IBSAL - Instituto de Investigación Biómedica de Salamanca (Castilla y León)

Permanent URI for this collectionhttps://hdl.handle.net/20.500.12105/16960

El Instituto de Investigación Biomédica de Salamanca (IBSAL) se constituyó el 21 de marzo de 2011 mediante Convenio firmado por la Consejería de Sanidad de la Junta de Castilla y León y la Universidad de Salamanca. A este convenio se sumó el Consejo Superior de Investigaciones Científicas (CSIC) el 10 de febrero de 2012. El IBSAL se constituye, así como un espacio para la investigación biomédica, orientado a la investigación básica, clínica, epidemiológica y en servicios de salud. Acreditado por el Instituto de Salud Carlos III como Instituto de Investigación Sanitaria en 2014, y renovando esta acreditación cada 5 años, forma parte así del total de 34 Institutos de Investigación Sanitaria acreditados existentes en la actualidad.

Browse

Now showing 1 - 20 of 90

Differences in the peripheral blood immune landscape between early-onset and late-onset colorectal cancer
(Frontiers Media, 2025-12-04) Sánchez-Menéndez, Clara; Rodríguez-Pérez, Jaime; Fuertes, Daniel; Leguizamon, Valentina; González-Sanmartín, María; Mateos, Elena; Cervero, Miguel; San José, Esther; Sanz, Gonzalo; Álvaro, Edurne; Ballestero-Pérez, Araceli; Martí-Gallostra, Marc; Rueda, José Antonio; Hurtado-Caballero, Elena; Pastor, Carlos; Balaguer, Francesc; Spinelli, Antonino; Martinez-Laso, Jorge; Torres, Montserrat; Perea, José; Coiras, Mayte; Spanish EOCRC Consortium (SECOC); Instituto de Salud Carlos III; Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Ministerio de Ciencia e Innovación (España); Centro de Investigación Biomédica en Red - CIBERINFEC (Enfermedades Infecciosas); Unión Europea. Comisión Europea. NextGenerationEU; Comunidad de Madrid (España)
Introduction: Colorectal cancer (CRC) is a leading cause of cancer-related mortality. While screening has reduced incidence in older adults, cases of early-onset CRC (EOCRC), diagnosed before age 50, are rising, highlighting the need to understand its unique biology. Immune responses, particularly T-cell infiltration measured by the tumor-based Immunoscore, are known predictors of CRC prognosis, but less is known about systemic immune differences by age at diagnosis. Methods: Peripheral blood mononuclear cells (PBMCs) from EOCRC (n=19) and late-onset CRC (LOCRC; n=19) participants recruited in Madrid (Spain) were analyzed for immune cell phenotypes, exhaustion markers, soluble cytokines, and metabolic activity. Results: Our study revealed distinct peripheral blood immune profiles differentiating EOCRC from LOCRC. EOCRC patients exhibited a heightened proinflammatory environment, with increased functional capacity of CD4+ Th1, Th9, and Th17 subsets to produce IFNg, IL-9, and IL-17A, respectively, and increased plasma levels of IFNg and CXCL8/IL-8. This suggests an active but potentially ineffective immune response. Conversely, LOCRC patients showed hallmarks of immunosenescence and chronic inflammation, including impaired cytokine production, higher frequencies of CD8+ Tgd and Th22 cells, and increased plasma CCL13/MCP-4, consistent with tissue remodeling and immune suppression. Biomarkers distinguishing EOCRC included reduced Th22 and CD8+ Tgd cell frequencies and higher NKT-like cells with increased IL-13 production by Th22 cells. Conclusions: EOCRC and LOCRC involved different immune mechanisms, where EOCRC showed an altered proinflammatory environment with preserved regulatory pathways, while LOCRC reflected age-related immune decline and inflammaging. Peripheral blood immune profiling offers a minimally invasive liquid Immunoscore for early detection and enables personalized immunotherapies for age-related immune landscapes, particularly benefiting younger individuals at risk of EOCRC.
Early detection of cognitive impairment in primary care: a mixed-methods protocol integrating data from multiple sources (DENDRITE study)
(2025-09-16) Almeida-Parra, Ángeles; Ropero-Sánchez, Andrea; Zamora Romero, Javier; Docío-Fernández, Laura; Fatjó-Vilas Mestre, Mar; Campuzano Ruiz, Susana; Lozano González, Pilar; Alonso-del-Cura, Olatz; Montero Calle, Ana; Barderas Manchado, Rodrigo; Moreno-Casbas, Teresa; MedPer_DC Project Working Group; Unión Europea. Comisión Europea. NextGenerationEU
Globally, over half of cognitive impairment cases identified in population-based studies remain undetected, and up to 90% of mild cases go undiagnosed. This represents a major public health challenge with significant implications for ageing populations and health systems. The present protocol outlines the integration of clinical, multiomic, healthcare, social, environmental, voice, and behavioral data, using artificial intelligence and advance statistical modeling, to develop a predictive risk model for the preclinical detection of cognitive impairment in adults aged 55–70 years. This is an observational, multicenter, non-interventional study employing a convergent mixed-methods approach. The design combines a prospective quantitative phase with a qualitative one based on discussion groups. The study will be conducted across six Spanish regions and seven primary healthcare centers located in different geographic areas. Each center will recruit 150 cognitively unimpaired participants, resulting in a total sample of 1050 participants. In addition, a calibration group of 100 participants diagnosed with mild cognitive impairment will be included. This protocol has been developed in accordance with the STROBE guidelines to ensure methodological rigor, transparency, and reproducibility. This research aims to develop a simple, cost-effective, and actionable tool for early preclinical detection of individuals at risk of cognitive impairment, enabling its integration into primary care and supporting timely, targeted interventions. This approach has the potential to reduce diagnostic delays, optimize healthcare resources, and promote equitable access to timely interventions, ultimately improving population health and quality of life.
