IdISSC - Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (Madrid)

Permanent URI for this collectionhttps://hdl.handle.net/20.500.12105/16969

El IdISSC es fruto de la relación entre el Servicio Madrileño de Salud (SERMAS) a través del Hospital Clínico San Carlos (HCSC) y Centros de Atención Primaria del área de influencia, la Universidad Complutense de Madrid (UCM), la Universidad Politécnica de Madrid (UPM), la Fundación para la Investigación Biomédica del HCSC (FIBHCSC) y la Consejería de Sanidad (Dirección General de Investigación, Docencia y Documentación). El IdISSC permite potenciar la colaboración y cooperación entre estos centros y grupos de investigación, con el fin de fomentar la investigación básica, clínica, tecnológica, epidemiológica y de servicios de salud; favorecer y desarrollar programas y proyectos de investigación o formación de investigadores; velar por la calidad, la ética y los principios deontológicos de la investigación; fomentar la cultura de la excelencia en la investigación en salud, y promover la traslación de los resultados a la sociedad, al sistema sanitario, a la comunidad científica, y al sistema económico, fomentando la innovación y la transferencia de resultados. Acreditado por el Instituto de Salud Carlos III como Instituto de Investigación Sanitaria en 2012, y renovando esta acreditación cada 5 años, forma parte así del total de 34 Institutos de Investigación Sanitaria acreditados existentes en la actualidad.

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Real-World Effectiveness and Safety of Upadacitinib in Patients with Ulcerative Colitis: A Systematic Review and Meta-Analysis
(Multidisciplinary Digital Publishing Institute (MDPI), 2025-03-25) Taxonera, Carlos; García-Brenes, Miguel A; Machín, María; Olivares, David; López-García, Olga N; Zapater, Raúl; Alba, Cristina
Background/Objectives: Evidence is needed on the real-world outcomes of upadacitinib in patients with ulcerative colitis. This systematic review and meta-analysis evaluated the real-world effectiveness of upadacitinib for active UC. Methods: The primary outcome was clinical remission evaluated at week 8. Secondary outcomes included response, steroid-free remission, biochemical remission, colectomy, and safety. A random-effects meta-analysis model was used to calculate the pooled effect sizes (percentages or incidence rates) of effectiveness and safety outcomes. Results: Twenty-four studies with 1388 patients were included. Ninety-four percent of patients had previously failed biologics or Janus kinase inhibitors (JAKi), including 53.2% with tofacitinib. Clinical remission at week 8 was achieved in 68.4% of patients (95% confidence interval 55.5-80.2). Clinical remission was achieved in 48.3%, 71.1%, and 64.6% of patients at weeks 2 to 6, 12 to 16, and 24 to 36, respectively. Response was achieved in 72.6%, 82.1%, and 78.7% of patients at weeks 2 to 6, week 8, and weeks 12 to 16, respectively. Steroid-free remission was achieved in 39% of patients at week 8. Upadacitinib results were unaffected by prior biologic or JAKi failure. Mean fecal calprotectin level decreased from 1485.0 µ/g at baseline to 454.8 µ/g post-treatment (p < 0.01). The mean CRP level decreased from 12.3 mg/L at baseline to 4.4 mg/L post-treatment (p = 0.02). The incidence rates of colectomy, serious adverse events, and herpes zoster were 13.3, 2.3, and 1.7 per 100 patient-years, respectively. Conclusions: This meta-analysis confirms the effectiveness and safety of upadacitinib in a highly treatment-refractory population of UC patients.
Immunogenicity of the Conjugate Meningococcal ACWY-TT Vaccine in Children and Adolescents Living with HIV
(Multidisciplinary Digital Publishing Institute (MDPI), 2024) Berzosa, Arantxa; Guillen, Sara; Epalza, Cristina; Escosa, Luis; Navarro, Maria Luisa; Prieto, Luis M; Sainz, Talia; Jimenez de Ory, Santiago; Montes Mota, Marina; Abad, Raquel; Vazquez-Moreno, Julio Alberto; Serrano García, Irene; Ramos-Amador, José Tomás; Fundación Familia Alonso; RETICS-Sida (RIS-ISCIII) (España); Instituto de Salud Carlos III; Centro de Investigación Biomédica en Red - CIBERINFEC (Enfermedades Infecciosas); European Society for Paediatric Infectious Diseases
Background: Children and adolescents living with HIV (CALHIV) are at high risk of meningococcal infections and may present lower immune responses to vaccines. The objectives of this study were to assess the immunogenicity of the quadrivalent Men ACWY-TT vaccine (Nimenrix®) in CALHIV after a two-dose schedule and to describe possible HIV-related factors that may affect the immunogenic response. Methods: A multicenter prospective study was designed, including CALHIV followed in five hospitals in Madrid, between 2019 and 2021. Two doses of the Men ACWY-TT vaccine were administered. Serum bactericidal antibody (SBA) assays using rabbit complement (rSBA) against serogroups C, W, and Y were used to determine seroprotection and vaccine response (the proportion achieving a putative protective titer of ≥eight or a ≥four-fold rise in titer from baseline). Serum was collected at baseline, and at 3 and 12 months after vaccination. Results: There were 29 CALHIV included, 76% of whom were perinatally infected. All were receiving TAR and presented a good immunovirological and clinical status overall. At baseline, 45% of CALHIV had seroprotective titers to at least one serogroup, with individual seroprotection rates of 24%, 28%, and 32% against C, W, and Y, respectively. After a two-dose schedule, vaccine response was 83% for each serogroup, eliciting a vaccine response to all serogroups in 69% of them. One year after vaccination, 75% of CALHIV maintained seroprotective titers against the C serogroup, and 96% against W and Y. None of the HIV-related characteristics analyzed could predict vaccine response or antibody duration. Conclusions: CALHIV who received effective TAR and presented a good immuno-virological situation achieved an appropriate vaccine response after two doses of the Men ACWY-TT vaccine, and antibody-mediated protection against serogroups C, W, and Y was maintained in more than 70% of the patients one year after vaccination.
