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Castro-Quezada I.,University of Granada | Artacho R.,University of Granada | Molina-Montes E.,Campus Universitario Of La Cartuja | Molina-Montes E.,CIBER ISCIII | And 2 more authors.
European Journal of Nutrition | Year: 2015

Purpose: To examine the association between dietary glycaemic index (GI) and dietary glycaemic load (GL) with cardiovascular disease (CVD) risk factors in a rural elderly population. Methods: A cross-sectional study was conducted in 343 subjects (60–74 years) residing in a Spanish rural area (Priego de Córdoba). Subjects were selected using stratified random sampling. Food intake was assessed using a validated food frequency questionnaire (FFQ). We assigned GI values to each item of the FFQ to estimate dietary GI and GL. Multivariate linear regression models were fitted to assess the association between GI/GL with CVD risk factors (blood glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, apolipoprotein A1, body mass index, waist circumference and blood pressure). The potential modifying effect of sex, smoking status, diabetes and medication has been explored. Results: A statistically significant inverse association between dietary GI and blood glucose was found in the multivariate model (p = 0.029): for every 10 unit increment of GI, serum glucose levels decreased by 0.2 units. However, statistical significance was lost after controlling for diabetes or hypoglycaemic medication. In the crude model, dietary GL was associated with triglycerides (ß for every 10 GL units increase = 0.70, p = 0.005), but statistical significance was lost in the multivariate model (p = 0.508). No associations were found between dietary GI/GL and the rest of the variables studied. Conclusions: Neither dietary GI nor GL were associated with CVD risk factors in the study population of Priego de Córdoba. Results obtained suggest the necessity to consider the diagnosis of diabetes in these studies. © 2014, Springer-Verlag Berlin Heidelberg.


Aguilar-Garduno C.,Campus Universitario Of La Cartuja | Aguilar-Garduno C.,Andalusian Observatory of Environmental Health | Lacasana M.,Campus Universitario Of La Cartuja | Lacasana M.,CIBER ISCIII | And 3 more authors.
Occupational and Environmental Medicine | Year: 2010

Objective: To assess the relationship between parental occupational exposure to organic solvents, and the risk of anencephaly in Mexico. Methods: A case-control study was conducted based on the registers of the Epidemiological Surveillance System for Neural Tube Defects in Mexico; 151 cases of anencephaly of >20 weeks' gestation were included. A control, born alive and without any apparent congenital malformations at birth, was selected for each case in the same maternity service in which the case was born. Information on occupational exposures, lifestyle habits, reproductive history, use of medicines, supplementation with multivitamins and folic acid, was obtained by a general questionnaire; a food frequency questionnaire was also applied to obtain information of daily intake of folate and other B vitamins. Occupational exposure to organic solvents was based on job title as a proxy for exposure and analysed considering two critical periods around conception. Results: In logistic regression analysis, the odds of having a child with anencephaly was higher if the mother or the father was occupationally exposed to organic solvents during the periconceptional period, or when both parents or at least one of them were occupationally exposed during this period with an adjusted odds ratio of 2.97 (95% CI 1.36 to 6.52). Conclusions: The results support the hypothesis that both maternal and paternal occupational exposure to organic solvents can increase the probability of having a child with anencephaly.


Schilmann A.,National Institute of Public Health | Lacasana M.,Campus Universitario Of La Cartuja | Lacasana M.,CIBER ISCIII | Blanco-Munoz J.,National Institute of Public Health | And 4 more authors.
Occupational and Environmental Medicine | Year: 2010

