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Quesada JA, López-Pineda A, Orozco-Beltrán D, Carratalá-Munuera C, Barber-Vallés X, Gil-Guillén VF, Nouni-García R, Carbonell-Soliva Á. Diabetes mellitus as a cause of premature death in small areas of Spain by socioeconomic level from 2016 to 2020: A multiple-cause approach. Prim Care Diabetes 2024:S1751-9918(24)00064-0. [PMID: 38514366 DOI: 10.1016/j.pcd.2024.03.004] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/12/2024] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE This study aimed to assess premature mortality due to Diabetes in small areas of Spain between 2016 and 2020, and its relationship with socioeconomic level and the immediate cause of death. As a secondary objective, we evaluated the effect of the Covid 19 pandemic. METHODS This was an ecological study of premature mortality due to Diabetes from 2016 to 2020, with a focus on small areas. All deaths in people under 75 years of age due to Diabetes as the underlying cause were included RESULTS: The final sample comprised 7382 premature deaths in 5967 census tracts. Women living in census tracts with an high level of deprivation(RR=2.40) were at a significantly higher risk. Mortality from Diabetes increased with deprivation, especially people aged 0-54(RR=2.40). People with an immediate cause of death related to a circulatory disease, living in census tracts with an high level of deprivation(RR=3.86) was associated with a significantly greater risk of death with underlying Diabetes. When a disease of the circulatory system was recorded as the immediate cause of death, being 65-74 years (RR=71.01) was associated with a significantly higher risk of premature mortality. CONCLUSIONS Living in geographic areas with higher levels of socioeconomic deprivation is associated with a higher risk of premature death from Diabetes in Spain. This relationship has a greater impact on women, people under 54 years, and people at risk of death caused directly by diseases of the circulatory system. Premature mortality due to diabetes saw a modest increase in 2020.
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Affiliation(s)
- José A Quesada
- Clinical Medicine Department, School of Medicine, University of Miguel Hernández de Elche, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain; Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), San Juan de Alicante 03550, Spain
| | - Adriana López-Pineda
- Clinical Medicine Department, School of Medicine, University of Miguel Hernández de Elche, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain; Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), San Juan de Alicante 03550, Spain
| | - Domingo Orozco-Beltrán
- Clinical Medicine Department, School of Medicine, University of Miguel Hernández de Elche, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain; Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), San Juan de Alicante 03550, Spain
| | - Concepción Carratalá-Munuera
- Clinical Medicine Department, School of Medicine, University of Miguel Hernández de Elche, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain; Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), San Juan de Alicante 03550, Spain
| | - Xavier Barber-Vallés
- Center for Operations Research, University Miguel Hernández of Elche, Elche, Alicante, Spain
| | - Vicente F Gil-Guillén
- Clinical Medicine Department, School of Medicine, University of Miguel Hernández de Elche, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain; Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), San Juan de Alicante 03550, Spain; Primary care research center, Miguel Hernández University, Elche, Alicante, Spain; Institute of Health and Biomedical Research of Alicante, General University Hospital of Alicante. Diagnostic Center, Fifth floor. Pintor Baeza street, 12, Alicante 03110, Spain
| | - Rauf Nouni-García
- Clinical Medicine Department, School of Medicine, University of Miguel Hernández de Elche, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain; Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), San Juan de Alicante 03550, Spain; Institute of Health and Biomedical Research of Alicante, General University Hospital of Alicante. Diagnostic Center, Fifth floor. Pintor Baeza street, 12, Alicante 03110, Spain.
| | - Álvaro Carbonell-Soliva
- Clinical Medicine Department, School of Medicine, University of Miguel Hernández de Elche, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain
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Rosas J, Llinares-Tello F, Senabre-Gallego JM, Barber-Vallés X, Santos-Soler G, Salas-Heredia E, Pons Bas A, Cano Pérez C, García-Carrasco M. Obesity decreases clinical efficacy and levels of adalimumab in patients with ankylosing spondylitis. Clin Exp Rheumatol 2017; 35:145-148. [PMID: 27908311] [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] [Received: 03/13/2016] [Accepted: 09/02/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Obesity can be a factor that affects response to anti-TNF drugs. However, studies on patients with ankylosing spondylitis (AS) are rare. We aimed to determine whether obesity affects serum levels of adalimumab (ADL), and immunogenicity and clinical efficacy of the drug in patients with AS. METHODS A cross-sectional study on 57 patients with axial AS receiving ADL was conducted. They received DMARD per standard of care at their rheumatologist's discretion. Patients' body mass index (BMI) was obtained when ADL treatment began. Clinical response was evaluated using the Spanish versions of the BASDAI index and the ASDAS ESR index. Serum concentrations of free ADL (trough level) and anti-ADL antibodies were measured using Promonitor-ADL and Promonitor Anti-ADL ELISA kits (Progenika Grifols SA, Spain), just prior to the next subcutaneous injection of ADL. RESULTS Patients with BMI >30 kg/ m2 (obese) as opposed to BMI <25 kg/ m2 (normal), presented lower blood ADL levels [5.0 (5.52) vs. 9.14 (4.3), p=0.032], increased ASDAS scores (2.58 [0.79] vs. 1.9 [0.83], p=0.03), and shorter ADL treatment time: 1.01 [0.84] vs. (1.85 [1.65]; p=0.08]), and increased BASDAI results (5.04 [2.5] vs. 3.5 [1.88]; p=0.06). Obese patients showed a lower probability of clinical response to ADL versus non-obese patients with regard to achieving BASDAI ≤4 (OR: 3.5, 95%CI: 0.84-17.19; p=0.05) or ASDAS ≤2.1 (OR: 4.64, 95%CI: 1.02-24.13; p=0.02). CONCLUSIONS Of the AS patients receiving treatment with ADL, those that are obese had significantly lower serum ADL levels and decreased clinical response without an increase in immunogenicity.