Changes in Alcohol Intake by Educational Level Among Older Men and Women in Spain During the 21st Century
(Oxford University Press, 2024) Donat López, Marta; Politi, Julieta; Guerras Moreira, Juan Miguel; Sordo, Luis; Cea-Soriano, Lucía; Pulido, Jose; Ronda, Elena; Regidor, Enrique; Barrio, Gregorio; Belza Egozcue, Maria Jose; Plan Nacional de Drogas (España); Instituto de Salud Carlos III
Background and objectives: Despite alcohol use being very common in older adults, studies are scarce and suggest alcohol use may be increasing. Furthermore, despite the known relationship between education and alcohol consumption, there is limited evidence of educational differences in older adults. Our objective was to describe trends in alcohol consumption in individuals aged ≥65 by sex and educational level in Spain. Research design and methods: In total, 43,157 participants aged ≥65 years were drawn from Spain's national health surveys between 2001 and 2020, representing the noninstitutionalized population. The outcomes were various measures of self-reported past-year alcohol intake. Age-standardized rates and negative binomial regression models were used to examine trends and differences in alcohol intake by educational level, sex, and period (2001-2009 vs 2011-2020). Results: The average daily alcohol intake and prevalence of heavy average drinking (>20/10 g/day) decreased over time, especially among men, whereas moderate average drinking remained unchanged or even increased. Alcohol intake increased with increasing educational levels. All drinking measures showed educational inequalities, and these were greater in women than men. The mean amount of drinking showed the greatest inequality, with adjusted prevalence ratio of 2.6 in women and 1.1 in men between university relative to primary education level. Discussion and implications: Alcohol intake in older adults decreased over time in Spain for heavy average drinking and average drinking amount, although not for moderate average drinking. Consumption remains highest among the highest educational levels, which may negatively affect health. Programs addressing alcohol consumption among older adults are needed to minimize alcohol-related harm.
Immunogenicity of a third dose with mRNA-vaccines in the ChAdOx1-S/BNT162b2 vaccination regimen against SARS-CoV-2 variants
(Elsevier, 2024-09-20) García-Pérez, Javier; Borobia, Alberto M; Perez-Olmeda, Mayte; Portolés, Antonio; Castaño, Luis; Campins-Artí, Magdalena; Bertrán, María Jesús; Bermejo, Mercedes; Arribas, José Ramón; López, Andrea; Ascaso-Del-Rio, Ana; Arana-Arri, Eunate; Fuentes Camps, Inmaculada; Vilella, Anna; Cascajero Díaz, Almudena; García-Morales, María Teresa; Castillo de la Osa, María; Pérez Ingidua, Carla; Lora, David; Jiménez Santana, Paloma; Pino-Rosa, Silvia del; Gómez de la Cámara, Agustín; de la Torre-Tarazona, Humberto Erick; Calonge, Esther; Cruces Fernández, Raquel; Belda-Iniesta, Cristobal; Alcamí, José; Frías, Jesús; Carcas, Antonio J; Díez-Fuertes, Francisco; CombiVacS Study Group; Instituto de Salud Carlos III; Plan Nacional de I+D+i (España); Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Unión Europea. Comisión Europea. H2020
CombiVacS study has demonstrated a strong immune response of the heterologous ChAdOx1-S/BNT162b2 vaccine combination. The primary outcomes of the study were to assess the humoral immune response against SARS-CoV-2, 28 days after a third dose of a mRNA vaccine, in subjects that received a previous prime-boost scheme with ChAdOx1-S/BNT162b2. Secondary outcomes extended the study to 3 and 6 months. The third vaccine dose of mRNA-1273 in naive participants previously vaccinated with ChAdOx1-S/BNT162b2 regimen reached higher neutralizing antibodies titers against the variants of concern Delta and BA.1 lineage of Omicron compared with those receiving a third dose of BNT162b2 at day 28. These differences between BNT162b2 and mRNA-1273 arms were observed against the ancestral variant G614 at day 90. Suboptimal neutralizing response was observed against BQ.1.1, XBB.1.5/XBB.1.9, and JN.1 in a relevant proportion of individuals 180 days after the third dose, even after asymptomatic Omicron breakthrough infections. EudraCT (2021-001978-37); ClinicalTrials.gov (NCT04860739).
Immunogenicity and reactogenicity of BNT162b2 booster in ChAdOx1-S-primed participants (CombiVacS): a multicentre, open-label, randomised, controlled, phase 2 trial
(Elsevier, 2021-07-10) Borobia, Alberto M; Carcas, Antonio J; Perez-Olmeda, Mayte; Castaño, Luis; Bertrán, María Jesús; García-Pérez, Javier; Campins, Magdalena; Portolés, Antonio; Gonzalez-Perez, Maria; García Morales, María Teresa; Arana-Arri, Eunate; Aldea, Marta; Díez-Fuertes, Francisco; Fuentes, Inmaculada; Ascaso, Ana; Lora, David; Imaz-Ayo, Natale; Barón-Mira, Lourdes E; Agustí, Antonia; Pérez-Ingidua, Carla; Gómez de la Cámara, Agustín; Arribas, José Ramón; Ochando, Jordi; Alcamí, José; Belda-Iniesta, Cristobal; Frías, Jesús; CombiVacS Study Group; Portoles, Pilar; Instituto de Salud Carlos III; Plan Nacional de I+D+i (España); Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Unión Europea. Comisión Europea. H2020
[EN] Background: To date, no immunological data on COVID-19 heterologous vaccination schedules in humans have been reported. We assessed the immunogenicity and reactogenicity of BNT162b2 (Comirnaty, BioNTech, Mainz, Germany) administered as second dose in participants primed with ChAdOx1-S (Vaxzevria, AstraZeneca, Oxford, UK). Methods: We did a phase 2, open-label, randomised, controlled trial on adults aged 18-60 years, vaccinated with a single dose of ChAdOx1-S 8-12 weeks before screening, and no history of SARS-CoV-2 infection. Participants were randomly assigned (2:1) to receive either BNT162b2 (0·3 mL) via a single intramuscular injection (intervention group) or continue observation (control group). The primary outcome was 14-day immunogenicity, measured by immunoassays for SARS-CoV-2 trimeric spike protein and receptor binding domain (RBD). Antibody functionality was assessed using a pseudovirus neutralisation assay, and cellular immune response using an interferon-γ immunoassay. The safety outcome was 7-day reactogenicity, measured as solicited local and systemic adverse events. The primary analysis included all participants who received at least one dose of BNT162b2 and who had at least one efficacy evaluation after baseline. The safety analysis included all participants who received BNT162b2. This study is registered with EudraCT (2021-001978-37) and ClinicalTrials.gov (NCT04860739), and is ongoing. Findings: Between April 24 and 30, 2021, 676 individuals were enrolled and randomly assigned to either the intervention group (n=450) or control group (n=226) at five university hospitals in Spain (mean age 44 years [SD 9]; 382 [57%] women and 294 [43%] men). 