Population-based multicase-control study in common tumors in Spain (MCC-Spain): rationale and study design

Introduction: We present the protocol of a large population-based case-control study of 5 common tumors in Spain (MCC-Spain) that evaluates environmental exposures and genetic factors. Methods: Between 2008-2013, 10,183 persons aged 20-85 years were enrolled in 23 hospitals and primary care centres in 12 Spanish provinces including 1,115 cases of a new diagnosis of prostate cancer, 1,750 of breast cancer, 2,171 of colorectal cancer, 492 of gastro-oesophageal cancer, 554 cases of chronic lymphocytic leukaemia (CLL) and 4,101 population-based controls matched by frequency to cases by age, sex and region of residence. Participation rates ranged from 57% (stomach cancer) to 87% (CLL cases) and from 30% to 77% in controls. Participants completed a face-to-face computerized interview on sociodemographic factors, environmental exposures, occupation, medication, lifestyle, and personal and family medical history. In addition, participants completed a self-administered food-frequency questionnaire and telephone interviews. Blood samples were collected from 76% of participants while saliva samples were collected in CLL cases and participants refusing blood extractions. Clinical information was recorded for cases and paraffin blocks and/or fresh tumor samples are available in most collaborating hospitals. Genotyping was done through an exome array enriched with genetic markers in specific pathways. Multiple analyses are planned to assess the association of environmental, personal and genetic risk factors for each tumor and to identify pleiotropic effects. Discussion: This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain.The study was partially funded by the “Accion Transversal del Cancer”, approved on the Spanish Ministry Council on the 11th October 2007, by the Instituto de Salud Carlos III-FEDER (PI08/1770, PI08/0533, PI08/1359, PS09/00773, PS09/01286, PS09/01903, PS09/02078, PS09/01662, PI11/01403, PI11/01889, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150), by the Fundación Marqués de Valdecilla (API 10/09), by the ICGC International Cancer Genome Consortium CLL, by the Junta de Castilla y León (LE22A10-2), by the Consejería de Salud of the Junta de Andalucía (PI-0571), by the Conselleria de Sanitat of the Generalitat Valenciana (AP 061/10), by the Recercaixa (2010ACUP 00310), by the Regional Government of the Basque Country by European Commission grants FOOD-CT- 2006-036224-HIWATE, by the Spanish Association Against Cancer (AECC) Scientific Foundation, by the The Catalan Government DURSI grant 2009SGR1489

Uso de técnicas de exposición en una clínica de psicología

The aim of this work is to explore the use of exposure techniques at the health care context of a clinical psychology facility. Different modalities of exposure techniques, their frequency of usage - both across the entire sample and considering different diagnostic groups – and their relationship to the treatment results, were analysed. From the 880 patients with diverse diagnosis treated at the University Psychology Clinic of the Universidad Complutense of Madrid, 67.2% were women, with a mean of 32.79 years. Results show that exposure techniques were used in 39.5% of total cases, being gradual exposure the most frequent (31.6%). Exposure techniques were employed foremost on anxiety disorders (70.8%), somatoform disorders (47.4%), and sexual disorders (47.1%). Also, it was observed that exposure techniques were used more often in cases with one or more comorbid diagnosis (55.4 vs. 36.3%). 74.1% of the patients treated with exposure techniques received therapeutic discharge, while 61.9% of patients not treated with exposure techniques were discharged. The results are discussed, emphasizing the utility of exposure techniques to treat avoidant or fearful behaviour regardless of the diagnosis.El objetivo del artículo es indagar el uso de las técnicas de exposición en la práctica de la Psicología Clínica asistencial. Se analiza el tipo de técnicas de exposición, su frecuencia de uso, tanto en general como en función del diagnóstico, y su relación con los resultados del tratamiento. De los 880 pacientes de la Clínica Universitaria de Psicología de la Universidad Complutense, con todo tipo de diagnóstico, el 67.2% son mujeres y su edad media es de 32.79 años. Los resultados señalan que el 39.5% de los casos ha utilizado alguna técnica de exposición, siendo la Exposición Gradual la más frecuente (31.6%). Predomina el uso de las técnicas de exposición en trastornos de ansiedad (70.8%), somatomorfos (47.4%) y sexuales (47.1%). Se observa un incremento en el uso de técnicas de exposición en los casos con comorbilidad (55.4% frente a 36.3%). De los casos que han recibido alguna técnica de exposición el 74.1% ha finalizado con éxito el tratamiento, frente al 61.9% de los que no han utilizado ninguna técnica de exposición. Se discuten los resultados destacando el valor de usar técnicas de exposición para reducir la evitación o las respuestas de miedo con independencia del diagnóstico

