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Castiella A, José Sánchez-Iturri M, Urreta I, Torrente S, Alcorta A, Zapata E. Effect of viral eradication with direct-acting antiviral agents on iron parameters in patients with chronic hepatitis c and hyperferritinemia. Can Liver J 2023; 6:412-416. [PMID: 38152323 PMCID: PMC10751007 DOI: 10.3138/canlivj-2022-0042] [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: 11/06/2022] [Accepted: 01/01/2023] [Indexed: 12/29/2023]
Abstract
Background Patients with chronic hepatitis C are at increased risk for hyperferritinemia (HF). Abnormalities of serum iron parameters are frequently observed in patients with chronic hepatitis C (CHC). About a third of patients have increased iron parameters. Recently, studies on the effect of direct-acting antiviral agents (DAAs) in HCV eradication in patients with increased serum iron has been published, demonstrating the restoration of normal iron status. The aim of this study was to evaluate the effect of viral eradication with DDAs in patients with CHC and HF. Methods Retrospective study conducted from January 2018 to December 2020 including patients treated with DAAs for HCV. Pre-treatment (PreT) and post-treatment (PostT) serum ferritin values were evaluated in all patients. Inclusion criteria: Pret HF (>400 μg/L); CHC patients treated with DAA achieving sustained viral response (SVR). Exclusion criteria: No PreT or PostT HF available; no SVR; lost patients. Results From 621 patients treated with DAAs for CHC, 77 presented HF (12.40%), and 74 were included in the study. Fifty nine were men (79.73%) with a mean age 58.33, SD 8.68; PreT mean ferritin: 893.20 (SD 1037.09); PostT: 264.17 (SD 161.33); PreT mean transferrin saturation: 40.96 (SD 15.71); PostT: 29.82 (SD 11.17); PreT mean serum iron 152.32 (SD 62.07), PostT: 109.32 (SD 39.49). When we compared PreT and PostT iron parameters, significant statistical differences were present considering ferritin (p = 0.0000), transferrin saturation (p = 0.0000), and iron (p = 0.0002) determinations. Conclusions SVR after DAAs for CHC induces a statistically significant reduction on iron parameters.
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Affiliation(s)
- Agustin Castiella
- Department of Gastroenterology, Donostia University Hospital, Donostia, Spain
| | | | - Iratxe Urreta
- Epidemiology Unit, Donostia University Hospital, Donostia, Spain
| | - Silvia Torrente
- Department of Gastroenterology, Donostia University Hospital, Donostia, Spain
| | - Ana Alcorta
- Department of Gastroenterology, Donostia University Hospital, Donostia, Spain
| | - Eva Zapata
- Department of Gastroenterology, Donostia University Hospital, Donostia, Spain
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Castiella A, Lopez-Dominguez L, Sanchez-Iturri MJ, Urreta I, De Diego A, Belzunegui J, Zapata E. Liver steatosis in patients with rheumatoid arthritis treated with methotrexate is associated with body mass index. World J Hepatol 2023; 15:699-706. [PMID: 37305368 PMCID: PMC10251276 DOI: 10.4254/wjh.v15.i5.699] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/07/2023] [Accepted: 04/10/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Methotrexate (MTX) is the usual first-line treatment for rheumatoid arthritis (RA). Long-term use of MTX has been associated with liver steatosis (LS) and liver fibrosis (LF).
AIM To determine if LS in patients treated with MTX for RA is associated with MTX cumulative dose (MTX-CD), metabolic syndrome (MtS), body mass index (BMI), the male sex, or LF.
METHODS A single-center, prospective study of patients receiving MTX for RA was performed from February 2019 to February 2020. The inclusion criteria were patients aged 18 years or older diagnosed with RA by a rheumatologist and being treated with MTX (without limitation on the duration of treatment). The exclusion criteria were previous diagnosis of liver disease (hepatitis B or C virus infection, known nonalcoholic fatty liver disease), alcohol consumption greater than 60 g/d in males or 40 g/d in females, human immunodeficiency virus infection on antiretroviral therapy, diabetes mellitus, chronic renal failure, congestive heart failure, or BMI greater than 30 kg/m². Patients receiving leflunomide in the 3 years prior to the study were also excluded. Transient elastography (FibroScan, Echosens®, Paris, France) was used for fibrosis determination (LF > 7 KpA) and computer attenuation parameter (CAP) for LS (CAP > 248 dB/m). Demographic variables, laboratory data, MTX-CD (> 4000 mg), MtS criteria, BMI (> 25), transient elastography, and CAP scores were collected from all patients.
RESULTS Fifty-nine patients were included. Forty-three were female (72.88%), and the mean age was 61.52 years (standard deviation: 11.73). When we compared MTX-CD ≤ 4000 mg (26 patients; 14 with LS and 12 without) with > 4000 mg (33 patients; 12 with LS and 21 without), no statistical differences were found (P = 0.179). We compared CAP scores stratified by MtS, BMI, sex, and LF. There were no significant differences in CAP scores based on the presence of MtS [CAP/MtS: 50 no MtS (84.75%); 9 MtS (15.25%); P = 0.138], the male sex (CAP/sex: 8 male/18 female LS; 8 male/25 female no LS; P = 0.576), or LF [CAP/fibrosis: 53 no LF (89.83%); 6 LF (10.17%); P = 0.239]. LS determined by CAP was significantly associated with BMI > 25 (CAP/BMI: 22 BMI ≤ 25 (37.29%); 37 BMI > 25 (62.71%); P = 0.002].
CONCLUSION LS in patients with RA treated with MTX was not associated with MTX-CD, LF, the male sex, or MtS. However, BMI was significantly related to LS in these patients.
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Affiliation(s)
- Agustin Castiella
- Department of Gastroenterology Service, Donostia University Hospital, Donostia 20014, Spain
| | | | | | - Iratxe Urreta
- Department of Clinical Epidemiology, Donostia University Hospital, Donostia 20014, Spain
| | - Andrea De Diego
- Department of Rheumatology, Donostia University Hospital, Donostia 20014, Spain
| | - Joaquin Belzunegui
- Department of Rheumatology, Donostia University Hospital, Donostia 20014, Spain
| | - Eva Zapata
- Department of Gastroenterology, Donostia University Hospital, Donostia 20014, Spain
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3
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Lopez I, Aguinagalde B, Urreta I, Royo I, Bolufer S, Sanchez L, Zabaleta J, Fernández-Monge A, Recuero JL, Sesma J, Amor S, Moradiellos FJ, Arrarás MJ, Blanco AI, Boada M, Sanchez D, Cabañero A, Moreno N, Cal I, Moreno R, Cilleruelo Á, Crowley S, Gómez D, Fernández E, Hernando F, García S, López C, García MD, García JM, Rivo JE, Garcia JA, Gelbenzu JJ, Ramírez ME, Giraldo CF, Mongil R, Gómez MT, Jiménez M, Henández J, Fibla JJ, Illana JD, Jauregui A, Jiménez U, Rojo R, Martínez NJ, Martínez E, Trujillo JC, Milla L, Moreno SB, Congregado M, Obiols C, Call S, Quero F, Ramos R, Rodríguez A, Simón CM, Embun R. Results in mediastinal lymph node staging of surgical lung cancer: Data from the prospective cohort of the Spanish Video-Assisted Thoracic Surgery Group. Cir Esp 2022:S2173-5077(22)00157-0. [PMID: 35671974 DOI: 10.1016/j.cireng.2022.06.006] [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] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The objective of this study was to assess the diagnostic performance of combined computerised tomography (CT) and positron emission tomography (PET) in mediastinal staging of surgical lung cancer based on data obtained from the prospective cohort of the Spanish Group for Video-Assisted Thoracic Surgery (GEVATS). METHODS A total of 2782 patients underwent surgery for primary lung carcinoma. We analysed diagnostic success in mediastinal lymph node staging (cN2) using CT and PET. Bivariate and multivariate analyses were performed of the factors involved in this success. The risk of unexpected pN2 disease was analysed for cases in which an invasive testing is recommended: cN1, the tumour centrally located or the tumour diameter >3 cm. RESULTS The overall success of CT together with PET was 82.9% with a positive predictive value of 0.21 and negative predictive value of 0.93. If the tumour was larger than 3 cm and for each unit increase in mediastinal SUVmax, the probability of success was lower with OR 0.59 (0.44-0.79) and 0.71 (0.66-0.75), respectively. In the video-assisted thoracic surgery (VATS) approach, the probability of success was higher with OR 2.04 (1.52-2.73). The risk of unexpected pN2 increased with the risk factors cN1, the tumour centrally located or the tumour diameter >3 cm: from 4.5% (0 factors) to 18.8% (3 factors) but did not differ significantly as a function of whether invasive testing was performed. CONCLUSIONS CT and PET together have a high negative predictive value. The overall success of the staging is lower in the case of tumours >3 cm and high mediastinal SUVmax, and it is higher when VATS is performed. The risk of unexpected pN2 is higher if the disease is cN1, the tumour centrally located or the tumour diameter >3 cm but does not vary significantly as a function of whether patients have undergone invasive testing.
