Nuestros investigadores

Francisco Guillén Grima

Publicaciones científicas más recientes (desde 2010)

Autores: Robles, JE; et al.
Revista: ARCHIVOS ESPAÑOLES DE UROLOGIA
ISSN 0004-0614  Vol. 72  Nº 1  2019  págs. 25 - 35
OBJECTIVES: Studying the psychosocial sphere of patients who undergo any treatment allows to have more information about its repercussion and can help the choice of an appropriate and personalized treatment. Due to the absence of specific instruments at present, the objective is to design and validate a health questionnaire regarding the treatment received with ESWL. METHODS: It was carried out in 6 phases using a sample of 50 patients treated with ESWL in 2015 in our center, whom we interviewed by telephone. In phase 1 the items were proposed based on bibliographic review, in phase 2 those that scored below 7 were eliminated according to the evaluation from 0 to 10 on the items made by specialists. In phase 3, values of 1 to 5 were assigned to each item and those with corrected correlation more than 0.2 and not significant (p>0.05) discriminant power with U-Mann Whitney were eliminated. In phase 4 the reliability of the questionnaire was checked with two indexes (Cronbach's alpha and two Guttman's halves). In phase 5, the factor analysis with Varimax rotation was performed to calculate the construct validity and in stage 6, the scores were analyzed to establish reference values. RESULTS: 50 patients (32 men, 18 women). Median age 59 years (27-79), In phase 1, 35 items were proposed, 9 of which were eliminated in phase 2. The initial questionnaire with 26 items was distributed, with 18 being eliminated in phase 3. The final questionnaire was formed with 8 items. In phase 4 the results of Cronbach's alpha and Guttman's two halves index were 0.44 and 0.323 respectively. In phase 5 after factor analysis, we found 4 factors with 2 items each (background, impact of the acute picture, post-treatment, quality of life) able to explain 71.19% of the variance. The median scores of the scale, extreme values and quartiles studied in phase 6 were respectively: P50: 17 (minimum-maximum 9-25), P25: 14 and P75: 20. CONCLUSIONS: The study carried out has provided a new instrument for assessing satisfaction after treatment with ESWL with adequate reliability and validity values. Future studies will be necessary to contrast its true clinical usefulness.
Autores: Brugos-Larumbe, A.; et al.
Revista: CLINICAL ENDOCRINOLOGY
ISSN 0300-0664  Vol. 89  Nº 3  2018  págs. 367 - 375
ContextTo study the prevalence of thyroid dysfunction in a very large unselected population. ObjectiveTo determine the prevalence of abnormal thyroid function and evaluate potential modulatory factors. Design and SettingThe Estudio de Atencion Primaria de Navarra, The APNA Study, is a cross-sectional study conducted in northern Spain. It involved 303883 people, of 20years of age and older, who live in the Navarra region. Participants are covered by the public healthcare system and medical records are digitalized. Main Outcome MeasuresThe information was gathered from e-registered data regarding serum thyrotropin (TSH), thyroid hormones, thyroid antibody concentration and clinical context. Measurements were logged (demographic information and potential thyroid function modulatory factors). ResultsSerum TSH (mU/L) normal range was established at 0.7-4.28. At the time of the study, 87% of the Navarra population had a TSH level within the normal range. Mean serum TSH in euthyroid individuals was higher in women (2.15) than in men (1.96) (P<.001) and higher in the obese with body mass index (BMI) 30kg/m(2) (2.12) as compared to the non-obese BMI <30kg/m(2) (2.06) (P<.001). Mean TSH for the entire population was 1.9. The native Spanish population had statistically significantly lower TSH (1.87) than non-native Spanish (2.15) (P<.001). Additionally, we observed that serum TSH levels decreased with age and an increase in the prevalence of hypothyroidism in the elderly and among people with low-income levels. The prevalence of thyroid dysfunction in Navarra was 12.3%. The prevalence of hypothyroidism (or high TSH) in the population was 8.8% (13.3% in women, 4.2% in men), and the prevalence of hyperthyroidism (or low TSH) was 4.3% (5.6% in women, 3.0% in men). ConclusionsNearly 15% of the general population suffers from biochemical thyroid dysfunction. The serum TSH level appears to be influenced by sex, BMI, age, ethnic origin and socio-economic status.
Autores: Castano-Garcia, A. , (Autor de correspondencia); Guillén-Grima, F; León Sanz, Pilar;
Revista: GACETA MEDICA DE MEXICO
ISSN 0016-3813  Vol. 154  Nº 1  2018  págs. 92 - 104
Objective: To evaluate some methodological and ethical quality variables of clinical trials (CTs) published in 10 family medicine journals. Methods: Quality descriptive study of 10 family medicine journals including CTs in humans published since 2010 to 2013. We obtained 141 CT and 2447 were excluded. Results: CTs parallels controlled in 92.9% (95% confidence interval [95% CI]: 92.0-93.9). Masked randomization in 72.3% (95% CI: 71.7-73.1), decentralized in 51.8% (95% CI: 51.4-52.4) and using as control an active treatment in 82.2% (95% CI: 81.5-83.1). Wrote informed consent in 48.9% (95% CI; 48.5-49.5) and it was not withdrawn in 56.0% of cases (95% CI: 55.5-56.7). Approval by clinical research ethics committee (CREC) in 134, and there was no conflict of interest in 117 CTs. Average K was 0.96 (95% CI: 0.93-0.99). Conclusions: We observe an increase in some quality variables like masked randomization (19.6%) and approval by CREC (75%) post CONSORT, in CTs published in 10 family medicine journals (2010-2013).
Autores: Serrano-Alonso, M; Guillén-Grima, F; Martín, Paloma Leticia; et al.
Revista: TRANSPLANT INFECTIOUS DISEASE
ISSN 1398-2273  Vol. 20  Nº 3  2018  págs. e12873
Background: Cytomegalovirus (CMV) is the most important viral pathogen in solid organ transplant (SOT) recipients. The role of secondary CMV prophylaxis in this population remains unclear. Methods: Retrospective cohort study in a single center. SOT recipients treated for CMV infection from 2007 to 2014 were studied to determine the efficacy and safety of secondary prophylaxis and its impact on graft loss and mortality. The outcome variable was CMV replication in the first 3 months after the end of therapy. Secondary variables were crude mortality and graft lost censored at 5 years after transplantation. Propensity score for the use of secondary prophylaxis was used to control selection bias. Results: Of the 126 treated patients, 103 (83.1%) received CMV secondary prophylaxis. CMV relapse occurred in 44 (35.5%) patients. The use of secondary prophylaxis was not associated with fewer relapses (34.0% in patients with prophylaxis vs. 42.9% in those without prophylaxis, p= 0.29).After a mean follow-up of 32.1 months, graft loss was not different between both groups but patient mortality was significantly lower in patients who received secondary prophylaxis (5.8% vs. 28.6%, p= 0.003). Conclusion: Secondary prophylaxis did not prevent CMV infection relapse but it was associated with improved patient survival.
Autores: Alvarez Zallo,N.; Aguinaga-Ontoso, I; Alvarez-Alvarez, I; et al.
Revista: ALLERGOLOGIA ET IMMUNOPATHOLOGIA
ISSN 0301-0546  Vol. 46  Nº 1  2018  págs. 9-14
he present study showed that the consumption of Mediterranean diet during pregnancy did not have a protective effect for wheezing, recurrent wheezing or eczema.
Autores: Al-Rahamneh, M. J. , (Autor de correspondencia); Al-Rahamneh, A. ; Guillén-Grima, F; et al.
