31 research outputs found
Clinical and ultrasound thyroid nodule characteristics and their association with cytological and histopathological outcomes: A retrospective multicenter study in high-resolution thyroid nodule clinics
Introduction: Thyroid nodules are a common finding. A high-resolution thyroid nodule
clinic (HR-TNC) condenses all tests required for the evaluation of thyroid nodules into a single
appointment. We aimed to evaluate the clinical outcomes at HR-TNCs. Design and Methods:
A retrospective cross-sectional multicenter study including data from four HR-TNCs in Spain.
We evaluated fine-needle aspiration (FNA) indications and the association between clinical and
ultrasound characteristics with cytological and histopathological outcomes. Results: A total of 2809
thyroid nodules were included; FNA was performed in 82.1%. Thyroid nodules that underwent
FNA were more likely larger, isoechoic, with microcalcifications, and in younger subjects. The rate
of nondiagnostic FNA was 4.3%. A solid component, irregular margins or microcalcifications,
significantly increased the odds of Bethesda IV-V-VI (vs. Bethesda II). Irregular margins and a solid
component were independently associated with increased odds of malignancy. Thyroid nodules
<20 mm and ≥20–<40 mm had a 6.5-fold and 3.3-fold increased risk for malignancy respectively
in comparison with those ≥40 mm. Conclusion: In this large multicenter study, we found that the
presence of a solid component and irregular margins are factors independently related to malignancy
in thyroid nodules. Since nodule size ≥40 mm was associated with the lowest odds of malignancy,
this cut-off should not be a factor leading to indicate thyroid surgery. HR-TNCs were associated with
a low rate of nondiagnostic FNA
Isotemporal substitution of inactive time with physical activity and time in bed: cross-sectional associations with cardiometabolic health in the PREDIMEDPlus study
Background: This study explored the association between inactive time and measures of adiposity, clinical parameters, obesity, type 2 diabetes and metabolic syndrome components. It further examined the impact of reallocating inactive time to time in bed, light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) on cardio-metabolic risk factors, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults.
Methods: This is a cross-sectional analysis of baseline data from 2189 Caucasian men and women (age 55-75 years, BMI 27-40 Kg/m2) from the PREDIMED-Plus study (http://www.predimedplus.com/). All participants had ≥3 components of the metabolic syndrome. Inactive time, physical activity and time in bed were objectively determined using triaxial accelerometers GENEActiv during 7 days (ActivInsights Ltd., Kimbolton, United Kingdom). Multiple adjusted linear and logistic regression models were used. Isotemporal substitution regression modelling was performed to assess the relationship of replacing the amount of time spent in one activity for another, on each outcome, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults.
Results: Inactive time was associated with indicators of obesity and the metabolic syndrome. Reallocating 30 min per day of inactive time to 30 min per day of time in bed was associated with lower BMI, waist circumference and glycated hemoglobin (HbA1c) (all p-values < 0.05). Reallocating 30 min per day of inactive time with 30 min per day of LPA or MVPA was associated with lower BMI, waist circumference, total fat, visceral adipose tissue, HbA1c, glucose, triglycerides, and higher body muscle mass and HDL cholesterol (all p-values < 0.05).
Conclusions: Inactive time was associated with a poor cardio-metabolic profile. Isotemporal substitution of inactive time with MVPA and LPA or time in bed could have beneficial impact on cardio-metabolic health
Relationship between olive oil consumption and ankle-brachial pressure index in a population at high cardiovascular risk
The aim of this study was to ascertain the association between the consumption of different categories of edible olive oils (virgin olive oils and olive oil) and olive pomace oil and ankle-brachial pressure index (ABI) in participants in the PREDIMED-Plus study, a trial of lifestyle modification for weight and cardiovascular event reduction in individuals with overweight/obesity harboring the metabolic syndrome.
Methods: We performed a cross-sectional analysis of the PREDIMED-Plus trial. Consumption of any category of olive oil and olive pomace oil was assessed through a validated food-frequency questionnaire. Multivariable linear regression models were fitted to assess associations between olive oil consumption and ABI. Additionally, ABI ≤1 was considered as the outcome in logistic models with different categories of olive oil and olive pomace oil as exposure.
