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Bruguera A, Egea-Cortés L, Mesías-Gazmuri J, Palacio-Vieira J, Forero CG, Miranda C, Saumoy M, Fernández E, Navarro G, Orti A, Miró JM, Casabona J, Reyes-Urueña J. Predictors of poor health-related quality of life among people living with HIV aged ≥60 years in the PISCIS cohort: Findings from the Vive+ project. HIV Med 2024; 25:424-439. [PMID: 38092529 DOI: 10.1111/hiv.13590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/11/2023] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Advancements in and accessibility to effective antiretroviral therapy has improved the life expectancy of people living with HIV, increasing the proportion of people living with HIV reaching older age (≥60 years), making this population's health-related quality of life (HRQoL) more relevant. Our aim was to identify the determinants of poor HRQoL in people living with HIV aged ≥60 years and compare them with those of their younger counterparts. METHODS We used data from the 'Vive+' study, a cross-sectional survey conducted between October 2019 and March 2020, nested within the PISCIS cohort of people living with HIV in Catalonia and the Balearic Islands, Spain. We used the 12-item short-form survey (SF-12), divided into a physical component summary (PCS) and a mental component summary (MCS), to evaluate HRQoL. We used the least absolute shrinkage and selection operator for variable selection and used multivariable regression models to identify predictors. RESULTS Of the 1060 people living with HIV (78.6% males) who participated in the study, 209 (19.7%) were aged ≥60 years. When comparing older people living with HIV (≥60 years) and their younger counterparts, older people exhibited a worse PCS (median 51.3 [interquartile range {IQR} 46.0-58.1] vs. 46.43 [IQR 42.5-52.7], p < 0.001) but a similar MCS (median 56.0 [IQR 49.34-64.7] vs. 57.0 [IQR 48.9-66.3], p = 0.476). In the multivariable analysis, cognitive function correlated with a PCS (β correlation factor [β] -0.18, p = 0.014), and depressive symptoms and satisfaction with social role correlated with an MCS (β 0.61 and β -0.97, respectively, p < 0.001) in people living with HIV aged ≥60 years. CONCLUSION Depressive symptoms, poor cognitive function, and lower satisfaction with social roles predict poorer HRQoL in older people living with HIV. These factors need to be considered when designing targeted interventions.
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Affiliation(s)
- Andreu Bruguera
- Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine, and Public Health, Univ Autonoma de Barcelona, Badalona, Spain
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - L Egea-Cortés
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
| | - J Mesías-Gazmuri
- Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine, and Public Health, Univ Autonoma de Barcelona, Badalona, Spain
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
| | - J Palacio-Vieira
- Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine, and Public Health, Univ Autonoma de Barcelona, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - C G Forero
- Department of Medicine. School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat, Spain
| | - C Miranda
- Infectious Diseases, University Hospital Germans Trias i Pujol, Badalona, Spain
| | - M Saumoy
- HIV and STD Unit, Department of Infectious Diseases, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Spain
| | - E Fernández
- Infectious Diseases Service. Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - G Navarro
- HIV/AIDS Unit, Parc Taulí Hospital Universitario, Institut d'Ivestigació i Innovació Parc Tauli (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - A Orti
- Verge de la Cinta Hospital, Tortosa, Spain
| | - J M Miró
- Infectious Diseases Service. Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - J Casabona
- Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine, and Public Health, Univ Autonoma de Barcelona, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine, Univ Autónoma de Barcelona, Badalona, Spain
| | - J Reyes-Urueña
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