Revista: ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA
ISSN 0213-005X  Vol. 36  Nº 6  2018  págs. 342 - 351
Background: The objective of this study was to update and analyze tuberculosis (TB) mortality data in the European Union between 2000 and 2010 separately for men and women and try to detect if there have been any changes in trends in each country and the association with the economic situation and inequalities. Methods: Data were extracted for tuberculosis deaths in 2000-2010 for 29 European Union countries and for Switzerland, via the World Health Organization (WHO) European detailed mortality database (DMDB), using the Mortality tabulation list 1 (MTLI) codes for men and women separately for one age group (20-85+). We estimated age-standardised mortality rates, and analyzed data using the Joinpoint Regression Program for men and women separately in the European Union overall and by individual country for each year. Results: Between 2000 and 2010, there were 68,771 recorded tuberculosis deaths in the European Union and the mortality rates were higher for men than women in the entire study zone. Overall, TB mortality rates declined linearly for both genders, but more in women than in men (from 5.43/100,000 in 2000 to 2.59/100,000 in 2010 in men and from 1.37/100,000 in 2000 to 0.51/100,000 in 2010 in women). There was decline in both genders for the entire study period, with a significant Estimated Annual Percentage Change (EAPC) of -8.1 for women and -7 for men when alpha < 0.05 and with a 95% confidence interval (CI). A higher tuberculosis mortality was associated with lower economic resources and greater inequalities. Conclusions: TB mortality rates in the European Union decreased overall in 2000-2010 for both genders. Men have higher TB mortality rates than women in all countries. Our findings were consistent with the downward TB mortality trend in many other countries worldwide. (C) 2017 Elsevier Espana, S.L.U. and Sociedad Espariola de Enfermedades Infecciosas y Microbiologia Clinica. All rights reserved.
Autores: Lehne, G. , (Autor de correspondencia); Zeeb, H.; Pischke, C. R.; et al.
Revista: ADDICTIVE BEHAVIORS
ISSN 0306-4603  Vol. 87  2018  págs. 17 - 23
Introduction The use of non-prescribed prescription sedatives and sleeping pills (NPPSSP) among university students has been described as an important public health issue. However, the impact of perceived social norms on students' use and attitudes towards use of NPPSSP is still unclear. Our aim was to investigate whether perceptions of peer use and approval of use are associated with students' personal use and approval of NPPSSP use. Methods: Cross-sectional data from the Social Norms Intervention for the prevention of Polydrug Use (SNIPE) project containing 4482 university students from seven European countries were analyzed to investigate self other discrepancies regarding personal use and attitudes towards NPPSSP use. Associations between personal and perceived peer use and between personal and perceived approval of use were examined using multivariable logistic regression. Results: The majority (51.0%) of students perceived their peers' NPPSSP use to be higher than their personal use. 92.6% of students perceived their peers' approval of NPPSSP use to be identical or higher than their personal approval. Students perceiving that the majority of peers had used NPPSSP at least once displayed higher odds for personal lifetime use (OR: 1.95, 95% CI: 1.49-2.55). Perceived peer approval of NPPSSP use was associated with higher odds for personal approval (OR: 5.49, 95% CI: 4.63-6.51). Conclusions: Among European university students, perceiving NPPSSP use and approval of use to be the norm was positively associated with students' personal NPPSSP use and approval of use, respectively. Interventions addressing perceived social norms may prevent or reduce NPPSSP use among university students.
Autores: Al-Rahamneh MJ; Al-Rahamneh A; Guillén-Grima, F; et al.
Revista: ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA
ISSN 0213-005X  Vol. 36  Nº 6  2018  págs. 343-351
TB mortality rates in the European Union decreased overall in 2000-2010 for both genders. Men have higher TB mortality rates than women in all countries. Our findings were consistent with the downward TB mortality trend in many other countries worldwide.
Autores: Niu, H. , (Autor de correspondencia); Alvarez-Alvarez, I.; Aguinaga-Ontoso, I.; et al.
Revista: AMERICAN JOURNAL OF ALZHEIMERS DISEASE AND OTHER DEMENTIAS
ISSN 1533-3175  Vol. 33  Nº 7  2018  págs. 440 - 449
Background: Alzheimer's disease (AD) has become a concerning public health issue. We aimed to analyze the trends of hospital morbidity from AD in the European Union (EU) in the period 2000 to 2014. Methods: Data from hospital discharges of men and women over 50 years old hospitalized due to AD in the EU were extracted from Eurostat database. We tested for secular trends computing anual percent change, and identified significant changes in the linear slope of the trend. Results: Hospital morbidity from AD showed a 0.8% (95% confidence intervals -2.2 to 0.6) slight declining trend in the EU. In men and women, we recorded a -0.5% and -1.0% decrease in hospital morbidity rates, respectively. Several countries showed changing trends during the study period. Conclusion: Alzheimer's disease hospital morbidity has slightly declined in the entire EU in the past years. Eastern European countries showed steadily increasing trends, whereas in western and Mediterranean countries the rates decreased or leveled off.
Autores: Orzanco-Garralda, M. R., (Autor de correspondencia); Guillén-Grima, F; Sainz-Suberviola, L.; et al.
Revista: REVISTA DE PSICOLOGIA DEL DEPORTE
ISSN 1132-239X  Vol. 27  Nº 1  2018  págs. 135 - 144
The active transport, whether walking or cycling, contributes to increasing the level of physical activity of people. This habit could be favoured by acting on certain psychosocial factors, and by creating favourable environments. The purpose of the present study was to determine the perception of individual factors and of the nearby environment, related in a special way to each of the two modalities of active transport, in a population sample of the adults living in the metropolitan area of Pamplona. A cross-sectional study was conducted based on the methodology suggested by the International Physical Activity and the Environment Network Adult Group, which studies the relationship between environmental factors and physical activity practiced by adults. The results showed that the lack of time to practice physical activity was more likely to be associated with the group that walked less, OR 1.23 (1.08-1.40), and the lack of enjoyment of the physical activity with those who transport by bicycle less, OR 1.29 (1.04-1.61). Also, the existence of trees in the streets was associated with a greater probability of transport by walking, OR 1.23 (1.03-1.46), while the presence of signs or zebra crossings, which helped pedestrians to cross, was related to a wider use of the bycicle, OR 1.42 (1.08-1.87). In conclusion, certain characteristics of the individual and the environment are particularly associated with walking while others are with the use of the bicycle. Thus, people who spend less time walking to go from one place to another indicate lack of time as the reason that prevents them from carrying out some physical activity, while the group that uses the bicycle less to transport indicates lack of enjoyment. In addition, the presence of trees on the pavements favours and encourages people to travel by walking and the perception of intense traffic is associated with the group that dedicates less time to walking in order to go from one place to another. However, developing infrastructures that facilitate the mobility of pedestrians is associated with a greater use of the bicycle for active transport.
Autores: Idoate, Miguel Ángel; Mejías, Luis Daniel; Abengozar, Marta; et al.
Revista: MODERN PATHOLOGY
ISSN 0893-3952  Vol. 31  Nº Supl. 2  2018  págs. 74 - 74
Autores: Delgado, JA; Guillén-Grima, F; Moreno, C; et al.
Revista: JOURNAL OF IMMUNOLOGICAL METHODS
ISSN 0022-1759  Vol. 442  2017  págs. 54 - 58
Bone marrow (BM) aspirates used for flow-cytometry (FCM) studies are usually obtained from a second aspiration, as the primary aspirate is used for morphological assessment. For this reason, the FCM samples unavoidably contain some blood; although, good-quality samples contain only a small amount. It is of utmost importance to assess the quality of samples prior to FCM analysis; yet, contamination with peripheral blood (PB) is not evaluated in most laboratories, possibly because the methods available are either qualitative or too complex for daily practice. Here, we propose a simple FCM method to quantitatively evaluate PB contamination in BM aspirates, by analyzing the percentage of plasma cells and CD34 + cells - two cell populations nearly absent from PB - and CD10 + granulocytes, which comprise the majority of the PB granulocyte population. We analyzed these three populations in 122 BM aspirates from subjects without hematological disease, and identified samples with PB contamination by performing a hierarchical cluster analysis. A discriminant analysis yielded a function, which we named the PB contamination index (PBCI). This index value gives a quantitative indication about the degree of hemodilution of a given sample. A threshold was identified that discriminates low-quality samples. The method and the threshold proved to be useful in BM aspirates infiltrated with malignant cells, with the exception of cases where hematological disease altered two of the three parameters included in the index. We have easily implemented the PBCI calculation in our daily routine, and find it very helpful for an accurate interpretation of FCM results in a large proportion of BM specimens. Limitations of the technique are discussed.