Novel risk loci for COVID-19 hospitalization among admixed American populations
(eLife Sciences Publications, 2024-10-03) Diz-de Almeida, Silvia; Cruz, Raquel; Luchessi, Andre D; Lorenzo-Salazar, José M; López de Heredia, Miguel; Quintela, Inés; González-Montelongo, Rafaela; Nogueira Silbiger, Vivian; Porras, Marta Sevilla; Tenorio Castaño, Jair Antonio; Nevado, Julián; Aguado, José María; Aguilar, Carlos; Aguilera-Albesa, Sergio; Almadana, Virginia; Almoguera, Berta; Alvarez, Nuria; Andreu-Bernabeu, Álvaro; Arana-Arri, Eunate; Arango, Celso; Arranz, María J; Artiga, Maria-Jesus; Baptista-Rosas, Raúl C; Barreda-Sánchez, María; Belhassen-García, Moncef; Bezerra, Joao F; Bezerra, Marcos A C; Boix-Palop, Lucía; Brion, María; Brugada, Ramón; Bustos, Matilde; Calderón, Enrique J; Carbonell, Cristina; Castano, Luis; Castelao, Jose E; Conde-Vicente, Rosa; Cordero-Lorenzana, M Lourdes; Cortes-Sanchez, Jose L; Corton, Marta; Darnaude, M Teresa; De Martino-Rodríguez, Alba; Del Campo-Pérez, Victor; Diaz de Bustamante, Aranzazu; Domínguez-Garrido, Elena; Eirós, Rocío; Fariñas, María Carmen; Fernandez-Nestosa, María J; Fernández-Robelo, Uxía; Fernandez-Rodriguez, Amanda; Fernández-Villa, Tania; Gago-Dominguez, Manuela; Gil-Fournier, Belén; Gómez-Arrue, Javier; González Álvarez, Beatriz; González Bernaldo de Quirós, Fernan; González-Neira, Anna; González-Peñas, Javier; Gutiérrez-Bautista, Juan F; Herrero, María José; Herrero-Gonzalez, Antonio; Jimenez-Sousa, Maria Angeles; Lattig, María Claudia; Liger Borja, Anabel; Lopez-Rodriguez, Rosario; Mancebo, Esther; Martín-López, Caridad; Martín, Vicente; Martinez-Nieto, Oscar; Martinez-Lopez, Iciar; Martinez-Resendez, Michel F; Martinez-Perez, Angel; Mazzeu, Juliana F; Merayo Macías, Eleuterio; Minguez, Pablo; Moreno Cuerda, Victor; Oliveira, Silviene F; Ortega-Paino, Eva; Pompa-Mera, Ericka N; Parellada, Mara; Paz-Artal, Estela; Santos, Ney PC; Pérez-Matute, Patricia; Perez, Patricia; Pérez-Tomás, M Elena; Perucho, Teresa; Pinsach-Abuin, Mel·lina; Pita, Guillermo; Porras-Hurtado, Gloria L; Pujol, Aurora; Ramiro León, Soraya; Resino, Salvador; Fernandes, Marianne R; Rodríguez-Ruiz, Emilio; Rodríguez-Artalejo, Fernando; Rodriguez-Garcia, José A; Ruiz-Cabello, Francisco; Ruiz-Hornillos, Javier; Ryan, Pablo; Soria, José Manuel; Souto, Juan Carlos; Tamayo, Eduardo; Tamayo-Velasco, Álvaro; Taracido-Fernandez, Juan Carlos; Teper, Alejandro; Torres-Tobar, Lilian; Urioste, Miguel; Valencia-Ramos, Juan; Yáñez, Zuleima; Zarate, Ruth; de Rojas, Itziar; Ruiz, Agustín; Sánchez, Pascual; Real, Luis Miguel; SCOURGE Cohort Group; Guillén-Navarro, Encarna; Ayuso, Carmen; Parra, Esteban; Riancho, José A; Rojas-Martinez, Augusto; Flores, Carlos; Instituto de Salud Carlos III; Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Banco Santander; Fundación La Caixa; Agencia Estatal de Investigación (España); Gobierno de Canarias (España); Fundación Canaria de Investigación Sanitaria; Xunta de Galicia (España); Fundación Amancio Ortega; Estrella de Levante; Colabora Mujer
The genetic basis of severe COVID-19 has been thoroughly studied, and many genetic risk factors shared between populations have been identified. However, reduced sample sizes from non-European groups have limited the discovery of population-specific common risk loci. In this second study nested in the SCOURGE consortium, we conducted a genome-wide association study (GWAS) for COVID-19 hospitalization in admixed Americans, comprising a total of 4702 hospitalized cases recruited by SCOURGE and seven other participating studies in the COVID-19 Host Genetic Initiative. We identified four genome-wide significant associations, two of which constitute novel loci and were first discovered in Latin American populations ( and ). A trans-ethnic meta-analysis revealed another novel cross-population risk locus in . Finally, we assessed the performance of a cross-ancestry polygenic risk score in the SCOURGE admixed American cohort. This study constitutes the largest GWAS for COVID-19 hospitalization in admixed Latin Americans conducted to date. This allowed to reveal novel risk loci and emphasize the need of considering the diversity of populations in genomic research.
Mitochondrial RNA methyltransferase TRMT61B is a new, potential biomarker and therapeutic target for highly aneuploid cancers
(Nature Publishing Group, 2023-01) Martin, Alberto; Epifano, Carolina; Vilaplana-Marti, Borja; Hernández Martínez, Iván; Macías, Rocío I R; Martínez-Ramírez, Ángel; Cerezo, Ana; Cabezas-Sainz, Pablo; Garranzo-Asensio, Maria; Amarilla-Quintana, Sandra; Gomez-Dominguez, Deborah; Caleiras, Eduardo; Camps, Jordi; Gomez Lopez, Gonzalo; Gómez de Cedrón, Marta; Ramírez de Molina, Ana; Barderas Manchado, Rodrigo; Sánchez, Laura; Velasco-Miguel, Susana; Perez de Castro, Ignacio; Asociación Española Contra el Cáncer; Ministerio de Ciencia e Innovación (España); Instituto de Salud Carlos III
Despite being frequently observed in cancer cells, chromosomal instability (CIN) and its immediate consequence, aneuploidy, trigger adverse effects on cellular homeostasis that need to be overcome by anti-stress mechanisms. As such, these safeguard responses represent a tumor-specific Achilles heel, since CIN and aneuploidy are rarely observed in normal cells. Recent data have revealed that epitranscriptomic marks catalyzed by RNA-modifying enzymes change under various stress insults. However, whether aneuploidy is associated with such RNA modifying pathways remains to be determined. Through an in silico search for aneuploidy biomarkers in cancer cells, we found TRMT61B, a mitochondrial RNA methyltransferase enzyme, to be associated with high levels of aneuploidy. Accordingly, TRMT61B protein levels are increased in tumor cell lines with an imbalanced karyotype as well as in different tumor types when compared to control tissues. Interestingly, while TRMT61B depletion induces senescence in melanoma cell lines with low levels of aneuploidy, it leads to apoptosis in cells with high levels. The therapeutic potential of these results was further validated by targeting TRMT61B in transwell and xenografts assays. We show that TRM61B depletion reduces the expression of several mitochondrial encoded proteins and limits mitochondrial function. Taken together, these results identify a new biomarker of aneuploidy in cancer cells that could potentially be used to selectively target highly aneuploid tumors.
