Person: Gutierrez-Gonzalez, Enrique
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First Name
Enrique
Last Name
Gutierrez-Gonzalez
Institution
ISCIII
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ISCIII::Escuela Nacional de Sanidad (ENS)
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CNIO Organization
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Publication Enfermedades Meningocócica en España. Análisis de la temporada 2015-2016(Instituto de Salud Carlos III (ISCIII). Centro Nacional de Epidemiología (CNE), 2017-10-08) Gutierrez-Gonzalez, Enrique; Martínez-Sánchez, Elena Vanesa; Amillategui Dos Santos, Rocío; Cano-Portero, Rosa[ES] La enfermedad meningocócica es de declaración obligatoria en España. Los casos se notifican de manera individualizada con periodicidad semanal incluyendo información epidemiológica y microbiológica a través de la Red Nacional de Vigilancia Epidemiológica (RENAVE). La presentación de esta enfermedad en la población española ha sufrido cambios muy importantes. El uso de la vacuna frente al serogrupo C ha causado un gran descenso de la incidencia por este serogrupo. Además en la última década también han disminuido los casos por serogrupo B. En la temporada 2015-2016 se notificaron 314 casos, de los que se confirmaron 268 y la incidencia fue de 0,58 por 100.000 habitantes. Se presenta el análisis de los resultados generales de la vigilancia epidemiológica de la enfermedad meningocócica para la temporada 2015-2016 en España y su comparación con las previas. [EN] Meningococcal disease is notifiable in Spain. The cases are notified individually on a weekly basis, including epidemiological and microbiological information through the National Network of Epidemiological Surveillance (RENAVE). The incidence of this disease in the Spanish population has undergone very important changes. Vaccination against serogroup C has caused a large decrease in the incidence of this serogroup. In addition, in the last decade cases caused by serogroup B have also decreased. In the 2015-2016 season, 314 cases were notified, of which 268 were confirmed and the incidence was 0.58 per 100,000 inhabitants. We analyzed the results of the epidemiological surveillance of meningococcal disease for the 2015-2016 season in Spain and its comparison with the previous ones.Publication Exploring clinical, echocardiographic and molecular biomarkers to predict bronchopulmonary dysplasia(Public Library of Science (PLOS), 2019) Alvarez-Fuente, Maria; Moreno, Laura; Lopez-Ortego, Paloma; Arruza, Luis; Avila-Alvarez, Alejandro; Muro, Marta; Gutierrez-Gonzalez, Enrique; Zozaya, Carlos; Sanchez-Helguera, Gema; Elorza, Dolores; Martinez-Ramas, Andrea; Villar, Gema; Labrandero, Carlos; Martinez, Lucia; Casado, Teresa; Cuadrado, Irene; Del Cerro, Maria Jesus; Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Instituto de Salud Carlos IIIINTRODUCTION: Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease in childhood, related to prematurity, and the most common cause of pulmonary hypertension (PH) secondary to pulmonary disease in children. Moderate and severe BPD have a worse outcome and relate more frequently with PH. The prediction of moderate or severe BPD development in extremely premature newborns is vital to implement preventive strategies. Starting with the hypothesis that molecular biomarkers were better than clinical and echocardiographic factors, this study aims to explore the ability of clinical, echocardiographic and analytical variables to predict moderate or severe BPD in a cohort of extremely preterm infants. PATIENTS AND METHODS: We designed a prospective longitudinal study, in which we followed a cohort of preterm newborns (gestational age <28 weeks and weight ≤ 1250 grams). In these newborns we recorded weekly clinical and echocardiographic variables as well as blood and tracheal aspirate samples, to analyze molecular biomarkers (IL-6, IL-1, IP10, uric acid, HGF, endothelin-1, VEGF, CCL5). Variables and samples were collected since birth up to week 36 (postmenstrual age), time-point at which the diagnosis of BPD is established. RESULTS: We included 50 patients with a median gestational age of 26 weeks (IQR 25-27) and weight of 871 g (SD 161,0) (range 590-1200g). Three patients were excluded due to an early death. Thirty-five patients (74.5%) developed BPD (mild n = 14, moderate n = 15, severe n = 6). We performed a logistic regression in order to identify risk factors for moderate or severe BPD. We compared two predictive models, one with two variables (mechanical ventilation and inter-ventricular septum flattening), and another-one with an additional molecular biomarker (ET-1). CONCLUSIONS: The combination of clinical and echocardiographic variables is a valuable tool for determining the risk of BPD. We find the two variable model (mechanical ventilation and echocardiographic signs of PH) more practical for clinical and research purposes. Future research on BPD prediction should be oriented to explore the potential role of ET-1.Publication Dietary Zinc and Risk of Prostate Cancer in Spain: MCC-Spain Study(Multidisciplinary Digital Publishing Institute (MDPI), 2018-12-20) Gutierrez-Gonzalez, Enrique; Castelló Pastor, Adela; Fernandez-Navarro, Pablo L; Castaño-Vinyals, Gemma; Llorca, Javier; Salas, Dolores; Salcedo-Bellido, Inmaculada; Aragonés, Nuria; Fernández-Tardón, Guillermo; Alguacil, Juan; Gràcia-Lavedan, Esther; García-Esquinas, Esther; Gómez-Acebo, Inés; Amiano, Pilar; Romaguera, Dora; Kogevinas, Manolis; Pollan-Santamaria, Marina; Perez-Gomez, Beatriz; Instituto de Salud Carlos III; Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Fundación Marqués de Valdecilla; Regional Government of Andalusia (España); Generalitat Valenciana (España); Basque Government (España); Fundación Caja de Ahorros de Asturias; University of Oviedo (España); Ministerio de Economía y Competitividad (España)Zinc is a key trace element in normal prostate cell metabolism, and is decreased in neoplastic cells. However, the association between dietary zinc and prostate cancer (PC) in epidemiologic studies is a conflicting one. Our aim was to explore this association in an MCC-Spain case-control study, considering tumor aggressiveness and extension, as