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Rovira E.,Catalonia Public Health Agency | Rovira E.,Institute dInvestigacio Sanitaria Pere Virgili | Cuadras A.,Catalonia Public Health Agency | Cuadras A.,Institute dInvestigacio Sanitaria Pere Virgili | And 13 more authors.
Environmental Research | Year: 2014

Residential proximity to environmental hazards has been related to adverse health outcomes. Respiratory health and allergies in children living near petrochemical sites have not been extensively studied. We evaluated the association between residential proximity to the petrochemical site of Tarragona (Catalonia, Spain) and the prevalence of asthma, respiratory symptoms and lung function in children. Children aged 6-7 (n=2672) and adolescents aged 13-14 (n=2524) residing near two large petrochemical sites and those living in a city with medium vehicular traffic were cross-sectionally compared with children from an area with low vehicular traffic and without industry. The prevalence of symptoms was measured using the International Study of Asthma and Allergies in Childhood written and video questionnaires. Lung function measurements were done in a subsample of 959 adolescents in the four areas. Multivariable analyses were done to estimate the effects of the residential area on symptoms and lung function adjusted for potential confounders. Crude prevalence of symptoms was similar across the studied areas. After adjustment, children and adolescents living near a petrochemical site had a statistically significant higher prevalence of respiratory hospitalizations in the previous year (Prevalence Ratio (PR)=1.49; 95%CI, 1.06-2.09) and of nocturnal cough (PR=1.29; 95%CI 1.05-1.57), respectively. Reduced lung function values among adolescents residing near the petrochemical areas were not observed. Although a higher prevalence of asthma in children and adolescents living near the petrochemical sites could not be demonstrated, as described in other studies, respiratory hospitalizations and nocturnal cough could be related to short-term exposures to pollutants. Other clinical and sub-clinical respiratory health effects in the petrochemical industry areas should be investigated. © 2014 Elsevier Inc.


Vinaixa M.,Rovira i Virgili University | Vinaixa M.,Institute dInvestigacio Sanitaria Pere Virgili | Rodriguez M.A.,Rovira i Virgili University | Rodriguez M.A.,Institute dInvestigacio Sanitaria Pere Virgili | And 14 more authors.
PLoS ONE | Year: 2011

Polycystic ovary syndrome (PCOS) is a variable disorder characterized by a broad spectrum of anomalies, including hyperandrogenemia, insulin resistance, dyslipidemia, body adiposity, low-grade inflammation and increased cardiovascular disease risks. Recently, a new polytherapy consisting of low-dose flutamide, metformin and pioglitazone in combination with an estro-progestagen resulted in the regulation of endocrine clinical markers in young and non-obese PCOS women. However, the metabolic processes involved in this phenotypic amelioration remain unidentified. In this work, we used NMR and MS-based untargeted metabolomics to study serum samples of young non-obese PCOS women prior to and at the end of a 30 months polytherapy receiving low-dose flutamide, metformin and pioglitazone in combination with an estro-progestagen. Our results reveal that the treatment decreased the levels of oxidized LDL particles in serum, as well as downstream metabolic oxidation products of LDL particles such as 9- and 13-HODE, azelaic acid and glutaric acid. In contrast, the radiuses of small dense LDL and large HDL particles were substantially increased after the treatment. Clinical and endocrine-metabolic markers were also monitored, showing that the level of HDL cholesterol was increased after the treatment, whereas the level of androgens and the carotid intima-media thickness were reduced. Significantly, the abundance of azelaic acid and the carotid intima-media thickness resulted in a high degree of correlation. Altogether, our results reveal that this new polytherapy markedly reverts the oxidant status of untreated PCOS women, and potentially improves the pro-atherosclerosis condition in these patients. © 2011 Vinaixa et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Diaz-Lopez A.,Institute dInvestigacio Sanitaria Pere Virgili | Diaz-Lopez A.,CIBER ISCIII | Bullo M.,Institute dInvestigacio Sanitaria Pere Virgili | Bullo M.,CIBER ISCIII | And 11 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2013