Objectives: Exposure assessment to a single pesticide does not capture the complexity of the occupational exposure. Recently, pesticide use patterns analysis has emerged as an alternative to study these exposures. The aim of this study is to identify the pesticide use pattern among flower growers in Mexico participating in the study on the endocrine and reproductive effects associated with pesticide exposure. Methods: A cross-sectional study was carried out to gather retrospective information on pesticide use applying a questionnaire to the person in charge of the participating flower growing farms. Information about seasonal frequency of pesticide use (rainy and dry) for the years 2004 and 2005 was obtained. Principal components analysis was performed. Results: Complete information was obtained for 88 farms and 23 pesticides were included in the analysis. Six principal components were selected, which explained more than 70% of the data variability. The identified pesticide use patterns during both years were: 1. fungicides benomyl, carbendazim, thiophanate and metalaxyl (both seasons), including triadimephon during the rainy season, chlorotalonyl and insecticide permethrin during the dry season; 2. insecticides oxamyl, biphenthrin and fungicide iprodione (both seasons), including insecticide methomyl during the dry season; 3. fungicide mancozeb and herbicide glyphosate (only during the rainy season); 4. insecticides metamidophos and parathion (both seasons); 5. insecticides omethoate and methomyl (only rainy season); and 6. insecticides abamectin and carbofuran (only dry season). Some pesticides do not show a clear pattern of seasonal use during the studied years. Conclusions: The principal component analysis is useful to summarise a large set of exposure variables into smaller groups of exposure patterns, identifying the mixtures of pesticides in the occupational environment that may have an interactive effect on a particular health effect.


Lacasan M.,Campus Universitario Of La Cartuja | Lacasan M.,CIBER ISCIII | Blanco-Munoz J.,National Institute of Public Health | Borja-Aburto V.H.,Mexican Institute of Social Security IMSS | And 8 more authors.
Public Health Nutrition | Year: 2012

Objective To evaluate the effects on anencephaly risk of the interaction between the maternal profile of folate, vitamin B12 and homocysteine and the 677C→T polymorphism in the gene encoding methylenetetrahydrofolate reductase (MTHFR). Design Case-control study paired (1:1) on maternity clinic, date of birth and state of residence. Cases of anencephaly were identified using the Registry of the Mexican Neural Tube Defect Epidemiological Surveillance System. Case and control mothers were selected from the same maternity departments. All mothers completed a structured questionnaire and blood samples were obtained to determine the MTHFR 677CTT polymorphism and biochemical profile. Setting Mexico, Puebla and Guerrero states, Mexico. Subjects A total of 151 mothers of cases and controls were enrolled from March 2000 to February 2001. We had complete information on biochemical profile and MTHFR C677T polymorphism for ninety-eight mothers of cases and ninety-one mothers of controls. Results The adjusted models show that the risk of anencephaly in mothers with 677TT genotype was reduced by 18 % (OR = 0.82; 95 % CI 0.72, 0.94) for each 1 ng/ml increment in serum folate. In terms of tertiles, mothers with 677TT genotype with serum folate levels in the upper tertile (>14.1 ng/ml) had a 95 % lower risk to have a child with anencephaly than mothers with serum folate levels in the first and second tertiles (P trend = 0.012). Conclusions Our data agree with the hypothesis of a gene-nutrient interaction between MTHFR 677CTT polymorphism and folate status. We observed a protective effect on anencephaly risk only in mothers with 677TT genotype as serum folate levels increased. © 2012 The Authors.


Blanco-Munoz J.,Instituto Nacional Of Salud Publica Of Mexico Insp National Institute Of Public Health Of Mexico | Lacasana Navarro M.,Campus Universitario Of La Cartuja | Lacasana Navarro M.,CIBER ISCIII | Aguilar-Garduno C.,Campus Universitario Of La Cartuja | And 7 more authors.
Occupational and Environmental Medicine | Year: 2012

Objectives: p,p′-Dichlorodiphenyldichloroethene (p,p′-DDE) acts as an androgen receptor antagonist, however data regarding its hormonal effects in men are limited. The objective of this study was to evaluate the association between serum levels of p,p′-DDE and reproductive hormone profile in Mexican male flower growers. Methods: A longitudinal study was carried out in a population of men working in the production of flowers and ornamental plants in two Mexican states during July-October 2004 (rainy season) and December 2004-May 2005 (dry season). A questionnaire including information on socioeconomic characteristics, tobacco and alcohol use, presence of chronic and acute diseases, occupational history and anthropometry was used and blood and urine samples were obtained. Serum levels of p,p′-DDE were analysed by gas chromatography; FSH, LH, testosterone, oestradiol, inhibin B and prolactin levels were measured by enzymatic immunoassay. Urinary levels of dialkylphosphates (DAPs) were analysed by gas chromatography. Associations between serum levels of p,p′-DDE and male reproductive hormones (both transformed to their natural logarithm) were evaluated using multivariate generalised estimating equation (GEE) models. Results: Median p,p′-DDE levels were 677.2 ng/g lipid (range 9.4-12 696.5) during the rainy season and 626.7 ng/g lipid (range 9.4-13 668.1) during the dry season. After adjusting for potential confounders (age, body mass index, state of residence and DAPs), p,p′-DDE levels were negatively associated with prolactin (β=-0.04; 95% CI -0.07 to -0.008) and testosterone (β=0.04; 95% CI -0.08 to 0.005) and positively with inhibin B (β=0.11; 95% CI 0.02 to 0.21). Conclusion: These results indicate that p,p′-DDE can affect hypothalamic-pituitary- gonadal axis function in humans.