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Affiliation(s)
- Iker Lopez
- Servicio de Cirugía Torácica, Hospital Universitario Donostia, Instituto de Investigación Sanitaria Biodonostia, San Sebastián-Donostia, Spain.
| | - Borja Aguinagalde
- Servicio de Cirugía Torácica, Hospital Universitario Donostia, Instituto de Investigación Sanitaria Biodonostia, San Sebastián-Donostia, Spain
| | - Iratxe Urreta
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Epidemiología Clínica, Servicio Vasco de Salud Osakidetza, Hospital Universitario Donostia, Unidad de Epidemiología Clínica, San Sebastián-Donostia, Spain
| | - Iñigo Royo
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
| | - Sergio Bolufer
- Servicio de Cirugía Torácica, Hospital Universitario General de Alicante, Alicante, Spain
| | - Laura Sanchez
- Servicio de Cirugía Torácica, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Jon Zabaleta
- Servicio de Cirugía Torácica, Hospital Universitario Donostia, Instituto de Investigación Sanitaria Biodonostia, San Sebastián-Donostia, Spain
| | - Arantza Fernández-Monge
- Servicio de Cirugía Torácica, Hospital Universitario Donostia, Instituto de Investigación Sanitaria Biodonostia, San Sebastián-Donostia, Spain
| | - José Luis Recuero
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
| | - Julio Sesma
- Servicio de Cirugía Torácica, Hospital Universitario General de Alicante, Alicante, Spain
| | - Sergio Amor
- Servicio de Cirugía Torácica, Hospital Universitario Quironsalud Madrid, Madrid, Spain
| | | | - Miguel Jesús Arrarás
- Servicio de Cirugía Torácica, Instituto Valenciano de Oncología, Valencia, Spain
| | - Ana Isabel Blanco
- Servicio de Cirugía Torácica, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Marc Boada
- Servicio de Cirugía Torácica, Hospital Clinic de Barcelona, Barcelona, Spain
| | - David Sanchez
- Servicio de Cirugía Torácica, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Alberto Cabañero
- Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Nicolás Moreno
- Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Isabel Cal
- Servicio de Cirugía Torácica, Hospital Universitario de la Princesa, Madrid, Spain
| | - Ramón Moreno
- Servicio de Cirugía Torácica, Hospital Universitario de la Princesa, Madrid, Spain
| | - Ángel Cilleruelo
- Servicio de Cirugía Torácica, Hospital Universitario Clínico de Valladolid, Valladolid, Spain
| | - Silvana Crowley
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - David Gómez
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Elena Fernández
- Servicio de Cirugía Torácica, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Santiago García
- Servicio de Cirugía Torácica, Hospital Universitario de Badajoz, Badajoz, Spain
| | - Cipriano López
- Servicio de Cirugía Torácica, Hospital Universitario de Badajoz, Badajoz, Spain
| | - María Dolores García
- Servicio de Cirugía Torácica, Hospital Universitario de Albacete, Albacete, Spain
| | - Jose María García
- Servicio de Cirugía Torácica, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - José Eduardo Rivo
- Servicio de Cirugía Torácica, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Jose Alberto Garcia
- Servicio de Cirugía Torácica, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Juan José Gelbenzu
- Servicio de Cirugía Torácica, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - María Elena Ramírez
- Servicio de Cirugía Torácica, Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | - Roberto Mongil
- Servicio de Cirugía Torácica, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - María Teresa Gómez
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain
| | - Marcelo Jiménez
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain
| | - Jorge Henández
- Servicio de Cirugía Torácica, Hospital Universitario Sagrat Cor, Barcelona, Spain
| | - Juan José Fibla
- Servicio de Cirugía Torácica, Hospital Universitario Sagrat Cor, Barcelona, Spain
| | | | - Alberto Jauregui
- Servicio de Cirugía Torácica, Hospital Universitario Vall d́Hebron, Barcelona, Spain
| | - Unai Jiménez
- Servicio de Cirugía Torácica, Hospital Universitario de Cruces, Bilbao, Spain
| | - Rafael Rojo
- Servicio de Cirugía Torácica, Hospital Universitario de Cruces, Bilbao, Spain
| | - Néstor J Martínez
- Servicio de Cirugía Torácica, Hospital Universitario La Ribera, Alcira, Valencia, Spain
| | - Elisabeth Martínez
- Servicio de Cirugía Torácica, Hospital Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Juan Carlos Trujillo
- Servicio de Cirugía Torácica, Hospital Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Lucía Milla
- Servicio de Cirugía Torácica, Hospital Arnau de Vilanova, Lleida, Spain
| | - Sergio B Moreno
- Servicio de Cirugía Torácica, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Miguel Congregado
- Servicio de Cirugía Torácica, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Carme Obiols
- Servicio de Cirugía Torácica, Hospital Universitario MútuaTerrasa, Universidad de Barcelona, Terrasa, Barcelona, Spain
| | - Sergi Call
- Servicio de Cirugía Torácica, Hospital Universitario MútuaTerrasa, Universidad de Barcelona, Terrasa, Barcelona, Spain
| | - Florencio Quero
- Servicio de Cirugía Torácica, Hospital Virgen de las Nieves, Granada, Spain
| | - Ricard Ramos
- Servicio de Cirugía Torácica, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Alberto Rodríguez
- Servicio de Cirugía Torácica, Hospital del Mar, Instituto de Investigación Médica Hospital del Mar, Barcelona, Spain
| | - Carlos María Simón
- Servicio de Cirugía Torácica, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Raul Embun
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
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Martínez García L, Samsó Jofra L, Alonso-Coello P, Ansuategi E, Asso Mistral L, Ballesteros M, Canelo-Aybar C, Casino G, Gallego Iborra A, Niño de Guzmán Quispe EP, Requeijo C, Roqué I Figuls M, Salas K, Ubeda M, Urreta I, Rosenbaum S. Teaching and learning how to make informed health choices: Protocol for a context analysis in Spanish primary schools. F1000Res 2021; 10:312. [PMID: 34631019 PMCID: PMC8474100 DOI: 10.12688/f1000research.51961.2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/06/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction The Informed Health Choices (IHC) project developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore the educational context for teaching and learning critical thinking about health in Spanish primary schools. Methods During the 2020-2021 school year, we will conduct 1) a systematic assessment of educational documents and resources, and 2) semi-structured interviews with key education and health stakeholders. In the systematic assessment of educational documents and resources, we will include state and autonomous communities' curriculums, school educational projects, and commonly used textbooks and other health teaching materials. In the semi-structured interviews, we will involve education and health policy makers, developers of learning resources, developers of health promotion and educational interventions, head teachers, teachers, families, and paediatric primary care providers. We will design and pilot a data extraction form and a semi-structured interview guide to collect the data. We will perform a quantitative and a qualitative analysis of the data to explore how critical thinking about health is being taught and learned in Spanish primary schools. Conclusion We will identify opportunities for and barriers to teaching and learning critical thinking about health in Spanish primary schools. We will formulate recommendations-for both practice and research purposes-on how to use, adapt (if needed), and implement the IHC resources in this context.
