I3PT - Instituto de Investigación e Innovación Parc Taulí (Cataluña)

Permanent URI for this collectionhttps://hdl.handle.net/20.500.12105/16939

El Instituto de Investigación e Innovación Parc Taulí (I3PT) se crea el 23 de marzo de 2015 mediante la firma de un convenio de colaboración entre las siguientes instituciones: Corporación Sanitaria Parc Taulí (Consorcio público integrado en el SNS), Sabadell Gent Gran Centro de Servicios SAU. UDIAT Centro de diagnóstico SAU, Fundación Parc Taulí y Universidad Autónoma de Barcelona. Núcleo del IIS: Hospital de Sabadell. El 9 de febrero de 2016 existe un acuerdo del Gobierno de la Generalitat por el que desaparece UDIAT y se integra en el consorcio Parc Taulí, quedando el IIS constituido por cuatro entidades. El 28/06/2019: Adenda al convenio de constitución renovando el acuerdo por 4 años más. Acreditado por el Instituto de Salud Carlos III como Instituto de Investigación Sanitaria en 2023, y renovando esta acreditación cada 5 años, forma parte así del total de 35 Institutos de Investigación Sanitaria acreditados existentes en la actualidad. El I3PT está comprometido con sus investigadores, con la comunidad científica y el territorio. En este sentido incorpora empresas, centros tecnológicos, centro de conocimiento y la universidad en su modelo, conformando un verdadero ecosistema de la investigación y la innovación.

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Mammographic density and breast cancer pathological subtypes by menopausal status and body mass index.
(BioMed Central (BMC), 2025-10-24) Fernández-Morata, Julia; Pollan-Santamaria, Marina; Fernandez de Larrea-Baz, Nerea; Pachón-Olmos, Vanessa; García-Pérez, Javier; Castelló Pastor, Adela; Sierra, Maria Angeles; de Lucas, Maria Pilar; Llobet, Rafael; Stradella, Agostina; Cantos, Blanca; Ramón Y Cajal, Teresa; Santisteban, Marta; Seguí, Miguel Ángel; Santaballa Bertrán, Ana; Granja, Mónica; Camps-Herrero, Julia; Recalde, Sabela; Núñez-García, Beatriz; Calvo Verges, Nuria; Perez-Gomez, Beatriz; Pastor-Barriuso, Roberto; Lope Carvajal, Virginia; Instituto de Salud Carlos III
Background: Mammographic density (MD) is an established biomarker of breast cancer (BC) risk. However, its relationship to BC pathological subtypes remains unclear. This study aimed to investigate this association and assess whether it differs by body mass index (BMI) and menopausal status. Methods: MD percentage was assessed in the diagnostic mammograms of the contralateral breast of 714 BC patients recruited from eight Spanish hospitals. Participants completed an epidemiological questionnaire, and hospital researchers collected clinical and pathological data. Standardized prevalences (SPs) and standardized prevalence ratios (SPRs) for each BC pathological subtype across MD categories were estimated based on multinomial logistic regression models, both overall and stratified by BMI and menopausal status. Results: Mean MD was 26.1% (SD = 17.3). Although no statistically significant differences were detected, women with MD ≥ 50% had a 13% lower SP of hormone receptor positive tumors (SPR = 0.87; 95% CI 0.67-1.13), a 36% higher SP of human epidermal growth factor receptor 2 positive (HER2+) tumors (SPR = 1.36; 95% CI 0.72-2.58), and a 23% higher SP of triple negative (TN) tumors (SPR = 1.23; 95% CI 0.47-3.22), compared to those with MD < 10%. These patterns were mainly observed in pre/perimenopausal women and in those with BMI ≥ 25 kg/m. Conclusions: High MD might be mainly associated with the development of more aggressive and non-hormone-dependent cancers, such as HER2+ and TN BC, especially among pre/perimenopausal an overweight women.
Electrical impedance tomography for PEEP titration in ARDS patients: a systematic review and meta-analysis
(Springer, 2025-02-26) Sanchez-Piedra, Carlos; Rodriguez Ortiz de Salazar, Begoña; Roca, Oriol; Prado-Galbarro, Francisco-Javier; Perestelo-Perez, Lilisbeth; Sanchez-Gomez, Luis Maria
To assess the efficacy of electrical impedance tomography (EIT)-guided positive end-expiratory pressure (PEEP) titration in improving outcomes for patients with acute respiratory distress syndrome (ARDS). A systematic review and meta-analysis was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials and observational studies with a control group comparing EIT-guided PEEP titration to other strategies were included. Endpoints analysed included mortality, days of mechanical ventilation (MV), intensive care unit (ICU) length of stay (LOS), weaning success rate, barotrauma, driving pressure (∆P), mechanical power (MP), Sequential Organ Failure Assessment (SOFA) score and adverse events. Pooled results were presented as Risk Ratio (RR) for dichotomous outcomes and standardized difference in means (SMD) for continuous outcomes. A total of 4 studies were identified (3 randomized controlled trials and one observational study). All studies were single-center studies (N total = 271 patients). The main limitations were related to potential bias in selecting reported outcomes. EIT-guided PEEP titration was associated with a significant reduction in mortality among critically ill patients with ARDS (RR = 0.64, 95% CI: 0.45-0.91). No significant differences were found in other outcomes. Our findings suggest that EIT may be a valuable tool for PEEP titration in critically ill patients with ARDS. By optimizing lung mechanics, EIT-guided PEEP titration may potentially reduce mortality rates. While larger, multicenter studies are needed to definitively establish the clinical role of EIT in ARDS management, our results provide promising evidence for its potential clinical impact.
