Public Health Direction

Donostia / San Sebastián, Spain

Public Health Direction

Donostia / San Sebastián, Spain

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Mihaila R.-G.,Lucian Blaga University | Ciuta D.,Lucian Blaga University | Mihaila R.,Public Health Direction
Archives of the Balkan Medical Union | Year: 2010

Backgrund: Statins lower the cholesterol synthesis but also induce selective apoptosis and inhibit the proliferation of leukemic cells. Besides, they inhibit P-glycoprotein, which is involved in multidrug resistance. Methods: We made a clinical trial on all the patients present in the database of the Hematology Department of the Emergency Departmental Clinical Hospital Sibiu in november 2009 who were diagnosed with chronic lymphocytic leukemia, and who agreed to participate in this trial and also had no counterindications for statins. Flowcytometrically we determined the expression of P-glycoprotein in lymphocytes from peripherical blood. Patients with P-glycoprotein positive recieved lovastatin (80 mg/ day, 6 days), after which the flowcytometric exam was repeated. Before the treatment, we carried out hemoleucogram, and before and after the treatment biochemical tests were determined. The results were statistically analyzed. Results: From 27 analyzed patients, P-glycoprotein was expressed on 6 (in average, 20±8.34% of lymphocyte were positive). After lovastatin treatment, the percent of positive lymphocyte for P-glycoprotcin diminished to 7.33%. Statistically the difference was significant (p = 0.016). The decrease was of 63.35% in comparison with the initial P-glycoprotein- positive lymphocyte number. Between the performed testes only cholesterolemia decreased from average 230.2±69.27 mg/dl to 183.2±42.3 mg/dl (p < 0.05) (an average decrease of 20.42%). Patients had no clinical or biological manifestations which could be considered as side effects. Conclusions: The 6 day administration of lovastin to chronic lympocytic leukemia patients significally decreased the cholesterol and the number of lymphocytes which expresses P-glycoprotein, sugesting that it could be an adjuvant treatment by lowering multidrug resistance, especially followed by conventional chemotherapy. Copyright © 2010 CELSIUS.


Lassale C.,Imperial College London | Gunter M.J.,Imperial College London | Romaguera D.,Imperial College London | Romaguera D.,Institute Investigacion Sanitaria Of Palma Idispa | And 63 more authors.
PLoS ONE | Year: 2016

Scores of overall diet quality have received increasing attention in relation to disease aetiology; however, their value in risk prediction has been little examined. The objective was to assess and compare the association and predictive performance of 10 diet quality scores on 10-year risk of all-cause, CVD and cancer mortality in 451,256 healthy participants to the European Prospective Investigation into Cancer and Nutrition, followed-up for a median of 12.8y. All dietary scores studied showed significant inverse associations with all outcomes. The range of HRs (95% CI) in the top vs. lowest quartile of dietary scores in a composite model including non-invasive factors (age, sex, smoking, body mass index, education, physical activity and study centre) was 0.75 (0.72-0.79) to 0.88 (0.84-0.92) for all-cause, 0.76 (0.69-0.83) to 0.84 (0.76-0.92) for CVD and 0.78 (0.73-0.83) to 0.91 (0.85-0.97) for cancer mortality. Models with dietary scores alone showed low discrimination, but composite models also including age, sex and other non-invasive factors showed good discrimination and calibration, which varied little between different diet scores examined. Mean C-statistic of full models was 0.73, 0.80 and 0.71 for all-cause, CVD and cancer mortality. Dietary scores have poor predictive performance for 10-year mortality risk when used in isolation but display good predictive ability in combination with other non-invasive common risk factors. © 2016 Lassale 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.