Executive Summary of the Consensus Statement of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Tropical Medicine and International Health (SEMTSI), the Spanish Association of Surgeons (AEC), the Spanish Society of Pneumology and Thoracic Surgery (SEPAR), the Spanish Society of Thoracic Surgery (SECT), the Spanish Society of Vascular and Interventional Radiology (SERVEI), and the Spanish Society of Paediatric Infectious Diseases (SEIP), on the Management of Cystic Echinococcosis
(Elsevier, 2020) Belhassen-García, Moncef; Balboa Arregui, Óscar; Calabuig-Muñoz, Eva; Carmena, David; Esteban Velasco, Maria Del Carmen; Fuentes Gago, Marta; Fumado Pérez, Victoria; García Alonso, Jesús; García López Hortelano, Milagros; González Fernández, Luis Miguel; Herrero Martínez, Juan María; Iglesias Iglesias, Manuel José; Jiménez López, Marcelo; López-Vélez, Rogelio; Muñoz-Bellvis, Luis; Muro, Antonio; Pardo-Lledías, Javier; Peñaranda-Vera, Maria; Perteguer-Prieto, Maria Jesus; Picado, Albert; Quiñones Sampedro, Jose Edecio; Rodríguez-Guardado, Azucena; Royo Crespo, Íñigo; Salvador, Fernando; Sánchez-Montalvá, Adrián; Torrús-Tendero, Diego; Velasco Pelayo, Luis; Sociedad Española de Medicina Tropical y Salud Internacional
[EN] The Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Tropical Medicine and International Health (SEMTSI), the Spanish Association of Surgeons (AEC), the Spanish Society of Pneumology and Thoracic Surgery (SEPAR), the Spanish Society of Thoracic Surgery (SECT), the Spanish Society of Vascular and Interventional Radiology (SERVEI), and the Spanish Society of Paediatric Infectious Diseases (SEIP) considered it pertinent to issue a consensus statement on the management of cystic echinococcosis (CE) to guide healthcare professionals in the care of patients with CE. Specialists from several fields (clinicians, surgeons, radiologists, microbiologists, and parasitologists) identified the most clinically relevant questions and developed this Consensus Statement, evaluating the available evidence-based data to propose a series of recommendations on the management of this disease. This Consensus Statement is accompanied by the corresponding references on which these recommendations are based. Prior to publication, the manuscript was open for comments and suggestions from the members of the SEIMC and the scientific committees and boards of the various societies involved. [ES] La Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), la Sociedad Española de Medicina Tropical y Salud Internacional (SEMTSI), la Asociación Española de Cirujanos (AEC), la Sociedad Española de Neumología y Cirugía Torácica (SEPAR), la Sociedad Española de Cirugía Torácica (SECT), la Sociedad Española de Radiología Vascular e Intervencionista (SERVEI) y la Sociedad Española de Infectología Pediátrica (SEIP) han considerado pertinente la elaboración de una declaración de consenso sobre el tratamiento de la equinococosis quística (EQ) que sirva de ayuda al personal sanitario en la atención de pacientes con EQ. Varios tipos de profesionales (médicos, cirujanos, radiólogos, microbiólogos y parasitólogos) han seleccionado las preguntas más clínicamente relevantes y han desarrollado esta Declaración de consenso, en la que evalúan los datos basados en la evidencia disponibles para proponer una serie de recomendaciones sobre el tratamiento de esta enfermedad. Esta Declaración de consenso se acompaña de la bibliografía correspondiente que fundamenta estas recomendaciones. Antes de su publicación, el manuscrito estuvo abierto a comentarios y sugerencias de los miembros de la SEIMC y de los comités científicos y juntas directivas de las diferentes sociedades implicadas.
Real-time PCR for malaria diagnosis and identification of Plasmodium species in febrile patients in Cubal, Angola
(BioMed Central (BMC), 2024-09-11) Mediavilla, Alejandro; Silgado, Aroa; Febrer-Sendra, Begoña; Crego-Vicente, Beatriz; Martínez-Vallejo, Patricia; Maturana, Carles Rubio; Goterris, Lidia; Nindia, Arlette; Martínez-Campreciós, Joan; Aixut, Sandra; Aznar-Ruiz-de-Alegría, María Luisa; Fernández-Soto, Pedro; Muro, Antonio; Salvador, Fernando; Molina, Israel; Berzosa, Pedro; Oliveira-Souto, Inés; Sulleiro, Elena
Background: Malaria is the parasitic disease with the highest morbimortality worldwide. The World Health Organization (WHO) estimates that there were approximately 249 million cases in 2022, of which 3.4% were in Angola. Diagnosis is based on parasite identification by microscopy examination, antigen detection, and/or molecular tests, such as polymerase chain reaction (PCR). This study aimed to evaluate the usefulness of real-time PCR as a diagnostic method for malaria in an endemic area (Cubal, Angola). Methods: A cross-sectional study was carried out at the Hospital Nossa Senhora da Paz in Cubal, Angola, including 200 patients who consulted for febrile syndrome between May and July 2022. From each patient, a capillary blood sample was obtained by finger prick for malaria field diagnosis [microscopy and rapid diagnostic test (RDT)] and venous blood sample for real-time PCR performed at the Hospital Universitario Vall d'Hebron in Barcelona, Spain. Any participant with a positive result from at least one of these three methods was diagnosed with malaria. Results: Of the 200 participants included, 54% were female and the median age was 7 years. Malaria was diagnosed by at least one of the three techniques (microscopy, RDT, and/or real-time PCR) in 58% of the participants, with RDT having the highest percentage of positivity (49%), followed by real-time PCR (39.5%) and microscopy (33.5%). Of the 61 discordant samples, 4 were only positive by microscopy, 13 by real-time PCR, and 26 by RDT. Plasmodium falciparum was the most frequent species detected (90.63%), followed by P. malariae (17.19%) and P. ovale (9.38%). Coinfections were detected in ten participants (15.63%): six (60%) were caused by P. falciparum and P. malariae, three (30%) by P. falciparum and P. ovale, and one (10%) triple infection with these three species. In addition, it was observed that P. falciparum and P. malariae coinfection significantly increased the parasite density of the latter. Conclusions: RDT was the technique with the highest positivity rate, followed by real-time PCR and microscopy. The results of the real-time PCR may have been underestimated due to suboptimal storage conditions during the transportation of the DNA eluates. However, real-time PCR techniques have an important role in the surveillance of circulating Plasmodium species, given the epidemiological importance of the increase in non-falciparum species in the country, and can provide an estimate of the intensity of infection.