Determinants of Adherence to World Cancer Research Fund/American Institute for Cancer Research Recommendations in Women with Breast Cancer
(Multidisciplinary Digital Publishing Institute (MDPI), 2025-02-19) Pachón Olmos, Vanessa; Pollan-Santamaria, Marina; Fernandez de Larrea-Baz, Nerea; Fernández-Morata, Julia; Ruiz Moreno, Emma; García-Pérez, Javier; Castelló Pastor, Adela; Sierra, Maria Angeles; de Lucas, Maria Pilar; Alonso Ledesma, Isabel; Stradella, Agostina; Cantos, Blanca; Ramón Y Cajal, Teresa; Santisteban, Marta; Seguí, Miguel Ángel; Santaballa Bertrán, Ana; Granja, Mónica; Camps-Herrero, Julia; Recalde, Sabela; Mendez, Miriam; Calvo Verges, Nuria; Perez-Gomez, Beatriz; Pastor-Barriuso, Roberto; Lope Carvajal, Virginia; Instituto de Salud Carlos III
Background/objectives: The 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations benefit primary prevention and survivor outcomes. This study evaluated the adherence to these recommendations during the year prior to breast cancer diagnosis and identified related clinical and sociodemographic factors. Methods: A total of 915 patients with breast cancer were recruited from eight hospitals in four regions of Spain. The participants completed an epidemiologic questionnaire and a food frequency questionnaire. The compliance with the WCRF/AICR recommendations was assessed using a standardized score based on seven recommendations. Standardized prevalences and standardized prevalence ratios (SPRs) for moderate and high adherence were calculated based on participant characteristics using binary and multinomial logistic regression models. Results: The mean adherence was 3.5 points out of 7. The recommendations with the best and worst adherence were avoiding sugar-sweetened drinks (54.4% adherence) and maintaining a fiber-rich diet (4.4% consumed ≥30 g/day). The overall adherence was better in women aged ≥60 years (SPR = 1.55; 95% CI = 1.09-2.22), and worse in those with a caloric intake ≥2000 kcal/day (SPR = 0.48; 95% CI = 0.37-0.62) or ≥2 comorbidities (SPR = 0.66; 95% CI = 0.49-0.89). The adherence to maintaining a healthy weight was worse in those with ≥2 comorbidities and stage III-IV tumors. The physical activity adherence was worse in working women and those with ≥2 comorbidities. The alcohol restriction adherence was worse in smokers. Younger women, smokers and those with a low calorie intake were less adherent to the fruit/vegetable recommendation. The consumption of fiber and limited consumption of red/processed meat adherence was poor in all the subgroups. The adherence to a limited consumption of fast food and sugary drinks was worse in younger women and high-calorie-diet consumers. Conclusions: The differences in the adherence to recommendations according to patient characteristics justify the design of personalized interventions for breast cancer patients.
