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Scheer C, Plans-Beriso E, Pastor-Barriuso R, Ortolá R, Sotos-Prieto M, Cabañas-Sánchez V, Gullón P, Ojeda Sánchez C, Ramis R, Fernández-Navarro P, Rodríguez-Artalejo F, García-Esquinas E. Exposure to green spaces, cardiovascular risk biomarkers and incident cardiovascular disease in older adults: The Seniors-Enrica II cohort. Environ Int 2024; 185:108570. [PMID: 38484611 DOI: 10.1016/j.envint.2024.108570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/07/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024]
Abstract
INTRODUCTION The impact of residential green spaces on cardiovascular health in older adults remains uncertain. METHODS Cohort study involving 2114 adults aged ≥ 65 years without cardiovascular disease (CVD), residing in five dense municipalities (Prince et al., 2015) of the Madrid region and with detailed characterization of their socioeconomic background, health behaviors, CVD biological risk factors, and mental, physical, and cognitive health. Greenness exposure was measured using the Normalized Difference Vegetation Index (NDVI) at varying distances from participants' homes. Traffic exposure, neighborhood environment, neighborhood walkability, and socioeconomic deprivation at the census level were also assessed. Serum N-terminal pro-B-type natriuretic peptide (NT-ProBNP), high-sensitivity troponin T (hs-TnT), interleukin 6 (IL-6), and Growth Differentiation Factor 15 (GDF-15) were measured at baseline, and incident CVD events identified through electronic medical records (International Classification of Primary Care-2 codes K74, K75, K77, K90, and K92). RESULTS After adjusting for sex, age, educational attainment, financial hardship and socioeconomic deprivation at the census level, an interquartile range (IQR) increase in NDVI at 250, 500, 750, and 1000 m around participants' homes was associated with mean differences in ProBNP of -5.56 % (95 %CI: -9.77; -1.35), -5.05 % (-9.58; -0.53), -4.24 % (-8.19, -0.19), and -4.16 % (-7.59; -0.74), respectively; and mean differences in hs-TnT among diabetic participants of -8.03 % (95 %CI: -13.30; -2.77), -9.52 % (-16.08; -2.96), -8.05 % (-13.94, -2.16) and -5.56 % (-10.75; -0.54), respectively. Of similar magnitude, although only statistically significant at 250 and 500 m, were the observed lower IL-6 levels with increasing greenness. GDF-15 levels were independent of NDVI. In prospective analyses (median follow-up 6.29 years), an IQR increase in residential greenness at 500, 750, and 1000 m was associated with a lower risk of incident CVD. The variables that contributed most to the apparent beneficial effects of greenness on CVD were lower exposure to traffic, improved cardiovascular risk factors, and enhanced physical performance. Additionally, neighborhood walkability and increased physical activity were notable contributors among individuals with diabetes. CONCLUSION Increased exposure to residential green space was associated with a moderate reduction in CVD risk in older adults residing in densely populated areas.
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Affiliation(s)
- Cara Scheer
- Fulda University of Applied Sciences. Fulda, Germany
| | - Elena Plans-Beriso
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcala, 28871 Madrid, Spain; Department of Chronic Diseases, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Roberto Pastor-Barriuso
- Department of Chronic Diseases, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Rosario Ortolá
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid. Madrid, Spain/ CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mercedes Sotos-Prieto
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid. Madrid, Spain/ CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; IMDEA Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Verónica Cabañas-Sánchez
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid. Madrid, Spain/ CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Pedro Gullón
- Department of Surgery, Social and Medical Sciences. School of Medicine and Health Sciences, Universidad de Alcala. Alcala de Henares, Madrid, Spain; Centre for Urban Research, RMIT University, Melbourne, Australia
| | | | - Rebeca Ramis
- Department of Chronic Diseases, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Pablo Fernández-Navarro
- Department of Chronic Diseases, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Chronic Diseases, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMDEA Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Esther García-Esquinas
- Department of Chronic Diseases, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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Del Río SG, Plans-Beriso E, Ramis R, Ortolá R, Pastor R, Sotos-Prieto M, Castelló A, Requena RO, Moleón JJJ, Félix BMF, Muriel A, Miret M, Mateos JLA, Choi YH, Rodríguez-Artalejo F, Fernández-Navarro P, García-Esquinas E. Exposure to residential traffic and trajectories of unhealthy ageing: results from a nationally-representative cohort of older adults. Environ Health 2024; 23:15. [PMID: 38303067 PMCID: PMC10832178 DOI: 10.1186/s12940-024-01057-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Traffic exposure has been associated with biomarkers of increased biological ageing, age-related chronic morbidities, and increased respiratory, cardiovascular, and all-cause mortality. Whether it is associated with functional impairments and unhealthy ageing trajectories is unknown. METHODS Nationally representative population-based cohort with 3,126 community-dwelling individuals aged ≥60 years who contributed 8,291 biannual visits over a 10 year period. Unhealthy ageing was estimated with a deficit accumulation index (DAI) based on the number and severity of 52 health deficits, including 22 objectively-measured impairments in physical and cognitive functioning. Differences in DAI at each follow-up across quintiles of residential traffic density (RTD) at 50 and 100 meters, and closest distance to a petrol station, were estimated using flexible marginal structural models with inverse probability of censoring weights. Models were adjusted for sociodemographic and time-varying lifestyle factors, social deprivation index at the census tract and residential exposure to natural spaces. RESULTS At baseline, the mean (SD) age and DAI score of the participants were 69.0 (6.6) years and 17.02 (11.0) %, and 54.0% were women. The median (IQR) RTD at 50 and 100 meters were 77 (31-467) and 509 (182-1802) vehicles/day, and the mean (SD) distance to the nearest petrol station of 962 (1317) meters. The average increase in DAI (95%CI) for participants in quintiles Q2-Q5 (vs Q1) of RTD at 50 meters was of 1.51 (0.50, 2.53), 0.98 (-0.05, 2.01), 2.20 (1.18, 3.21) and 1.98 (0.90, 3.05), respectively. Consistent findings were observed at 100 meters. By domains, most of the deficits accumulated with increased RTD were of a functional nature, although RTD at 50 meters was also associated with worse self-reported health, increased vitality problems and higher incidence of chronic morbidities. Living closer to a petrol station was associated with a higher incidence of functional impairments and chronic morbidities. CONCLUSIONS Exposure to nearby residential traffic is associated with accelerated trajectories of unhealthy ageing. Diminishing traffic pollution should become a priority intervention for adding healthy years to life in the old age.
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Affiliation(s)
- Sergio Gómez Del Río
- Department of Preventive Medicine, Hospital Central de la Cruz Roja San José y Santa Adela, Madrid, Spain
| | - Elena Plans-Beriso
- Department of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Rebeca Ramis
- Department of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology, Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Rosario Ortolá
- Consortium for Biomedical Research in Epidemiology, Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Roberto Pastor
- Department of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology, Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Mercedes Sotos-Prieto
- Consortium for Biomedical Research in Epidemiology, Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- IMDEA-Food Institute (CEI UAM+CSIC), Madrid, Spain
| | - Adela Castelló
- Department of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology, Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Rocío Olmedo Requena
- Consortium for Biomedical Research in Epidemiology, Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
| | - José Juan Jiménez Moleón
- Consortium for Biomedical Research in Epidemiology, Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
| | - Borja María Fernández Félix
- Consortium for Biomedical Research in Epidemiology, Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Clinical Biostatistics Unit, Hospital Ramón y Cajal (IRYCIS), Madrid, Spain
| | - Alfonso Muriel
- Consortium for Biomedical Research in Epidemiology, Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Clinical Biostatistics Unit, Hospital Ramón y Cajal (IRYCIS), Madrid, Spain
- Department of Nursery and Physiotherapy, Universidad de Alcalá, Madrid, Spain
| | - Marta Miret
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Consortium for Biomedical Research in Mental Health (CIBER en Salud Mental - CIBERSAM), Madrid, Spain
| | - Jose Luis Ayuso Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Consortium for Biomedical Research in Mental Health (CIBER en Salud Mental - CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitario de La Princesa, Madrid, Spain
| | - Yoon-Hyeong Choi
- School of Health and Environmental Science, College of Health Science, Korea University, Seoul, Korea
| | - Fernando Rodríguez-Artalejo
- Consortium for Biomedical Research in Epidemiology, Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- IMDEA-Food Institute (CEI UAM+CSIC), Madrid, Spain
| | - Pablo Fernández-Navarro
- Department of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology, Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
| | - Esther García-Esquinas
- Department of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology, Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
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Lahera A, Vela-Martín L, Fernández-Navarro P, Llamas P, López-Lorenzo JL, Cornago J, Santos J, Fernández-Piqueras J, Villa-Morales M. The JAK3 Q988P mutation reveals oncogenic potential and resistance to ruxolitinib. Mol Carcinog 2024; 63:5-10. [PMID: 37712558 DOI: 10.1002/mc.23632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/08/2023] [Accepted: 08/31/2023] [Indexed: 09/16/2023]
Abstract
T-cell acute lymphoblastic leukemia (T-ALL) arises from the malignant transformation of T-cell progenitors at various differentiation stages. Given that patients who relapse have a dismal prognosis, there is an urgent need to identify the molecular alterations that are present in such patients and promote leukemogenesis to implement personalized therapies with higher efficacy and fewer adverse effects. In the present manuscript, we identified the JAK3Q988P mutation in a T-ALL patient who did not achieve a durable response after the conventional treatment and whose tumor cells at relapse presented constitutive activation of the JAK/STAT pathway. Although JAK3Q988P has been previously identified in T-ALL patients from different studies, the functional consequences exerted by this mutation remain unexplored. Through the combination of different hematopoietic cellular models, we functionally characterize JAK3Q988P as an oncogenic mutation that contributes to leukemogenesis. Notably, JAK3Q988P not only promotes constitutive activation of the JAK/STAT pathway in the absence of cytokines and growth factors, as is the case for other JAK3 mutations that have been functionally characterized as oncogenic, but also functions independently of JAK1 and IL2RG, resulting in high oncogenic potential as well as resistance to ruxolitinib. Our results indicate that ruxolitinib may not be efficient for future patients bearing the JAK3Q988P mutation who instead may obtain greater benefits from treatments involving other pharmacological inhibitors such as tofacitinib.
