849 research outputs found
Validation of metabolic syndrome using medical records in the SUN cohort
The objective of this study was to evaluate the validity of self
reported criteria of Metabolic Syndrome (MS) in the SUN (Seguimiento Universidad
de Navarra) cohort using their medical records as the gold standard. METHODS: We
selected 336 participants and we obtained MS related data according to Adult
Treatment Panel III (ATP III) and International Diabetes Federation (IDF). Then
we compared information on the self reported diagnosis of MS and MS diagnosed in
their medical records. We calculated the proportion of confirmed MS, the
proportion of confirmed non-MS and the intraclass correlation coefficients for
each component of the MS. RESULTS: From those 336 selected participants, we
obtained sufficient data in 172 participants to confirm or reject MS using ATP
III criteria. The proportion of confirmed MS was 91.2% (95% CI: 80.7- 97.1) and
the proportion of confirmed non-MS was 92.2% (95% CI: 85.7-96.4) using ATP III
criteria. The proportion of confirmed MS using IDF criteria was 100% (95% CI:
87.2-100) and the proportion of confirmed non-MS was 97.1% (95% CI: 85.1-99.9).
Kappa Index was 0.82 in the group diagnosed by ATP III criteria and 0.97 in the
group diagnosed by IDF criteria. Intraclass correlation coefficients for the
different component of MS were: 0.93 (IC 95%:0.91- 0.95) for BMI; 0.96 (IC 95%:
0.93-0.98) for waist circumference; 0.75 (IC 95%: 0.66-0.82) for fasting glucose;
0.50 (IC 95%:0.35-0.639) for HDL cholesterol; 0.78 (IC 95%: 0.70-0.84) for
triglycerides; 0.49 (IC 95%:0.34-0.61) for systolic blood pressure and 0.55 (IC
95%: 0.41-0.65) for diastolic blood pressure. CONCLUSIONS: Self-reported MS based
on self reported components of the SM in a Spanish cohort of university graduates
was sufficiently valid as to be used in epidemiological studies
Use of colonoscopy as a primary screening test for colorectal cancer in average risk people
The use of colonoscopy as a primary screening test for colorectal
cancer (CRC) in average risk adults is a subject of controversy. Our primary
objective was to build a predictive model based on a few simple variables that
could be used as a guide for identifying average risk adults more suitable for
examination with colonoscopy as a primary screening test. METHODS: The prevalence
of advanced adenomas was assessed by primary screening colonoscopy in 2210
consecutive adults at least 40 yr old, without known risk factors for CRC. Age,
gender, and clinical and biochemical data were compared among people without
adenomas, those with non-advanced adenomas, and those with any advanced neoplasm.
A combined score to assess the risk of advanced adenomas was built with the
variables selected by multiple logistic regression analysis. RESULTS: Neoplastic
lesions were found in 617 subjects (27.9%), including 259 with at least one
neoplasm that was 10 mm or larger, villous, or with moderate-to-severe dysplasia,
and 11 with invasive cancers. Advanced lesions were more frequent among men,
older people, and those with a higher body mass index (BMI). These three
variables were independent predictors of advanced adenomas in multivariate
analysis. A score combining age, sex, and BMI was developed as a guide for
identifying individuals more suitable for screening colonoscopy. CONCLUSIONS:
Age, gender, and BMI can be used to build a simple score to select those average
risk adults who might be candidates for primary screening colonoscop
Diagnostic value of distal colonic polyps for prediction of advanced proximal neoplasia in an average-risk population undergoing screening colonoscopy
For colorectal cancer screening, the predictive value of distal
findings in the ascertainment of proximal lesions is not fully established. The
aims of this study were to assess distal findings as predictors of advanced
proximal neoplasia and to compare the predictive value of endoscopy alone vs.
combined endoscopic and histopathologic data. METHODS: Primary colonoscopy
screening was performed in 2210 consecutive, average-risk adults. Age, gender,
endoscopic (size, number of polyps), and histopathologic distal findings were
used as potential predictors of advanced proximal neoplasms (i.e., any adenoma >
or =1 cm in size, and/or with villous histology, and/or with severe dysplasia or
invasive cancer). Polyps were defined as distal if located in the descending
colon, the sigmoid colon, or the rectum. Those in other locations were designated
proximal. RESULTS: Neoplastic lesions, including 11 invasive cancers, were found
in 617 (27.9%) patients. Advanced proximal neoplasms without any distal adenoma
were present in 1.3% of patients. Of the advanced proximal lesions, 39% were not
associated with any distal polyp. Older age, male gender, and distal adenoma were
independent predictors of advanced proximal neoplasms. The predictive ability of
a model with endoscopic data alone did not improve after inclusion of
histopathologic data. In multivariate logistic regression analysis, the
predictive ability of models that use age, gender, and any combination of distal
findings was relatively low. The proportion of advanced proximal neoplasms
identified if any distal polyp was an indication for colonoscopy was only 62%.
