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Purpose: To evaluate the association between ejaculation frequency (EF) during four stages of life and prostate cancer (PCa) according to tumor aggressiveness, PCa stage, and urinary symptomatology. Materials and Methods: A total of 456 incident PCa cases histologically confirmed, and 427 controls aged 40–80 years from the CAPLIFE study were analyzed. This study is a population-based case-control study carried out in the south of Spain. Average EF was measured for: (1) 20s, (2) 30s, (3) 40s, and (4) one year before the interview. EF was categorized into: (1) 0–3, (2) 4, and (3) >4 ejaculations/month. Sociodemographic, lifestyle, and medical information were also collected. To estimate the association between EF and PCa, adjusted ORs (aORs) and 95% CIs were calculated by logistic regression models. Results: A year before the interview, PCa cases ejaculated less frequently than the controls. An inverse association was observed between the EF a year before and PCa, aOR=1.64 (95% CI 1.03–2.61) for men with 4 ejaculations/month, and aOR=2.38 (95% CI 1.57–3.60) for men with 0–3 ejaculations/month, compared to men with >4. The association was higher for cases with ISUP 3–5 (aOR=2.76 [95% CI 1.34–5.67] for men with 0–3 ejaculations/month) or with a locally advancedmetastatic tumor (aOR=4.70 [95% CI 1.55–14.29]). Moreover, men with moderate urinary symptoms and 0–3 ejaculations/ month had the highest risk, aOR=3.83 (95% CI 1.84–7.95). Conclusions: A low EF could be associated with a higher risk of PCa, especially for cases with ISUP 3–5 or with a locally advanced-metastatic tumor. [ABSTRACT FROM AUTHOR]

Background: Mothers and their offspring may benefit from lifestyle interventions during pregnancy. We systematically reviewed the literature to map and evaluate the quality of long-term offspring outcomes in follow-up cohorts of randomised controlled trials (RCTs). Methods: We searched MEDLINE, EMBASE, CINAHL, Database of Abstracts of Reviews of Effects and Cochrane Central (until March 2019) for all RCTs evaluating any lifestyle (diet or exercise) intervention during pregnancy and their follow-up cohorts. Two reviews evaluated the extracted outcomes using two standardised assessment tools, one for quality of reporting (score range 0–6) and another for the variation in outcome selection. We extracted data in duplicate and reported using natural frequencies, medians, ranges, means and standard deviation (SD). Results: We captured 30 long-term offspring outcomes reported in six articles (four studies). Offspring anthropometric measurements were the most commonly reported outcomes. There was a large variation in the measurement tools used. The mean overall quality score for outcome reporting was 3.33 (SD 1.24), with poor reporting of secondary outcomes and limited justification for the choice of the reported outcomes. Most studies showed selective reporting for both their primary and secondary outcomes. Conclusion: The quality of reporting for long-term offspring outcomes following lifestyle interventions in pregnancy is varied with evidence of selective outcome reporting. Developing a core outcome set will help to reduce the variations in outcome reporting to optimise future research. [ABSTRACT FROM AUTHOR]

Several epidemiologic studies and clinical trials have demonstrated the value of balanced nutrition during pregnancy. This study aimed to examine the degree of adherence to nutritional recommendations among 1,175 pregnant Spanish women and the factors associated with such adherence to pre-pregnancy and during the first half of pregnancy. Data were collected during June 2004-March 2007 and included socio-demographic and lifestyle factors. Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were computed using logistic regression models to identify factors associated with adherence to dietary recommendations. Before pregnancy, slightly less than one quarter of the pregnant women (21 percent) did not meet the recommended intake of both vegetables and cereals, and 50 percent did not meet the recommended intake of fruits. Yet most of the participants exceeded the recommended values for proteins. During pregnancy, the adherence for all food types decreased. Factors associated with adherence to the nutritional recommendations were similar before and during pregnancy. Adherence to the Spanish Society of Community Nutrition dietary recommendations was lower among pregnant women who were younger, from a low social class, smokers, and had a low level of physical activity. These findings suggest that nutritional education should become an essential part of antenatal care. [ABSTRACT FROM AUTHOR]

Objective Understanding obesity misperception and associated factors can improve strategies to increase obesity identification and intervention. We investigate underestimation of child excess weight with a broader perspective, incorporating perceptions, views, and psychosocial aspects associated with obesity. Methods This study used cross-sectional data from the Spanish National Health Survey in 2011-2012 for children aged 2-14 years who are overweight or obese. Percentages of parental misperceived excess weight were calculated. Crude and adjusted analyses were performed for both child and parental factors analyzing associations with underestimation. Results Two-five year olds have the highest prevalence of misperceived overweight or obesity around 90%. In the 10-14 year old age group approximately 63% of overweight teens were misperceived as normal weight and 35.7 and 40% of obese males and females. Child gender did not affect underestimation, whereas a younger age did. Aspects of child social and mental health were associated with under-estimation, as was short sleep duration. Exercise, weekend TV and videogames, and food habits had no effect on underestimation. Fathers were more likely to misperceive their child´s weight status; however parent's age had no effect. Smokers and parents with excess weight were less likely to misperceive their child´s weight status. Parents being on a diet also decreased odds of underestimation. Conclusions for practice This study identifies some characteristics of both parents and children which are associated with under-estimation of child excess weight. These characteristics can be used for consideration in primary care, prevention strategies and for further research. [ABSTRACT FROM AUTHOR]