EGFR amplification and EGFRvIII predict and participate in TAT-Cx43266-283 antitumor response in preclinical glioblastoma models
(Oxford University Press, 2024-07-05) Álvarez-Vázquez, Andrea; San-Segundo, Laura; Cerveró-García, Pilar; Flores-Hernández, Raquel; Ollauri-Ibáñez, Claudia; Segura-Collar, Berta; Hubert, Christopher G; Morrison, Gillian; Pollard, Steven M; Lathia, Justin D; Sánchez-Gómez, Pilar; Tabernero, Arantxa; Álvarez-Vázquez, Andrea; San-Segundo, Laura; Cerveró-García, Pilar; Flores-Hernández, Raquel; Ollauri-Ibáñez, Claudia; Segura-Collar, Berta; Hubert, Christopher G; Morrison, Gillian; Pollard, Steven M; Lathia, Justin D; Tabernero, Arantxa; Junta de Castilla y León (España); Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Agencia Estatal de Investigación (España); Ministerio de Ciencia e Innovación (España); Unión Europea. Comisión Europea. NextGenerationEU; Instituto de Salud Carlos III; Cleveland Clinic Lerner Research Institute; Cancer Research UK (Reino Unido); European Molecular Biology Organization
Background: Glioblastoma (GBM) commonly displays epidermal growth factor receptor (EGFR) alterations (mainly amplification and EGFRvIII) and TAT-Cx43266-283 is a Src-inhibitory peptide with antitumor properties in preclinical GBM models. Given the link between EGFR and Src, the aim of this study was to explore the role of EGFR in the antitumor effects of TAT-Cx43266-283. Methods: The effect of TAT-Cx43266-283, temozolomide (TMZ), and erlotinib (EGFR inhibitor) was studied in patient-derived GBM stem cells (GSCs) and murine neural stem cells (NSCs) with and without EGFR alterations, in vitro and in vivo. EGFR alterations were analyzed by western blot and fluorescence in situ hybridization in these cells, and compared with Src activity and survival in GBM samples from The Cancer Genome Atlas. Results: The effect of TAT-Cx43266-283 correlated with EGFR alterations in a set of patient-derived GSCs and was stronger than that exerted by TMZ and erlotinib. In fact, TAT-Cx43266-283 only affected NSCs with EGFR alterations, but not healthy NSCs. EGFR alterations correlated with Src activity and poor survival in GBM patients. Finally, tumors generated from NSCs with EGFR alterations showed a decrease in growth, invasiveness, and vascularization after treatment with TAT-Cx43266-283, which enhanced the survival of immunocompetent mice. Conclusions: Clinically relevant EGFR alterations are predictors of TAT-Cx43266-283 response and part of its mechanism of action, even in TMZ- and erlotinib-resistant GSCs. TAT-Cx43266-283 targets NSCs with GBM-driver mutations, including EGFR alterations, in an immunocompetent GBM model in vivo, suggesting a promising effect on GBM recurrence. Together, this study represents an important step toward the clinical application of TAT-Cx43266-283.
Low anti-SARS-CoV-2 S antibody levels predict increased mortality and dissemination of viral components in the blood of critical COVID-19 patients
(Wiley, 2022-02) Martin-Vicente, Maria; Almansa, Raquel; Martinez, Isidoro; Tedim, Ana P; Bustamante, Elena; Tamayo, Luis; Aldecoa, César; Gómez, José Manuel; Renedo, Gloria; Berezo, Jose Ángel; Cedeño, Jamil Antonio; Mamolar, Nuria; García Olivares, Pablo; Herrán-Monge, Rubén; Cicuendez, Ramón; Enríquez, Pedro; Ortega, Alicia; Jorge, Noelia; Doncel, Cristina; de la Fuente, Amanda; Bustamante-Munguira, Juan; Muñoz-Gómez, María José; González-Rivera, Milagros; Puertas, Carolina; Mas-Lloret, Vicente; Vazquez-Alcaraz, Monica; Perez-Garcia, Felipe; Rico-Feijoo, Jesús; Martín, Silvia; Motos, Anna; Fernandez-Barat, Laia; Eiros, José María; Domínguez-Gil, Marta; Ferrer, Ricard; Barbé, Ferrán; Trapiello, Wysali; Kelvin, David J; Bermejo-Martin, Jesús F; Resino, Salvador; Torres, Antoni; Canadian Institutes of Health Research; Nova Scotia Health Research Foundation; Atlantic Genome (Canada); Li Ka Shing Foundation; Dalhousie Medical Research Foundation; Canada Research Chairs; Instituto de Salud Carlos III; Centro de Investigación Biomédica en Red - CIBERES (Enfermedades Respiratorias); Junta de Castilla y León (España); Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF)
Background: Anti-SARS-CoV-2 S antibodies prevent viral replication. Critically ill COVID-19 patients show viral material in plasma, associated with a dysregulated host response. If these antibodies influence survival and viral dissemination in ICU-COVID patients is unknown. Patients/methods: We studied the impact of anti-SARS-CoV-2 S antibodies levels on survival, viral RNA-load in plasma, and N-antigenaemia in 92 COVID-19 patients over ICU admission. Results: Frequency of N-antigenaemia was >2.5-fold higher in absence of antibodies. Antibodies correlated inversely with viral RNA-load in plasma, representing a protective factor against mortality (adjusted HR [CI 95%], p): (S IgM [AUC ≥ 60]: 0.44 [0.22; 0.88], 0.020); (S IgG [AUC ≥ 237]: 0.31 [0.16; 0.61], <0.001). Viral RNA-load in plasma and N-antigenaemia predicted increased mortality: (N1-viral load [≥2.156 copies/ml]: 2.25 [1.16; 4.36], 0.016); (N-antigenaemia: 2.45 [1.27; 4.69], 0.007). Conclusions: Low anti-SARS-CoV-2 S antibody levels predict mortality in critical COVID-19. Our findings support that these antibodies contribute to prevent systemic dissemination of SARS-CoV-2.
