Sleep duration and napping in relation to colorectal and gastric cancer in the MCC-Spain study

Sleep duration is a novel and potentially modifiable risk factor for cancer. We evaluated the association of self-reported sleep duration and daytime napping with odds of colorectal and gastric cancer. We included 2008 incident colorectal cancer cases, 542 gastric cancer cases and 3622 frequency-matched population controls, recruited in the MCC-Spain case-control study (2008-2013). Sleep information, socio-demographic and lifestyle characteristics were obtained through personal interviews. Multivariable adjusted logistic regression models were used to estimate odds ratios (OR) with 95% confidence intervals (CI) for cancer, across categories of sleep duration (? 5, 6, 7, 8, ? 9 hours/day), daytime napping frequency (naps/week) and duration (minutes/nap). Compared to 7 hours of sleep, long sleep was associated with increased odds of colorectal (OR?9 hours: 1.59; 95%CI 1.30-1.94) and gastric cancer (OR?9 hours: 1.95; 1.37-2.76); short sleep was associated with increased odds of gastric cancer (OR?5 hours: 1.32; 0.93-1.88). Frequent and long daytime naps increased the odds of colorectal (OR6-7 naps/week, ?30 min: 1.32; 1.14-1.54) and gastric cancer (OR6-7 naps/week, ?30 min: 1.56; 1.21-2.02). Effects of short sleep and frequent long naps were stronger among participants with night shift-work history. Sleep and circadian disruption may jointly play a role in the etiology of colorectal and gastric cancer.Funding: The study was funded by the “Accion Transversal del Cancer”, approved on the Spanish Ministry Council on 11 October 2007, by the Instituto de Salud Carlos III-FEDER (PI08/1770, PI08/0533, PI08/1359, PI09/00773-Cantabria, PI09/01286-León, PI09/01903-Valencia, PI09/02078-Huelva, PI09/01662-Granada, PI11/01403, PI11/01889-FEDER, 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 (The ICGC CLL-Genome Project is funded by Spanish Ministerio de Economía y Competitividad (MINECO) through the Instituto de Salud Carlos III (ISCIII) and Red Temática de Investigación del Cáncer (RTICC) del ISCIII (RD12/0036/0036)), by the Junta de Castilla y León (LE22A10-2), by the Consejería de Salud of the Junta de Andalucía (2009-S0143), by the Conselleria de Sanitat of the Generalitat Valenciana (AP_061/10), by the Recercaixa (2010ACUP 00310), by the European Commission grants FOOD-CT-2006-036224-HIWATE, by the Spanish Association Against Cancer (AECC) Scientific Foundation, by the Catalan Government DURSI grant 2009SGR1489. KP received a predoctoral grant PFIS (FI09/00385). MCT is funded by a Ramón y Cajal fellowship (RYC-2017-01892) from the Spanish Ministry of Science, Innovation and Universities and cofunded by the European Social Fund. ISGlobal acknowledges support from the Spanish Ministry of Science and Innovation through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program. Agency for Management of University and Research Grants (AGAUR) of the Catalan Government grant 2017SGR723. Spanish Association Against Cancer (AECC) Scientific Foundation. DC is supported by Spanish Ministry of Economy and Competitiveness—Carlos III Institute of Health cofunded by FEDER funds/European Regional Develpment Fund (ERDF)—a way to build Europe (PI17/01280), the Centro de Investigacion Biomedica en Red: Epidemiologia y Salud Publica (CIBERESP, Spain) and the Agencia de Gestio d’Ajuts Universitaris i de Recerca (AGAUR), CERCA Programme/Generalitat de Catalunya for institutional suport (2017SGR1085). VM is funded by the Agency for Management of University and Research Grants (AGAUR) of the Catalan Government grant 2017SGR723; Instituto de Salud Carlos III, co-funded by FEDER funds—a way to build Europe—; Spanish Association Against Cancer (AECC) Scientific Foundation. Sample collection of this work was supported by the Xarxa de Bancs de Tumors de Catalunya sponsored by Pla Director d’Oncología de Catalunya (XBTC)", Plataforma Biobancos PT13/0010/0013" and ICOBIOBANC, sponsored by the Catalan Institute of Oncology. We thank CERCA Program, Generalitat de Catalunya for institutional support

Epidemiología básica. Material docente para prácticas en ciencias de la salud

Material docente teórico práctico para apoyar la enseñanza de la epidemiología. Consta de 4 unidades, cada una de ellas con una introducción teórica y unos ejercicios basados en artículos publicados en inglés en revistas científicas

