Diagnostic Biomarkers: Are We Moving from Discovery to Clinical Application?

Despite considerable research investment, moving from biomarker discovery to clinical application has presented unique challenges. We aimed to evaluate progress toward clinical application of a sample of molecular- and “omics”-based diagnostic tests over a 10-year period. METHODS We used Scopus to locate studies, published before the December 31, 2016, citing 107 original-research articles published in 2006 that assessed the diagnostic value of a molecular- or “omics”-based test. We identified diagnostic studies of the same test and disease and determined whether the article represented progress in the validation of the molecular test. We classified the types of progress: (a) clinical validation (measuring diagnostic accuracy in a series of patients similar to the population in which the test will be used in practice), (b) technical improvement, (c) extended diagnostic application (modification of the diagnostic question attended initially by the test), (d) economic evaluation, or (e) clinical use or implementation. RESULTS In the 10-year period analyzed, 4257 articles cited the 107 diagnostic studies; 118 (2.8%) were diagnostic studies of the same test, and of these papers, 25 (21.2%) did not constitute progress toward validation of the test for use in clinical practice (potential research waste). Of the 107 molecular- or “omics”-based tests described in 2006, only 28 (26.2%) appeared to have made progress toward clinical application. Only 4 (9.1%) of 44 proteomics-based tests had made progress toward clinical application. CONCLUSIONS Articles evaluating molecular- or “omics”-based diagnostic tests are numerous in biomedical journals. Few tests have made progress toward clinical application in the 10 years following their discover

The Relevance of Microcystin Monitoring in Dialysis Centers of Sicilians Cities: An Environmental Study

Background: Sicilian surface basins are among the most important water supply resources available on the island. They are often affected by harmful cyanobacteria blooms as Planktothrix rubescens and Microcystis aeruginosa. Since dialysates are produced using network water, they could contain cyanotoxins. No study has been conducted yet to evaluate the removal efficiency of osmotic systems for cyanotoxins in abnormal conditions at room temperatures of about 40°C. The aim of this study was to monitor the presence of microcystins in Sicilian dialysis center, network waters and, finally, dialysates produced from these waters in an Agrigento dialysis unit where environmental conditions are favorable for algal bloom. Methods: This clinic normally receives surface water from artificial basins, where several times, traces of cyanobacteria have been detected. Moreover, dialysates and underground supply waters of a clinic in Catania were also sampled as control. Samplings were performed in summer 2018, when room temperatures were above 38 °C. A total of 40 samples were analyzed by ELISA assay. Results: Results of our monitoring highlighted concentrations of MCs in waters of several basins among LOD - 155 ng/L, lower than WHO reference value for drinking waters (1,0 µg/L), that decrease up to undetectable levels whereas no MC contamination was detected both in supply waters and dialysates. Conclusion: Although our first set of data outcomes seem to be quite comforting, an improvement of law and a complete census of the water supplies of dialysate centers would be ideal

Longitudinal association of telomere length and obesity indices in an intervention study with a Mediterranean diet: the PREDIMED-NAVARRA trial

Background: Telomeres are nucleoprotein structures that protect the ends of eukaryote chromosomes. Shorter telomere length (TL) is associated with some age-related human disorders, but its relationship with obesity or adiposity parameters remains unclear. Objective: The aim of this study was to assess the relationship between TL and changes in adiposity indices after a 5-year nutritional intervention. Design and subjects: TL was measured by quantitative real-time PCR in 521 subjects (55-80 years, 55% women). Participants were randomly selected from the PREDIMED-NAVARRA centre after they completed a 5-year intervention programme. Anthropometric parameters were directly measured by trained personnel at baseline and on a yearly basis thereafter. TL at baseline and changes in TL after a 5-year intervention were assessed. Results: Higher baseline TL significantly predicted a greater decrease in body weight (B=−1.09 kg, 95% confidence interval (CI): −2.01 to −0.16), body mass index (BMI) (B=−0.47 kg m−2, 95% CI: −0.83 to −0.11), waist circumference (B=−1.15 cm, 95% CI: −2.28 to −0.01) and waist to height ratio (B=−0.008, 95% CI: −0.010 to −0.001) in multiple-adjusted models. In addition, changes in TL during the 5-year intervention were inversely associated with changes in the four anthropometric variables. The reduction in adiposity indices during the intervention, associated with increasing TL, was even higher among subjects with the longest telomeres at baseline. Logistic regression analysis showed that the risk of remaining obese after 5 years was lower in those participants who initially had the longest telomeres and increased their TL after intervention (odds ratio=0.27, 95% CI: 0.03-2.03). Conclusions: Our research suggests that TL is inversely associated with changes in obesity parameters. The assessment of TL can provide further insights for biological pathways leading to adiposity. We show for the first time an improvement of obesity indices when an increase in TL is observed after a 5-year Mediterranean diet intervention