Blanco-Munoz J.,National University of Costa Rica | Morales M.M.,CINVESTAV | Lacasana M.,Campus Universitario Of La Cartuja | Lacasana M.,CIBER ISCIII | And 3 more authors.
Human Reproduction | Year: 2010

Background: Studies on experimental animals have found that organophosphate (OP) pesticides may act as endocrine disruptors; however, their effects on the human hormonal profile have not yet been adequately characterized. We evaluate the association between exposure to OP pesticides, measured through dialkyl phosphate (DAP) metabolites urinary levels, and the male hormone profile. Methods: A cross-sectional study was performed in 104 floriculturists of Morelos, Mexico. A structured questionnaire was applied to get information on sociodemographic characteristics, anthropometry, clinical history, alcohol and tobacco consumption, and work history. DAP metabolites [dimethylphosphate (DMP), dimethylthiophosphate, dimethyldithiophosphate, diethylphosphate (DEP), diethylthiophosphate (DETP) and diethyldithiophosphate] were determined using gas-liquid chromatography. Serum levels of FSH, LH, prolactin, testosterone, inhibin B and estradiol were determined using enzyme-linked immunosorbent assay. Multiple linear regression was used to study the association between DAP metabolite levels and male hormonal profile. Data were adjusted by p,p′-dichlorodiphenyldichloroethene serum levels and other potential confounders. Results: There was a negative association between inhibin B and urinary levels of DMP, DEP, DETP and total DAP metabolites. DEP levels were negatively associated with serum FSH concentrations, but marginally and positively associated with those of testosterone. DETP was marginally associated with lower LH serum levels. There were no other significant associations among OP metabolites and serum hormone levels. Conclusion: SInhibin B and FSH vary according to levels of DAP metabolites in men occupationally exposed to OP pesticides. These Results: suggest that OP pesticides could act as endocrine disruptors in humans; however, most hormonal values fell within the wide normal range and associations were small. There is, therefore, a need for further investigation to elucidate their biological and clinical relevance. © 2010 The Author.


Blanco-Munoz J.,National University of Costa Rica | Lacasana M.,National University of Costa Rica | Lacasana M.,Campus Universitario Of La Cartuja | Lacasana M.,CIBER ISCIII | And 2 more authors.
Science of the Total Environment | Year: 2012

The nowledge about the effect of cigarette smoking on the male reproductive function is still limited. The objective of this study was to evaluate the association between active exposure to tobacco smoke and the male reproductive hormone profile in a group of 136 Mexican flower growers. Serum levels of FSH, LH, prolactin, total testosterone, Inhibin B and estradiol were measured using enzyme-linked immunoabsorbent assay. Weight and height were also measured and a structured questionnaire was applied to get information on sociodemographic characteristics, clinical and work history and alcohol and tobacco consumption (current smoking habit and number of cigarettes smoked per day). Based on this information tobacco consumption was divided into four categories: never-smokers, ex-smokers, current smokers under five cigarettes/day and current smokers over or equal to five cigarettes/day. Using the group of never-smokers as reference and after adjusting for potential confounders, current smokers of five or more cigarettes/day showed significantly higher levels of LH (β = 0.33, p = 0.01), prolactin (β = 0.18, p = 0.03) and testosterone (β = 0.21, p = 0.02). Current smokers of less than five cigarettes/day also showed higher levels of prolactin (β = 0.12, p = 0.03) and testosterone (β = 0.18, p < 0.01). Hormone levels of ex-smokers were similar to those of never-smokers. Our results are compatible with the hypothesis that tobacco consumption may act as an endocrine disruptor on the male hormone profile. © 2012 Elsevier B.V.