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Affiliation(s)
- Laura Martínez García
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Laura Samsó Jofra
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Eukane Ansuategi
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Osakidetza, OSI Donostialdea, University Hospital of Donostia, Library Service, Donostia, Spain
| | - Laia Asso Mistral
- Maternal and Child Health Service, General Subdirectorate of Health Promotion, Public Health Agency of Catalonia, Barcelona, Spain
| | - Monica Ballesteros
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | - Carlos Canelo-Aybar
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Gonzalo Casino
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | | | | | - Carolina Requeijo
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Marta Roqué I Figuls
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | - Karla Salas
- Health Services Research Group - Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mar Ubeda
- Osakidetza, OSI Donostialdea, University Hospital of Donostia, Library Service, Donostia, Spain
| | - Iratxe Urreta
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Clinical Epidemiology and Research Unit, University Hospital of Donostia, Donostia, Spain
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
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5
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Landa M, Ninchritz E, Álvarez L, Palicio I, Urreta I. Autologous Tragal Perichondrium Graft for Vocal Fold Scar and Sulcus Vocalis. J Voice 2021; 36:701-706. [PMID: 33934935 DOI: 10.1016/j.jvoice.2020.08.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/19/2020] [Accepted: 08/19/2020] [Indexed: 11/29/2022]
Abstract
Between 2006 and 2016 in a Tertiary Academic Center, 11 patients underwent phonomicrosurgery with tragal perichondrium graft placement in Reinke's space for the treatment of sulcus (Ford type 2) and vocal fold scar. A total of six patients out of 11 had an additional autologous fat implantation in order to improve the glottic closure. We evaluated the functional outcome using the Spanish validated version of the VHI- 30 before and 6 months after the surgery. We also measured the subjective appreciation of the obtained outcome, a perceptual voice evaluation using GRBAS scale, and changes in videostroboscopy examinations concerning mucosal wave and glottic closure. In the VHI-30 questionnaire, we observed an improvement in all patients (six of which showed an improvement of 50% or more) with statistically significant results (P = 0.003), and no significant differences between sulcus (Ford type 2) and vocal cord scar patients (P = 0.7579). The results obtained from the single question assessing changes in voice quality showed a high improvement in seven patients. According to the GRBAS scale, all cases improved. Concerning the results of the videostroboscopy, two patients obtained very favorable results, eight of them presented a moderate recovery and only one improved slightly. The following complications were identified: two granulomas, a graft extrusion and a tragal infection. The tragal perichondrium used as an autograft in Reinke's space appears to be a safe and satisfactory choice, comparable to other grafts such as temporalis fascia or autologous fat.
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Affiliation(s)
- Mikel Landa
- Department of Otorhinolaryngology, University Hospital Donostia-San Sebastián, Spain.
| | - Elisabeth Ninchritz
- Department of Otorhinolaryngology, University Hospital Donostia-San Sebastián, Spain
| | - Leire Álvarez
- Department of Otorhinolaryngology, University Hospital Donostia-San Sebastián, Spain
| | - Idoia Palicio
- Department of Otorhinolaryngology, University Hospital Donostia-San Sebastián, Spain
| | - Iratxe Urreta
- Epidemiology unit, University Hospital Donostia-San Sebastián, Spain
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6
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Uranga A, González C, Furundarena JR, Robado N, Rey M, Aragon L, Urreta I, Aranbarri A, De Juan MD, Araiz M. Large granular lymphocyte leukaemia study at the University Hospital of Donostia. J Clin Pathol 2021; 75:226-233. [PMID: 33479020 DOI: 10.1136/jclinpath-2020-207191] [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] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/29/2020] [Accepted: 01/04/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Large granular lymphocyte (LGL) leukaemia is considered a mature T-cell or natural killer (NK) cell neoplasm, characterised by a clonal proliferation of LGL. AIMS To analyse the characteristics and to establish (if possible) the prognostic parameters of these patients diagnosed in a single centre: University Hospital of Donostia. METHODS We retrospectively studied data about 308 patients with LGL leukaemia diagnosed in our centre. RESULTS The frequency of T-LGL leukaemia and chronic lymphoproliferative disorder of NK cells was 89% and 6.8% respectively, and no aggressive NK-LGL leukaemia was seen in our population. The median age at diagnosis was 65.7 years and male-to-female ratio was 1.08. 59% of our patients were asymptomatic at the time of diagnosis. Most patients presented lymphocytosis and 63.6% more than 20% LGLs in the peripheral blood count, but it has to be taken into account that these results may be influenced by the selection bias of our study, as we recognised these patients as 'alarms of the laboratory analysers'. Neutropenia was the most common cytopenia, and autoimmune disorders were described in 16.5% of the patients. Only 12 patients (3.9%) required treatment, a much lower percentage that the one reported in the literature, and this is consistent with the fact that patients were less symptomatic than in other series, as we expected. The 5-year and 15-year overall survival was 92% and 87%, respectively. CONCLUSIONS Our patients may represent the even more benign end of the spectrum of clonal T LGL and NK proliferations.
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Affiliation(s)
- Alasne Uranga
- Hematología y Hemoterapia, Hospital Universitario Donostia, Donostia, Spain
| | - Carmen González
- Hematología y Hemoterapia, Hospital Universitario Donostia, Donostia, Spain
| | - J R Furundarena
- Hematología y Hemoterapia, Hospital Universitario Donostia, Donostia, Spain
| | - Naiara Robado
- Hematología y Hemoterapia, Hospital Zumarraga, Zumarraga, Spain
| | - Mercedes Rey
- Inmunología, Hospital Universitario Donostia, Donostia, Spain
| | - Larraitz Aragon
- Inmunología, Hospital Universitario Donostia, Donostia, Spain
| | - Iratxe Urreta
- Epidemiología, Hospital Universitario Donostia, Donostia, Spain
| | - Ane Aranbarri
- Hematología y Hemoterapia, Hospital Galdakao-Usansolo, Galdacano, Spain
| | | | - Maria Araiz
- Hematología y Hemoterapia, Hospital Universitario Donostia, Donostia, Spain
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7
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Castiella A, Urreta I, Zapata E, Alústiza JM, de Juan MD, Emparanza JI. Prediction of liver iron overload in the Basque country (Spain) in patients referred for hyperferritinemia. Dig Liver Dis 2021; 53:137-138. [PMID: 33191133 DOI: 10.1016/j.dld.2020.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Agustin Castiella
- Gastroenterology Service, Donostia University Hospital, Donostia, Spain; Gastroenterology Service, Mendaro Hospital, Mendaro, Spain; Corresponding author at: Gastroenterology Service, Donostia University Hospital, Donostia, Spain..
| | - Iratxe Urreta
- Clinical Epidemiology Unit, CASPe, CIBER-ESP, Donostia University Hospital, Donostia, Spain
| | - Eva Zapata
- Gastroenterology Service, Donostia University Hospital, Donostia, Spain; Gastroenterology Service, Mendaro Hospital, Mendaro, Spain
| | | | | | - José I Emparanza
- Clinical Epidemiology Unit, CASPe, CIBER-ESP, Donostia University Hospital, Donostia, Spain
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Ansuategi E, Ubeda M, Iglesias M, Urreta I, Emparanza JI. Challenges for medical libraries in times of COVID-19: Making clinical decisions that uphold research quality. EFI 2020. [DOI: 10.3233/efi-200009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Distance working in the context of the COVID-19 crisis has engendered a new model of collaborative activity for the Library of Donostialdea Integrated Health Organisation (San Sebastián, Spain). Promoted by the Clinical Epidemiology and Research Unit, this initiative has enabled Hospital Management to respond to some of the gaps in information revealed during the pandemic. Changes in editorial policies offering open access information, the lack of peer-reviewed literature, and the spread of scientific literature through social media are some of the factors that stand out in the search for the best evidence during the COVID-19 pandemic.