Autores: Guillén-Grima, F; et al.
Revista: TECNOHOSPITAL
ISSN 1645-9431  Vol. 79  2017  págs. 18-20
Autores: Gómez Roig, MD; Mazarico, E; Ferrero,S; et al.
Revista: JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH
ISSN 1341-8076  Vol. 43  Nº 7  2017  págs. 1145-1151
Mothers of SGA fetuses had a different nutritional intake and cigarette smoking habits compared with mothers of AGA fetuses. No other differentiating lifestyle habits were observed between the groups. Thus, intrauterine growth conditions might be improved by the endorsement of certain dietary habits during pregnancy.
Autores: Aguinaga-Ontoso, I.; Alvarez - Alvarez, I.; et al.
Revista: ALLERGOLOGIA ET IMMUNOPATHOLOGIA
ISSN 0301-0546  Vol. 45  Nº 3  2017  págs. 227 - 233
Background The objective of the study was to examine the relationship between asthma and overweight¿obesity in Spanish children and adolescents and to determine whether this relationship was affected by gender and atopy. Methods The study involves 8607 Spanish children and adolescents from the International Study of Asthma and Allergies in Childhood phase III. Unconditional logistic regression was used to obtain adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for the association between asthma symptoms and overweight¿obesity in the two groups. Afterwards, it was stratified by sex and rhinoconjunctivitis. Results The prevalence of overweight and obesity in 6¿7-year-old children was 18.6% and 5.2% respectively and in 13¿14 year-old teenagers was 11.4% and 1.1% respectively. Only the obese children, not the overweight children, of the 6¿7 year old group had a higher risk of any asthma symptoms (wheezing ever: OR 1.68 [1.15¿2.47], asthma ever: OR 2.29 [1.43¿3.68], current asthma 2.56 [1.54¿4.28], severe asthma 3.18 [1.50¿6.73], exercise-induced asthma 2.71 [1.45¿5.05]). The obese girls had an increased risk of suffering any asthma symptoms (wheezing ever: OR 1.73 [1.05¿2.91], asthma ever: OR 3.12 [1.67¿5.82], current asthma 3.20 [1.65¿6.19], severe asthma 4.83[1.94¿12.04], exercise-induced asthma 3.68 [1.67¿8.08]). The obese children without rhinoconjunctivitis had a higher risk of asthma symptoms. Conclusions Obesity and asthma symptoms were associated in 6¿7 year-old children but not in 13¿14 year-old teenagers. The association was stronger in non-atopic children and obese girls.
Autores: Guillén-Grima, F; Hontanilla B;
Revista: JOURNAL OF PLASTIC SURGERY AND HAND SURGERY
ISSN 2000-6764  Vol. 51  Nº 6  2017  págs. 14-19
Both techniques were similar regarding satisfaction. In this study, patients with large resection and high BMI more often had the inverted T technique and were just as happy as those with smaller resections, who more often had the vertical techniques.
Autores: Niu, H. , (Autor de correspondencia); Alvarez, Ismael; Guillén-Grima, F; et al.
Revista: NEUROLOGIA
ISSN 0213-4853  Vol. 32  Nº 8  2017  págs. 523 - 532
Background: A disease of unknown aetiology, Alzheimer's disease (AD) is the most common type of dementia. As the elderly population grows worldwide, the number of patients with AD also increases rapidly. The aim of this meta-analysis is to evaluate the prevalence and incidence of AD in Europe. Methodology: We conducted a literature search on Medline, Scopus, and CINAHL Complete using the keywords Alzheimer, Alzheimer's disease, and AD combined with prevalence, incidence, and epidemiology. A Bayesian random effects model with 95% credible intervals was used. The 12 statistic was applied to assess heterogeneity. Results: The prevalence of Alzheimer's disease in Europe was estimated at 5.05% (95% CI, 4.73-5.39). The prevalence in men was 3.31% (95% CI, 2.85-3.80) and in women, 7.13% (95% CI, 6.56-7.72), and increased with age. The incidence of Alzheimer's disease in Europe was 11.08 per 1000 person-years (95% CI, 10.30-11.89). Broken down by sex, it was 7.02 per 1000 person-years (95% CI, 6.06-8.05) in men and 13.25 per 1000 person-years (95% CI, 12.05-14.51) in women; again these rates increased with age. Conclusions: The results of our meta-analysis allow a better grasp of the impact of this disease in Europe. (C) 2016 Sociedad Espanola de Neurologia. Published by Elsevier Espana, S.L.U.
Autores: Idoate, Miguel Ángel; Janeiro, A. L.; Lecumberri, A.; et al.
Revista: MODERN PATHOLOGY
ISSN 0893-3952  Vol. 30  Nº Supl. 2  2017  págs. 434A
Autores: Guillen-Aguinaga, S.; Jauregui Presa, I.; Aguinaga-Ontoso, E.; et al.
Revista: BRITISH JOURNAL OF DERMATOLOGY
ISSN 0007-0963  Vol. 175  Nº 6  2016  págs. 1153 - 1165
There is a lack of large, randomized, double-blind studies that address antihistamine updosing for chronic spontaneous urticaria (CSU). The objective of this systematic review is to explore and analyse available data to provide clinical evidence for the efficacy of antihistamine updosing. We searched the literature in Medline, Scopus, Google Scholar, Embase, Web of Science and Cochrane databases using the keywords 'chronic, urticaria, antihistamines' to identify studies published between January 1990 and November 2014. We assessed quality using the Jadad score that evaluates quality of randomization, double-blinding and losses to follow-up. We identified 1042 articles and 15 articles were included in the final evaluation. We performed two meta-analyses, one that included studies that analysed treatment response among groups receiving different antihistamine dosages vs. placebo, and another that analysed antihistamine updosing in those patients who did not respond to standard dosages. Only five articles obtained a high quality level score. We did not find significant differences in response rates or number of weals in those patients who received a standard dosage vs. a high dosage. We found a significant improvement only in the pruritus variable of the Urticaria Activity Score scale. The estimated relative risk for improvement by increasing the antihistamine dosage was 2.27 [95% confidence interval (CI) 1.68-3.06]; however, there was significant heterogeneity. The proportion of nonrespondent patients with CSU who responded to antihistamine updosing was 63.2% (95% CI 57-69.6). We found that updosing antihistamines significantly improved control of pruritus but not weal number. However, the relative weakness of the studies and the significant heterogeneity among them made it difficult to reach a final conclusion.