Role of personal aptitudes as determinants of incident morbidity, lifestyles, quality of life, use of health services, and mortality (DESVELA cohort): quantitative study protocol for a prospective cohort study in a hybrid analysis
(Frontiers Media, 2023) Martí-Lluch, Ruth; Bolíbar, Bonaventura; Llobera Cànaves, Joan; Maderuelo-Fernández, José A; Magallón-Botaya, Rosa; Sánchez-Pérez, Álvaro; Fernández-Domínguez, Maria José; Motrico, Emma; Vicens-Pons, Enric; Notario-Pacheco, Blanca; Alves-Cabratosa, Lia; Ramos, Rafael
Introduction: The healthcare and well-being of the population depend on multiple factors and should adapt to societal changes. The opposite is also occurring; society has evolved concerning the individuals' approach to their care, which includes participation in decision-making processes. In this scenario, health promotion and prevention become crucial to provide an integrated perspective in the organization and management of the health systems.Health status and well-being depend on many aspects, determinants of health, which in turn may be modulated by individual behavior. Certain models and frameworks try to study the determinants of health and individual human behaviors, separately. However, the interrelation between these two aspects has not been examined in our population.Our main objective is to analyze whether personal aptitudes related to behaviors are independently associated with the incidence of morbidity. A secondary objective will enquire whether these personal aptitudes are independently associated with lower all-cause mortality, enhanced adoption of healthy lifestyles, higher quality of life, and lower utilization of health services during follow-up. Methods: This protocol addresses the quantitative branch of a multicenter project (10 teams) for the creation of a cohort of at least 3,083 persons aged 35 to 74 years from 9 Autonomous Communities (AACC). The personal variables to evaluate are self-efficacy, activation, health literacy, resilience, locus of control, and personality traits. Socio-demographic covariates and social capital will be recorded. A physical examination, blood analysis, and cognitive evaluation will be carried out.Several sets of six Cox models (one for each independent variable) will analyze the incidence of morbidity (objective 1); all-cause mortality and the rest of the dependent variables (objective 2). The models will be adjusted for the indicated covariates, and random effects will estimate Potential heterogeneity between AACC. Discussion: The analysis of the association of certain behavioral patterns and determinants of health is essential and will contribute to improving health promotion and prevention strategies. The description of the individual elements and interrelated aspects that modulate the onset and persistence of diseases will allow the evaluation of their role as prognostic factors and contribute to the development of patient-tailored preventive measures and healthcare.Clinical Trial Registration: ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.
Promoting Physical Activity in a Primary Care Practice in People Living with Dementia and Their Family Caregivers
(Multidisciplinary Digital Publishing Institute (MDPI), 2023-04-27) de Dios-Rodríguez, Elena; Patino-Alonso, Carmen; González-Sánchez, Susana; Tamayo-Morales, Olaya; Ripoll Amengual, Joana; Mora-Simón, Sara; Unzueta-Arce, Jaime; Gómez-Marcos, Manuel A; García-Ortiz, Luis; Rodríguez-Sánchez, Emiliano
People living with dementia (PLWD) and their family caregivers report higher rates of having a sedentary lifestyle than their non-disabled peers do. This study analyzed the effectiveness of an intervention designed to increase physical activity among PLWD and their family caregivers in primary health care settings. A cluster-randomized multicenter clinical trial was conducted. Participants from four health centers were randomly assigned to the intervention group (IG) or the control group (CG) in a 1:1 ratio using Epidat software. After a seven-day period with a digital pedometer (Omron Hj-321 lay-UPS), participants were asked to complete the International Physical Activity Questionnaire Short Form (IPAQ-SF). PLWD and caregivers allocated to the IG were given brief advice, educational materials and an additional 15 min appointment to prescribe an individualized physical activity plan. Seventy PLWD and 80 caregivers were assigned to the CG and 70 PLWD and 96 caregivers were assigned to the IG. Results of the pedometer assessment show that in PLWD, the IG's activity increased by 52.89 aerobic steps at 6 months and the CG's activity decreased by 615.93 aerobic steps, showing a net increase in the IG of 668.82 (95% CI: -444.27 to 1781.91; p = 0.227). For caregivers in the IG, activity increased by 356.91 aerobic steps and in the CG it decreased by 12.95 aerobic steps, showing a net increase in favor of the IG of 369.86 (95%CI: -659.33 to 1399.05; p = 0.476). The effectiveness of interventions to increase physical activity in this group of people with dementia and their caregivers did not achieved positive results overall but may have provided suggestions for family physicians and physical therapists to improve physical activity among people with dementia and their families.
La Red de Investigación en Actividades Preventivas y Promoción de la Salud (redIAPP): una red de referencia e impulsora de la investigación en atención primaria
(Elsevier, 2023-07-21) Bolibar Ribas, Bonaventura; Llobera Cànaves, Joan; García-Ortiz, Luis; Bellón, Juan-Ángel; Ramos, Rafel; García-Campayo, Javier; Sánchez-Pérez, Álvaro; Claveria, Ana; Martínez, Vicente; Vicens, Enric; Minué, César; Gil-Guillen, Vicente; Berenguera, Anna; Moleras-Serra, Anna
[ES] La Red de Investigación en Actividades Preventivas y Promoción de la Salud (redIAPP), una red de referencia e impulsora de la investigación en atención primaria fue creada en 2003 gracias al programa Redes Temáticas de Investigación Cooperativa en Salud (RETICS) del Instituto de Salud Carlos III (ISCIII). Su creación ha supuesto un cambio radical en la situación de la investigación en atención primaria. A lo largo de sus 19 años (2003-2021) han participado distintos grupos de investigación y comunidades autónomas, y se han desarrollado distintas líneas de investigación con numerosos proyectos y publicaciones. A pesar de las dificultades sufridas, ha creado una experiencia de investigación colaborativa entre distintas comunidades autónomas con gran vitalidad y con importantes resultados para la atención primaria. La redIAPP, por tanto, ha sido un gran referente para la investigación en atención primaria y para la profundización de su área de conocimiento. Se sugieren varias líneas de mejora para el futuro de la investigación en atención primaria. [EN] The Research Network on Preventive Activities and Health Promotion (redIAPP), a reference network and promoter of primary care research was created in 2003 thanks to the program Thematic Networks for Cooperative Research in Health (RETICS) of the Instituto de Salud Carlos III (ISCIII). Its creation has meant a radical change in the situation of research in primary care. Throughout its 19 years (2003-2021), different research groups and autonomous communities have participated, and different lines of research have been developed with numerous projects and publications. Despite the difficulties suffered, it has created a collaborative research experience between different autonomous communities with great vitality and with important results for primary care. The redIAPP, therefore, has been a great reference for research in primary care and for the deepening of its area of knowledge. Several lines of improvement are suggested for the future of primary care research.