Epidemiological and clinical characterization of community, healthcare-associated and nosocomial colonization and infection due to carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in Spain
(Springer, 2024-12) Salamanca-Rivera, Elena; Palacios-Baena, Zaira R; Cañada-Garcia, Javier Enrique; Moure García, Zaira; Perez-Vazquez, Maria; Calvo-Montes, Jorge; Martínez-Martínez, Luis; Cantón, Rafael; Ruiz Carrascoso, Guillermo; Pitart, Cristina; Navarro, Ferran; Bou, Germán; Mulet, Xavier; González-López, Juan José; Sivianes, Fran; Delgado-Valverde, Mercedes; Pascual, Álvaro; Oteo-Iglesias, Jesus; Rodríguez-Baño, Jesús; GEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study Group; Instituto de Salud Carlos III; Ministerio de Ciencia e Innovación (España); Unión Europea. Comisión Europea. NextGenerationEU; Plan Nacional de I+D+i (España); Ministerio de Economía y Competitividad (España); Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Centro de Investigación Biomédica en Red - CIBERINFEC (Enfermedades Infecciosas)
Background: Community-acquired (CA) and healthcare-associated (HCA) infections caused by carbapenemase-producing Enterobacterales (CPE) are not well characterized. The objective was to provide detailed information about the clinical and molecular epidemiological features of nosocomial, HCA and CA infections caused by carbapenemase-producing Klebsiella pneumoniae (CP-Kp) and Escherichia coli (CP-Ec). Methods: A prospective cohort study was performed in 59 Spanish hospitals from February to March 2019, including the first 10 consecutive patients from whom CP-Kp or CP-Ec were isolated. Patients were stratified according to acquisition type. A multivariate analysis was performed to identify the impact of acquisition type in 30-day mortality. Results: Overall, 386 patients were included (363 [94%] with CP-Kp and 23 [6%] CP-Ec); in 296 patients (76.3%), the CPE was causing an infection. Acquisition was CA in 31 (8.0%) patients, HCA in 183 (47.4%) and nosocomial in 172 (48.3%). Among patients with a HCA acquisition, 100 (54.6%) had been previously admitted to hospital and 71 (38.8%) were nursing home residents. Urinary tract infections accounted for 19/23 (82.6%), 89/130 (68.5%) and 42/143 (29.4%) of CA, HCA and nosocomial infections, respectively. Overall, 68 infections (23%) were bacteremia (8.7%, 17.7% and 30.1% of CA, HCA and nosocomial, respectively). Mortality in infections was 28% (13%, 14.6% and 42.7% of CA, HCA and nosocomial, respectively). Nosocomial bloodstream infections were associated with increased odds for mortality (adjusted OR, 4.00; 95%CI 1.21-13.19). Conclusions: HCA and CA infections caused by CPE are frequent and clinically significant. This information may be useful for a better understanding of the epidemiology of CPE.
Evolution of invasive pneumococcal disease by serotype 3 in adults: a Spanish three-decade retrospective study
(Elsevier, 2024-06) Calvo-Silveria, Sara; González-Díaz, Aida; Grau, Inmaculada; Marimón, José María; Cercenado, Emilia; Quesada, M Dolores; Casabella, Antonio; Larrosa, Nieves; Yuste, Jose Enrique; Berbel, Dàmaris; Alonso, Marta; Tubau, Fe; Belman, Sophie; Cadenas-Jiménez, Irene; Martin-Galiano, Antonio Javier; Domínguez, María Ángeles; Martí, Sara; Liñares, Josefina; Pallarés, Román; Càmara, Jordi; Ardanuy, Carmen; Instituto de Salud Carlos III; Centro de Investigación Biomédica en Red - CIBERES (Enfermedades Respiratorias); Centro de Investigación Biomédica en Red - CIBERINFEC (Enfermedades Infecciosas)
Background: Invasive pneumococcal disease due to serotype 3 (S3-IPD) is associated with high mortality rates and long-term adverse effects. The introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) into the Spanish paediatric immunisation programme has not led to a decrease in the adult S3-IPD. We aimed to analyse the incidence, clinical characteristics and genomics of S3-IPD in adults in Spain. Methods: Adult IPD episodes hospitalized in a Southern Barcelona hospital were prospectively collected (1994-2020). For genomic comparison, S3-IPD isolates from six Spanish hospitals (2008-2020) and historical isolates (1989-1993) were analysed by WGS (Illumina and/or MinION). Findings: From 1994 to 2020, 270 S3-IPD episodes were detected. When comparing pre-PCV (1994-2001) and late-PCV13 (2016-2020) periods, only modest changes in S3-IPD were observed (from 1.58 to 1.28 episodes per 100,000 inhabitants year). In this period, the incidence of the two main lineages shifted from 0.38 to 0.67 (CC180-GPSC12) and from 1.18 to 0.55 (CC260-GPSC83). The overall 30-day mortality remained high (24.1%), though a decrease was observed between the pre-PCV (32.4%; 95.0% CI, 22.0-45.0) and the late-PCV13 period (16.7%; 95.0% CI, 7.5-32.0) (p = 0.06). At the same time, comorbidities increased from 77.3% (95.0% CI, 65.0-86.0) to 85.7% (95.0% CI, 71.0-94.0) (p = 0.69). There were no differences in clinical characteristics or 30-day mortality between the two S3 lineages. Although both lineages were genetically homogeneous, the CC180-GPSC12 lineage presented a higher SNP density, a more open pan-genome, and a major presence of prophages and mobile genetic elements carrying resistance genes. Interpretation: Adult S3-IPD remained stable in our area over the study period despite PCV13 introduction in children. However, a clonal shift was observed. The decrease in mortality rates and the increase in comorbidities suggest a change in clinical management and overall population characteristics. The low genetic variability and absence of clinical differences between lineages highlight the role of the S3 capsule in the disease severity.
Increased grey matter volumes in the temporal lobe and its relationship with cognitive functioning in euthymic patients with bipolar disorder.