Context and Objective: Because it has been suggested that osteocalcin (OC), an osteoblast-derived hormone, is a new link between bone and glucose metabolism, we tested whether serum carboxylated osteocalcin (cOC) and undercarboxylated osteocalcin (ucOC) levels are independently associated with the development of type 2 diabetes in subjects at high cardiovascular risk. Design, Setting, and Participants: A prospective, nested case-control study was conducted using datafromthe Prevención con Dieta Mediterrá nea(PREDIMED)study.Weincluded 153 case subjects with newly diagnosed diabetes and 306 individually matched control subjects free of diabetes identified during a mean 5-year follow-up. Conditional logistic regression models were used to estimate matched odds ratios for incident diabetes according to categories of both forms of OC measured by ELISAs. Results: Baseline serum concentrations of both forms ofOCwere significantly lower in case subjects than in control subjects. In subjects with incident cases of diabetes, concentrations of cOC, but not of ucOC, were inversely and significantly associated with homeostasis model assessment of insulin resistance levels (β = -0.335) and with fasting glucose concentrations (β = -0.044) in control subjects, independent of other relevant confounders. In the conditional logistic model that took into account the matching factors, the odds ratios for diabetes incidence in the lowest vs the highest tertile of cOC and ucOC were 2.03 (95% confidence interval, 1.32-3.13) and 1.88 (1.23- 2.85), respectively. Further adjustment for family history of diabetes, lifestyle, and other confounding factors did not appreciably change the magnitude of these associations. Conclusion: In a population at high cardiovascular risk, low concentrations of serum cOC and ucOC were strongly associated with an increased risk of incident diabetes. Copyright © 2013 by The Endocrine Society.


Closa-Monasterolo R.,Rovira i Virgili University | Closa-Monasterolo R.,Institute dInvestigacio Sanitaria Pere Virgili | Ferre N.,Rovira i Virgili University | Ferre N.,Institute dInvestigacio Sanitaria Pere Virgili | And 15 more authors.
American Journal of Clinical Nutrition | Year: 2011

Background: Nutritional factors during a sensitive period can influence child development in a sex-related manner. Objective: Our aim was to investigate whether sex modulates the responses of relevant biochemical parameters and growth to different protein intakes early in life. Design: In a randomized controlled trial, formula-fed infants were assigned to receive formula with higher protein (HP) or lower protein (LP) content. The main outcome measures were insulin-like growth factor (IGF)-1 axis parameters, weight, length, BMI, leptin, and C-peptide/creatinine ratio at 6 mo of age. Dietary intake during the first 6 mo of life was also assessed. Results: The IGF-1 axis response to HP feeding was modulated by sex. Total and free IGF-1 and IGF binding protein 3 concentrations were higher in girls than in boys. Compared with the LP diet, the HP diet was associated with higher IGF-1 and lower IGF binding protein 2 secretion. The response to this HP content formula tended to be stronger in girls than in boys. The HP diet was associated with a higher C-peptide/creatinine ratio. The leptin concentration was higher in girls than in boys and was correlated to the IGF-1 axis parameters. No interaction between sex and nutritional intervention was shown on growth. Conclusions: Our findings show that the endocrine response to a high protein diet early in life may be modulated by sex. The IGF-1 axis of female infants shows a stronger response to the nutritional intervention than does that of male infants, but there is no enhanced effect on growth. This trial was registered at clinicaltrials. gov as NCT00338689. © 2011 American Society for Nutrition.


Guix J.,Servei Regional al Camp de Tarragona | Guix J.,Rovira i Virgili University | Guix J.,Institute dInvestigacio Sanitaria Pere Virgili | Bocio A.,Servei Regional al Camp de Tarragona | And 7 more authors.
Gaceta Sanitaria | Year: 2013

Public health action on a territory is complex and requires the involvement of multiple actors, who do not always act coordinately. Networks of organizations structures including the whole of the local actors facilitate the generation of synergies and enable greater effectiveness and efficiency of the joint action from the different actors on a same landscape. We present 3 years experience of four Public Health Committees in a region of Catalonia (Spain), composed by the main actors in public health planning. Each of the committees is organized on a plenary and working groups on issues arising from the regional health diagnosis, and coincident with the Health Plan of the Region. Coordination in no case implies the loss or dilution of the firm of the actor generator of intervention initiative in public health, but their empowerment and collaboration by the other actors. In conclusion welcomes the creation of a culture of collaboration and synergies between the different organizations concerned. Lack of specificity is observed in establishing operational objectives, and the need for greater coordination and involvement of the components of the various working groups. © 2012 SESPAS.


Miro J.,Unit for the Study and Treatment of Pain ALGOS | Miro J.,Institute dInvestigacio Sanitaria Pere Virgili | Miro J.,Rovira i Virgili University | Huguet A.,Unit for the Study and Treatment of Pain ALGOS | Jensen M.P.,University of Washington
Pain Medicine (United States) | Year: 2014