Impact of adherence to individual quality-of-care indicators on the prognosis of bloodstream infection due to Staphylococcus aureus: a prospective observational multicentre cohort
(Elsevier, 2023-04) Escrihuela-Vidal, Francesc; Kaasch, Achim J; Von Cube, Maja; Rieg, Siegbert; Kern, Winfried V; Seifert, Harald; Song, Kyoung-Ho; Liao, Chun-Hsing; Tilley, Robert; Gott, Hannah; Scarborough, Matt; Gordon, Claire; Llewelyn, Martin J; Kuehl, Richard; Morata, Laura; Soriano, Alex; Edgeworth, Jonathan; Ruiz de Gopegui-Bordes, Enrique; Nsutebu, Emmanuel; Cisneros, José Miguel; Fowler, Vance G.; Thwaites, Guy; López-Contreras, Joaquín; Barlow, Gavin; Ternavasio-De La Vega, Hugo Guillermo; Rodriguez-Bano, Jesus; Lopez-Cortes, Luis Eduardo
Objectives: To analyse the adherence and impact of quality-of-care indicators (QCIs) in the management of Staphylococcus aureus bloodstream infection in a prospective and multicentre cohort. Methods: Analysis of the prospective, multicentre international S. Aureus Collaboration cohort of S. Aureus bloodstream infection cases observed between January 2013 and April 2015. Multivariable analysis was performed to evaluate the impact of adherence to QCIs on 90-day mortality. Results: A total of 1784 cases were included. Overall, 90-day mortality was 29.9% and mean follow-up period was 118 days. Adherence was 67% (n = 1180/1762) for follow-up blood cultures, 31% (n = 416/1342) for early focus control, 77.6% (n = 546/704) for performance of echocardiography, 75.5% (n = 1348/1784) for adequacy of targeted antimicrobial therapy, 88.6% (n = 851/960) for adequacy of treatment duration in non-complicated bloodstream infections and 61.2% (n = 366/598) in complicated bloodstream infections. Full bundle adherence was 18.4% (n = 328/1784). After controlling for immortal time bias and potential confounders, focus control (adjusted hazard ratio = 0.76; 95% CI, 0.59-0.99; p 0.038) and adequate targeted antimicrobial therapy (adjusted hazard ratio = 0.75; 95% CI, 0.61-0.91; p 0.004) were associated with low 90-day mortality. Discussion: Adherence to QCIs in S. Aureus bloodstream infection did not reach expected rates. Apart from the benefits of application as a bundle, focus control and adequate targeted therapy were independently associated with low mortality.
Daratumumab, carfilzomib, and dexamethasone in relapsed or refractory myeloma: final analysis of PLEIADES and EQUULEUS
(Springer, 2023-03-07) Moreau, Philippe; Chari, Ajai; Oriol, Albert; Martinez-Lopez, Joaquin; Haenel, Mathias; Touzeau, Cyrille; Ailawadhi, Sikander; Besemer, Britta; de la Rubia Comos, Javier; Encinas, Cristina; Mateos, Maria-Victoria; Salwender, Hans; Rodriguez-Otero, Paula; Hulin, Cyrille; Karlin, Lionel; Sureda, Anna; Bargay Lleonart, Joan; Benboubker, Lotfi; Rosiñol, Laura; Tarantolo, Stefano; Terebelo, Howard; Yang, Shiyi; Wang, Jing Jing; Nnane, Ivo; Qi, Ming; Kosh, Michele; Delioukina, Maria; Goldschmidt, Hartmut; Moreau, Philippe; Chari, Ajai; Oriol, Albert; Martinez-Lopez, Joaquin; Haenel, Mathias; Touzeau, Cyrille; Ailawadhi, Sikander; Besemer, Britta; de la Rubia Comos, Javier; Encinas, Cristina; Mateos, Maria-Victoria; Salwender, Hans; Rodriguez-Otero, Paula; Hulin, Cyrille; Karlin, Lionel; Sureda, Anna; Bargay Lleonart, Joan; Benboubker, Lotfi; Rosiñol, Laura; Tarantolo, Stefano; Terebelo, Howard; Yang, Shiyi; Wang, Jing Jing; Nnane, Ivo; Qi, Ming; Kosh, Michele; Delioukina, Maria; Goldschmidt, Hartmut
A multiple health behaviour change intervention to prevent depression: A randomized controlled trial
(Elsevier, 2023) Gómez-Gómez, Irene; Motrico, Emma; Moreno-Peral, Patricia; Casajuana-Closas, Marc; López-Jiménez, Tomàs; Zabaleta-Del-Olmo, Edurne; Clavería, Ana; Llobera Cànaves, Joan; Martí-Lluch, Ruth; Ramos, Rafael; Maderuelo-Fernández, José-Ángel; Vicens-Caldentey, Caterina; Domínguez-García, Marta; Bartolomé-Moreno, Cruz; Recio-Rodriguez, Jose I; Bellón, Juan Á
Objective: To examine the effectiveness of a 12-month MHBC intervention in the prevention of onset depression in primary health care (PHC). Methods: Twenty-two PHC centres took part in the cluster-randomized controlled trial. Patients were randomized to receive either usual care or an MHBC intervention. The endpoints were onset of major depression and reduction of depressive symptoms in participants without baseline depression at a 12-month follow-up. Results: 2531 patients agreed and were eligible to participate. At baseline, around 43% were smokers, 82% were non-adherent to the Mediterranean diet and 55% did not perform enough physical activity. The intervention group exhibited a greater positive change in two or more behaviours (OR 1.75 [95%CI: 1.17 to 2.62]; p = 0.006); any behaviour (OR 1.58 [95%CI: 1.13 to 2.20]; p = 0.007); and adherence to the Mediterranean diet (OR 1.94 [95%CI: 1.29 to 2.94]; p = 0.002), while this increase was not statistically significant for smoking and physical activity. The intervention was not effective in preventing major depression (OR 1.17; [95% CI 0.53 to 2.59)]; p = 0.690) or reducing depressive symptoms (Mean difference: 0.30; [95% CI -0.77 to 1.36]; p = 0.726) during follow-up. Conclusions: As compared to usual care, the MHBC intervention provided a non-significant reduction in the incidence of major depression. Trial registration: ClinicalTrials.gov, NCT03136211.