Background Inadequate maternal nutrition is regarded as one of the most important indicators of fetal growth. The aim of this study was to analyze the associated risk of having a small for gestational age (SGA) infant according to the mother's dairy intake during the first half of pregnancy. Methods A prospective cohort study was performed using 1175 healthy pregnant women selected from the catchment area of Virgen de las Nieves University Hospital, Granada (Spain). SGA was defined as neonates weighing less than the 10th percentile, adjusted for gestational age. Factors associated with SGA were analyzed using logistic regression models. Population attributable fractions of SGA according to dairy intake were estimated. Results Dairy intake among women who gave birth to SGA infants was 513.9, versus 590.3 g/day for women with appropriate size for gestational age infants ( P = 0.003). An increased intake of dairy products by 100 g/day during the first half of pregnancy decreased the risk of having a SGA infant by 11.0 %, aOR = 0.89 (0.83, 0.96). A dose-response gradient between dairy intake and SGA was observed. Conclusions An inadequate intake of dairy products is associated with a higher risk of SGA. Our results suggest a possible causal relation between dairy intake during pregnancy and the weight of the newborn, although we cannot discard residual confounding. These results should be further supported by properly designed studies. [ABSTRACT FROM AUTHOR]

Objective: Historical decreases in sleep duration in children have been documented worldwide; however, there is sparse information on sleep duration in differing cultural regions. We assess sleep duration and its trends for children in Spain from 1987 to 2011 and associated sociodemographic characteristics.Methods: Data from eight Spanish National Health Surveys, from 1987 to 2011, were collected on parent-reported sleep duration and associated socio-demographic characteristics including age, sex, parental level of education, child body mass index (BMI), and physical activity. A total of 24,867 children aged 2-14 years were included in the final sample.Results: Overall, short sleep duration increased to 44.7% from 29.8% in 1987. Decreasing sleep duration trends were found in all demographic groups, decreasing by around 20 minutes in 24 hours from 1987 to 2011; decreasing to 10 hours 16 minutes in 2- to 5-year olds, 9 hours 31 minutes in 6- to 9-year-olds, and 8 hours 52 minutes in 10- to 14-year-olds. No difference in sleep duration was found between girls and boys. Sleep duration was associated with year of survey, age, level of parental education, obesity, and exercise.Conclusions: Almost 45% of children in Spain are not sleeping the recommended amount. Regional differences in sleep attitudes and duration alongside a lack of consistency in cut-offs for age-appropriate ideal sleep in literature is a barrier for international comparison and highlights the need for research in physiological sleep requirements. With the association of short sleep duration with many different health outcomes, sleep should be considered as a modifiable lifestyle factor and a public health issue. [ABSTRACT FROM AUTHOR]

ObjectiveTo analyse the factors associated with the level of adherence to a Mediterranean dietary pattern in healthy Spanish women before pregnancy.DesignA prospective series of 1175 women. An FFQ validated in Spanish populations served to collect dietary data. The Mediterranean Diet Adherence Index was used to assess the level of adherence to a Mediterranean diet pattern. Polytomic regression was performed to identify the associated factors.SettingCatchment area of Virgen de las Nieves University Hospital, Andalusia, Spain.SubjectsThe women were invited to participate in the study at the 20th–22nd gestational week. The selection criteria were: Spanish nationality, 18 years of age or older, singleton pregnancy and absence of health problems that required modifying the diet or physical activity.ResultsAn inverse relationship was found between women's age and level of adherence to a Mediterranean diet pattern, with a clear dose–response association: a younger age entailed worse adherence (P < 0·001). The habit of smoking and sedentary lifestyle had a positive relationship with low adherence, giving OR = 5·36 (95 % 1·91, 15·07) for women who smoked >20 cigarettes/d and OR = 2·07 (95 % CI 1·34, 3·17) for sedentary women. Higher age, higher educational level, and higher social class of the women were associated with a higher level of adherence to the Mediterranean diet (P < 0·001).ConclusionsIn our sample population, younger age, lower social class, primary educational level and elements of an unhealthy lifestyle such as smoking and lack of exercise were associated with low adherence to a Mediterranean diet. [ABSTRACT FROM AUTHOR]

To quantify changes in leisure time physical activity (LTPA) type, frequency, duration and intensity during the first half of pregnancy as compared with the year prior to pregnancy. A cross sectional study was conducted at the Maternal University Hospital in Granada, Spain. A total of 1,175 healthy pregnant women attending a scheduled visit during the 20-22nd gestational week were enrolled in the study. Information about socio-demographic, obstetric and life-style variables during the previous year and the first half of pregnancy were collected. LTPA was quantified by assigning metabolic equivalents to each activity according to frequency, intensity and duration. The prevalence of women who met the optimal physical activity recommendations before and during pregnancy was calculated, and the McNemar-Bowker symmetry test was used to assess changes in type, frequency, intensity and duration of activities between the two periods. Some sort of LTPA was performed before and during pregnancy by 68.6 % of the pregnant women. Respectively, just 27.5 % and 19.4 % of women fulfilled LTPA recommendations prior to pregnancy and during pregnancy; 12.6 % of the women meeting recommendations prior to pregnancy later did not meet those recommendations during gestation, and 4.5 % showed the reverse trend. A light increase in walking as a LTPA, and a decrease in the rest of the LTPA type activities, were seen during pregnancy. Some 13.4 % of women changed from moderate-the year before- to light LTPA- during pregnancy. Pregnancy involved a decrease in LTPA, not only regarding frequency, but also duration and intensity. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To identify key factors involved in modifying leisure time physical activity (LTPA) during early pregnancy. Methods: A prospective study was conducted of 1175 pregnant women who attended a scheduled visit at Virgen de las Nieves University Hospital, Granada, Spain, at 20–22weeks of pregnancy. The Paffenbarger Physical Activity Questionnaire was used to collect data regarding participation in any LTPA or physical activity performed according to society recommendations during early pregnancy and in the year before pregnancy. A polytomous regression model was used to identify factors associated with LTPA. Results: Approximately 20.0% of the women did not engage in any LTPA, and 68.0% did not achieve the recommendations for exercise, either before or during pregnancy. Desirable changes related to performing any LTPA or the society recommendations for LTPA during pregnancy were associated with university level of education (aOR, 3.64 [95% CI, 1.54–8.56] and aOR, 1.75 [95% CI, 0.67–4.57], respectively) and smoking cessation at pregnancy (aOR, 2.05 [95% CI, 0.97–4.35] and aOR, 4.83 [95% CI, 1.31–17.83], respectively). Conclusion: Few women achieved the minimum recommendations for exercise before or during pregnancy. Nevertheless, adoption of healthy lifestyle choices during pregnancy seemed to promote other healthy habits, such as participation in LTPA. [Copyright &y& Elsevier]