Uso de técnicas de exposición en una clínica de psicología

The aim of this work is to explore the use of exposure techniques at the health care context of a clinical psychology facility. Different modalities of exposure techniques, their frequency of usage - both across the entire sample and considering different diagnostic groups – and their relationship to the treatment results, were analysed. From the 880 patients with diverse diagnosis treated at the University Psychology Clinic of the Universidad Complutense of Madrid, 67.2% were women, with a mean of 32.79 years. Results show that exposure techniques were used in 39.5% of total cases, being gradual exposure the most frequent (31.6%). Exposure techniques were employed foremost on anxiety disorders (70.8%), somatoform disorders (47.4%), and sexual disorders (47.1%). Also, it was observed that exposure techniques were used more often in cases with one or more comorbid diagnosis (55.4 vs. 36.3%). 74.1% of the patients treated with exposure techniques received therapeutic discharge, while 61.9% of patients not treated with exposure techniques were discharged. The results are discussed, emphasizing the utility of exposure techniques to treat avoidant or fearful behaviour regardless of the diagnosis.El objetivo del artículo es indagar el uso de las técnicas de exposición en la práctica de la Psicología Clínica asistencial. Se analiza el tipo de técnicas de exposición, su frecuencia de uso, tanto en general como en función del diagnóstico, y su relación con los resultados del tratamiento. De los 880 pacientes de la Clínica Universitaria de Psicología de la Universidad Complutense, con todo tipo de diagnóstico, el 67.2% son mujeres y su edad media es de 32.79 años. Los resultados señalan que el 39.5% de los casos ha utilizado alguna técnica de exposición, siendo la Exposición Gradual la más frecuente (31.6%). Predomina el uso de las técnicas de exposición en trastornos de ansiedad (70.8%), somatomorfos (47.4%) y sexuales (47.1%). Se observa un incremento en el uso de técnicas de exposición en los casos con comorbilidad (55.4% frente a 36.3%). De los casos que han recibido alguna técnica de exposición el 74.1% ha finalizado con éxito el tratamiento, frente al 61.9% de los que no han utilizado ninguna técnica de exposición. Se discuten los resultados destacando el valor de usar técnicas de exposición para reducir la evitación o las respuestas de miedo con independencia del diagnóstico

Psicothema

Resumen tomado de la publicaciónAntecedentes: el objetivo de este trabajo es determinar si, en el tratamiento de los Trastornos de Ansiedad en un contexto asistencial, el uso conjunto de Tratamientos Psicológicos Empíricamente Apoyados (TEAs) y Tratamiento Farmacológico (TF) consigue mejores resultados que el uso solo de TEAs. Método: se diseñó un estudio cuasiexperimental, con una muestra de 287 pacientes con diagnóstico primario de Trastorno de Ansiedad. El 25,1% de los pacientes (n= 72) recibió TEAs+TF y el 74,9% (n= 216) solo TEAs. En el pretratamiento no aparecieron diferencias intergrupo en el nivel de ansiedad y sintomatología depresiva, duración del problema y comorbilidad, pero sí en tratamientos previos (menos en el grupo de TEA). Resultados: tras la intervención ambos grupos mostraron valores similares en el porcentaje de éxito y efectividad, nivel de ejecución de tareas, puntualidad y asistencia, sin embargo hubo diferencias significativas en la duración del tratamiento, que fue significativamente más largo en el grupo de TEA+TF (16,58 sesiones frente 13,04 sesiones). Conclusiones: se concluye que añadir TF al TEA no mejora los resultados pero incrementa los costos y duración del tratamiento, reduciendo la eficiencia de la intervención.Universidad de Oviedo. Biblioteca de Psicología; Plaza Feijoo, s/n.; 33003 Oviedo; Tel. +34985104146; Fax +34985104126; [email protected]