Results: Among 4330 participants, the highest quintile of total olive oil consumption (sum of all categories of olive oil and olive pomace oil) was associated with higher mean values of ABI (beta coefficient: 0.014, 95% confidence interval [CI]: 0.002, 0.027) (p for trend = 0.010). Logistic models comparing the consumption of different categories of olive oils, olive pomace oil and ABI ≤1 values revealed an inverse association between virgin olive oils consumption and the likelihood of a low ABI (odds ratio [OR] 0.73, 95% CI [0.56, 0.97]), while consumption of olive pomace oil was positively associated with a low ABI (OR 1.22 95% CI [1.00, 1.48]).
Conclusions: In a Mediterranean population at high cardiovascular risk, total olive oil consumption was associated with a higher mean ABI. These results suggest that olive oil consumption may be beneficial for peripheral artery disease prevention, but longitudinal studies are needed
Long daytime napping is associated with increased adiposity and type 2 diabetes in an elderly population with metabolic syndrome
Research examining associations between objectively-measured napping time and type
2 diabetes (T2D) is lacking. This study aimed to evaluate daytime napping in relation to T2D and
adiposity measures in elderly individuals from the Mediterranean region. A cross-sectional analysis of
baseline data from 2190 elderly participants with overweight/obesity and metabolic syndrome, in the
PREDIMED-Plus trial, was carried out. Accelerometer-derived napping was measured. Prevalence
ratios (PR) and 95% confidence intervals (CI) for T2D were obtained using multivariable-adjusted
Cox regression with constant time. Linear regression models were fitted to examine associations of
napping with body mass index (BMI) and waist circumference (WC). Participants napping ≥90 min
had a higher prevalence of T2D (PR 1.37 (1.06, 1.78)) compared with those napping 5 to <30 min per
day. Significant positive associations with BMI and WC were found in those participants napping
≥30 min as compared to those napping 5 to <30 min per day. The findings of this study suggest that
longer daytime napping is associated with higher T2D prevalence and greater adiposity measures in
an elderly Spanish population at high cardiovascular risk
Desempenho e características de carcaça de coelhos alimentados com rações contendo diferentes níveis de amido e fontes de fibra
RICORS2040 : The need for collaborative research in chronic kidney disease
Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true
Clinical and ultrasound thyroid nodule characteristics and their association with cytological and histopathological outcomes: A retrospective multicenter study in high-resolution thyroid nodule clinics
Introduction: Thyroid nodules are a common finding. A high-resolution thyroid nodule
clinic (HR-TNC) condenses all tests required for the evaluation of thyroid nodules into a single
appointment. We aimed to evaluate the clinical outcomes at HR-TNCs. Design and Methods:
A retrospective cross-sectional multicenter study including data from four HR-TNCs in Spain.
We evaluated fine-needle aspiration (FNA) indications and the association between clinical and
ultrasound characteristics with cytological and histopathological outcomes. Results: A total of 2809
thyroid nodules were included; FNA was performed in 82.1%. Thyroid nodules that underwent
FNA were more likely larger, isoechoic, with microcalcifications, and in younger subjects. The rate
of nondiagnostic FNA was 4.3%. A solid component, irregular margins or microcalcifications,
significantly increased the odds of Bethesda IV-V-VI (vs. Bethesda II). Irregular margins and a solid
component were independently associated with increased odds of malignancy. Thyroid nodules
<20 mm and ≥20–<40 mm had a 6.5-fold and 3.3-fold increased risk for malignancy respectively
in comparison with those ≥40 mm. Conclusion: In this large multicenter study, we found that the
presence of a solid component and irregular margins are factors independently related to malignancy
in thyroid nodules. Since nodule size ≥40 mm was associated with the lowest odds of malignancy,
this cut-off should not be a factor leading to indicate thyroid surgery. HR-TNCs were associated with
a low rate of nondiagnostic FNA
Occult Hepatitis C virus infection among hemodialysis patients
Occult hepatitis C virus (HCV) infection (i.e., detectable HCV-RNA in the liver
or peripheral blood mononuclear cells) in the absence of both serum HCV-RNA and
anti-HCV antibodies has not been investigated in hemodialysis patients. In this