Background: Findings related to the association between persistent organic pollutants (POPs) and gestational diabetes mellitus (GDM) are inconclusive. Objectives: To estimate the strength of the association between POP exposure and GDM in a systematic review with meta‐analysis. Search strategy: MEDLINE, Scopus and Web of Science were searched until July 2023. Selection criteria: Cohort and case–control studies analysing the association between POPs and GDM. Data collection and analysis: We assessed the risk of bias using the Quality in Prognosis Studies scale (QUIPS). Standardised mean differences were pooled using random‐effect models. Main results: Sixteen articles including 12 216 participants were selected. The risk of bias was high in four articles (25%), moderate in 11 (68.75%) and low in one (6.25%). Small mean difference between GDM cases and controls was observed for PFHpA (0.26, 95% confidence interval [CI] 0.1–0.35, I2 = 0.0%), PCB180 (0.37, 95% CI 0.19–0.56; I2 = 25.3%), BDE47 (0.23, 95% CI 0.0–0.45, I2 = 0%), BDE99 (0.36, 95% CI 0.14–0.59; I2 = 0%), BDE100 (0.42, 95% CI 0.19–0.64; I2 = 0%) and HCB (0.22, 95% CI 0.01–0.42, I2 = 39.6%). No considerable difference was observed for the rest of POPs. Conclusion: Small mean differences between GDM cases and controls were observed for some POPs. However, evidence shows mostly moderate quality and results were heterogeneous. Improved research methodology is needed to assess POPs and GDM risk. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of replacing 1 h/week of watching television with 1 h/week of light to moderate (LMPA) or vigorous physical activity (VPA) before and during pregnancy on the risk of gestational diabetes mellitus (GDM). Methods: A case–control study was conducted in pregnant women. Physical activity and television watching before and during pregnancy were assessed using the Paffenbarger Physical Activity Questionnaire. Each type of activity was classified according to intensity (metabolic equivalent of task; MET): less than 6 METs is LMPA, 6 METs or more is VPA. The duration of physical activity and watching television was calculated, and logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals for their association with GDM risk. The isotemporal substitution model was used to calculate the effect of replacing 1 h/week of watching television with the same duration of physical activity. Results: The GDM cases (n = 290) spent less time performing VPA than controls without GDM (n = 1175) and more time watching television during pregnancy (P < 0.05). During pregnancy, the risk of GDM increased for each hour of watching television (aOR = 1.02; 95% confidence interval 1.00–1.03). Women who spent more time watching television during pregnancy were likely to develop GDM (aOR>14 h/week vs. 0–6 h/week = 2.03; 95% confidence interval 1.35–3.08). Replacing 1 h/week of watching television with 1 h/week of VPA during pregnancy could decrease the chance of developing GDM (aOR = 0.66; 95% confidence interval 0.43–1.00). Conclusions: A simple change of 1 h/week of watching television for 1 h/week of VPA in pregnant women may reduce the risk of GDM considerably. Synopsis: Substituting 1 h/week of watching television with 1 h/week of vigorous physical activity during pregnancy could reduce gestational diabetes mellitus risk by 34%. [ABSTRACT FROM AUTHOR]

In a peer-review of teaching (PRT) program, we aimed to i) use pre and post-observation questionnaires to enhance self-reflection, and ii) perform a nominal group technique (NGT) to agree on improvements. The questionnaires showed that PRT helped discovering new weaknesses but not new strengths, and that preconceived negative feelings vanished during the teaching observation. The NGT highlighted that ensuring the pairs of teachers belong to different knowledge areas and offering information to future participants may improve the PRT program and increase faculty participation. In conclusion, questionnaires along the PRT program promoted self-reflection and important improvements were made by the NGT. [ABSTRACT FROM AUTHOR]

Evaluation studies of outcomes used in clinical research and their consistency are appearing more frequently in the literature, as a key part of the core outcome set (COS) development. Current guidance suggests such evaluation studies should use systematic review methodology as their default. We aimed to examine the methods used. We searched the Core Outcome Measures in Effectiveness Trials (COMET) database (up to May 2019) supplementing it with additional resources. We included evaluation studies of outcome consistency in clinical studies across health subjects and used a subset of A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 (items 1–9) to assess their methods. Of 93 included evaluation studies of outcome consistency (90 full reports, three summaries), 91% (85/93) reported performing literature searches in at least one bibliographic database, and 79% (73/93) was labelled as a "systematic review". The evaluations varied in terms of satisfying AMSTAR 2 criteria, such that 81/93 (87%) had implemented PICO in the research question, whereas only 5/93 (6%) had included the exclusions list. None of the evaluation studies explained how inconsistency of outcomes was detected, however, 80/90 (88%) concluded inconsistency in individual outcomes (66%, 55/90) or outcome domains (20%, 18/90). Methods used in evaluation studies of outcome consistency in clinical studies differed considerably. Despite frequent being labelled as a "systematic review", adoption of systematic review methodology is selective. While the impact on COS development is unknown, authors of these studies should refrain from labelling them as "systematic review" and focus on ensuring that the methods used to generate the different outcomes and outcome domains are reported transparently. [ABSTRACT FROM AUTHOR]

