepatic enzymes were frequently increased within the first month after surgery; however, they subsequently normalized, and this was found to have no clinical significance. CONCLUSION: In clinical practice, the 5-ALA showed a good safety profile, but the benefits related to 5-ALA have not been yet clearly shown. The improved differentiation expected by fluorescence between normal and tumor cerebral tissue was suboptimal in a relevant number of patients; in addition, the expected higher degree of resection was lower than in clinical trials as well as incomplete resection was not identified as a prognostic factor risk for death. Because optimal fluorescence was correlated to higher complete resection rate, further research is needed to identify patients (or tumors) with more surgery benefits when using the 5-ALA. Funding for this work was provided by the Spanish Ministry of Health (through two research projects which codes were: TRA-085 [convocatoria de ayudas para el fomento de la traslación de la aplicación de terapéutica de medicamentos de uso humano, huérfanos y terapias avanzadas de la Orden Ministerial SAS 2481/2009] and EC11-040 [convocatoria de ayudas para la investigación clínica independiente de la Orden Ministerial SPI 2885/ 2011]).
Published: 2016

23. The lincRNA HOTAIRM1, located in the HOXA genomic region, is expressed in acute myeloid leukemia, impacts prognosis in patients in the intermediate-risk cytogenetic category, and is associated with a distinctive microRNA signature

Author: Díaz-Beyá, Marina, Brunet Mauri, Maria Salut, Nomdedeu, Josep, Pratcorona, Marta, Cordeiro, Anna, Gallardo, David, Escoda, Lourdes, Tormo, Mar, Heras, Inmaculada, Ribera, Jose-Maria, Duarte, Rafael, Llano Queipo, María Paz de, Bargay, Joan, Sampol, Antonia, Nomdedeu, Meritxell, Risueño, Ruth M., Hoyos Colell, Montserrat, Sierra Gil, Jorge, Monzo, Mariano, Navarro, Alfons, Esteve Reyner, Jordi, Cooperative AML group CETLAM, Universitat Autònoma de Barcelona, Universitat de Barcelona, Cooperative AML group CETLAM, [Díaz-Beyá,M, Pratcorona,M, Nomdedéu, M, Esteve,J] Hematology Department, Hospital Clinic, Institut d’Investigacions Bomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. [Díaz-Beyá,M, Brunet,S, Nomdedéu,J, Ribera,JM, Risueño,RM, Sierra,J, Esteve,J] Josep Carreras Leukemia Research Institute (IJC), Barcelona, Spain. [Brunet,S, Hoyos,M, Sierra,J] Hematology Service, Institut d’Investigació Biomèdica Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Banc de Sang i Teixits de Catalunya, Spain. [Nomdedéu,J] Laboratory of Hematology Service, Institut d’Investigació Biomèdica Sant Pau. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. [Cordeiro,A, Monzo,M, Navarro,A] Molecular Oncology and Embryology Laboratory, Human Anatomy Unit, School of Medicine, University of Barcelona, IDIBAPS, Barcelona, Spain. [Gallardo,D] Hematology Department, Catalan Institute of Oncology (ICO), Girona, Spain. [Escoda,L] Hematology Department, Hospital Joan XXIII, Tarragona, Spain. [Tormo,M] Hematology Department, Hospital Clínico, Valencia, Spain. [Heras,I] University Hospital Morales Meseguer, Murcia, Spain. [Ribera,JM] Hematology Department, Catalan Institute of Oncology (ICO), Hospital Germans Trias i Pujol, Badalona, Spain. [Duarte,R] Department of Hematology, Catalan Institute of Oncology (ICO), Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain. [Queipo de Llano,MP] Hospital Virgen de la Victoria, Málaga, Spain. [Bargay,J] Hospital de Son Llàtzer, Palma de Mallorca, Spain. [Sampol,A] Hospital Son Espases, Palma de Mallorca, Spain. [Esteve,J] University of Barcelona, Spain., Marina Díaz-Beyá is supported by ISCII (Rio Hortega CM13/00205). This research was in part supported by Fundación Española de Hematologia y Hemoterapia (beca de investigación MDB). This research is also supported by grants from Fondo de Investigaciones Sanitarias/Instituto de Salud Carlos III PI13/00999 (IP:Dr. Jordi Esteve), RETICS RD12/0036/0010 (JE, and MDB) and SDCSD from School of Medicine, University of Barcelona, AECC-Catalunya 2013 (AN) (sponsored by Mat Holding). Anna Cordeiro is an APIF fellow of the University of Barcelona.
Subjects: Male, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Recurrence [Medical Subject Headings], Oncology, regulación de la expresión génica, high risk patient, acute myeloblastic leukemia, granulocyte colony stimulating factor, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Leucemia mieloide aguda, proteínas nucleares, AML, cytarabine, nuclear protein, evaluación de riesgos, chi square distribution, Odds Ratio, genetics, promyelocytic leukemia, disease free survival, mediana edad, MicroARNs, anciano, análisis citogenético, microRNA, adult, disease course, Pronóstico, Leucèmia, risk assessment, distribución de la ji al cuadrado, gene expression regulation, adulto, cociente de probabilidades relativas, Humanos, Gene Expression Regulation, Neoplastic, adulto joven, Leukemia, Myeloid, Acute, aged, Cytogenetic Analysis, lincRNA, Disease Progression, fenotipo, HOTAIRM, RNA, Long Noncoding, nucleophosmin, Nucleophosmin, low risk patient, Human molecular genetics, Acute promyelocytic leukemia, medicine.medical_specialty, Leucèmia mieloide, long non-coding RNA HOTAIRM1, human, Recurrencia, Risk Assessment, cancer prognosis, Disease-Free Survival, mitoxantrone, Article, Humans, human, protein expression, Leucemia promielocítica aguda, Aged, pruebas de valores predictivos, Chi-Square Distribution, Proportional hazards model, HoxA protein, HOX antisense intergenic RNA myeloid 1, medicine.disease, major clinical study, Chemicals and Drugs::Nucleic Acids, Nucleotides, and Nucleosides::Antisense Elements (Genetics)::RNA, Antisense::MicroRNAs [Medical Subject Headings], Chemicals and Drugs::Nucleic Acids, Nucleotides, and Nucleosides::Nucleic Acids::RNA::RNA, Untranslated [Medical Subject Headings], homeodomain protein, Mutation, tumor marker, incidence, Genètica, Diseases::Neoplasms::Neoplasms by Histologic Type::Leukemia::Leukemia, Myeloid::Leukemia, Myeloid, Acute::Leukemia, Promyelocytic, Acute [Medical Subject Headings], Micro RNAs, Time Factors, Myeloid, modelos de riesgos proporcionales, correlation analysis, humanos, adolescente, Kaplan-Meier Estimate, idarubicin, etoposide, cytogenetics, lncRNA, Risk Factors, hemic and lymphatic diseases, Cumulative incidence, supervivencia sin enfermedad, gene mutation, leucemia, Leukemia, resultado del tratamiento, chromosome analysis, Nuclear Proteins, Myeloid leukemia, microRNA 196b, Middle Aged, HOX, Phenotype, unclassified drug, ARN, Treatment Outcome, medicine.anatomical_structure, female, Female, Disciplines and Occupations::Natural Science Disciplines::Biological Science Disciplines::Biology::Genetics::Genomics [Medical Subject Headings], NPM1 gene, Research Paper, Hox gene, intermediate risk patient, Adult, estimación de Kaplan-Meier, Diseases::Neoplasms::Neoplasms by Histologic Type::Leukemia::Leukemia, Myeloid::Leukemia, Myeloid, Acute [Medical Subject Headings], ARN no traducido, Adolescent, Genómica, gene overexpression, overall survival, long untranslated RNA, protein localization, Kapl, Young Adult, factores de tiempo, male, Predictive Value of Tests, progresión de la enfermedad, Internal medicine, Biomarkers, Tumor, medicine, gene expression profiling, factores de riesgo, Genetic Predisposition to Disease, controlled study, análisis multifactorial, perfiles de expresión génica, gene, mutación, Proportional Hazards Models, Homeodomain Proteins, MIRN196 microRNA, human, proteínas de homeodominios, business.industry, Gene Expression Profiling, predisposición genética a la enfermedad, microARN, Gene expression profiling, MicroRNAs, cancer recurrence, Gene Expression Regulation, adolescent, Multivariate Analysis, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis [Medical Subject Headings], RNA, Genètica molecular humana, business, genetic predisposition
Abstract: Long non-coding RNAs (lncRNAs) are deregulated in several tumors, although their role in acute myeloid leukemia (AML) is mostly unknown. We have examined the expression of the lncRNA HOX antisense intergenic RNA myeloid 1 (HOTAIRM1) in 241 AML patients. We have correlated HOTAIRM1 expression with a miRNA expression profile. We have also analyzed the prognostic value of HOTAIRM1 expression in 215 intermediate-risk AML (IR-AML) patients. The lowest expression level was observed in acute promyelocytic leukemia (P < 0.001) and the highest in t(6; 9) AML (P = 0.005). In 215 IR-AML patients, high HOTAIRM1 expression was independently associated with shorter overall survival OR: 2.04; P = 0.001), shorter leukemia-free survival (OR: 2.56; P < 0.001) and a higher cumulative incidence of relapse (OR: 1.67; P = 0.046). Moreover, HOTAIRM1 maintained its independent prognostic value within the favorable molecular subgroup (OR: 3.43; P = 0.009). Interestingly, HOTAIRM1 was overexpressed in NPM1-mutated AML (P < 0.001) and within this group retained its prognostic value (OR: 2.21; P = 0.01). Moreover, HOTAIRM1 expression was associated with a specific 33- microRNA signature that included miR-196b (P < 0.001). miR-196b is located in the HOX genomic region and has previously been reported to have an independent prognostic value in AML. miR-196b and HOTAIRM1 in combination as a prognostic factor can classify patients as high-, intermediate-, or low-risk (5-year OS: 24% vs 42% vs 70%; P = 0.004). Determination of HOTAIRM1 level at diagnosis provided relevant prognostic information in IR-AML and allowed refinement of risk stratification based on common molecular markers. The prognostic information provided by HOTAIRM1 was strengthened when combined with miR-196b expression. Furthermore, HOTAIRM1 correlated with a 33-miRNA signature., Marina Diaz-Beya is supported by ISCII (Rio Hortega CM13/00205). This research was in part supported by Fundacion Espanola de Hematologia Hemoterapia (beca de investigacion MDB). This research is also supported by grants from Fondo de Investigaciones Sanitarias/Instituto de Salud Carlos III PI13/00999 (IP: Dr. Jordi Esteve), RETICS RD12/0036/0010 (JE; MDB) and SDCSD from School of Medicine, University of Barcelona, AECC-Catalunya 2013 (AN) (sponsored by Mat Holding). Anna Cordeiro is an APIF fellow of the University of Barcelona
Published: 2015
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24. Registry of the Spanish network for systemic sclerosis: Survival, prognostic factors, and causes of death

Author: Simeón Aznar, Carmen Pilar, Fonollosa Pla, Vicent, Tolosa Vilella, Carles, Espinosa Garriga, Gerard, Campillo Grau, M., Ramos Casals, Manuel, García Hernández, F.J., Castillo Palma, María Jesús, Sánchez Román, J., Callejas Rubio, José Luis, Ortego Centeno, Norberto, Egurbide Arberas, María Victoria, Trapiella Martínez, Luis, Caminal Montero, L., Sáez Comet, Luis, Velilla Marco, J., Camps García, María Teresa, Ramón Garrido, E . de, Esteban Marcos, E.M., Pallarés Ferreres, Lucio, Navarrete Navarrete, N., Vargas Hitos, José Antonio, Gómez de la Torre, Ricardo, Salvador Cervelló, Gonzalo, Ríos Blanco, Juan José, Vilardell Tarrés, M., Spanish Scleroderma Study Group (SSSG), Autoimmune Diseases Study Group (GEAS), Spanish Society of Internal Medicine (SEMI), Systemic Autoimmune Diseases Group (GEAS), Spanish Scleroderma Study Group (SSSG), Spanish Society of Internal Medicine, Spain, [Simeón-Aznar,CP, Fonollosa-Plá,V, Vilardell-Tarrés,M] Department of Internal Medicine, Hospital Valld’Hebron. [Tolosa-Vilella,C] Department of Internal Medicine, Hospital Parc Taulí, Sabadell. [Espinosa-Garriga,G, Campillo-Grau,M] Department of Autoimmune Diseases, Hospital Clinic. [Campillo-Grau,M] Laboratori of Computacional Medicine, Bioestatistics Unit, Universitat Autònoma de Barcelona, Bellaterra, Barcelona. [García-Hernández,FJ, Castillo-Palma,MJ, Sánchez-Román,J] Unit of Connective Tissue Diseases, Department of Internal Medicine, Hospital Virgen del Rocio, Sevilla. [Callejas-Rubio,JL, Ortego-Centeno,N] Unit of Autoimmune Systemic Diseases, Department of Internal Medicine, Hospital Clínico San Cecilio, Granada. [Egurbide-Arberas,MV] Department of Internal Medicine, Hospital de Cruces, Galdakano, Bilbao. [Trapiellla-Martínez,L] Department of Internal Medicine, Hospital de Cabueñes, Gijón. [Caminal-Montero,L] Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo. [Sáez-Comet,L, Velilla-Marco,J] Department of Internal Medicine, Hospital Miguel Servet, Zaragoza. [Camps-García,MT, de Ramón-Garrido,E] Department of Internal Medicine, Hospital Carlos Haya, Málaga. [Esteban-Marcos,EM, Pallarés-Ferreres,L]Department of Internal Medicine, Hospital Son Espases, Palma de Mallorca. [Navarrete-Navarrete,N, Vargas-Hitos,JA] Department of Internal Medicine, Hospital Virgen de las Nieves, Granada. [Gómez de la Torre,R] Department of Internal Medicine, Hospital San Agustín, Avilés. [Salvador-Cervello,G] Department of Internal Medicine, Hospital La Fe, Valencia. [Rios-Blanco,JJ] Department of Internal Medicine, Hospital La Paz, Madrid, and Universitat de Barcelona
Subjects: Male, Multivariate analysis, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings], sistema de registros, Diseases::Respiratory Tract Diseases::Lung Diseases::Hypertension, Pulmonary [Medical Subject Headings], Autoimmune diseases, humanos, Scleroderma Renal Crisis, España, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Ulcer [Medical Subject Headings], Scleroderma, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings], Diseases::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Interstitial [Medical Subject Headings], Diseases::Skin and Connective Tissue Diseases::Connective Tissue Diseases::Scleroderma, Systemic [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Úlcera, Risk Factors, Cause of Death, Registries, Masculino, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence [Medical Subject Headings], Diseases::Skin and Connective Tissue Diseases::Connective Tissue Diseases::Scleroderma, Systemic::Scleroderma, Limited [Medical Subject Headings], mediana edad, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Cause of Death [Medical Subject Headings], Cause of death, Esclerodermia limitada, anciano, Esclerodermia difusa, Malalties autoimmunitàries, Interstitial lung disease, Pronóstico, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Questionnaires [Medical Subject Headings], General Medicine, adulto, Middle Aged, Modelos de riesgos proporcionales, Diseases::Skin and Connective Tissue Diseases::Connective Tissue Diseases::Scleroderma, Systemic::Scleroderma, Limited::CREST Syndrome [Medical Subject Headings], Humanos, Encuestas y cuestionarios, Female, Factores de riesgo, Adult, medicine.medical_specialty, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Analysis of Variance::Multivariate Analysis [Medical Subject Headings], Check Tags::Male [Medical Subject Headings], causas de muerte, Internal medicine, Progresión de la enfermedad, Análisis multivariante, medicine, factores de riesgo, Tasa de supervivencia, Humans, Espanya, Survival rate, Aged, Retrospective Studies, Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings], Diseases::Skin and Connective Tissue Diseases::Connective Tissue Diseases::Scleroderma, Systemic::Scleroderma, Diffuse [Medical Subject Headings], Scleroderma, Systemic, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Disease Progression [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Survival Rate [Medical Subject Headings], business.industry, estudios retrospectivos, Retrospective cohort study, medicine.disease, Pulmonary hypertension, Surgery, Causas de muerte, Scleroderma (Disease), Enfermedades pulmonares Intersticiales, Spain, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis [Medical Subject Headings], Esclerodèrmia, business, Síndrome CREST, Prevalencia, Hipertensión pulmonar
Abstract: Systemic sclerosis (SSc) is a rare, multisystem disease showing a large individual variability in disease progression and prognosis. In the present study, we assess survival, causes of death, and risk factors of mortality in a large series of Spanish SSc patients. Consecutive SSc patients fulfilling criteria of the classification by LeRoy were recruited in the survey. Kaplan-Meier and Cox proportional-hazards models were used to analyze survival and to identify predictors of mortality. Among 879 consecutive patients, 138 (15.7%) deaths were registered. Seventy-six out of 138 (55%) deceased patients were due to causes attributed to SSc, and pulmonary hypertension (PH) was the leading cause in 23 (16.6%) patients. Survival rates were 96%, 93%, 83%, and 73% at 5, 10, 20, and 30 years after the first symptom, respectively. Survival rates for diffuse cutaneous SSc (dcSSc) and limited cutaneous SSc were 91%, 86%, 64%, and 39%; and 97%, 95%, 85%, and 81% at 5, 10, 20, and 30 years, respectively (log-rank: 67.63, P
Published: 2015