Sex differences in the antidepressant-like response and molecular events induced by the imidazoline-2 receptor agonist CR4056 in rats

In searching for novel targets to design antidepressants, among the characterized imidazoline receptors (IR), I2 receptors are an innovative therapeutical approach since they are dysregulated in major depressive disorder and by classical antidepressant treatments. In fact, several I2 agonists have been characterized for their antidepressant-like potential, but the results in terms of efficacy were mixed and exclusively reported in male rodents. Since there are well-known sex differences in antidepressant-like efficacy, this study characterized the potential effects induced by two I2 drugs, CR4056 (i.e., most promising drug already in phase II clinical trial for its analgesic properties) and B06 (a compound from a new family of bicyclic α-iminophosphonates) under the stress of the forced-swim test in male and female rats exposed to early-life stress. Moreover, some hippocampal neuroplasticity markers related to the potential effects observed were also evaluated (i.e., FADD, p-ERK/ERK, mBDNF, cell proliferation: Ki-67 + cells). The main results replicated the only prior study reporting the efficacy of CR4056 in male rats, while providing new data on its efficacy in females, which was clearly dependent on prior early-life stress exposure. Moreover, B06 showed no antidepressant-like effects in male or female rats. Finally, CR4056 increased FADD content and decreased cell proliferation in hippocampus, without affecting p- ERK/t-ERK ratio and/or mBDNF content. Interestingly, these effects were exclusively observed in female rats, and independently of early-life conditions, suggesting some distinctive molecular underpinnings participating in the therapeutic response of CR4056 for both sexes. In conjunction, these results present CR4056 with an antidepressant-like potential, especially in female rats exposed to stress early in life, together with some neuronal correlates described in the context of these behavioral changes in females

Psicothema

Resumen tomado de la publicaciónLos objetivos del artículo son analizar las características sociodemográficas y clínicas de los pacientes con trastornos de ansiedad, tratados en una clínica de psicología, y los resultados del tratamiento en cada uno de los trastornos de ansiedad. Se analizan los datos de 282 pacientes de la Clínica Universitaria de Psicología de la Universidad Complutense de Madrid que presentaban al menos un diagnóstico de ansiedad según criterios DSM-IV-TR. Los trastornos de ansiedad más frecuentes son el trastorno de ansiedad no especificado (19,1 por ciento) y la fobia social (18,8 por ciento). Se observan diferencias significativas en función del sexo, siendo el porcentaje de mujeres significativamente superior al de hombres en todos los problemas excepto en el trastorno obsesivo-compulsivo. El trastorno de ansiedad no especificado requirió un menor número de sesiones de evaluación y tratamiento, mientras que el trastorno obsesivo compulsivo requirió un mayor número de sesiones. No aparecieron diferencias significativas en porcentajes de altas y abandonos en fobia específica, trastorno de ansiedad generalizada y trastorno obsesivo-compulsivo. Se discuten las diferencias entre los datos epidemiológicos y clínicos y sus implicaciones para el tratamiento.AsturiasColegio Oficial de Psicólogos de Asturias; Calle Ildefonso Sánchez del Río, 4-1 B; 33001 Oviedo; Tel. +34985285778; Fax +34985281374;Universidad de Oviedo. Facultad de Psicología; Plaza Feijoo, s. n.; 33003 Oviedo; Tel. +34985104146; Fax +34985104126;ES