Utility of PHQ-2, PHQ-8 and PHQ-9 for detecting major depression in primary health care: a validation study in Spain
(Cambridge University Press, 2022-10-19) Gómez-Gómez, Irene; Benítez, Isabel; Bellón, Juan; Moreno-Peral, Patricia; Oliván-Blázquez, Bárbara; Clavería, Ana; Zabaleta-Del-Olmo, Edurne; Llobera Cànaves, Joan; Serrano-Ripoll, Maria Jesus; Tamayo-Morales, Olaya; Motrico, Emma
Background: Primary health care (PHC) professionals may play a crucial role in improving early diagnosis of depressive disorders. However, only 50% of cases are detected in PHC. The most widely used screening instrument for major depression is the Patient Health Questionnaire (PHQ), including the two-, eight- and nine-item versions. Surprisingly, there is neither enough evidence about the validity of PHQ in PHC patients in Spain nor indications about how to interpret the total scores. This study aimed to gather validity evidence to support the use of the three PHQ versions to screen for major depression in PHC in Spain. Additionally, the present study provided information for helping professionals to choose the best PHQ version according to the context. Methods: The sample was composed of 2579 participants from 22 Spanish PHC centers participating in the EIRA-3 study. The reliability and validity of the three PHQ versions for Spanish PHC patients were assessed based on responses to the questionnaire. Results: The PHQ-8 and PHQ-9 showed high internal consistency. The results obtained confirm the theoretically expected relationship between PHQ results and anxiety, social support and health-related QoL. A single-factor solution was confirmed. Regarding to the level of agreement with the CIDI interview (used as the criterion), our results indicate that the PHQ has a good discrimination power. The optimal cut-off values were: ⩾2 for PHQ-2, ⩾7 for PHQ-8 and ⩾8 for PHQ-9. Conclusions: PHQ is a good and valuable tool for detecting major depression in PHC patients in Spain.
Thrombocytopenia and Therapeutic Strategies after Allogeneic Hematopoietic Stem Cell Transplantation
(Multidisciplinary Digital Publishing Institute (MDPI), 2022-03) Bento, Leyre; Canaro Hirnyk, Mariana; Bastida, Jose Maria; Sampol Mayol, Antonia
Thrombocytopenia following allogeneic hematopoietic stem cell transplantation is a usual complication and can lead to high morbidity and mortality. New strategies, such as the use of another graft versus host-disease prophylaxis, alternative donors, and management of infections, have improved the survival of these patients. The mechanisms are unknown; therefore, the identification of new strategies to manage this potentially serious problem is needed. Thrombopoietin receptor agonists are currently available to stimulate platelet production. Some small retrospective studies have reported their potential efficacy in an allogeneic stem cell transplant setting, confirming good tolerability. Recent studies with higher numbers of patients also support their safety and efficacy in this setting, hence establishing the use of these drugs as a promising strategy for this post-transplant complication. However, prospective trials are needed to confirm these results.
Long-Term Effectiveness of a Smartphone App and a Smart Band on Arterial Stiffness and Central Hemodynamic Parameters in a Population with Overweight and Obesity (Evident 3 Study): Randomised Controlled Trial
(Multidisciplinary Digital Publishing Institute (MDPI), 2022-11-10) Gómez-Sánchez, Leticia; Gómez-Sánchez, Marta; Lugones-Sánchez, Cristina; Rodríguez-Sánchez, Emiliano; Tamayo-Morales, Olaya; Gonzalez-Sánchez, Susana; Magallón-Botaya, Rosa; Ramírez-Manent, José Ignacio; Recio-Rodriguez, Jose I; Agudo-Conde, Cristina; García-Ortiz, Luis; Gómez-Marcos, Manuel A
mHealth technologies could help to improve cardiovascular health; however, their effect on arterial stiffness and hemodynamic parameters has not been explored to date. To evaluate the effect of a mHealth intervention, at 3 and 12 months, on arterial stiffness and central hemodynamic parameters in a sedentary population with overweight and obesity. Randomised controlled clinical trial (Evident 3 study). 253 subjects were included: 127 in the intervention group (IG) and 126 in the control group (CG). The IG subjects were briefed on the use of the Evident 3 app and a smart band (Mi Band 2, Xiaomi) for 3 months to promote healthy lifestyles. All measurements were recorded in the baseline visit and at 3 and 12 months. The carotid-femoral pulse wave velocity (cfPWV) and the central hemodynamic parameters were measured using a SphigmoCor Systemﾮ device, whereas the brachial-ankle pulse wave velocity (baPWV) and the Cardio Ankle Vascular Index (CAVI) were measured using a VaSera VS-2000ﾮ device. Of the 253 subjects who attended the initial visit, 237 (93.7%) completed the visit at 3 months of the intervention, and 217 (85.3%) completed the visit at 12 months of the intervention. At 12 months, IG showed a decrease in peripheral augmentation index (PAIx) (-3.60; 95% CI -7.22 to -0.00) and ejection duration (ED) (-0.82; 95% CI -1.36 to -0.27), and an increase in subendocardial viability ratio (SEVR) (5.31; 95% CI 1.18 to 9.44). In CG, cfPWV decreased at 3 months (-0.28 m/s; 95% CI -0.54 to -0.02) and at 12 months (-0.30 m/s, 95% CI -0.54 to -0.05), central diastolic pressure (cDBP) decreased at 12 months (-1.64 mm/Hg; 95% CI -3.19 to -0.10). When comparing the groups we found no differences between any variables analyzed. In sedentary adults with overweight or obesity, the multicomponent intervention (Smartphone app and an activity-tracking band) for 3 months did not modify arterial stiffness or the central hemodynamic parameters, with respect to the control group. However, at 12 months, CG presented a decrease of cfPWV and cDBP, whereas IG showed a decrease of PAIx and ED and an increase of SEVR.