25. The expression level of BAALC-associated microRNA miR-3151 is an independent prognostic factor in younger patients with cytogenetic intermediate-risk acute myeloid leukemia

Author: J. Nomdedeu, Ruth M. Risueño, Marta Pratcorona, Carmen Pedro, Mar Tormo, M.P. Queipo de Llano, Meritxell Nomdedeu, Montserrat Arnan, Lourdes Escoda, Jordi Esteve, Alfons Navarro, Josep Martí, J. Bargay, S Brunet, Montserrat Hoyos, David Gallardo, Marina Díaz-Beyá, Olga Salamero, Anna Cordeiro, Josep-Maria Ribera, Antonia Sampol, Inmaculada Heras, Joan J. Castellano, Josep M. Sierra, Mariano Monzo, [Díaz-Beyá,M, Pratcorona,M, Nomdedeu,M, Esteve,J] Hematology Department, IDIBAPS, Hospital Clinic Villarroel, Barcelona, Spain. [Díaz-Beyá,M, Brunet,S, Nomdedéu,J, Ribera,JM, Risueño,RM, Sierra,J, Esteve,J] Josep Carreras Leukaemia Research Institute, Barcelona, Spain. [Brunet,S, Hoyos,M, Sierra,J] Hematology Department and Biological Hematology Laboratory, Hospital de Sant Pau, Barcelona, IIB-Sant Pau Research Institute, Universitat Autonoma of Barcelona, Spain. [Cordeiro,A, Castellano,JJ, Monzó,M, Navarro,A] Molecular Oncology and Embryology Laboratory, Human Anatomy Unit, School of Medicine, University of Barcelona, Spain. [Tormo,M] Hematology Department, Hospital Clínico, Valencia, Spain. [Escoda,L] Hematology Department, Hospital Joan XXIII, Tarragona, Spain. [Ribera,JM] Hematology Department, Institut Català D'Oncologia (ICO)-Hospital Germans Trias i Pujol, Badalona, Spain. [Arnán,M] ICO, Hematology Department, Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain. [Heras,I] Hematology Department, Hospital Morales Meseguer, Murcia, Spain. [Gallardo,D] Hematology Department, ICO Josep Trueta, Girona, Spain. [Bargay,J, Sampol,A] Hematology Department, Hospital de Son Llàtzer, Palma de Mallorca, Spain. [Queipo de Llano,MP] Hematology Department, Hospital Virgen de la Victoria, Málaga, Spain. [Salamero,O] Hematology Department, Hospital Vall D'Hebron, Barcelona, Spain. [Martí,JM] Hematology Department, Hospital Mutua de Terrassa, Barcelona, Spain. [Pedro,C] Hematology Department, Hospital del Mar, Barcelona, Spain. [Esteve,J] University of Barcelona, Spain., Marina Díaz-Beyá is supported by ISCIII (Río Hortega CM13/00205). This research was in part supported by Fundación Española de Hematología y Hemoterapia (beca de investigación MDB). This research is also supported by grants from Fondo de Investigaciones Sanitarias/Instituto de Salud Carlos III PI13/00999 (PI: JE), RETICS RD12/0036/0010 (JE, MDB) and SDCSD from School of Medicine, University of Barcelona, AECC-Catalunya 2013 (AN) (sponsored by Mat Holding), and grants AGAUR 2014SGR-1281, ISCIII RD12/0036/0071 and PI014/00450 (JS). Anna Cordeiro is an APIF fellow of the University of Barcelona., and Universitat de Barcelona
Subjects: Male, Oncology, Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Aromatic::Polycyclic Hydrocarbons, Aromatic::Naphthacenes::Anthracyclines::Daunorubicin::Idarubicin [Medical Subject Headings], Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Recurrence [Medical Subject Headings], Micro RNAs, proteínas de neoplasias, Myeloid, modelos de riesgos proporcionales, humanos, Mitoxantrona, adolescente, Kaplan-Meier Estimate, Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 1-Ring::Pyrimidines::Pyrimidine Nucleosides::Cytidine::Cytarabine [Medical Subject Headings], Phenomena and Processes::Genetic Phenomena::Genetic Processes::Gene Expression [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Leucemia mieloide aguda, Risk Factors, Information Science::Information Science::Data Collection::Vital Statistics::Morbidity::Incidence [Medical Subject Headings], Idarrubicina, Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Aromatic::Polycyclic Hydrocarbons, Aromatic::Naphthalenes::Tetrahydronaphthalenes::Podophyllotoxin::Etoposide [Medical Subject Headings], Cumulative incidence, supervivencia sin enfermedad, mediana edad, BAALC, leucemia, anciano, MicroARNs, Leukemia, análisis citogenético, Hematology, Pronóstico, Myeloid leukemia, MicroRNA Expression Profile, adulto, Middle Aged, Prognosis, Neoplasm Proteins, Humanos, Phenomena and Processes::Genetic Phenomena::Genetic Structures::Chromosomes::Karyotype [Medical Subject Headings], adulto joven, Malalts de càncer, pronóstico, Leukemia, Myeloid, Acute, medicine.anatomical_structure, Cytogenetic Analysis, Female, Original Article, Incidencia, estimación de Kaplan-Meier, Adult, medicine.medical_specialty, Diseases::Neoplasms::Neoplasms by Histologic Type::Leukemia::Leukemia, Myeloid::Leukemia, Myeloid, Acute [Medical Subject Headings], Adolescent, Pronòstic mèdic, Leucèmia mieloide, Anciano, Recurrencia, Citogenética, Biology, Etopósido, Disease-Free Survival, Young Adult, Cariotipo, Internal medicine, Análisis multivariante, Biomarkers, Tumor, medicine, factores de riesgo, Humans, Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Aromatic::Polycyclic Hydrocarbons, Aromatic::Anthracenes::Anthraquinones::Mitoxantrone [Medical Subject Headings], Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Leucèmia mieloide aguda -- Aspectes genètics, Aged, Proportional Hazards Models, Análisis citogenético, Proportional hazards model, Disciplines and Occupations::Natural Science Disciplines::Biological Science Disciplines::Biology::Genetics::Cytogenetics [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Cytological Techniques::Cytogenetic Analysis [Medical Subject Headings], Cancer patients, microARN, medicine.disease, Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Statistics as Topic::Analysis of Variance::Multivariate Analysis [Medical Subject Headings], Chemicals and Drugs::Nucleic Acids, Nucleotides, and Nucleosides::Antisense Elements (Genetics)::RNA, Antisense::MicroRNAs [Medical Subject Headings], transcriptoma, MicroRNAs, Citarabina, Immunology, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis [Medical Subject Headings], Transcriptome, Expresión génica
Abstract: Acute myeloid leukemia (AML) is a heterogeneous disease whose prognosis is mainly related to the biological risk conferred by cytogenetics and molecular profiling. In elderly patients (>= 60 years) with normal karyotype AML miR-3151 have been identified as a prognostic factor. However, miR-3151 prognostic value has not been examined in younger AML patients. In the present work, we have studied miR-3151 alone and in combination with BAALC, its host gene, in a cohort of 181 younger intermediate-risk AML (IR-AML) patients. Patients with higher expression of miR-3151 had shorter overall survival (P = 0.0025), shorter leukemia-free survival (P = 0.026) and higher cumulative incidence of relapse (P = 0.082). Moreover, in the multivariate analysis miR-3151 emerged as independent prognostic marker in both the overall series and within the unfavorable molecular prognostic category. Interestingly, the combined determination of both miR-3151 and BAALC improved this prognostic stratification, with patients with low levels of both parameters showing a better outcome compared with those patients harboring increased levels of one or both markers (P = 0.003). In addition, we studied the microRNA expression profile associated with miR-3151 identifying a six-microRNA signature. In conclusion, the analysis of miR-3151 and BAALC expression may well contribute to an improved prognostic stratification of younger patients with IR-AML., Marina Diaz-Beya is supported by ISCIII (Rio Hortega CM13/00205). This research was in part supported by Fundacion Espanola de Hematologia y Hemoterapia (beca de investigacion MDB). This research is also supported by grants from Fondo de Investigaciones Sanitarias/Instituto de Salud Carlos III PI13/00999 (PI: JE), RETICS RD12/0036/0010 (JE; MDB) and SDCSD from School of Medicine, University of Barcelona, AECC-Catalunya 2013 (AN) (sponsored by Mat Holding), and grants AGAUR 2014SGR-1281, ISCIII RD12/0036/0071 and PI014/00450 (JS). Anna Cordeiro is an APIF fellow of the University of Barcelona.
Published: 2015

26. Prognosis Relevance of Serum Cytokines in Pancreatic Cancer

Author: Jose Prados, M.J. Alejandre, Francisco M. Ortuño, Antonio Irigoyen, Carolina Torres, Octavio Caba, Joaquina Martínez-Galán, Antonia Aránega, Sonia Perales, Ana Linares, Ignacio Rojas, Juan Ramón Delgado, Rogelio Palomino-Morales, [Torres,C, Linares,A, Alejandre,MJ, Palomino-Morales,RJ, Perales,S] Department of Biochemistry and Molecular Biology I, University of Granada, Granada, Spain. [Caba,O] Department of Health Sciences, University of Jaen, Jaen, Spain. [Prados,J, Aránega,A] Department of Human Anatomy and Embryology, University of Granada, Granada, Spain. [Delgado,JR, Irigoyen,A, Martínez-Galán,J] Oncology Service, Virgen de las Nieves Hospital, Granada, Spain. [Ortuño,FM, Rojas,I] Department of Computer Architecture and Computer Technology (CITIC-UGR), University of Granada, Granada, Spain, and The study was fully supported by ROCHE FARMA S.A (ref.H/OH-TAR-10/131 and ref. H/OH-TRR-08/59) and Instituto de Salud Carlos III (ISCIII) (Clinical trial ref. EC08/00009),and the Government of Andalusia Project P12-TIC-2082
Subjects: Oncology, Male, Antibody microarray, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings], Desoxicitidina, medicine.medical_treatment, lcsh:Medicine, Disease, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Pancreatic ductal adenocarcinoma, Factor de crecimiento endotelial vascular derivado de glándulas endocrinas, Timidina fosforilasa, Serum cytokines, Marcadores biológicos, Pronóstico, Citocinas, General Medicine, Middle Aged, Modelos de riesgos proporcionales, Humanos, Survival Rate, Cytokines, Female, Adjuvant, Carcinoma ductal pancreático, medicine.drug, Carcinoma, Pancreatic Ductal, Research Article, Adult, medicine.medical_specialty, Article Subject, Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 1-Ring::Pyrimidines::Pyrimidine Nucleosides::Cytidine::Deoxycytidine [Medical Subject Headings], General Biochemistry, Genetics and Molecular Biology, Disease-Free Survival, Internal medicine, Pancreatic cancer, medicine, Chemicals and Drugs::Biological Factors::Biological Markers [Medical Subject Headings], Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Transferases::Glycosyltransferases::Pentosyltransferases::Pyrimidine Phosphorylases::Thymidine Phosphorylase [Medical Subject Headings], Humans, Chemotherapy, Survival rate, Aged, Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Peptides::Intercellular Signaling Peptides and Proteins::Cytokines [Medical Subject Headings], Markers, General Immunology and Microbiology, Diseases::Neoplasms::Neoplasms by Site::Endocrine Gland Neoplasms::Pancreatic Neoplasms::Carcinoma, Pancreatic Ductal [Medical Subject Headings], business.industry, Neoplasias pancreáticas, lcsh:R, medicine.disease, Gemcitabine, Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Pancreatic Neoplasms [Medical Subject Headings], Pancreatic Neoplasms, Immunology, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis [Medical Subject Headings], business, CD80
Abstract: The overall survival of patients with pancreatic ductal adenocarcinoma is extremely low. Although gemcitabine is the standard used chemotherapy for this disease, clinical outcomes do not reflect significant improvements, not even when combined with adjuvant treatments. There is an urgent need for prognosis markers to be found. The aim of this study was to analyze the potential value of serum cytokines to find a profile that can predict the clinical outcome in patients with pancreatic cancer and to establish a practical prognosis index that significantly predicts patients’ outcomes. We have conducted an extensive analysis of serum prognosis biomarkers using an antibody array comprising 507 human cytokines. Overall survival was estimated using the Kaplan-Meier method. Univariate and multivariate Cox’s proportional hazard models were used to analyze prognosis factors. To determine the extent that survival could be predicted based on this index, we used the leave-one-out cross-validation model. The multivariate model showed a better performance and it could represent a novel panel of serum cytokines that correlates to poor prognosis in pancreatic cancer. B7-1/CD80, EG-VEGF/PK1, IL-29, NRG1-beta1/HRG1-beta1, and PD-ECGF expressions portend a poor prognosis for patients with pancreatic cancer and these cytokines could represent novel therapeutic targets for this disease., The study was fully supported by ROCHE FARMA S.A (ref. H/OH-TAR-10/131 and ref. H/OH-TRR-08/59) and Instituto de Salud Carlos III (ISCIII) (Clinical trial ref. EC08/00009), and the Government of Andalusia Project P12-TIC-2082.
Published: 2015

27. Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study

Author: Carla H. van Gils, E. Riboli, Christos Tsironis, Anne-Claire Vergnaud, H. Bas Bueno-de-Mesquita, Laureen Dartois, José Ramón Quirós, Veronika Fedirko, Pietro Ferrari, Teresa Norat, Pagona Lagiou, Christina C. Dahm, Giovanna Masala, Timothy J. Key, Mark J. Gunter, Maria Wennberg, Kay-Tee Khaw, Verena Katzke, Petra H.M. Peeters, Aurelio Barricarte, Heather Ward, Nicholas J. Wareham, Anne Tjønneland, Lena Maria Nilsson, Bodil Ohlsson, Valeria Pala, Laure Dossus, Antonia Trichopoulou, Tilman Kühn, Heiner Boeing, Elisabete Weiderpass, Petra A. Wark, M. Dorronsoro, Carmen Navarro, Camilla Plambeck Hansen, Genevieve Buckland, Salvatore Panico, Marie-Christine Boutron-Ruault, María José Sánchez, Paolo Vineis, Peter D. Siersema, Karin Jirström, Dora Romaguera, Rosario Tumino, Mazda Jenab, Romaguera, Dora, Ward, Heather, Wark, Petra A, Vergnaud, Anne Claire, Peeters, Petra H, van Gils, Carla H, Ferrari, Pietro, Fedirko, Veronika, Jenab, Mazda, Boutron Ruault, Marie Christine, Dossus, Laure, Dartois, Laureen, Hansen, Camilla Plambeck, Dahm, Christina Catherine, Buckland, Genevieve, Sánchez, María José, Dorronsoro, Miren, Navarro, Carmen, Barricarte, Aurelio, Key, Timothy J, Trichopoulou, Antonia, Tsironis, Christo, Lagiou, Pagona, Masala, Giovanna, Pala, Valeria, Tumino, Rosario, Vineis, Paolo, Panico, Salvatore, Bueno de Mesquita, H. Ba, Siersema, Peter D, Ohlsson, Bodil, Jirström, Karin, Wennberg, Maria, Nilsson, Lena M, Weiderpass, Elisabete, Kühn, Tilman, Katzke, Verena, Khaw, Kay Tee, Wareham, Nick J, Tjønneland, Anne, Boeing, Heiner, Quirós, José R, Gunter, Marc J, Riboli, Elio, Norat, Teresa, Department of Medical and Clinical Genetics, Medicum, BMC, BMC, Department of Epidemiology and Public Health, Imperial College London, Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, CIBER Fisiopatología de la Obesidad y Nutrición ( (CIBEROBN)), Instituto de Salud Carlos III [Madrid] (ISC), Department of Primary Care and Public Health, Department of Epidemiology, University Medical Center [Utrecht]-Julius Center for Health Sciences and Primary Care, Nutrition and Metabolism Section, International Agency for Cancer Research (IACR), Emory University [Atlanta, GA]-Rollins School of Public Health-Winship Cancer Institute, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Section for Epidemiology, Aarhus University [Aarhus], Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL)-Cancer Epidemiology Research Programme, Granada Cancer Registry, Andalusian School of Public Health [Granada], Consorcio de Investigación Biomédica en Red especializado en Epidemiología y Salud Pública (CIBERESP), Los Centros de Investigación Biomédica en Red (CIBER), Murcia Regional Health Council [Murcia], Department of Health and Social Sciences, Universidad de Murcia, Navarre Public Health Institute, Cancer Epidemiology Unit, University of Oxford, Hellenic Health Foundation, Bureau of Epidemiologic Research, Academy of Athens, Department of Hygiene, Epidemiology and Medical Statistics, Harvard School of Public Health, Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Tumori - National Cancer Institute [Milan], Cancer Registry and Histopathology Unit, Department of Oncology-Civile - M.P.Arezzo Hospital, Human Genetics Foundation (HuGeF), Università degli studi di Torino = University of Turin (UNITO), Dipartimento di Medicina Clinica e Chirurgia, University of Naples Federico II = Università degli studi di Napoli Federico II, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya = Universiti Malaya [Kuala Lumpur, Malaisie] (UM), Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment [Bilthoven] (RIVM), Department of Gastroenterology and Hepatology, University Medical Center [Utrecht], Division of Internal Medicine, Skane University Hospital [Malmo], Lund University [Lund]-Lund University [Lund], Division of Oncology and Pathology, Lund University [Lund], Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Arctic Research Centre, Department of Community Medicine, The Arctic University of Norway [Tromsø, Norway] (UiT), Department of Research, Cancer Registry of Norway, Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet [Stockholm], Genetic Epidemiology Group [Helsinki], Folkhälsan Research Center, Faculty of Medecine [Helsinki], Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Faculty of Medecine [Helsinki], Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Division of Cancer Epidemiology, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Clinical Gerontology Unit, University of Cambridge [UK] (CAM), MRC Epidemiology Unit, University of Cambridge [UK] (CAM)-Institute of Metabolic Science, Danish Cancer Society Research Center, German Institute of Human Nutrition (DIfE) Potsdam-Rehbrücke, Public Health Directorate, Khaw, Kay-Tee [0000-0002-8802-2903], Wareham, Nicholas [0000-0003-1422-2993], Apollo - University of Cambridge Repository, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), University of Oxford [Oxford], Università degli studi di Torino (UNITO), University of Naples Federico II, University of Malaya, The Arctic University of Norway, University of Helsinki-University of Helsinki-Faculty of Medecine [Helsinki], University of Helsinki-University of Helsinki, [Romaguera,D, Ward,H, Vergnaud,A, Peeters,PH, Vineis,P, Bueno-de-Mesquita,HB, Gunter, MJ, Riboli,E, Norat,T] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. [Romaguera,D] Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, Palma de Mallorca, Spain. [Romaguera,D] CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. [Wark,PA] Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK. [Peeters,PH, Gils, CH] Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. [Ferrari,P, Jenab,M] International Agency for Cancer Research (IARC), Lyon CEDEX, France. [Fedirko,V] Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA. [Fedirko,V] Winship Cancer Institute, Emory University, Atlanta, USA. [Boutron-Ruault,M, Dossus,L, Dartois,L] Inserm (Institut National de la Santé et de la Recherche Médicale), Centre for Research in Epidemiology and Population Health (CESP), Vaillant, Villejuif, Cedex, France. [Boutron-Ruault,M, Dartois,L] Univ Paris Sud, Villejuif, France. [Boutron-Ruault,M, Dartois,L] Gustave Roussy, Villejuif, France. [Hansen,CP, Dahm,CC] Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus C, Denmark. [Buckland,G] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain. [Sánchez,MJ] Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs. GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. [Sánchez,MJ, Dorronsoro,M, Navarro,C, Barricarte,A] CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. [Dorronsoro,M] Public Health Direction and Biodonostia Basque Regional Health Department, San Sebastian, Spain. [Navarro,C] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. Department of Health and Social Sciences, Universidad de Murcia, Campus Universitario de Espinardo, Murcia, Spain. [Barricarte,A] Navarre Public Health Institute, Pamplona, Spain. [Key,TJ] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford UK. [Trichopoulou,A, Tsironis,C] Hellenic Health Foundation, Athens, Greece . [Trichopoulou,A, Lagiou,P] Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece. [Lagiou,P] Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Lagiou,P] Department of Epidemiology, Harvard School of Public Health, Boston, USA. [Masala,G] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Florence, Italy. [Pala,V] Epidemiology and Prevention Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, 'Civic – M.P. Arezzo' Hospital, Ragusa, Italy. [Vineis,P] HuGeF Foundation, Turin, Italy. [Panico,S] Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy. [Bueno-de-Mesquita,HB] Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven The Netherlands. [Bueno-de-Mesquita,HB, Siersema,PD] Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. [Bueno-de-Mesquita,HB] Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. [Ohlsson,B] Division of Internal Medicine, Department of Clinical Sciences, Skane University Hospital, Malmo, Lund University, Lund, Sweden. [Jirström,K] Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden. [Wennberg,M] Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden. [Nilsson,LM] Arctic Research Centre, Umeå University, Umeå, Sweden. [Weiderpass,E] Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, ISM - Universitetet i Tromsø, Tromsø, Norway. Department of Research, Cancer Registry of Norway, Majorstuen Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Department of Genetic Epidemiology, Folkhälsan Research Center, Folkhälsan Research Center, Biomedicum 1, University of Helsinki, Helsinki, Finland. [Kühn,T, Katzke,V] German Cancer Research Center (DKFZ), Division of Cancer Epidemiology Im Neuenheimer Feld 581, Heidelberg, Germany. [Khaw,K] University of Cambridge School of Clinical Medicine, Clinical Gerontology Unit Box 251, Addenbrooke’s Hospital, Cambridge, UK. [Wareham,NJ] MRC Epidemiology Unit, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK. [Tjønneland,A] Danish Cancer Society Research Center, Copenhagen, Denmark. [Boeing,H] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. [Quirós,JR] Public Health Directorate, Oviedo Asturias, Spain., This study was funded by the World Cancer Research Fund (WCRF) International Regular Grant Programme (Grant number 2009/44). Dora Romaguera holds a Ramon y Cajal contract (Ministerio de Economía y Competitividad, Spain and European Regional Development Fund, RYC-2011-08796). In addition, EPIC investigators acknowledge funding from the following agencies: Europe Against Cancer Program of the European Commission (SANCO), German Cancer Aid, German Cancer Research Center (DKFZ), German Federal Ministry of Education and Research (BMBF), Danish Cancer Society, Catalan Institute of Oncology, Spain, Health Research Fund (FIS) of the Spanish Ministry of Health, Spanish Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RCESP exp. C03/09 and ISCIII RETICC RD06/0020/0091, Spain, Cancer Research UK, Medical Research Council, United Kingdom, The Hellenic Health Foundation, Greece, Italian Association for Research on Cancer (AIRC), Italian National Research Council, Fondazione-Istituto Banco Napoli, Italy, Dutch Ministry of Public Health, Welfare and Sports, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), The Netherlands, Swedish Cancer Society, Swedish Scientific Council, Regional Government of Skåne, Sweden, Helga—Nordic Center of Excellence Programme in Nutrition and Health, French League against Cancer (LNCC), National Institute for Health and Medical Research (INSERM), France, Mutuelle Générale de l'Education Romaguera et al. BMC Medicine (2015) 13:107 Page 10 of 12 Nationale (MGEN), France, 3 M Co., France, Gustave Roussy Institute (IGR), France, and and General Councils of France. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Subjects: Male, physical activity, 0302 clinical medicine, estudios prospectivos, Prospective Studies, estudios de cohortes, mediana edad, Aged, 80 and over, anciano, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Motor Activity [Medical Subject Headings], dieta, Incidence, Hazard ratio, COLON-CANCER, General Medicine, adulto, 3. Good health, Näringslära, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, estilo de vida, Cohort, Dieta, Estilo de Vida, RESEARCH FUND/AMERICAN INSTITUTE, Cohort study, Human, medicine.medical_specialty, Concordance, European Continental Ancestry Group, DIAGNOSIS, incidencia, White People, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Càncer colorectal, Neoplasias Colorrectales, BREAST-CANCER, Humans, Life Style, Aged, Cancer prevention, Proportional hazards model, Physical activity, Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms [Medical Subject Headings], Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Life Style [Medical Subject Headings], weight, LIFE-STYLE FACTORS, Colorectal cancer, REPRODUCTIVE HISTORY, Prospective Studie, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], Cancer and Oncology, Proportional Hazards Model, grupo de ascendencia continental europea, Estudios de Cohortes, Gerontology, cumplimiento del paciente, Survival, modelos de riesgos proporcionales, VDP::Medisinske Fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803, [SDV]Life Sciences [q-bio], humanos, Colorectal Neoplasm, Alcohol consumption, Breast cancer, Prospective study, Named Groups::Persons::Survivors [Medical Subject Headings], Cohort Studies, 030212 general & internal medicine, Prospective cohort study, Non-U.S. Gov't, 2. Zero hunger, Medicine(all), RISK, Nutrition and Dietetics, Healthy lifestyle, Diet, Weight, Research Support, Non-U.S. Gov't, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, European Prospective Investigation into Cancer and Nutrition, VDP::Medical disciplines: 700::Health sciences: 800::Epidemiology medical and dental statistics: 803, NUTRITION, Female, Colorectal Neoplasms, Research Article, Adult, neoplasias colorrectales, 3122 Cancers, RECREATIONAL PHYSICAL-ACTIVITY, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], colorectal cancer, Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], Research Support, survival, Sobrevivientes, healthy lifestyle, Internal medicine, medicine, Journal Article, Proportional Hazards Models, Actividad Motora, business.industry, Physical fitness, BODY-MASS INDEX, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Other Clinical Medicine, 3121 General medicine, internal medicine and other clinical medicine, Patient Compliance, Cohort Studie, business, diet, Condició física
Abstract: Background: Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance with these recommendations measured using an index score (the WCRF/AICR score) was associated with lower cancer incidence and mortality. The aim of this study was to evaluate the association between pre-diagnostic concordance with WCRF/AICR recommendations and mortality in colorectal cancer (CRC) patients. Methods: The association between the WCRF/AICR score (score range 0-6 in men and 0-7 in women; higher scores indicate greater concordance) assessed on average 6.4 years before diagnosis and CRC-specific (n = 872) and overall mortality (n = 1,113) was prospectively examined among 3,292 participants diagnosed with CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (mean follow-up time after diagnosis 4.2 years). Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. Results: The HRs (95% CIs) for CRC-specific mortality among participants in the second (score range in men/women: 2.25-2.75/3.25-3.75), third (3-3.75/4-4.75), and fourth (4-6/5-7) categories of the score were 0.87 (0.72-1.06), 0.74 (0.61-0.90), and 0.70 (0.56-0.89), respectively (P for trend, We would like to acknowledge the contribution of all participants in the study. This study was funded by the World Cancer Research Fund (WCRF) International Regular Grant Programme (Grant number 2009/44). Dora Romaguera holds a Ramon y Cajal contract (Ministerio de Economia y Competitividad, Spain and European Regional Development Fund; RYC-2011-08796). In addition, EPIC investigators acknowledge funding from the following agencies: Europe Against Cancer Program of the European Commission (SANCO); German Cancer Aid; German Cancer Research Center (DKFZ); German Federal Ministry of Education and Research (BMBF); Danish Cancer Society; Catalan Institute of Oncology, Spain; Health Research Fund (FIS) of the Spanish Ministry of Health; Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia (no. 6236) and Navarra; ISCIII RCESP exp. C03/09 and ISCIII RETICC RD06/0020/0091, Spain; Cancer Research UK; Medical Research Council, United Kingdom; The Hellenic Health Foundation, Greece; Italian Association for Research on Cancer (AIRC); Italian National Research Council; Fondazione-Istituto Banco Napoli, Italy; Dutch Ministry of Public Health, Welfare and Sports, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), The Netherlands; Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skane, Sweden; Helga-Nordic Center of Excellence Programme in Nutrition and Health; French League against Cancer (LNCC); National Institute for Health and Medical Research (INSERM), France; Mutuelle Generale de l'Education Nationale (MGEN), France; 3 M Co., France; Gustave Roussy Institute (IGR), France; and General Councils of France.
Published: 2014
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28. Impact of psychosocial factors on cardiovascular morbimortality: a prospective cohort study

