Revisió de les intervencions adreçades a l’obesitat i el sobrepès infantil i juvenil

Sobrepès; Sedentarisme; Revisió sistemàticaOverweight; Sedentary lifestyle; Systematic reviewSobrepeso; Sedentarismo; Revisión sistemáticaAquest informe de revisió aborda el tractament del sobrepès i l'obesitat infantojuvenil. La població diana d’aquest treball són nens i nenes i adolescents menors de 18 anys, amb sobrepès i/o obesitat S'exclouen explícitament el tractament de les causes secundàries de l'obesitat infantojuvenil, els trastorns de la conducta alimentària i el tractament de les comorbiditats associades a l’obesitat i/o el sobrepès, com també els tractaments farmacològics i quirúrgics

Revisión crítica de las intervenciones dirigidas a la obesidad infantojuvenil

Sobrepès; Estil de vida; Recerca bibliogràficaOverweight; Lifestyle; Bibliographic searchSobrepeso; Estilo de vida; Búsqueda bibliográficaEl objetivo del presente informe ha sido analizar los estudios sobre la obesidad infantojuvenil incluidos en una actualización publicada en 2009 teniendo en cuenta factores metodológicos (tipos de estudio incluidos, país/es del estudio, rango de tamaños muestrales analizados), así como los posibles factores asociados al fracaso de la intervención (participación y adherencia). También se compararon las nuevas evidencias aportadas con los conocimientos de la actualización previ

Development and external validation of a faecal immunochemical test-based prediction model for colorectal cancer detection in symptomatic patients

Background: Risk prediction models for colorectal cancer (CRC) detection in symptomatic patients based on available biomarkers may improve CRC diagnosis. Our aim was to develop, compare with the NICE referral criteria and externally validate a CRC prediction model, COLONPREDICT, based on clinical and laboratory variables. Methods: This prospective cross-sectional study included consecutive patients with gastrointestinal symptoms referred for colonoscopy between March 2012 and September 2013 in a derivation cohort and between March 2014 and March 2015 in a validation cohort. In the derivation cohort, we assessed symptoms and the NICE referral criteria, and determined levels of faecal haemoglobin and calprotectin, blood haemoglobin, and serum carcinoembryonic antigen before performing an anorectal examination and a colonoscopy. A multivariate logistic regression analysis was used to develop the model with diagnostic accuracy with CRC detection as the main outcome. Results: We included 1572 patients in the derivation cohort and 1481 in the validation cohorts, with a 13.6 % and 9. 1 % CRC prevalence respectively. The final prediction model included 11 variables: age (years) (odds ratio [OR] 1.04, 95 % confidence interval [CI] 1.02-1.06), male gender (OR 2.2, 95 % CI 1.5-3.4), faecal haemoglobin >= 20 mu g/g (OR 17.0, 95 % CI 10.0-28.6), blood haemoglobin = 3 ng/mL (OR 4.5, 95 % CI 3.0-6.8), acetylsalicylic acid treatment (OR 0.4, 95 % CI 0.2-0.7), previous colonoscopy (OR 0.1, 95 % CI 0.06-0.2), rectal mass (OR 14.8, 95 % CI 5.3-41.0), benign anorectal lesion (OR 0.3, 95 % CI 0.2-0.4), rectal bleeding (OR 2.2, 95 % CI 1.4-3.4) and change in bowel habit (OR 1.7, 95 % CI 1.1-2.5). The area under the curve (AUC) was 0.92 (95 % CI 0.91-0.94), higher than the NICE referral criteria (AUC 0.59, 95 % CI 0.55-0.63; p < 0.001). On the basis of the thresholds with 90 % (5.6) and 99 % (3.5) sensitivity, we divided the derivation cohort into three risk groups for CRC detection: high (30.9 % of the cohort, positive predictive value [PPV] 40.7 %, 95 % CI 36.7-45.9 %), intermediate (29.5 %, PPV 4.4 %, 95 % CI 2.8-6.8 %) and low (39.5 %, PPV 0.2 %, 95 % CI 0.0-1.1 %). The discriminatory ability was equivalent in the validation cohort (AUC 0.92, 95 % CI 0.90-0.94; p = 0.7). Conclusions: COLONPREDICT is a highly accurate prediction model for CRC detection.This study was funded by a grant from Instituto de Salud Carlos III (PI11/00094). JC and VH have received an intensification grant through the European Commission funded "BIOCAPS" project (FP-7-REGPOT 2012-2013-1, Grant agreement no. FP7-316265). The validation cohort recruitment was funded by a grant from Fundacio de la Marato TV3 2012 (785/U/2013). The funding institutions had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication

Case-control study for colorectal cancer genetic susceptibility in EPICOLON: previously identified variants and mucins

<p>Abstract</p> <p>Background</p> <p>Colorectal cancer (CRC) is the second leading cause of cancer death in developed countries. Familial aggregation in CRC is also important outside syndromic forms and, in this case, a polygenic model with several common low-penetrance alleles contributing to CRC genetic predisposition could be hypothesized. Mucins and GALNTs (N-acetylgalactosaminyltransferase) are interesting candidates for CRC genetic susceptibility and have not been previously evaluated. We present results for ten genetic variants linked to CRC risk in previous studies (previously identified category) and 18 selected variants from the mucin gene family in a case-control association study from the Spanish EPICOLON consortium.</p> <p>Methods</p> <p>CRC cases and matched controls were from EPICOLON, a prospective, multicenter, nationwide Spanish initiative, comprised of two independent stages. Stage 1 corresponded to 515 CRC cases and 515 controls, whereas stage 2 consisted of 901 CRC cases and 909 controls. Also, an independent cohort of 549 CRC cases and 599 controls outside EPICOLON was available for additional replication. Genotyping was performed for ten previously identified SNPs in <it>ADH1C</it>, <it>APC</it>, <it>CCDN1</it>, <it>IL6</it>, <it>IL8</it>, <it>IRS1</it>, <it>MTHFR</it>, <it>PPARG</it>, <it>VDR </it>and <it>ARL11</it>, and 18 selected variants in the mucin gene family.</p> <p>Results</p> <p>None of the 28 SNPs analyzed in our study was found to be associated with CRC risk. Although four SNPs were significant with a <it>P</it>-value < 0.05 in EPICOLON stage 1 [rs698 in <it>ADH1C </it>(OR = 1.63, 95% CI = 1.06-2.50, <it>P</it>-value = 0.02, recessive), rs1800795 in <it>IL6 </it>(OR = 1.62, 95% CI = 1.10-2.37, <it>P</it>-value = 0.01, recessive), rs3803185 in <it>ARL11 </it>(OR = 1.58, 95% CI = 1.17-2.15, <it>P</it>-value = 0.007, codominant), and rs2102302 in <it>GALNTL2 </it>(OR = 1.20, 95% CI = 1.00-1.44, <it>P</it>-value = 0.04, log-additive 0, 1, 2 alleles], only rs3803185 achieved statistical significance in EPICOLON stage 2 (OR = 1.34, 95% CI = 1.06-1.69, <it>P</it>-value = 0.01, recessive). In the joint analysis for both stages, results were only significant for rs3803185 (OR = 1.12, 95% CI = 1.00-1.25, <it>P</it>-value = 0.04, log-additive 0, 1, 2 alleles) and borderline significant for rs698 and rs2102302. The rs3803185 variant was not significantly associated with CRC risk in an external cohort (MCC-Spain), but it still showed some borderline significance in the pooled analysis of both cohorts (OR = 1.08, 95% CI = 0.98-1.18, <it>P</it>-value = 0.09, log-additive 0, 1, 2 alleles).</p> <p>Conclusions</p> <p><it>ARL11</it>, <it>ADH1C</it>, <it>GALNTL2 </it>and <it>IL6 </it>genetic variants may have an effect on CRC risk. Further validation and meta-analyses should be undertaken in larger CRC studies.</p

Crònica sentimental de Solencio de Bastaras: Solencio de Bastaras. Bastaras-Panzano (Osca)

Crònica de les expedicions espeleològiques que durant els anys 1968, 1971-1972, 1993 i 2000-2001 l�autor realitzà com a integrant dels clubs excursionistes de Montblanc i Terrassa a les coves de Solencio de Bastaras (Osca). És de remarcar l�accident de 1971 que costà la vida a tres espeleòlegs catalans.Chronicle of speleological expeditions that during the years 1968, 1971-1972, 1993 and 2000-2001 the author conducted as part of Montblanc and Terrassa Climbing Club in the caves of Solencio de Bastaras (Huesca). It is worth noting the crash of 1971 that cost the lives of three cavers from Catalunya.Crónica de las expediciones espeleológicas que en los años 1968, 1971-1972, 1993 y 2000- 2001 el autor del presente artículo realizó como componente de los clubs excursionistas de Montblanc y Terrassa a las cuevas de Solencio de Bastaras (Huesca). Cabe destacar el accidente de 1971 que costó la vida a tres espeleólogos catalanes