Autores: Castaño Garcia, A.; Guillén-Grima, F; León Sanz, Pilar;
Revista: FAMILY MEDICINE & MEDICAL SCIENCE RESEARCH
ISSN 2327-4972  Vol. 5  Nº 200  2016  págs. -
Introduction: At present, the quality of the publication of Control Trials (CTs) in medical journals improved due to the inclusion of the CONSORT (CONsolidated Standards of Reporting Trials) standards and the Declaration of Helsinki. The aim is to analyse methodological and ethical quality of published CTs in Annals of Family Medicine journal. Material and methods: We use a 133-item checklist divided into 11 sections based on CONSORT and the Declaration of Helsinki. The Confidence Interval of 95% (95% CI) of Clopper-Pearson for ¿ average is calculated. Results: We found 35 CTs in a literature review (2010-2013) on March 25, 2014 according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis). CT was mentioned in all heading/subheadings; CT controlled parallels in 80%; cluster type 45.7%. The most observed method was masked, active-controlled, decentralized randomization. The most frequently found category was an open CT assessing a medical intervention, with a positive significant result surveyed. The most common Informed Consent (IC) was in writing, not clearly voluntary, without prior knowledge and doubtful. It was not withdrawn in 45.7% of cases. A grant/scholarship was found to be the most frequent incentive for researchers. In 28 CTs there was no conflict of interest. The ¿ average was 0.93 (95% CI, 0.90-0.96). Conclusions: CT published ¿standard¿ characteristic are indicated. Following the CONSORT standards publication, it has increased the overall quality of the CTs published. But there are some areas for improvement in the methodological and ethical quality of the CTs published from 2010 to 2013 in Annals of Family Medicine.
Autores: Martín-Rodríguez, E.; Guillén-Grima, F; Aubá, Enrique; et al.
Revista: EUROPEAN PSYCHIATRY
ISSN 0924-9338  Vol. 32  2016  págs. 55 - 60
BACKGROUND: The association between body mass index (BMI) and depression is complex and controversial. The present study examined the relationship between BMI and new-onset depression during 7 years of follow-up in 20,212 adult women attending Primary Health Care Centres in Navarra, Spain. METHODS: The Atención Primaria de Navarra (APNA) study is a dynamic prospective cohort study. A total of 20,212 women aged 18-99 years (mean age: 50.7±18.5 years) without depression at baseline were selected from 2004 to 2011. We estimated the incidence of depression. We used the Kaplan-Meier analysis to predict the survival curve. The risk of depression onset according to different measures of BMI at baseline was assessed using Cox regression analyses. RESULTS: During the 7 years of follow-up, depression appeared in 8.9% (95% CI 8.5-9.3). The highest rates of depression incidence at follow-up occurred in underweight and obese women (9.8% [95% CI 7.3-12.9] and 10.3% [95% CI 9.5-11.1] respectively). The distribution of depression incidence by weight category was U-shaped. The risk of depression increased over time with an observed Kaplan-Meier estimation of 6.67. After adjusting for age, underweight and obese women at baseline have increased risk of depression onset during the follow-up period compared with normal weight women (HR=1.48, 95% CI=1.09-2.00 and HR=1.14, 95% CI=1.01-1.29 respectively). CONCLUSIONS: In this 7-year prospective study in the APNA women population, depression emerged in 8.9%. Being underweight or obese (not overweight) at baseline is significantly associated with future onset of depression.
Autores: Guillén-Aguinaga, S.; Jáuregui Presa, I.; Aguinaga-Ontoso, E.; et al.
Revista: BRITISH JOURNAL OF DERMATOLOGY
ISSN 0007-0963  Vol. 175  Nº 6  2016  págs. 1153-1165
There is a lack of large, randomized, double-blind studies that address antihistamine updosing for chronic spontaneous urticaria (CSU). The objective of this systematic review is to explore and analyse available data to provide clinical evidence for the efficacy of antihistamine updosing. We searched the literature in Medline, Scopus, Google Scholar, Embase, Web of Science and Cochrane databases using the keywords 'chronic, urticaria, antihistamines' to identify studies published between January 1990 and November 2014. We assessed quality using the Jadad score that evaluates quality of randomization, double-blinding and losses to follow-up. We identified 1042 articles and 15 articles were included in the final evaluation. We performed two meta-analyses, one that included studies that analysed treatment response among groups receiving different antihistamine dosages vs. placebo, and another that analysed antihistamine updosing in those patients who did not respond to standard dosages. Only five articles obtained a high quality level score. We did not find significant differences in response rates or number of weals in those patients who received a standard dosage vs. a high dosage. We found a significant improvement only in the pruritus variable of the Urticaria Activity Score scale. The estimated relative risk for improvement by increasing the antihistamine dosage was 2·27 [95% confidence interval (CI) 1·68-3·06]; however, there was significant heterogeneity. The proportion o
Autores: Guillén-Grima, F; Aguinaga-Ontoso, I. ; et al.
Revista: ANALES DEL SISTEMA SANITARIO DE NAVARRA
ISSN 1137-6627  Vol. 39  Nº 2  2016  págs. 237-248
A valid instrument that makes it possible to propose it as a tool for applying measures promoting health in young people.
Autores: Guillén-Grima, F; Crespo-Eguílaz, Nerea; et al.
Revista: EUROPEAN JOURNAL OF PAEDIATRIC NEUROLOGY
ISSN 1090-3798  Vol. 20  Nº 6  2016  págs. 925-937
Symptoms of inattention and hyperactivity are correlated with impaired sleep duration and quality; specifically, there is an association between ADHD symptoms and problems falling asleep and parasomnias, however, the current study does not address the nature and direction of causality. Children with ADHD and receiving methylphenidate had fewer sleep disorders, suggesting that, at least in some children, stimulant treatment is associated with improvement of some aspects of sleep. Shorter sleep duration in adolescents under pharmacological treatment for ADHD tended to result in more errors of omission, suggesting that it is important to promote good sleep habits in this population.
Autores: Rodríguez-Fraile, M; Sancho, Lidia; Guillén-Grima, F; et al.
Revista: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
ISSN 1619-7070  Vol. 43  2016  págs. S329 - S329
Autores: Soto Ruiz, M. N.; Aguinaga, I.; Canga, N; et al.
Revista: NUTRICION HOSPITALARIA
ISSN 0212-1611  Vol. 31  Nº 6  2015  págs. 2400-06
University years are a critical factor for the gain weight, particularly males. Consideration of this, is necessary the development of effective weight gain prevention strategies during the university.
Autores: Centeno, Carlos; Lynch T.; Garralda, Eduardo; et al.
Revista: PALLIATIVE MEDICINE
ISSN 0269-2163  Vol. 30  Nº 4  2015  págs. 251 - 262
Although there has been a positive development in overall palliative care coverage in Europe between 2005 and 2012, the services available in most countries are still insufficient to meet the palliative care needs of the population.
Autores: Soto Ruiz, MN. ; Marin Fernández, M.; Aguinaga Ontoso, I.; et al.
Revista: NUTRICION HOSPITALARIA
ISSN 0212-1611  Vol. 31  Nº 5  2015  págs. 2269-2275
Un alto porcentaje de universitarios tenían una percepción de imagen corporal que no se correspondía con la realidad, mostrando la preocupación de este grupo de población por su imagen corporal. Se identificaron más casos de alteración de la percepción de imagen corporal en mujeres, que en general sobreestimaban su índice de masa corporal. En los hombres, la tendencia era a subestimarlo. Coincidiendo con otras investigaciones
Autores: Pérez-Pevida, Belén; Pascual, Eider; et al.
Revista: ENDOCRINOLOGIA Y NUTRICION
ISSN 1575-0922  Vol. 62  2015  págs. 106 - 107
Autores: Pascual, Eider; Galofre, Juan Carlos; Pérez-Pevida, Belén; et al.