Author: José-V Sorlí, Jordi Salas-Salvadó, Fernando Arós, Xavier Pintó, Valentina Ruiz-Gutiérrez, Miguel-Angel Martínez-González, Enrique Gómez-Gracia, Olga Castañer, Miguel-Angel Muñoz, Javier Díez-Espino, Josep Basora, Ramon Estruch, José Lapetra, Dolores Corella, Miquel Fiol, Emilio Ros, R. M. Lamuela-Raventos, Cília Mejía-Lancheros, Lluis Serra-Majem, Universitat de Barcelona, Psicologia, Universitat Rovira i Virgili., Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (España), Centro Nacional de Investigaciones Cardiovasculares (España), Ministerio de Ciencia e Innovación (España), Fundación Mapfre, Junta de Andalucía, Generalitat Valenciana, Nafarroako Gobernua, and Generalitat de Catalunya
Subjects: Male, Time Factors, modelos de riesgos proporcionales, Epidemiology, humanos, depresión, Myocardial Infarction, 1471-2261, Social support, disparidades en el estado de salud, Clinical trials, Risk Factors, estudios prospectivos, Cause of Death, evaluación de riesgos, Medicine, Longitudinal Studies, Prospective Studies, Prospective cohort study, Stroke, mediana edad, Health inequalities, Cause of death, Aged, 80 and over, education.field_of_study, anciano, Depression, Factors de risc en les malalties, Hazard ratio, Middle Aged, Prognosis, pronóstico, Socioeconomic position, Cardiovascular diseases, Estudi de casos, Educational Status, Female, Risk assessment, Cardiology and Cardiovascular Medicine, Psychosocial, Research Article, medicine.medical_specialty, Risk factors in diseases, Population, Acute myocardial infarction, Risk Assessment, Educational level, factores de tiempo, causas de muerte, Internal medicine, factores de riesgo, Humans, análisis multifactorial, accidente cerebrovascular, cardiovascular diseases, education, Epidemiologia, infarto de miocardio, Aged, Proportional Hazards Models, business.industry, Proportional hazards model, Malalties cardiovasculars, Health Status Disparities, medicine.disease, apoyo social, Morbiditat, Spain, Multivariate Analysis, Physical therapy, Housing, Cardiovascular death, estudios longitudinales, Case studies, Morbidity, business, Assaigs clínics
Abstract: [Background] Whilst it is well known that psychosocial determinants may contribute to cardiovascular diseases (CVD), data from specific groups are scarce. The present study aims to determine the contribution of psychosocial determinants in increasing the risk of cardiovascular events (myocardial infarction and stroke), and death from CVD, in a high risk adult population., [Methods] Longitudinal prospective study of 7263 patients (57.5% women), mean age 67.0 (SD 6.2) free from CVD but at high risk, with a median follow-up of 4.8 years (from October 2003 to December 2010). The Hazard Ratios (HRs) of cardiovascular events (myocardial infarction, stroke, and death from cardiovascular causes) related to educational attainment, diagnosed depression (based on medical records), and low social support (number of people living in the household) were estimated by multivariate Cox regression models., [Results] Stroke incidence was associated with low educational level in the whole population (HR: 1.83, 95% CI: 1.09–3.09), and especially in men (HR: 2.11, 95% CI 1.09–4.06). Myocardial infarction and CVD mortality were not associated with any of the psychosocial factors considered., [Conclusion] Adults with low educational level had a higher risk of stroke. Depression and low social support were not associated with CVD incidence., [Trial registration] Clinical trial registration information unique identifier: ISRCTN35739639., Instituto de Salud Carlos III, and Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, and Centro Nacional de Investigaciones Cardiovasculares, Fondo de Investigación Sanitaria–Fondo Europeo de Desarrollo Regional, Ministerio de Ciencia e Innovación, Fundación Mapfre 2010, Consejería de Salud de la Junta de Andalucía, Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana, and the Regional Government of Navarra. None of the institutions described above have influenced the design, collection, analysis, and interpretation of data; the writing of the manuscript; and the decision to submit the manuscript for publication.
Published: 2014
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29. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk

Author: Castro-Quezada, Itandehui, Sanchez-Villegas, Almudena, Estruch, Ramon, Salas-Salvado, Jordi, Corella, Dolores, Schroeder, Helmut, Alvarez-Perez, Jacqueline, Dolores Ruiz-Lopez, Maria, Artacho, Reyes, Ros, Emilio, Bullo, Monica, Covas, Maria-Isabel, Ruiz-Gutierrez, Valentina, Ruiz-Canela, Miguel, Buil-Cosiales, Pilar, Gomez-Gracia, Enrique, Lapetra, Jose, Pinto, Xavier, Aros, Fernando, Fiol Sala, Miquel, Maria Lamuela-Raventos, Rosa, Angel Martinez-Gonzalez, Miguel, Serra-Majem, Lluis, PREDIMED Study Investigators, Bioquímica i Biotecnologia, Universitat Rovira i Virgili., and Universitat de Barcelona
Subjects: Gerontology, Male, Physiology, Epidemiology, modelos de riesgos proporcionales, humanos, lcsh:Medicine, Dieta mediterrània, Fats, Elderly, Risk Factors, índice glucémico, Cause of Death, Medicine and Health Sciences, Medicine, lcsh:Science, mediana edad, Aged, 80 and over, education.field_of_study, anciano, Multidisciplinary, Death rates, Geography, Geographical regions, dieta, Mortality rate, Hazard ratio, Regional geography, Age Factors, Middle Aged, Glycemic index, Cardiovascular diseases, Quartile, Physiological Parameters, Cardiovascular Diseases, Female, Dieta, Research Article, medicine.medical_specialty, Population, Carbohydrates, enfermedades cardiovasculares, Blood sugar, National Death Index, causas de muerte, Internal medicine, Glycemic load, Dietary Carbohydrates, Mortalitat, Humans, factores de riesgo, Obesity, Fatty acids, Mortality, education, Cardiovascular Disease Epidemiology, Glycemic, Nutrition, Aged, Proportional Hazards Models, conducta alimentaria, business.industry, Physical activity, carbohidratos dietéticos, Malalties cardiovasculars, lcsh:R, Body Weight, Biology and Life Sciences, PREDIMED study, Nutrients, Feeding Behavior, Genitourinary cancers, Diet, Earth sciences, Glucèmia, Geriatrics, Glycemic Index, lcsh:Q, Mediterranean Basin, business, human activities
Abstract: © 2014 Castro-Quezada et al. Objective: Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. Material and Methods: The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ). We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. Results: We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths). As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR =2.15 (95% CI: 1.15-4.04); P for trend =0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. Conclusions: High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk., This report has been supported by the official funding agency for biomedical research of the Spanish government, Instituto de Salud Carlos III (ISCIII), through grants provided to research networks specifically developed for the trial [RTIC G03/140, to R E; RTIC RD 06/0045, to MA M-G] and through Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERobn); Centro Nacional de Investigaciones Cardiovasculares [CNIC 06/2007]; Fondo de Investigación Sanitaria–Fondo Europeo de Desarrollo Regional [PI04-2239, PI 05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI10/01407, PI10/02658, PI11/01647, and P11/02505]; Ministerio de Ciencia e Innovación [AGL-2009-13906-C02 and AGL2010-22319-C03]; Fundación Mapfre 2010; Agencia Canaria de Investigación, Innovación y Sociedad de la Información-EU FEDER [PI 2007/050]; Consejería de Salud de la Junta de Andalucía [PI0105/2007]; Public Health Division of the Department of Health of the Autonomous Government of Catalonia; Generalitat Valenciana [ACOMP06109, GVACOMP2010-181, GVACOMP2011-151, CS2010-AP-111, and CS2011-AP-042]; Regional Government of Navarra [P27/2011] and IC-Q is supported by a scholarship of the Consejo Nacional de Ciencia y Tecnología de México (National Council on Science and Technology of México, CONACYT). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Published: 2014
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30. Polyphenol intake and mortality risk: a re-analysis of the PREDIMED trial

Author: Valentina Ruiz-Gutiérrez, Jordi Salas-Salvadó, Ramon Estruch, María Isabel Covas, E. Ros, Rosa M. Lamuela-Raventós, Miquel Fiol, Eric B. Rimm, Miguel Angel Muñoz, Lluis Serra-Majem, Alexander Medina-Remón, Enrique Gómez-Gracia, Anna Tresserra-Rimbau, Miguel Ángel Martínez-González, J. Lapetra, M. Carmen López-Sabater, Alfredo Gea, Fernando Arós, Dolores Corella, Xavier Pintó, Bioquímica i Biotecnologia, Universitat Rovira i Virgili., Universitat de Barcelona, Ministerio de Ciencia e Innovación (España), Instituto de Salud Carlos III, and Comisión Interministerial de Ciencia y Tecnología, CICYT (España)
Subjects: Male, riesgo, Mediterranean diet, modelos de riesgos proporcionales, humanos, Physiology, Diet, Mediterranean, Antioxidants, Risk Factors, Sistema cardiovascular--Malalties, Cause of Death, Neoplasms, flavonoides, Epidemiology, Stilbenes, Hydroxybenzoates, 1741-7015, mediana edad, Cause of death, Aged, 80 and over, Medicine(all), neoplasias, anciano, dieta, Hazard ratio, food and beverages, General Medicine, Middle Aged, Cardiovascular disease, All-cause mortality, Metabolisme, Cardiovascular Diseases, Polifenols, Female, Research Article, Risk, PREDIMED, medicine.medical_specialty, enfermedades cardiovasculares, Lignans, Insulin resistance, Mediterranean cooking, Medical statistics, causas de muerte, hidroxibenzoatos, Cuina mediterrània, antioxidantes, medicine, Mortalitat, Humans, factores de riesgo, Food consumption, Mortality, polifenoles, Aged, Proportional Hazards Models, Flavonoids, Proportional hazards model, business.industry, Polyphenols, PREDIMED study, Polyphenol intake, medicine.disease, Confidence interval, Biotechnology, Diet, Metabolism, Polyphenol, Commentary, business, Estadística mèdica, Consum d'aliments
Abstract: [Background] Polyphenols may lower the risk of cardiovascular disease (CVD) and other chronic diseases due to their antioxidant and anti-inflammatory properties, as well as their beneficial effects on blood pressure, lipids and insulin resistance. However, no previous epidemiological studies have evaluated the relationship between the intake of total polyphenols intake and polyphenol subclasses with overall mortality. Our aim was to evaluate whether polyphenol intake is associated with all-cause mortality in subjects at high cardiovascular risk., [Methods] We used data from the PREDIMED study, a 7,447-participant, parallel-group, randomized, multicenter, controlled five-year feeding trial aimed at assessing the effects of the Mediterranean Diet in primary prevention of cardiovascular disease. Polyphenol intake was calculated by matching food consumption data from repeated food frequency questionnaires (FFQ) with the Phenol-Explorer database on the polyphenol content of each reported food. Hazard ratios (HR) and 95% confidence intervals (CI) between polyphenol intake and mortality were estimated using time-dependent Cox proportional hazard models., [Results] Over an average of 4.8 years of follow-up, we observed 327 deaths. After multivariate adjustment, we found a 37% relative reduction in all-cause mortality comparing the highest versus the lowest quintiles of total polyphenol intake (hazard ratio (HR) = 0.63; 95% CI 0.41 to 0.97; P for trend = 0.12). Among the polyphenol subclasses, stilbenes and lignans were significantly associated with reduced all-cause mortality (HR =0.48; 95% CI 0.25 to 0.91; P for trend = 0.04 and HR = 0.60; 95% CI 0.37 to 0.97; P for trend = 0.03, respectively), with no significant associations apparent in the rest (flavonoids or phenolic acids)., [Conclusions] Among high-risk subjects, those who reported a high polyphenol intake, especially of stilbenes and lignans, showed a reduced risk of overall mortality compared to those with lower intakes. These results may be useful to determine optimal polyphenol intake or specific food sources of polyphenols that may reduce the risk of all-cause mortality., [Clinical trial registration] ISRCTN35739639., This study was supported in part by CICYT (AGL2010-22319-C03) from the Spanish Ministry of Science and Innovation (MICINN), and the Instituto de Salud Carlos III, ISCIII (CIBERobn-CB06/03, RD 06/0045, PI1002658 and PI1001407). The CIBERobn is an initiative of the ISCIII, Spain. ATR received support from ISCIII (FI10/00265).
Published: 2014
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31. Obesity indexes and total mortality among elderly subjects at high cardiovascular risk: The PREDIMED study

Author: Maira Bes-Rastrollo, Enrique Gómez-Gracia, Dolores Corella, Guillermo Sáez-Tormo, Montserrat Fitó, Emilio Ros, Javier Rekondo, José Manuel Santos-Lozano, J. Alfredo Martínez, Sonia Eguaras, Ana García-Arellano, Rosa M. Lamuela-Raventós, Ramon Estruch, Mònica Bulló, Xavier Pintó, Lluis Serra-Majem, Estefanía Toledo, Miquel Fiol, Miguel Ángel Martínez-González, Bioquímica i Biotecnologia, Universitat Rovira i Virgili., and Universitat de Barcelona
Subjects: Male, Gerontology, modelos de riesgos proporcionales, humanos, Dieta mediterrània, Body Mass Index, Waist–hip ratio, Risk Factors, Medicine and Health Sciences, Abdominal obesity, mediana edad, Aged, 80 and over, Clinical Trials as Topic, anciano, Multidisciplinary, Anthropometry, Mortality rate, Hazard ratio, Age Factors, Middle Aged, Cardiovascular diseases, Research Design, Cardiovascular Diseases, Physical Sciences, Observational Studies, Medicine, Obesitat, Female, medicine.symptom, Waist Circumference, Statistics (Mathematics), Research Article, PREDIMED, Waist, Clinical Research Design, Science, Cardiology, enfermedades cardiovasculares, Research and Analysis Methods, ensayos clínicos como asunto, medicine, Humans, factores de riesgo, Obesity, Statistical Methods, Mortality, obesidad, Aged, Proportional Hazards Models, perímetro abdominal, business.industry, Waist-Hip Ratio, Malalties cardiovasculars, índice de masa corporal, medicine.disease, Cardiovascular risk, índice cintura-cadera, business, Body mass index, Mathematics, Meta-Analysis, Demography, Antropometria
Abstract: Background: Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality. Methods: We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and height) with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years) and 57% were women (60 to 80 years). All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009. Results: After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70) were 1.02 (0.78-1.34), 1.30 (0.97-1.75) and 1.55 (1.06-2.26). When we used WC (cut-off points: 100, 105 and 110 cm), the multivariable adjusted Hazard Ratios (HRs) for mortality were 1.18 (0.88-1.59), 1.02 (0.74-1.41) and 1.57 (1.19-2.08). In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial. Conclusions: Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality., Supported by the official funding agency for biomedical research of the Spanish government, Instituto de Salud Carlos III (ISCIII), through grants provided to research networks specifically developed for the trial (RTIC G03/140, to Dr. Estruch; RTIC RD 06/0045, to Dr. Martinez-Gonzalez and through Centro de Investigacion Biomedica en Red de Fisiopatologia de la Obesidad y Nutricion [CIBERobn]), and by grants from Centro Nacional de Investigaciones Cardiovasculares (CNIC 06/2007), Fondo de Investigacion Sanitaria-Fondo Europeo de Desarrollo Regional (PI04-2239, PI 05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI07/0473, PI10/01407, PI10/02658, PI11/01647, and P11/02505), Ministerio de Ciencia e Innovacion (AGL-2009-13906-C02 and AGL2010-22319-C03), Fundacion Mapfre 2010, Consejeria de Salud de la Junta de Andalucia (PI0105/2007), Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana (ACOMP06109, GVACOMP2010-181, GVACOMP2011-151, CS2010-AP-111, and CS2011-AP-042), and Regional Government of Navarra (P27/2011). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Published: 2014
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32. Combined impact of healthy lifestyle factors on colorectal cancer : a large European cohort study