Longitudinal association of telomere length and obesity indices in an intervention study with a Mediterranean diet: the PREDIMED-NAVARRA trial

Background: Telomeres are nucleoprotein structures that protect the ends of eukaryote chromosomes. Shorter telomere length (TL) is associated with some age-related human disorders, but its relationship with obesity or adiposity parameters remains unclear. Objective: The aim of this study was to assess the relationship between TL and changes in adiposity indices after a 5-year nutritional intervention. Design and subjects: TL was measured by quantitative real-time PCR in 521 subjects (55-80 years, 55% women). Participants were randomly selected from the PREDIMED-NAVARRA centre after they completed a 5-year intervention programme. Anthropometric parameters were directly measured by trained personnel at baseline and on a yearly basis thereafter. TL at baseline and changes in TL after 5-year intervention were assessed. Results: Higher baseline TL significantly predicted a greater decrease in body weight (B= -1.09 kg, 95%CI: -2.01 to -0.16), BMI (B= -0.47 kg/m2, 95%CI: -0.83 to -0.11), waist circumference (B= -1.15 cm, 95%CI: -2.28 to -0.01), and waist to height ratio (B= -0.008, 95%CI: -0.010 to -0.001) in multiple-adjusted models. In addition, changes in TL during the 5-year intervention were inversely associated with changes in the four anthropometric variables. The reduction in adiposity indices during the intervention, associated with increasing TL, was even higher among subjects with the longest telomeres at baseline. Logistic regression analysis showed that the risk of remaining obese after 5 years was lower in those participants who initially had the longest telomeres and increased their TL after intervention (OR=0.27, 95%CI: 0.03 to 2.03). Conclusions: Our research suggests that TL is inversely associated with changes in obesity parameters. The assessment of TL can provide further insights for biological pathways leading to adiposity. We show for the first time an improvement of obesity indices when an increase in TL is observed after a 5-year Mediterranean diet intervention

High efficacy of Sofosbuvir plus Simeprevir in a large cohort of Spanish cirrhotic patients infected with genotypes 1 and 4

[Abstract] Background and Aims. Hepatitis C (HCV) therapy with Sofosbuvir (SOF)/Simeprevir (SMV) in clinical trials and real‐world clinical practice, showed high rates of sustained virological response (SVR) in non‐cirrhotic genotype (GT)‐1 and GT‐4 patients. These results were slightly lower in cirrhotic patients. We investigated real‐life effectiveness and safety of SOF/SMV with or without ribavirin (RBV) in a large cohort of cirrhotic patients. Methods. This collaborative multicentre study included data from 968 patients with cirrhosis infected with HCV‐GT1 or 4, treated with SOF/SMV±RBV in 30 centres across Spain between January‐2014 and December‐2015. Demographic, clinical, virological and safety data were analysed. Results. Overall SVR was 92.3%; the majority of patients were treated with RBV (62%) for 12 weeks (92.4%). No significant differences in SVR were observed between genotypes (GT1a:94.3%; GT1b:91.7%; GT4:91.1%). Those patients with more advanced liver disease (Child B/C, MELD≥10) or portal hypertension (platelet count≤100×109/L, transient elastography≥21 Kpa) showed significantly lower SVR rates (84.4%‐91.9%) than patients with less advanced liver disease (93.8%‐95.9%, P<.01 in all cases). In the multivariate analysis, the use of RBV, female gender, baseline albumin≥35 g/L, MELD<10 and lack of exposure to a triple therapy regimen were independent predictors of SVR (P<.05). Serious adverse events (SAEs) and SAE‐associated discontinuation events occurred in 5.9% and 2.6%. Conclusions. In this large cohort of cirrhotic patients managed in the real‐world setting in Spain, SOF/SMV±RBV yielded to excellent SVR rates, especially in patients with compensated liver cirrhosis. In addition, this combination showed to be safe, with low rates of SAEs and early discontinuations.Instituto de Salud Carlos III; PI15/0015

Sofosbuvir/ledipasvir plus ribavirin achieves high SVR12 in genotype‐3 patients with compensated cirrhosis and similar to sofosbuvir plus daclatasvir: a multicentre real life cohort

Poster abstrac

Moliére era negro

Seleccionado en la convocatoria: Ayudas a la innovación e investigación educativa en centros docentes de niveles no universitarios, Gobierno de Aragón 2010-11Proyecto del IES Bajo Aragón cuyo objetivo es la formación de un grupo de teatro desde un ámbito interdisciplinar. Sus objetivos son: formar al alumnado en valores de respeto, tolerancia, sensibilización, solidaridad y voluntariado a través del juego; analizar y localizar dinámicas que lleven a la reflexión sobre estereotipos presentes en la sociedad; desarrollar las capacidades de cohesión grupal; adquirir herramientas para la formación de una obra teatral; y potenciar socialización y la integración. Se forma un grupo de teatro formado por los alumnos interesados que representan los conceptos y técnicas aprendidas a través de la representación de obras a final de curso.Gobierno de Aragón. Departamento de Educación, Cultura y DeporteAragónDirección General de Política Educativa; Avda. Gómez Laguna, 25, planta 2; 50009 Zaragoza; Tel. +34976715416; Fax +34976715496ES