663 (98%) participants (n=441 intervention, n=222 control) completed the study up to day 14. In the intervention group, geometric mean titres of RBD antibodies increased from 71·46 BAU/mL (95% CI 59·84-85·33) at baseline to 7756·68 BAU/mL (7371·53-8161·96) at day 14 (p<0·0001). IgG against trimeric spike protein increased from 98·40 BAU/mL (95% CI 85·69-112·99) to 3684·87 BAU/mL (3429·87-3958·83). The interventional:control ratio was 77·69 (95% CI 59·57-101·32) for RBD protein and 36·41 (29·31-45·23) for trimeric spike protein IgG. Reactions were mild (n=1210 [68%]) or moderate (n=530 [30%]), with injection site pain (n=395 [88%]), induration (n=159 [35%]), headache (n=199 [44%]), and myalgia (n=194 [43%]) the most commonly reported adverse events. No serious adverse events were reported. Interpretation: BNT162b2 given as a second dose in individuals prime vaccinated with ChAdOx1-S induced a robust immune response, with an acceptable and manageable reactogenicity profile. [ES] Antecedentes: No hay datos de eficacia inmunológica procedentes de esquemas de vacunación heteróloga frente a SARS--CoV-2 en humanos. Este estudio evaluó la inmunogenicidad y la reactogenicidad de BNT162b2 (Comirnaty, BioNTech) administrado como segunda dosis en personas que habían recibido previamente una dosis de ChAdOx1-S (Vaxzevria, Astra Zeneca). Método: Realizamos un ensayo clínico de fase 2, abierto, aleatorizado y controlado en adultos de 18 a 59 años, vacunados con una dosis única de ChAdOx1-S entre 8 y 12 semanas antes del cribado, y sin antecedentes de infección por SARS-CoV-2 (EudraCT #2021-001978-37 y NCT04860739). Los participantes fueron asignados al azar (2:1) a un grupo que recibió BNT162b2 (0,3 mL, inyección intramuscular única) y a un grupo de control. Los objetivos principales fueron la reactogenicidad a los 7 días y la respuesta IgG anti-proteína spike a los 14 días, medida ésta a través de inmunoensayos que identificaban la proteína S trimérica del SARS-CoV-2 y el dominio de unión al receptor (RBD) de ésta. La funcionalidad de los anticuerpos y la respuesta inmunitaria celular se evaluaron mediante un ensayo de neutralización de pseudovirus y un inmunoensayo de IFN-gamma, respectivamente. Resultados: Entre el 24 y el 30 de abril de 2021, 676 individuos fueron asignados al azar (n=450 del grupo de intervención, n=226 del grupo de control) en 5 centros de España, y 663 (441 y 222, respectivamente) completaron el estudio al día 14 (edad media de 44 [SD 9], 56% [382] mujeres). En el grupo de intervención, la media geométrica de los títulos de anticuerpos antiRBD (GMT) aumentó de 71.46 BAU/mL (IC del 95%: 59.84-85.33) en el momento inicial a 7756.68 (7371.53; 8161.96) en el día 14 (p < 0-0001). La IgG contra la proteína S trimérica aumentó de 98.4 [85.69-112.99] a 3684.87 [3429.87-3958.83]). La relación respuesta/control fue de 77.69 (IC 95%: 59.57; 101.32) y 36.41 (29.31; 45.23) para la IgG contra la proteína de S trimérica y la RBD, respectivamente. Las reacciones fueron predominantemente leves (1.210; 68%) o moderadas (530; 30%), y la más frecuente consistió en dolor en el lugar de la inyección (395; 88%), induración (159; 35%), dolor de cabeza (199; 44%) y mialgia (194; 43%). No se notificaron acontecimientos adversos graves. Interpretación: El BNT162b2 administrado como segunda dosis en individuos vacunados con una primera dosis de ChAdOx1-S indujo una respuesta inmune robusta con un perfil de reactogenicidad aceptable y manejable.
Monkeypox outbreak in Madrid (Spain): Clinical and virological aspects.
(Elsevier, 2022-07-10) Orviz, Eva; Negredo, Anabel; Ayerdi, Oskar; Vazquez, Ana; Muñoz-Gómez, Ana; Monzon-Fernandez, Sara; Clavo, Petunia; Zaballos, Ángel; Vera, Mar; Sánchez, Patricia; Cabello, Noemi; Jimenez Sancho, Maria Pilar; Pérez-García, Jorge A; Varona Fernandez, Sarai; Del Romero, Jorge; Cuesta de la Plaza, Isabel; Delgado-Iribarren, Alberto; Torres, Montse; Sagastagoitia, Iñigo; Palacios, Gustavo; Estrada, Vicente; Sánchez-Seco, María Paz; Grupo Viruela del Simio Madrid CNM/ISCIII/HCSC/Sandoval; Centro de Investigación Biomédica en Red - CIBERINFEC (Enfermedades Infecciosas)
Background: Monkeypox is the most prevalent Orthopoxvirus zoonosis infection since the eradication of smallpox. The current multi-country outbreak involves five WHO regions affecting mainly Europe. Accurate clinical and virological aspects of the disease outside endemic areas are needed. Methods: We performed an observational study of cases diagnosed in Madrid (Spain) (May/June 2022). Confirmation from vesicular lesions swabs, Orthopoxvirus real-time PCR, sequencing, phylogenetic analysis, and direct detection by Electron microscopy was performed. In addition, a structured epidemiological questionnaire was completed systematically to gather sociodemographic, clinical, and behavioral data from all confirmed cases. Findings: We extracted data from 48 patients, all cisgender men. The median age was 35 years (IQR 29 – 44), and 87.5% were MSM. The most prevalent symptoms were the presence of vesicular-umbilicated and pseudo-pustular skin lesions (93.8%), asthenia (66.6%), and fever (52.1%). In addition, the location of the lesions in the genital or perianal area was related to the role in sexual intercourse (p<0.001). Sequencing analysis indicated the virus circulating in Spain belongs to the western African clade. Like the other European cases in the outbreak, the Spanish isolates are a direct descendant of viruses previously detected in Nigeria, the UK, Singapore, and Israel in 2017–2018. Conclusions: Monkeypox is an emerging infectious disease in Europe where community transmission is reported, mainly in MSM. The first symptom was skin lesions instead of classical fever and rash. The disease follows a self-limited course, and there have been no cases with a serious presentation or severe complications.
Experience of the national cohort of pregnant women with HIV and their children in Spain: temporal trends in vertical transmission of HIV and associated infections
(Elsevier, 2024-10) Illán Ramos, Marta; Berzosa Sánchez, Arantxa; Carrasco García, Itziar; Diaz Franco, Asuncion; Jarrin Vera, Inmaculada; Prieto Tato, Luis; Polo Rodríguez, Rosa; Navarro Gómez, María Luisa; Ramos Amador, José Tomás; Grupo de Trabajo de la Cohorte Nacional de mujeres embarazadas que viven con VIH y sus hijos en España; Ministerio de Sanidad (España)
Introduction: The vertical transmission rate (VTR) of HIV has decreased to less than 2% in high-income countries, in spite of which perinatal infections continue to occur. We present data from the national cohort of pregnant women living with HIV and their children in Spain. The objectives were to describe the characteristics of this population, evaluate the VTR of HIV, the safety of antiretroviral therapy (ART) and the prevalence of coinfection. Patients and methods: Multicentre prospective, observational and descriptive study with participation of 62 hospitals. The sample included pegnant women living with HIV whose children were born between January 2020 and December 2022. We collected prospective data on the characteristics of mothers and children using an online questionnaire (REDCap web application). Results: The study included 414 mother-child dyads. Most mothers were immigrants (227/349; 65.1%). The main route of HIV infection was heterosexual transmission (160/402; 39.8%), followed by vertical transmission (44/402; 10.9%). The diagnosis was made before conception in 313/389 women (80.4%), 394/402 (98%) received ART during pregnancy and 356/402 (89.3%) had an undetectable viral load at the time of delivery. The delivery was vaginal in 230/388 children (59.3%). The proportion of preterm birth was 11.1%. The most frequent neonatal prophylaxis approach was monotherapy with zidovudine (358/414; 86.5%). There were 3 cases of vertical transmission of HIV (95% CI, 0%-1.54%). Only one newborn was breastfed. Conclusions: At present, most women living with HIV in Spain receive the diagnosis before conception, are of foreign ancestry and achieve good control of the infection. Although the VTR is very low in Spain, there are still infections that could be prevented with early diagnosis and treatment.