Author: Domenico Palli, Aurelio Barricarte, José Ramón Quirós, Laureen Dartois, Heather Ward, Salvatore Panico, Isabelle Romieu, Veronika Fedirko, Ulrika Ericson, Kim Overvad, Miren Dorronsoro, Pagona Lagiou, Krasimira Aleksandrova, Rudolf Kaaks, Kay-Tee Khaw, Anne Tjønneland, Elio Riboli, Laure Dossus, Sabina Rinaldi, Ingrid Ljuslinder, Genevieve Buckland, Marc J. Gunter, Petra H.M. Peeters, Vittorio Krogh, Alessio Naccarati, Ingegerd Johansson, Bodil Ohlsson, Peter D. Siersema, Kathryn E. Bradbury, Heiner Boeing, María José Sánchez, Mazda Jenab, Antonia Trichopoulou, H. Bas Bueno-de-Mesquita, Elisabete Weiderpass, Guri Skeie, Kristin Benjaminsen Borch, Tobias Pischon, Sven Knüppel, Teresa Norat, Nicholas J. Wareham, Joyce Kong, Dora Romaguera, Kuanrong Li, Dimitrios Trichopoulos, Rosario Tumino, Marie-Christine Boutron-Ruault, María Dolores Chirlaque, [Aleksandrova,K, Knüppe,S, Boeing,H] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany. [Pischon,T] Molecular Epidemiology Group, Max Delbrueck Center for Molecular Medicine (MDC), Berlin-Buch, Germany. [Jenab,M, Fedirko,V, Rinald,S, Romieu,I, Kong,J] International Agency for Research on Cancer (IARC-WHO), Lyon, France. [Bueno-de-Mesquita,HB] National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands. [Bueno-de-Mesquita,HB, Siersema,PD] Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, the Netherlands. [Bueno-de-Mesquita,HB, Norat,T, Romaguera,D, Peeters,PHM, Gunter,MJ, Ward,HA, Riboli,E] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. [Fedirko,V] Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, USA. [Romaguera,D] Instituto de Investigacion Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, Palma de Mallorca, Spain. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Santiago de Compostela, Spain. [Boutron-Ruault,M, Dossus,L, Dartois,L] Inserm, Centre for research in Epidemiology and Population Health (CESP), Nutrition, Hormones and Women’s Health team, Villejuif, France. Univ Paris Sud, Villejuif, France. IGR, Villejuif, France. [Kaaks,R, Li,K] Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany. [Tjønneland,K] Diet, Genes and Environment Danish Cancer Society Research Center, Copenhagen, Denmark. [Overvad,K] Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark. [Quirós,JR] Public Health Directorate, Asturias, Spain. [Buckland,G] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain. [Sánchez,MJ] Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Granada, Spain. [Sánchez,MJ, Chirlaque,M] CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Dorronsoro,M] Epidemiology and Health Information, Public Health Division of Gipuzkoa, Basque Regional Health Department, San Sebastian, Spain. [Chirlaque,M] Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain. [Barricarte,A] Navarre Public Health Institute, Pamplona, Spain. [Khaw,K] Clinical Gerontology Unit, Addenbrooke’s Hospital, University of Cambridge School of Clinical Medicine, Cambridge, UK. [Wareham,NJ] MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK. [Bradbury,KE] Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. [Trichopoulou,A] Hellenic Health Foundation, Athens, Greece. [Trichopoulou,A, Lagiou,P, Trichopoulos,D] Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece. [Lagiou,P, Trichopoulos,D] Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Trichopoulos,D] Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. [Palli,D] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Florence, Italy. [Krogh,V] Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, 'M.P.Arezzo' Hospital, Ragusa, Italy. [Naccarati,A] HuGeF - Human Genetics Foundation – Torino, Molecular and Genetic Epidemiology Unit, Turin, Italy. [Panico,S] Department of clinical and experimental medicine-Federico II University, Naples, Italy. [Peeters,PHM] Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherland. [Ljuslinder,I] Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden. [Johansson,I] Department of Odontology, Umeå University, Umeå, Sweden. [Ericson,U] Diabetes and Cardiovascular Disease, Genetic Epidemiology, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden. [Ohlsson,B] Department of Clinical Sciences, Division of Internal Medicine, Skåne University Hospital Malmö, Lund University, Malmö, Sweden. [Weiderpass,E, Skeie,G, Borch,KB] Department of Community Medicine, Faculty of Health Sciences, University of Tromso, The Arctic University of Norway, Tromsø, Norway. [Weiderpass,E] Department of Research, Cancer Registry of Norway, Oslo, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Samfundet Folkhälsan, Helsinki, Finland., The coordination of the EPIC study is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l¿Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany), Hellenic Health Foundation (Greece), Italian Association for Research on Cancer (AIRC), National Research Council, HuGeF Foundation, Compagnia di San Paolo, Sicily Regional Government, AIRE ONLUS Ragusa and AVIS Ragusa (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF) and Statistics Netherlands (The Netherlands), ERC-2009-AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health, Norwegian Research Council, Norwegian Cancer Society, University of Tromso (Norway), Health Research Fund (FIS), Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain), Swedish Cancer Society, Swedish Scientific Council and Regional Government of Skåne and Västerbotten (Sweden), Cancer Research UK, Medical Research Council (United Kingdom)., Aleksandrova, Krasimira, Pischon, Tobia, Jenab, Mazda, Bueno de Mesquita, H. Ba, Fedirko, Veronika, Norat, Teresa, Romaguera, Dora, Knüppel, Sven, Boutron Ruault, Marie Christine, Dossus, Laure, Dartois, Laureen, Kaaks, Rudolf, Li, Kuanrong, Tjønneland, Anne, Overvad, Kim, Quirós, José Ramón, Buckland, Genevieve, Sánchez, María José, Dorronsoro, Miren, Chirlaque, Maria Dolore, Barricarte, Aurelio, Khaw, Kay Tee, Wareham, Nicholas J, Bradbury, Kathryn E, Trichopoulou, Antonia, Lagiou, Pagona, Trichopoulos, Dimitrio, Palli, Domenico, Krogh, Vittorio, Tumino, Rosario, Naccarati, Alessio, Panico, Salvatore, Siersema, Peter D, Peeters, Petra H. M, Ljuslinder, Ingrid, Johansson, Ingegerd, Ericson, Ulrika, Ohlsson, Bodil, Weiderpass, Elisabete, Skeie, Guri, Borch, Kristin Benjaminsen, Rinaldi, Sabina, Romieu, Isabelle, Kong, Joyce, Gunter, Marc J, Ward, Heather A, Riboli, Elio, and Boeing, Heiner
Subjects: Male, consumo de alcohol, Health Behavior, 0302 clinical medicine, estudios prospectivos, European Prospective Investigation into Cancer and, Prospective Studies, estudios de cohortes, mediana edad, PROPORTION, anciano, education.field_of_study, VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Motor Activity [Medical Subject Headings], dieta, Incidence, COLON-CANCER, Hazard ratio, lifestyle factors, General Medicine, adulto, 3. Good health, estilo de vida, 030220 oncology & carcinogenesis, Cohort, acrylamide, Dieta, Cohort study, Human, medicine.medical_specialty, Alcohol Drinking, European Continental Ancestry Group, Lifestyles, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Habits::Smoking [Medical Subject Headings], European Prospective Investigation into Cancer and Nutrition (EPIC), Endocrinology and Diabetes, dietary questionnaires, haemoglobin adducts, incidencia, White People, 03 medical and health sciences, Càncer colorectal, population attributable risks, Humans, education, Life Style, METAANALYSIS, Aged, Cancer och onkologi, Science & Technology, Proportional hazards model, VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Oncology: 762, biomarkers, Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms [Medical Subject Headings], Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Life Style [Medical Subject Headings], PREVENTION, Prospective Studie, MYOCARDIAL-INFARCTION, ATTRIBUTABLE RISK, Cardiovascular and Metabolic Diseases, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], Cancer and Oncology, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Drinking Behavior::Alcohol Drinking [Medical Subject Headings], RISK-FACTORS, Proportional Hazards Model, grupo de ascendencia continental europea, measurement errors, Gerontology, colorectal cancer, combined impact, modelos de riesgos proporcionales, humanos, Colorectal Neoplasm, Cohort Studies, Risk Factors, Neoplasias colorrectales, Hábito de fumar, 030212 general & internal medicine, Prospective cohort study, conducta sanitaria, Medicine(all), Consumo de alcohol, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, European Prospective Investigation into Cancer and Nutrition, Europe, NUTRITION, Female, Colorectal Neoplasms, Life Sciences & Biomedicine, Research Article, Adult, Estils de vida, neoplasias colorrectales, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings], Population, Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings], smoking, Medicine, General & Internal, General & Internal Medicine, Internal medicine, medicine, factores de riesgo, Proportional Hazards Models, Nutrition (EPIC), RECTAL CANCERS, business.industry, Risk Factor, Diet, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Onkologi: 762, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, PHYSICAL-ACTIVITY, Attributable risk, Cohort Studie, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, business
Abstract: Background: Excess body weight, physical activity, smoking, alcohol consumption and certain dietary factors are individually related to colorectal cancer (CRC) risk; however, little is known about their joint effects. The aim of this study was to develop a healthy lifestyle index (HLI) composed of five potentially modifiable lifestyle factors healthy weight, physical activity, non-smoking, limited alcohol consumption and a healthy diet, and to explore the association of this index with CRC incidence using data collected within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Methods: In the EPIC cohort, a total of 347,237 men and women, 25- to 70-years old, provided dietary and lifestyle information at study baseline (1992 to 2000). Over a median follow-up time of 12 years, 3,759 incident CRC cases were identified. The association between a HLI and CRC risk was evaluated using Cox proportional hazards regression models and population attributable risks (PARs) have been calculated. Results: After accounting for study centre, age, sex and education, compared with 0 or 1 healthy lifestyle factors, the hazard ratio (HR) for CRC was 0.87 (95% confidence interval (CI): 0.44 to 0.77) for two factors, 0.79 (95% CI: 0.70 to 0.89) for three factors, 0.66 (95% CI: 0.58 to 0.75) for four factors and 0.63 (95% CI: 0.54 to 0.74) for five factors; P-trend, The coordination of the EPIC study is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Generale de l'Education Nationale, Institut National de la Sante et de la Recherche Medicale (INSERM) (France); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); Hellenic Health Foundation (Greece); Italian Association for Research on Cancer (AIRC), National Research Council, HuGeF Foundation, Compagnia di San Paolo, Sicily Regional Government, AIRE ONLUS Ragusa and AVIS Ragusa (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF) and Statistics Netherlands (The Netherlands); ERC-2009-AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health, Norwegian Research Council, Norwegian Cancer Society, University of Tromso (Norway); Health Research Fund (FIS), Regional Governments of Andalucia, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Scientific Council and Regional Government of Skane and Vasterbotten (Sweden); Cancer Research UK, Medical Research Council (United Kingdom).
Published: 2014
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33. Effect of Statin Therapy in the Outcome of Bloodstream Infections Due to Staphylococcus aureus: A Prospective Cohort Study

Author: C. Velasco, Marina de Cueto, Jesús Rodríguez-Baño, Álvaro Pascual, Luis Eduardo López-Cortés, Juan Gálvez-Acebal, María Dolores del Toro, Miguel A. Muniain, Francisco Javier Caballero, Universidad de Sevilla. Departamento de Medicina, Universidad de Sevilla. Departamento de Microbiología, [López-Cortés,LE, Gálvez-Acebal,J, Del Toro,MD, Velasco,C, de Cueto,M, Muniain,MA, Pascual,A, Rodríguez-Baño,J] Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Seville, Spain. [Caballero,FJ, Rodríguez-Baño,J] Spanish Network for Research in Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain. [Velasco,C, Pascual,A] Departamento de Microbiología, Universidad de Sevilla, Seville, Spain. [Gálvez-Acebal,J, and Rodríguez-Baño,J] Departamento de Medicina, Universidad de Sevilla, Seville, Spain.
Subjects: Male, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Survival Analysis [Medical Subject Headings], Bacteremia, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Medicine, Prospective Studies, Prospective cohort study, Health Care::Health Care Quality, Access, and Evaluation::Delivery of Health Care::Tertiary Healthcare [Medical Subject Headings], Multidisciplinary, Organisms::Bacteria::Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Rods::Staphylococcaceae::Staphylococcus::Staphylococcus aureus [Medical Subject Headings], Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Bacteremia [Medical Subject Headings], Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Antimetabolites::Hypolipidemic Agents::Anticholesteremic Agents::Hydroxymethylglutaryl-CoA [Medical Subject Headings], Middle Aged, Staphylococcal Infections, Shock, Septic, Anti-Bacterial Agents, SAB, Treatment Outcome, Antibacterianos, Infectious diseases, Female, Research Article, Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents [Medical Subject Headings], medicine.medical_specialty, Staphylococcus aureus, Diseases::Bacterial Infections and Mycoses::Infection::Sepsis::Shock, Septic [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings], Infecciones Estafilocócicas, Science, Análisis de Supervivencia, Check Tags::Male [Medical Subject Headings], Staphylococcal infections, Sepsis, Inhibidores de Hidroximetilglutaril-CoA Reductasas, Internal medicine, Humans, Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Choque Séptico, Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Staphylococcal Infections [Medical Subject Headings], Survival analysis, Aged, Proportional Hazards Models, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome [Medical Subject Headings], Tertiary Healthcare, business.industry, Proportional hazards model, Septic shock, Statins, medicine.disease, Survival Analysis, Surgery, Check Tags::Female [Medical Subject Headings], Propensity score matching, Bacteriemia, Hydroxymethylglutaryl-CoA Reductase Inhibitors, business, Modelos de Riesgos Proporcionales
Abstract: Introduction: Statins have pleiotropic effects that could influence the prevention and outcome of some infectious diseases. There is no information about their specific effect on Staphylococcus aureus bacteremia (SAB). Methods: A prospective cohort study including all SAB diagnosed in patients aged $18 years admitted to a 950-bed tertiary hospital from March 2008 to January 2011 was performed. The main outcome variable was 14-day mortality, and the secondary outcome variables were 30-day mortality, persistent bacteremia (PB) and presence of severe sepsis or septic shock at diagnosis of SAB. The effect of statin therapy at the onset of SAB was studied by multivariate logistic regression and Cox regression analysis, including a propensity score for statin therapy. Results: We included 160 episodes. Thirty-three patients (21.3%) were receiving statins at the onset of SAB. 14-day mortality was 21.3%. After adjustment for age, Charlson index, Pitt score, adequate management, and high risk source, statin therapy had a protective effect on 14-day mortality (adjusted OR = 0.08; 95% CI: 0.01–0.66; p = 0.02), and PB (OR = 0.89; 95% CI: 0.27– 1.00; p = 0.05) although the effect was not significant on 30-day mortality (OR = 0.35; 95% CI: 0.10–1.23; p = 0.10) or presentation with severe sepsis or septic shock (adjusted OR = 0.89; CI 95%: 0.27–2.94; p = 0.8). An effect on 30-day mortality could neither be demonstrated on Cox analysis (adjusted HR = 0.5; 95% CI: 0.19–1.29; p = 0.15). Conclusions: Statin treatment in patients with SAB was associated with lower early mortality and PB. Randomized studies are necessary to identify the role of statins in the treatment of patients with SAB
Published: 2013

34. Development and Validation of a Risk Score Predicting Substantial Weight Gain over 5 Years in Middle-Aged European Men and Women