CONCLUSIONS: A strategy in which colonoscopy is performed solely in patients with
distal colonic findings is not effective screening for the detection of advanced
proximal neoplasms in an average-risk populatio
Role of targeted therapies in rheumatic patients on COVID-19 outcomes: Results from the COVIDSER study
Objectives To analyse the effect of targeted therapies, either biological (b) disease-modifying antirheumatic drugs (DMARDs), targeted synthetic (ts) DMARDs and other factors (demographics, comorbidities or COVID-19 symptoms) on the risk of COVID-19 related hospitalisation in patients with inflammatory rheumatic diseases. Methods The COVIDSER study is an observational cohort including 7782 patients with inflammatory rheumatic diseases. Multivariable logistic regression was used to estimate ORs and 95% CIs of hospitalisation. Antirheumatic medication taken immediately prior to infection, demographic characteristics, rheumatic disease diagnosis, comorbidities and COVID-19 symptoms were analysed. Results A total of 426 cases of symptomatic COVID-19 from 1 March 2020 to 13 April 2021 were included in the analyses: 106 (24.9%) were hospitalised and 19 (4.4%) died. In multivariate-adjusted models, bDMARDs and tsDMARDs in combination were not associated with hospitalisation compared with conventional synthetic DMARDs (OR 0.55, 95% CI 0.24 to 1.25 of b/tsDMARDs, p=0.15). Tumour necrosis factor inhibitors (TNF-i) were associated with a reduced likelihood of hospitalisation (OR 0.32, 95% CI 0.12 to 0.82, p=0.018), whereas rituximab showed a tendency to an increased risk of hospitalisation (OR 4.85, 95% CI 0.86 to 27.2). Glucocorticoid use was not associated with hospitalisation (OR 1.69, 95% CI 0.81 to 3.55). A mix of sociodemographic factors, comorbidities and COVID-19 symptoms contribute to patients'' hospitalisation. Conclusions The use of targeted therapies as a group is not associated with COVID-19 severity, except for rituximab, which shows a trend towards an increased risk of hospitalisation, while TNF-i was associated with decreased odds of hospitalisation in patients with rheumatic disease. Other factors like age, male gender, comorbidities and COVID-19 symptoms do play a role.
Prospective study of changes in sugar-sweetened beverages consumption and incidence of metabolic syndrome and its components
The incidence of the metabolic syndrome (MetS) is increasing and lifestyle behaviours may play a role. The aim of the present study was to prospectively assess the association between changes in the consumption of sugar-sweetened beverages (SSB) and the incidence of the MetS and its components in a Spanish cohort of university graduates. We included 8157 participants initially free of the MetS and followed up during at least 6 years. SSB consumption was collected by a FFQ previously validated in Spain. The change in SSB consumption was calculated as the difference between SSB consumption at a 6-year follow-up and baseline consumption. The MetS was defined according to the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute's new definition of the MetS that had harmonised previous definitions. The associations between changes in SSB intake and the MetS were examined using multiple logistic regression. We observed 361 incident cases of the MetS. Participants who increased their consumption of SSB (upper v. lower quintile) had a significantly higher risk of developing the MetS (adjusted OR 2·2, 95 % CI 1·4, 3·5; P for trend = 0·003). Similarly, they presented a significantly higher risk of developing high blood pressure (adjusted OR 1·6, 95 % CI 1·3, 2·1), central obesity (adjusted OR 2·3, 95 % CI 1·9, 2·7), hypertriacylglycerolaemia (adjusted OR 1·7, 95 % CI 1·1, 2·6) or impaired fasting glucose (adjusted OR 1·6, 95 % CI 1·1, 2·2). In conclusion, an increase in SSB consumption was associated with a higher risk of developing the MetS and other metabolic disorders after 6 years of follow-up in a Mediterranean cohort of university graduates
Prognostic utility of serum free light chain ratios and heavy-light chain ratios in multiple myeloma in three PETHEMA/GEM phase III clinical trials