(Elsevier, 2024-02-15) Porta-Casteràs, D; Vicent-Gil, M; Serra-Blasco, M; Navarra-Ventura, Guillem; Solé, B; Montejo, L; Torrent, C; Martinez-Aran, A; De la Peña-Arteaga, V; Palao, D; Vieta, E; Cardoner, N; Cano, M
Background: Bipolar disorder (BD) is characterized by episodic mood dysregulation, although a significant portion of patients suffer persistent cognitive impairment during euthymia. Previous magnetic resonance imaging (MRI) research suggests BD patients may have accelerated brain aging, observed as lower grey matter volumes. How these neurostructural alterations are related to the cognitive profile of BD is unclear. Methods: We aim to explore this relationship in euthymic BD patients with multimodal structural neuroimaging. A sample of 27 euthymic BD patients and 24 healthy controls (HC) underwent structural grey matter MRI and diffusion-weighted imaging (DWI). BD patient's cognition was also assessed. FreeSurfer algorithms were used to obtain estimations of regional grey matter volumes. White matter pathways were reconstructed using TRACULA, and four diffusion metrics were extracted. ANCOVA models were performed to compare BD patients and HC values of regional grey matter volume and diffusion metrics. Global brain measures were also compared. Bivariate Pearson correlations were explored between significant brain results and five cognitive domains. Results: Euthymic BD patients showed higher ventricular volume (F(1, 46) = 6.04; p = 0.018) and regional grey matter volumes in the left fusiform (F(1, 46) = 15.03; pFDR = 0.015) and bilateral parahippocampal gyri compared to HC (L: F(1, 46) = 12.79, pFDR = 0.025/ R: F(1, 46) = 15.25, pFDR = 0.015). Higher grey matter volumes were correlated with greater executive function (r = 0.53, p = 0.008). Limitations: We evaluated a modest sample size with concurrent pharmacological treatment. Conclusions: Higher medial temporal volumes in euthymic BD patients may be a potential signature of brain resilience and cognitive adaptation to a putative illness neuroprogression. This knowledge should be integrated into further efforts to implement imaging into BD clinical management.
International Consensus Document on Obstructive Sleep Apnea
(Elsevier, 2022-01) Mediano San Andres, Olga; Gonzalez Mangado, Nicolas; Montserrat, Josep M; Luz Alonso-Alvarez, M; Almendros, Isaac; Alonso-Fernandez, Alberto; Barbe, Ferran; Borsini, Eduardo; Caballero-Eraso, Candelaria; Cano-Pumarega, Irene; de Carlos Villafranca, Felix; Carmona-Bernal, Carmen; Carrillo Alduenda, Jose Luis; Chiner, Eusebi; Cordero Guevara, Jose Aurelio; de Manuel, Luis; Duran Cantolla, Joaquin; Farre, Ramon; Franceschini, Carlos; Gaig, Carles; Garcia Ramos, Pedro; Garcia-Rio, Francisco; Garmendia, Onintza; Gomez Garcia, Teresa; Gonzalez Pondal, Silvia; Hoyo Rodrigo, M. Blanca; Lecube, Albert; Antonio Madrid, Juan; Maniegas Lozano, Lourdes; Martinez Carrasco, Jose Luis; Fernando Masa, Juan; Masdeu Margalef, Maria Jose; Mayos Perez, Merce; Mirabet Lis, Enrique; Monasterio, Carmen; Navarro Soriano, Nieves; Olea de la Fuente, Erika; Plaza, Guillermo; Puertas Cuesta, Francisco Javier; Rabec, Claudio; Resano, Pilar; Rigau, David; Roncero, Alejandra; Ruiz, Concepcion; Salord, Neus; Saltijeral, Adriana; Sampol Rubio, Gabriel; Sanchez Quiroga, M. Angeles; Sans Capdevila, Oscar; Teixeira, Carlos; Tinahones, Francisco J; Maria Togeiro, Sonia; Troncoso Acevedo, Maria Fernanda; Vargas Ramirez, Leslie Katherine; Winck, Joao; Zabala Urionaguena, Nerea; Egea Santaolalla, Carlos; Spanish Sleep Network
The main aim of this international consensus document on obstructive sleep apnea is to provide guidelines based on a critical analysis of the latest literature to help health professionals make the best decisions in the care of adult patients with this disease. The expert working group was formed primarily of 17 scientific societies and 56 specialists from a wide geographical area (including the participation of 4 international societies), an expert in methodology, and a document a list from the Iberoamerican Cochrane Center. The document consists of a main section containing the most significant innovations and a series of online manuscripts that report the systematic literature searches performed for each section of the international consensus document. This document does not discuss pediatric patients or the management of patients receiving chronic non-invasive mechanical ventilation (these topics will be addressed in separate consensus documents).