Author: Philippos Orfanos, Lefkos T. Middleton, Vittorio Krogh, Kuanrong Li, J. Ramón Quirós, Sven Knüppel, Birgit Teucher, Eva Ardanaz, Heiner Boeing, Anne M. May, Laureen Dartois, Guy Fagherazzi, Domenico Palli, Peter Wallström, Bo Hedblad, Jytte Halkjær, Rosario Tumino, Annika Steffen, José María Huerta, María José Sánchez, Amalia Mattiello, Nicholas J. Wareham, Kim Overvad, H. Bas Bueno-de-Mesquita, Kay-Tee Khaw, Daphne L. van der A, Antonia Trichopoulou, Miren Dorronsoro, Anne Tjønneland, Paolo Vineis, Thorkild I. A. Sørensen, Dimitrios Trichopoulos, Noémie Travier, Petra H.M. Peeters, Francesca L. Crowe, [Steffen,A, Knüppel,S, Boeing,H] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany. [Sørensen,TIA] Instiute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals – Part of Copenhagen University Hospital, The Capital Region, Denmark. [Travier,N] Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology, Barcelona, Spain. [Sánchez,MJ] Andalusian School of Public Health, Granada, Spain. [Huerta,JM] Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain. [Sánchez,MJ, Huerta,JM, Ardanaz,E] CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. [Quirós,JR] Public Health Directorate, Asturias, Spain. [Ardanaz,E] Navarre Public Health Institute, Pamplona, Spain. [Dorronsoro,M] Basque Regional Health Department and Ciberesp – Biodonostia, San Sebastian, Spain. [Teucher,B, Li,K] Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany. [Bueno-de-Mesquita,HB, A,D] National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. [Bueno-de-Mesquita,HB] Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. [Mattiello,A] Dipartimento di Medicina Clinica e Chirurgia, Frederico II University, Naples, Italy. [Palli,D] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute, Florence, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, ‘‘Civile – M.P.Arezzo’’ Hospital, Ragusa, Italy. [Krogh,V] Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. [Vineis,P] HuGeF Foundation Torino, Italy. [Trichopoulou,A, Orfanos,P, Trichopoulos,D] Hellenic Health Foundation, Athens, Greece. [Trichopoulou,A, Orfanos,P] WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Trichopoulos,D] Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America. [Trichopoulos,D] Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece. [Hedblad,B] Department of Clinical Sciences in Malmö, Clinical Research Centre, Skane University Hospital, Malmö, Sweden. [Wallström,P] Nutrition Epidemiology Research Group, Department of Clinical Sciences, Lund University, Malmö, Sweden. [Overvad,K] Section of Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark. [Halkjær,J, Tjønneland,A] Danish Cancer Society Research Center, Copenhagen, Denmark. [Fagherazzi,G, Dartois,L] Inserm, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Villejuif, France. Paris South University, Villejuif, France. [Crowe,F] Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom. [Khaw,K] Clinical Gerontology Unit, University of Cambridge, Cambridge, United Kingdom. [Wareham,N] Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. [Vineis,P, Middleton,L] School of Public Health, Imperial College, London, United Kingdom. [May,AM, Peeters,PHM] Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands. [Peeters,PHM] Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom., This publication arises from a collaboration of two EU projects, the Diet, Obesity and Genes (DiOGenes) project and the Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating out of Home and Obesity (PANACEA) project. DiOGenes is a pan-European study within the EU Sixth Framework Programme for Research and Technological Development (2005-2009) (FOOD-CT-2005-513946, http://www.diogenes.eu.org). PANACEA received funding from the EU in the framework of the Public Health Programme (project 2005328). This work was further supported by the European Commission: Public Health and Consumer Protection Directorate 1993–2004, the Research Directorate-General 2005, the Ligue contre le Cancer, the Societe´ 3M, the Mutuelle Ge´ne´ rale de l’Education Nationale, and the Institut National de la Sante´ et de la Recherche Me´ dicale, German Cancer Aid, the German Cancer Research Center, and the Federal Ministry of Education and Research (Germany), the Danish Cancer Society (Denmark), Health Research Fund (FIS) of the Spanish Ministry of Health RTICC ’Red Tema´tica de Investigacio´n Cooperativa en Ca´ncer (grant number C03/10, R06/0020), the participating regional governments and institutions of Spain, Cancer Research United Kingdom, the Medical Research Council, the Stroke Association, the British Heart Foundation, the Department of Health, the Food Standards Agency, and the Wellcome Trust (United Kingdom), the Italian Association for Research on Cancer and the National Research Council (Italy), the Dutch Ministry of Public Health, Welfare and Sports, the Dutch Ministry of Health, Dutch Prevention Funds, LK Research Funds, the Dutch Zorg Onderzoek Nederland, and the World Cancer Research Fund (Netherlands), and the Swedish Cancer Society, the Swedish Scientific Council, and the Regional Government of Skane. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Subjects: Male, Gerontology, Research Validity, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings], Non-Clinical Medicine, Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight::Body Weight Changes::Weight Gain [Medical Subject Headings], Epidemiology, lcsh:Medicine, Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Weight Gain, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Cohort Studies, Mediana Edad, 0302 clinical medicine, Risk Factors, Positive predicative value, Aumento de Peso, Cardiac and Cardiovascular Systems, Prospective Studies, 030212 general & internal medicine, Masculino, lcsh:Science, Factores de Riesgo, education.field_of_study, Multidisciplinary, Framingham Risk Score, Nutrition and Dietetics, Adulto, Femenino, Geographicals::Geographic Locations::Europe [Medical Subject Headings], Epidemiology of Aging, Estudios Prospectivos, Middle Aged, Research Assessment, Humanos, 3. Good health, European Prospective Investigation into Cancer and Nutrition, Europe, Medicine, Female, Public Health, medicine.symptom, Europa, Research Article, Adult, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings], Clinical Research Design, Science Policy, Anciano, Population, Check Tags::Male [Medical Subject Headings], 030209 endocrinology & metabolism, External validity, 03 medical and health sciences, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], medicine, Humans, Obesity, Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Statistical Methods, education, Aged, Proportional Hazards Models, Nutrition, Health Care Policy, Receiver operating characteristic, business.industry, Proportional hazards model, lcsh:R, Health Risk Analysis, Check Tags::Female [Medical Subject Headings], lcsh:Q, Modelos de Riesgos Proporcionales, business, Weight gain, Demography
Abstract: Journal Article; Research Support, Non-U.S. Gov't; BACKGROUND Identifying individuals at high risk of excess weight gain may help targeting prevention efforts at those at risk of various metabolic diseases associated with weight gain. Our aim was to develop a risk score to identify these individuals and validate it in an external population. METHODS We used lifestyle and nutritional data from 53°758 individuals followed for a median of 5.4 years from six centers of the European Prospective Investigation into Cancer and Nutrition (EPIC) to develop a risk score to predict substantial weight gain (SWG) for the next 5 years (derivation sample). Assuming linear weight gain, SWG was defined as gaining ≥ 10% of baseline weight during follow-up. Proportional hazards models were used to identify significant predictors of SWG separately by EPIC center. Regression coefficients of predictors were pooled using random-effects meta-analysis. Pooled coefficients were used to assign weights to each predictor. The risk score was calculated as a linear combination of the predictors. External validity of the score was evaluated in nine other centers of the EPIC study (validation sample). RESULTS Our final model included age, sex, baseline weight, level of education, baseline smoking, sports activity, alcohol use, and intake of six food groups. The model's discriminatory ability measured by the area under a receiver operating characteristic curve was 0.64 (95% CI = 0.63-0.65) in the derivation sample and 0.57 (95% CI = 0.56-0.58) in the validation sample, with variation between centers. Positive and negative predictive values for the optimal cut-off value of ≥ 200 points were 9% and 96%, respectively. CONCLUSION The present risk score confidently excluded a large proportion of individuals from being at any appreciable risk to develop SWG within the next 5 years. Future studies, however, may attempt to further refine the positive prediction of the score. Yes
Published: 2013
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35. Clinical and prehospital survival indicators in blunt trauma: a multivariate analysis

Author: Regina Marcia Cardoso de Sousa and Marisa Aparecida Amaro Malvestio
Subjects: Modelos de riscos proporcionais, Supervivencia, Survival, Proportional hazards models, Traumatismo múltiple, Multiple trauma, Acidentes de trânsito, Modelos de riesgos proporcionales, Traumatismo múltiplo, General Nursing, Sobrevivência, Accidents, traffic, Accidentes de tráfico
Abstract: O objetivo do estudo foi identificar os indicadores clínicos e pré-hospitalares associados à sobrevivência de vítimas de trauma fechado. Foram utilizadas a análise de sobrevivência de Kaplan Meier, e de Riscos Proporcionais de Cox, para analisar a associação de 33 variáveis ao óbito precoce e tardio, propondo modelos multivariados. Os modelos finais até 48h pós-trauma evidenciaram altos coeficientes de risco promovidos pelas lesões abdominais, Injury Severity Score >25, procedimentos respiratórios avançados e compressões torácicas pré-hospitalares. No modelo até 7 dias, a pressão arterial sistólica na cena do acidente, se menor de 75mmHg, foi associada a maior risco de óbito e se ausente, foi associada ao mais elevado risco de óbito após 7 dias. A reposição de volume pré-hospitalar apresentou efeito protetor em todos os períodos. Os resultados sugerem que a magnitude da hipoxemia e da instabilidade hemodinâmica diante da hemorragia, influenciaram de forma significante o óbito precoce e tardio desse grupo de vítimas. The aim of the study was to identify the clinical and prehospital indicators associated to the survival of blunt trauma victims. The Kaplan Meier survival analysis and the Cox proportional hazards model were used to analyze the association of 33 variables to early and late death, proposing multivariate models. The final models until 48 hours post-trauma showed high rates of risk promoted by abdominal injuries, Injury Severity Score > 25, advanced respiratory procedures and prehospital chest compressions. In the model up to 7 days, a systolic blood pressure in accident site lower than 75mmHg was associated with increased risk of death, and if absent it was associated with higher risk of death after 7 days. The prehospital volume replacement showed a protective effect in all periods. Results suggest that the magnitude of hypoxemia and hemodynamic instability due to bleeding had a significant influence on early and late death in this group of victims. El objetivo del estudio fue identificar los indicadores clínicos y prehospitalarios asociados a la supervivencia de víctimas de trauma cerrado. Fueron utilizados el Análisis de Supervivencia de Kaplan-Meier y de Riesgos Proporcionales de Cox para examinar la asociación de 33 variables respecto de la muerte temprana y tardía, proponiéndose modelos multivariados. Los modelos finales hasta 48 horas post trauma mostraron altos coeficientes de riesgo promovidos por las lesiones abdominales, Injury Severity Score > 25, procesos respiratorias avanzados y compresiones torácicas prehospitalarias. En el modelo hasta 7 días, la presión arterial sistólica en la escena del accidente, cuando resultó inferior a 75mmHg, se asoció con mayor riesgo de muerte y, en caso de ausencia, se asoció con el mayor riesgo de muerte posterior a 7 días. La reposición de volumen prehospitalario mostró un efecto protector en todos los períodos. Los resultados sugieren que la magnitud de la hipoxemia y la inestabilidad hemodinámica debida a la hemorragia influyeron de manera significativa en la muerte temprana y tardía en este grupo de víctimas.
Published: 2010

36. Effect of Statin Therapy in the Outcome of Bloodstream Infections Due to Staphylococcus aureus: A Prospective Cohort Study

Author: Universidad de Sevilla. Departamento de Medicina, Universidad de Sevilla. Departamento de Microbiología, López Cortés, Luis Eduardo, Gálvez-Acebal, Juan, Toro López, María Dolores del, Velasco Ramírez, María del Carmen, Cueto López, Marina de, Caballero, Francisco J., Muniain Ezcurra, Miguel Angel, Pascual Hernández, Álvaro, Rodríguez-Baño, Jesús, Universidad de Sevilla. Departamento de Medicina, Universidad de Sevilla. Departamento de Microbiología, López Cortés, Luis Eduardo, Gálvez-Acebal, Juan, Toro López, María Dolores del, Velasco Ramírez, María del Carmen, Cueto López, Marina de, Caballero, Francisco J., Muniain Ezcurra, Miguel Angel, Pascual Hernández, Álvaro, and Rodríguez-Baño, Jesús
Abstract: Introduction: Statins have pleiotropic effects that could influence the prevention and outcome of some infectious diseases. There is no information about their specific effect on Staphylococcus aureus bacteremia (SAB). Methods: A prospective cohort study including all SAB diagnosed in patients aged $18 years admitted to a 950-bed tertiary hospital from March 2008 to January 2011 was performed. The main outcome variable was 14-day mortality, and the secondary outcome variables were 30-day mortality, persistent bacteremia (PB) and presence of severe sepsis or septic shock at diagnosis of SAB. The effect of statin therapy at the onset of SAB was studied by multivariate logistic regression and Cox regression analysis, including a propensity score for statin therapy. Results: We included 160 episodes. Thirty-three patients (21.3%) were receiving statins at the onset of SAB. 14-day mortality was 21.3%. After adjustment for age, Charlson index, Pitt score, adequate management, and high risk source, statin therapy had a protective effect on 14-day mortality (adjusted OR = 0.08; 95% CI: 0.01–0.66; p = 0.02), and PB (OR = 0.89; 95% CI: 0.27– 1.00; p = 0.05) although the effect was not significant on 30-day mortality (OR = 0.35; 95% CI: 0.10–1.23; p = 0.10) or presentation with severe sepsis or septic shock (adjusted OR = 0.89; CI 95%: 0.27–2.94; p = 0.8). An effect on 30-day mortality could neither be demonstrated on Cox analysis (adjusted HR = 0.5; 95% CI: 0.19–1.29; p = 0.15). Conclusions: Statin treatment in patients with SAB was associated with lower early mortality and PB. Randomized studies are necessary to identify the role of statins in the treatment of patients with SAB
Published: 2013

37. Carcinoma de células renales. Modelo predictivo de progresión

Author: Pascual Regueiro, Daniel and Borque Fernando, Ángel
Subjects: pronóstico, nomograma, modelos de riesgos proporcionales, carcinoma de células renales
Abstract: Hemos generado un modelo predictivo, nomograma, basado en variables clínico - patológicas en el carcinoma de células renales, tras la cirugía con intención curativa y sin enfermedad residual, basándonos en 274 pacientes tratados con nefrectomía en el Hospital Universitario Miguel Servet de Zaragoza, (años 1985 2004). Variables estudiadas: sexo, edad, hematocrito y hemoglobina según sexo, hábito tabáquico, motivo de consulta, tamaño tumoral, estadio, invasión suprarrenal, localización, técnica quirúrgica, tipo celular, grado de Fuhrman, invasión microscópica de cápsula, vasos, linfáticos, o vía urinaria, y necrosis. Variable resultado: cualquier tipo de progresión. Se calculan: curvas de Kaplan-Meyer y regresión uni y multivariante de Cox. Tasa de progresión: 12,1% (33/274). Mediana de seguimiento, 4,40 años. Tiempo mediano hasta progresión: 1,99 años. Factores pronósticos que componen el modelo predictivo definitivo: Hábito tabáquico, hematuria macroscópica, tamaño tumoral > 6,5 cm., pT3, tipo sarcomatoide, edad > 55 años. Calibración (Shrinkage 0,81), discriminación (C-índex Gönen-Heller 0,73).
Published: 2008

38. Predetermining value analysis of the prehospital phase procedures in trauma victims survival

Author: Regina Marcia Cardoso de Sousa and Marisa Aparecida Amaro Malvestio
Subjects: traffic, assistência pré-hospitalar, Adult, Male, Emergency Medical Services, modelos de riesgos proporcionales, proportional hazards model, accidents, Accidents, Traffic, assistencia prehospitalaria, Kaplan-Meier Estimate, accidentes de tránsito, Life Support Care, Catchment Area, Health, acidentes de trânsito, Humans, Wounds and Injuries, Female, modelos de riscos proporcionais, prehospitalcare, General Nursing, Brazil, Retrospective Studies
Abstract: The aim of this study was to analyze the determining value of the procedures carried out during prehospital care in the survival time of traffic accident victims. Data of 175 victims with Revised Trauma Score £ 11, cared for and transported by advanced life support to tertiary referral hospitals, were submitted to Kaplan-Meier Survival Analysis and to Cox proportional hazards model. Four procedure groups associated with survival were identified: basic circulatory; advanced respiratory; volume replaced and medication. Until hospital discharge, the victims who underwent orotracheal intubation and chest compressions showed 3.6 and 6.4 times higher death hazards, respectively. The need for definitive airway and cardiopulmonary resuscitation in the prehospital phase was predetermining with higher death hazard. The less than 1000ml intravenous fluid replacement was the only predetermining factor with protective power against death hazard. La propuesta de este estudio fue analizar el valor determinante de los procedimientos realizados durante la atención prehospitalaria en el tiempo de sobrevivencia de víctimas de accidentes de tránsito. Datos de 175 víctimas con Revised Trauma Score < 11, atendidas y transportadas por el soporte avanzado a la vida a hospitales terciarios, fueron sometidos al análisis de sobrevivencia de Kaplan Méier y al análisis de Riesgos Proporcionales de Cox. Se identificaron 4 grupos de procedimientos asociados a la sobrevivencia: circulatorios básicos; respiratorios avanzados; volumen repuesto y medicamentos. Hasta el alta hospitalaria, las víctimas sometidas a la intubación orotraqueal y compresiones toráxicas presentaron 3,6 y 6,4 veces mayor riesgo de muerte, respectivamente. La necesidad de mantener la vía aérea definitiva permeable y hacer reanimación cardiorrespiratoria en la fase prehospitalaria fue predeterminante de un mayor riesgo de muerte. La reposición de volumen inferior a 1000ml fue el único factor predeterminante con fuerza protectora para el riesgo de muerte. A proposta deste estudo foi analisar o valor predeterminante dos procedimentos realizados, durante o atendimento pré-hospitalar no tempo de sobrevivência de vítimas de acidentes de trânsito. Dados de 175 vítimas com Revised Trauma Score < 11, atendidas e transportadas pelo suporte avançado à vida a hospitais terciários, foram submetidas à Análise de Sobrevivência de Kaplan Méier e à Análise de Riscos Proporcionais de Cox. Identificou-se 4 grupos de procedimentos associados à sobrevivência: circulatórios básicos; respiratórios avançados; volume reposto e medicamentos. Até a alta hospitalar, as vítimas, submetidas à entubação orotraqueal e compressões torácicas, apresentaram 3,6 e 6,4 vezes maior risco para o óbito, respectivamente. A necessidade de realização de via aérea definitiva e de reanimação cardiorrespiratória na fase pré-hospitalar foi predeterminante de maior risco para o óbito. A reposição de volume inferior a 1000ml foi o único fator predeterminante com força protetora para o risco de óbito.
Published: 2007

