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Cangas de Onís, Spain

Alvarez Caro F.,Hospital Carmen y Severo Ochoa | Diaz Martin J.J.,Hospital Central de Asturias | Riano Galan I.,Hospital San Agustin | Perez Solis D.,Hospital San Agustin | And 2 more authors.
Anales de Pediatria | Year: 2011

Introduction: Classic cardiovascular risk factors are present in infancy. C-reactive protein, leptin and adiponectin are the most important inflammatory cardiovascular risk markers. Patients and methods: A descriptive, cross-sectional study, including children aged 6-12 years old from two local primary schools in the city of Avilés. Body measurements were made to determine the prevalence of obesity and overweight. Systolic and diastolic blood pressure was measured and the presence of metabolic syndrome was determined. Family income, dietary, and life-style habits were collected using the questionnaires GRAFFAR, KIDMED and Self-report instruments for measuring physical activity, respectively. Blood analysis included lipid profile, insulin resistance profile, liver profile, C-reactive protein, leptin and adiponectin. Results: A total of 459 schoolchildren were included of whom 31% were overweight and 10.9% were obese. Obese children were heavier with higher levels of body mass index, waist circumference, blood pressure, C- reactive protein, leptin, and lower levels of HDL-cholesterol and apolipoprotein A than non-obese children. No differences were found in physical and sedentary activities, but obese children had a worse quality diet than non-obese children. Conclusions: Prevalence of obesity and overweight is reaching worrying levels in school age children. Obesity is associated with other classic and inflammatory cardiovascular risk factors. Obese children have a worse quality diet, although they do not do any less physical activities or any more sedentary than non-obese children. © 2010 Asociación Española de Pediatría. Published by Elsevier España, S.L. All rights reserved.

Lopez de Maturana E.,Genetic and Molecular Epidemiology Group | Picornell A.,Genetic and Molecular Epidemiology Group | Masson-Lecomte A.,Genetic and Molecular Epidemiology Group | Kogevinas M.,Center for Research in Environmental Epidemiology | And 87 more authors.
BMC Cancer | Year: 2016

Background: We adapted Bayesian statistical learning strategies to the prognosis field to investigate if genome-wide common SNP improve the prediction ability of clinico-pathological prognosticators and applied it to non-muscle invasive bladder cancer (NMIBC) patients. Methods: Adapted Bayesian sequential threshold models in combination with LASSO were applied to consider the time-to-event and the censoring nature of data. We studied 822 NMIBC patients followed-up >10years. The study outcomes were time-to-first-recurrence and time-to-progression. The predictive ability of the models including up to 171,304 SNP and/or 6 clinico-pathological prognosticators was evaluated using AUC-ROC and determination coefficient. Results: Clinico-pathological prognosticators explained a larger proportion of the time-to-first-recurrence (3.1%) and time-to-progression (5.4%) phenotypic variances than SNPs (1 and 0.01%, respectively). Adding SNPs to the clinico-pathological-parameters model slightly improved the prediction of time-to-first-recurrence (up to 4%). The prediction of time-to-progression using both clinico-pathological prognosticators and SNP did not improve. Heritability (ĥ 2) of both outcomes was <1% in NMIBC. Conclusions: We adapted a Bayesian statistical learning method to deal with a large number of parameters in prognostic studies. Common SNPs showed a limited role in predicting NMIBC outcomes yielding a very low heritability for both outcomes. We report for the first time a heritability estimate for a disease outcome. Our method can be extended to other disease models. © 2016 de Maturana et al.

Perez Guirado A.,CS de Cangas del Narcea | Fernandez Fernandez R.I.,CS de Cangas del Narcea | Arbesu Fernandez E.,Hospital Carmen y Severo Ochoa | Santos Rodriguez P.M.,CS de Cangas del Narcea
Pediatria de Atencion Primaria | Year: 2013

Lyme borreliosis is a multisystem disease mainly dermatological, rheumatical, neurological and cardio-logical. The detection and treatment in the early stages are essential to prevent its progression. The pediatrician, therefore, must be aware of the clinical presentations of the disease as well as to establish a correct diagnosis and treatment. Two cases are presented involving the most common forms of presentation.