Revista: ENDOCRINOLOGIA Y NUTRICION
ISSN 1575-0922  Vol. 62  Nº Supl  2015  págs. 20
Autores: Sadaba, María Belén; Campanero, MA; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 9  Nº 2  2014  págs. e89747
Palonosetron is a potent second generation 5- hydroxytryptamine-3 selective antagonist which can be administered by either intravenous (IV) or oral routes, but subcutaneous (SC) administration of palonosetron has never been studied, even though it could have useful clinical applications. In this study, we evaluate the bioavailability of SC palonosetron. PATIENTS AND METHODS: Patients treated with platinum-based chemotherapy were randomized to receive SC or IV palonosetron, followed by the alternative route in a crossover manner, during the first two cycles of chemotherapy. Blood samples were collected at baseline and 10, 15, 30, 45, 60, 90 minutes and 2, 3, 4, 6, 8, 12 and 24 h after palonosetron administration. Urine was collected during 12 hours following palonosetron. We compared pharmacokinetic parameters including AUC0-24h, t1/2, and Cmax observed with each route of administration by analysis of variance (ANOVA). RESULTS: From October 2009 to July 2010, 25 evaluable patients were included. AUC0-24h for IV and SC palonosetron were respectively 14.1 and 12.7 ng × h/ml (p¿=¿0.160). Bioavalability of SC palonosetron was 118% (95% IC: 69-168). Cmax was lower with SC than with IV route and was reached 15 minutes following SC administration. CONCLUSIONS: Palonosetron bioavailability was similar when administered by either SC or IV route. This new route of administration might be specially useful for outpatient management of emesis and for administration of oral chemotherapy.
Autores: Radua J.; Pozo, NO; et al.
Revista: NEUROPSYCHOLOGIA
ISSN 0028-3932  Vol. 58  2014  págs. 14 - 22
Objectives: We hypothesize that time perception and executive functions are interrelated and share neuroanatomical basis, and that fluctuations in levels of cognitive effort play a role in mediating that relation. The main goal of this study was to identify brain structures activated both by increases in cognitive activity and during time perception tasks. Methods: We performed a multimodal meta-analysis to identify common brain regions in the findings of (a) an SDM meta-analysis of neuroimaging studies assessing the brain response to increasing levels of cognitive difficulty, and (b) an ALE meta-analysis on neuroimaging of time perception (Ortuño, Guillén-Grima, López-García, Gómez, & Pla, 2011). Results and Conclusions: Consistent with results of previous, separate meta-analyses, the current study supports the hypothesis that there exists a group of brain regions engaged both in time perception tasks and during tasks requiring cognitive effort. Thus, brain regions associated with working memory and executive functions were found to be engaged during time estimation tasks, and regions associated with time perception were found to be engaged by an increase in the difficulty of non-temporal tasks. The implication is that temporal perception and cognitive processes demanding cognitive control become interlinked when there is an increase in the level of cognitive effort demanded.
Autores: Pascual, Eider; Aubá, María; et al.
Revista: ENDOCRINOLOGIA Y NUTRICION
ISSN 1575-0922  Vol. 61  Nº 7  2014  págs.  377-381
The presence of thyroid autoimmunity in women with TSH above the recommended values at the beginning of pregnancy is not associated to development of GD. However, GD prevalence was higher in these patients as compared to the Spanish general population, suggesting the need for closer monitoring in pregnant women with TSH levels ¿ 2.5 mU/mL.
Autores: Álvarez Zallo, N; Guillén-Grima, F; Aguinaga-Ontoso, I.; et al.
Revista: NUTRICION HOSPITALARIA
ISSN 0212-1611  Vol. 30  Nº 3  2014  págs. 519-525
La obesidad en niños esta relacionada con los síntomas de asma. Las niñas obesas presentan un mayor riesgo y mayor gravedad de síntomas de asma que los niños.
Autores: Guillén-Grima, F; et al.
Revista: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
ISSN 1873-734X  Vol. 45  Nº 5  2014  págs. 1118
Autores: Pascual, Eider; Guillén-Grima, F; et al.
Revista: ENDOCRINE REVIEWS
ISSN 0163-769X  Vol. 35  Nº 3 Supl.  2014  págs. MON-0493
The relationship between metformin, thyroid function, and thyroid volume has been of interest to many investigators. A number of studies have consistently reported a TSH-lowering effect of metformin in hypothyroid patients. In addition, some previous reports found that metformin, alone or in combination with levothyroxine, shrank thyroid nodules in diabetic individuals with insulin resistance. Furthermore, other authors showed an anti-goitrogenic effect of metformin on subjects with type 2 diabetes (T2DM). Unfortunately, literature on the association between T2DM and thyroid volume is sparse. We designed a two-group retrospective study with euthyroid T2DM patients treated with metformin (Group A) or with other anti-diabetes agents (Group B). Examined were basal TSH (mU/mL), HbA1c (%), BMI (kg/m2), and thyroid nodule size (mm) assessed by sonography. The same examinations were repeated one year later. Exclusion criteria included the following conditions: type 1 diabetes, thyroid dysfunction, levothyroxine or antithyroid treatment, and corticoid therapy. Results from Groups A and B were compared using the Student¿s t and the Mann-Whitney U tests. A total of 63 nodules were analyzed. Group A included 31 nodules from 18 patients. Group B included 32 nodules from 15 patients. Groups A and B pre-TSH levels were 1.62± 1.19 and 2.06± 1.28, respectively; we found no statistically significant differences between them (p=0.164). Groups A and B post-TSH levels were 1.34± 0.87 and 1.99± 1.33, respectively; we observed a statistically significant difference between them (p=0.003). Groups A and B basal nodules mean size were 17.31± 9.97 and 12.45± 8.12, respectively. After one year of treatment, Groups A and B nodules mean size were 17.97± 10.31 and 12.90±7.92, respectively; we did not observe a statistically significant difference between them (p=0.961). We observed no statistically significant difference between Groups A and B in pre- and post-BMI, HbA1c, T2DM duration (data not shown). No patient in Group B was treated with glitazones. Conclusions: Thyroid nodule size in euthyroid patients with T2DM diabetes remained unchanged following treatment with metformin for one year despite changes in TSH levels. Nothing to Disclose: EP, GG, FG, BP, PA, JL, JE, JS, JCG - See more at: http://press.endocrine.org/doi/abs/10.1210/endo-meetings.2014.THPTA.3.MON-0493#sthash.Hod9WZQL.dpuf
Autores: Miranda J.; et al.
Revista: ENDOCRINOLOGIA Y NUTRICION
ISSN 1575-0922  Vol. 61  Nº Esp. Congreso  2014  págs. 61-62
Autores: Pascual, Eider; Pérez-Pevida, Belén; et al.
Revista: ENDOCRINOLOGIA Y NUTRICION
ISSN 1575-0922  Nº 61  2014  págs. 108
Autores: Pascual, Eider; Pérez-Pevida, Belén; et al.
Revista: ENDOCRINOLOGIA Y NUTRICION
ISSN 1575-0922  Vol. 61  2014  págs. 112
Autores: Pérez-Pevida, Belén; Guillén-Grima, F; et al.
Revista: EUROPEAN THYROID JOURNAL
ISSN 2235-0640  Vol. 3  Nº Supl 1  2014  págs. 195
Autores: Pascual, Eider; Pérez-Pevida, Belén; et al.