We investigated the prognostic impact and clinical utility of serum free light chains (sFLC) and serum heavy-light chains (sHLC) in patients with multiple myeloma treated according to the GEM2005MENOS65, GEM2005MAS65, and GEM2010MAS65 PETHEMA/GEM phase III clinical trials. Serum samples collected at diagnosis were retrospectively analyzed for sFLC (n = 623) and sHLC (n = 183). After induction or autologous transplantation, 309 and 89 samples respectively were available for sFLC and sHLC assays. At diagnosis, a highly abnormal (HA) sFLC ratio (sFLCr) (32) was not associated with higher risk of progression. After therapy, persistence of involved-sFLC levels >100 mg/L implied worse survival (overall survival [OS], P = 0.03; progression-free survival [PFS], P = 0.007). Among patients that achieved a complete response, sFLCr normalization did not necessarily indicate a higher quality response. We conducted sHLC investigations for IgG and IgA MM. Absolute sHLC values were correlated with monoclonal protein levels measured with serum protein electrophoresis. At diagnosis, HA-sHLCrs (73) showed a higher risk of progression (P = 0.006). Additionally, involved-sHLC levels >5 g/L after treatment were associated with shorter survival (OS, P = 0.001; PFS, P = 0.018). The HA-sHLCr could have prognostic value at diagnosis; absolute values of involved-sFLC >100 mg/L and involved-sHLC >5 g/L could have prognostic value after treatment
Análisis critico de la respuesta completa estricta en mieloma múltiple. actualización de los datos basados en el estudio fase 3 PETHEMA/GEM2012MENOS65
CO-001
Introducción: Para establecer diferencias pronósticas entre los pacientes con MM que alcanzan RC, el IMWG introdujo un criterio de respuesta más estricto (RC estricta) añadiendo al criterio de RC, la existencia de cadenas ligeras en suero (CLLs) normales y la ausencia de CP clonales en MO por IHQ. En el año 2011 la CMF de baja sensibilidad se incluyó como técnica alternativa a la IHQ para establecer RC estricta (RCs). Sin embargo, el valor pronóstico de la ratio kappa/lambda no está claro (Blood 2015. 126:858-62).
Métodos: Se incluyeron 458 pacientes =65 años del ensayo clínico GEM2012MENOS65 (NCT01916252). Ocho discontinuaron pronto y no fueron evaluables. Las CLLs fueron clasificadas como normal (0.26- 1.65) o anormal (1.65 si el paciente era ) (FREELITE assay). La EMR fue evaluada mediante citometria de flujo (CMF). El límite de detección fue de 3x10-6. Todas las RC con CLLs normales y ausencia de CP por CMF con una sensibilidad de 10-2 fueron considerados en RCs. La mediana de seguimiento fue 47.5 meses. , ,
Explorando la celula de origen y los programas transcripcionales patologicos en mieloma multiple (MM) y amiloidosis de cadena ligera (AL) mediante la diseccion del desarrollo de la celula plasmatica (CP) normal
CO-009
MM y AL son las dos gammapatias monoclonales malignas más comunes. Los intentos para identificar las diferencias genéticas entre ambas han tenido poco éxito. Además, se desconoce si MM y AL emergen del mismo compartimento de CPs normales. Nos proponemos definir el atlas trancripcional del desarrollo de la CP normal en sangre periférica (SP) y medula ósea (MO), y compararlo con el programa transcripcional de las CPs clonales de MM y AL. Se estudiaron 93 individuos, en 7 donantes sanos (DS), se aislaron CP de SP según su isotipo de cadena pesada (IgG, IgA and IgM). Adicionalmente, se obtuvieron 5 subpoblaciones de CP de MO basadas en la expresión de CD19, CD39, CD81 y CD56. Las CPs clonales de pacientes con MM (n=38) y AL (n=41) se separaron mediante FACS por fenotipo aberrante especifico de paciente. Para estudiar poblaciones de CP con un reducido numero de células aisladas, empleamos un método de RNAseq de alta sensibilidad (MARS-seq). Se realizaron todas las comparaciones pareadas posibles de expresión diferencial (Deseq2). Se generaron datos de expresión mediante single-cell RNAseq (scRNAseq, 10xGenomics) de un total de 35, 910 PCs de 3 HA, 2 MM and 2 AL, que fueron analizados de manera integrada con el paquete Seurat en R. ..
Towards the high-accuracy determination of the 238U fission cross section at the threshold region at CERN - N-TOF
The 238U fission cross section is an international standard beyond 2 MeV where the fission plateau starts. However, due to its importance in fission reactors, this cross-section should be very accurately known also in the threshold region below 2 MeV. The 238U fission cross section has been measured relative to the 235U fission cross section at CERN - n-TOF with different detection systems. These datasets have been collected and suitably combined to increase the counting statistics in the threshold region from about 300 keV up to 3 MeV. The results are compared with other experimental data, evaluated libraries, and the IAEA standards
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