Marti R.,Institute Catala Of La Salut |
Marti R.,Institute Dinvestigacio Biomedica Of Girona Dr Josep Trueta Idibgi |
Parramon D.,Institute Catala Of La Salut |
Parramon D.,Institute Dinvestigacio Biomedica Of Girona Dr Josep Trueta Idibgi |
And 14 more authors.
BMC Cardiovascular Disorders | Year: 2011
Background: Cardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. Our purpose is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population.Methods/Design: This project involves 3 groups belonging to REDIAPP (RETICS RD06/0018) from 3 Spanish regions. We will recruit a multicenter cohort of 2688 patients at intermediate risk (coronary risk between 5 and 15% or vascular death risk between 3-5% over 10 years) and no history of atherosclerotic disease, selected at random. We will record socio-demographic data, information on diet, physical activity, comorbidity and intermittent claudication. We will measure ABI, pulse wave velocity and cardio ankle vascular index at rest and after a light intensity exercise. Blood pressure and anthropometric data will be also recorded. We will also quantify lipids, glucose and glycosylated hemoglobin in a fasting blood sample and postprandial capillary glucose. Eighteen months after the recruitment, patients will be followed up to determine the incidence of vascular events (later follow-ups are planned at 5 and 10 years). We will analyze whether the new proposed risk factors contribute to improve the risk functions based on classic risk factors.Discussion: Primary prevention of cardiovascular diseases is a priority in public health policy of developed and developing countries. The fundamental strategy consists in identifying people in a high risk situation in which preventive measures are effective and efficient. Improvement of these predictions in our country will have an immediate, clinical and welfare impact and a short term public health effect.Trial Registration: Clinical Trials.gov Identifier: NCT01428934. © 2011 Martí et al; licensee BioMed Central Ltd.
Bosch de Basea M.,Center for Research in Environmental Epidemiology |
Bosch de Basea M.,University Pompeu Fabra |
Bosch de Basea M.,CIBER ISCIII |
Salotti J.A.,Royal Infirmary |
And 16 more authors.
Pediatric Radiology | Year: 2016
Background: Although there are undeniable diagnostic benefits of CT scanning, its increasing use in paediatric radiology has become a topic of concern regarding patient radioprotection. Objective: To assess the rate of CT scanning in Catalonia, Spain, among patients younger than 21 years old at the scan time. Materials and methods: This is a sub-study of a larger international cohort study (EPI-CT, the International pediatric CT scan study). Data were retrieved from the radiological information systems (RIS) of eight hospitals in Catalonia since the implementation of digital registration (between 1991 and 2010) until 2013. Results: The absolute number of CT scans annually increased 4.5% between 1991 and 2013, which was less accentuated when RIS was implemented in most hospitals. Because the population attending the hospitals also increased, however, the rate of scanned patients changed little (8.3 to 9.4 per 1,000 population). The proportions of patients with more than one CT and more than three CTs showed a 1.51- and 2.7-fold increase, respectively, over the 23 years. Conclusion: Gradual increases in numbers of examinations and scanned patients were observed in Catalonia, potentially explained by new CT scanning indications and increases in the availability of scanners, the number of scans per patient and the size of the attended population. © 2015, The Author(s).
Proportion of breast cancer in women aged 50 to 69 years from Girona, Spain, according to detection method [Proporción de cáncer de mama en mujeres de 50 a 69 años de Girona según el método de detección]
Puig-Vives M.,Institute Dinvestigacio Biomedica Of Girona Dr Josep Trueta Idibgi |
Puig-Vives M.,University of Girona |
Puig-Vives M.,Research Center Biomedica En Red Of Epidemiologia lud Publica |
Osca-Gelis G.,Institute Dinvestigacio Biomedica Of Girona Dr Josep Trueta Idibgi |
And 9 more authors.
Medicina Clinica | Year: 2014
Background and objective The aim of this study was to determine the tumor stage, the proportion of cases and the age specific rate of breast cancer (BC) cases according to detection method. Material and method Cases of women aged 50 to 69 years diagnosed with BC in the Girona province during 1999-2006 were extracted from the population-based Girona Cancer Registry (n = 1,254). BC was classified by detection method: screen-detected cancer, interval cancer and others. Proportion of cases and age-specific incidence were calculated according to detection method. Results During the period 2002-2006, the proportion of screen-detected cancers, interval cancers and other cancers were 42.2%, 5.8% and 52.2%, respectively. After implementation of the early detection of breast cancer program (PDPCM), the incidence of screen-detected cases raised; thereafter, interval cancers also increased and the rate of other cancers decreased. Conclusions In the Girona province during the fully implemented PDPCM period (2002-2006), interval cancers represented a low proportion (5.8%) of women diagnosed with BC at 50 to 69 years old. © 2013 Elsevier España, S.L.U.
Pol-Pons,Institute Catala Of La Salut |
Aubanell-Serra,Institute Catala Of La Salut |
Vidal,Institute Catala Of La Salut |
Ojeda-Ciurana,Institute Catala Of La Salut |
And 6 more authors.