39. La edad como escala de tiempo en el análisis de la supervivencia por trastornos crónicos

Author: Rius Gibert, Cristina and Pérez Albarracín, Gloria
Subjects: Análisis de supervivencia, Estudios de cohortes, Cohort studies, Chronic diseases cofounder, Trastornos crónicos, Survival analysis, Modelos de riesgos proporcionales, Proportional hazard models, Factores confusores
Abstract: Fundamento: El análisis de supervivencia de estudios de cohortes no tiene en cuenta la edad a la que un individuo muere sino durante el cual ha estado siendo incluido en el seguimiento. El objetivo de este trabajo es valorar las diferencias que resultan en el cálculo del riesgo relativo cuando se utiliza la edad en lugar de seguimiento como escala de tiempo en el análisis de supervivencia de los trastornos crónicos. Métodos: Se analizan los datos de la cohorte de seguimiento de 5 años de la encuesta de salud de Cataluña (COHESCA). Se ajustan modelos de Cox con el tiempo de seguimiento (enfoque «habitual») y la edad (enfoque «alternativo») como escala de tiempo. Como principal covariable se usa el índice de comorbilidad y se ajusta por variables demográficas, estilos de vida y salud auto-percibida. Resultados: En los hombres de 40-64 años en el enfoque "habitual" no se observa aumento significativo del riesgo relativo de morir. En las mujeres de 40-64 años con puntuación 3-4 del índice hay un incremento significativo del riesgo relativo. En las personas mayores de 64 años se observa un aumento significativo del riesgo para la puntuación 3-4 [RRhombres=2,1 (1,3-2,5); RRmujeres=2,1 (1,2-3,7)] y > o = 5 del índice (RRhombres=3,4 (1,7-6,9); RRmujeres=4,0 (2,1-7,7). En el enfoque «alternativo», el riesgo relativo fue de 1,0 (0,7-1,4) en los hombres con una puntuación de 1-2, 1,5 (1,0-2,3) para los de 3-4 y 2,6 (1,4-4,9) para los de > o = 5. En las mujeres, los RR fueron respectivamente 0,8 (0,5-1,2), 1,7 (1,1-2,7) y 2,6 (1,5-4,8). Conclusiones: Ambos enfoques muestran un aumento del riesgo relativo según el índice de comorbilidad. Sin embargo, en el enfoque «alternativo», se ajusta por el efecto confundidor de la edad. Background: Cohort study survival analysis does not take into account the age at which an individual dies, but rather the age throughout which the individual has been included in the follow-up. This study is aimed at assessing the resulting differences in the calculation of the relative risk (RR) when the age is used instead of follow-up as a timescale in the chronic diseases survival analysis. Methods: The five-year cohort follow-up data for the Catalan Health Interview Survey (COHESCA) is analyzed. Cox models are adjusted to the follow-up time («standard» approach) and the age («alternative» approach) as the timescale. The main covariable used is the comorbility index, which is adjusted by demographics, lifestyles and self-perceived health. Results: Among men in the 40-64 age range, using the «standard» approach, no significant increase in the RR of death was found. Among women within the 40-64 age range with a 3-4 score on the index, there was a significant increase in the RR. Among those over age 64, a significant increase in the risk was found for the 3-4 score (RRmen= 2.1(1.3-2.5); RRwomen=2.1(1.2-3.7)) and > or = 5 on the index (RRmen= 3.4(1.7-6.9); RRwomen=4.0(2.1-7.7)). Using the «alternative» approach, the RR was 1.0 (0.7-1.4) among men with a score of 1-2, 1.5 (1.0-2.3) for those with a score of 3-4 and 2.6 (1.4-4.9) for those with a score of > or = 5. Among women, the RR were respectively 0.8 (0.5-1.2), 1.7 (1.1-2.7) and 2.6 (1.5-4.8). Conclusions: Both approaches showed an increase in the RR according to the comorbility index. However, in the «alternative» approach, it is adjusted by the confounding effect of age.
Published: 2006

40. La edad como escala de tiempo en el análisis de la supervivencia por trastornos crónicos

Author: Cristina Rius Gibert and Gloria Pérez Albarracín
Subjects: Análisis de supervivencia, lcsh:Public aspects of medicine, lcsh:R, Estudios de cohortes, lcsh:Medicine, lcsh:RA1-1270, General Medicine, Trastornos crónicos, Modelos de riesgos proporcionales, Factores confusores
Abstract: Fundamento: El análisis de supervivencia de estudios de cohortes no tiene en cuenta la edad a la que un individuo muere sino durante el cual ha estado siendo incluido en el seguimiento. El objetivo de este trabajo es valorar las diferencias que resultan en el cálculo del riesgo relativo cuando se utiliza la edad en lugar de seguimiento como escala de tiempo en el análisis de supervivencia de los trastornos crónicos. Métodos: Se analizan los datos de la cohorte de seguimiento de 5 años de la encuesta de salud de Cataluña (COHESCA). Se ajustan modelos de Cox con el tiempo de seguimiento (enfoque «habitual») y la edad (enfoque «alternativo») como escala de tiempo. Como principal covariable se usa el índice de comorbilidad y se ajusta por variables demográficas, estilos de vida y salud auto-percibida. Resultados: En los hombres de 40-64 años en el enfoque "habitual" no se observa aumento significativo del riesgo relativo de morir. En las mujeres de 40-64 años con puntuación 3-4 del índice hay un incremento significativo del riesgo relativo. En las personas mayores de 64 años se observa un aumento significativo del riesgo para la puntuación 3-4 [RRhombres=2,1 (1,3-2,5); RRmujeres=2,1 (1,2-3,7)] y > o = 5 del índice (RRhombres=3,4 (1,7-6,9); RRmujeres=4,0 (2,1-7,7). En el enfoque «alternativo», el riesgo relativo fue de 1,0 (0,7-1,4) en los hombres con una puntuación de 1-2, 1,5 (1,0-2,3) para los de 3-4 y 2,6 (1,4-4,9) para los de > o = 5. En las mujeres, los RR fueron respectivamente 0,8 (0,5-1,2), 1,7 (1,1-2,7) y 2,6 (1,5-4,8). Conclusiones: Ambos enfoques muestran un aumento del riesgo relativo según el índice de comorbilidad. Sin embargo, en el enfoque «alternativo», se ajusta por el efecto confundidor de la edad.
Published: 2006

41. La edad como escala de tiempo en el análisis de la supervivencia por trastornos crónicos

Author: Pérez, Gloria, Rius Gibert, Cristina, Pérez, Gloria, and Rius Gibert, Cristina
Abstract: Fundamento: El análisis de supervivencia de estudios de cohortes no tiene en cuenta la edad a la que un individuo muere sino durante el cual ha estado siendo incluido en el seguimiento. El objetivo de este trabajo es valorar las diferencias que resultan en el cálculo del riesgo relativo cuando se utiliza la edad en lugar de seguimiento como escala de tiempo en el análisis de supervivencia de los trastornos crónicos. Métodos: Se analizan los datos de la cohorte de seguimiento de 5 años de la encuesta de salud de Cataluña (COHESCA). Se ajustan modelos de Cox con el tiempo de seguimiento (enfoque «habitual») y la edad (enfoque «alternativo») como escala de tiempo. Como principal covariable se usa el índice de comorbilidad y se ajusta por variables demográficas, estilos de vida y salud auto-percibida. Resultados: En los hombres de 40-64 años en el enfoque "habitual" no se observa aumento significativo del riesgo relativo de morir. En las mujeres de 40-64 años con puntuación 3-4 del índice hay un incremento significativo del riesgo relativo. En las personas mayores de 64 años se observa un aumento significativo del riesgo para la puntuación 3-4 [RRhombres=2,1 (1,3-2,5); RRmujeres=2,1 (1,2-3,7)] y >=5 del índice (RRhombres=3,4 (1,7-6,9); RRmujeres=4,0 (2,1-7,7). En el enfoque «alternativo», el riesgo relativo fue de 1,0 (0,7-1,4) en los hombres con una puntuación de 1-2, 1,5 (1,0-2,3) para los de 3-4 y 2,6 (1,4-4,9) para los de >=5. En las mujeres, los RR fueron respectivamente 0,8 (0,5-1,2), 1,7 (1,1-2,7) y 2,6 (1,5-4,8). Conclusiones: Ambos enfoques muestran un aumento del riesgo relativo según el índice de comorbilidad. Sin embargo, en el enfoque «alternativo», se ajusta por el efecto confundidor de la edad.
Published: 2006

42. Rates of, and risk factors for, severe infections in patients with systemic autoimmune diseases receiving biological agents off-label

Author: Diaz-Lagares, Candido, Perez-Alvarez, Roberto, Garcia-Hernandez, Francisco J., Ayala-Gutierrez, Maria M., Luis Callejas, Jose, Martinez-Berriotxoa, Agustin, Rascon, Javier, Caminal-Montero, Luis, Selva-O'Callaghan, Albert, Oristrell, Joaquim, Hidalgo, Carmen, Gomez-de-la-Torre, Ricardo, Saez, Luis, Canora-Lebrato, Jesus, Camps, Maria-Teresa, Ortego-Centeno, Norberto, Castillo-Palma, Maria-Jesus, Ramos-Casals, Manuel, and BIOGEAS Study Grp
Subjects: Male, modelos de riesgos proporcionales, humanos, enfermedades autoinmunes, adolescente, Kaplan-Meier Estimate, vasculitis, Etanercept, rituximab, Infection rate, systemic lupus erythematosus, Risk Factors, adalimumab, Immunology and Allergy, Sjogren syndrome, Young adult, mediana edad, Aged, 80 and over, anciano, Middle Aged, adulto, adulto joven, Female, productos biológicos, Rituximab, prescripción en indicaciones no aprobadas, Infection, Vasculitis, Research Article, medicine.drug, Adult, estimación de Kaplan-Meier, medicine.medical_specialty, Adolescent, Immunology, macromolecular substances, Infections, Autoimmune Diseases, Young Adult, Rheumatology, Internal medicine, Adalimumab, medicine, Humans, factores de riesgo, Aged, Proportional Hazards Models, Biological Products, business.industry, Off-Label Use, infección, medicine.disease, Sjögren syndrome, Infliximab, Observational study, infliximab, business, etanercept
Abstract: Introduction: The purpose of this observational study was to analyze the rates, characteristics and associated risk factors of severe infections in patients with systemic autoimmune diseases (SAD) who were treated off-label with biological agents in daily practice. Methods: The BIOGEAS registry is an ongoing Spanish prospective cohort study investigating the long-term safety and efficacy of the off-label use of biological agents in adult patients with severe, refractory SAD. Severe infections were defined according to previous studies as those that required intravenous treatment or that led to hospitalization or death. Patients contributed person-years of follow-up for the period in which they were treated with biological agents. Results: A total of 344 patients with SAD treated with biological agents off-label were included in the Registry until July 2010. The first biological therapies included rituximab in 264 (77%) patients, infliximab in 37 (11%), etanercept in 21 (6%), adalimumab in 19 (5%), and 'other' agents in 3 (1%). Forty-five severe infections occurred in 37 patients after a mean follow-up of 26.76 months. These infections resulted in four deaths. The crude rate of severe infections was 90.9 events/1000 person-years (112.5 for rituximab, 76.9 for infliximab, 66.9 for adalimumab and 30.5 for etanercept respectively). In patients treated with more than two courses of rituximab, the crude rate of severe infection was 226.4 events/1000 person-years. A pathogen was identified in 24 (53%) severe infections. The most common sites of severe infection were the lower respiratory tract (39%), bacteremia/sepsis (20%) and the urinary tract (16%). There were no significant differences relating to gender, SAD, agent, other previous therapies, number of previous immunosuppressive agents received or other therapies administered concomitantly. Cox regression analysis showed that age (P = 0.015) was independently associated with an increased risk of severe infection. Survival curves showed a lower survival rate in patients with severe infections (log-rank and Breslow tests < 0.001). Conclusions: The rates of severe infections in SAD patients with severe, refractory disease treated depended on the biological agent used, with the highest rates being observed for rituximab and the lowest for etanercept. The rate of infection was especially high in patients receiving three or more courses of rituximab. In patients with severe infections, survival was significantly reduced. Older age was the only significant predictive factor of severe infection., The BIOGEAS Study group has received educational grants from Roche and Abbott supporting the design and maintenance of the webpage [35]. All authors have declared no conflicts of interest. None has received grants from these laboratories or conducted clinical trials with rituximab or etanercept as principal investigators or received honoraria as an Advisory Board member for Roche and Abbott. The financial support of Roche and Abbott is exclusively limited to maintaining the BIOGEAS webpage.
Published: 2011
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43. [Use of multiple regression models in observational studies (1970-2013) and requirements of the STROBE guidelines in Spanish scientific journals].