Revista: AVANCES EN DIABETOLOGIA
ISSN 1134-3230  Vol. 30  2014  págs. 4
Objetivos: La deficiencia de vitamina D es altamente prevalente en todo el mundo. Durante mucho tiempo ha sido conocida por ser una parte esencial del metabolismo óseo; sin embargo, la evidencia reciente sugiere una posible asociación entre los niveles disminuidos de vitamina D y diversas condiciones patológicas incluyendo las enfermedades cardiovasculares y la diabetes mellitus. Por ello, nuestro objetivo fue evaluar la asociación entre los niveles bajos de 25-hidroxivitamina D (25 (OH) D) y la presencia de trastornos cardiometabólicos en pacientes diabéticos tipo 2 (DM2). Material y métodos: Se realizó un estudio transversal en el que se incluyeron de forma aleatoria 108 pacientes con DM2 que realizaron cribado de los niveles de 25 (OH) D entre los años 2007 y 2013. Se excluyeron los pacientes diagnosticados de DM tipo 1, LADA o hiperparatiroidismo primario, aquellos en tratamiento con vitamina D y/o calcio, o con antecedente previo de cirugía bariátrica. Según los niveles de 25 (OH) D, los pacientes fueron divididos en tres grupos: deficiente (< 20 ng/ml), insuficiente (20- < 30 ng/ml) y normal (¿ 30 ng/ml). El análisis se realizó mediante Regresión Lineal Múltiple cuando la variable dependiente era cuantitativa y mediante Regresión Logística en el caso de variables categóricas. Resultados: Del total de la muestra, 69 (63,9%) pacientes presentaron niveles disminuidos de 25 (OH) D, entre ellos 36 (33,3%) deficiencia y 33 (30,6%) insuficiencia, y 39 (36,1%) obtuvieron valores normales. Niveles deficientes e insuficientes de 25 (OH) D fueron inversamente asociados con la cifra de hemoglobina glicosilada (A1c) (p = 0,006 y 0,012, respectivamente), la cardiopatía isquémica (p = 0,011 y 0,022), el infarto agudo de miocardio (p = 0,090 y 0,049) y la retinopatía diabética (p = 0,007 y 0,018), tras ajustar por edad, sexo, índice de masa corporal, hábito tabáquico y enólico, actividad física, estación del año, calcio, paratohormona, años de evolución de la diabetes, función renal y cociente albúmina/creatinina. Únicamente los niveles deficientes de 25 (OH) D obtuvieron una significativa asociación inversa con la glucemia basal (p = 0,008) y la vasculopatía periférica (p = 0,019). No se encontró asociación con las cifras de tensión arterial sistólica o diastólica, los niveles de colesterol total, HDL-colesterol, LDL-colesterol o triglicéridos, el accidente cerebrovascular, la neuropatía o la nefropatía diabética. Conclusiones: Niveles disminuidos de 25 (OH) vitamina D se asocian con un aumento del riesgo cardiovascular, peor control glucémico y mayor prevalencia de complicaciones derivadas de la DM2 en estos pacientes. Se requieren ensayos que permitan evaluar el impacto de la suplementación de la vitamina D sobre estos resultados para confirmar su causalidad.
Autores: Toledo, Juan Bautista; Martínez, Miguel Ángel; et al.
Revista: GENES AND NUTRITION
ISSN 1555-8932  Vol. 8  Nº 1  2013  págs. 61 - 67
Genetic factors may interact with lifestyle factors to modify obesity risk. FTO and PPARG2 are relevant obesogenes. Our aim was to explore the effect of Pro12Ala (rs1801282) of PPARG2 and rs9939609 of FTO on obesity risk and to examine their interaction with lifestyle factors in an elderly population. Subjects (n = 978; aged 69 ± 6) were recruited from the SUN (Seguimiento Universidad de Navarra) Project. DNA was obtained from saliva, and lifestyle and dietary data were collected by validated self-reported questionnaires. Genotyping was assessed by RT-PCR plus allele discrimination. Subjects carrying the Ala allele of PPARG2 gene had a significantly increased obesity risk compared to non-carrier (Pro12Pro) subjects (OR, 1.66; 95 % CI, 1.01-2.74; p = 0.045). Greater obesity risk was also found in inactive or high carbohydrate intake subjects with the Ala12 allele of PPARG2 gene. Interestingly, subjects carrying the Ala allele of the PPARG2 gene and with a high CHO (&gt;246 g/day) intake had an increased obesity risk compared to Pro12Pro subjects (OR, 2.67; 95 % CI, 1.3-5.46; p = 0.007; p for [CHO × PPARG2] interaction = 0.046). Moreover, in subjects with a high CHO intake, the co-presence of the Ala allele of PPARG2 gene and one minor A allele (rs9939609) of FTO gene did increase obesity risk (OR, 3.26; 95 % CI, 1.19-8.89; p = 0.021) when compared to non-carrier (Pro12Pro/TT) subjects. In conclusion, it appears that lifestyle factors may act as effect modifiers for obesity risk linked to Ala12 allele of the PPARG2 gene and the minor A allele of FTO gene in an elderly population.
Autores: Toledo, Estefanía Ainhoa; Martínez, Miguel Ángel; et al.
Revista: OBESITY
ISSN 1469-3259  Vol. 21  Nº 7  2013  págs. 1486-1495
The meta-analysis revealed a higher BMI with an overall estimation of +0.065 kg/m(2) (95%CI = 0.026-0.103, P = 0.001) for homo-/heterozygous carriers of the Ala allele of the PPARG2 gene in comparison to non-carriers. The analysis also showed that there was heterogeneity (P for heterogeneity <0.001), but funnel plots did not suggest apparent publication bias. Furthermore, the association between the Pro12Ala polymorphism of the PPARG2 gene and increased BMI was stronger in Caucasian. Thus, carriers of the Ala allele had significantly higher BMI than non-carriers in a subsample of 6,528 Caucasian male subjects (standardized mean difference = 0.090, 95%CI=0.032-0.148, P = 0.002, P for heterogeneity = 0.121). CONCLUSION: This updated meta-analysis showed that carriers of the Ala12 allele of the PPARG2 gene had a higher average BMI.
Autores: Marta Lizarbe Chocarro; Guillén-Grima, F; Canga, N;
Revista: METAS DE ENFERMERIA
ISSN 1138-7262  Vol. 16  Nº 8  2013  págs. 20-25
El paciente afectado de disfagia puede alimentarse mediante la gastrostomía radiológica percutánea (GRP). Objetivos: determinar el nivel de dependencia para las actividades básicas de la vida diaria (ABVD) de los pacientes portadores de GRP, describir el perfil del cuidador y evaluar la capacidad para la realización del autocuidado y la relación existente entre estos factores. Material y métodos: estudio descriptivo mediante encuesta de 48 pacientes sometidos a recambio de sonda de GRP, entre el 1 de enero y el 30 de septiembre de 2010. Se recogieron características del paciente: edad, sexo, patología causante de la disfagia, complicaciones relacionadas con la GRP y número de recambios de sonda e índice de Barthel (IB) y realización del autocuidado del estoma, la sonda y la administración de la nutrición enteral. Características del cuidador: formal o informal, sexo, edad y relación de parentesco con el paciente. Para el análisis de los datos se utilizó la estadística descriptiva, el test exacto de Fisher, la prueba U Mann-Whitney, y para el análisis multivariante la regresión lineal múltiple. Resultados: población de 65,81 años de media, femenina (60,41%) y afectados de disfagia neurológica (85,41%), con tasa de complicaciones mayores del 4,1% y media de recambios de 9,52. IB medio de 25,94. Cuidador formal en 14 pacientes e informal en 20 (familiar directo, mujer y de edad superior a los 50 años). 13/48 pacientes han realizado el autocuidado. El 77,8% del número de recambio
Autores: Martínez, Miguel Ángel; Martínez, JA; et al.
Revista: OBESITY FACTS
ISSN 1662-4025  Vol. 6  Nº Suppl. 1  2013  págs. 186
Autores: Pascual, Eider; Pérez-Pevida, Belén; et al.
Revista: AVANCES EN DIABETOLOGIA
ISSN 1134-3230  Vol. 29  2013  págs. 38
Autores: contreras R; Martínez, JA; et al.