Rede de Aerobiologia da Extremadura

The development of aerobiological networks in Spain has been made at the level of the autonomous communities. In Extremadura the sampling is conducted by the University of Extremadura. It began in 1993 with a station in Badajoz (BA). Two towns have had sampling on a temporary basis: Cáceres (CC 1996-2001) and Merida (ME 1996-1998). Currently there are 3 more sampling stations, which have been running since 2011: Plasencia (PL), Don Benito (DB) and Zafra (ZA), and CC again recently. The Annual Pollen Index (annual daily amounts) has shown an average of more than 50.000 pollen grains/m3 (23.532-92.655). In Badajoz (23 years) the results show a downward trend. The maximum daily concentration peaks were reached in 1997, with values of 6.102 grains/ m3 (CC 21/3) and 5.041 grains/m3 (BA 23/3). The five most important pollen types represent 78% of all the pollen registered. Their importance varies from one station to another. Quercus, Poaceae, Olea, Cupressaceae and Platanus, in this order, are the most abundant pollen types in all stations, except Platanus, which is the second most abundant in DB, and Olea, which is second in ZA. The data have been available on the research group’s website (www.aerouex.es) since 2006, and the record of visitors to the site shows a signi cant correlation with the concentration of pollen. Extremadura stands out for its high pollen concentrations of Poaceae and Quercus, due to its wide expanses of oak and cork trees. Pollen from ornamental sources –Cupressaceae and Platanus— shows a strong dependence on their abundance and distribution.El desarrollo de redes aerobiológicas en España se ha realizado a nivel de las comunidades autónomas. En Extremadura el muestreo llevado a cabo por la Universidad de Extremadura comenzó en 1993 con la estación de Badajoz (BA). Dos localidades han tenido muestreo de forma temporal, Cáceres (CC 1996-2001) y Mérida (ME 1996-1998). En la actualidad se cuenta con 3 estaciones de muestreo más, funcionando desde 2011: Plasencia (PL), Don Benito (DB) y Zafra (ZA) y, de forma reciente, nuevamente CC. El Índice Polínico Anual (la suma de las concentraciones de polen diarias para un año) ha mostrado un promedio de más de 50.000 granos/m3 (23.532-92.655). Para Badajoz (23 años) se aprecia una tendencia a la reducción. Los picos de concentración diaria máxima se alcanzaron en 1997 con valores de 6.102 granos/m3 (CC 21/3) y 5.041 granos/m3 (BA 23/3). Los cinco tipos polínicos más relevantes representan el 78% del total de polen registrado. Su importancia varía de una estación a otra. Quercus, Poaceae, Olea, Cupressaceae y Platanus, en este orden, son los tipos más abundantes en todas las estaciones, excepto Platanus que es el segundo en DB y Olea que es el segundo en ZA. Desde 2006 los datos están disponibles a través de la página web del grupo de investigación (www.aerouex.es) y el registro de los accesos a dicho sitio muestra una correlación significativa con la concentración de polen. Extremadura se destaca por los altos valores de concentración de polen de Quercus y Poaceae, debido a la gran extensión de encinares y alcornocales. El polen de fuentes ornamentales, Cupressaceae y Platanus, muestra una importante dependencia de su abundancia y distribución en las localidades estudiadas.O desenvolvimento das redes de aerobiologia em Espanha foi realizado ao nível das comunidades autónomas. Na Extremadura a amostragem levada a cabo pela Universidade de Extremadura começou em 1993 com a estação de Badajoz (BA). Duas localidades foram temporariamente estudadas como pontos de amostragem, Cáceres (CC 1996-2001) e Mérida (ME 1996-1998). Existem, atualmente, em execução desde 2011, mais 3 estações de amostragem: Plasencia (PL), Don Benito (DB) e Zafra (ZA) e, recentemente, de novo CC. O Índice Polínico Anual (somas diárias anuais) mostrou uma média de mais de 50.000 grãos/m3 (23.532-92.655). Em Badajoz (23 anos) verifica-se uma tendência para a redução da concentração. Os picos de concentração máximos diários foram alcançados em 1997 com os valores de 6.102 grãos/m3 (CC 21/3) e 5.041 grãos/m3 (BA 23/3). Os cinco tipos polínicos mais importantes representam 78% de pólen total registrado. A sua importância varia de uma estação para outra. Quercus, Poaceae, Olea, Cupressaceae e Platanus, nesta ordem, são os tipos mais abundantes em todas as estações, exceto Platanus que é o segundo em DB e Olea que é o segundo em ZA. Os dados estão disponíveis desde 2006 através do site do grupo de investigação (www. aerouex.es) e o registro de acessos mostra uma correlação significativa com a concentração de pólen. A Extremadura destaca-se pelos valores elevados de concentração de pólen de Poaceae e de Quercus, devido à grande extensão de azinheiras e sobreiros. O pólen de origens ornamentais, Cupressaceae e Platanus, mostra uma dependência significativa de sua abundância e distribuição nas localidades estudadas

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Sin / Sense

Sexto desafío por la erradicación de la violencia contra las mujeres del Institut Universitari d’Estudis Feministes i de Gènere «Purificación Escribano» de la Universitat Jaume