Johansson M.,International Agency for Research on Cancer IARC WHO | Fanidi A.,International Agency for Research on Cancer IARC WHO | Muller D.C.,International Agency for Research on Cancer IARC WHO | Bassett J.K.,Cancer Epidemiology Center | And 60 more authors.
Journal of the National Cancer Institute | Year: 2014

Background The etiology of renal cell carcinoma (RCC) is only partially understood, but a metabolic component appears likely. We investigated biomarkers of one-carbon metabolism and RCC onset and survival. Methods The European Prospective Investigation into Cancer and Nutrition (EPIC) recruited 385747 participants with blood samples between 1992 and 2000, and this analysis included 556 RCC case-control pairs. A subsequent replication study included 144 case-control pairs nested within the Melbourne Collaborative Cohort Study (MCCS). Plasma concentrations of vitamin B2, vitamin B6, folate, vitamin B12, methionine and homocysteine were measured in prediagnostic samples and evaluated with respect to RCC risk using conditional and unconditional logistic regression models, and to all-cause mortality in RCC cases using Cox regression models. All statistical tests were two-sided. Results EPIC participants with higher plasma concentrations of vitamin B6 had lower risk of RCC, the odds ratio comparing the 4th and 1st quartiles (OR4vs1) being 0.40 95% confidence interval [CI] = 0.28 to 0.57, P trend <. 001. We found similar results after adjusting for potential confounders (adjusted P trend <. 001). In survival analysis, the hazard ratio for all-cause mortality in RCC cases when comparing the 4th and 1st quartiles (HR4vs1) of vitamin B6 was 0.57 (95% CI = 0.37 to 0.87, P trend <. 001). Subsequent replication of these associations within the MCCS yielded very similar results for both RCC risk (OR4vs1 = 0.47, 95% CI = 0.23 to 0.99, P trend =. 07) and all-cause mortality (HR4vs1 = 0.56, 95% CI = 0.27 to 1.17, P trend =. 02). No association was evident for the other measured biomarkers. Conclusion Study participants with higher circulating concentrations of vitamin B6 had lower risk of RCC and improved survival following diagnosis in two independent cohorts. © The Author 2014.


Mihaila R.-G.,Lucian Blaga University | Rezi E.-C.,Urgency County Clinical Hospital | Nedelcu L.,Transylvania University | Mutu C.,Urgency County Clinical Hospital | And 4 more authors.
Archives of the Balkan Medical Union | Year: 2011

Background: Hepatitis C virus infection is frequent, but its effects on the nervous system are less known. Methods: We studied the neuropsychic disorders of the patients with viral hepatitis C without prior interferon treatment. Results: Out of the 22 included patients, 36.36% presented neurologic disorder, probably linked to the viral hepatitis C infection. 50% of them had psychiatric disorders. The value that quantifies the asthenia on the Piper Scale in the group of patients was 4.0036±1.90 (moderate degree of asthenia). In 18.18% of the patients were pathological modifications of the electroencephalographic signals. There was no correlation between the analyzed hepatic tests and the presence of neurologic and psychiatric disorders or the alterations of the electroencephalographic signals. Conclusions: The neurologic disorders potentially induced by the hepatitis C virus, affected over one third of the studied patients and the psychiatric disorders - half of them. The average degree of asthenia of the study group was moderate. Copyright © 2011 CELSIUS.


Tamayo-Uria I.,Center for Research in Environmental Epidemiology | Tamayo-Uria I.,University Pompeu Fabra | Tamayo-Uria I.,CIBER ISCIII | Altzibar J.M.,CIBER ISCIII | And 4 more authors.
COPD: Journal of Chronic Obstructive Pulmonary Disease | Year: 2016

Chronic obstructive pulmonary disease (COPD) is a prevalent condition in adults aged ≥40 years characterized by progressive airflow limitation associated with chronic inflammatory response to noxious particles in the airways and lungs. Smoking, genetics, air pollution, nutrition and other factors may influence COPD development. Most hospitalizations and deaths for COPD are caused by its acute exacerbations, which greatly affect the health and quality of life of COPD patients and pose a high burden on health services. The aims of this project were to identify trends, geographic patterns and risk factors for COPD exacerbations, as revealed by hospitalizations and deaths, in the Basque Country, Spain, over a period of 12 years (2000–2011). Hospitalization and mortality rates for COPD were 262 and 18 per 100,000 population, respectively, with clusters around the biggest cities. Hospital mortality was 7.4%. Most hospitalized patients were male (77.4%) and accounted for 72.1% of hospital mortality. Hospitalizations decreased during the study period, except for 50–64 year-old women, peaking significantly. Using a multivariate modeling approach it was shown that hospitalizations were positively correlated with increased atmospheric concentrations of NO2, CO, PM10, and SO2, and increased influenza incidence, but were negatively associated with increased temperatures and atmospheric O3 concentration. COPD exacerbations decreased in the Basque Country during 2000–2011, but not among 50–64-year-old women, reflecting the high smoking prevalence among Spanish women during the 1970–1990s. The main metropolitan areas were those with the highest risk for COPD exacerbations, calling attention to the role of heavy car traffic. Influenza virus, cold temperatures, and increased atmospheric NO2, CO, PM10, and SO2 (but decreased O3) concentrations were identified as potential contributors to the burden of COPD exacerbations in the community. These findings are important for both the understanding of the disease process and in providing potential targets for COPD-reducing initiatives and new avenues for research. © 2016 Taylor & Francis Group, LLC