The G4 resolvase Dhx36 modulates cardiomyocyte differentiation and ventricular conduction system development
(Nature Publishing Group, 2024-10-04) Gomez-del Arco, Pablo; Isern, Joan; Jimenez-Carretero, Daniel; Lopez-Maderuelo, Dolores; Piñeiro-Sabarís, Rebeca; El Abdellaoui-Soussi, Fadoua; Torroja, Carlos; Vera-Pedrosa, María Linarejos; Grima-Terrén, Mercedes; Benguria, Alberto; Simón-Chica, Ana; Queiro-Palou, Antonio; Dopazo, Ana; Sanchez-Cabo, Fatima; Jalife, Jose; de la Pompa, Jose Luis; Filgueiras-Rama, David; Munoz-Canoves, Pura; Redondo, Juan Miguel; Ministerio de Ciencia e Innovación (España); Unión Europea. Comisión Europea. European Research Council (ERC); Fundación La Caixa; Unión Europea. Comisión Europea. H2020; Fundación La Marató TV3; Ministerio de Ciencia e Innovación. Centro de Excelencia Severo Ochoa (España); Agencia Estatal de Investigación (España); Comunidad de Madrid (España); Unión Europea. Fondo Social Europeo (ESF/FSE); Instituto de Salud Carlos III; Centro de Investigación Biomédica en Red - CIBERCV (Enfermedades Cardiovasculares); Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Consejo Superior de Investigaciones Científicas (España); Autonomous University of Madrid (España); Sociedad Española de Cardiología
Extensive genetic studies have elucidated cardiomyocyte differentiation and associated gene networks using single-cell RNA-seq, yet the intricate transcriptional mechanisms governing cardiac conduction system (CCS) development and working cardiomyocyte differentiation remain largely unexplored. Here we show that mice deleted for Dhx36 (encoding the Dhx36 helicase) in the embryonic or neonatal heart develop overt dilated cardiomyopathy, surface ECG alterations related to cardiac impulse propagation, and (in the embryonic heart) a lack of a ventricular conduction system (VCS). Heart snRNA-seq and snATAC-seq reveal the role of Dhx36 in CCS development and in the differentiation of working cardiomyocytes. Dhx36 deficiency directly influences cardiomyocyte gene networks by disrupting the resolution of promoter G-quadruplexes in key cardiac genes, impacting cardiomyocyte differentiation and CCS morphogenesis, and ultimately leading to dilated cardiomyopathy and atrioventricular block. These findings further identify crucial genes and pathways that regulate the development and function of the VCS/Purkinje fiber (PF) network.
Cross-sectional and longitudinal associations of adherence to WCRF/AICR cancer prevention recommendations with health-related quality of life in breast cancer survivors. Health-EpiGEICAM study
(Elsevier, 2024-08) Lope Carvajal, Virginia; Guerrero-Zotano, Ángel; Fernandez de Larrea-Baz, Nerea; Antolín, Silvia; Benavent Viñuales, Marta; Bermejo, Begoña; Ruiz Moreno, Emma; Baena-Cañada, José Manuel; París, Lorena; Antón, Antonio; Chacón, José Ignacio; Muñoz, Montserrat; García-Sáenz, José Ángel; Olier, Clara; Sánchez Rovira, Pedro; Arcusa Lanza, Angels; González, Sonia; Brunet, Joan; Oltra, Amparo; Bezares, Susana; Rosell, Libertad; Perez-Gomez, Beatriz; Pastor-Barriuso, Roberto; Martín, Miguel; Pollan-Santamaria, Marina; Asociación Española Contra el Cáncer; Instituto de Salud Carlos III
Objectives: Adherence to healthy lifestyle recommendations has been reported to improve health-related quality of life (HRQL) in breast cancer (BC) patients, but the influence of long-term behavioral changes remains unknown. We evaluated the association between adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations and HRQL both, at BC diagnosis and the change 7-12 years later. Design: Prospective cohort study. Settings and participants: A total of 406 breast cancer survivors, from the EpiGEICAM study, were recruited in 16 Spanish hospitals. Measurements: Epidemiological, clinical, dietary, physical activity and HRQL information was collected both at recruitment and 7-12 years later. A 7-item score to measure compliance with recommendations was assessed according to the 2018 WCRF/AICR scoring criteria. HRQL was evaluated using SF-36 questionnaire. Linear mixed models for longitudinal data were used to assess the cross-sectional and longitudinal association between adherence score and the physical and mental component summary scores. Results: At diagnosis, for each unit increase in WCRF/AICR score adherence, the HRQL physical domain increased 0.78 points (95%CI: -0.04 to 1.60; P trend:0.06). The mean change in physical HRQL from diagnosis to follow-up per unit increase in within-subject adherence score was 0.73 points (95%CI: -0.18 to 1.65; P trend: 0.12). For the mental domain, no association was observed with compliance with the recommendations at diagnosis, nor with changes in adherence over time. Conclusions: Our results suggest that Increased adherence to WCRF/AICR cancer prevention recommendations over time could contribute to slightly improved long-term physical HRQoL in BC survivors.