Allogeneic Hematopoietic Stem Cell Transplantation in Transformed Follicular Lymphoma (tFL): Results of a Retrospective Multicenter Study from GELTAMO/GETH-TC Spanish Groups
(Multidisciplinary Digital Publishing Institute (MDPI), 2022-11-18) Rey-Bua, Beatriz; Cabrero, Mónica; Bento, Leyre; Montoro, Juan; Bastos-Oreiro, Mariana; Parody, Rocio; Yanez, Lucrecia; Lopez-Godino, Oriana; Zanabili, Joud; Herrera, Pilar; Gutierrez, Gonzalo; Perez, Ariadna; Piñana, Jose L; Novelli, Silvana; Cortés, María; Sureda, Ana Maria; Caballero, Dolores; García-Sancho, Alejandro Martín
Background: Transformation of follicular lymphoma into an aggressive lymphoma (tFL) worsens the prognosis and the standard treatment is not completely defined. Allogeneic hematopoietic stem cell transplantation (alloSCT) could be a potentially curative option for these patients, but it has not been widely explored. Methods: We designed a retrospective multicenter study to analyze the efficacy and toxicity of alloSCT in tFL patients and potential prognostic factors of survival. Results: A total of 43 patients diagnosed with tFL who underwent alloSCT in 14 Spanish centers between January 2000 and January 2019 were included. Median age was 44 (31-67) years. After a median follow-up of 58 months, estimated 5-year overall survival (OS) and progression-free survival (PFS) were both 35%. Estimated 100-day and 1-year non-relapse mortality (NRM) were 20% and 34%, respectively. The type of conditioning regimen (3-year OS of 52% vs. 20%, respectively, for reduced-intensity vs. myeloablative conditioning) and development of chronic graft versus host disease (cGVHD) (3-year OS of 75% vs. 40%) were the only factors significantly associated with OS. The only variable with an independent association with OS was cGVHD (HR, 3.4; 95% CI, 1.2-9.6). Conclusions: Our results indicate that alloSCT continues to be a potentially curative option for patients with tFL.
Implementation of the EIRA 3 Intervention by Targeting Primary Health Care Practitioners: Effectiveness in Increasing Physical Activity
(Multidisciplinary Digital Publishing Institute (MDPI), 2021-10-08) Contreras-Martos, Sara; Leiva Rus, Alfonso; Sanchez, Álvaro; Motrico, Emma; Bellón, Juan; Aldecoa Landesa, Susana; Magallón-Botaya, Rosa; Casajuana-Closas, Marc; Zabaleta-Del-Olmo, Edurne; Bol�bar, Bonaventura; Maderuelo, José-Ángel; Llobera Cànaves, Joan
The World Health Organization (WHO) estimated that physical inactivity (PI) is responsible for 20 to 30% of all non-communicable diseases. We aimed to analyze the effectiveness of a multiple health behavior change (MHBC) intervention to increase physical activity (PA) in patients 45 to 75 years old who had at least 2 of 3 unhealthy behaviors (tobacco use, reduced fruit and vegetable consumption, and insufficient PA). The MHBC intervention is based on the Transtheoretical Model and the conceptual framework of the "5 A's" and includes an individually tailored intervention, group sessions, and the use of community resources. We included 3062 participants, 1481 in the intervention group and 1581 in the control group. After 12 months, there were no differences in PA intensity measured by metabolic_equivalent_of_task_minutes/week (adjusted mean difference: 284.093, 95% CI: -298.24, 866.42) nor in the proportion of participants who increased PA levels to moderate or high (OR: 1.02, 95% CI: 0.85, 1.23; p = 0.822), and no differences in blood pressure, weight loss, or waist circumference. We found an increased proportion of patients in the intervention group who followed the WHO recommendations for PA (OR: 1.29; 95% CI: 1.04, 1.60; p = 0.02). We concluded that the intervention did not lead to a significant increase in PA.
Effectiveness of a Multicomponent Intervention in Primary Care That Addresses Patients with Diabetes Mellitus with Two or More Unhealthy Habits, Such as Diet, Physical Activity or Smoking: Multicenter Randomized Cluster Trial (EIRA Study)
(Multidisciplinary Digital Publishing Institute (MDPI), 2021-06) Represas-Carrera, Francisco; Couso-Viana, Sabela; Mendez-Lopez, Fatima; Masluk, Barbara; Magallon-Botaya, Rosa; Recio-Rodriguez, Jose I; Pombo, Haizea; Leiva Rus, Alfonso; Gil-Girbau, Montserrat; Motrico, Emma; Marti-Lluch, Ruth; Gude, Francisco; Claveria, Ana
Introduction: We evaluated the effectiveness of an individual, group and community intervention to improve the glycemic control of patients with diabetes mellitus aged 45-75 years with two or three unhealthy life habits. As secondary endpoints, we evaluated the inverventions' effectiveness on adhering to Mediterranean diet, physical activity, sedentary lifestyle, smoking and quality of life. Method: A randomized clinical cluster (health centers) trial with two parallel groups in Spain from January 2016 to December 2019 was used. Patients with diabetes mellitus aged 45-75 years with two unhealthy life habits or more (smoking, not adhering to Mediterranean diet or little physical activity) participated. Centers were randomly assigned. The sample size was estimated to be 420 people for the main outcome variable. Educational intervention was done to improve adherence to Mediterranean diet, physical activity and smoking cessation by individual, group and community interventions for 12 months. Controls received the usual health care. The outcome variables were: HbA1c (main), the Mediterranean diet adherence score (MEDAS), the international diet quality index (DQI-I), the international physical activity questionnaire (IPAQ), sedentary lifestyle, smoking >= 1 cigarette/day and the EuroQuol questionnaire (EVA-EuroQol5D5L). Results: In total, 13 control centers (n = 356) and 12 intervention centers (n = 338) were included with similar baseline conditions. An analysis for intention-to-treat was done by applying multilevel mixed models fitted by basal values and the health center: the HbA1c adjusted mean difference = -0.09 (95% CI: -0.29-0.10), the DQI-I adjusted mean difference = 0.25 (95% CI: -0.32-0.82), the MEDAS adjusted mean difference = 0.45 (95% CI: 0.01-0.89), moderate/high physical activity OR = 1.09 (95% CI: 0.64-1.86), not living a sedentary lifestyle OR = 0.97 (95% CI: 0.55-1.73), no smoking OR = 0.61 (95% CI: 0.54-1.06), EVA adjusted mean difference = -1.26 (95% CI: -4.98-2.45). Conclusions: No statistically significant changes were found for either glycemic control or physical activity, sedentary lifestyle, smoking and quality of life. The multicomponent individual, group and community interventions only showed a statistically significant improvement in adhering to Mediterranean diet. Such innovative interventions need further research to demonstrate their effectiveness in patients with poor glycemic control.

Browse

Recent Submissions