Possible role of chondroitin sulphate and glucosamine for primary prevention of colorectal cancer. Results from the MCC-Spain study

A safe and effective colorectal cancer (CRC) chemoprevention agent remains to be discovered. We aim to evaluate the association between the use of glucosamine and/or chondroitin sulphate and risk of colorectal cancer (CRC) in the MCC-Spain study, a case-control study performed in Spain that included 2140 cases of CRC and 3950 population controls. Subjects were interviewed on sociodemographic factors, lifestyle, family and medical history and regular drug use. Adjusted odds ratios and their 95% confidence intervals were estimated. The reported frequency of chondroitin and/or glucosamine use was 2.03% in controls and 0.89% in cases. Users had a reduced risk of CRC (OR: 0.47; 95% CI: 0.28-0.79), but it was no longer significant when adjusted for NSAID (nonsteroidal anti-inflammatory drugs) use (OR: 0.82; 95% CI: 0.47-1.40). A meta-analysis with previous studies suggested a protective effect, overall and stratified by NSAID use (OR: 0.77; 95% CI: 0.62-0.97). We have not found strong evidence of an independent preventive effect of CG on CRC in our population because the observed effects of our study could be attributed to NSAIDs concurrent use. These results merit further research due to the safety profile of these drugs

Possible role of chondroitin sulphate and glucosamine for primary prevention of colorectal cancer. Results from the MCC-Spain study

A safe and effective colorectal cancer (CRC) chemoprevention agent remains to be discovered. We aim to evaluate the association between the use of glucosamine and/or chondroitin sulphate and risk of colorectal cancer (CRC) in the MCC-Spain study, a case-control study performed in Spain that included 2140 cases of CRC and 3950 population controls. Subjects were interviewed on sociodemographic factors, lifestyle, family and medical history and regular drug use. Adjusted odds ratios and their 95% confidence intervals were estimated. The reported frequency of chondroitin and/or glucosamine use was 2.03% in controls and 0.89% in cases. Users had a reduced risk of CRC (OR: 0.47; 95% CI: 0.28-0.79), but it was no longer significant when adjusted for NSAID (nonsteroidal anti-inflammatory drugs) use (OR: 0.82; 95% CI: 0.47-1.40). A meta-analysis with previous studies suggested a protective effect, overall and stratified by NSAID use (OR: 0.77; 95% CI: 0.62-0.97). We have not found strong evidence of an independent preventive effect of CG on CRC in our population because the observed effects of our study could be attributed to NSAIDs concurrent use. These results merit further research due to the safety profile of these drugs

Possible role of chondroitin sulphate and glucosamine for primary prevention of colorectal cancer. Results from the MCC-Spain study

A safe and effective colorectal cancer (CRC) chemoprevention agent remains to be discovered. We aim to evaluate the association between the use of glucosamine and/or chondroitin sulphate and risk of colorectal cancer (CRC) in the MCC-Spain study, a case-control study performed in Spain that included 2140 cases of CRC and 3950 population controls. Subjects were interviewed on sociodemographic factors, lifestyle, family and medical history and regular drug use. Adjusted odds ratios and their 95% confidence intervals were estimated. The reported frequency of chondroitin and/or glucosamine use was 2.03% in controls and 0.89% in cases. Users had a reduced risk of CRC (OR: 0.47; 95% CI: 0.28-0.79), but it was no longer significant when adjusted for NSAID (nonsteroidal anti-inflammatory drugs) use (OR: 0.82; 95% CI: 0.47-1.40). A meta-analysis with previous studies suggested a protective effect, overall and stratified by NSAID use (OR: 0.77; 95% CI: 0.62-0.97). We have not found strong evidence of an independent preventive effect of CG on CRC in our population because the observed effects of our study could be attributed to NSAIDs concurrent use. These results merit further research due to the safety profile of these drugs