Physician-perceived utility of the EORTC QLQ-GINET21 questionnaire in the treatment of patients with gastrointestinal neuroendocrine tumours: a multicentre, cross-sectional survey (QUALINETS)
(BioMed Central (BMC), 2021-01-30) Benavent, Marta; Sastre, Javier; García Escobar, Ignacio; Segura, Angel; Capdevila, Jaume; Carmona, Alberto; Sevilla, Isabel; Alonso, Teresa; Crespo, Guillermo; García, Lourdes; Canal, Neus; de la Cruz, Guillermo; Gallego, Javier
Background and objective: Patient-reported outcome measures can provide clinicians with valuable information to improve doctor-patient communication and inform clinical decision-making. The aim of this study was to evaluate the physician-perceived utility of the QLQ-GINET21 in routine clinical practice in patients with gastrointestinal neuroendocrine tumours (GI-NETs). Secondary aims were to explore the patient, clinician, and/or centre-related variables potentially associated with perceived clinical utility. Methods: Non-interventional, cross-sectional, multicentre study conducted at 34 hospitals in Spain and Portugal (NCT02853422). Patients diagnosed with GI-NETs completed two health-related quality of life (HRQoL) questionnaires (QLQ-C30, QLQ-GINET21) during a single routine visit. Physicians completed a 14-item ad hoc survey to rate the clinical utility of QLQ-GINET21 on three dimensions: 1)therapeutic and clinical decision-making, 2)doctor-patient communication, 3)questionnaire characteristics. Results: A total of 199 patients at 34 centres were enrolled by 36 participating clinicians. The highest rated dimension on the QLQ-GINET21 was questionnaire characteristics (86.9% of responses indicating "high utility"), followed by doctor-patient communication (74.4%), and therapeutic and clinical decision-making (65.8%). One physician-related variable (GI-NET patient volume > 30 patients/year) was associated with high clinical utility and two variables (older age/less experience treating GI-NETs) with low clinical utility. Conclusions: Clinician-perceived clinical utility of QLQ-GINET21 is high. Clinicians valued the instruments' capacity to provide a better understanding of patient perspectives and to identify the factors that had the largest influence on patient HRQoL.
Clinical audit of COPD in outpatient respiratory clinics in Spain: the EPOCONSUL study.
(2017-01-25) Calle Rubio, Myriam; Alcázar Navarrete, Bernardino; Soriano, Joan B; Soler-Cataluña, Juan J; Rodríguez González-Moro, José Miguel; Fuentes Ferrer, Manuel E; Lopez-Campos, Jose Luis
Background: Chronic obstructive pulmonary disease (COPD) outpatients account for a large burden of usual care by respirologists. EPOCONSUL is the first national clinical audit conducted in Spain on the medical care for COPD patients delivered in outpatient respiratory clinics. We aimed to evaluate the clinical interventions and the degree of adherence to recommendations in outpatients of current COPD clinical practice guidelines. Methodology: This is an observational study with prospective recruitment (May 2014-May 2015) of patients with a COPD diagnosis as seen in outpatient respiratory clinics. The information collected was historical in nature as for the clinical data of the last and previous consultations, and the information concerning hospital resources was concurrent. Results: A total of 17,893 clinical records of COPD patients in outpatient respiratory clinics from 59 Spanish hospitals were evaluated. Of the 5,726 patients selected, 4,508 (78.7%) were eligible. Overall, 12.1% of COPD patients did not fulfill a diagnostic spirometry criteria. Considerable variability existed in the available resources and work organization of the hospitals, although the majority were university hospitals with respiratory inpatient units. There was insufficient implementation of clinical guidelines in preventive and educational matters. In contrast, quantitative evaluation of dyspnea grade (81.9%) and exacerbation history (70.9%) were more frequently performed. Only 12.4% had COPD severity calculated according to the Body mass index, airflow Obstruction, Dyspnoea and Exercise capacity (BODE) index. Phenotype characteristics according to Spanish National Guideline for COPD were determined in 46.3% of the audited patients, and the risk evaluation according to Global initiative for chronic Obstructive Lung Disease was estimated only in 21.9%. Conclusion: The EPOCONSUL study reports the current situation of medical care for COPD patients in outpatient clinics in Spain, revealing its variability, strengths, and weaknesses. This information has to be accounted for by health managers to define corrective strategies and maximize good clinical practice.
Variability in adherence to clinical practice guidelines and recommendations in COPD outpatients: a multi-level, cross-sectional analysis of the EPOCONSUL study.
(2017-12-02) Calle Rubio, Myriam; Lopez-Campos, Jose Luis; Soler-Cataluña, Juan J; Alcázar Navarrete, Bernardino; Soriano, Joan B; Rodríguez González-Moro, José Miguel; Fuentes Ferrer, Manuel E; Rodríguez Hermosa, Juan Luis; EPOCONSUL Study
Background: Clinical audits have reported considerable variability in COPD medical care and frequent inconsistencies with recommendations. The objectives of this study were to identify factors associated with a better adherence to clinical practice guidelines and to explore determinants of this variability at the the hospital level. Methods: EPOCONSUL is a Spanish nationwide clinical audit that evaluates the outpatient management of COPD. Multilevel logistic regression with two levels was performed to assess the relationships between individual and disease-related factors, as well as hospital characteristics. Results: A total of 4508 clinical records of COPD patients from 59 Spanish hospitals were evaluated. High variability was observed among hospitals in terms of medical care. Some of the patient's characteristics (airflow obstruction, degree of dyspnea, exacerbation risk, presence of comorbidities), the hospital factors (size and respiratory nurses available) and treatment at a specialized COPD outpatient clinic were identified as factors associated with a better adherence to recommendations, although this only explains a small proportion of the total variance. Conclusion: To be treated at a specialized COPD outpatient clinic and some intrinsic patient characteristics were factors associated with a better adherence to guideline recommendations, although these variables were only explaining part of the high variability observed among hospitals in terms of COPD medical care.
Learning, internalisation and integration of the COVID-19 pandemic in healthcare workers: A qualitative document analysis
(Wiley, 2024-09-19) Abad-Corpa, Eva; Rich-Ruiz, Manuel; Sánchez-López, Dolores; Solano Ruiz, Carmen; Casado-Ramirez, Elvira; Arregui-Gallego, Beatriz; Moreno-Casbas, Teresa; Muñoz-Jiménez, Daniel; Vidal-Thomàs, María Clara; Company-Sancho, María Consuelo; Orts-Cortes, Maria Isabel; Fundación BBVA
The COVID-19 pandemic triggered an unprecedented health crisis that impacted healthcare systems worldwide. This study explores how Spanish healthcare workers learned, internalised and integrated values and work behaviours during the COVID-19 pandemic and their impact on the personal sphere. This documentary research, using images, narratives and audiovisual content, was framed within the interpretative hermeneutic paradigm. Categories and subcategories emerged after a final theoretical sampling that focused on the analysis. Data triangulation between researchers favoured theoretical saturation. A total of 117 images and 27 texts were selected. The analysis identified three stages: bewilderment, seeking functionality in the chaos and integrating chaos into care. The data reflects how the need for security and knowledge, and the exhaustion and frustration caused by the initial working conditions, prompted adaptive responses. These responses involved focusing on problem-solving and strengthening group sentiments and solidarity. Subsequently, the data indicates the acceptance of new structural, organisational and communication aspects. The findings of the analysis will contribute towards finding a framework that can help understand community health crisis events.