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Affiliation(s)
- José Rosas
- Rheumatology Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain.
| | | | | | | | | | | | - Ana Pons Bas
- Rheumatology Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
| | - Catalina Cano Pérez
- Rheumatology Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
| | - Mario García-Carrasco
- Systemic Autoimmune Disease Research Unit HGR-36-CIBIOR IMSS Puebla; and Department of Rheumatology and Immunology, Benemérita Universidad Autónoma of Puebla, México
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Llinares-Tello F, Rosas-Gómez de Salazar J, Senabre-Gallego JM, Santos-Soler G, Santos-Ramírez C, Salas-Heredia E, Barber-Vallés X, Molina-García J. Erratum to: Practical application of acid dissociation in monitoring patients treated with adalimumab. Rheumatol Int 2014. [DOI: 10.1007/s00296-014-3060-9] [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: 11/24/2022]
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Rosas J, Llinares-Tello F, de la Torre I, Santos-Ramírez C, Senabre-Gallego JM, Valor L, Barber-Vallés X, Hernández-Flórez D, Santos-Soler G, Salas-Heredia E, Carreño L. Clinical relevance of monitoring serum levels of adalimumab in patients with rheumatoid arthritis in daily practice. Clin Exp Rheumatol 2014; 32:942-948. [PMID: 25327159] [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] [Received: 03/09/2014] [Accepted: 06/24/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVES The aim of this paper is to assess the usefulness of measuring serum levels of adalimumab (ADL) and anti-ADL antibodies in 57 patients with rheumatoid arthritis (RA) treated with ADL for at least 3 months in daily practice. METHODS All patients received concomitant disease-modifying anti-rheumatic drug (DMARD). Receiver-operator characteristics (ROC) analysis was used to obtain the cut-off value of ADL for low disease activity (DAS28-ESR ≤3.2). RESULTS Anti-ADL antibodies were detected in 4 (7%) patients with a mean (SD) DAS28 score of 4.6 (0.9). Patients with positive anti-ADL antibodies had significantly lower levels of ADL and higher DAS28 scores than those with negative antibodies. Patients with DAS28 ≤3.2 as compared with patients with DAS28 >3.2 showed significantly better SDAI score, higher serum concentrations of ADL and none of them showed anti-ADL antibodies. The cut-off of serum level of ADL for DAS28 <3.2 was 4.3 mg/L. According to serum levels of ADL, patients were grouped into group 1 (low level) <5.5 mg/L, group 2 (medium level) 5.5-11.3 mg/L and group 3 (high level) >11.3 mg/L. Patients in the medium group were closed to clinical remission (median DAS28 2.7) and patients in the high group were on clinical remission (DAS28 2.1). CONCLUSIONS Serum levels of ADL should be maintained >4.3 mg/L. In patients with ADL levels >11.3 mg/L, a decrease of the dose of ADL or an increase in the interval between doses may be planned. The presence of anti-ADL antibodies was associated with a loss of clinical efficacy of ADL.
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MESH Headings
- Adalimumab
- Aged
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/blood
- Antibodies, Monoclonal, Humanized/immunology
- Antirheumatic Agents/administration & dosage
- Antirheumatic Agents/blood
- Antirheumatic Agents/immunology
- Area Under Curve
- Arthritis, Rheumatoid/blood
- Arthritis, Rheumatoid/diagnosis
- Arthritis, Rheumatoid/drug therapy
- Arthritis, Rheumatoid/immunology
- Biomarkers/blood
- Cross-Sectional Studies
- Drug Monitoring
- Female
- Humans
- Male
- Middle Aged
- Predictive Value of Tests
- ROC Curve
- Spain
- Time Factors
- Treatment Outcome
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Affiliation(s)
- José Rosas
- Department of Rheumatology, Marina Baixa Hospital, Villajoyosa, Alicante, Spain.