Background: In cancer care, the promotion and implementation of shared decision‐making in clinical practice guidelines (CPG) and consensus statements may have potential differences by gender. Objective: To systematically analyse recommendations concerning shared decision‐making in CPGs and consensus statements for the most frequent cancers exclusively among males (prostate) and females (endometrial). Search Strategy: We prospectively registered the protocol at PROSPERO (ID: RD42021241127). MEDLINE, EMBASE, Web of Science, Scopus and online sources (8 guideline databases and 65 professional society websites) were searched independently by two reviewers, without language restrictions. Inclusion Criteria: CPGs and consensus statements about the diagnosis or treatment of prostate and endometrial cancers were included from January 2015 to August 2021. Data Extraction and Synthesis: Quality assessment deployed a previously developed 31‐item tool and differences between the two cancers analysed. Main Results: A total of 176 documents met inclusion criteria, 97 for prostate cancer (84 CPGs and 13 consensus statements) and 79 for endometrial cancer (67 CPGs and 12 consensus statements). Shared decision‐making was recommended more often in prostate cancer guidelines compared to endometrial cancer (46/97 vs. 13/79, 47.4% vs. 16.5%; p <.001). Compared to prostate cancer guidelines (mean 2.14 items, standard deviation 3.45), compliance with the shared‐decision‐making 31‐item tool was lower for endometrial cancer guidelines (mean 0.48 items, standard deviation 1.29) (p <.001). Regarding advice on the implementation of shared decision‐making, it was only reported in 3 (3.8%) endometrial cancer guidelines and in 16 (16.5%) prostate cancer guidelines (p <.001). Discussion and Conclusions: We observed a significant gender bias as shared decision‐making was systematically more often recommended in the prostate compared to endometrial cancer guidelines. These findings should encourage new CPGs and consensus statements to consider shared decision‐making for improving cancer care regardless of the gender affected. Patient or Public Contribution: The findings may inform future recommendations for professional associations and governments to update and develop high‐quality clinical guidelines to consider patients' preferences and shared decision‐making in cancer care. [ABSTRACT FROM AUTHOR]

(1) Background: The accuracy of ultrasound estimation of fetal weight (EFW) at term may be useful in addressing obstetric complications since birth weight (BW) is a parameter that represents an important prognostic factor for perinatal and maternal morbidity. (2) Methods: In a retrospective cohort study of 2156 women with a singleton pregnancy, it is verified whether or not perinatal and maternal morbidity differs between extreme BWs estimated at term by ultrasound within the seven days prior to birth with Accurate EFW (difference < 10% between EFW and BW) and those with Non-Accurate EFW (difference ≥ 10% between EFW and BW). (3) Results: Significantly worse perinatal outcomes (according to different variables such as higher rate of arterial pH at birth < 7.20, higher rate of 1-min Apgar < 7, higher rate of 5-min Apgar < 7, higher grade of neonatal resuscitation and need for admission to the neonatal care unit) were found for extreme BW estimated by antepartum ultrasounds with Non-Accurate EFW compared with those with Accurate EFW. This was the case when extreme BWs were compared according to percentile distribution by sex and gestational age following the national reference growth charts (small for gestational age and large for gestational age), and when they were compared according to weight range (low birth weight and high birth weight). (4) Conclusions: Clinicians should make a greater effort when performing EFW by ultrasound at term in cases of suspected extreme fetal weights, and need to take an increasingly prudent approach to its management. [ABSTRACT FROM AUTHOR]

Purpose: To analyse the Health-Related Quality of Life (HRQoL) at diagnosis of patients with prostate cancer (PCa) according to tumour extension and urinary symptomatology and to explore factors associated with HRQoL. Methods: 408 Controls and 463 PCa cases were included. Eligibility criteria were a new diagnosis of PCa (cases), 40–80 years of age, and residence in the participating hospitals' coverage area for ≥ 6 months before recruitment. HRQoL was evaluated using the 12-Item Short-Form Health Survey, Mental (MCS) and Physical Component Summaries (PCS), and urinary symptoms with the International Prostate Symptom Score. HRQoL scores for all PCa cases, according to tumour extension and urinary symptoms, were compared with controls. In addition, information about lifestyles and comorbidities was collected and its association with low HRQoL (lower scores) were explored using logistic regression models. Results: Overall cases had similar PCS score, but lower MCS score than controls. The lowest standardised scores for both PCS and MCS were reached by cases with severe urinary symptoms and a metastatic tumour [mean (SD); PCS: 41.9 (11.5), MCS: 42.3 (10.3)]. Having "below" PCS and MCS scores was associated with the presence of three or more comorbidities in the cases [aOR = 2.86 (1.19–6.84) for PCS and aOR = 3.58 (1.37–9.31) for MCS] and with severe urinary symptomatology [aOR = 4.71 (1.84–12.08) for PCS and aOR = 7.63 (2.70–21.58) for MCS]. Conclusion: The mental dimension of HRQoL at diagnosis of patients with PCa was lower than in controls, especially for cases with severe urinary symptoms and a metastatic tumour. Comorbidities and urinary symptoms were variables associated with the HRQoL of PCa cases. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were to study the mobility recovery in hip fracture patients and determine the influence of cognitive impairment on mobility within the first 3 months after surgery. Design: This prospective cohort study was carried out in an acute public hospital in southern Spain and included 275 patients, 65 years or older, with a hip fracture. Mobility and Cognitive status were measured by Tinetti Performance-Oriented Mobility Assessment and Pfeiffers' Scale (Short Portable Mental State Questionnaire), respectively. Multiple linear regression was used to examine the influence of cognitive impairment on mobility. Results: The median Performance-Oriented Mobility Assessment score changed from 4 (3-4) points at discharge to 17 (7-22) at 3 months. All degrees of cognitive impairment were negatively associated with gait and balance at 1 and 3 months after surgery (P < 0.01). Age, weight bearing, length of hospital stay, and postsurgical complications were also identified as independent predictors of mobility outcome at 3 months. Conclusions: Cognitive impairment is a negative prognostic factor for the recovery of mobility in elderly patients with a hip fracture. New treatment strategies are needed for hip fracture patients with cognitive impairment. [ABSTRACT FROM AUTHOR]