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Affiliation(s)
- Antonio Lahera
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain
- Division of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain
| | - Laura Vela-Martín
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain
- Division of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain
| | - Pablo Fernández-Navarro
- Division of Cancer and Environmental Epidemiology, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
- Division of Epidemiology and Control of Chronic Diseases, Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pilar Llamas
- Division of Hematology and Hemotherapy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - José L López-Lorenzo
- Division of Hematology and Hemotherapy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Javier Cornago
- Division of Hematology and Hemotherapy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Javier Santos
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain
- Division of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain
- Division of Genome Dynamics and Function, Institute for Molecular Biology-IUBM (Universidad Autónoma de Madrid), Madrid, Spain
| | - José Fernández-Piqueras
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain
- Division of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain
- Division of Genome Dynamics and Function, Institute for Molecular Biology-IUBM (Universidad Autónoma de Madrid), Madrid, Spain
| | - María Villa-Morales
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain
- Division of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain
- Division of Genome Dynamics and Function, Institute for Molecular Biology-IUBM (Universidad Autónoma de Madrid), Madrid, Spain
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García-Esquinas E, Carballo-Casla A, Ortolá R, Sotos-Prieto M, Olmedo P, Gil F, Plans-Beriso E, Fernández-Navarro P, Pastor-Barriuso R, Rodríguez-Artalejo F. Blood Selenium Concentrations Are Inversely Associated with the Risk of Undernutrition in Older Adults. Nutrients 2023; 15:4750. [PMID: 38004143 PMCID: PMC10674362 DOI: 10.3390/nu15224750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/13/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Selenium is an essential trace element with an antioxidant and anti-inflammatory capacity that has been associated in experimental studies with beneficial effects on appetite control, the regulation of the gut microbiota, and control of the anabolic-catabolic balance. The main aim of the present study was to evaluate the association between circulating selenium concentrations and the risk of developing undernutrition in older adults. METHODS This was a cohort study with 1398 well-nourished community-dwelling individuals aged ≥ 65 years residing in Spain in 2017, who were followed for a mean of 2.3 years. Whole blood selenium was measured at baseline using inductively coupled plasma-mass spectrometry. Undernutrition was assessed at baseline and at follow-up, and defined as having at least one of the three GLIM phenotypic criteria (involuntary weight loss, a low body mass index, and a reduced muscle mass) and at least one of the two etiologic criteria (reduced food consumption or nutrient assimilation and inflammation/disease burden). RESULTS During the follow-up, 142 participants (11%) developed moderate undernutrition and 113 (8.8%) severe undernutrition. The standardized relative risks of moderate and severe undernutrition at the 75th percentile of Se levels versus the 25th were 0.90 and 0.70, respectively. In dose-response analyses, the risk of severe undernutrition decreased linearly with increasing selenium concentrations. This association was independent of protein intake or diet quality and was stronger among participants with a diagnosis of a musculoskeletal disorder. CONCLUSIONS The results suggest that an adequate dietary selenium status is needed to prevent undernutrition in older adults. Also, this may open the door for clinical trials with selenium supplementation, at doses considered as safe, to prevent undernutrition.
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Affiliation(s)
- Esther García-Esquinas
- Department of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain; (E.P.-B.); (P.F.-N.); (R.P.-B.)
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), 28029 Madrid, Spain; (A.C.-C.); (R.O.); (M.S.-P.); (F.R.-A.)
| | - Adrián Carballo-Casla
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), 28029 Madrid, Spain; (A.C.-C.); (R.O.); (M.S.-P.); (F.R.-A.)
- Aging Research Center, Department of Neurobiology, Care Sciences and Society Karolinska Institutet & Stockholm University, 141 86 Stockholm, Sweden
| | - Rosario Ortolá
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), 28029 Madrid, Spain; (A.C.-C.); (R.O.); (M.S.-P.); (F.R.-A.)
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
| | - Mercedes Sotos-Prieto
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), 28029 Madrid, Spain; (A.C.-C.); (R.O.); (M.S.-P.); (F.R.-A.)
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- IMDEA Food Institute, CEI UAM+CSIC, 28049 Madrid, Spain
| | - Pablo Olmedo
- Department of Legal Medicine, Toxicology, and Physical Anthropology, School of Medicine, University of Granada, 18071 Granada, Spain; (P.O.); (F.G.)
| | - Fernando Gil
- Department of Legal Medicine, Toxicology, and Physical Anthropology, School of Medicine, University of Granada, 18071 Granada, Spain; (P.O.); (F.G.)
| | - Elena Plans-Beriso
- Department of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain; (E.P.-B.); (P.F.-N.); (R.P.-B.)
| | - Pablo Fernández-Navarro
- Department of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain; (E.P.-B.); (P.F.-N.); (R.P.-B.)
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), 28029 Madrid, Spain; (A.C.-C.); (R.O.); (M.S.-P.); (F.R.-A.)
| | - Roberto Pastor-Barriuso
- Department of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain; (E.P.-B.); (P.F.-N.); (R.P.-B.)
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), 28029 Madrid, Spain; (A.C.-C.); (R.O.); (M.S.-P.); (F.R.-A.)
| | - Fernando Rodríguez-Artalejo
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), 28029 Madrid, Spain; (A.C.-C.); (R.O.); (M.S.-P.); (F.R.-A.)
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- IMDEA Food Institute, CEI UAM+CSIC, 28049 Madrid, Spain
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Redondo-Sánchez D, Fernández-Navarro P, Rodríguez-Barranco M, Nuñez O, Petrova D, García-Torrecillas JM, Jiménez-Moleón JJ, Sánchez MJ. Socio-economic inequalities in lung cancer mortality in Spain: a nation-wide study using area-based deprivation. Int J Equity Health 2023; 22:145. [PMID: 37533035 PMCID: PMC10399030 DOI: 10.1186/s12939-023-01970-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/19/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Lung cancer is the main cause of cancer mortality worldwide and in Spain. Several previous studies have documented socio-economic inequalities in lung cancer mortality but these have focused on specific provinces or cities. The goal of this study was to describe lung cancer mortality in Spain by sex as a function of socio-economic deprivation. METHODS We analysed all registered deaths from lung cancer during the period 2011-2017 in Spain. Mortality data was obtained from the National Institute of Statistics, and socio-economic level was measured with the small-area deprivation index developed by the Spanish Society of Epidemiology, with the census tract of residence at the time of death as the unit of analysis. We computed crude and age-standardized rates per 100,000 inhabitants by sex, deprivation quintile, and type of municipality (rural, semi-rural, urban) considering the 2013 European standard population (ASR-E). We further calculated ASR-E ratios between the most deprived (Q5) and the least deprived (Q1) areas and mapped census tract smoothed standardized lung cancer mortality ratios by sex. RESULTS We observed 148,425 lung cancer deaths (80.7% in men), with 73.5 deaths per 100,000 men and 17.1 deaths per 100,000 women. Deaths from lung cancer in men were five times more frequent than in women (ASR-E ratio = 5.3). Women residing in the least deprived areas had higher mortality from lung cancer (ASR-E = 22.2), compared to women residing in the most deprived areas (ASR-E = 13.2), with a clear gradient among the quintiles of deprivation. For men, this pattern was reversed, with the highest mortality occurring in areas of lower socio-economic level (ASR-E = 99.0 in Q5 vs. ASR-E = 86.6 in Q1). These socio-economic inequalities remained fairly stable over time and across urban and rural areas. CONCLUSIONS Socio-economic status is strongly related to lung cancer mortality, showing opposite patterns in men and women, such that mortality is highest in women residing in the least deprived areas and men residing in the most deprived areas. Systematic surveillance of lung cancer mortality by socio-economic status may facilitate the assessment of public health interventions aimed at mitigating cancer inequalities in Spain.
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Grants
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- PI18/01593 EU/FEDER Instituto de Salud Carlos III
- PI18/01593 EU/FEDER Instituto de Salud Carlos III
- PI18/01593 EU/FEDER Instituto de Salud Carlos III
- Not applicable Acciones de Movilidad CIBERESP, 2022
- JC2019-039691-I Juan de la Cierva Fellowship from the Ministry of Science and the National Research Agency of Spain
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Affiliation(s)
- Daniel Redondo-Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain.