Factors associated with sick leave duration in patients suffering from major depressive disorder initiating antidepressant treatment: a real-world evidence study in Germany and Spain
(Taylor & Francis, 2022-07-08) Roca, Miquel; Bonelli, Annalisa; Cattaneo, Agnese; Comandini, Alessandro; Di Dato, Giorgio; Heiman, Franca; Pegoraro, Valeria; Kasper, Siegfried; Volz, Hans-Peter; Palao, Diego
Objective: To describe MDD patients starting antidepressant (AD) treatment by pharmacological approach and identify factors associated with a longer sick leave (SL) duration. Methods: Retrospective study on IQVIA German Disease Analyser (specialists) and Spanish Longitudinal Patient Database (general practitioners and specialists). MDD patients initiating AD treatment between July 2016-June 2018 were grouped by therapeutic approach (AD monotherapy vs. combination/switch/add-on) and their characteristics were analysed descriptively. Multiple logistic regression models were run to evaluate factors affecting SL duration (i.e., >30 days). Results: One thousand six hundred and eighty-five patients (monotherapy: 58%; combination/switch/add-on: 42%) met inclusion criteria for Germany, and 1817 for Spain (monotherapy: 83%; combination/switch/add-on: 17%). AD treatment influenced SL duration: combination/switch/add-on patients had a 2-fold and a 4-fold risk of having >30 days of SL than monotherapy patients, respectively in Germany and Spain. Patients with a gap of time between MDD diagnosis and AD treatment initiation had a higher likelihood of experiencing a longer SL both in Germany and Spain (38% higher likelihood and 6-fold risk of having >30 days of SL, respectively). Conclusions: A careful and timely selection of AD treatment approach at the time of MDD diagnosis may improve functional recovery and help to reduce SL, minimising the socio-economic burden of the disease.Key pointsThe major depressive disorder has a substantial impact on work absenteeism.The present study aimed to describe MDD patients starting antidepressant (AD) treatment depending on the pharmacological approach and to identify factors associated with longer sick leave (SL) duration.Patients receiving AD monotherapy had a lower likelihood of having more than 30 days of sick leave than those receiving AD combination/switch/add-on.Patients for whom a gap of time between MDD diagnosis and initiation of AD treatment was observed, showed a higher likelihood of having more than 30 days of sick leave.Because findings from this analysis relied on secondary data, the authors would like to claim the urgency of conducting prospective observational studies that further investigate the effect that different AD therapeutic approaches and timely initiation of treatment might exert on patients' recovery.
Daptomycin Plus Fosfomycin Versus Daptomycin Alone for Methicillin-resistant Staphylococcus aureus Bacteremia and Endocarditis: A Randomized Clinical Trial
(Oxford University Press, 2021-05-01) Pujol, Miquel; Miró, José María; Shaw, Evelyn; Aguado, José María; San-Juan, Rafael; Puig-Asensio, Mireia; Pigrau, Carles; Calbo, Esther; Montejo, Miguel; Rodriguez-Alvarez, Regino; Garcia-Pais, Maria-Jose; Pintado, Vicente; Escudero-Sanchez, Rosa; Lopez-Contreras, Joaquin; Morata, Laura; Montero, Milagros; Andres, Marta; Pasquau, Juan; Arenas, Maria-del-Mar; Padilla, Belen; Murillas, Javier; Jover-Saenz, Alfredo; Lopez-Cortes, Luis Eduardo; Garcia-Pardo, Graciano; Gasch, Oriol; Videla, Sebastian; Hereu, Pilar; Tebe, Cristian; Pallares, Natalia; Sanllorente, Mireia; Dominguez, Maria-Angeles; Camara, Jordi; Ferrer, Ana; Padulles, Ariadna; Cuervo, Guillermo; Carratalà, Jordi; MRSA Bacteremia (BACSARM) Trial Investigators
Background. We aimed to determine whether daptomycin plus fosfomycin provides higher treatment success than daptomycin alone for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and endocarditis. Methods. A randomized (1:1) phase 3 superiority, open-label, and parallel group clinical trial of adult inpatients with MRSA bacteremia was conducted at 18 Spanish hospitals. Patients were randomly assigned to receive either 10 mg/kg of daptomycin intravenously daily plus 2 g of fosfomycin intravenously every 6 hours, or 10 mg/kg of daptomycin intravenously daily. Primary endpoint was treatment success 6 weeks after the end of therapy. Results. of 167 patients randomized, 155 completed the trial and were assessed for the primary endpoint. Treatment success at 6 weeks after the end of therapy was achieved in 40 of 74 patients who received daptomycin plus fosfomycin and in 34 of 81 patients who were given daptomycin alone (54.1% vs 42.0%; relative risk, 1.29 [95% confidence interval, .93-1.8]; P = .135). At 6 weeks, daptomycin plus fosfomycin was associated with lower microbiologic failure (0 vs 9 patients; P = .003) and lower complicated bacteremia (16.2% vs 32.1%; P = .022). Adverse events leading to treatment discontinuation occurred in 13 of 74 patients (17.6%) receiving daptomycin plus fosfomycin, and in 4 of 81 patients (4.9%) receiving daptomycin alone (P = .018). Conclusions. Daptomycin plus fosfomycin provided 12% higher rate of treatment success than daptomycin alone, but this difference did not reach statistical significance. This antibiotic combination prevented microbiological failure and complicated bacteremia, but it was more often associated with adverse events.