Microbial Phenolic Metabolites Are Associated with Improved Cognitive Health
(Wiley, 2024-01) Domínguez-López, Inés; Galkina, Polina; Parilli-Moser, Isabella; Arancibia-Riveros, Camila; Martínez-González, Miguel Ángel; Salas-Salvado, Jordi; Corella, Dolores; Malcampo, Mireia; Martínez, J Alfredo; Tojal-Sierra, Lucas; Wärnberg, Julia; Vioque, Jesus; Romaguera, Dora; López-Miranda, José; Estruch, Ramon; Tinahones, Francisco J; Santos-Lozano, José Manuel; Serra-Majem, Lluis; Bueno-Cavanillas, Aurora; Tur, Josep A; Rubín-García, María; Pintó, Xavier; Fernández-Aranda, Fernando; Delgado-Rodríguez, Miguel; Barabash-Bustelo, Ana; Vidal, Josep; Vazquez, Clotilde; Daimiel, Lidia; Ros, Emilio; Toledo, Estefanía; Atzeni, Alessandro; Asensio, Eva M; Vera, Natàlia; Garcia-Rios, Antonio; Torres-Collado, Laura; Pérez-Farinós, Napoleón; Zulet, Marian; Chaplin, Alice; Casas, Rosa; Martín-Peláez, Sandra; Vaquero-Luna, Jessica; Gómez-Pérez, Ana Maria; Vazquez-Ruiz, Zenaida; Shyam, Sangeetha; Ortega-Azorín, Carolina; Talens, Natàlia; Peña-Orihuela, Patricia J; Oncina-Canovas, Alejandro; Diez-Espino, Javier; Babio, Nancy; Fitó, Montserrat; Lamuela-Raventós, Rosa M
Scope: Diets rich in polyphenols has been associated with better cognitive performance. The aim of this study is to assess the relationship between microbial phenolic metabolites (MPM) in urine and cognition in the context of an older population at high cardiovascular risk. Methods and results: A cross-sectional analysis is conducted in 400 individuals of the PREDIMED-Plus study. Liquid chromatography coupled to mass spectrometry is used to identify urinary MPM. Mediterranean diet (MedDiet) adherence is estimated with a 17-item questionnaire and cognitive function is evaluated with a battery of neuropsychological tests. Multivariable-adjusted linear regression models are fitted to assess the relationship of urinary MPM with the MedDiet and cognitive tests. Protocatechuic acid and enterolactone glucuronide are associated with higher adherence to the MedDiet. Regarding cognitive function, protocatechuic acid, vanillic acid glucuronide, 3-hydroxybenzoic acid, enterodiol glucuronide, and enterolactone glucuronide are directly associated with a global composite score of all the cognitive tests. Furthermore, protocatechuic acid and enterolactone glucuronide are associated with higher scores in the Mini-Mental State Examination, whereas enterodiol glucuronide is associated with improved Clock Drawing Test scores. Conclusions: These results suggest that the MedDiet is linked to MPM associated with better cognitive performance in an older population.
Association between type 2 diabetes and depressive symptoms after a 1-year follow-up in an older adult Mediterranean population
(Springer, 2024-01-13) Baenas, I; Camacho-Barcia, L; Granero, R; Razquin, C; Corella, D; Gómez-Martínez, Carlos; Castañer-Niño, O; Martínez, JA; Alonso-Gómez, ÁM; Wärnberg, Julia; Vioque, Jesus; Romaguera, Dora; López-Miranda, J; Estruch, R; Tinahones, Francisco J; Lapetra, J; Serra-Majem, Lluis; Cano-Ibáñez, N; Tur, Josep A; Martín-Sánchez, V; Pintó, X; Gaforio, J J; Matía-Martín, P; Vidal, Josep; Vazquez, Clotilde; Daimiel, L; Ros, Emilio; Jiménez-Murcia, S; Dalsgaard, S; Garcia-Arellano, A; Babio, N; Sorli, Jose V; Lassale, C; García-de-la-Hera, M; Gómez-García, E; Zulet, MA; Konieczna, Jadwiga; Martín-Peláez, S; Tojal-Sierra, Lucas; Basterra-Gortari, FJ; de Las Heras-Delgado, S; Portoles, O; Muñoz-Pérez, MÁ; Arenas-Larriva, AP; Compañ-Gabucio, L; Eguaras, S; Shyam, Sangeetha; Fitó, M; Baños, RM; Salas-Salvado, Jordi; Fernández-Aranda, F
Objectives: To examine the cross-sectional association between baseline depressive symptoms and the presence of type 2 diabetes (T2D), and its association with glycated hemoglobin (HbA1c) and other metabolic variables, and the prospective association of depressive symptoms and HbA1c after 1 year of follow-up. Methods: n = 6224 Mediterranean older adults with overweight/obesity and metabolic syndrome (48% females, mean age 64.9 ± 4.9 years) were evaluated in the framework of the PREDIMED-Plus study cohort. Depressive symptoms were assessed using the Beck Depression Inventory-II and HbA1c was used to measure metabolic control. Results: The presence of T2D increased the likelihood of higher levels of depressive symptoms (χ2 = 15.84, p = 0.001). Polynomial contrast revealed a positive linear relationship (χ2 = 13.49, p = 0.001), the higher the depressive symptoms levels, the higher the prevalence of T2D. Longitudinal analyses showed that the higher baseline depressive symptoms levels, the higher the likelihood of being within the HbA1c ≥ 7% at 1-year level (Wald-χ2 = 24.06, df = 3, p < .001, for the full adjusted model). Additionally, depressive levels at baseline and duration of T2D predicted higher HbA1c and body mass index, and lower physical activity and adherence to Mediterranean Diet at 1 year of follow-up. Conclusions: This study supports an association between T2D and the severity of depressive symptoms, suggesting a worse metabolic control from mild severity levels in the short-medium term, influenced by lifestyle habits related to diabetes care. Screening for depressive symptoms and a multidisciplinary integrative therapeutic approach should be ensured in patients with T2D.
Diagnosis and treatment of disorders of intracranial pressure: consensus statement of the Spanish Society of Neurology's Headache Study Group
(Elsevier, 2024-02-29) García-Ull, J; González-García, N; Torres-Ferrus, Marta; García-Azorín, D; Molina-Martinez, Francisco José; Beltrán-Blasco, I; Santos-Lasaosa, Sonia; Latorre, G; Gago-Veiga, A B; Láinez, J M; Porta-Etessam, J; Nieves-Castellanos, C; Mínguez-Olaondo, A; López-Bravo, A; Quintas, S; Morollón, N; Díaz-Insa, S; Belvís, R; Irimia, P
[EN] Primary intracranial pressure disorders include idiopathic intracranial hypertension and spontaneous intracranial hypotension. These two entities have presented a remarkable advance in diagnostic and therapeutic techniques in recent years. Therefore, the Spanish Society of Neurology's Headache Study Group (GECSEN) considered it necessary to prepare this consensus document with the inclusion of diagnostic and therapeutic algorithms to facilitate and improve their management in clinical practice. This document was created by a committee of experts of the GECSEN based on a systematic review of the literature, incorporating the experience of the participants, and establishing practical recommendations with levels of evidence and grades of recommendation. [ES] Los trastornos primarios de la presión intracraneal incluyen la hipertensión intracraneal idiopática y la hipotensión intracraneal espontánea. El diagnóstico y tratamiento de ambas entidades ha presentado un avance destacable en los últimos años; por lo que desde el Grupo de Estudio de Cefaleas de la Sociedad Española de Neurología (GECSEN) consideramos necesaria la elaboración de este documento de consenso con la inclusión de algoritmos diagnósticos y terapéuticos para mejorar su manejo en la práctica diaria. Este documento ha sido redactado por un comité de expertos del GECSEN tras realizar una revisión sistemática de la bibliografía, incorporando la experiencia de los participantes y estableciendo unas recomendaciones prácticas con niveles de evidencia y grados de recomendación.