well as genetic susceptibility to PC. 733 incident cases and 1228 population-based controls were included for this study. Dietary zinc was assessed using a food frequency questionnaire, and genetic susceptibility was assessed with a single nucleotide polymorphisms (SNP)-based polygenic risk score (PRS). The association between zinc intake and PC was evaluated with mixed logistic and multinomial regression models. They showed an increased risk of PC in those with higher intake of zinc (Odds Ratio (OR) tertile 3vs1: 1.39; 95% Confidence interval (CI):1.00⁻1.95). This association was mainly observed in low grade PC (Gleason = 6 RRR tertile 3vs1: 1.76; 95% CI:1.18⁻2.63) as well as in localized tumors (cT1-cT2a RRR tertile 3vs1: 1.40; 95% CI:1.00⁻1.95) and among those with higher PRS (OR tertile 3vs1: 1.50; 95% CI:0.89⁻2.53). In conclusion, a higher dietary zinc intake could increase the risk of low grade and localized tumors. Men with higher genetic susceptibility0020might also have a higher risk of PC associated with this nutrient intake.Publication Toenails as biomarker of exposure to essential trace metals: A review.(Elsevier, 2019) Gutierrez-Gonzalez, Enrique; García-Esquinas, Esther; Fernandez de Larrea-Baz, Nerea; Salcedo-Bellido, Inmaculada; Navas-Acien, Ana; Lope Carvajal, Virginia; Gómez-Ariza, José Luis; Pastor-Barriuso, Roberto; Pollan-Santamaria, Marina; Perez-Gomez, Beatriz; Instituto de Salud Carlos IIIHealth problems associated with essential trace metals can result from both inadequate (i.e., low intake) and excessive exposures (i.e., from environmental and/or occupational source). Thus, measuring the exposure level is a real challenge for epidemiologists. Among non-invasive biomarkers that intend to measure long-term exposure to essential trace metals, the toenail is probably the biological matrix with the greatest potential. This systematic review collects the current evidence regarding the validity of toenail clippings as exposure biomarker for trace metals such as boron, cobalt, copper, iron, manganese, molybdenum, selenium, silicon, vanadium and zinc. Special attention was paid to the time-window of exposure reflected by the toenail, the intraindividual variability in exposure levels over time in this matrix, and the relationship of toenail with other biomarkers, personal characteristics and environmental sources. Our search identified 139 papers, with selenium and zinc being the most studied elements. The variability among studies suggests that toenail levels may reflect different degrees of exposure and probably correspond to exposures occurred 3-12 months before sampling (i.e., for manganese/selenium). Few studies assessed the reproducibility of results over time and, for samples obtained 1-6 years apart, the correlation coefficient were between 0.26 and 0.66. Trace metal levels in toenails did not correlate well with those in the blood and urine and showed low-moderate correlation with those in the hair and fingernails. Available data suggests that for some elements (Se, Mn, Zn) toenail concentrations reflect long-term external exposures in fairly reproducible levels, while for other metals, this association has not yet been assessed. Among dietary factors, only toenail selenium showed clear associations with the intake of supplements or specific foods. The toenail levels could also represent occupational exposure, for instance, Mn exposure in welders. The scarcity of information on other essential trace elements, together with the great heterogeneity among studies makes the validation of the usage of toenails as biomarkers of exposure to these elements difficult. Standardization of sample collection, quality control, analytical techniques and reporting procedures might facilitate further research focused on the clear understanding of the significance of essential levels in this promising matrix and would enhance its utility in epidemiological research.Publication Effect of vaccination, comorbidities and age on mortality and severe disease associated with influenza during the season 2016-2017 in a Spanish tertiary hospital.(Elsevier, 2019) Gutierrez-Gonzalez, Enrique; Cantero-Escribano, José M; Redondo Bravo, Lidia; San Juan-Sanz, Isabel; Robustillo-Rodela, Ana; Cendejas-Bueno, Emilio; Influenza Working GroupIdentifying risk factors for complications or death associated with influenza remains crucial to target preventive interventions. Scores like the Charlson comorbidity index (CCI) may be of help. The aims of this study were to assess the effect of vaccination and comorbidities on severe influenza disease and influenza-related death among hospitalized patients during the season 2016/17; and to evaluate the validity of the CCI to predict death among these patients. Data from adult patients (≥18 years old) with influenza infection admitted to La Paz University Hospital (LPUH) were recorded during the 2016/17 epidemic. The effect of influenza vaccine to prevent severe influenza or death was evaluated using multivariate logistic regression models. The area under the curve of the CCI and the age-adjusted CCI were compared to assess the predictive effect on mortality. A total of 342 adult patients with influenza infection were admitted, of which 83 developed severe influenza and 25 died during hospitalization. There were no differences between patients who survived and those who died concerning the CCI, but the age-adjusted CCI was higher in fatal cases (p-value=0.005). Influenza vaccine had no statistically significant effect on the risk of mortality (p-value=0.162) while age (OR: 1.12, p-value<0.001) and dementia (OR: 3.05, p-value=0.016) proved to be independent predictors for mortality. The seasonal vaccine was found to be protective for severe infection (OR: 0.54, p-value=0.019). The age-adjusted CCI was a better predictor of mortality than the crude CCI. Age and dementia are significant independent risk factors for mortality associated with influenza among hospitalized patients. The age-adjusted CCI seems to be a better predictor of mortality than the crude CCI. Influenza vaccine has shown to be effective in preventing severe influenza in the season 2016/17 among hospitalized patients and should be promoted in population at risk.