Author: Real J, Cleries R, Forné C, Roso-Llorach A, and Martínez-Sánchez JM
Subjects: Data Interpretation, Statistical, Observational Studies as Topic standards, Poisson Distribution, PubMed, Spain, Bibliometrics, Editorial Policies, Guidelines as Topic, Multivariate Analysis, Observational Studies as Topic methods, Periodicals as Topic standards, Regression Analysis
Abstract: Background: In medicine and biomedical research, statistical techniques like logistic, linear, Cox and Poisson regression are widely known. The main objective is to describe the evolution of multivariate techniques used in observational studies indexed in PubMed (1970-2013), and to check the requirements of the STROBE guidelines in the author guidelines in Spanish journals indexed in PubMed., Methods: A targeted PubMed search was performed to identify papers that used logistic linear Cox and Poisson models. Furthermore, a review was also made of the author guidelines of journals published in Spain and indexed in PubMed and Web of Science., Results: Only 6.1% of the indexed manuscripts included a term related to multivariate analysis, increasing from 0.14% in 1980 to 12.3% in 2013. In 2013, 6.7, 2.5, 3.5, and 0.31% of the manuscripts contained terms related to logistic, linear, Cox and Poisson regression, respectively. On the other hand, 12.8% of journals author guidelines explicitly recommend to follow the STROBE guidelines, and 35.9% recommend the CONSORT guideline., Conclusions: A low percentage of Spanish scientific journals indexed in PubMed include the STROBE statement requirement in the author guidelines. Multivariate regression models in published observational studies such as logistic regression, linear, Cox and Poisson are increasingly used both at international level, as well as in journals published in Spanish., (Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)
Published: 2016
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44. Effectiveness and safety of different azacitidine dosage regimens in patients with myelodysplastic syndromes or acute myeloid leukemia

Author: Garcia-Delgado, Regina, de Miguel, Dunia, Bailen, Alicia, Ramon Gonzalez, Jose, Bargay, Joan, Falantes, Jose F., Andreu, Rafael, Fernando, Ramosh, Tormo, Mar, Brunet, Salut, Figueredo, Antonio, Casano, Javier, Medina, Angeles, Badiella, Llorenc, Fernandez Jurado, Antonio, Sanz, Guillermo, and Asociacion Andaluza de Hematologia
Subjects: Oncology, Adult, Male, Cancer Research, medicine.medical_specialty, Antimetabolites, Antineoplastic, Antimetabolites, modelos de riesgos proporcionales, azacitidina, Azacitidine, humanos, Myelodysplastic syndromes, Pharmacology, Neutropenia, síndromes mielodisplásicos, Internal medicine, Dosing schedules, medicine, Overall survival, Humans, In patient, Adverse effect, mediana edad, leucemia, Aged, Proportional Hazards Models, Retrospective Studies, Aged, 80 and over, anciano, Leukemia, Acute myeloid leukemia, business.industry, estudios retrospectivos, antimetabolitos, Myeloid leukemia, Hematology, adulto, Middle Aged, medicine.disease, Leukemia, Myeloid, Acute, Tolerability, Female, Safety, business, medicine.drug
Abstract: We investigated the effectiveness and tolerability of azacitidine in patients with World Health Organization-defined myelodysplastic syndromes, or acute myeloid leukemia with 20-30% bone marrow blasts. Patients were treated with azacitidine, with one of three dosage regimens: for 5 days (AZA 5); 7 days including a 2-day break (AZA 5-2-2); or 7 days (AZA 7); all 28-day cycles. Overall response rates were 39.4%, 67.9%, and 51.3%, respectively, and median overall survival (OS) durations were 13.2, 19.1, and 14.9 months. Neutropenia was the most common grade 3-4 adverse event. These results suggest better effectiveness-tolerability profiles for 7-day schedules., The authors received editorial/writing support provided by Christian Geest, PhD, from Excerpta Medica, funded by Celgene Corporation. The authors had full access to the data and are fully responsible for content and editorial decisions for this manuscript.
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45. Dietary α-Linolenic Acid, Marine ω-3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study

Author: Sala-Vila, A., Guasch-Ferré, Marta, Hu, F.B., Sánchez-Tainta, A., Bulló, M., Serra-Mir, M., López-Sabater, C., Sorlí, J.V., Arós, F., Fiol, M., Muñoz, M.A., Riera, C., Francés, F., Vinyoles, E., Guarner, A., Márquez, F., Guillén, M., Rovira, M.A., Piñol, J.L., Sacanella, E., Basora, T., García, Y., Rovira, A., Santamaría, M.I., Mata, M., de Juan, C., Ruiz-Gutiérrez, Valentina, Pages, M.A., Brau, A., Urtasun-Samper, A., Ruano, C., Tresserra-Rimbau, A., de Santamaría, L., Llopis-Osorio, E., Marti, A., Chiva, G., Moñino, M., Mitjavila, M.T., Valderas, P., Arranz, S., Carrasco, P., Alonso Gómez, A., Galera, A., Alonso, A., Baena, J.M., Basterra-Gortari, F. Javier, Carratalá-Calvo, A., Gil Zarzosa, J., García, M., Pérez-Heras, A., Frontera, G., Oller, M., Benavent, J., Gea, A., Ginard, M., Amat, J., Gueto Rubio, M.V., Diaz-López, A., Clos, J., Pla, I., Amorós, M., Bonet, M.T., Baby, P., de la Torre, Rafael, Martín, M.T., Lapetra, José, Lamuela-Raventós, Rosa M., García-Valdueza, M., Sánchez, M.S., Martin, F., Macías-Gutiérrez, B., Altirriba, J., Tort, R., Isach, A., Fitó, Montserrat, Sarmiendo De La Fe, F., Romero, S., Costa, B., Elosúa, R., García, L., Cabré, J.J., Babio, N., Santana-Santana, A.J., Fernández-Ballart, J., Hernández, J.M., García García, M., Ibarrola-Jurado, Nuria, San Vicente, J., Toledo, E., Buil-Cosiales, P., Ruiz-Canela, M., Vargas López, E., Simón, C., de Diego Salas, J., Sanjulián, B., Felipe, I., Falcón-Sanabria, I., Serra-Majem, L., Trias, F., Díez-Espino, Javier, Viñas, C., Martínez, E., Extremera-Urabayen, V., Núñez-Córdoba, J.M., Proenza, A., Santos, J.M., García-Arellano, A., Marrugat, J., González, J.I., Ferrer, M., Arroyo-Azpa, C., García-Pérez, L., Villanueva-Tellería, J., Cortés-Ugalde, F., Gilabert, R., de la Cruz, E., Sagredo-Arce, T., Ros, E., Duaso, I., Jurado-Ruíz, Enrique, Sarasa, I., De La Noceda-Montoy, M.D.G., Saiz, C., Mengual, L., Vigata-López, M.D., Portolés, O., Giménez, F.J., Montero Romero, Emilio, Verdú, J.M., Martínez, P., Coltell, O., Ortiz, A.P., Soler, Y., Cofán, M., Guillem-Saiz, P., Osma, R., Yuste, M.C., Quiles, L., Ruiz-Baixauli, J., Estruch, R., Pascual, V., Baca Osorio, A., Fiol, F., Bertolín-Muñoz, A., Salaverría, I., del Hierro, T., Corella, D., Razquin, C., Portillo, M.P., Algorta, J., Sánchez Luque, J.J., Ramos, A., Francisco, S., Jover, A., Parra, L., García, J., Covas, María Isabel, Medina-Remón, Alexander, Iglesias, C., Tello, S., Sáez, G., Zazpe, I., Salas-Salvadó, J., Prieto, R., Liroz, M., Vila, J., Álvarez-Pérez, J., Molina, C., Schröder, H., Díaz Benítez, E., Bautista-Castaño, Inmaculada, Martínez-González, M.A., Doménech, M., Godoy, D., Manzano, E., Maldonado-Díaz, I., Flores, G., Quinzavos, L., Churio-Beraza, B., Sánchez-Villegas, A., Barragán, R., Sorli, M., Castro, I., Gómez-Gracia, Enrique, Roura, P., García Roselló, J., Henríquez, P., Tur, J., Ortega-Calvo, M., Fernández-Crehuet, Joaquín, Benítez Pont, R., Bianchi Alba, M., Wärnberg, J., Loma-Osorio, A., Alegret, C., Gómez-Huelgas, R., Asensio, E.M., Alfredo Martínez, J., Bargalló, N., Martínez-González, J., Román, P., Bes-Rastrollo, M., Velasco García, V., García, F.José, Iglesias, P., González, R., Goñi, E., Muñoz-Aguayo, Daniel, Corchado, Y., Millán, S., Sanz, E., Mayoral, E., Leal, M., Martínez-Lapiscina, E.H., Lama, C., Padres, E., Ortega-Azorín, C., Pintó, Xavier, Altés, A., Figueras, R., Solanich, X., Pujol, R., Castellote-Bargalló, A. I., Simón-García, C., Arceiz Campo, M.T., Corbella, E., Valls-Pedret, C., Serrano-Martínez, M., Casas, R., Martín-Rillo, M.J., Cabezas, C., Universitat de Barcelona, Instituto de Salud Carlos III, Centro Nacional de Investigaciones Cardiovasculares (España), and Ministerio de Ciencia e Innovación (España)
Subjects: Male, Gerontology, Time Factors, Epidemiology, modelos de riesgos proporcionales, humanos, 030204 cardiovascular system & hematology, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, estudios prospectivos, evaluación de riesgos, Medicine, Nuts, Sudden cardian death, 030212 general & internal medicine, Food science, Longitudinal Studies, Prospective Studies, mediana edad, Original Research, Diet and Nutrition, Aged, 80 and over, chemistry.chemical_classification, education.field_of_study, anciano, alpha-Linolenic acid, dieta, Factors de risc en les malalties, Hàbits alimentaris, Fatty Acids, ω-3 fatty acids, Fatty acids in human nutrition, alpha-Linolenic Acid, distribución de la ji al cuadrado, Middle Aged, Cardiovascular system, nutrition, Cardiovascular Diseases, Female, Dieta, Cardiology and Cardiovascular Medicine, Nutritive Value, conducta de reducción del riesgo, Risk factors in diseases, Food habits, Population, enfermedades cardiovasculares, 030209 endocrinology & metabolism, Juglans, Risk Assessment, sudden cardiac death, 03 medical and health sciences, alimentos del mar, factores de tiempo, Mediterranean cooking, Àcids grassos en la nutrició, Fatty Acids, Omega-3, Cuina mediterrània, Peix com a aliment, Humans, factores de riesgo, análisis multifactorial, education, Olive Oil, Dieta -- Mediterrània, Regió de la, Dieta mediterranea, ácidos grasos, α-linolenic acid, Aged, Proportional Hazards Models, Sistema cardiovascular, Chi-Square Distribution, business.industry, Correction, Fatty acid, Hàbits alimentaris -- Mediterrània, Regió de la, Protective Factors, Fish consumption, Predimed, Diet, nueces, chemistry, Seafood, Spain, Multivariate Analysis, valor nutritivo, estudios longitudinales, fatty acid, business, Risk Reduction Behavior, ácido alfa-linolénico
Abstract: 12 Páginas.-- 6 Tablas.-- 1 Figura, Background-Epidemiological evidence suggests a cardioprotective role of α-linolenic acid (ALA), a plant-derived ω-3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω-3 fatty acids (long-chain n-3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all-cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long-chain n-3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results-We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable-adjusted Cox regressionmodels were fitted to estimate hazard ratios. ALA intake correlated towalnut consumption (r=0.94). During a 5.9-y follow-up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios formeeting ALArecommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56-0.92) for all-causemortality and 0.95 (95% CI 0.58-1.57) for fatal cardiovascular disease. The hazard ratios formeeting the recommendation for long-chain n-3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67-1.05) for all-causemortality, 0.61 (95% CI 0.39-0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29-0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22-1.01) for sudden cardiac death. The highest reduction in all-cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45-0.87]). Conclusions-In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all-cause mortality, whereas protection from cardiac mortality is limited to fish-derived long-chain n-3 polyunsaturated fatty acids., This study was funded in part by Instituto de Salud Carlos III (ISCIII) (Spanish Ministry of Economy) through grants RTIC G03/140, RTIC RD 06/0045, Centro Nacional de Investigaciones Cardiovasculares CNIC 06/2007, ISCIII FIS PS09/01292, the Spanish Ministry of Science and Innovation (MICINN) AGL2010‐22319‐C03‐02 and AGL2009‐13906‐C02‐02, and an unrestricted grant from the California Walnut Commission. Sala‐Vila holds a Miguel Servet I fellowship from the Ministry of Economy and Competitiveness through the ISCIII.

46. Granulocyte colony-stimulating factor in the treatment of high-risk febrile neutropenia: A multicenter randomized trial

Author: Luis Paz-Ares, Antonio Rueda, Carlos Lage Gómez, Carlos Lumbreras, Jose Luis Perez-Gracia, Hernán Cortés-Funes, A. Yubero, María Victoria Tornamira, Marta López-Brea, Alberto Arcediano, Rocio Garcia-Carbonero, Vicente Guillem, Alejandro Tres, Javier Hornedo, Fernando Ribera, Jose I. Mayordomo, [García-Carbonero,R, Tornamira,MV, Arcediano,A, Gómez,C, Pérez-Gracia,JL, Hornedo,J, Cortés-Funes,H, Paz-Ares,L] Division of Medical Oncology, Hospital Universitario Doce de Octubre, Madrid, Spain. [Mayordomo,JI, Yubero,A, Trés,A] Division of Medical Oncology, Hospital Clínico, Zaragoza, Spain. [López-Brea,M, and Rivera,F] Division of Medical Oncology, Hospital M. Valdecilla, Santander, Spain. [Rueda Domínguez,A] Division of Medical Oncology, Hospital Universitario Virgen de la Victoria, Málaga, Spain. [Guillém,V] Division of Medical Oncology, Instituto Valenciano de Oncologia, Valencia, Spain. [Lumbreras,C] Division of Infectious Diseases, Hospital Universitario Doce de Octubre, Madrid, Spain.
Subjects: Male, Cancer Research, Time Factors, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings], Phenomena and Processes::Physical Phenomena::Time::Time Factors [Medical Subject Headings], Cost-Benefit Analysis, España, Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Peptides::Intercellular Signaling Peptides and Proteins::Cytokines::Hematopoietic Cell Growth Factors::Colony-Stimulating Factors::Granulocyte Colony-Stimulating Factor [Medical Subject Headings], Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Temperature Changes::Fever [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Neoplasms, Antineoplastic Combined Chemotherapy Protocols, Granulocyte Colony-Stimulating Factor, Medicine, Prospective Studies, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Clinical Protocols::Antineoplastic Protocols::Antineoplastic Combined Chemotherapy Protocols [Medical Subject Headings], Geographicals::Geographic Locations::Europe::Spain [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Administration Schedule [Medical Subject Headings], Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Survival Analysis [Medical Subject Headings], Leukopenia, Diseases::Neoplasms [Medical Subject Headings], Middle Aged, Chemotherapy regimen, Neoplasias, Granulocyte colony-stimulating factor, Anti-Bacterial Agents, Treatment Outcome, Antibacterianos, Oncology, Amikacin, Absolute neutrophil count, Diseases::Hemic and Lymphatic Diseases::Hematologic Diseases::Leukocyte Disorders::Leukopenia::Agranulocytosis::Neutropenia [Medical Subject Headings], Female, medicine.symptom, Análisis Costo-Beneficio, Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents [Medical Subject Headings], medicine.drug, Protocolos de Quimioterapia Combinada Antineoplásica, medicine.medical_specialty, Neutropenia, Fever, Análisis de Supervivencia, Resultado del Tratamiento, Check Tags::Male [Medical Subject Headings], Drug Administration Schedule, Health Care::Health Care Economics and Organizations::Economics::Costs and Cost Analysis::Cost-Benefit Analysis [Medical Subject Headings], Internal medicine, Humans, Health Care::Health Care Facilities, Manpower, and Services::Health Services::Patient Care::Hospitalization::Length of Stay [Medical Subject Headings], Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Aged, Proportional Hazards Models, Performance status, business.industry, Esquema de Medicación, Length of Stay, medicine.disease, Survival Analysis, Surgery, Factor Estimulante de Colonias de Granulocitos, Check Tags::Female [Medical Subject Headings], Spain, Health Care::Health Services Administration::Quality of Health Care::Outcome and Process Assessment (Health Care)::Outcome Assessment (Health Care)::Treatment Outcome [Medical Subject Headings], Modelos de Riesgos Proporcionales, business, Fiebre, Factores de Tiempo, Febrile neutropenia, Tiempo de Internación
Abstract: Presented in part at the 35th American Society of Clinical Oncology meeting. Atlanta (GA); 1999. Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; BACKGROUND Granulocyte colony-stimulating factors (G-CSFs) have been shown to help prevent febrile neutropenia in certain subgroups of cancer patients undergoing chemotherapy, but their role in treating febrile neutropenia is controversial. The purpose of our study was to evaluate-in a prospective multicenter randomized clinical trial-the efficacy of adding G-CSF to broad-spectrum antibiotic treatment of patients with solid tumors and high-risk febrile neutropenia. METHODS A total of 210 patients with solid tumors treated with conventional-dose chemotherapy who presented with fever and grade IV neutropenia were considered to be eligible for the trial. They met at least one of the following high-risk criteria: profound neutropenia (absolute neutrophil count

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