study, real-time PCR and in situ hybridization was used to test for the presence
of genomic and antigenomic HCV-RNA in peripheral blood mononuclear cells of 109
hemodialysis patients with abnormal levels of liver enzymes. Occult HCV
infection, determined by the presence of genomic HCV-RNA, was found in 45% of the
patients; 53% of these patients had ongoing HCV replication, indicated by the
presence of antigenomic HCV-RNA. Patients with occult HCV infection had spent a
significantly longer time on hemodialysis and had significantly higher mean
alanine aminotransferase levels during the 6 mo before study entry. Logistic
regression analysis revealed that mortality was associated with age >60 yr (odds
ratio 3.30; 95% confidence interval 1.05 to 10.33) and the presence of occult HCV
infection (odds ratio 3.84; 95% confidence interval 1.29 to 11.43). In
conclusion, the prevalence of occult HCV infection is high among hemodialysis
patients with persistently abnormal values of liver enzymes of unknown cause. The
clinical significance of occult HCV infection in these patients requires further
study
Association of irisin with fat mass, resting energy expenditure, and daily activity in conditions of extreme body mass index
FNDC5/irisin has been recently postulated as beneficial in the treatment of obesity and diabetes because it is induced in muscle by exercise, increasing energy expenditure. However, recent reports have shown that WAT also secretes irisin and that circulating irisin is elevated in obese subjects. The aim of this study was to evaluate irisin levels in conditions of extreme BMI and its correlation with basal metabolism and daily activity. The study involved 145 female patients, including 96 with extreme BMIs (30 anorexic (AN) and 66 obese (OB)) and 49 healthy normal weight (NW). The plasma irisin levels were significantly elevated in the OB patients compared with the AN and NW patients. Irisin also correlated positively with body weight, BMI, and fat mass. The OB patients exhibited the highest REE and higher daily physical activity compared with the AN patients but lower activity compared with the NW patients. The irisin levels were inversely correlated with daily physical activity and directly correlated with REE. Fat mass contributed to most of the variability of the irisin plasma levels independently of the other studied parameters. Conclusion. Irisin levels are influenced by energy expenditure independently of daily physical activity but fat mass is the main contributing factor
Modulation of the endocannabinoids N-arachidonoylethanolamine (AEA) and 2-arachidonoylglycerol (2-AG) on executive functions in humans
Animal studies point to an implication of the endocannabinoid system on executive functions. In humans, several studies have suggested an association between acute or chronic use of exogenous cannabinoids (Δ9-tetrahydrocannabinol) and executive impairments. However, to date, no published reports establish the relationship between endocannabinoids, as biomarkers of the cannabinoid neurotransmission system, and executive functioning in humans. The aim of the present study was to explore the association between circulating levels of plasma endocannabinoids N-arachidonoylethanolamine (AEA) and 2-Arachidonoylglycerol (2-AG) and executive functions (decision making, response inhibition and cognitive flexibility) in healthy subjects. One hundred and fifty seven subjects were included and assessed with the Wisconsin Card Sorting Test; Stroop Color and Word Test; and Iowa Gambling Task. All participants were female, aged between 18 and 60 years and spoke Spanish as their first language. Results showed a negative correlation between 2-AG and cognitive flexibility performance (r = -.37; p<.05). A positive correlation was found between AEA concentrations and both cognitive flexibility (r = .59; p<.05) and decision making performance (r = .23; P<.05). There was no significant correlation between either 2-AG (r = -.17) or AEA (r = -.08) concentrations and inhibition response. These results show, in humans, a relevant modulation of the endocannabinoid system on prefrontal-dependent cognitive functioning. The present study might have significant implications for the underlying executive alterations described in some psychiatric disorders currently associated with endocannabinoids deregulation (namely drug abuse/dependence, depression, obesity and eating disorders). Understanding the neurobiology of their dysexecutive profile might certainly contribute to the development of new treatments and pharmacological approaches