Objective: Pain attitudes and beliefs are hypothesized to influence pain and adjustment to pain. Valid and reliable measures of these beliefs are necessary to test their hypothesized associations with outcomes. The Pediatric version of the Survey of Pain Attitudes (Peds-SOPA) is a new measure with limited evidence regarding its psychometric properties. This study sought to: 1) evaluate the predictive validity, reliability, and factor structure of the Peds-SOPA; and 2) determine if there are sex- or age-related differences in children's attitudes toward pain. Design: Longitudinal study. Participants: Five hundred and sixty-one schoolchildren between 8 and 16 years old participated in this study. Results: Factor analyses supported the seven-factor structure described by the original authors. The Peds-SOPA showed acceptable reliability with Cronbach alpha values ranging from 0.68 to 0.80. The Peds-SOPA scales also demonstrated prospective predictive validity via their associations with pain intensity, and pain status at 1-year follow-up. The findings also showed some few sex- and age-specific differences in the Peds-SOPA scores. Conclusions: The current findings provide additional support for the reliability and validity of the Peds-SOPA, and suggest that children's pain attitudes and beliefs might be important intervention targets in pain treatment. © 2014 American Academy of Pain Medicine.


Miro J.,Unit for the Study and Treatment of Pain ALGOS | Miro J.,Research Center for Behavior Assessment | Miro J.,Institute Dinvestigacio Sanitaria Pere Virgili | de la Vega R.,Unit for the Study and Treatment of Pain ALGOS | And 11 more authors.
Disability and Rehabilitation | Year: 2016

Purpose: The purpose of this study is to identify the cutoffs that are most suitable for classifying average and worst pain intensity as being mild, moderate, or severe in young people with physical disabilities. Method: Survey study using a convenience sample of 113 young people (mean age = 14.19; SD = 2.9; age range: 8–20) with physical disabilities (namely, spinal cord injury, cerebral palsy, spina bifida, limb deficiency (acquired or congenital), or neuromuscular disease). Results: The findings support a non-linear association between pain intensity and pain interference. In addition, the optimal cutoffs for classifying average and worst pain as mild, moderate, or severe differed. For average pain, the best cutoffs were the following: 0–3 for mild, 4–6 for moderate, and 7–10 for severe pain, whereas the optimal classification for worst pain was 0–4 for mild, 5–6 for moderate, and 7–10 for severe pain. Conclusions: The findings provide important information that may be used to help make decisions regarding pain treatment in young people with disabilities and also highlight the need to use different cutoffs for classifying pain intensity in young people with disabilities than those that have been suggested for adults with chronic pain.Implications for rehabilitationMost clinical guidelines make treatment recommendations based on classifications of pain intensity as being mild, moderate, and severe that do not have a clear cut association with pain intensity ratings.Cutoffs that are deemed to be the most appropriate for classifying pain intensity as mild, moderate, and severe appear to depend, at least in part, on the pain population that is being studied and pain domain that is being used.This work helps to advance our knowledge regarding the meaning of pain intensity ratings in young people with physical disabilities.Clinicians can use this information to make empirically guided decisions regarding when to intervene in young people with disabilities and chronic pain. © 2016 Informa UK Limited, trading as Taylor & Francis Group


Llaurado-Serra M.,Institute dinvestigacio Sanitaria Pere Virgili | Llaurado-Serra M.,University Hospital Joan | Llaurado-Serra M.,Rovira i Virgili University | Ulldemolins M.,Autonomous University of Barcelona | And 27 more authors.
Medicina Intensiva | Year: 2015

Objectives: To evaluate head-of-bed elevation (HOBE) compliance in mechanically ventilated (MV) patients during different time periods, in order to identify factors that may influence compliance and to compare direct-observation compliance with checklist-reported compliance. Design and setting: A prospective observational study was carried out in a polyvalent Intensive Care Unit. Patients: All consecutive patients with MV and no contraindication for semi-recumbency were studied. Intervention and variables: HOBE was observed during four periods of one month each for one year, the first period being blinded. HOBE was measured with an electronic device three times daily. Main variables were HOBE, type of airway device, type of bed, nursing shift, day of the week and checklist-reported compliance. No patient characteristics were collected. Results: During the four periods, 2639 observations were collected. Global HOBE compliance was 24.0%, and the median angle head-of-bed elevation (M-HOBE) was 24.0° (IQR 18.8-30.0). HOBE compliance and M-HOBE by periods were as follows: blinded period: 13.8% and 21.1° (IQR 16.3-24.4); period 1: 25.5% and 24.3° (IQR 18.8-30.2); period 2: 22.7% and 24.4° (IQR 18.9-29.6); and period 3: 31.4% and 26.7° (IQR 21.3-32.6) (p<. 0.001). An overestimation of 50-60% was found when comparing self-reported compliance using a checklist versus direct-observation compliance (p<. 0.001).Multivariate logistic regression analysis found the presence of an endotracheal tube (ET) and bed without HOBE measuring device to be independently associated to greater compliance (p<. 0.05). Conclusions: Although compliance increased significantly during the study period, it was still not optimal. Checklist-reported compliance significantly overestimated HOBE compliance. The presence of an ET and a bed without HOBE measuring device was associated to greater compliance. © 2014 Elsevier España, S.L.U. and SEMICYUC.