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain.
| | - Pablo Fernández-Navarro
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, 28029, Spain
| | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain
| | - Olivier Nuñez
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, 28029, Spain
| | - Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain
| | - Juan Manuel García-Torrecillas
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Emergency and Research Unit, Torrecárdenas University Hospital, Almería, 04009, Spain
| | - Jose Juan Jiménez-Moleón
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, 18071, Spain
| | - María-José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain
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6
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Villa-Morales M, Pérez-Gómez L, Pérez-Gómez E, López-Nieva P, Fernández-Navarro P, Santos J. Identification of NRF2 Activation as a Prognostic Biomarker in T-Cell Acute Lymphoblastic Leukaemia. Int J Mol Sci 2023; 24:10350. [PMID: 37373496 DOI: 10.3390/ijms241210350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
The standard-of-care treatment of T-cell acute lymphoblastic leukaemia (T-ALL) with chemotherapy usually achieves reasonable rates of initial complete response. However, patients who relapse or do not respond to conventional therapy show dismal outcomes, with cure rates below 10% and limited therapeutic options. To ameliorate the clinical management of these patients, it is urgent to identify biomarkers able to predict their outcomes. In this work, we investigate whether NRF2 activation constitutes a biomarker with prognostic value in T-ALL. Using transcriptomic, genomic, and clinical data, we found that T-ALL patients with high NFE2L2 levels had shorter overall survival. Our results demonstrate that the PI3K-AKT-mTOR pathway is involved in the oncogenic signalling induced by NRF2 in T-ALL. Furthermore, T-ALL patients with high NFE2L2 levels displayed genetic programs of drug resistance that may be provided by NRF2-induced biosynthesis of glutathione. Altogether, our results indicate that high levels of NFE2L2 may be a predictive biomarker of poor treatment response in T-ALL patients, which would explain the poor prognosis associated with these patients. This enhanced understanding of NRF2 biology in T-ALL may allow a more refined stratification of patients and the proposal of targeted therapies, with the ultimate goal of improving the outcome of relapsed/refractory T-ALL patients.
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Affiliation(s)
- María Villa-Morales
- Department of Biology, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), 28049 Madrid, Spain
- Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, 28040 Madrid, Spain
- Institute for Molecular Biology-IUBM, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Laura Pérez-Gómez
- Department of Biology, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), 28049 Madrid, Spain
| | - Eduardo Pérez-Gómez
- Departamento de Bioquímica y Biología Molecular, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Instituto de Investigación Hospital 12 de Octubre, 28041 Madrid, Spain
| | - Pilar López-Nieva
- Department of Biology, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), 28049 Madrid, Spain
- Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, 28040 Madrid, Spain
- Institute for Molecular Biology-IUBM, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Pablo Fernández-Navarro
- Unit of Cancer and Environmental Epidemiology, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Networking Biomedical Research Centre of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Javier Santos
- Department of Biology, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), 28049 Madrid, Spain
- Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, 28040 Madrid, Spain
- Institute for Molecular Biology-IUBM, Universidad Autónoma de Madrid, 28049 Madrid, Spain
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7
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Lahera A, Vela-Martín L, López-Nieva P, Salgado RN, Rodríguez-Perales S, Torres-Ruiz R, López-Lorenzo JL, Cornago J, Llamas P, Fernández-Navarro P, Sánchez-Domínguez R, Segovia JC, Sastre I, Cobos-Fernández MÁ, Menéndez P, Santos J, Fernández-Piqueras J, Villa-Morales M. Comprehensive characterization of a novel, oncogenic and targetable SEPTIN6::ABL2 fusion in T-ALL. Br J Haematol 2023. [PMID: 37264982 DOI: 10.1111/bjh.18901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/17/2023] [Accepted: 05/23/2023] [Indexed: 06/03/2023]
Affiliation(s)
- Antonio Lahera
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain
- Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain
| | - Laura Vela-Martín
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain
- Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain
| | - Pilar López-Nieva
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain
- Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain
- Institute for Molecular Biology-IUBM, Universidad Autónoma de Madrid, Madrid, Spain
| | - Rocío N Salgado
- Cytogenetics Service, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Sandra Rodríguez-Perales
- Molecular Cytogenetics & Genome Editing Unit, Human Cancer Genetics Program, Centro Nacional de Investigaciones Oncologicas (CNIO), Madrid, Spain
| | - Raúl Torres-Ruiz
- Molecular Cytogenetics & Genome Editing Unit, Human Cancer Genetics Program, Centro Nacional de Investigaciones Oncologicas (CNIO), Madrid, Spain
- Division of Cell Technology, Biomedical Innovative Unit, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid, Spain
- Advanced Therapy Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD/UAM), Madrid, Spain
| | - José L López-Lorenzo
- Division of Hematology and Hemotherapy, IIS Fundación Jiménez Díaz, Madrid, Spain
| | - Javier Cornago
- Division of Hematology and Hemotherapy, IIS Fundación Jiménez Díaz, Madrid, Spain
| | - Pilar Llamas
- Division of Hematology and Hemotherapy, IIS Fundación Jiménez Díaz, Madrid, Spain
| | - Pablo Fernández-Navarro
- Unit of Cancer and Environmental Epidemiology, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
- Networking Biomedical Research Centre of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Rebeca Sánchez-Domínguez
- Division of Cell Technology, Biomedical Innovative Unit, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid, Spain
- Advanced Therapy Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD/UAM), Madrid, Spain
- Networking Biomedical Research Centre of Rare Diseases (CIBERER), Madrid, Spain
| | - José C Segovia
- Division of Cell Technology, Biomedical Innovative Unit, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid, Spain
- Advanced Therapy Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD/UAM), Madrid, Spain
- Networking Biomedical Research Centre of Rare Diseases (CIBERER), Madrid, Spain
| | - Isabel Sastre
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain
| | | | - Pablo Menéndez
- Josep Carreras Leukemia Research Institute, Barcelona, Spain
- Red Española de Terapias Avanzadas (TERAV)-Instituto de Salud Carlos III (ISCIII) (RICORS, RD21/0017/0029), Madrid, Spain
- CIBER-ONC, ISCIII, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
- Department of Biomedicine, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Javier Santos
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain
- Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain
- Institute for Molecular Biology-IUBM, Universidad Autónoma de Madrid, Madrid, Spain
| | - José Fernández-Piqueras
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain
- Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain
- Institute for Molecular Biology-IUBM, Universidad Autónoma de Madrid, Madrid, Spain
| | - María Villa-Morales
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Genome Dynamics and Function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain
- Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain
- Institute for Molecular Biology-IUBM, Universidad Autónoma de Madrid, Madrid, Spain
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8
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Pérez-Gómez B, Pastor-Barriuso R, Fernández-de-Larrea N, Hernán MA, Pérez-Olmeda M, Oteo-Iglesias J, Fernández-Navarro P, Fernández-García A, Martín M, Cruz I, Sanmartín JL, León-Paniagua J, Muñoz-Montalvo JF, Blanco F, Yotti R, Pollán M. SARS-CoV-2 Infection During the First and Second Pandemic Waves in Spain: the ENE-COVID Study. Am J Public Health 2023; 113:533-544. [PMID: 36893370 PMCID: PMC10088950 DOI: 10.2105/ajph.2023.307233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2023] [Indexed: 03/11/2023]
Abstract
Objectives. To describe participant characteristics associated with severe acute respiratory syndrome coronavirus 2 infection in Spain's first 2 COVID-19 waves per the Spanish National Seroepidemiological Survey of SARS-CoV-2 Infection (ENE-COVID). Methods. A representative cohort of the noninstitutionalized Spanish population, selected through stratified 2-stage sampling, answered a questionnaire and received point-of-care testing April to June 2020 (first wave: n = 68 287); previously seronegative participants repeated the questionnaire and test November 2020 (second wave: n = 44 451). We estimated seropositivity by wave and participant characteristics, accounting for sampling weights, nonresponse, and design effects. Results. We found that 6.0% (95% confidence interval [CI] = 5.7%, 6.4%) of Spain's population was infected by June and 3.8% (95% CI = 3.5%, 4.1%) more by November 2020. Both genders were equally affected. Seroprevalence decreased with age in adults 20 years and older in the second wave; socioeconomic differences increased. Health care workers were affected at 11.1% (95% CI = 9.0%, 13.6%) and 6.1% (95% CI = 4.4%, 8.5%) in the first and second waves, respectively. Living with an infected person increased infection risk to 22.1% (95% CI = 18.9%, 25.6%) in the first and 35.0% (95% CI = 30.8%, 39.4%) in the second wave. Conclusions. ENE-COVID characterized the first 2 pandemic waves, when information from surveillance systems was incomplete. (Am J Public Health. 2023;113(5):533-544. https://doi.org/10.2105/AJPH.2023.307233).
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Affiliation(s)
- Beatriz Pérez-Gómez
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Roberto Pastor-Barriuso
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Nerea Fernández-de-Larrea
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Miguel A Hernán
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Mayte Pérez-Olmeda
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Jesús Oteo-Iglesias
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Pablo Fernández-Navarro
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Aurora Fernández-García
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Mariano Martín
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Israel Cruz
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - José L Sanmartín
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - José León-Paniagua
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Juan F Muñoz-Montalvo
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Faustino Blanco
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Raquel Yotti
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
| | - Marina Pollán
- Beatriz Pérez-Gómez, Roberto Pastor-Barriuso, Nerea Fernández-de-Larrea, Pablo Fernández-Navarro, and Marina Pollán are with the National Centre for Epidemiology and the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. Miguel A. Hernán is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA. Mayte Pérez-Olmeda, Jesús Oteo-Iglesias, and Aurora Fernández-García are with the National Centre for Microbiology and the Consortium for Biomedical Research in Infectious Diseases (CIBERINFEC), ISCIII. Mariano Martín, José L. Sanmartín, Juan F. Muñoz-Montalvo, and Faustino Blanco are with the Deputy Directorate of Information Technologies, Ministry of Health, Madrid, Spain. Israel Cruz is with the National School of Public Health, ISCIII. José León-Paniagua and Raquel Yotti are with ISCIII
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9
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Lahera A, López-Nieva P, Alarcón H, Marín-Rubio JL, Cobos-Fernández MÁ, Fernández-Navarro P, Fernández AF, Vela-Martín L, Sastre I, Ruiz-García S, Llamas P, López-Lorenzo JL, Cornago J, Santos J, Fernández-Piqueras J, Villa-Morales M. SOCS3 deregulation contributes to aberrant activation of the JAK/STAT pathway in precursor T-cell neoplasms. Br J Haematol 2023; 201:718-724. [PMID: 36786170 DOI: 10.1111/bjh.18694] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/15/2023]
Abstract
Despite the Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathway being frequently altered in T-ALL/LBL, no specific therapy has been approved for T-ALL/LBL patients with constitutive signalling by JAK/STAT, so there is an urgent need to identify pathway members that may be potential therapeutic targets. In the present study, we searched for JAK/STAT pathway members potentially modulated through aberrant methylation and identified SOCS3 hypermethylation as a recurrent event in T-ALL/LBL. Additionally, we explored the implications of SOCS3 deregulation in T-ALL/LBL and demonstrated that SOCS3 counteracts the constitutive activation of the JAK/STAT pathway through different molecular mechanisms. Therefore, SOCS3 emerges as a potential therapeutic target in T-ALL/LBL.