Ultra-processed foods consumption as a promoting factor of greenhouse gas emissions, water, energy, and land use: A longitudinal assessment
(Elsevier, 2023-05-24) Garcia, Silvia; Pastor, Rosario; Monserrat-Mesquida, Margalida; Álvarez-Álvarez, Laura; Rubín-García, María; Martínez-González, Miguel Ángel; Salas-Salvado, Jordi; Corella, Dolores; Fito, Montserrat; Martínez, J Alfredo; Tojal-Sierra, Lucas; Wärnberg, Julia; Vioque, Jesus; Romaguera, Dora; López-Miranda, José; Estruch, Ramon; Tinahones, Francisco J; Santos-Lozano, José Manuel; Serra-Majem, Lluis; Cano-Ibañez, Naomi; Pintó, Xavier; Delgado-Rodriguez, Miguel; Matía-Martín, Pilar; Vidal, Josep; Vazquez, Clotilde; Daimiel, Lidia; Ros, Emilio; Buil-Cosiales, Pilar; Martínez-Rodríguez, María Ángeles; Coltell, Oscar; Castañer, Olga; Garcia-Rios, Antonio; Barceló Cañellas, María de la Concepión; Gómez-Gracia, Enrique; Zulet, Maria Ángeles; Konieczna, Jadwiga; Casas, Rosa; Massó-Guijarro, Paloma; Goicolea-Güemez, Leire; Rosa Bernal-Lopez, Maria; Bes-Rastrollo, Maira; Shyam, Sangeetha; González, José I; Zomeño-Fajardo, María Dolores; Peña-Orihuela, Patricia J; González-Palacios, Sandra; Toledo, Estefanía; Khoury, Nadine; Perez, Karla Alejandra; Martín-Sánchez, Vicente; Tur, Josep A; Bouzas, Cristina
Background: Dietary patterns can produce an environmental impact. Changes in people's diet, such as the increased consumption of ultra-processed food (UPF) can not only influence human health but also environment sustainability. Objectives: Assessment of the impact of 2-year changes in UPF consumption on greenhouse gas emissions and water, energy and land use. Design: A 2-year longitudinal study after a dietary intervention including 5879 participants from a Southern European population between the ages of 55-75 years with metabolic syndrome. Methods: Food intake was assessed using a validated 143-item food frequency questionnaire, which allowed classifying foods according to the NOVA system. In addition, sociodemographic data, Mediterranean diet adherence, and physical activity were obtained from validated questionnaires. Greenhouse gas emissions, water, energy and land use were calculated by means of the Agribalyse® 3.0.1 database of environmental impact indicators for food items. Changes in UPF consumption during a 2-year period were analyzed. Statistical analyses were conducted using computed General Linear Models. Results: Participants with major reductions in their UPF consumption reduced their impact by -0.6 kg of CO2eq and -5.3 MJ of energy. Water use was the only factor that increased as the percentage of UPF was reduced. Conclusions: Low consumption of ultra-processed foods may contribute to environmental sustainability. The processing level of the consumed food should be considered not only for nutritional advice on health but also for environmental protection. Trial registration: ISRCTN, ISRCTN89898870. Registered 05 September 2013, http://www.isrctn.com/ISRCTN89898870.
The CARBA-MAP study: national mapping of carbapenemases in Spain (2014-2018)
(Frontiers Media, 2023) Gracia-Ahufinger, Irene; López-González, Laura; Vasallo, Francisco José; Galar, Alicia; Siller, María; Pitart, Cristina; Bloise, Iván; Torrecillas, Miriam; Gijón-Cordero, Desirée; Viñado, Belén; Castillo-García, Javier; Campo, Rainer; Mulet, Xavier; Madueño-Alonso, Ana; Chamizo-López, Francisco Javier; Arrastia-Erviti, Maitane; Galán-Sánchez, Fátima; Fernández-Quejo, Melisa; Rodríguez-Díaz, Juan Carlos; Gutiérrez-Zufiaurre, María Nieves; Rodríguez-Maresca, Manuel Angel; Ortega-Lafont, María Del Pilar; Yague-Guirao, Genoveva; Chaves-Blanco, Lucía; Colomina-Rodríguez, Javier; Vidal-Acuña, María Reyes; Portillo, María Eugenia; Franco-Álvarez de Luna, Francisco; Centelles-Serrano, María José; Azcona-Gutiérrez, José Manuel; Delgado-Iribarren García Campero, Alberto; Rey-Cao, Sonia; Muñoz, Patricia; Calvo-Montes, Jorge; Zboromyrska, Yuliya; Grandioso, David; Càmara, Jordi; Cantón, Rafael; Larrosa-Escartín, Nieves; Díaz-Regañón, Jazmín; Martínez-Martínez, Luis
Introduction: Infections caused by carbapenem-resistant Enterobacterales (CRE) and carbapenem-resistant Pseudomonas aeruginosa, including isolates producing acquired carbapenemases, constitute a prevalent health problem worldwide. The primary objective of this study was to determine the distribution of the different carbapenemases among carbapenemase-producing Enterobacterales (CPE, specifically Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, and Klebsiella aerogenes) and carbapenemase-producing P. aeruginosa (CPPA) in Spain from January 2014 to December 2018. Methods: A national, retrospective, cross-sectional multicenter study was performed. The study included the first isolate per patient and year obtained from clinical samples and obtained for diagnosis of infection in hospitalized patients. A structured questionnaire was completed by the participating centers using the REDCap platform, and results were analyzed using IBM SPSS Statistics 29.0.0. Results: A total of 2,704 carbapenemase-producing microorganisms were included, for which the type of carbapenemase was determined in 2692 cases: 2280 CPE (84.7%) and 412 CPPA (15.3%), most often using molecular methods and immunochromatographic assays. Globally, the most frequent types of carbapenemase in Enterobacterales and P. aeruginosa were OXA-48-like, alone or in combination with other enzymes (1,523 cases, 66.8%) and VIM (365 cases, 88.6%), respectively. Among Enterobacterales, carbapenemase-producing K. pneumoniae was reported in 1821 cases (79.9%), followed by E. cloacae complex in 334 cases (14.6%). In Enterobacterales, KPC is mainly present in the South and South-East regions of Spain and OXA-48-like in the rest of the country. Regarding P. aeruginosa, VIM is widely distributed all over the country. Globally, an increasing percentage of OXA-48-like enzymes was observed from 2014 to 2017. KPC enzymes were more frequent in 2017-2018 compared to 2014-2016. Discussion: Data from this study help to understand the situation and evolution of the main species of CPE and CPPA in Spain, with practical implications for control and optimal treatment of infections caused by these multi-drug resistant organisms.