Introduction: The development of second primary tumours (SPTs) is one of the main causes of low survival in patients with head and neck cancer (HNC). The aim of this study was to review the evidence about factors associated with developing SPTs in patients with HNC. Methods: An updated systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines, and the search was performed in Pubmed and Scopus. Only original articles with a cohort or case–control design were included. Article quality was assessed with the Newcastle–Ottawa scale. Results: Thirty‐six and two case‐control studies were included, with quality medium (n = 5) to high (n = 33). Tobacco showed a significant association with SPT development, with risks ranging from 1.41 (95%CI: 1.04–1.91) to 5.52 (95%CI: 2.91–10.49). Regarding alcohol, risks ranged from 1.46 (95%CI: 1.12–1.91) to 21.3 (95%CI: 2.9–156). Location of the index tumour in the hypopharynx/oropharynx, absence of human papillomavirus and presence of a premalignant lesion also increased the risk of SPTs. More controversy was found for sex, age and other clinical factors of the tumour. Conclusion: Toxic lifestyle habits and clinical factors were associated with the risk of SPTs in HNC patients. These findings may improve individualised prevention strategies in its follow‐up. [ABSTRACT FROM AUTHOR]

Simple Summary: Although some nutrients, foods, and food groups have been linked to prostate cancer (PCa), their relationship remains unclear. In this sense, dietary patterns allow a global approach to diet. This study evaluated the role of dietary patterns on PCa by tumor aggressiveness and extension. A total of 428 incident PCa cases and 393 controls were included. When comparing scores in the highest vs. lowest tertiles, an unhealthy dietary pattern was associated with higher odds of PCa. This association was observed only for PCa ISUP 1 or 2 tumors and localized PCa cases. We were unable to establish a clear association between Western or Mediterranean dietary patterns and PCa. These results increase the evidence of a possible relationship between diet and PCa. Therefore, future recommendations should focus on avoiding unhealthy dietary patterns. The etiology of prostate cancer (PCa) remains uncertain, and the role of diet is unclear. We aimed to evaluate the role of diet, through dietary patterns, on PCa, considering tumor aggressiveness and extension. The CAPLIFE study is a population-based case-control study including a total of 428 incident PCa cases and 393 controls aged 40–80 years. Dietary information was collected through a validated food frequency questionnaire. Three dietary patterns were identified through principal component analysis: "Mediterranean," "Western," and "Unhealthy," which were categorized into tertiles according to the control group cutoff points. Tumor aggressiveness and extension was determined. Logistic regression models were used to assess the association between dietary patterns and PCa. High adherence to an unhealthy dietary pattern was associated with higher odds of PCa, ORT3vsT1 = 1.52 (95% CI 1.02–2.27), especially for cases with ISUP 1–2 and localized PCa tumors. This association was not observed with a Western or Mediterranean pattern. In conclusion, adherence to an unhealthy diet appears to be associated with higher odds of PCa, especially for cases with ISUP 1–2 and localized PCa tumors. [ABSTRACT FROM AUTHOR]

Unlabelled: Objetive: identify whether there is an increased risk of adverse perinatal outcomes, like prematurity or decreased weight in newborns, associated with caffeine consumption during the first half of pregnancy in pregnant women of our population.Methods: transversal study carried out in 1 175 patients from Virgen de las Nieves University Hospital of Granada (Spain). Information about caffeine consumption during first half of gestation and perinatal outcomes was obtained by personal interview, medical records and telephone call after delivery. The average caffeine intake was calculated from meals and drinks included in a validated questionnaire.Results: there was no difference in caffeine consumption in pregnant women with birth weight ≥2 500 g and. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study was to identify the prevalence and factors associated with the performance of minimal beneficial leisure-time physical activity in the first half of pregnancy according to the criteria of the American College of Sport and Medicine (ACSM) and the American College of Obstetricians and Gynecologists (ACOG). Material and methods. This was a cross-sectional study carried out at the Maternal and Neonatal University Hospital in Granada, which services the whole population of the hospital reference area. We studied 1,175 healthy pregnant women aged over 18 years. Information about sociodemographics, lifestyles, obstetric antecedents and anthropometric variables were collected. The amount of leisure-time physical activity was quantified by assigning metabolic equivalents to each activity. The ACSM and ACOG criteria were used to define optimal physical activity in the first half of pregnancy. The frequency of compliance for both criteria was estimated. Multiple logistic regression models were fitted to study the factors associated with the recommendations. Results. Only 20.3% (95% confidence interval 15.50-26.10) of the women complied with ACOG criteria. More women complied with ACSM recommendations (70.8%, 95% confidence interval 67.5 -73.8), which are less restrictive criteria. Women aged 30 years old or older and those with a university degree tended to devote more time to exercising according to both recommendations. Conclusion. The prevalence of pregnant women who performed minimal beneficial leisure-time physical activity was lower with the dominant and more accepted criteria. It is necessary to encourage physical activity, mainly among those who are younger, and those with lower levels of educational attainment. [ABSTRACT FROM AUTHOR]