New Metrics to Assess Type 2 Diabetes after Bariatric Surgery: The Time-Within-Remission Range
(Multidisciplinary Digital Publishing Institute (MDPI), 2020-04) de Hollanda, Ana; Lecube, Albert; Rubio, Miguel Angel; Sanchez, Enric; Vilarrasa, Nuria; Oliva, Jose Gregorio; Fernandez-Soto, Maria Luisa; Salas-Salvado, Jordi; Ballesteros-Pomar, Maria D.; Ciudin, Andreea; Torres, Ferran; Vidal, Concepcion; Morales, Maria Jose; Valdes, Sergio; Pellitero, Silvia; Minambres, Inka; Masmiquel, Lluis; Goday, Albert; Suarez, Lorena; Flores, Liliam; Bueno, Marta; Caixas, Assumpta; Breton, Irene; Camara, Rosa; Olbeyra, Romina; Penso, Rona; de la Cruz, Maria Jose; Simo-Servat, Andreu; Pereyra-Garcia, Francisca Maria; Lopez-Mezquita, Elena Teresa; Gils, Anna; Fidilio, Enzamaria; Bandres, Orosia; Martinez, Angel; Abuin, Jose; Marques-Pamies, Montserrat; Tuneu, Laura; Arteaga, Magdalena; Castaner, Olga; Goñi, Fernando; Arrizabalaga, Cristina; Antonio Botana, Manuel; Calanas, Alfonso; Rebollo, Angel
Almost one third of patients do not achieve type 2 diabetes remission after bariatric surgery or are unable to sustain this effect long term. Our objective was to delve further into the dynamic responses of diabetes after bariatric surgery and to evaluate the time-within-remission range as a variable of metabolic control. A descriptive cohort study was done using a computerised multicentre and multidisciplinary registry. All data were adjusted by propensity score. A total of 1186 subjects with a follow-up of 4.5 +/- 2.5 years were included. Type of surgery, diabetes remission, recurrence of diabetes, time-within-remission range and key predictors of diabetes outcomes were assessed. All patients (70% women, 51.4 +/- 9.2 years old, body mass index (BMI) 46.3 +/- 6.9 kg/m(2)) underwent primary bariatric procedures. Time-within-remission range were 83.3% (33.3-91.6) after gastric bypass, 68.7% (7.1-87.5) after sleeve gastrectomy and 90% (83.3-92.8) after malabsorptive techniques (p < 0.001 for all). Duration of diabetes, baseline HbA1c and insulin treatment were significantly negatively correlated with the time-within-remission range. The association of bariatric techniques with time-within-remission range, using gastric bypass as a reference, were: odds ratio (OR) 3.70 (2.34-5.84), p < 0.001 for malabsorptive techniques and OR 0.55 (0.40-0.75), p < 0.001 for sleeve gastrectomy. Characteristics of type 2 diabetes powerfully influence the outcomes of bariatric surgery. The time-within-remission range unveils a superiority of gastric bypass compared to sleeve gastrectomy.
Relationship between the respiratory microbiome and the severity of airflow limitation, history of exacerbations and circulating eosinophils in COPD patients
(BioMed Central (BMC), 2019-06-24) Millares, Laura; Pascual, Sergi; Monton, Concepcion; Garcia-Nunez, Marian; Lalmolda, Cristina; Faner, Rosa; Casadevall, Carme; Seto, Laia; Capilla, Silvia; Moreno, Amalia; Angelica Castro-Acosta, Ady; Jose Alvarez-Martinez, Carlos; Sibila, Oriol; Peces-Barba, German; García-Cosío, Borja; Agusti, Alvar; Gea, Joaquim; Monso, Eduard
Background: The respiratory microbiome is altered in COPD patients but its relationship with core components of the disease, such as the severity of airflow limitation, the frequency of exacerbations or the circulating levels of eosinophils, is unclear. Methods: Cross-sectional study comprising 72 clinically stable COPD patients (mean age 68 [SD 7.9] years; FEV1 48.7 [SD 20.1]% of reference) who provided spontaneous sputum samples for 16S rRNA gene amplification and sequencing. The microbiome composition was analysed with QIIME. Results: We observed that: (1) more severe airflow limitation was associated with reduced relative abundance (RA) of Treponema and an increase in Pseudomonas; (2) patients with 2 exacerbations the previous year showed a significantly different bacterial community with respect to non-exacerbators (p=0.014), with changes in 13 genera, including an increase of Pseudomonas, and finally, (3) peripheral eosinophils levels 2% were associated with more diverse microbiome [Chao1 224.51 (74.88) vs 277.39 (78.92) p=0.006; Shannon 3.94 (1.05) vs 4.54 (1.06) p=0.020], and a significant increase in the RAs of 20 genera. Conclusion: The respiratory microbiome in clinically stable COPD patients varies significantly according to the severity of airflow limitation, previous history of exacerbations and circulating eosinophils levels.