Marinescu P.,Public Health Direction | Manolescu L.S.C.,Carol Davila University of Medicine and Pharmacy
Romanian Biotechnological Letters | Year: 2012

Objectives: Human immunodeficiency virus (HIV) can affect the central nervous system and determine HIV encephalopathy (HE). Evidence of hepatitis B virus (HBV) was found in cerebrospinal fluid in HIV co-infected patients. Here we assessed the degree of association between HBV infection and prognosis of HE in a large cohort of 462 HIV infected patients over a ten years period and the role of nadir CD4 cell count. Materials and methods: HIV encephalopathy, HBV infections markers, HIV RNA and CD4cell were measured and retrospectively analyzed. Results: The prevalence of HE was 22. 7%. More than half, 50.4% of the patients with HE presented HBV infection. Among the fifty three patients that presented at the same time HE and HBV infection, more than half, 66.03%, were first infected with HBV and then developed HE. It is possible that HBV infection is a risk factor for developing of HE. Further studies are needed to prove the HBV neurotropic potential. Conclusions: The prognosis of HE was not significantly different in HBV presence or under antiretroviral treatment. Absolute CD4 nadir count and class C3 are proved to be strong predictors of HE in HIV infected patients even after several changes in antiretroviral therapy schemes. © 2012 University of Bucharest.


Quintero-Herrera L.L.,Technological University of Pereira | Ramirez-Jaramillo V.,Technological University of Pereira | Bernal-Gutierrez S.,Technological University of Pereira | Cardenas-Giraldo E.V.,Technological University of Pereira | And 8 more authors.
Journal of Infection and Public Health | Year: 2015

Dengue continues to be the most important viral vector-borne disease in the world, particularly in Asia and Latin America, and is significantly affected by climate variability. The influence of climate in an endemic region of Colombia, from 2010 to 2011, was assessed. Epidemiological surveillance data (weekly cases) were collected, and incidence rates were calculated. Poisson regression models were used to assess the influence of the macroclimatic variable ONI (Oscillation Niño Index) and the microclimatic variable pluviometry (mm of rain for Risaralda) on the dengue incidence rate, adjusting by year and week. During the study period, 13,650 cases were reported. In 2010, the rates ranged from 8.6 cases/100,000 pop. up to a peak of 75.3 cases/100,000 pop. for a cumulative rate of 456.2 cases/100,000 pop. in that week. The climate variability in 2010 was higher (ONI 1.6, El Niño to -1.5, La Niña) than in 2011 (ONI -1.4, La Niña to -0.2, Neutral). The mean pluviometry was 248.45mm (min 135.9-max 432.84). During El Niño, cases were significantly higher (mean 433.81) than during the climate neutral period (142.48) and during the La Niña (52.80) phases (ANOVA F=66.59; p<0.001). Regression models showed that the ONI (coefficient 0.329; 95%CI 0.209-0.450) and pluviometry (coefficient 0.003; 95%CI 0.002-0.004) were highly significant independent variables associated with dengue incidence rate, after adjusting by year and week (p<0.001, pseudo r2=0.6913). El Niño significantly affected the incidence of dengue in Risaralda. This association with climate change and variability should be considered in the elements influencing disease epidemiology. In addition, predictive models should be developed further with more available data from disease surveillance. © 2014 King Saud Bin Abdulaziz University for Health Sciences.

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