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Miranda-Mendizabal A, Piqueras J, Castellví P, Álvarez S, Díaz S, Gómez L, Recoder S, Sánchez N, García Durán E, Forero CG. Risk factors for mental health disorders during the COVID-19 pandemic in Spain: A cohort study. Eur J Public Health 2022. [PMCID: PMC9593788 DOI: 10.1093/eurpub/ckac129.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Data comparing the populations’ mental health from before, during and after the pandemic is needed. We aim to assess the risk factors for the first-onset and persistence of major depressive disorder (MDD) and suicidal thoughts and behaviours (STB) during the first year of the pandemic among the Spanish general population. Methods Cohort study through two online surveys from before the pandemic (N = 2,005, October/November 2019) and 12-months later (N = 1,357) on an adult Spanish, nationally representative, population-based sample. Multiple logistic regression models were used to assess the association between socio-demographic, COVID-19 related variables and healthcare received during the pandemic with the onset and persistence of MDD and STB. Results Women have more than 3-fold risk for the onset (OR 3.18; CI95% 1.40 -7.22) and persistence (OR 8.62; CI95% 1.74-42.48) of MDD. Studying and working at the same time (OR 10.13; CI95% 2.17-47.35) and having close relatives/friends with COVID-19 infection (OR 14.84; CI95% 1.91-115.18) or death (OR 5.26; CI95% 1.56-17.73) due to COVID-19 are risk factors for MDD onset. Sick-leave (OR 17.19; CI95% 2.65-112.56) and unemployment (OR 7.01; CI95% 1.85-26.43) increased the risk for MDD persistence. Death of friends/colleagues due to COVID-19 (OR 8.40; CI95% 1.47-48.07) increased the risk for STB onset, and being on sick-leave (OR 7.91; CI95% 1.80-34.66) for STB persistence. Conclusions During the COVID-19 pandemic, women were consistently more at risk of having worse mental health than men. Direct and indirect consequences caused or aggravated by the pandemic are common risk factors for the increased risk for the onset and persistence of both MDD and STB. Identification of high-risk subgroups and risk factors for MDD and STB among the Spanish general population will allow the developing and implementing of evidence-driven strategies for reducing the long-term impact of the pandemic in populations’ mental health. Key messages • The pandemic consequences, whether due to having had COVID-19, having close people affected or who have died from the infection and the social consequences increase the risk for worse mental health. • Evidence-driven strategies for reducing the long-term impact of the pandemic in populations’ mental health should be a public health priority.
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Affiliation(s)
- A Miranda-Mendizabal
- School of Medicine, Universitat Internacional de Catalunya , Sant Cugat del Vallès, Spain
| | - J Piqueras
- School of Medicine, Universitat Internacional de Catalunya , Sant Cugat del Vallès, Spain
| | - P Castellví
- School of Medicine, Universitat Internacional de Catalunya , Sant Cugat del Vallès, Spain
| | - S Álvarez
- School of Medicine, Universitat Internacional de Catalunya , Sant Cugat del Vallès, Spain
| | - S Díaz
- School of Medicine, Universitat Internacional de Catalunya , Sant Cugat del Vallès, Spain
| | - L Gómez
- School of Medicine, Universitat Internacional de Catalunya , Sant Cugat del Vallès, Spain
| | - S Recoder
- Department of Basic Sciences, Universitat Internacional de Catalunya , Sant Cugat del Vallès, Spain
| | - N Sánchez
- School of Medicine, Universitat Internacional de Catalunya , Sant Cugat del Vallès, Spain
| | - E García Durán
- School of Medicine, Universitat Internacional de Catalunya , Sant Cugat del Vallès, Spain
| | - CG Forero
- School of Medicine, Universitat Internacional de Catalunya , Sant Cugat del Vallès, Spain
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López E, Forero C, Plans C, Granell R, Carreto P, Ruano A. Diagnóstico prenatal del arco aórtico derecho, importancia de los planos de Yagel. Nuestra experiencia, descripción de 2 casos. Clínica e Investigación en Ginecología y Obstetricia 2018. [DOI: 10.1016/j.gine.2016.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Trapero JI, Arizmendi CJ, Gonzalez H, Forero C, Giraldo BF. Nonlinear dynamic analysis of the cardiorespiratory system in patients undergoing the weaning process. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2017:3493-3496. [PMID: 29060650 DOI: 10.1109/embc.2017.8037609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this work, the cardiorespiratory pattern of patients undergoing extubation process is studied. First, the respiratory and cardiac signals were resampled, next the Symbolic Dynamics (SD) technique was implemented, followed of a dimensionality reduction applying Forward Selection (FS) and Moving Window with Variance Analysis (MWVA) methods. Finally, the Linear Discriminant Analysis (LDA) and Support Vector Machines (SVM) classifiers were used. The study analyzed 153 patients undergoing weaning process, classified into 3 groups: Successful Group (SG: 94 patients), Failed Group (FG: 39 patients), and patients who had been successful during the extubation and had to be reintubated before 48 hours, Reintubated Group (RG: 21 patients). According to the results, the best classification present an accuracy higher than 88.98 ± 0.013% in all proposed combinations.