PON-1 and ferroxidase activities in older patients with mild cognitive impairment, late onset Alzheimer's disease or vascular dementia

Background: A large body of evidence suggests that not only cerebral but also systemic oxidative stress (OxS) might be involved in the pathogenesis of late onset Alzheimer's disease (LOAD) and vascular dementia (VAD), as well as of the prodromal phase of dementia, the so-called mild cognitive impairment (MCI). In the present study, we evaluated whether paraoxonase 1 (PON-1) and ferroxidase (FeOx) activities, because of their well acknowledged effectiveness as systemic antioxidants, might be associated with dementia and/or MCI. Methods: Serum arylesterase and paraoxonase of PON-1, along with FeOx I (ceruloplasmin-related) and II activities were assessed in 223 MCI, 162 LOAD, 65 VAD patients, and in 143 older normal cognitive controls. Results: Among the enzymatic activities examined, only arylesterase significantly changed across the groups (ANOVA: p<0.001), with similar lower levels in MCI, LOAD, and VAD compared to controls. By multivariate logistic regression analysis we showed that, in respect to controls, low levels (under the median value) of serum arylesterase were independently associated with an increase in the likelihood of being affected by LOAD [odds ratio (OR) 2.8, 95% confidence interval (CI) 1.5-5.0], VAD (OR 2.7, 95% CI 1.2-6.2), or MCI (OR 2.3, 95% CI 1.3-3.8). Conclusions: Overall, our results suggest that depression of PON-1, and in particular, of arylesterase activity, in serum might be an early feature of dementia-related diseases. Further longitudinal exploration of the role of this enzyme in the onset and progression of these disorders are required

Sindrome delle apnee ostruttive nei pazienti obesi: effetti sul profilo metabolico e cardiovascolare e risposta a 6 mesi alla terapia comportamentale.

Sindrome delle apnee ostruttive nei pazienti obesi: effetti sul profilo metabolico e cardiovascolare e risposta a 6 mesi alla terapia comportamentale. 30° Congresso Nazionale Società Italiana Studio Aterosclerosi, Roma, 20-22 novembre 2016

Obstructive Sleep Apnea syndrome in obese patients: Effects on metabolic and cardiovascular profile and impact of 6 months of behavioural therapy

Obstructive sleep apnea syndrome in obese patients: effects on metabolic and cardiovascular profile and impact of 6 months of behavioural therap

Nucleotide receptor: an emerging family of regulatory molecules in blood cells

Nucleotides are emerging as an ubiquitous family of extracellular signaling molecules. It has been known for many years that adenosine diphosphate is a potent platelet aggregating factor, but it is now clear that virtually every circulating cell is responsive to nucleotides. Effects as different as proliferation or differentiation, chemotaxis, release of cytokines or lysosomal constituents, and generation of reactive oxygen or nitrogen species are elicited upon stimulation of blood cells with extracellular adenosine triphosphate (ATP). These effects are mediated through a specific class of plasma membrane receptors called purinergic P2 receptors that, according to the molecular structure, are further subdivided into 2 subfamilies: P2Y and P2X. ATP and possibly other nucleotides are released from damaged cells or secreted via nonlytic mechanisms. Thus, during inflammation or vascular damage, nucleotides may provide an important mechanism involved in the activation of leukocytes and platelets. However, the cell physiology of these receptors is still at its dawn, and the precise function of the multiple P2X and P2Y receptor subtypes remains to be understood

In Situ Endothelial SARS-CoV-2 Presence and PROS1 Plasma Levels Alteration in SARS-CoV-2-Associated Coagulopathies

Background: Coagulation decompensation is one of the complications most frequently encountered in COVID-19 patients with a poor prognosis or long-COVID syndrome, possibly due to the persistence of SARS-CoV-2 infection in the cardiovascular system. To date, the mechanism underlying the alteration of the coagulation cascade in COVID-19 patients remains misunderstood and the anticoagulant protein S (PROS1) has been described as a potential risk factor for complications related to COVID-19, due to PLpro SARS-CoV-2 enzyme proteolysis. Methods: Biopsies and blood samples were collected from SARS-CoV-2 positive and negative swab test subjects with coagulopathies (peripheral arterial thrombosis), and SARS-CoV-2 presence, ACE2 and CD147 expression, and plasmatic levels of PROS1 were evaluated. Results: We reported a significant decrease of plasmatic PROS1 in the coagulopathic SARS-CoV-2 swab positive cohort, in association with SARS-CoV-2 in situ infection and CD147 peculiar expression. These data suggested that SARS-CoV-2 associated thrombotic/ischemic events might involve PROS1 cleavage by viral PLpro directly in the site of infection, leading to the loss of its anticoagulant function. Conclusions: Based on this evidence, the identification of predisposing factors, such as CD147 increased expression, and the use of PLpro inhibitors to preserve PROS1 function, might be useful for COVID-19 coagulopathies management