Midwifery | Year: 2016
Background validated and reliable tools measuring the level of competence about breastfeeding amongst health professionals who attend mothers in primary care are scarce. Objective to develop and validate a self-administered online questionnaire to assess basic competence about breastfeeding in the full range of health professionals attending lactating mothers in primary care. Design methodological study. Settings the study was conducted in 33 primary care centers administered by the Catalan Health Institute (Institut Català de la Salut) in the Girona Region (northeast Spain). Participants the questionnaire was sent to 398 health professionals who were likely to be in contact with breast feeding mothers. We included midwives, general practitioners, pediatric nurses (who provide care for children from birth to 14 years old), non-pediatric nurses (who provide care for patients older than 14 year), pediatricians, and gynecologists. The random sampling was stratified by discipline to ensure representativeness. Methods the development and validation of the self-administered online questionnaire had five phases: (1) literature review, preparation of a draft for evaluation by an expert panel and pilot study; (2) design of a questionnaire based on observations from Phase 1; (3) questionnaire administration to a random sample of 398 health professionals, stratified by discipline; (4) re-testing after four weeks; and (5) assessment of construct validity using factor analysis and hypothesis-testing, comparing scores between professional groups and estimating effect size. Internal consistency was assessed by Cronbach alpha and reproducibility by the intraclass correlation coefficient. Findings The response rate was 69.3%. The final version of the questionnaire has 24 items. The uni-dimensionality of the questionnaire was confirmed by the factor analysis. The score differed significantly between professional groups (F=12.904; p<0.001), among whom midwives achieved the highest score (129±10 points) and non-pediatric nurses the lowest (111±14 points).The effect sized values ranged from 0.6 and 1.5. Cronbach alpha was 0.870 (95% CI: 0.847, 0.891) and intraclass correlation coefficient was 0.856 (95%CI: 0.817, 0.888). Conclusions this is a valid and reliable questionnaire to assess a basic level of competence about breast feeding among primary care professionals involved in supporting breast-feeding mothers. This questionnaire may help to identify health professionals who require support to improve their capability to manage women who are breast feeding. © 2016 The Authors
Vert A.,Laboratori Denginyeria Of Proteines |
Vert A.,Institute Dinvestigacio Biomedica Of Girona Dr Josep Trueta Idibgi |
Castro J.,Laboratori Denginyeria Of Proteines |
Castro J.,Institute Dinvestigacio Biomedica Of Girona Dr Josep Trueta Idibgi |
And 12 more authors.
Molecular Pharmaceutics | Year: 2012
Ribonucleases are promising agents for use in anticancer therapy. Engineering a nuclear localization signal into the sequence of the human pancreatic ribonuclease has been revealed as a new strategy to endow this enzyme with cytotoxic activity against tumor cells. We previously described a cytotoxic human pancreatic ribonuclease variant, named PE5, which is able to cleave nuclear RNA, inducing the apoptosis of cancer cells and reducing the amount of P-glycoprotein in different multidrug-resistant cell lines. These results open the opportunity to use this ribonuclease in combination with other chemotherapeutics. In this work, we have investigated how to improve the properties of PE5 as an antitumor drug candidate. When attempting to develop a recombinant protein as a drug, two of the main desirable attributes are minimum immunogenicity and maximum potency. The improvements of PE5 have been designed in both senses. First, in order to reduce the potential immunogenicity of the protein, we have studied which residues mutated on PE5 can be reverted to those of the wild-type human pancreatic ribonuclease sequence without affecting its cytotoxicity. Second, we have investigated the effect of introducing an additional nuclear localization signal at different sites of PE5 in an effort to obtain a more cytotoxic enzyme. We show that the nuclear localization signal location is critical for the cytotoxicity. One of these variants, named NLSPE5, presents about a 10-fold increase in cytotoxicity respective to PE5. This variant induces apoptosis and kills the cells using the same mechanism as PE5. © 2012 American Chemical Society.
PubMed | Hospital Dr Josep Trueta, Institute Dinvestigacio Biomedica Of Girona Dr Josep Trueta Idibgi and España University
Type: Journal Article | Journal: Medicina clinica | Year: 2014
The aim of this study was to determine the tumor stage, the proportion of cases and the age specific rate of breast cancer (BC) cases according to detection method.Cases of women aged 50 to 69 years diagnosed with BC in the Girona province during 1999-2006 were extracted from the population-based Girona Cancer Registry (n=1,254). BC was classified by detection method: screen-detected cancer, interval cancer and others. Proportion of cases and age-specific incidence were calculated according to detection method.During the period 2002-2006, the proportion of screen-detected cancers, interval cancers and other cancers were 42.2%, 5.8% and 52.2%, respectively. After implementation of the early detection of breast cancer program (PDPCM), the incidence of screen-detected cases raised; thereafter, interval cancers also increased and the rate of other cancers decreased.In the Girona province during the fully implemented PDPCM period (2002-2006), interval cancers represented a low proportion (5.8%) of women diagnosed with BC at 50 to 69 years old.