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Affiliation(s)
- Eukene Ansuategi
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Medical Library, San Sebastián, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Marimar Ubeda
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Medical Library, San Sebastián, Spain
| | - Mayte Iglesias
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- Biodonostia Health Research Institute, San Sebastián, Spain
| | - Iratxe Urreta
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- Biodonostia Health Research Institute, San Sebastián, Spain
| | - Jose Ignacio Emparanza
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- Biodonostia Health Research Institute, San Sebastián, Spain
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Castiella A, Zapata E, Urreta I, Zubiaurre L, Alústiza JM, Otazua P, Emparanza JI. Body mass index and alcohol consumption are directly related with liver steatosis. Results from a prospective study of patients referred for hyperferritinemia. Ann Hepatol 2020; 19:697. [PMID: 32866690 DOI: 10.1016/j.aohep.2020.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 07/31/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Agustín Castiella
- Gastroenterology, Donostia University Hospital, Donostia, Spain; Gastroenterology, Mendaro Hospital, Mendaro, Spain.
| | - Eva Zapata
- Gastroenterology, Donostia University Hospital, Donostia, Spain; Gastroenterology, Mendaro Hospital, Mendaro, Spain
| | - Iratxe Urreta
- Clinical Epidemiology, Clinical Epidemiology Unit, CASPe, CIBER-ESP, DonostiaUniversity Hospital, Donostia, Spain
| | - Leire Zubiaurre
- Gastroenterology, Donostia University Hospital, Donostia, Spain; Gastroenterology, Mendaro Hospital, Mendaro, Spain
| | | | - Pedro Otazua
- Gastroenterology, Mondragon Hospital, Mondragon, Spain
| | - José Ignacio Emparanza
- Clinical Epidemiology, Clinical Epidemiology Unit, CASPe, CIBER-ESP, DonostiaUniversity Hospital, Donostia, Spain
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Castiella A, Urreta I, Zapata E, de Juan M, Alústiza JM, Emparanza JI. Dysmetabolic iron overload syndrome and its relationship with HFE gene mutations and with liver steatosis. Dig Liver Dis 2020; 52:683-685. [PMID: 32359860 DOI: 10.1016/j.dld.2020.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Agustín Castiella
- Gastroenterology Service, Donostia University Hospital, Donostia, Spain; Clinical Epidemiology Unit, CASPe, CIBER-ESP, Donostia University Hospital, Donostia, Spain.
| | - Iratxe Urreta
- Clinical Epidemiology Unit, CASPe, CIBER-ESP, Donostia University Hospital, Donostia, Spain
| | - Eva Zapata
- Gastroenterology Service, Donostia University Hospital, Donostia, Spain; Clinical Epidemiology Unit, CASPe, CIBER-ESP, Donostia University Hospital, Donostia, Spain
| | | | | | - José Ignacio Emparanza
- Clinical Epidemiology Unit, CASPe, CIBER-ESP, Donostia University Hospital, Donostia, Spain
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Castiella A, Urreta I, Zapata E, de Juan MD, Emparanza JI. H63/H63D genotype and the H63D allele are associated in patients with hyperferritinemia to the development of metabolic syndrome. Eur J Intern Med 2020; 72:106-107. [PMID: 31796245 DOI: 10.1016/j.ejim.2019.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 11/23/2019] [Accepted: 11/26/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Agustin Castiella
- Gastroenterology Service, Donostia University Hospital, P. Dr Beguristain s/n, 20014 Donostia, Spain; Gastroenterology Service, Mendaro hospital, Mendaro, Spain.
| | - Iratxe Urreta
- Clinical Epidemiology Unit, CASPe, CIBER-ESP, Donostia University Hospital, P. Dr Beguristain s/n, 20014 Donostia, Spain
| | - Eva Zapata
- Gastroenterology Service, Donostia University Hospital, P. Dr Beguristain s/n, 20014 Donostia, Spain
| | - M Dolores de Juan
- Immunology Unit, Donostia University Hospital, P. Dr Beguristain s/n, 20014 Donostia, Spain
| | - Jose I Emparanza
- Clinical Epidemiology Unit, CASPe, CIBER-ESP, Donostia University Hospital, P. Dr Beguristain s/n, 20014 Donostia, Spain
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Castiella A, Urreta I, Zapata E, Zubiaurre L, Alústiza JM, Otazua P, Salvador E, Letamendi G, Arrizabalaga B, Rincón ML, Emparanza JI. Liver iron concentration in dysmetabolic hyperferritinemia: Results from a prospective cohort of 276 patients. Ann Hepatol 2020; 19:31-35. [PMID: 31587985 DOI: 10.1016/j.aohep.2019.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 06/30/2019] [Accepted: 07/02/2019] [Indexed: 02/08/2023]
Abstract
INTRODUCTION AND OBJECTIVES We aimed to study the liver iron concentration in patients referred for hyperferritinemia to six hospitals in the Basque Country and to determine if there were differences between patients with or without metabolic syndrome. PATIENTS AND METHODS Metabolic syndrome was defined by accepted criteria. Liver iron concentration was determined by magnetic resonance imaging. RESULTS We obtained the data needed to diagnose metabolic syndrome in 276 patients; a total of 135 patients (49%), 115/240 men (48%), and 20/36 women (55.6%) presented metabolic syndrome. In all 276 patients, an MRI for the determination of liver iron concentration (mean±SD) was performed. The mean liver iron concentration was 30.83±19.38 for women with metabolic syndrome, 38.84±25.50 for men with metabolic syndrome, and 37.66±24.79 (CI 95%; 33.44-41.88) for the whole metabolic syndrome group. In 141 patients (51%), metabolic syndrome was not diagnosed: 125/240 were men (52%) and 16/36 were women (44.4%). The mean liver iron concentration was 34.88±16.18 for women without metabolic syndrome, 44.48±38.16 for men without metabolic syndrome, and 43.39±36.43 (CI 95%, 37.32-49.46) for the whole non-metabolic syndrome group. Comparison of the mean liver iron concentration from both groups (metabolic syndrome vs non-metabolic syndrome) revealed no significant differences (p=0.12). CONCLUSIONS Patients with hyperferritinemia and metabolic syndrome presented a mildly increased mean liver iron concentration that was not significantly different to that of patients with hyperferritinemia and non-metabolic syndrome.
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Affiliation(s)
- Agustin Castiella
- Gastroenterology Service, Mendaro Hospital, Mendaro, Spain; Gastroenterology Service, Donostia University Hospital, Donostia, Spain.
| | - Iratxe Urreta
- Clinical Epidemiology Unit, CASPe, CIBER-ESP, Donostia University Hospital, Donostia, Spain
| | - Eva Zapata
- Gastroenterology Service, Mendaro Hospital, Mendaro, Spain; Gastroenterology Service, Donostia University Hospital, Donostia, Spain
| | | | | | - Pedro Otazua
- Gastroenterology Service, Mondragon Hospital, Mondragon, Spain
| | | | | | | | | | - José I Emparanza
- Clinical Epidemiology Unit, CASPe, CIBER-ESP, Donostia University Hospital, Donostia, Spain
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Furundarena JR, Uranga A, Alkorta A, González C, Javier Ferreiro J, Rey M, Aragón L, Urreta I, Emparanza JI, Redín H, Garrido A, Araiz M. Evaluation of the predictive value of the hematopoietic progenitor cell count using an automated hematology analyzer for CD34+ stem cell mobilization and apheresis product yield. Int J Lab Hematol 2019; 42:170-179. [DOI: 10.1111/ijlh.13142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 10/16/2019] [Accepted: 11/21/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Alasne Uranga
- Hematology Laboratory Donostia University Hospital (DUH) Donostia Spain
| | - Aitziber Alkorta
- Hematopoietic Stem Cell Transplantation Unit Hematology Department Donostia University Hospital (DUH) Donostia Spain
| | - Carmen González
- Hematology Laboratory Donostia University Hospital (DUH) Donostia Spain
| | - José Javier Ferreiro
- Hematopoietic Stem Cell Transplantation Unit Hematology Department Donostia University Hospital (DUH) Donostia Spain
| | - Mercedes Rey
- Immunology Laboratory Donostia University Hospital (DUH) Donostia Spain
| | - Larraitz Aragón
- Immunology Laboratory Donostia University Hospital (DUH) Donostia Spain
| | - Iratxe Urreta
- Clinical Epidemiology Unit Donostia University Hospital (DUH) Donostia Spain
| | | | - Helena Redín
- Core Laboratory Donostia University Hospital (DUH) Donostia Spain
| | - Adolfo Garrido
- Core Laboratory Donostia University Hospital (DUH) Donostia Spain
| | - María Araiz
- Hematopoietic Stem Cell Transplantation Unit Hematology Department Donostia University Hospital (DUH) Donostia Spain
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Martínez García L, Alonso-Coello P, Asso Ministral L, Ballesté-Delpierre C, Canelo Aybar C, de Britos C, Fernández Rodríguez A, Gallego Iborra A, Leo Rosas V, Llaquet P, Niño de Guzmán Quispe EP, Pérez-Gaxiola G, Requeijo C, Salas-Gama K, Samsó Jofra L, Terres J, Urreta I, Rosenbaum S. Learning to make informed health choices: Protocol for a pilot study in schools in Barcelona. F1000Res 2019; 8:2018. [PMID: 32528654 PMCID: PMC7268153 DOI: 10.12688/f1000research.21292.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/20/2019] [Indexed: 11/04/2023] Open
Abstract
Introduction: The Informed Health Choices (IHC) project has developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore both the students' and teachers' experience when using these resources in the context of Barcelona (Spain). Methods: During the 2019-2020 school year, we will conduct a pilot study with 4 th and 5 th-year primary school students (9 to 11-year-olds) from three schools in Barcelona. The intervention in the schools will include: 1) a workshop with the teachers, and 2) lessons to the students. The data collection will include: 1) initial assessment of the resources by the teachers, 2) non-participatory observations during the lessons, 3) semi-structured interviews with the students after a lesson, 4) assessment of the lessons by the teachers, 5) treatment claim assessment by the students, and 6) final assessment of the resources by the teachers. We will use ad hoc questionnaires and guides to register the data. We will perform a quantitative and qualitative analysis of the data to explore understandability, desirability, suitability, usefulness, facilitators and barriers of the resources. The most relevant results will be discussed and some recommendations on how to use, how to adapt (if needed), and how to implement the IHC resources to this context will be agreed. We will publish the study results in a peer-reviewed journal and in several Internet resources (web pages, electronic bulletins, and social media), and we will present them to the different users of interest in conferences, workshops, and meetings. Ethical considerations: The study protocol has obtained an approval exemption from the Ethics Committee of the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain).