Objective: To estimate physical activity (PA) in healthy women before and during pregnancy and to evaluate the features associated with moderate PA (MPA). Methods: A prospective cohort study was conducted on women selected 14 weeks of pregnancy during 2013–2015 in primary public health service centers in southern Spain. Type, duration, and frequency of PA (IPAQ questionnaire in first, second, and third trimesters [T1, T2, T3]) were measured. Variables associated with MPA were evaluated using multiple logistic regressions controlling for age, pre‐pregnancy obesity, level of education, number of living children, pre‐pregnancy PA, and adherence to Mediterranean diet (AMD). Results: Out of 463 women, MPA was estimated in 64% pre‐pregnancy, and 54%, 61%, and 59% in T1, T2, and T3, respectively. MPA was associated with greater AMD in T2 (adjusted odds ratio [aOR] 1.17, 95% confidence interval [CI] 1.04–1.33) and T3 (aOR 1.16, 95% CI 1.02–1.31), previous PA (aOR 13.5, 95% CI 8.12–22.5 in T1; aOR 2.61, 95% CI 1.72–3.96 in T2; aOR 2.59, 95% CI 1.65–4.05 in T3), and pre‐pregnancy obesity (aOR 2.97, 95% CI 1.28–6.89 in T1; aOR 2.69, 95% CI 1.23–3.60 in T3). Conclusion: PA decreased at the beginning of pregnancy, but compliance remained over 50%. MPA was associated with diet, pre‐pregnancy PA, and obesity. Synopsis: Moderate physical activity (MPA) was achieved by >50% of women during pregnancy. MPA was associated with healthy diet, pre‐pregnancy obesity, and greater PA before pregnancy. [ABSTRACT FROM AUTHOR]

Background: The CUN-BAE (Clínica Universidad de Navarra-Body adiposity estimator) index is an anthropometric index based on age, sex and body mass index (BMI) for a refined prediction of body fatness in adults. CUN-BAE may help detect metabolically unhealthy individuals with otherwise normal weight according to BMI or waist circumference (WC). The aim of this study was to evaluate whether CUN-BAE, independent of its components (BMI, age and sex), was associated with cardiometabolic conditions including arterial hypertension, diabetes mellitus and metabolic syndrome (MetS). Methods: The ENRICA study was based on a cross-sectional sample of non-institutionalized men and women representative of the adult Spanish population. Body weight, height, and WC were measured in all participants. The residual of CUN-BAE (rCUN-BAE), i.e. the part of the index not explained by its components, was calculated. The associations of CUN-BAE, rCUN-BAE, BMI and WC with hypertension, diabetes and MetS were analysed by multivariate logistic regression, and the Akaike information criterion (AIC) was calculated. Results: The sample included 12,122 individuals. rCUN-BAE was associated with hypertension (OR 1.14, 95% CI 1.07–1.21) and MetS (OR 1.48, 1.37–1.60), but not with diabetes (OR 1.05, 0.94–1.16). In subjects with a BMI < 25 kg/m2, CUN-BAE was significantly associated with all three outcome variables. CUN-BAE was more strongly associated with the cardiometabolic conditions than BMI and WC and fit similar AICs. Conclusions: The CUN-BAE index for body fatness was positively associated with hypertension, diabetes and MetS in adults independent of BMI or WC. CUN-BAE may help to identify individuals with cardiometabolic conditions beyond BMI, but this needs to be confirmed in prospective settings. [ABSTRACT FROM AUTHOR]

Purpose: To assess if the associations found between three previously identified dietary patterns with breast, prostate and gastric cancer are also observed for colorectal cancer (CRC). Methods: MCC-Spain is a multicase-control study that collected information of 1629 incident cases of CRC and 3509 population-based controls from 11 Spanish provinces. Western, Prudent and Mediterranean data-driven dietary patterns—derived in another Spanish case-control study—were reconstructed in MCC-Spain. Their association with CRC was assessed using mixed multivariable logistic regression models considering a possible interaction with sex. Risk by tumor site (proximal colon, distal colon, and rectum) was evaluated using multinomial regression models. Results: While no effect of the Prudent pattern on CRC risk was observed, a high adherence to the Western dietary pattern was associated with increased CRC risk for both males [ORfourth(Q4) vs. first(Q1)quartile (95% CI): 1.45 (1.11;1.91)] and females [ORQ4 vs. Q1 (95% CI): 1.50 (1.07;2.09)] but seem to be confined to distal colon [ORfourth(Q4) vs. first(Q1)quartile (95% CI): 2.02 (1.44;2.84)] and rectal [ORQ4 vs. Q1 (95% CI): 1.46 (1.05;2.01)] tumors. The protective effect of the Mediterranean dietary pattern against CRC was observed for both sexes [males: ORQ4 vs. Q1 (95% CI): 0.71 (0.55;0.92); females: ORQ4 vs. Q1 (95% CI): 0.56 (0.40;0.77)] and for all cancer sites: proximal colon [ORQ4 vs. Q1 (95% CI): 0.70 (0.51;0.97)], distal colon [ORQ4 vs. Q1 (95% CI): 0.65 (0.48;0.89)], and rectum (ORQ4 vs. Q1 (95% CI): 0.60 (0.45;0.81)]. Conclusion: Our results are consistent with most of the associations previously found between these patterns and breast, prostate and gastric cancer risk and indicate that consuming whole fruits, vegetables, legumes, olive oil, nuts, and fish and avoiding red and processed meat, refined grains, sweets, caloric drinks, juices, convenience food, and sauces might reduce CRC risk. [ABSTRACT FROM AUTHOR]

The article focuses on the risk factors associated with the diagnosis of chronic lymphocytic leukaemia (CLL) in Asians. It talks about the insulin growth factor (IGF) being composed of polypeptide hormones which are important for growth, apoptosis and survival of the patient diagnosed with CLL. It tells about females being diagnosed more than males in the population.