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Vilagut G, Forero CG, Adroher ND, Olariu E, Cella D, Alonso J. Testing the PROMIS® Depression measures for monitoring depression in a clinical sample outside the US. J Psychiatr Res 2015; 68:140-50. [PMID: 26228413 DOI: 10.1016/j.jpsychires.2015.06.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 06/15/2015] [Accepted: 06/15/2015] [Indexed: 11/28/2022]
Abstract
The Patient Reported Outcomes Measurement Information System (PROMIS) was devised to facilitate assessment of patient self-reported health status, taking advantage of Item Response Theory. We aimed to assess measurement properties of the PROMIS Depression item bank and an 8-item static short form in a Spanish clinical sample. A three-month follow-up study of patients with active mood/anxiety symptoms (n = 218) was carried out. We assessed model unidimensionality (Confirmatory Item Factor Analysis), reliability (internal consistency and Item Information Curves), and validity (convergent-discriminant with correlations; known-groups with comparison of means and effect sizes; and criterion validity with Receiver operating Characteristics (ROC) analysis). We also assessed 3-month responsiveness to change (Cohen's effect sizes (d) in stable and recovered patients). The unidimensional model showed adequate fit (CFI = 0.97, RMSEA = 0.08). Information Curves had reliabilities over 0.90 throughout most of the score continuum. As expected, we observed high correlations with external self-reported depression, and moderate with self-reported anxiety and clinical measures. The item bank showed an increasing severity gradient from no disorder (mean = 48, SE = 0.6) to depression with comorbid anxiety (mean = 55.8, SE = 0.4). PROMIS detected depression disorder with great accuracy according to the area under the curve (AUC = 0.89). Both formats, item bank and short form, were highly responsive to change in recovered patients (d > 0.7) and had small changes in stable patients (d < 0.2). The good metric properties of the Spanish PROMIS Depression measures provide further evidence of their adequacy for monitoring depression levels of patients in clinical settings. This double check of quality (within countries and populations) supports the ability of PROMIS measures for guaranteeing fair comparisons across languages and countries in specific clinical populations.
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Affiliation(s)
- G Vilagut
- Health Services Research Unit, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Carrer del Doctor Aiguader, 88, Edifici PRBB, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10-12, 08002, Barcelona, Spain.
| | - C G Forero
- Health Services Research Unit, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Carrer del Doctor Aiguader, 88, Edifici PRBB, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
| | - N D Adroher
- Health Services Research Unit, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Carrer del Doctor Aiguader, 88, Edifici PRBB, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
| | - E Olariu
- Health Services Research Unit, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Carrer del Doctor Aiguader, 88, Edifici PRBB, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10-12, 08002, Barcelona, Spain.
| | - D Cella
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
| | - J Alonso
- Health Services Research Unit, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Carrer del Doctor Aiguader, 88, Edifici PRBB, 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10-12, 08002, Barcelona, Spain.