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Affiliation(s)
- Laura Martínez García
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Laia Asso Ministral
- Maternal and Child Health Service, General Subdirectorate of Health Promotion, Public Health Agency of Catalonia, Barcelona, Spain
| | | | - Carlos Canelo Aybar
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | | | | | | | - Victoria Leo Rosas
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | | | | | | | - Carolina Requeijo
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Karla Salas-Gama
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laura Samsó Jofra
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Iratxe Urreta
- Clinical Epidemiology and Research Unit, University Hospital of Donostia, Donostia, Spain
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
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Martínez García L, Alonso-Coello P, Asso Ministral L, Ballesté-Delpierre C, Canelo Aybar C, de Britos C, Fernández Rodríguez A, Gallego Iborra A, Leo Rosas V, Llaquet P, Niño de Guzmán Quispe EP, Pérez-Gaxiola G, Requeijo C, Salas-Gama K, Samsó Jofra L, Terres J, Urreta I, Rosenbaum S. Learning to make informed health choices: Protocol for a pilot study in schools in Barcelona. F1000Res 2019; 8:2018. [PMID: 32528654 PMCID: PMC7268153 DOI: 10.12688/f1000research.21292.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2020] [Indexed: 11/04/2023] Open
Abstract
Introduction: The Informed Health Choices (IHC) project has developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore both the students' and teachers' experience when using these resources in the context of Barcelona (Spain). Methods: During the 2019-2020 school year, we will conduct a pilot study with 4 th and 5 th-year primary school students (9 to 11-year-olds) from three schools in Barcelona. The intervention in the schools will include: 1) assessment of the IHC resources by the teachers before the lessons, 2) non-participatory observations during the lessons, 3) semi-structured interviews with the students after a lesson, 4) assessment of the lessons by the teachers after a lesson, 5) treatment claim assessment by the students at the end of the lessons, and 6) assessment of the IHC resources by the teachers at the end of the lessons. We will use ad hoc questionnaires and guides to register the data. We will perform a quantitative and qualitative analysis of the data to explore understandability, desirability, suitability, usefulness, facilitators and barriers of the resources. The most relevant results will be discussed and some recommendations on how to use, how to adapt (if needed), and how to implement the IHC resources to this context will be agreed. The findings of the contextualization activities could inform the design of a cluster-randomised trial, to determine the effectiveness of the IHC resources in this context prior to scaling-up its use. Ethical considerations: The study protocol has obtained an approval exemption from the Ethics Committee of the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain).
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Affiliation(s)
- Laura Martínez García
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Laia Asso Ministral
- Maternal and Child Health Service, General Subdirectorate of Health Promotion, Public Health Agency of Catalonia, Barcelona, Spain
| | | | - Carlos Canelo Aybar
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | | | | | | | - Victoria Leo Rosas
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | | | | | | | - Carolina Requeijo
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Karla Salas-Gama
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laura Samsó Jofra
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Iratxe Urreta
- Clinical Epidemiology and Research Unit, University Hospital of Donostia, Donostia, Spain
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
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Martínez García L, Alonso-Coello P, Asso Ministral L, Ballesté-Delpierre C, Canelo Aybar C, de Britos C, Fernández Rodríguez A, Gallego Iborra A, Leo Rosas V, Llaquet P, Niño de Guzmán Quispe EP, Pérez-Gaxiola G, Requeijo C, Salas-Gama K, Samsó Jofra L, Terres J, Urreta I, Rosenbaum S. Learning to make informed health choices: Protocol for a pilot study in schools in Barcelona. F1000Res 2019; 8:2018. [PMID: 32528654 PMCID: PMC7268153 DOI: 10.12688/f1000research.21292.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction: The Informed Health Choices (IHC) project has developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore both the students' and teachers' experience when using these resources in the context of Barcelona (Spain). Methods: During the 2019-2020 school year, we will conduct a pilot study with 4 th and 5 th-year primary school students (9 to 11-year-olds) from three schools in Barcelona. The intervention in the schools will include: 1) a workshop with the teachers, and 2) lessons to the students. The data collection will include: 1) assessment of the IHC resources by the teachers before the lessons, 2) non-participatory observations during the lessons, 3) semi-structured interviews with the students after a lesson, 4) assessment of the lessons by the teachers after a lesson, 5) treatment claim assessment by the students at the end of the lessons, and 6) assessment of the IHC resources by the teachers at the end of the lessons. We will use ad hoc questionnaires and guides to register the data. We will perform a quantitative and qualitative analysis of the data to explore understandability, desirability, suitability, usefulness, facilitators and barriers of the resources. The most relevant results will be discussed and some recommendations on how to use, how to adapt (if needed), and how to implement the IHC resources to this context will be agreed. The findings of the contextualization activities could inform the design of a cluster-randomised trial, to determine the effectiveness of the IHC resources in this context prior to scaling-up its use. Ethical considerations: The study protocol has obtained an approval exemption from the Ethics Committee of the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain).
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Affiliation(s)
- Laura Martínez García
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Laia Asso Ministral
- Maternal and Child Health Service, General Subdirectorate of Health Promotion, Public Health Agency of Catalonia, Barcelona, Spain
| | | | - Carlos Canelo Aybar
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | | | | | | | - Victoria Leo Rosas
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | | | | | | | - Carolina Requeijo
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Karla Salas-Gama
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laura Samsó Jofra
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Iratxe Urreta
- Clinical Epidemiology and Research Unit, University Hospital of Donostia, Donostia, Spain
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
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Martínez Basterra Z, Fernández de Pinedo M, Rey JA, Palicio I, Soriano-Reixach MM, Urreta I, Altuna Mariezcurena X. Phone Speech Recognition Improvement in Noisy Environment: Use of a Bluetooth Accessory. Ear Nose Throat J 2019; 100:490-496. [PMID: 31597532 DOI: 10.1177/0145561319880384] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To evaluate speech understanding in noise and patient satisfaction using the new Cochlear Wireless Phone Clip device. MATERIAL AND METHODS Twenty-nine experienced cochlear implant (CI) users (>6 months usage) were situated in a soundproof room where a 65 dB SPL Spanish cocktail noise was generated continuously from 4 loudspeakers. Lists of disyllabic words were presented through the clinic landline telephone to the patients. Patients were tested first holding the phone and then with the Cochlear Phone Clip© paired to the CP910 using various mixing ratios (2:1, 4:1, and Phone Clip© only). RESULTS Statistically significant (P < .001) improvement of speech recognition performance was found in cell phone usage by wireless transmission and also when using this new device. Kepler questionnaire results showed that before using Phone Clip in everyday life, 55.2% of patients described themselves highly or greatly affected by their deafness for telephone use and 80% moderately to greatly affected. Kim questionnaire results showed statistically significant differences (P < .001) in the subjective satisfaction of the Bluetooth-implemented CI compared to the conventional mode for sound quality, noise interference, and sound accuracy. CONCLUSIONS The wireless Phone Clip© device helps implanted people to improve subjective and objective speech recognition performance through the phone in noisy environments.