Introduction: Introduction: different diets during pregnancy might have an impact on the health as reflected by the birth weight of the newborn. The consumption of meat and meat products during pregnancy and its relationship with the newborn health status have been studied by several authors. The studies carried out show inconsistent results. Objective: to analyse the association between maternal dietary intake of meat and meat products and the risk of small for gestational age (SGA) newborn. Methods: a matched case-control study of 518 cases and controls of pregnant women was performed in Spain. Cases were women with a SGA newborn. Data about demographic characteristics and diet were collected. Meat consumption was gathered through a validated food frequency questionnaire. Meat and meat products intakes were categorized in quintiles (Q1-Q5).The association between maternal meat and meat product intakes and SGA was assessed by logistic regression models with adjustment for confounding factors. Results: an intake of meat products above 6.8 g/day was associated with a lower risk of SGA delivery (OR = 0.7; 95% CI, 0.53-0.93) after adjusting for smoking, body mass index, previous preterm-low birth weight, newborn gender and adherence to Mediterranean diet. Conclusions: meat consumption was not associated with SGA, whereas meat products showed a moderate protective relationship. [ABSTRACT FROM AUTHOR]

Background: The influence of dietary habits on the development of gastric adenocarcinoma is not clear. The objective of the present study was to explore the association of three previously identified dietary patterns with gastric adenocarcinoma by sex, age, cancer site, and morphology.Methods: MCC-Spain is a multicase-control study that included 295 incident cases of gastric adenocarcinoma and 3040 controls. The association of the Western, Prudent, and Mediterranean dietary patterns—derived in another Spanish case-control study—with gastric adenocarcinoma was assessed using multivariable logistic regression models with random province-specific intercepts and considering a possible interaction with sex and age. Risk according to tumor site (cardia, non-cardia) and morphology (intestinal/diffuse) was evaluated using multinomial regression models.Results: A high adherence to the Western pattern increased gastric adenocarcinoma risk [odds ratiofourth_vs._first_quartile (95% confidence interval), 2.09 (1.31; 3.33)] even at low levels [odds ratiosecond_vs._first_quartile (95% confidence interval), 1.63 (1.05; 2.52)]. High adherence to the Mediterranean dietary pattern could prevent gastric adenocarcinoma [odds ratiofourth_vs._first_quartile (95% confidence interval), 0.53 (0.34; 0.82)]. Although no significant heterogeneity of effects was observed, the harmful effect of the Western pattern was stronger among older participants and for non-cardia adenocarcinomas, whereas the protective effect of the Mediterranean pattern was only observed among younger participants and for non-cardia tumors.Conclusion: Decreasing the consumption of fatty and sugary products and of red and processed meat in favor of an increase in the intake of fruits, vegetables, legumes, olive oil, nuts, and fish might prevent gastric adenocarcinoma. [ABSTRACT FROM AUTHOR]

Purpose: Although there is convincing evidence that red and processed meat intake increases the risk of colorectal cancer (CRC), the potential role of meat cooking practices has not been established yet and could partly explain the current heterogeneity of results among studies. Therefore, we aimed to investigate the association between meat consumption and cooking practices and the risk of CRC in a population-based case-control study.Methods: A total of 1671 CRC cases and 3095 controls recruited in Spain between September 2008 and December 2013 completing a food frequency questionnaire with a meat-specific module were included in the analyses. Odds ratios (OR) and confidence intervals (CI) were estimated by logistic regression models adjusted for known confounders.Results: Total meat intake was associated with increased risk of CRC (ORT3-T1 1.41; 95% CI 1.19-1.67; ptrend < 0.001), and similar associations were found for white, red and processed/cured/organ meat. Rare-cooked meat preference was associated with low risk of CRC in red meat (ORrare vs. medium 0.66; 95% CI 0.51-0.85) and total meat (ORrare vs. medium 0.56; 95% CI 0.37-0.86) consumers, these associations being stronger in women than in men. Griddle-grilled/barbecued meat was associated with an increased CRC risk (total meat: OR 1.45; 95% CI 1.13-1.87). Stewing (OR 1.25; 95% CI 1.04-1.51) and oven-baking (OR 1.18; 95% CI 1.00-1.40) were associated with increased CRC risk of white, but not red, meat.Conclusions: Our study supports an association of white, red, processed/cured/organ and total meat intake with an increased risk of CRC. Moreover, our study showed that cooking practices can modulate such risk. [ABSTRACT FROM AUTHOR]