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Gallardo-Pujol D, Forero CG, Maydeu-Olivares A, Andrés-Pueyo A. [The development of antisocial behavior: psychobiological and environmental factors and gene-environment interactions]. Rev Neurol 2009; 48:191-198. [PMID: 19226487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Antisocial behavior is a complex phenomenon with strong implications in neurology and psychiatry. In order to study the ontogenetic development of antisocial behavior, we must check for the existence of physiological mechanisms related to it, and to understand its environmentally-modulated functioning. AIM To review the state-of-the-art of the development of antisocial behavior, and especially, of the interaction between environmental and genetic factors. DEVELOPMENT Recent research has highlighted certain brain alterations linked to violent behavior, either at structural, or functional or biochemical levels. Genetic research has also made some advances in this field, discovering some genes--i.e. monoamineoxidase A (MAOA)--related to antisocial behavior. However, the importance of environmental factors in its development must not be left behind. Recent studies have shown that individuals carrying a low transcriptional activity allele of the MAOA gene, and that also suffered severe maltreatment are more prone to antisocial behavior. This interaction is biologically relevant, as there are underlying biological mechanisms that may be able to explain the ethiopathogeny of antisocial behavior. CONCLUSIONS Although the works herein presented pioneered the field, they are limited by the fact that all the reviewed variables are associated to antisocial behavior, but they lack direct causal evidence of their effects on antisocial behavior. Undoubtedly, future research on psychobiological mechanisms and the understanding of their environmental modulation will help finding therapeutic targets and preventive strategies for antisocial behavior.
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Affiliation(s)
- D Gallardo-Pujol
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universitat de Barcelona, Barcelona, España.
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Abstract
The invasion of the erythrocyte by Plasmodium falciparum depends on the ability of the merozoite to move through the membrane invagination. This ability is probably mediated by actin dependent motors. Using affinity columns with G-actin and F-actin we isolated actin binding proteins from the parasite. By immunoblotting and immunoprecipitation with specific antibodies we identified the presence of tropomyosin, myosin, a-actinin, and two different actins in the eluate corresponding to F-actin binding proteins. In addition to these, a 240-260 kDa doublet, different in size from the erythrocyte spectrin, reacted with an antibody against human spectrin. All the above mentioned proteins were metabolically radiolabeled when the parasite was cultured with 35S-methionine. The presence of these proteins in P. falciparum is indicative of a complex cytoskeleton and supports the proposed role for an actin-myosin motor during invasion.
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Affiliation(s)
- C Forero
- Departmento de Química, Facultad de Ciencias, Universidad Nacional de Colombia, Bogotá
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Vargas L, Patiño PJ, Rodríguez MF, Forero C, Montoya F, Montoya CJ, Sorensen RU, de Olarte DG. Increase in granulocyte-macrophage-colony-stimulating factor secretion and the respiratory burst with decreased L-selectin expression in hyper-IgE syndrome patients. Ann Allergy Asthma Immunol 1999; 83:245-51. [PMID: 10507271 DOI: 10.1016/s1081-1206(10)62648-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The hyper-IgE syndrome is a primary immunodeficiency characterized by severe recurrent abscesses, pneumonia with pneumatocele formation, and elevated serum IgE. Eosinophilia, neutrophil chemotactic defects, and marked tissue damage are frequently present in this syndrome. OBJECTIVE To study whether functional changes in cytokines, adhesion molecules, and neutrophils might help explain these clinical observations. METHODS The following functions were analyzed in patients with the hyper-IgE syndrome and in controls: (1) production of granulocyte-macrophage-colony-stimulating factor by peripheral blood mononuclear cells by ELISA; (2) respiratory burst and reactive oxygen intermediates production by peripheral neutrophils using the luminol-enhanced chemiluminescense technique; and (3) expression of L-selectin on granulocytes and lymphocytes by flow cytometry. RESULTS Patients with hyper-IgE syndrome had significantly increased production of granulocyte-macrophage-colony-stimulating factor by resting or stimulated mononuclear cells, increased generation of reactive oxygen intermediates by neutrophils treated with opsonized zymosan, and reduced L-selectin expression on quiescent and activated granulocytes and lymphocytes. CONCLUSIONS Our results suggest that an important feature of the hyper-IgE syndrome is the increased production of granulocyte-macrophage-colony-stimulating factor, which may explain the reduced L-selectin expression, decreased chemotaxis, and increased oxygen radical production and tissue damage in this disease.
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Affiliation(s)
- L Vargas
- Immunology Laboratory, University of Antioquia, Medellín, Colombia
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