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Affiliation(s)
- Antonio Lahera
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Genome dynamics and function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain.,Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain
| | - Pilar López-Nieva
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Genome dynamics and function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain.,Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain.,Institute for Molecular Biology-IUBM (Universidad Autónoma de Madrid), Madrid, Spain
| | - Hernán Alarcón
- Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain
| | - José L Marín-Rubio
- Laboratory for Biological Mass Spectrometry, Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - María Á Cobos-Fernández
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Genome dynamics and function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain.,Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain.,Institute for Molecular Biology-IUBM (Universidad Autónoma de Madrid), Madrid, Spain
| | - Pablo Fernández-Navarro
- Unit of Cancer and Environmental Epidemiology, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.,Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Agustín F Fernández
- Cancer Epigenetics and Nanomedicine Laboratory, Nanomaterials and Nanotechnology Research Center (CINN-CSIC), Health Research Institute of Asturias (ISPA), Institute of Oncology of Asturias (IUOPA), University of Oviedo, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Oviedo, Spain
| | - Laura Vela-Martín
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Genome dynamics and function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain.,Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain
| | - Isabel Sastre
- Department of Genome dynamics and function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain
| | - Sara Ruiz-García
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Genome dynamics and function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain.,Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain
| | - Pilar Llamas
- Division of Hematology and Hemotherapy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - José L López-Lorenzo
- Division of Hematology and Hemotherapy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Javier Cornago
- Division of Hematology and Hemotherapy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Javier Santos
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Genome dynamics and function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain.,Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain.,Institute for Molecular Biology-IUBM (Universidad Autónoma de Madrid), Madrid, Spain
| | - José Fernández-Piqueras
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Genome dynamics and function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain.,Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain.,Institute for Molecular Biology-IUBM (Universidad Autónoma de Madrid), Madrid, Spain
| | - María Villa-Morales
- Department of Biology, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Genome dynamics and function, Centro de Biología Molecular Severo Ochoa (CBMSO), Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), Madrid, Spain.,Area of Genetics and Genomics, IIS Fundación Jiménez Díaz, Madrid, Spain.,Institute for Molecular Biology-IUBM (Universidad Autónoma de Madrid), Madrid, Spain
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10
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Gutiérrez-González E, Fernández-Navarro P, Pastor-Barriuso R, García-Pérez J, Castaño-Vinyals G, Martín-Sánchez V, Amiano P, Gómez-Acebo I, Guevara M, Fernández-Tardón G, Salcedo-Bellido I, Moreno V, Pinto-Carbó M, Alguacil J, Marcos-Gragera R, Gómez-Gómez JH, Gómez-Ariza JL, García-Barrera T, Varea-Jiménez E, Núñez O, Espinosa A, Molina de la Torre AJ, Aizpurua-Atxega A, Alonso-Molero J, Ederra-Sanz M, Belmonte T, Aragonés N, Kogevinas M, Pollán M, Pérez-Gómez B. Toenail zinc as a biomarker: Relationship with sources of environmental exposure and with genetic variability in MCC-Spain study. Environ Int 2022; 169:107525. [PMID: 36150295 DOI: 10.1016/j.envint.2022.107525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Toenails are commonly used as biomarkers of exposure to zinc (Zn), but there is scarce information about their relationship with sources of exposure to Zn. OBJECTIVES To investigate the main determinants of toenail Zn, including selected sources of environmental exposure to Zn and individual genetic variability in Zn metabolism. METHODS We determined toenail Zn by inductively coupled plasma mass spectrometry in 3,448 general population controls from the MultiCase-Control study MCC-Spain. We assessed dietary and supplement Zn intake using food frequency questionnaires, residential proximity to Zn-emitting industries and residential topsoil Zn levels through interpolation methods. We constructed a polygenic score of genetic variability based on 81 single nucleotide polymorphisms in genes involved in Zn metabolism. Geometric mean ratios of toenail Zn across categories of each determinant were estimated from multivariate linear regression models on log-transformed toenail Zn. RESULTS Geometric mean toenail Zn was 104.1 µg/g in men and 100.3 µg/g in women. Geometric mean toenail Zn levels were 7 % lower (95 % confidence interval 1-13 %) in men older than 69 years and those in the upper tertile of fibre intake, and 9 % higher (3-16 %) in smoking men. Women residing within 3 km from Zn-emitting industries had 4 % higher geometric mean toenail Zn levels (0-9 %). Dietary Zn intake and polygenic score were unrelated to toenail Zn. Overall, the available determinants only explained 9.3 % of toenail Zn variability in men and 4.8 % in women. DISCUSSION Sociodemographic factors, lifestyle, diet, and environmental exposure explained little of the individual variability of toenail Zn in the study population. The available genetic variants related to Zn metabolism were not associated with toenail Zn.
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Affiliation(s)
- Enrique Gutiérrez-González
- Spanish Agency for Food Safety and Nutrition, Ministry for Consumer Affairs, Alcala 56 St, 28014 Madrid, Spain
| | - Pablo Fernández-Navarro
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Roberto Pastor-Barriuso
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Javier García-Pérez
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Barcelona Institute of Global Health (ISGlobal), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain; University Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain
| | - Vicente Martín-Sánchez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Institute of Biomedicine (IBIOMED), University of León, Campus Universitario de Vegazana, 24071 León, Spain
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Sub-Directorate for Public Health and Addictions of Gipuzkoa, Health Department of the Basque Government, Antso Jakituna Hiribidea, 35, 20010 San Sebastian, Spain; Epidemiology and Public Health Area, Biodonostia Health Research Institute, Paseo Dr. Begiristain, 20014 San Sebastian, Spain
| | - Inés Gómez-Acebo
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Department of Medical and Surgical Sciences, Faculty of Medicine, University of Cantabria-IDIVAL, Calle Cardenal Herrera Oria, 39011 Santander, Spain
| | - Marcela Guevara
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Public Health Institute of Navarra, C. Leyre, 15, 31003 Pamplona, Navarra, Spain; V, C. de Irunlarrea, 3, 31008 Pamplona, Navarra, Spain
| | - Guillermo Fernández-Tardón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Health Research Institute of Asturias (ISPA), University of Oviedo, Av. del Hospital Universitario, 33011 Oviedo, Spain
| | - Inmaculada Salcedo-Bellido
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Av. de la Investigación, 11, 18016 Granada, Spain
| | - Victor Moreno
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Oncology Data Analytics Program, Catalan Institute of Oncology (ICO), Avinguda de la Granvia de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Colorectal Cancer Group, ONCOBELL Program, Institut de Recerca Biomedica de Bellvitge (IDIBELL), Avinguda de la Granvia de l'Hospitalet, 199, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Carrer de Casanova, 143, 08036 Barcelona, Spain
| | - Marina Pinto-Carbó
- Cancer and Public Health Area, The Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Av. de Catalunya, 21, 46020 Valencia, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Centre for Health and Environmental Research, Huelva University, s, Campus El Carmen, Avda. Andalucía, 21071 Huelva, Spain
| | - Rafael Marcos-Gragera
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology (ICO), IDIBGI, Oncology Coordination Plan, Department of Health Government of Catalonia, Carrer del Dr. Castany, 17190 Girona, Spain; University of Girona, Plaça de Sant Domènec, 3, 17004 Girona, Spain
| | - Jesús Humberto Gómez-Gómez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Campus de Ciencias de la Salud, Carretera Buenavista, 30120 El Palmar Murcia, Spain
| | - José Luis Gómez-Ariza
- Department of Chemistry, Faculty of Experimental Sciences, Campus El Carmen, University of Huelva, C/ Menéndez Pelayo, 21002 Huelva, Spain
| | - Tamara García-Barrera
- Department of Chemistry, Faculty of Experimental Sciences, Campus El Carmen, University of Huelva, C/ Menéndez Pelayo, 21002 Huelva, Spain
| | - Elena Varea-Jiménez
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
| | - Olivier Núñez
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Ana Espinosa
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Barcelona Institute of Global Health (ISGlobal), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain; University Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Spain
| | - Antonio J Molina de la Torre
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Institute of Biomedicine (IBIOMED), University of León, Campus Universitario de Vegazana, 24071 León, Spain
| | - Amaia Aizpurua-Atxega
- Sub-Directorate for Public Health and Addictions of Gipuzkoa, Health Department of the Basque Government, Antso Jakituna Hiribidea, 35, 20010 San Sebastian, Spain
| | - Jessica Alonso-Molero
- Department of Medical and Surgical Sciences, Faculty of Medicine, University of Cantabria-IDIVAL, Calle Cardenal Herrera Oria, 39011 Santander, Spain
| | - María Ederra-Sanz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Public Health Institute of Navarra, C. Leyre, 15, 31003 Pamplona, Navarra, Spain; V, C. de Irunlarrea, 3, 31008 Pamplona, Navarra, Spain
| | - Thalia Belmonte
- Public Health Department, University of Oviedo, Av. Julián Clavería, 6, 33006 Oviedo, Spain
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Epidemiology Section, Division of Public Health, Department of Health, C. San Martín de Porres, 6, 28035 Madrid, Spain
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain; Barcelona Institute of Global Health (ISGlobal), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain; University Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain
| | - Marina Pollán
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Beatriz Pérez-Gómez
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Monforte de Lemos 5, 28029 Madrid, Spain.