Metabolic syndrome criteria and severity and carbon dioxide (CO2) emissions in an adult population
(BioMed Central (BMC), 2023-07-13) Garcia, Silvia; Pastor, Rosario; Monserrat-Mesquida, Margalida; Álvarez-Álvarez, Laura; Rubín-García, María; Martínez-González, Miguel Ángel; Salas-Salvado, Jordi; Corella, Dolores; Goday, Albert; Martínez, J Alfredo; Alonso-Gómez, Ángel M; Wärnberg, Julia; Vioque, Jesus; Romaguera, Dora; Lopez-Miranda, José; Estruch, Ramon; Tinahones, Francisco J; Lapetra, José; Serra-Majem, Lluis; Riquelme-Gallego, Blanca; Pintó, Xavier; Gaforio, José J; Matía, Pilar; Vidal, Josep; Vazquez, Clotilde; Daimiel, Lidia; Ros, Emilio; Sayon-Orea, Carmen; Guillem-Saiz, Patricia; Valle-Hita, Cristina; Cabanes, Robert; Abete, Itziar; Goicolea-Güemez, Leire; Gómez-Gracia, Enrique; Tercero-Maciá, Cristina; Colom Fernández, Antoni; García-Ríos, Antonio; Castro-Barquero, Sara; Fernández-García, José Carlos; Santos-Lozano, José Manuel; Cenoz, Juan Carlos; Barragán, Rocío; Khoury, Nadine; Castañer, Olga; Zulet, María Ángeles; Vaquero-Luna, Jessica; Bes-Rastrollo, Maira; de Las Heras-Delgado, Sara; Ciurana, Ramon; Martín-Sánchez, Vicente; Tur, Josep A; Bouzas, Cristina
Background: Metabolic syndrome (MetS) has become a growing risk factor of some non-communicable diseases. Increase of greenhouse gas emissions affects the planet. Aims: To assess the association between MetS severity and amount of carbon dioxide (CO2) emitted in an adult population. Design: Cross-sectional study (n = 6646; 55-76-year-old-men; 60-75-year-old-women with MetS). Methods: Dietary habits were assessed using a pre-validated semi quantitative 143-item food frequency questionnaire. The amount of CO2 emitted due to the production of food consumed by person and day was calculated using a European database, and the severity of the MetS was calculated with the MetS Severity Score. Results: Higher glycaemia levels were found in people with higher CO2 emissions. The risk of having high severe MetS was related to high CO2 emissions. Conclusions: Low CO2 emissions diet would help to reduce MetS severity. Advantages for both health and the environment were found following a more sustainable diet. Trial registration: ISRCTN, ISRCTN89898870 . Registered 05 September 2013.
Increased ultra-processed food consumption is associated with worsening of cardiometabolic risk factors in adults with metabolic syndrome: Longitudinal analysis from a randomized trial
(Elsevier, 2023-06-07) González-Palacios, Sandra; Oncina-Cánovas, Alejandro; García-de-la-Hera, Manuela; Martínez-González, Miguel Ángel; Salas-Salvado, Jordi; Corella, Dolores; Schröder, Helmut; Martínez, J Alfredo; Alonso-Gómez, Ángel M; Wärnberg, Julia; Romaguera, Dora; López-Miranda, José; Estruch, Ramon; Tinahones, Francisco J; Lapetra, José; Serra-Majem, Lluis; Cano-Ibañez, Naomi; Tur, Josep A; Martín-Sánchez, Vicente; Pintó, Xavier; Delgado-Rodriguez, Miguel; Matía-Martín, Pilar; Vidal, Josep; Vazquez, Clotilde; Daimiel, Lidia; Ros, Emilio; Bes-Rastrollo, Maira; Atzeni, Alessandro; Sorli, Jose V; Zomeño-Fajardo, María Dolores; Peña-Orihuela, Patricia J; Compañ-Gabucio, Laura M; Barón-López, Francisco J; Zulet, María Ángeles; Konieczna, Jadwiga; Casas, Rosa M; Garrido-Garrido, Eva M; Tojal-Sierra, Lucas; Gomez-Perez, Ana M; Ruiz-Canela, Miguel; Palau-Galindo, Antoni; Saiz, Carmen; Pérez-Vega, Karla A; Garcia-Rios, Antonio; Torres-Collado, Laura; Basterra-Gortari, Javier; Garcidueñas-Fimbres, Tany E; Malcampo, Mireia; Vioque, Jesus
Background and aims: The association between changes in ultra-processed food (UPF) consumption and cardiometabolic risk (CMR) factors remains understudied. We evaluated the association between changes in UPF consumption over 12 months of follow-up and changes in CMR factors in adults diagnosed with metabolic syndrome. Methods: We analysed data from 5373 adults (aged 55-75 years) participating in the PREDIMED-Plus trial. Diet was evaluated at baseline, 6- and 12-month visits using a validated food frequency questionnaire, and UPF consumption (in grams/day and percentage of total daily dietary intake in grams) was categorized based on NOVA classification. We used mixed-effects linear models with repeated measurements at baseline, 6 and 12 months of follow-up to assess the associations between changes in UPF consumption and changes in CMR factors adjusting for sociodemographic and lifestyles variables. Results: In multivariable-adjusted models, when comparing the highest versus the lowest quartile of UPF consumption, positive associations were found for several CMR factors: weight (kg, β = 1.09; 95% confidence interval 0.91 to 1.26); BMI (kg/m2, β = 0.39; 0.33 to 0.46); waist circumference (cm, β = 1.03; 0.81 to 1.26); diastolic blood pressure (mm Hg, β = 0.67; 0.29 to 1.06); fasting blood glucose (mg/dl, β = 1.66; 0.61 to 2.70); HbA1c (%, β = 0.04; 0.01 to 0.07); triglycerides (mg/dl, β = 6.79; 3.66 to 9.91) and triglycerides and glucose index (β = 0.06; 0.04 to 0.08). Conclusions: Higher UPF consumption was associated with adverse evolution in objectively measured CMR factors after 12 months of follow-up in adults with metabolic syndrome. Further research is needed to explore whether these changes persist for longer periods.

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