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Affiliation(s)
- Zuriñe Martínez Basterra
- Otorhinolaryngology-Otology Department, 16650Hospital Universitario, Donostia-San Sebastián, Sebastián, Spain
| | | | - Jorge Alberto Rey
- Otorhinolaryngology-Otology Department, 16650Hospital Universitario, Donostia-San Sebastián, Sebastián, Spain
| | - Idoia Palicio
- Otorhinolaryngology-Otology Department, 16650Hospital Universitario, Donostia-San Sebastián, Sebastián, Spain
| | | | - Iratxe Urreta
- Epidemiology Department, 16650Hospital Universitario, Donostia-San Sebastián, Sebastián, Spain
| | - Xabier Altuna Mariezcurena
- Otorhinolaryngology-Otology Department, 16650Hospital Universitario, Donostia-San Sebastián, Sebastián, Spain
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18
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Ripa C, Ercilla M, Ariztia M, Urreta I, Gayán M, Pascual P, Carmona P, Leunda L, Lizardi A, Barral J, Odriozola B, Lombera L, Bachiller M. Early dietary supplementation enriched in Vitamin D and calcium B-hydroxy-B-methylbutirate in hip fracture: does it improve postoperative complications? Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1578] [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: 10/28/2022]
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19
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Ercilla M, Ripa C, Ariztia M, Urreta I, Gayán M, Carmona M, Pascual P, Leunda L, Lizardi A, Barral J, Odriozola B, Lombera L. Early dietary supplementation enriched in Vitamin D and calcium β-hydroxy-β-methylbutirate in hip fracture: Does it improve functional recovery? Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1981] [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: 12/01/2022]
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Ripa C, Ercilla M, Ariztia M, Urreta I, Gayán M, Pascual P, Carmona P, Leunda L, Lizardi A, Barral J, Odriozola B, Lombera L. Early dietary supplementation enriched in Vitamin D and calcium B-hydroxy-B-methylbutirate in hip fracture: Does it improve nutritional status? Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1579] [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: 11/16/2022]
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Ecay-Torres M, Estanga A, Tainta M, Izagirre A, Garcia-Sebastian M, Villanua J, Clerigue M, Iriondo A, Urreta I, Arrospide A, Díaz-Mardomingo C, Kivipelto M, Martinez-Lage P. Increased CAIDE dementia risk, cognition, CSF biomarkers, and vascular burden in healthy adults. Neurology 2018; 91:e217-e226. [PMID: 29898969 DOI: 10.1212/wnl.0000000000005824] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/11/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To investigate the cognitive profile of healthy individuals with increased Cardiovascular Risk Factors, Aging and Dementia (CAIDE) dementia risk score and to explore whether this association is related to vascular burden and CSF biomarkers of amyloidosis and neurodegeneration. METHOD Cognitively normal participants (mean age 57.6 years) from the Gipuzkoa Alzheimer Project study were classified as having high risk (HR; n = 82) or low risk (LR; n = 293) for dementia according to a CAIDE score cutoff of 9. Cognitive composites were compared between groups. We explored using generalized linear models the role of APOE genotype, MRI white matter hyperintensities (WMH), and CSF (n = 218) levels of β-amyloid1-42 (Aβ1-42), total tau (t-tau), and phosphorylated tau (p-tau) in the association between CAIDE score and cognition. RESULTS HR participants obtained lower scores on executive function (EF) (p = 0.001) and visual perception and construction (VPC) (p < 0.001) composites. EF composite was associated with CAIDE score × p-tau (p = 0.001), CAIDE score × t-tau (p = 0.001), and WMH (p = 0.003). VPC composite was associated with APOE (p = 0.001), Aβ1-42 (p = 0.004), the interaction APOE × Aβ1-42 (p = 0.003), and WMH (p = 0.004). Performance on global memory was associated with Aβ1-42 (p = 0.006), APOE (p = 0.008), and their interaction (p = 0.006). Analyses were adjusted for age, education, sex, premorbid intelligence, and stress. CONCLUSION Healthy participants at increased dementia risk based on CAIDE scores show lower performance in EF and VPC. This difference is related to APOE, WMH, and Alzheimer biomarkers.
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Affiliation(s)
- Mirian Ecay-Torres
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Ainara Estanga
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Mikel Tainta
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Andrea Izagirre
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Maite Garcia-Sebastian
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Jorge Villanua
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Montserrat Clerigue
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Ane Iriondo
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Iratxe Urreta
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Arantzazu Arrospide
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Carmen Díaz-Mardomingo
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Miia Kivipelto
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Pablo Martinez-Lage
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden.
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Ban JW, Emparanza JI, Urreta I, Burls A. Design Characteristics Influence Performance of Clinical Prediction Rules in Validation: A Meta-Epidemiological Study. PLoS One 2016; 11:e0145779. [PMID: 26730980 PMCID: PMC4701404 DOI: 10.1371/journal.pone.0145779] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 12/08/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Many new clinical prediction rules are derived and validated. But the design and reporting quality of clinical prediction research has been less than optimal. We aimed to assess whether design characteristics of validation studies were associated with the overestimation of clinical prediction rules' performance. We also aimed to evaluate whether validation studies clearly reported important methodological characteristics. METHODS Electronic databases were searched for systematic reviews of clinical prediction rule studies published between 2006 and 2010. Data were extracted from the eligible validation studies included in the systematic reviews. A meta-analytic meta-epidemiological approach was used to assess the influence of design characteristics on predictive performance. From each validation study, it was assessed whether 7 design and 7 reporting characteristics were properly described. RESULTS A total of 287 validation studies of clinical prediction rule were collected from 15 systematic reviews (31 meta-analyses). Validation studies using case-control design produced a summary diagnostic odds ratio (DOR) 2.2 times (95% CI: 1.2-4.3) larger than validation studies using cohort design and unclear design. When differential verification was used, the summary DOR was overestimated by twofold (95% CI: 1.2 -3.1) compared to complete, partial and unclear verification. The summary RDOR of validation studies with inadequate sample size was 1.9 (95% CI: 1.2 -3.1) compared to studies with adequate sample size. Study site, reliability, and clinical prediction rule was adequately described in 10.1%, 9.4%, and 7.0% of validation studies respectively. CONCLUSION Validation studies with design shortcomings may overestimate the performance of clinical prediction rules. The quality of reporting among studies validating clinical prediction rules needs to be improved.
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Affiliation(s)
- Jong-Wook Ban
- Evidence-Based Health Care Programme, Department of Continuing Education, Kellogg College, University of Oxford, Oxford, United Kingdom
| | - José Ignacio Emparanza
- CASPe, CIBER-ESP, Clinical Epidemiology Unit, Hospital Universitario Donostia, San Sebastian, Spain
| | - Iratxe Urreta
- CASPe, CIBER-ESP, Clinical Epidemiology Unit, Hospital Universitario Donostia, San Sebastian, Spain
| | - Amanda Burls
- School of Health Sciences, City University London, London, United Kingdom
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Campos N, Torné JM, Bleda MJ, Manich A, Urreta I, Montalbán IA, Castañón S, Moncalean P, Santos M. Proteomic and transcriptomic analysis of rice tranglutaminase and chloroplast-related proteins. Plant Sci 2014; 229:142-153. [PMID: 25443841 DOI: 10.1016/j.plantsci.2014.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 09/08/2014] [Accepted: 09/09/2014] [Indexed: 05/09/2023]
Abstract
The recently cloned rice transglutaminase gene (tgo) is the second plant transglutaminase identified to date (Campos et al. Plant Sci. 205-206 (2013) 97-110). Similarly to its counterpart in maize (tgz), this rice TGase was localized in the chloroplast, although in this case not exclusively. To further characterise plastidial tgo functionality, proteomic and transcriptomic studies were carried out to identify possible TGO-related proteins. Some LHCII antenna proteins were identified as TGO related using an in vitro proteomic approach, as well as ATPase and some PSII core proteins by mass spectrometry. To study the relationship between TGO and other plastidial proteins, a transcriptomic in vivo Dynamic Array (Fluidigm™) was used to analyse the mRNA expression of 30 plastidial genes with respect to that of tgo, in rice plants subjected to different periods of continuous illumination. The results indicated a gene-dependent tendency in the expression pattern that was related to tgo expression and to the illumination cycle. For certain genes, including tgo, significant differences between treatments, principally at the initiation and/or at the end of the illumination period, connected with the day/night cycling of gene expression, were observed. The tgo expression was especially related to plastidial proteins involved in photoprotection and the thylakoid electrochemical gradient.