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11
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Ayuso-Álvarez A, Ortiz C, López-Cuadrado T, Rodríguez-Blázquez C, Fernández-Navarro P, González-Palacios J, Damián J, Galán I. Rural-urban gradients and all-cause, cardiovascular and cancer mortality in Spain using individual data. SSM Popul Health 2022; 19:101232. [PMID: 36188419 PMCID: PMC9516441 DOI: 10.1016/j.ssmph.2022.101232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 11/30/2022] Open
Abstract
The literature reporting on rural-urban health status disparities remains inconclusive. We analyzed data from a longitudinal population-based study using individual observations. Our results show that the risks of all-cause and cancer mortality are greater in large cities than in other municipalities, with no clear urban-rural gradient. Not differences were found among territories in cardiovascular mortality.
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Affiliation(s)
- Ana Ayuso-Álvarez
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Sociology Department, Faculty of Economic and Business Sciences, Autonomous University of Madrid, Spain
| | - Cristina Ortiz
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Teresa López-Cuadrado
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, Autonomous University of Madrid/IdiPAZ, Madrid, Spain
| | | | - Pablo Fernández-Navarro
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Bioinformatics and Data Management Group (BIODAMA), National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Javier González-Palacios
- Bioinformatics and Data Management Group (BIODAMA), National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Javier Damián
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Iñaki Galán
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, Autonomous University of Madrid/IdiPAZ, Madrid, Spain
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12
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Ayuso-Álvarez A, Nuñez O, Martín-Méndez I, Bel-Lán A, Tellez-Plaza M, Pérez-Gómez B, Galán I, Fernández-Navarro P. Metal and metalloid levels in topsoil and municipal cardiovascular mortality in Spain. Environ Res 2022; 204:112395. [PMID: 34800529 DOI: 10.1016/j.envres.2021.112395] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 06/13/2023]
Abstract
The role of metals and metalloids beyond arsenic, copper, lead and cadmium in cardiovascular disease is not entirely clear. The aim of this study was to assess the association between 18 metal or metalloid levels in topsoil (upper soil horizon) with all-cause and specific cardiovascular mortality endpoints in Spain. We designed an ecological spatial study, to assess cardiovascular mortality in 7941 Spanish mainland towns from 2010 to 2014. The estimation of metals and metalloids concentration in topsoil came from the Geochemical Atlas of Spain from 13,317 soil samples. We also summarized the joint variability of the metals using principal components analysis (PCA). These components (PCs) were included in a Besag, York, and Mollié model to assess their association with cardiovascular mortality from all causes, coronary heart disease, cerebrovascular, hypertension, and conduction disorders. Our results showed, both in men and women, that at the lowest component scores range, PC2 (mainly reflecting Al, Be, Tl and U) was positively associated with coronary heart disease and cerebrovascular mortality. At medium/highest scores range, PC4 (mainly reflecting Hg) was positively associated with cerebrovascular mortality. For PC3 (reflecting Se), the association with coronary heart disease mortality was positive only in men at the highest PC scores range. For PC1 (partly reflecting metals such as Pb, As, Cu or Cd), we observed a strongly suggestive positive association with all-cause cardiovascular diseases mortality. Our ecological results are consistent with the available evidence supporting a cardiovascular role of excessive exposure to Se, Hg, Pb, As, Cu and Cd, but also identify Al, Be, Tl and U as potentially novel cardiovascular factors. Additional research is needed to confirm the biological relevance of our findings.
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Affiliation(s)
- Ana Ayuso-Álvarez
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Faculty of Economics and Business, Autonomous University of Madrid, Spain
| | - Olivier Nuñez
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Iván Martín-Méndez
- Geological Survey of Spain (Instituto Geológico y Minero de España, IGME-CSIC), Spain
| | - Alejandro Bel-Lán
- Geological Survey of Spain (Instituto Geológico y Minero de España, IGME-CSIC), Spain
| | - Maria Tellez-Plaza
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Autonomous University of Madrid/IdiPAZ, Madrid, Spain
| | - Beatriz Pérez-Gómez
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Iñaki Galán
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Autonomous University of Madrid/IdiPAZ, Madrid, Spain
| | - Pablo Fernández-Navarro
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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13
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De Salazar PM, Lu F, Hay JA, Gómez-Barroso D, Fernández-Navarro P, Martínez EV, Astray-Mochales J, Amillategui R, García-Fulgueiras A, Chirlaque MD, Sánchez-Migallón A, Larrauri A, Sierra MJ, Lipsitch M, Simón F, Santillana M, Hernán MA. Near real-time surveillance of the SARS-CoV-2 epidemic with incomplete data. PLoS Comput Biol 2022; 18:e1009964. [PMID: 35358171 PMCID: PMC9004750 DOI: 10.1371/journal.pcbi.1009964] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/12/2022] [Accepted: 02/24/2022] [Indexed: 12/17/2022] Open
Abstract
When responding to infectious disease outbreaks, rapid and accurate estimation of the epidemic trajectory is critical. However, two common data collection problems affect the reliability of the epidemiological data in real time: missing information on the time of first symptoms, and retrospective revision of historical information, including right censoring. Here, we propose an approach to construct epidemic curves in near real time that addresses these two challenges by 1) imputation of dates of symptom onset for reported cases using a dynamically-estimated "backward" reporting delay conditional distribution, and 2) adjustment for right censoring using the NobBS software package to nowcast cases by date of symptom onset. This process allows us to obtain an approximation of the time-varying reproduction number (Rt) in real time. We apply this approach to characterize the early SARS-CoV-2 outbreak in two Spanish regions between March and April 2020. We evaluate how these real-time estimates compare with more complete epidemiological data that became available later. We explore the impact of the different assumptions on the estimates, and compare our estimates with those obtained from commonly used surveillance approaches. Our framework can help improve accuracy, quantify uncertainty, and evaluate frequently unstated assumptions when recovering the epidemic curves from limited data obtained from public health systems in other locations.
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Affiliation(s)
- Pablo M. De Salazar
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of america
| | - Fred Lu
- Machine Intelligence Lab, Boston Children’s Hospital, Boston, Massachusetts, United States
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, Massachusetts, United States of america
| | - James A Hay
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of america
| | - Diana Gómez-Barroso
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pablo Fernández-Navarro
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Elena V Martínez
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
| | | | - Rocío Amillategui
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
| | - Ana García-Fulgueiras
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Maria D Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Alonso Sánchez-Migallón
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Amparo Larrauri
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - María J Sierra
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINF), Madrid, Spain
| | - Marc Lipsitch
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of america
| | - Fernando Simón
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
| | - Mauricio Santillana
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of america
- Machine Intelligence Lab, Boston Children’s Hospital, Boston, Massachusetts, United States
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, Massachusetts, United States of america
- Department of Pediatrics, Harvard Medical School, Harvard University, Boston, Massachusetts, United States of america
| | - Miguel A Hernán
- CAUSALab, Department of Epidemiology and Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of america
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14
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Redondo-Sánchez D, Petrova D, Rodríguez-Barranco M, Fernández-Navarro P, Jiménez-Moleón JJ, Sánchez MJ. Socio-Economic Inequalities in Lung Cancer Outcomes: An Overview of Systematic Reviews. Cancers (Basel) 2022; 14:398. [PMID: 35053559 PMCID: PMC8773607 DOI: 10.3390/cancers14020398] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 01/27/2023] Open
Abstract
In the past decade, evidence has accumulated about socio-economic inequalities in very diverse lung cancer outcomes. To better understand the global effects of socio-economic factors in lung cancer, we conducted an overview of systematic reviews. Four databases were searched for systematic reviews reporting on the relationship between measures of socio-economic status (SES) (individual or area-based) and diverse lung cancer outcomes, including epidemiological indicators and diagnosis- and treatment-related variables. AMSTAR-2 was used to assess the quality of the selected systematic reviews. Eight systematic reviews based on 220 original studies and 8 different indicators were identified. Compared to people with a high SES, people with a lower SES appear to be more likely to develop and die from lung cancer. People with lower SES also have lower cancer survival, most likely due to the lower likelihood of receiving both traditional and next-generation treatments, higher rates of comorbidities, and the higher likelihood of being admitted as emergency. People with a lower SES are generally not diagnosed at later stages, but this may change after broader implementation of lung cancer screening, as early evidence suggests that there may be socio-economic inequalities in its use.
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Affiliation(s)
- Daniel Redondo-Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain; (D.R.-S.); (M.R.-B.); (J.J.J.-M.); (M.-J.S.)
- Escuela Andaluza de Salud Pública, 18080 Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain;
| | - Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain; (D.R.-S.); (M.R.-B.); (J.J.J.-M.); (M.-J.S.)
- Escuela Andaluza de Salud Pública, 18080 Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain;
| | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain; (D.R.-S.); (M.R.-B.); (J.J.J.-M.); (M.-J.S.)