Tome-Pires C.,Chair in Pediatric Pain URV FundacionGrunenthal and Unit for the Study and Treatment of Pain ALGOS | Tome-Pires C.,Research Center for Behavior Assessment | Tome-Pires C.,Institute dInvestigacio Sanitaria Pere Virgili | Sole E.,Chair in Pediatric Pain URV FundacionGrunenthal and Unit for the Study and Treatment of Pain ALGOS | And 14 more authors.
Scandinavian Journal of Pain | Year: 2016

Background Psychological factors are thought to impact headache as triggering, maintaining, and exacerbating factors. A better understanding of the role that modifiable factors, such as anxiety or depression, play in the impact of migraine could help identify potential treatment targets in this population. Objectives The objective of this study was to evaluate the relative importance of anxiety and depression as predictors of the impact of migraine on function. Thus, we aim to understand the relative importance that anxiety and depression have on the impact of migraines by assessing both and some life domains. Methods Cross-sectional study involving forty-three individuals, mostly females (93%), with migraine headaches aged between 20 and 60 years old. Participants answered questions about headache pain intensity at the time of data collection and the usual in the past 30 days (0–10 Numerical Rating Scales) as well as other pain characteristics (i.e., duration, frequency, and duration), headache impact (vitality and social, role, and cognitive functioning), anxiety and depression by using the Hospital Anxiety and Depression Scale. Results Anxiety (r = 0.56, p < .001), but not depression (r = 0.09, p = .59), was significantly associated with headache impact. Thus showing the relative importance that anxiety has on headache impact. Conclusions The findings support a larger role for anxiety than depression in the impact of migraine headaches on patient function. There are a number of mechanisms by which anxiety could potentially influence the impact of headache on patient function, and this study highlights that anxiety could potentially be a trigger of headache activity. Implications The findings thus suggest the possibility that treatments that focus on anxiety might be potentially more important for individuals with migraine than treatments that focus on depression, at least with respect to having a beneficial impact on the interference of headache with activity. Research is needed to evaluate the beneficial impact of anxiety treatment in individuals with migraine headaches. Clinicians should evaluate and consider treating, as appropriate and necessary, anxiety in patients with migraine. © 2016 Scandinavian Association for the Study of Pain


Hanhineva K.,University of Eastern Finland | Lankinen M.A.,University of Eastern Finland | Pedret A.,Institute dInvestigacio Sanitaria Pere Virgili | Schwab U.,University of Eastern Finland | And 10 more authors.
Journal of Nutrition | Year: 2015

Background: Nontargeted metabolite profiling allows for concomitant examination of a wide range of metabolite species, elucidating the metabolic alterations caused by dietary interventions. Objective: The aim of the current study was to investigate the effects of dietary modifications on the basis of increasing consumption of whole grains, fatty fish, and bilberries on plasma metabolite profiles to identify applicable biomarkers for dietary intake and endogenous metabolism. Methods: Metabolite profiling analysiswas performed on fasting plasma samples collected in a 12-wk parallel-group interventionwith 106 participantswith features ofmetabolic syndrome whowere randomly assigned to 3 dietary interventions: 1)whole-grain products, fatty fish, and bilberries [healthy diet (HD)]; 2) a whole-grain-enriched diet with the same grain products as in the HD intervention but with no change in fish or berry consumption; and 3) refined-wheat breads and restrictions on fish and berries (control diet). In addition, correlation analyses were conducted with the food intake data to define the food items correlating with the biomarker candidates. Results: Nontargetedmetabolite profiling showed marked differences in fasting plasma after the intervention diets compared with the control diet. In both intervention groups, a significant increase was observed in 2 signals identified as glucuronidated alk(en)- ylresorcinols [corrected P value (Pcorr) < 0.05], which correlated strongly with the intake of whole-grain products (r=0.63, P < 0.001). In addition, the HD intervention increased the signals for furan fatty acids [3-carboxy-4-methyl-5-propyl-2-furanpropionic acid (CMPF)], hippuric acid, and various lipid species incorporating polyunsaturated fatty acids (Pcorr < 0.05). In particular, plasma CMPF correlated strongly with the intake of fish (r = 0.47, P < 0.001) but not with intakes of any other foods. Conclusions: Novel biomarkers of the intake of health-beneficial food items included in the Nordic diet were identified by the metabolite profiling of fasting plasma and confirmed by the correlation analyses with dietary records. The one with the most potential was CMPF, which was shown to be a highly specific biomarker for fatty fish intake. This trial was registered at clinicaltrials.gov as NCT00573781. © 2015 American Society for Nutrition.

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