Salgado T.M.,University of Lisbon | Arguello B.,University of Lisbon | Martinez-Martinez F.,Campus Universitario Of La Cartuja | Benrimoj S.I.,University of Technology, Sydney | Fernandez-Llimos F.,University of Lisbon
European Journal of Clinical Pharmacology | Year: 2013

Purpose: Information about dosing adjustments in patients with chronic kidney disease is important to avoid toxicity for several medicines. The aim of our study was to assess the clinical relevance of the instructions for dose adjustment in patients with renal impairment provided in the Summaries of Product Characteristics (SmPCs) approved by the European Medicines Agency (EMA). Methods: SmPCs available on the EMA website on April 2011 were retrieved, and information on the elimination route and instructions for use in renal impairment was analysed independently by two of the authors. SmPCs were classified as containing 'explicit' or 'poor' information based on whether they presented (or not) instructions for use of the medicine in renal impairment. Information was considered 'relevant' if SmPCs provided clear instructions for dose adjustment. Results: Of the 356 SmPCs analysed, 13.8 and 37.4 % were classified as providing poor information and explicit but not relevant information, respectively. Only 48.8 % SmPCs provided both explicit and relevant information on medicine use in renal impairment. No difference was found in the average time since last update among SmPCs classified as containing explicit or poor information, as well as those classified as containing relevant or not relevant information. Also, no association was found between the clinical relevance of the information and whether or not the medication was an orphan drug, and 80 % SmPCs did not provide information on the use of the medicine in patients undergoing haemodialysis. Conclusions: Based on our analysis, current versions of SmPCs are characterised by several information deficits and by containing recommendations that are not relevant to clinical practice in terms of dose adjustment in renal impairment. These shortcomings might limit their usefulness for healthcare professionals and integration into clinical decision-making support systems. © 2013 Springer-Verlag Berlin Heidelberg.


PubMed | Hospital Universitario Virgen Macarena, Hospital Universitario Virgen del Rocio, Pediatria Atencion Primaria and Campus Universitario Of La Cartuja
Type: | Journal: Anales de pediatria (Barcelona, Spain : 2003) | Year: 2017

The postcode (where the home is situated) is an indicator of socioeconomic status and is associated with morbidity, mortality, and the use of health services. The aim of this study was to analyse its effects on paediatric admissions and to determine the rates of the most common causes of paediatric admissions in Seville.An observational cross-sectional study with two analysis units: under 15 year-old admissions in public hospitals in Seville (n=2,660) and city districts of Seville (n=11). The independent variable analysed was whether the postcode of the admitted patients was within a Regional Government designated area with social transformation needs. The analysis of the admissions was performed using XChildren living in districts with a lower socioeconomic status were on average 7 months younger (P<.001), and they were significantly more likely to be admitted via the emergency department (P<.001). There was no statistical difference detected in either the length of hospital stay or mortality. The crude admission rate ratio was higher in districts with a lower socioeconomic status (1.8), with a higher specific rate ratio detected in admissions due to asthma, respiratory infections, inguinal hernia, and epilepsy/convulsions.Paediatric hospital admission rates of the main diagnoses were higher in districts with a lower socioeconomic status. Children living in these districts were more likely to be admitted younger and via the emergency department.


Tagiew R.,TU Bergakademie Freiberg | Ignatov D.I.,National Research University Higher School of Economics | Amroush F.,Campus Universitario Of La Cartuja
Proceedings - IEEE 13th International Conference on Data Mining Workshops, ICDMW 2013 | Year: 2013

In this paper, we want to introduce experimental economics to the field of data mining and vice versa. It continues related work on mining deterministic behavior rules of human subjects in data gathered from experiments. Game-theoretic predictions partially fail to work with this data. Equilibria also known as game-theoretic predictions solely succeed with experienced subjects in specific games - conditions, which are rarely given. Contemporary experimental economics offers a number of alternative models apart from game theory. In relevant literature, these models are always biased by philosophical plausibility considerations and are claimed to fit the data. An agnostic data mining approach to the problem is introduced in this paper - the philosophical plausibility considerations follow after the correlations are found. No other biases are regarded apart from determinism. The dataset of the paper ''Social Learning in Networks' by Choi et al 2012 is taken for evaluation. As a result, we come up with new findings. As future work, the design of a new infrastructure is discussed. © 2013 IEEE.

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