- Escuela Andaluza de Salud Pública, 18080 Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain;
| | - Pablo Fernández-Navarro
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain;
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain
| | - José Juan Jiménez-Moleón
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain; (D.R.-S.); (M.R.-B.); (J.J.J.-M.); (M.-J.S.)
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain;
- Department of Preventive Medicine and Public Health, University of Granada, 18071 Granada, Spain
| | - Maria-José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain; (D.R.-S.); (M.R.-B.); (J.J.J.-M.); (M.-J.S.)
- Escuela Andaluza de Salud Pública, 18080 Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain;
- Department of Preventive Medicine and Public Health, University of Granada, 18071 Granada, Spain
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15
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Pulido J, Hoyos J, Martínez-Ruiz V, Sordo L, Fernández-Navarro P, Barrio G, Regidor E. Long-term impact of the 2008 economic crisis in Spain on road traffic collisions mortality by socioeconomic position. Health Place 2021; 71:102666. [PMID: 34507036 DOI: 10.1016/j.healthplace.2021.102666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/24/2021] [Accepted: 09/02/2021] [Indexed: 11/26/2022]
Abstract
We aimed to assess the effect of the 2008 crisis on road traffic collision (RTC) mortality in Spain, by socioeconomic position (SEP) and type of road use. This prospective, country-wide study covered all adults living in Spain and aged ≥30 years in November 2001. The long-term effect of the crisis was assessed by measuring the monthly percentage change (MPC) in RTC mortality between the pre-crisis (2002-2007) and crisis period (2008-2011). During the recession, RTC mortality fell more in people with low compared to high SEP, so MPCs difference between periods were of a higher magnitude in the low compared to high SEP groups, especially among men motorcyclists. RTC mortality trends were favorable following the 2008 crisis, particularly among low-SEP groups. In men motorcyclists, the upward trend of the pre-crisis period reversed course.
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Affiliation(s)
- J Pulido
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid. Plaza Ramón y Cajal, S/n., 28040, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain
| | - J Hoyos
- CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain.
| | - V Martínez-Ruiz
- CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Avda. de La Investigación 11. 18016, Granada, Spain
| | - L Sordo
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid. Plaza Ramón y Cajal, S/n., 28040, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain
| | - P Fernández-Navarro
- CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain; Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Calle Sinesio Delgado, 4. 28029, Madrid, Spain
| | - G Barrio
- CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain; National School of Public Health. Carlos III Institute of Health, Calle Sinesio Delgado, 4. 28029, Madrid, Spain
| | - E Regidor
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid. Plaza Ramón y Cajal, S/n., 28040, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain; Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Calle Del Profesor Martín Lagos. 28040, Madrid, Spain
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16
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Santos-Lozano A, Barrán AT, Fernández-Navarro P, Valenzuela PL, Castillo-Garcia A, Ruilope LM, Ríos Insua D, Ordovas JM, Ley V, Lucia A. Association between physical activity and cardiovascular risk factors: Dose and sex matter. J Sport Health Sci 2021; 10:604-606. [PMID: 33722759 PMCID: PMC8500806 DOI: 10.1016/j.jshs.2021.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/18/2020] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Alejandro Santos-Lozano
- i+HeALTH, Department of Health Sciences, European University Miguel de Cervantes, Valladolid 47012, Spain; Research Institute of the Hospital 12 de Octubre (imas12, PaHerg group), and (CIBER en Fragilidad y Envejecimiento Saludable - CIBEFES), Madrid 28041, Spain.
| | | | - Pablo Fernández-Navarro
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid 28029, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid 28029, Spain
| | - Pedro L Valenzuela
- Department of Systems Biology, University of Alcalá, Madrid 28801, Spain
| | | | - Luis M Ruilope
- Hypertension Unit and Cardiorenal Translational Laboratory, Research Institute of the Hospital 12 de Octubre (imas12), Madrid 28041, Spain
| | - David Ríos Insua
- Institute of Mathematical Sciences (ICMAT-CSIC), Madrid 28049, Spain
| | - José M Ordovas
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA
| | - Victoria Ley
- Spanish State Research Agency, Ministry of Science, Innovation and Universities, Madrid 28046, Spain
| | - Alejandro Lucia
- Research Institute of the Hospital 12 de Octubre (imas12, PaHerg group), and (CIBER en Fragilidad y Envejecimiento Saludable - CIBEFES), Madrid 28041, Spain; Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid 28670, Spain
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17
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Pérez-Gómez B, Pastor-Barriuso R, Pérez-Olmeda M, Hernán MA, Oteo-Iglesias J, Fernández de Larrea N, Fernández-García A, Martín M, Fernández-Navarro P, Cruz I, Sanmartín JL, León Paniagua J, Muñoz-Montalvo JF, Blanco F, Yotti R, Pollán M. ENE-COVID nationwide serosurvey served to characterize asymptomatic infections and to develop a symptom-based risk score to predict COVID-19. J Clin Epidemiol 2021; 139:240-254. [PMID: 34126206 PMCID: PMC8192836 DOI: 10.1016/j.jclinepi.2021.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/18/2021] [Accepted: 06/03/2021] [Indexed: 12/24/2022]
Abstract
Objectives To characterize asymptomatic SARS-CoV-2 infections and develop a symptom-based risk score useful in primary healthcare. Study design and setting Sixty-one thousand ninty-two community-dwelling participants in a nationwide population-based serosurvey completed a questionnaire on COVID-19 symptoms and received an immunoassay for SARS-CoV-2 IgG antibodies between April 27 and June 22, 2020. Standardized prevalence ratios for asymptomatic infection were estimated across participant characteristics. We constructed a symptom-based risk score and evaluated its ability to predict SARS-CoV-2 infection. Results Of all, 28.7% of infections were asymptomatic (95% CI 26.1–31.4%). Standardized asymptomatic prevalence ratios were 1.19 (1.02–1.40) for men vs. women, 1.82 (1.33–2.50) and 1.45 (0.96–2.18) for individuals <20 and ≥80 years vs. those aged 40–59, 1.27 (1.03–1.55) for smokers vs. nonsmokers, and 1.91 (1.59–2.29) for individuals without vs. with case contact. In symptomatic population, a symptom-based score (weights: severe tiredness = 1; absence of sore throat = 1; fever = 2; anosmia/ageusia = 5) reached standardized seroprevalence ratio of 8.71 (7.37–10.3), discrimination index of 0.79 (0.77–0.81), and sensitivity and specificity of 71.4% (68.1–74.4%) and 74.2% (73.1–75.2%) for a score ≥3. Conclusion The presence of anosmia/ageusia, fever with severe tiredness, or fever without sore throat should serve to suspect COVID-19 in areas with active viral circulation. The proportion of asymptomatics in children and adolescents challenges infection control.
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Affiliation(s)
- Beatriz Pérez-Gómez
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Roberto Pastor-Barriuso
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Mayte Pérez-Olmeda
- National Centre for Microbiology, Instituto de Salud Carlos III (ISCIII), Ctra de Pozuelo 28, 28222 Madrid, Spain
| | - Miguel A Hernán
- Departments of Epidemiology and Biostatistics, Harvard T H Chan School of Public Health, Harvard-MIT Division of Health Sciences and Technology, 677 Huntington Ave, Boston, MA 02115, USA
| | - Jesús Oteo-Iglesias
- National Centre for Microbiology, Instituto de Salud Carlos III (ISCIII), Ctra de Pozuelo 28, 28222 Madrid, Spain; Spanish Network for Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Nerea Fernández de Larrea
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Aurora Fernández-García
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain; National Centre for Microbiology, Instituto de Salud Carlos III (ISCIII), Ctra de Pozuelo 28, 28222 Madrid, Spain
| | - Mariano Martín
- Deputy Directorate of Information Technologies, Ministry of Health, Paseo del Prado 18, 28014 Madrid, Spain
| | - Pablo Fernández-Navarro
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Israel Cruz
- National School of Public Health, Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Jose L Sanmartín
- Deputy Directorate of Information Technologies, Ministry of Health, Paseo del Prado 18, 28014 Madrid, Spain
| | - Jose León Paniagua
- Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Juan F Muñoz-Montalvo
- Deputy Directorate of Information Technologies, Ministry of Health, Paseo del Prado 18, 28014 Madrid, Spain
| | - Faustino Blanco
- Deputy Directorate of Information Technologies, Ministry of Health, Paseo del Prado 18, 28014 Madrid, Spain
| | - Raquel Yotti
- Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain
| | - Marina Pollán
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 5, 28029 Madrid, Spain.