Mediterranean Alcohol-Drinking Pattern and Arterial Hypertension in the “Seguimiento Universidad de Navarra” (SUN) Prospective Cohort Study

Alcohol drinking patterns may determine the risk of hypertension and may also modify the detrimental effect of high alcohol intake. We prospectively evaluated the effect of the Mediterranean alcohol-drinking pattern and its interaction with the amount of alcohol consumed on the incidence of arterial hypertension. In the “Seguimiento Universidad de Navarra” (SUN) cohort, we followed-up 13,805 participants, all of them initially free of hypertension, during a maximum period of 16 years. Information about diet, chronic diseases, lifestyle and newly diagnosed hypertension was collected using validated questionnaires. We used a 7-item score (0 to 9 points) that jointly considered moderate alcohol consumption, distributed over the week, with meals, and a preference for red wine and avoidance of binge-drinking. During 142,404 person-years of follow-up, 1443 incident cases of hypertension were identified. Low adherence (score 7) category. Among alcohol consumers, a high adherence to the MADP is associated with a lower incidence of hypertension. Compared with abstinence, a high adherence did not seem to differ regarding its effect on hypertension risk

Longitudinal association of telomere length and obesity indices in an intervention study with a Mediterranean diet: the PREDIMED-NAVARRA trial

Background: Telomeres are nucleoprotein structures that protect the ends of eukaryote chromosomes. Shorter telomere length (TL) is associated with some age-related human disorders, but its relationship with obesity or adiposity parameters remains unclear. Objective: The aim of this study was to assess the relationship between TL and changes in adiposity indices after a 5-year nutritional intervention. Design and subjects: TL was measured by quantitative real-time PCR in 521 subjects (55-80 years, 55% women). Participants were randomly selected from the PREDIMED-NAVARRA centre after they completed a 5-year intervention programme. Anthropometric parameters were directly measured by trained personnel at baseline and on a yearly basis thereafter. TL at baseline and changes in TL after a 5-year intervention were assessed. Results: Higher baseline TL significantly predicted a greater decrease in body weight (B=−1.09 kg, 95% confidence interval (CI): −2.01 to −0.16), body mass index (BMI) (B=−0.47 kg m−2, 95% CI: −0.83 to −0.11), waist circumference (B=−1.15 cm, 95% CI: −2.28 to −0.01) and waist to height ratio (B=−0.008, 95% CI: −0.010 to −0.001) in multiple-adjusted models. In addition, changes in TL during the 5-year intervention were inversely associated with changes in the four anthropometric variables. The reduction in adiposity indices during the intervention, associated with increasing TL, was even higher among subjects with the longest telomeres at baseline. Logistic regression analysis showed that the risk of remaining obese after 5 years was lower in those participants who initially had the longest telomeres and increased their TL after intervention (odds ratio=0.27, 95% CI: 0.03-2.03). Conclusions: Our research suggests that TL is inversely associated with changes in obesity parameters. The assessment of TL can provide further insights for biological pathways leading to adiposity. We show for the first time an improvement of obesity indices when an increase in TL is observed after a 5-year Mediterranean diet intervention

Metodologías activas de aprendizaje para combatir el edadismo: Aplicación del PEACE (Positive Education about Aging and Contact Experiences) en el grado de Trabajo Social

El Trabajo Social es una disciplina vinculada a colectivos vulnerables y con mayor exposición a diversas manifestaciones relacionadas con los estereotipos, prejuicios y la discriminación. En este sentido, este proyecto se ocupó la formación docente universitaria en el ámbito de la lucha y erradicación del edadismo, junto con acciones encaminadas al encuentro intergeneracional para promover un trato igualitario entre estudiantes y las personas mayores y se basó en el Modelo PEACE (Positive Education about Aging and Contact Experiences). Supuso la realización de siete talleres en tres optativas el grado de Trabajo Social, planeados desde el cruce de la interseccionalidad de grupos y/o mitos más comunes sobre las personas mayores en España, tales como: personas mayores LGTBIQ+, las minorías étnicas y/o personas migrantes, la sexualidad e intimidad en la vejez y la prevalencia de enfermedades o bien la funcionalidad física y cognitiva. De esta manera, en los talleres se intentó problematizar estos elementos y se desmitificaron los principales mitos/estereotipos a la luz de las principales teóricas, datos y evidencia empírica. También en dichas actividades formativas se trabajaron grupalmente algunas estrategias para, desde el Trabajo social, luchar en erradicarlas.Depto. de Trabajo Social y Servicios SocialesFac. de Trabajo SocialFALSEsubmitte