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Affiliation(s)
- N Campos
- Molecular Genetics Department, Centre for Research in Agricultural Genomics: CRAG (Consorci CSIC-IRTA-UAB-UB), Campus UAB, Bellaterra, 08193 Barcelona, Spain.
| | - J M Torné
- Molecular Genetics Department, Centre for Research in Agricultural Genomics: CRAG (Consorci CSIC-IRTA-UAB-UB), Campus UAB, Bellaterra, 08193 Barcelona, Spain.
| | - M J Bleda
- Institute of Advanced Chemistry of Catalonia IQAC, CSIC, Jordi Girona 18-26, 08034 Barcelona, Spain.
| | - A Manich
- Department of Chemical and Surfactants Technology, Institute of Advanced Chemistry of Catalonia IQAC, CSIC, Jordi Girona 18-26, 08034 Barcelona, Spain.
| | - I Urreta
- Biotechnology Department, Neiker-Tecnalia, Arkaute, Vitoria, Campus Agroalimentario de Arkaute, Aptdo.46, E-01080 Vitoria-Gasteiz, Araba, Spain.
| | - I A Montalbán
- Biotechnology Department, Neiker-Tecnalia, Arkaute, Campus Agroalimentario de Arkaute Apto 46, E-01080, Vitoria-Gasteiz, Araba, Spain.
| | - S Castañón
- Biotechnology Department, Neiker-Tecnalia, Arkaute, Campus Agroalimentario de Arkaute, Aptdo.46, E-01080 Vitoria-Gasteiz, Araba, Spain.
| | - P Moncalean
- Biotechnology Department, Neiker-Tecnalia, Arkaute, Campus Agroalimentario de Arkaute, Apto 46, E-01080 Vitoria-Gasteiz, Araba, Spain.
| | - M Santos
- Molecular Genetics Department, Centre for Research in Agricultural Genomics: CRAG (Consorci CSIC-IRTA-UAB-UB), Campus UAB, Bellaterra, 08193 Barcelona, Spain.
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Urreta I, Ikaran Z, Janices I, Ibañez E, Castro-Puyana M, Castañón S, Suárez-Alvarez S. Revalorization of Neochloris oleoabundans biomass as source of biodiesel by concurrent production of lipids and carotenoids. ALGAL RES 2014. [DOI: 10.1016/j.algal.2014.05.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Castle M, Nájera E, Samprón N, Bollar A, Urreta I, Urculo E. [Frameless stereotactic biopsy: diagnostic yield and complications]. Neurocirugia (Astur) 2014; 25:56-61. [PMID: 24656870 DOI: 10.1016/j.neucir.2013.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 09/16/2013] [Accepted: 11/24/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the variables that could modify the diagnostic yield of frameless stereotactic biopsy, as well as its complications. MATERIALS AND METHOD This was a retrospective study of frameless stereotactic biopsies carried out between July 2008 and December 2011 at Donostia University Hospital. The variables studied were size, distance to the cortex, contrast uptake and location. RESULTS A total of 70 patients were included (75 biopsies); 39 males and 31 females with an age range between 39 and 83 years. The total diagnostic yield in our series was 97.1%. For lesions >19mm, the technique offered a sensitivity of 95.2% (95% CI: 86.9-98.4) and specificity of 57.1% (95% CI: 25.0-84.2). The yield was lower for lesions within 17mm of the cortex: sensitivity of 74.6% (95% CI: 62.1-84.7) and specificity of 71.4% (95% CI: 29.0-96.3). Seven (10%) patients developed complications after the first biopsy and none after the second. CONCLUSIONS The diagnostic yield was lower for lesions less than 2cm in size and located superficially. In this series we did not observe an increased rate of complications after a second biopsy.
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Affiliation(s)
- Maria Castle
- Departamento de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.
| | - Edinson Nájera
- Departamento de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Nicolas Samprón
- Departamento de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Alicia Bollar
- Departamento de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Iratxe Urreta
- Departamento de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Enrique Urculo
- Departamento de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
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Abraira V, Muriel A, Emparanza JI, Pijoan JI, Royuela A, Plana MN, Cano A, Urreta I, Zamora J. Reporting quality of survival analyses in medical journals still needs improvement. A minimal requirements proposal. J Clin Epidemiol 2013; 66:1340-6.e5. [DOI: 10.1016/j.jclinepi.2013.06.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 06/06/2013] [Accepted: 06/10/2013] [Indexed: 11/28/2022]
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Campos N, Castañón S, Urreta I, Santos M, Torné JM. Rice transglutaminase gene: Identification, protein expression, functionality, light dependence and specific cell location. Plant Sci 2013; 205-206:97-110. [PMID: 23498867 DOI: 10.1016/j.plantsci.2013.01.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 01/17/2013] [Accepted: 01/21/2013] [Indexed: 05/04/2023]
Abstract
Transglutaminases (TGases), that catalyze post-translational modification of proteins, are scarcely known in plants. As part of a project to characterize transglutaminase genes in new plant species, the identification and characterization of a TGase in rice is presented. Using differential primers, a cDNA (tgo) of 1767bp from genomic rice DNA amplification was obtained. The primers were designed from the rice DNA sequence relatively homologous to the gene encoding active maize chloroplast TGase. Amino acid sequence of the deduced rice TGase protein (TGO) indicated that it contains the enzyme catalytic triad (Cys-His-Asp), three repeats, myristoylation domains and a leucine zipper motif. The TGO recombinant protein was characterized, showing specific activity regulation, and indicating that tgo encoded for an authentic TGase. Substrate preference and Ca(2+) dependent activity were also detected. In the rice plant TGO protein was immunolocalized in the grana chloroplasts, in protein vesicles near them, and in the bulliform cells. Immunoblot analyses, tgo mRNA expression, and TGase activity indicated that TGO expression in rice was light dependent and regulated by the illumination period. This work increases significantly our plant TGase understanding. Its functional role in rice, which is a good model system for C3 plants, is discussed.
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Affiliation(s)
- N Campos
- Molecular Genetics Department, Centre for Research in Agricultural Genomics: CRAG (Consorci CSIC-IRTA-UAB-UB), Campus UAB, Bellaterra, 08193 Barcelona, Spain.
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Alonso C, Larburu I, Bon E, González MM, Iglesias MT, Urreta I, Emparanza JI. Efficacy of petrolatum jelly for the prevention of diaper rash: a randomized clinical trial. J SPEC PEDIATR NURS 2013; 18:123-32. [PMID: 23560584 DOI: 10.1111/jspn.12022] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 01/10/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess the efficacy of petrolatum jelly for the prevention of diaper rash and to evaluate the relationship between the occurrence of diaper rash and certain treatments and type of nutrition. DESIGN AND METHODS A randomized clinical trial was carried out with two parallel groups (n = 213) at the neonatal care unit of Donostia University Hospital in San Sebastián, Guipuzcoa Province, Spain. RESULTS There was a lower incidence of diaper rash in the experimental group with petrolatum jelly (17.1%) than the control group (22.2%), but the difference was not statistically significant (p =.39). The use of antibiotics and oral 50% glucose as well as an increased number of stools are associated with a higher incidence of diaper rash, while breastfeeding and phototherapy are protective factors. PRACTICE IMPLICATIONS Prevention is strengthened by a better understanding of the risk factors.