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18
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Batista J, Fernández-Navarro P, Gonçalves MM. Internalized relationships and narrative change in psychotherapy: A thematic analysis case study. Journal of Constructivist Psychology 2021. [DOI: 10.1080/10720537.2020.1717112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- J. Batista
- Escola de Psicologia, Universidade do Minho, Campus de Gualtar, Braga, Portugal
| | | | - Miguel M. Gonçalves
- Escola de Psicologia, Universidade do Minho, Campus de Gualtar, Braga, Portugal
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19
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Garcia-Martínez J, Maestre-Castillo D, Payán-Bravo MA, Fernández-Navarro P. Innovative Moments in Group Therapy: Analyzing voices of group change. Journal of Constructivist Psychology 2021. [DOI: 10.1080/10720537.2020.1717143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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20
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Redondo-Sánchez D, Rodríguez-Barranco M, Ameijide A, Alonso FJ, Fernández-Navarro P, Jiménez-Moleón JJ, Sánchez MJ. Cancer incidence estimation from mortality data: a validation study within a population-based cancer registry. Popul Health Metr 2021; 19:18. [PMID: 33757540 PMCID: PMC7988947 DOI: 10.1186/s12963-021-00248-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 03/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Population-based cancer registries are required to calculate cancer incidence in a geographical area, and several methods have been developed to obtain estimations of cancer incidence in areas not covered by a cancer registry. However, an extended analysis of those methods in order to confirm their validity is still needed. Methods We assessed the validity of one of the most frequently used methods to estimate cancer incidence, on the basis of cancer mortality data and the incidence-to-mortality ratio (IMR), the IMR method. Using the previous 15-year cancer mortality time series, we derived the expected yearly number of cancer cases in the period 2004–2013 for six cancer sites for each sex. Generalized linear mixed models, including a polynomial function for the year of death and smoothing splines for age, were adjusted. Models were fitted under a Bayesian framework based on Markov chain Monte Carlo methods. The IMR method was applied to five scenarios reflecting different assumptions regarding the behavior of the IMR. We compared incident cases estimated with the IMR method to observed cases diagnosed in 2004–2013 in Granada. A goodness-of-fit (GOF) indicator was formulated to determine the best estimation scenario. Results A total of 39,848 cancer incidence cases and 43,884 deaths due to cancer were included. The relative differences between the observed and predicted numbers of cancer cases were less than 10% for most cancer sites. The constant assumption for the IMR trend provided the best GOF for colon, rectal, lung, bladder, and stomach cancers in men and colon, rectum, breast, and corpus uteri in women. The linear assumption was better for lung and ovarian cancers in women and prostate cancer in men. In the best scenario, the mean absolute percentage error was 6% in men and 4% in women for overall cancer. Female breast cancer and prostate cancer obtained the worst GOF results in all scenarios. Conclusion A comparison with a historical time series of real data in a population-based cancer registry indicated that the IMR method is a valid tool for the estimation of cancer incidence. The goodness-of-fit indicator proposed can help select the best assumption for the IMR based on a statistical argument. Supplementary Information The online version contains supplementary material available at 10.1186/s12963-021-00248-1.
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Affiliation(s)
- Daniel Redondo-Sánchez
- Granada Cancer Registry, Andalusian School of Public Health (EASP), Campus Universitario de Cartuja, C/Cuesta del Observatorio 4, 18011, Granada, Spain.,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), University of Granada, Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Miguel Rodríguez-Barranco
- Granada Cancer Registry, Andalusian School of Public Health (EASP), Campus Universitario de Cartuja, C/Cuesta del Observatorio 4, 18011, Granada, Spain. .,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), University of Granada, Granada, Spain. .,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Alberto Ameijide
- Tarragona Cancer Registry, Foundation Society for Cancer Research and Prevention (FUNCA), Pere Virgili Health Research Institute (IISPV), Reus, Spain
| | | | - Pablo Fernández-Navarro
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Jose Juan Jiménez-Moleón
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), University of Granada, Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - María-José Sánchez
- Granada Cancer Registry, Andalusian School of Public Health (EASP), Campus Universitario de Cartuja, C/Cuesta del Observatorio 4, 18011, Granada, Spain.,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), University of Granada, Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
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21
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Valenzuela PL, Santos-Lozano A, Barrán AT, Fernández-Navarro P, Castillo-García A, Ruilope LM, Ríos Insua D, Ordovas JM, Ley V, Lucia A. Joint association of physical activity and body mass index with cardiovascular risk: a nationwide population-based cross-sectional study. Eur J Prev Cardiol 2021; 29:e50-e52. [PMID: 33580798 DOI: 10.1093/eurjpc/zwaa151] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 11/14/2022]
Affiliation(s)
| | - Alejandro Santos-Lozano
- i+HeALTH, Department of Health Sciences, European University Miguel de Cervantes, Valladolid, Spain.,Research Group in Physical Activity and Health, Research Institute of the Hospital 12 de Octubre ('imas12'), Madrid, Spain
| | - Alberto Torres Barrán
- Data Lab Department, Institute of Mathematical Sciences (ICMAT-CSIC), Madrid, Spain.,Komorebi A.I. Technologies, Madrid, Spain
| | - Pablo Fernández-Navarro
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Madrid, Spain Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | | | - Luis M Ruilope
- Hypertension Unit and Cardiorenal Translational Laboratory, Research Institute of the Hospital 12 de Octubre (imas12), Madrid, Spain
| | - David Ríos Insua
- Data Lab Department, Institute of Mathematical Sciences (ICMAT-CSIC), Madrid, Spain
| | - José M Ordovas
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Victoria Ley
- Spanish State Research Agency, Ministry of Science, Innovation and Universities, Madrid, Spain
| | - Alejandro Lucia
- Research Group in Physical Activity and Health, Research Institute of the Hospital 12 de Octubre ('imas12'), Madrid, Spain.,Faculty of Sport Sciences, European University, s/n. 28670. Villaviciosa de Odón, E-28670 Madrid, Spain
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22
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De Salazar PM, Lu F, Hay JA, Gómez-Barroso D, Fernández-Navarro P, Martínez E, Astray-Mochales J, Amillategui R, García-Fulgueiras A, Chirlaque MD, Sánchez-Migallón A, Larrauri A, Sierra MJ, Lipsitch M, Simón F, Santillana M, Hernán MA. Near real-time surveillance of the SARS-CoV-2 epidemic with incomplete data. medRxiv 2021:2021.01.25.20230094. [PMID: 33532788 PMCID: PMC7852239 DOI: 10.1101/2021.01.25.20230094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Designing public health responses to outbreaks requires close monitoring of population-level health indicators in real-time. Thus, an accurate estimation of the epidemic curve is critical. We propose an approach to reconstruct epidemic curves in near real time. We apply this approach to characterize the early SARS-CoV-2 outbreak in two Spanish regions between March and April 2020. We address two data collection problems that affected the reliability of the available real-time epidemiological data, namely, the frequent missing information documenting when a patient first experienced symptoms, and the frequent retrospective revision of historical information (including right censoring). This is done by using a novel back-calculating procedure based on imputing patients' dates of symptom onset from reported cases, according to a dynamically-estimated "backward" reporting delay conditional distribution, and adjusting for right censoring using an existing package, NobBS , to estimate in real time (nowcast) cases by date of symptom onset. This process allows us to obtain an approximation of the time-varying reproduction number ( R t ) in real-time. At each step, we evaluate how different assumptions affect the recovered epidemiological events and compare the proposed approach to the alternative procedure of merely using curves of case counts, by report day, to characterize the time-evolution of the outbreak. Finally, we assess how these real-time estimates compare with subsequently documented epidemiological information that is considered more reliable and complete that became available later in time. Our approach may help improve accuracy, quantify uncertainty, and evaluate frequently unstated assumptions when recovering the epidemic curves from limited data obtained from public health surveillance systems in other locations.
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Affiliation(s)
- PM De Salazar
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, United States
| | - F Lu
- Machine Intelligence Lab, Boston Children’s Hospital, Boston, United States
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, United States
| | - JA Hay
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, United States
| | - D Gómez-Barroso
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
| | - P Fernández-Navarro
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
| | - E Martínez
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
| | - J Astray-Mochales
- Directorate-General for Public Health, Madrid General Health Authority, Spain
| | - R Amillategui
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
| | - A García-Fulgueiras
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - MD Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - A Sánchez-Migallón
- Directorate-General for Public Health, Madrid General Health Authority, Spain
| | - A Larrauri
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, United States
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
| | - MJ Sierra
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
| | - M Lipsitch
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, United States
| | - F Simón
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
| | - M Santillana
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, United States
- Machine Intelligence Lab, Boston Children’s Hospital, Boston, United States
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, United States
- Department of Pediatrics, Harvard Medical School, Harvard University, Boston, United States
| | - MA Hernán
- Department of Epidemiology and Department of Biostatistics, Harvard T.H. Chan School of Public Health; Harvard-MIT Division of Health Sciences and Technology, Boston, United States
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23
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Palmí-Perales F, Gómez-Rubio V, López-Abente G, Ramis R, Sanz-Anquela JM, Fernández-Navarro P. Approximate Bayesian inference for multivariate point pattern analysis in disease mapping. Biom J 2020; 63:632-649. [PMID: 33345346 DOI: 10.1002/bimj.201900396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 11/08/2022]
Abstract
We present a novel approach for analysing multivariate case-control georeferenced data in a Bayesian disease mapping context using stochastic partial differential equations (SPDEs) and the integrated nested Laplace approximation (INLA) for model fitting. In particular, we propose smooth terms based on SPDE models to estimate the underlying spatial variation as well as risk associated to pollution sources. Log-Gaussian Cox processes are used to estimate the intensity of the cases and controls, to account for risk factors and include a term to measure spatial residual variation. Each intensity is modelled on a baseline spatial effect (estimated from both controls and cases), a disease-specific spatial term and the effects of some covariates. By fitting these models, the residual spatial terms can be easily compared to detect high-risk areas not explained by the covariates. Three different types of effects to model exposure to pollution sources are considered on the distance to the source: a fixed effect, a smooth term to model non-linear effects by means of a discrete random walk of order one and a Gaussian process in one dimension with a Matérn covariance function. Spatial terms are modelled using a Gaussian process in two dimensions with a Matérn covariance function and are approximated using an approach based on solving an SPDE through INLA. Finally, this new framework is applied to a dataset of three different types of cancer and a set of controls from Alcalá de Henares (Madrid, Spain). Covariates available include the distance to several polluting industries and socioeconomic indicators. Our findings point to a possible risk increase due to the proximity to some of these industries.