Revista: CHRONOBIOLOGY INTERNATIONAL
ISSN 1525-6073  Vol. 29  Nº 10  2012  págs. 1397-1404
Genetic factors may interact with physical activity levels to modify obesity risk. Our aim was to explore the influence of rs1801260 single-nucleotide polymorphism (SNP) (3111T/C) of CLOCK gene on obesity risk, and to examine its potential interaction with lifestyle factors in an elderly population within the SUN ("Seguimiento Universidad de Navarra") Project. Subjects (n¿=¿903, aged 69¿±¿6 yrs) were recruited from the SUN Project. DNA was obtained from saliva, whereas lifestyle and dietary data were collected by validated self-report questionnaires. Genotype was assessed by reverse transcriptase-polymerase chain reaction (RT-PCR) plus allele discrimination. A significant interaction was observed between the 3111T/C SNP of CLOCK gene and sex for overweight/obesity risk (p for sex¿×¿CLOCK interaction &lt;.001). Our results showed that women carrying the C allele of CLOCK gene had a marginally significant lower risk of overweight/obesity compared with noncarrier-TT-subjects (odds ratio [OR]: .61, 95% confidence interval [CI]: .36-1.04; p¿=¿.069). Moreover, this association of the C allele with a decreased overweight/obesity risk might be enhanced in those women with a high physical activity level. Women practicing more than 16.8 metabolic equivalent tasks (hours per week) had a significantly lower overweight/obesity risk (OR: .36, 95% CI: .17-.79; p¿=¿.011). Furthermore, a significant interaction between the 3111T/C gene variant and physical activity (PA) for overweight/obesity risk was observed but only in women (p for PA¿×¿CLOCK interaction &lt;.050). In conclusion, it appears that physical activity levels may act by modifying the association of the 3111T/C SNP (rs1801260) of the CLOCK gene with overweight/obesity risk in elderly women in the SUN Project.
Autores: Martínez, Miguel Ángel; Guillén-Grima, F; de Irala, J; et al.
Revista: JOURNAL OF NUTRITION
ISSN 0022-3166  Vol. 142  Nº 9  2012  págs. 1672-8
The available large prospective studies supporting an inverse association between better adherence to the Mediterranean diet and lower mortality have mainly included older adults. It is not clear whether this inverse association is also present among younger individuals at lower mortality risk. Our aim was to assess the association between adherence to the Mediterranean diet and total mortality in middle-aged adults from the Seguimiento Universidad de Navarra (SUN) Project. We followed 15,535 Spanish university graduates for a mean of 6.8 y. Their mean age was 38 ± 12 y, 59.6% were females, and all were initially free of cardiovascular disease, cancer, and diabetes. A validated FFQ was used to assess dietary habits. Adherence to the Mediterranean diet was categorized into 3 groups according to the Mediterranean Diet Score (low, 0-2 points; moderate, 3-5 points; and high, 6-9 points). The outcome variable was total mortality. Cox proportional hazards models were used to estimate HR and 95% CI. We adjusted the estimates for sex, age, years of university education, BMI, smoking, physical activity, television watching, history of depression and baseline hypertension, and hypercholesterolemia. We observed 125 deaths during 105,980 person-years of follow-up. The fully adjusted HR for moderate and high adherence were 0.58 (95% CI: 0.34, 0.99; P = 0.05) and 0.38 (95% CI: 0.21, 0.70; P = 0.002), respectively. For each 2-point increment in the Mediterranean Diet Score, the HR of death
Autores: Guillén-Grima, F; et al.
Revista: CLINICAL AND TRANSLATIONAL ONCOLOGY
ISSN 1699-048X  Vol. 14  Nº 11  2012  págs. 835-41
The management of operable locally advanced N2 non-small cell lung cancer (NSCLC) is a controversial topic. Concurrent chemoradiation (CT-RT) is considered the standard of care for inoperable or unresectable patients, but the role of trimodality treatment remains controversial. We present our institution's experience with the management of stage III (N2) NSCLC patients, analyzing whether the addition of surgery improves survival when compared with definitive CT-RT alone. METHODS: From 1996 to 2006, 72 N2 NSCLC patients were treated. Thirty-four patients received cisplatin-based induction chemotherapy, followed by paclitaxel-cisplatin CT-RT, and 38 patients underwent surgery preceded by induction and/or followed by adjuvant therapy. Survival curves were estimated by Kaplan-Meier analysis, and the differences were assessed with the log-rank test. RESULTS: Most of the patients (87 %) were men. The median age was 59 years. A statistically significant association between T3-T4c and definitive CT-RT as well as between T1-T2c and surgery was noted (p < 0.0001). After a median follow-up period of 35 months, the median overall survival (OS) was 42 months for the surgery group versus 41 months for the CT-RT patients (p = 0.590). The median progression-free survival (PFS) was 14 months after surgery and 25 months after CT-RT (p = 0.933). Responders to radical CT-RT had a better OS than non-responders (43 vs. 17 months, respectively, p = 0.011). No significant differences were found in
Autores: Galar, Alicia; Leiva, José; et al.
Revista: JOURNAL OF INFECTION
ISSN 0163-4453  Vol. 65  Nº 4  2012  págs. 302-309
The clinical value of information provided by the Microbiology Laboratory may be reduced by the time it takes to generate results for healthcare providers. The aim of this study was to measure the clinical and economic impact associated with rapid reporting of microbiological results. Methods: 574 hospitalized patients with a bacterial clinical infection confirmed by culture were evaluated. 284 hospitalized patients were included in the historical control group (results available the day following the analysis) and 290 in the intervention group (results available the same day of the analysis). The Vitek (R) 2 system (bioMerieux) was used for identification and antimicrobial susceptibility testing in both groups. Results: Faster reporting of microbiological results enabled the clinician to optimize the antibiotic treatment sooner (P < 0.001). This reduction in turnaround time (17.6 h) was associated with improved clinical outcome, a significant reduction in the length of hospitalization and the number of microbiological and biochemical tests performed. Intubation requirements were significantly lower in the intervention group. Mortality rates did not differ significantly between the two groups. Costs incurred for patients in the intervention group were significantly lower than those in the control group, including costs for Microbiology Laboratory testing, antibiotic costs, length of hospitalization and other patient care costs. Conclusions: Rapid microbiological information was associated with quality improvement seen in earlier changes in antibiotic use, an improved clinical outcome and financial benefits. (C) 2012 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
Autores: Galar, Alicia; Yuste, JR; et al.
Revista: EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY AND INFECTIOUS DISEASES
ISSN 0934-9723  Vol. 31  Nº 9  2012  págs. 2245-252
Inappropriate antibiotic prescriptions are associated with an increase in healthcare costs and a decrease in the quality of care. The aim of this study was to measure the clinical and economic impact of rapid microbiological reporting on the specimens most frequently processed by the Microbiology Laboratory. The Vitek® 2 system (bioMérieux) was used for identification and susceptibility testing. Only hospitalized patients with bacterial infections were included. Two groups were established, a historical control group (results available the day following the analysis) and an intervention group (results available the same day of the analysis). Specimens studied and the median length of time from the introduction of the microorganism in the Vitek® 2 until microbiological report were as follows: wound and abscess (control¿=¿23.5 h, intervention¿=¿9.5 h, p¿<¿0.001), blood (control¿=¿23.5 h, intervention¿=¿9.2 h, p¿<¿0.001), and urine (control¿=¿23.4 h, intervention¿=¿9.3 h, p¿<¿0.001). Outcome parameters were hospital stay and mortality rates. Hospital costs were calculated. The mortality rates did not differ significantly between the two groups. Faster reporting of identification and antimicrobial susceptibility results was associated with a significant reduction in hospital stay and in overall costs for those patients from whom wound, abscess, and urine specimens were analyzed. However, the antimicrobial results of blood culture isolates did not lead to significant clinical or f
Autores: Toledo, Juan Bautista; Martínez, Miguel Ángel; et al.
Revista: OBESITY FACTS
ISSN 1662-4025  Vol. 5  Nº Supl.1  2012  págs. 82
Autores: Guillén-Grima, F; et al.
Revista: RISK ANALYSIS
ISSN 0272-4332  Vol. 31  Nº 3  2011  págs. 466 - 474
Autores: Guillén-Grima, F; Pérez-Fernandez, Nicolás;
Revista: LARYNGOSCOPE
ISSN 0023-852X  Vol. 121  Nº 8  2011  págs. 1810 - 1817
We have identified four distinct profiles of patients with definite Menière's disease that we consider as "mildly active elderly," "mildly active young," "active compensated," and "active uncompensated." We have demonstrated that only in a restricted popu
Autores: Manrique, Raquel; Guillén-Grima, F; Pérez-Fernandez, Nicolás;
Revista: Otology & Neurotology
ISSN 1531-7129  Vol. 32  Nº 3  2011  págs. 4661 - 4665
Autores: García Franco, C.E.; Guillén-Grima, F; et al.