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Affiliation(s)
- Carmen Alonso
- Donostia University Hospital, San Sebastián, Guipuzcoa Province, Spain
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Castro-Puyana M, Herrero M, Urreta I, Mendiola JA, Cifuentes A, Ibáñez E, Suárez-Alvarez S. Optimization of clean extraction methods to isolate carotenoids from the microalga Neochloris oleoabundans and subsequent chemical characterization using liquid chromatography tandem mass spectrometry. Anal Bioanal Chem 2013; 405:4607-16. [PMID: 23314588 DOI: 10.1007/s00216-012-6687-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 12/12/2012] [Accepted: 12/20/2012] [Indexed: 11/25/2022]
Abstract
A novel experimental design was used to optimize the extraction of carotenoids from Neochloris oleoabundans using pressurized liquid extraction with food-grade solvents such as ethanol and limonene. Experimental factors, including the extraction temperature and the solvent composition, were optimized using a three-level factorial design. The response variables extraction yield and total amount of carotenoids were assessed. The statistical analysis of the results provided mathematical models to predict the behavior of the responses as a function of the factors involved in the process. The optimum conditions predicted by the model developed in this study were 112 °C as the extraction temperature and 100% ethanol as the extraction solvent. Chemical characterization of the extracts obtained was performed by means of high-performance liquid chromatography-tandem mass spectrometry. The results obtained demonstrated that, under certain growth conditions (photoautotrophically cultured in a medium supplemented with 0.3 g L(-1) KNO3), N. oleoabundans accumulated significant total amounts of the carotenoids (from 57.4 to 120.2 mg carotenoids per gram of extract depending on the extraction conditions), mainly lutein, cantaxanthin, zeaxanthin, and astaxanthin monoesters and diesters.
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Affiliation(s)
- María Castro-Puyana
- Laboratory of Foodomics, Bioactivity and Food Analysis Department, Institute of Food Science Research (CIAL-CSIC), Campus UAM Cantoblanco, Madrid, Spain
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30
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Martinez JA, Belastegui A, Basabe I, Goicoechea X, Aguirre C, Lizeaga N, Urreta I, Emparanza JI. Derivation and validation of a clinical prediction rule for delirium in patients admitted to a medical ward: an observational study. BMJ Open 2012; 2:bmjopen-2012-001599. [PMID: 22983876 PMCID: PMC3467592 DOI: 10.1136/bmjopen-2012-001599] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To develop and validate a simple clinical prediction rule, based on variables easily measurable at admission, to identify patients at high risk of developing delirium during their hospital stay on an internal medicine ward. DESIGN Prospective study of two cohorts of patients admitted between 1 May and 30 June 2008 (derivation cohort), and between 1 May and 30 June 2009 (validation cohort). SETTING A tertiary hospital in Donostia-Gipuzkoa (Spain). PARTICIPANTS In total 397 patients participated in the study. The mean age and incidence of delirium were 75.9 years and 13%, respectively, in the derivation cohort, and 75.8 years and 25% in the validation cohort. MAIN OUTCOME MEASURES The predictive variables analysed and finally included in the rule were: being aged 85 years old or older, being dependent in five or more activities of daily living, and taking two or more psychotropic drugs (antipsychotics, benzodiazepines, antidepressants, anticonvulsant and/or antidementia drugs). The variable of interest was delirium as defined by the short Confusion Assessment Method, which assesses four characteristics: acute onset and fluctuating course, inattention, disorganised thinking and altered level of consciousness. RESULTS We developed a rule in which the individual risk of delirium is obtained by adding one point for each criterion met (age≥85, high level of dependence, and being on psychotropic medication). The result is considered positive if the score is ≥1. The rule accuracy was: sensitivity=93.4% (95% CI 85.5% to 97.2%), specificity=60.6% (95% CI 54.1% to 66.8%), positive predictive value=44.4% (95% CI 36.9% to 52.1%) and negative predictive value=96.5% (95% CI: 92% to 98.5%). The area under the receiver operator characteristic (ROC) curve was 0.85 for the validation cohort. CONCLUSIONS The presence or absence of any of the three predictive factors (age≥85, high level of dependence and psychotropic medication) allowed us to classify patients on internal medicine wards according to the risk of developing delirium. The simplicity of the variables in our clinical prediction rule means that the data collection required is feasible in busy medicine units.
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Affiliation(s)
| | - Ana Belastegui
- Department of Internal Medicine, Donostia University Hospital, San Sebastian, Spain
| | - Iban Basabe
- Department of Internal Medicine, Donostia University Hospital, San Sebastian, Spain
| | - Xabier Goicoechea
- Department of Internal Medicine, Donostia University Hospital, San Sebastian, Spain
| | - Cristina Aguirre
- Department of Internal Medicine, Donostia University Hospital, San Sebastian, Spain
| | - Nerea Lizeaga
- Department of Internal Medicine, Donostia University Hospital, San Sebastian, Spain
| | - Iratxe Urreta
- Clinical Epidemiology Unit, CIBER-ESP & Critical Appraisal Skills Programme—Spain (CASPe), Donostia University Hospital, San Sebastian, Spain
| | - Jose Ignacio Emparanza
- Clinical Epidemiology Unit, CIBER-ESP & Critical Appraisal Skills Programme—Spain (CASPe), Donostia University Hospital, San Sebastian, Spain
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Urreta I, Oyanguren I, Castañón S. Tobacco as biofactory for biologically active hPL production: a human hormone with potential applications in type-1 diabetes. Transgenic Res 2011; 20:721-33. [PMID: 20960057 DOI: 10.1007/s11248-010-9452-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Accepted: 10/05/2010] [Indexed: 10/18/2022]
Abstract
Human placental lactogen (hPL) is a peptidic hormone that belongs to the short list of growth factors that could treat type-1 diabetes through pancreatic islet transplantation. Placental lactogen has the capacity to improve islet survival and function before or after transplantation. In this study, transgenic tobacco plants were used as a novel expression system for the production of recombinant hPL protein (rhPL). The expression vector pNEKhPL2 containing hPL cDNA was introduced into tobacco plants; the transcriptional activity was confirmed by real-time PCR, and the rhPL levels reached 1% of the total soluble protein (TSP) content in plants cultivated in the greenhouse. In vitro bioassays using the rat insulinoma (INS-1) cell line showed that recombinant protein was able to induce cell proliferation and activate the JAK-2/STAT-5 signal transduction pathway, demonstrating that plant cells can produce the biologically active hPL protein. To further characterize the plant expression system for hPL production, we analyzed the stability of the protein during the life cycle of tobacco plants as well as the transmission of the transgenic trait to the progeny. The recombinant protein was stably accumulated in young leaves, reaching the maximum level in the first month (6.51 μg/g of fresh weight), but showing a decreasing trend of 26% from the initial sampling time until the end of plant's life cycle. The progeny of the selected pNEKhPL2 plant showed in vitro expression levels of up to 1.1% of TSP. Our results therefore indicate that transgenic plants are a suitable expression system for hPL production.
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Affiliation(s)
- Iratxe Urreta
- Neiker-Tecnalia, Arkaute, PO Box 46, E-01080, Vitoria-Gasteiz, Spain
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Sistiaga A, Urreta I, Jodar M, Cobo AM, Emparanza J, Otaegui D, Poza JJ, Merino JJ, Imaz H, Martí-Massó JF, López de Munain A. Cognitive/personality pattern and triplet expansion size in adult myotonic dystrophy type 1 (DM1): CTG repeats, cognition and personality in DM1. Psychol Med 2010; 40:487-495. [PMID: 19627641 DOI: 10.1017/s0033291709990602] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although central nervous system (CNS) involvement in adult myotonic dystrophy type 1 (DM1) was described long ago, the large number of variables affecting the cognitive and personality profile have made it difficult to determine the effect of DM1 on the brain. The aim of this study was to define the cognitive and personality patterns in adult DM1 patients, and to analyse the relationship between these clinical patterns and their association with the underlying molecular defect. METHOD We examined 121 adult DM1 patients with confirmed molecular CTG repeat expansion and 54 control subjects using comprehensive neuropsychological tests and personality assessments with the Millon Clinical Multiaxial Inventory (MCMI)-II. We used a multiple linear regression model to assess the effect of each variable on cognition and personality adjusted to the remainders. RESULTS Patients performed significantly worse than controls in tests measuring executive function (principally cognitive inflexibility) and visuoconstructive ability. In the personality profile, some paranoid and aggressive traits were predominant. Furthermore, there was a significant negative correlation between the CTG expansion size and many of the neuropsychological and personality measures. The molecular defect also correlated with patients' daytime somnolence. CONCLUSIONS Besides muscular symptomatology, there is significant CTG-dependent involvement of the CNS in adult DM1 patients. Our data indicate that the cognitive impairment predominantly affects the fronto-parietal lobe.
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Affiliation(s)
- A Sistiaga
- Experimental Unit, Hospital Donostia, San Sebastian, Spain.
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