SEOM clinical guideline for treatment of kidney cancer (2017)
(Springer, 2018-01) Gallardo, E; Mendez-Vidal, MJ; Perez-Gracia, JL; Sepúlveda-Sánchez, Juan Manuel; Campayo, M; Chirivella-Gonzalez, I; Garcia-del-Muro, X; Gonzalez-del-Alba, A; Grande, E; Suarez, C
The goal of this article is to provide recommendations about the management of kidney cancer. Based on pathologic and molecular features, several kidney cancer variants were described. Nephron-sparing techniques are the gold standard of localized disease. After a randomized trial, sunitinib could be considered in adjuvant treatment in high-risk patients. Patients with advanced disease constitute a heterogeneous population. Prognostic classification should be considered. Both sunitinib and pazopanib are the standard options for first-line systemic therapy in advanced renal cell carcinoma. Based on the results of two randomized trials, both nivolumab and cabozantinib should be considered the standard for second and further lines of therapy. Response evaluation for present therapies is a challenge.
Attentional Control and Fear Extinction in Subclinical Fear: An Exploratory Study
(Frontiers Media, 2017-09-26) Forcadell, Eduard; Torrents-Rodas, David; Treen, Devi; Fullana, Miquel A; Tortella-Feliu, Miquel
Attentional control (AC) and fear extinction learning are known to be involved in pathological anxiety. In this study we explored whether individual differences in non-emotional AC were associated with individual differences in the magnitude and gradient of fear extinction (learning and recall). In 50 individuals with fear of spiders, we collected measures of non-emotional AC by means of self-report and by assessing the functioning of the major attention networks (executive control, orienting, and alerting). The participants then underwent a paradigm assessing fear extinction learning and extinction recall. The two components of the orienting network functioning (costs and benefits) were significantly associated with fear extinction gradient over and above the effects of trait anxiety. Specifically, participants with enhanced orienting costs (i.e., difficulties in disengaging attention from cues not relevant for the task) showed faster extinction learning, while those with enhanced orienting benefits (i.e., attention facilitated by valid cues) exhibited faster extinction recall as measured by fear-potentiated startle and Unconditioned Stimulus expectancies, respectively. Our findings suggest that, in non-emotional conditions, the orienting component of attention may be predictive of fear extinction. They also show that the use of fear extinction gradients and the exploration of individual differences in non-emotional AC (using performance-based measures of attentional network functioning) can provide a better understanding of individual differences in fear learning. Our findings also may help to understand differences in exposure therapy outcomes.
Whole Transcription Profile of Responders to Anti-TNF Drugs in Pediatric Inflammatory Bowel Disease
(Multidisciplinary Digital Publishing Institute (MDPI), 2021-01-13) Salvador-Martín, Sara; Kaczmarczyk, Bartosz; Álvarez, Rebeca; Navas-López, Víctor Manuel; Gallego-Fernández, Carmen; Moreno-Álvarez, Ana; Solar-Boga, Alfonso; Sánchez, Cesar; Tolin, Mar; Velasco, Marta; Muñoz-Codoceo, Rosana; Rodriguez-Martinez, Alejandro; Vayo, Concepción A.; Bossacoma, Ferrán; Pujol-Muncunill, Gemma; Fobelo, María J.; Millán-Jiménez, Antonio; Magallares, Lorena; Martínez-Ojinaga, Eva; Loverdos, Inés; Eizaguirre, Francisco J.; Blanca-García, José A.; Clemente, Susana; García-Romero, Ruth; Merino-Bohórquez, Vicente; González de Caldas, Rafael; Vázquez, Enrique; Dopazo, Ana; Sanjurjo-Sáez, María; López-Fernández, Luis A.; Instituto de Salud Carlos III; Comunidad de Madrid (España); Fundación para la Investigación Biomédica del Hospital Gregorio Marañón; Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF)
Background: Up to 30% of patients with pediatric inflammatory bowel disease (IBD) do not respond to anti-Tumor Necrosis Factor (anti-TNF) therapy. The aim of this study was to identify pharmacogenomic markers that predict early response to anti-TNF drugs in pediatric patients with IBD. Methods: An observational, longitudinal, prospective cohort study was conducted. The study population comprised 38 patients with IBD aged < 18 years who started treatment with infliximab or adalimumab (29 responders and nine non-responders). Whole gene expression profiles from total RNA isolated from whole blood samples of six responders and six non-responders taken before administration of the biologic and after two weeks of therapy were analyzed using next-generation RNA sequencing. The expression of six selected genes was measured for purposes of validation in all of the 38 patients recruited using qPCR. Results: Genes were differentially expressed in non-responders and responders (32 before initiation of treatment and 44 after two weeks, Log2FC (Fold change) >0.6 or <−0.6 and p value < 0.05). After validation, FCGR1A, FCGR1B, and GBP1 were overexpressed in non-responders two weeks after initiation of anti-TNF treatment (Log2FC 1.05, 1.21, and 1.08, respectively, p value < 0.05). Conclusion: Expression of the FCGR1A, FCGR1B, and GBP1 genes is a pharmacogenomic biomarker of early response to anti-TNF agents in pediatric IBD.