Revista: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
ISSN 1010-7940  Vol. 40  Nº 4  2011  págs. e146 -e151
Our results support the view of surgical sympathectomy as the gold-standard treatment in severe cases of Hh and Fb. Radiofrequency sympathicolysis is useful as a second-treatment choice for Hh patients. Fb patients do not benefit from radiofrequency sympathicolysis.
Autores: Toledo, Juan Bautista; Martínez, Miguel Ángel; et al.
Revista: Annals of Nutrition and Metabolism
ISSN 0250-6807  Vol. 58  Nº Supplement 3  2011  págs. 263 - 263
Autores: Torre, Wenceslao; et al.
Revista: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
ISSN 1010-7940  Vol. 5  Nº 37  2010  págs. 1205 - 1208
Autores: Urtasun, F.; Barberena, J.; et al.
Revista: CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY
ISSN 0174-1551  Vol. 34  Nº 5  2010  págs. 911 - 917
Autores: Sánchez, A; Pimenta, AM; et al.
Revista: OBESITY
ISSN 1930-7381  Vol. 18  Nº 7  2010  págs. 1443 - 1448
This study included 11,825 participants of a Spanish dynamic prospective cohort based on former students from University of Navarra, registered professionals from some Spanish provinces, and university graduates from other associations, followed-up for 6.1 years. We aimed to assess the association between childhood or young adult overweight/obesity and the risk of depression. Participants were asked to select which of nine figures most closely represented their body shape at ages 5 and 20 years. Childhood and young adult overweight/obesity was defined as those cases in which participants reported body shape corresponding to the figures 6¿9 (more obese categories) at age 5 or 20, respectively. A subject was classified as incident case of depression if he/she was initially free of depression and reported physician-made diagnosis of depression and/or the use of antidepressant medication in at least one of biannual follow-up questionnaires. The association between childhood and young adult overweight/obesity and incidence of depression was estimated by multiple-adjusted hazard ratio (HR) and its 95% confidence interval (95% CI). Overweight/obesity at age 5 years predicted an increased risk for adult depression (HR = 1.50, 95% CI = 1.06¿2.12), and a stronger association was observed at age 20 years ((HR = 2.22, 95% CI = 1.22¿4.08), (subjects younger than 30 years at recruitment were excluded from this last analysis)). Childhood or young adult overweight/obesity was associated with elevated risk of adult depression. These results, if causal and confirmed in other prospective studies, support treating childhood and young adult overweight/obesity as part of comprehensive adult depression prevention efforts.
Autores: Sainz-Gómez, C.; Fernandez-Robredo, P; Salinas, Ángel María; et al.
Revista: EUROPEAN JOURNAL OF OPHTHALMOLOGY
ISSN 1120-6721  Vol. 20  Nº 2  2010  págs. 442 - 450
Purpose. To estimate the prevalence and causes of bilateral blindness and visual impairment in an urban institutionalized population aged 65 years and older. Methods. A total of 392 nursing home residents completed a standardized eye examination, including measurement of visual acuity (VA), intraocular pressure, lens opacity grading, indirect ophthalmoscopy, and photography of the macular area. The major causes of vision loss identified for all participants were blindness and visual impairment. Results. The average subject age was 82 years (65¿97); women outnumbered men 263 to 129. The prevalence of bilateral blindness (VA ¿1.0 logarithm of the minimum angle of resolution [logMAR]) was 14.9% (43/288); the prevalence of visual impairment (VA ¿0.5 and 1.0 logMAR) was 31.9% (92/288). Blindness and visual impairment increased significantly with age (p<0.05), odds ratio (OR) 1.047 and 1.088, respectively. Cataract was the most common cause of bilateral blindness and visual impairment (27.9% and 44.6%, respectively) followed by pathologic myopia (23.3%) and age-related macular degeneration (AMD) (20.9%) for blindness, and by AMD (27.2%) and pathologic myopia (12%) for visual impairment. Fifty percent of subjects with visual loss had the potential for improved vision with medical or surgical intervention. Conclusions. Although the prevalences were high, these data are important since it is difficult for epidemiologic studies to include aged, institutionalized individuals, although their numbers are increasing. Recognition of the predominant causes of visual loss dependent on age is fundamental for early diagnosis and treatment of ocular diseases. Many cases of low vision can be treated with appropriate ophthalmologic care.
Autores: Fernández, Secundino; Guillén-Grima, F; et al.
Revista: AURIS NASUS LARYNX
ISSN 0385-8146  Vol. 37  Nº 4  2010  págs. 409 - 414
Objective: To evaluate the value of different variables of the clinical history, auditory and vestibular tests and handicap measurements to define intractable or disabling Meniere's disease. Methods: This is a prospective study with 212 patients of which 155 were treated with intratympanic gentamicin and considered to be suffering a medically intractable Meniere's disease. Age and sex adjustments were performed with the 11 variables selected. Discriminant analysis was performed either using the aforementioned variables or following the stepwise method. Results: Different variables needed to be sex and/or age adjusted and both data were included in the discriminant function. Two different mathematical formulas were obtained and four models were analyzed. With the model selected, diagnostic accuracy is 77.7%, sensitivity is 94.9% and specificity is 52.8%. Conclusion: After discriminant analysis we found that the most informative variables were the number of vertigo spells, the speech discrimination score, the time constant of the VOR and a measure of handicap, the "dizziness index". (C) 2009 Elsevier Ireland Ltd. All rights reserved.
Autores: Lynch, T.; Clark, D; Centeno, Carlos; et al.
Revista: Palliative Medicine
ISSN 0269-2163  Vol. 24  Nº 8  2010  págs. 812 - 819
Autores: Prior, Celia; Guillén-Grima, F; Robles, JE; et al.
Revista: WORLD JOURNAL OF UROLOGY
ISSN 0724-4983  Vol. 28  Nº 6  2010  págs. 681-686
Autores: Yuste, JR; Guillén-Grima, F;
Libro:  Guía para la profilaxis y tratamiento de las infecciones y política antibiótica. 2ª ed
Nº Capítulo 10  2015  págs. 164-176
Autores: Moreno-Galarraga, L.; Guillén-Grima, F; de Irala, J;
Libro:  Conceptos de salud pública y estrategias preventivas: un manual para ciencias de la salud
2013  págs. 373 - 377
Autores: Canga, N; Garcia-Vivar, C; Guillén-Grima, F;
Libro:  Conceptos de Salud Pública y estrategia preventiva
2013  págs. 443-448
Autores: Infanti J,; Sixsmith, J.; Barry, M.; et al.
2013 
There is an impressive body of literature on risk communication relevant to the prevention and control of communicable diseases. This literature is complicated, however, by blurred definitions and overlap between risk communication and crisis communication. It is also widely dispersed across academic disciplines, lacking rigorous empirical evidence to demonstrate effectiveness, challenged by the complex and unpredictable ways that individuals perceive risk and the environmental, social, cultural and linguistic factors through which risk communication is viewed. At the European level, there is a need to bring the work on risk communication for communicable diseases together on many levels: Theoretical models of risk communication must be integrated across disciplines. The bridge between academic research and risk communication in practice needs to be strengthened (that is, findings of research need to be better communicated to end users and built into risk communication planning, guidance documents, training modules). Risk communicators should be collaborating more closely with community-level health providers and media. In addition, there is consensus in much of the literature reviewed on the need for coordinated leadership at the European level to ensure structured and systematic approaches to risk communication planning, preparedness and response. We have a clearer picture today than a decade ago about the requirements, parameters and challenges of communicating risks of co