Casado Escribano P.,Hospital La Princesa | Fernandez Rodriguez J.M.,Hospital Carmen y Severo Ochoa | Betegon Nicolas L.,Bristol Myers Squibb | Sanchez-Covisa J.,Astrazeneca | Brosa M.,Oblikue Consulting
Atencion Primaria | Year: 2015

Objective To assess the efficiency of the combined therapy with metformin and dapagliflozin, a new oral anti-diabetic drug with an insulin-independent mechanism of action, in the treatment of type-2 diabetes mellitus (T2DM) compared to DPP4 inhibitors, sulphonylureas and thiazolidindiones, also combined with metformin. Design Cost-effectiveness analysis using a discrete event simulation model based on the results of the available clinical trials and considering patient's entire life as time horizon. Setting National Health System perspective. Participants The model simulated the natural history of 30,000 patients with T2DM for each of the options compared. Main measurements Quality-adjusted life-years (QALY) and economic consequences of managing the disease and its complications. The analysis considered direct costs updated to 2013. A discount rate of 3% was applied to costs and health outcomes. Results In the main analysis comparing dapagliflozin with DPP4 inhibitors, dapagliflozin resulted in a treatment option that would provide a slightly higher effectiveness (0.019 QALY) and lower overall associated costs (-€42). In the additional analyses, dapagliflozin was a cost-effective option compared with sulphonylureas and thiazolidinediones resulting in a cost per QALY gained of €3,560 and €2,007, respectively. The univariate and probabilistic sensitivity analyses confirmed the robustness of the results. Conclusions The results of the analyses performed suggested that dapagliflozin, in combination with metformin, would be a cost-effective alternative in the Spanish context for the treatment of T2DM.

Molina-Infante J.,Hospital San Pedro de Alcantara | Lucendo A.J.,Hospital General | Angueira T.,Hospital General | Rodriguez-Tellez M.,Hospital Virgen Macarena | And 15 more authors.
Alimentary Pharmacology and Therapeutics | Year: 2015

Background Empiric triple therapy for Helicobacter pylori should be abandoned when clarithromycin resistance rate is >15-20%. Optimisation of triple therapy (high-dose acid suppression and 14-day duration) can increase eradication rates by 10%. Aim To compare the efficacy and safety of optimised triple (OPT-TRI) and nonbismuth quadruple concomitant (OPT-CON) therapies. Methods Prospective multicentre study in 16 Spanish centres using triple therapy in clinical practice. In a 3-month two-phase fashion, the first 402 patients received an OPT-TRI therapy [esomeprazole (40 mg b.d.), amoxicillin (1 g b.d) and clarithromycin (500 mg b.d) for 14 days] and the last 375 patients an OPT-CON treatment [OPT-TRI therapy plus metronidazole (500 mg b.d)]. Results Seven-hundred seventy-seven consecutive patients were included (402 OPT-TRI, 375 OPT-CON). The OPT-CON therapy achieved significantly higher eradication rates in the per-protocol [82.3% (95% CI = 78-86%) vs. 93.8% (91-96%), P < 0.001] and intention-to-treat analysis [81.3% (78-86%) vs. 90.4% (87-93%), P < 0.001]. Adverse events (97% mild/moderate) were significantly more common with OPT-CON therapy (39% vs. 47%, P = 0.016), but full compliance with therapy was similar between groups (94% vs. 92%, P = 0.4). OPT-CON therapy was the only significant predictor of successful eradication (odds ratio, 2.24; 95% CI: 1.48-3.51, P < 0.001). The rate of participating centres achieving cure rates ≥90% favoured OPT-CON therapy (OPT-TRI 25% vs. OPT-CON 62%). Conclusions Empiric OPT-CON therapy achieved significantly higher cure rates (>90%) compared to OPT-TRI therapy. Addition of metronidazole to OPT-TRI therapy increased eradication rates by 10%, resulting in more mild adverse effects, but without impairing compliance with therapy. © 2015 John Wiley & Sons Ltd.

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