Frequency of low-level and high-level mosaicism in sporadic retinoblastoma: genotype-phenotype relationships.
(Springer, 2020-01) Rodriguez-Martin, Carlos; Robledo, Cristina; Gomez-Mariano, Gema Maria; Monzon-Fernandez, Sara; Sastre, Ana; Abelairas, Jose; Sabado, Constantino; Martín-Begué, Nieves; Ferreres, Joan Carles; Fernández-Teijeiro, Ana; González-Campora, Ricardo; Rios-Moreno, María José; Zaballos, Ángel; Cuesta de la Plaza, Isabel; Martinez-Delgado, Beatriz; Posada De la Paz, Manuel; Alonso, Javier; Instituto de Salud Carlos III; Asociación Pablo Ugarte contra el cáncer infantil; Fundación la Sonrisa de Alex para la investigación y el tratamiento del sarcoma de Ewing; Ministerio de Economía y Competitividad (España); Centro de Investigación Biomedica en Red - CIBER; Asociación Todos somos Iván
Somatic mutational mosaicism is a common feature of monogenic genetic disorders, particularly in diseases such as retinoblastoma, with high rates of de novo mutations. The detection and quantification of mosaicism is particularly relevant in these diseases, since it has important implications for genetic counseling, patient management, and probably also on disease onset and progression. In order to assess the rate of somatic mosaicism (high- and low-level mosaicism) in sporadic retinoblastoma patients, we analyzed a cohort of 153 patients with sporadic retinoblastoma using ultra deep next-generation sequencing. High-level mosaicism was detected in 14 out of 100 (14%) bilateral patients and in 11 out of 29 (38%) unilateral patients in whom conventional Sanger sequencing identified a pathogenic mutation in blood DNA. In addition, low-level mosaicism was detected in 3 out of 16 (19%) unilateral patients in whom conventional screening was negative in blood DNA. Our results also reveal that mosaicism was associated to delayed retinoblastoma onset particularly in unilateral patients. Finally we compared the level of mosaicism in different tissues to identify the best DNA source to identify mosaicism in retinoblastoma patients. In light of these results we recommended analyzing the mosaic status in all retinoblastoma patients using accurate techniques such as next-generation sequencing, even in those cases in which conventional Sanger sequencing identified a pathogenic mutation in blood DNA. Our results suggest that a significant proportion of those cases are truly mosaics that could have been overlooked. This information should be taking into consideration in the management and genetic counseling of retinoblastoma patients and families.
Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults
(Elsevier, 2019-09) Ciruela, Pilar; Broner, Sonia; Izquierdo, Conchita; Pallarés, Román; Muñoz-Almagro, Carmen; Hernández, Sergi; Grau, Inmaculada; Domínguez, Angela; Jané, Mireia; The Catalan Working Group on Invasive Pneumococcal Disease; Fenoll, Asuncion; Unión Europea. European Centre for Disease Prevention and Control (ECDC); Centro de Investigación Biomédica en Red - CIBERESP (Epidemiología y Salud Pública)
Objectives: The aim of this study was to assess the indirect effect of paediatric 13-valent pneumococcal conjugate vaccine (PCV13) vaccination on people ≥65 years of age with invasive pneumococcal disease (IPD) in Catalonia and to determine factors predictive of mortality. Methods: During 2014-2016, 1285 IPD cases were reported to the Public Health Agency of Catalonia. The indirect effect of paediatric PCV13 vaccination was calculated by comparing the incidence rate (IR) in 2016 (PCV13 year) with that in 2009 (pre-PCV13). Predictors of mortality were determined using multivariate logistic regression. Results: Comparing 2016 and 2009, IPD decreased by 19% (IR 40.1 and 32.5 per 100 000 person-years, respectively). PCV13 serotypes decreased by 57% (IR 23.7 and 10.1), while non-PCV13 serotypes increased by 36% (IR 16.4 and 22.4). During 2014-2016, the mortality rate was 17.5%, and mortality was associated with age ≥85 years (adjusted odds ratio (aOR) 2.91, 95% confidence interval (CI) 1.89, 4.48), meningitis (aOR 2.29, 95% CI 1.25, 4.19), non-focal bacteraemia (aOR 3.73, 95% CI 2.00, 6.94), and ≥1 high-risk condition (aOR 1.89, 95% CI 1.08, 3.32). PPV23non13 serotypes were associated with lower mortality than PCV13 serotypes (aOR 0.54, 95% CI 0.34, 0.86). Conclusions: The incidence of IPD in people ≥65 years of age decreased after the introduction of paediatric PCV13, and this was due to a reduction in PCV13 serotypes, although an increase in non-PCV13 serotypes was observed. Mortality was associated with age, meningitis, non-focal bacteraemia, ≥1 high-risk condition, and PCV13 serotypes.

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