Background: Evidence for a protective role of physical activity against development of stomach cancer is yet inconclusive. We studied the association of domain-specific physical activity and the risk of gastric adenocarcinoma (GAC), by site and histology, in the MCC-Spain case-control study. Methods: 428 histologically confirmed GAC cases (67% men) including the gastro-esophageal region and 3225 controls were included. Cases were recruited in hospitals from 10 different Spanish regions, whereas population controls were randomly selected within the respective hospitals' catchment areas. A physical activity (PA) questionnaire was used to gather information on household and recreational activities, allowing estimation of PA volume (in metabolic equivalents (MET)-min/week). Participants also reported the intensity of working PA and daily sitting time. Questionnaire data on diet, lifestyles and clinical variables including Helicobacter pylori serology were available. Adjusted odds ratios (OR) of GAC were estimated for domains of physical activity, stratifying by sex, site (cardia vs. non-cardia), and Lauren classification (intestinal vs. diffuse). Results: Household physical activity (HPA) showed a strong inverse association with GAC, observed for both cardia and non-cardia tumours. Risk of overall gastric cancer was 50% lower risk among participants in the highest HPA category (OR = 0.50, 95%CI: 0.38, 0.66). Recreational physical activity (RPA) was also associated with lower overall GAC risk (OR = 0.68, 95% CI: 0.52, 0.88), particularly at moderate levels of intensity such as walking (OR = 0.61, 95% CI: 0.46, 0.79). The protective effect of RPA was strongest for non-cardia tumours. Sedentary time was not related to GAC risk (p-trend = 0.392), but the potential protective effect of RPA was restricted to non-sedentary participants. Conclusions: Both household and recreational physical activities were independently related to lower GAC risk in the MCC-Spain study. [ABSTRACT FROM AUTHOR]

The potential protective effect of renin-angiotensin system (RAS) inhibitors is a subject of increasing interest due to their possible role as chemopreventive agents against colorectal cancer (CRC). To evaluate this association, we conducted a case-control study with 2165 cases of colorectal cancer, diagnosed between 2007 and 2012, and 3912 population controls frequency matched (by age, sex and region) from the Spanish multicenter case-control study MCC-Spain. We found a significant protective effect of the angiotensin-converting enzyme Inhibitors (ACEIs) against CRC, limited to the under-65years group (OR=0.65 95%CI (0.48-0.89)) and to a lesser degree to men (OR=0.81 95%CI (0.66-0.99). In contrast, the angiotensin receptor blockers (ARBs) did not show a significant effect. Regarding the duration of use, a greater protection was observed in men as the length of consumption increases. In contrast, in the under-65 stratum, the strongest association was found in short-term treatments. Finally, by analyzing ACEIs effect by colon subsite, we found no differences, except for under 65years old, where the maximum protection was seen in the proximal intestine, descending in the distal and rectum (without statistical significance). In conclusion, our study shows a protective effect on CRC of the ACEis limited to males and people under 65years old, which increases in proximal colon in the latter. If confirmed, these results may suggest a novel approach to proximal CRC prevention, given the shortcomings of colonoscopy screening in this location. [ABSTRACT FROM AUTHOR]

This study aimed to quantify the association between pedestrian- and driver-related factors and the risk of causing road crashes involving pedestrians in urban areas in Spain between 1993 and 2011. From the nationwide police-based registry of road crashes with victims in Spain, we analyzed all 63,205 pairs of pedestrians and drivers involved in crashes in urban areas in which only the pedestrian or only the driver was at fault. Logistic regression models were used to obtain adjusted odds ratios to assess the strength of association between each individual-related variable and the pedestrian’s odds of being at fault for the crash (and conversely, the driver’s odds of not being at fault). The subgroups of road users at high risk of causing a road crash with a pedestrian in urban areas were young and male pedestrians, pedestrians with psychophysical conditions or health problems, the youngest and the oldest drivers, and drivers with markers of high-risk behaviors (alcohol use, nonuse of safety devices, and driving without a valid license). These subgroups should be targeted by preventive strategies intended to decrease the rate of urban road crashes involving pedestrians in Spain. [ABSTRACT FROM AUTHOR]

This study was designed to quantify the percent contribution of exposure, risk of collision and fatality rate to the association of age and sex with the mortality rates among cyclists in Spain, and to track the changes in these contributions with time. Data were analyzed for 50,042 cyclists involved in road crashes in Spain from 1993 to 2011, and also for a subset of 13,119 non-infractor cyclists involved in collisions with a vehicle whose driver committed an infraction (used as a proxy sample of all cyclists on the road). We used decomposition and quasi-induced exposure methods to obtain the percent contributions of these three components to the mortality rate ratios for each age and sex group compared to males aged 25–34 years. Death rates increased with age, and the main component of this increase was fatality (around 70%). Among younger cyclists, however, the main component of increased death rates was risk of a collision. Males had higher death rates than females in every age group: this rate increased from 6.4 in the 5–14 year old group to 18.8 in the 65–79 year old group. Exposure, the main component of this increase, ranged between 70% and 90% in all age categories, although the fatality component also contributed to this increase. The contributions of exposure, risk of crash and fatality to cyclist death rates were strongly associated with age and sex. Young male cyclists were a high-risk group because all three components tended to increase their mortality rate. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of age on the increase in DM prevalence in Spain between 2001 and 2012. Methods: From the DM prevalence data of the National Health Surveys performed in Spain in 2001, 2006, and 2012 and age distribution of the population, adjusted prevalence rates by age for each year were calculated by the direct method, taking the 2006 population as the reference one. Crude and adjusted percentage increases were also calculated for the whole period and for the 2001-2006 and 2006-2012 sub-periods. Results: 12.5% of the crude DM prevalence increase is attributable to the population aging during the whole period. Although the trends are different in the two sub-periods, adjusted prevalence rates also show an increasing trend. Conclusions: Aside from population aging, there exist other factors responsible for the increase in diabetes prevalence rates in Spain in 2001-2012 that should be known. [ABSTRACT FROM AUTHOR]