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Martín-Sánchez AM, Cherif S, Ben-Abda J, Barber-Vallés X, Pérez-Álvarez JÁ, Sayas-Barberá E. Phytochemicals in date co-products and their antioxidant activity. Food Chem 2014; 158:513-20. [PMID: 24731377 DOI: 10.1016/j.foodchem.2014.02.172] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 02/25/2014] [Accepted: 02/28/2014] [Indexed: 01/18/2023]
Abstract
The date agro-industry needs to find appropriate techniques to give value to their co-products. This study analyzes twelve intermediate food products (IFPs) from date co-products, Medjool and Confitera cv. at several ripening stages, blanched and unblanched, for their content in bioactive compounds (phenols, tannins, flavonoids, carotenoids and anthocyanins) and the antioxidant activity (AA). IFPs from the more unripe stages had the highest AA and phytochemicals content, mainly phenols, up to 1.4 g GAE/100 g, with high proportions of tannins. Flavonoids were found in high amounts, up to 874 mg RE/100 g. Among the AA are significant the antiradical efficiency (4.62 mM TE/100 g) and chelating activity (252 μM EDTA/100 g). Blanching was beneficial for Confitera IFPs. A positive correlation was found between phenols, tannins and flavonoids and the AA; and their content could be used as indicator of the AA. Date IFPs have potential use as an antioxidant functional ingredient.
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Affiliation(s)
- Ana María Martín-Sánchez
- IPOA Research Group (Grupo 1-UMH, Grupo REVIV-Generalitat Valenciana), AgroFood Technology Department, Escuela Politécnica Superior de Orihuela, Miguel Hernández University, Ctra. Beniel, Km 3.2, Orihuela, Alicante E-03312, Spain
| | - Sarra Cherif
- IPOA Research Group (Grupo 1-UMH, Grupo REVIV-Generalitat Valenciana), AgroFood Technology Department, Escuela Politécnica Superior de Orihuela, Miguel Hernández University, Ctra. Beniel, Km 3.2, Orihuela, Alicante E-03312, Spain; Agronomic Superior Research and Teaching Institute, Tunisia
| | - Jamel Ben-Abda
- Agronomic Superior Research and Teaching Institute, Tunisia
| | | | - José Ángel Pérez-Álvarez
- IPOA Research Group (Grupo 1-UMH, Grupo REVIV-Generalitat Valenciana), AgroFood Technology Department, Escuela Politécnica Superior de Orihuela, Miguel Hernández University, Ctra. Beniel, Km 3.2, Orihuela, Alicante E-03312, Spain; Cátedra Palmeral de Elche. Miguel Hernández University, Spain.
| | - Estrella Sayas-Barberá
- IPOA Research Group (Grupo 1-UMH, Grupo REVIV-Generalitat Valenciana), AgroFood Technology Department, Escuela Politécnica Superior de Orihuela, Miguel Hernández University, Ctra. Beniel, Km 3.2, Orihuela, Alicante E-03312, Spain; Cátedra Palmeral de Elche. Miguel Hernández University, Spain
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Senabre-Gallego JM, Rosas-Gómez de Salazar J, Santos-Soler G, Santos-Ramírez C, Sánchez-Barrioluengo M, Salas-Heredia E, Barber-Vallés X, Cano-Pérez C, Llahí-Vidal N, Riestra-Juán R. [Duration of treatment with etanercept and motives for discontinuation in a cohort of patients with rheumatic disease]. ACTA ACUST UNITED AC 2011; 7:385-8. [PMID: 22078696 DOI: 10.1016/j.reuma.2011.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Revised: 06/17/2011] [Accepted: 06/28/2011] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the duration of etanercept (ETN) treatment and motives for discontinuation in our local cohort of patients with rheumatic pathology and compare them to the group with other biological treatments. PATIENTS AND METHODS Prospective observational cohort study. Disease diagnosis, start and end date and motive for discontinuation were recorded. Survival estimation was explored using Kaplan-Meier analysis with remaining patients censored at 1-year, 2-years and 5-years follow-up. RESULTS Ninety-two (45%) out of 205 patients started ETN treatment. Disease diagnoses recorded were: 48% rheumatoid arthritis, 33% ankylosing spondylitis, 11% psoriatic arthritis, 8% others (juvenile idiopathic arthritis, inflammatory bowel disease related spondylitis, SAPHO syndrome). 52% of patients are still on the drug. The motives for discontinuation were: inefficacy (65%), adverse events (33%) and lack of compliance (2%). Two patients discontinued ETN due to prolonged disease control. Adverse events were: infection (4 patients), post-injection skin reaction (3), uveitis (3), neoplasia (2) and others (3). Using a Kaplan-Meier analysis, at 1-year 64% (CI(95%) 54-74) of patients with ETN treatment had not experienced treatment failure, at 2-years, 59% (48-69) and at 5-years, 43% (30-52). With the rest of biologicals estimated survival was 61% (51-68), 47,5% (40-55) and 23% (10,5-32) respectively. Statistical analysis revealed significant differences (log-rank: P=.024; Breslow: P=.068; Tarone-Ware: P=.040). CONCLUSIONS In our cohort of patients treated with ETN the estimated survival was better than patients treated with other biological drugs at 1-year, 2-years and 5-years.
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