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Affiliation(s)
- Francisco Palmí-Perales
- Department of Mathematics, School of Industrial Engineering-Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Virgilio Gómez-Rubio
- Department of Mathematics, School of Industrial Engineering-Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Gonzalo López-Abente
- Environmental and Cancer Epidemiology Unit, Carlos III Institute of Health, C/ Sinesio Delgado, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health, CIBER Epidemiología y Salud Pública - CIBERESP, Spain
| | - Rebeca Ramis
- Environmental and Cancer Epidemiology Unit, Carlos III Institute of Health, C/ Sinesio Delgado, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health, CIBER Epidemiología y Salud Pública - CIBERESP, Spain
| | - José Miguel Sanz-Anquela
- Cancer Registry and Pathology Department, Hospital Universitario Príncipe de Asturias, Campus Universitario, Alcalá de Henares, Madrid, Spain.,Department of Medicine and Medical Specialties, Faculty of Medicine, University of Alcalá de Henares, Campus Universitario, Alcalá de Henares, Madrid, Spain
| | - Pablo Fernández-Navarro
- Environmental and Cancer Epidemiology Unit, Carlos III Institute of Health, C/ Sinesio Delgado, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health, CIBER Epidemiología y Salud Pública - CIBERESP, Spain
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24
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Pastor-Barriuso R, Pérez-Gómez B, Hernán MA, Pérez-Olmeda M, Yotti R, Oteo-Iglesias J, Sanmartín JL, León-Gómez I, Fernández-García A, Fernández-Navarro P, Cruz I, Martín M, Delgado-Sanz C, Fernández de Larrea N, León Paniagua J, Muñoz-Montalvo JF, Blanco F, Larrauri A, Pollán M. Infection fatality risk for SARS-CoV-2 in community dwelling population of Spain: nationwide seroepidemiological study. BMJ 2020; 371:m4509. [PMID: 33246972 PMCID: PMC7690290 DOI: 10.1136/bmj.m4509] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To estimate the infection fatality risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), based on deaths with confirmed coronavirus disease 2019 (covid-19) and excess deaths from all causes. DESIGN Nationwide seroepidemiological study. SETTING First wave of covid-19 pandemic in Spain. PARTICIPANTS Community dwelling individuals of all ages. MAIN OUTCOME MEASURES The main outcome measure was overall, and age and sex specific, infection fatality risk for SARS-CoV-2 (the number of covid-19 deaths and excess deaths divided by the estimated number of SARS-CoV-2 infections) in the community dwelling Spanish population. Deaths with laboratory confirmed covid-19 were obtained from the National Epidemiological Surveillance Network (RENAVE) and excess all cause deaths from the Monitoring Mortality System (MoMo), up to 15 July 2020. SARS-CoV-2 infections in Spain were derived from the estimated seroprevalence by a chemiluminescent microparticle immunoassay for IgG antibodies in 61 098 participants in the ENE-COVID nationwide seroepidemiological survey between 27 April and 22 June 2020. RESULTS The overall infection fatality risk was 0.8% (19 228 of 2.3 million infected individuals, 95% confidence interval 0.8% to 0.9%) for confirmed covid-19 deaths and 1.1% (24 778 of 2.3 million infected individuals, 1.0% to 1.2%) for excess deaths. The infection fatality risk was 1.1% (95% confidence interval 1.0% to 1.2%) to 1.4% (1.3% to 1.5%) in men and 0.6% (0.5% to 0.6%) to 0.8% (0.7% to 0.8%) in women. The infection fatality risk increased sharply after age 50, ranging from 11.6% (8.1% to 16.5%) to 16.4% (11.4% to 23.2%) in men aged 80 or more and from 4.6% (3.4% to 6.3%) to 6.5% (4.7% to 8.8%) in women aged 80 or more. CONCLUSION The increase in SARS-CoV-2 infection fatality risk after age 50 appeared to be more noticeable in men than in women. Based on the results of this study, fatality from covid-19 was greater than that reported for other common respiratory diseases, such as seasonal influenza.
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Affiliation(s)
- Roberto Pastor-Barriuso
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Joint first authors
| | - Beatriz Pérez-Gómez
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Joint first authors
| | - Miguel A Hernán
- Departments of Epidemiology and Biostatistics, Harvard TH Chan School of Public Health; Harvard-MIT Division of Health Sciences and Technology, Boston, MA, USA
| | - Mayte Pérez-Olmeda
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | | | - Jesús Oteo-Iglesias
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
- Spanish Network for Research in Infectious Diseases (REIPI), Institute of Health Carlos III, Madrid, Spain
| | | | - Inmaculada León-Gómez
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Aurora Fernández-García
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Pablo Fernández-Navarro
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Israel Cruz
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain
| | | | - Concepción Delgado-Sanz
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Nerea Fernández de Larrea
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | | | | | - Amparo Larrauri
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Joint senior authors
| | - Marina Pollán
- National Centre for Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Joint senior authors
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25
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Ortiz-Pinto M, Pérez-Gómez B, Galán I, Sarmiento-Suárez R, Gómez-García T, Fernández-Navarro P, Padrón-Monedero A, Noguer I. Hospital admissions/mortality ratio: a composite health indicator for monitoring NCD. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Our aim was to test the usefulness of a new tool to monitor NCD. We evaluated a composite indicator, the ratio of hospitalizations vs mortality rates (HMR), by assessing its capacity of identifying additional variability among regions. In this communication, we present the analysis corresponding to ischemic heart disease as an example.
Methods
We used the Hospital Morbidity Survey and the Death Statistics for Spain in 2016, both provided by the National Institute of Statistics, to calculate age-adjusted hospitalisation and mortality rates for ischemic heart disease for men and women in all 52 provinces of Spain. Subsequently, we computed HMR, the ratio of the age-adjusted of hospital morbidity and mortality rates. The correlation and linear adjustment between provincial mortality and morbidity rates, as well as mortality and HMR, were also estimated by sex.
Results
The rate of hospital admissions for ischemic heart disease in Spain was 407 per 100,000 in men and 129.4 in women. The mortality rate was 93.1 per 100,000 in men and 40.3 in women. In both sexes, the highest morbidity and mortality rates were observed in the south of Spain. Pearson correlation between morbidity and mortality rates were 0.53 (p < 0.01) in men and 0.75 (p < 0.05) in women. HMR showed a different spatial pattern with important variability. In men the average ratio was 4.3, with a range of 2.8 (Tenerife) to 7.1 (Melilla); in women the average was 3.2 with a range between1.7 (Zamora and Tenerife) and 4.7 (Barcelona), and in both sexes very high ratios were found in Catalonia's provinces. Association between mortality rate and HMR showed a negative correlation in both men (-0.39; p < 0.01) and women (-0.24; p < 0.05).
Conclusions
HMR is a composite indicator that provides complementary information regarding the individual analysis of hospital morbidity and mortality rates. HMR of ischemic heart disease shows an important geographical variability and an inverse association with mortality.
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Affiliation(s)
- M Ortiz-Pinto
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - B Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - I Galán
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - R Sarmiento-Suárez
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - T Gómez-García
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - P Fernández-Navarro
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - A Padrón-Monedero
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - I Noguer
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
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26
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Padrón-Monedero A, Sarmiento-Suárez S, Gómez-García T, Ortiz-Pinto M, Pérez-Gómez B, Fernández-Navarro P, Galán I, Noguer I. Towards an EU sustainable health information infrastructure. Integrating technical and political views and interest. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Health information systems (HIS) play a key role in providing information for decision-making. Europe lacks of an integrated HIS on non-communicable diseases (NCD) and Health Systems Performance (HSP) able to compare health problems across countries. NCDs are the main contributor to the EU-burden of disease, including the highest mortality rates. There is a general agreement among public health policy makers and researchers on the need of an integrated EU health information (HI) infrastructure to monitor risk factors, NCD and HSP. Such infrastructure would provide common inputs for public health and research to prioritize health policies. However, there is no EU-EEA consensus on how to go forward with this initiative.
Methods
The Information for Action (InfAct) project is aimed at establishing a sustainable HI infrastructure on HIS and HSP by cataloging resources, experience, research capacities and expertise into a 'one-stop shop'. Significant political will is needed to support and systematically feed a functional and permanent governance structure. InfAct provides a ground for Member States to discuss and generate consensus through two main boards: 1) Technical Dialogues (TD), composed by national experts, to discuss scientific aspects, feasibility and added value; and 2) Assembly of Members (AoM) where political representatives from Ministries of Health and Research provide the framework of political acceptance and guarantee of implementation and future development.
Results
Both boards reveal different interests and concerns. The AoM rather focused on resources and necessary political decisions based on expected returns. The TD focused on feasibility aspects and new adaptations required from current systems. The feedback provided by both boards is key to develop a sustainable EU-HIS infrastructure.
Conclusions
The TD and the AoM are key forums to provide feedback, guidance and advocacy to build a sustainable EU-HIS infrastructure
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Affiliation(s)
- A Padrón-Monedero
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - S Sarmiento-Suárez
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - T Gómez-García
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - M Ortiz-Pinto
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - B Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - P Fernández-Navarro
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - I Galán
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - I Noguer
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
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27
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Fernández-Navarro P, Pérez-Gómez B, Gómez-García T, Sarmiento-Suárez R, Padrón-Monedero A, Ortiz-Pinto M, Galán I, Noguer I. Use of non-health EU databases for health surveillance. En-risk application. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
To combine health information and environmental health determinants is key, for epidemiological monitoring and health risk studies but its integration represents a challenge that requires specific expertise. An example of a potentially useful source of significant environmental data relevant for health is the European Pollutant Release and Transfer Register (E-PRTR), which allows estimating exposure to industrial pollution. Our aim was to develop an easy-to-use tool that allows to perform a screening suggesting the presence/absence of excess risk of a disease linked to residential proximity to industrial pollution.
Methods
En-risk: java interactive tool was developed to merge E-PRTR information and municipal mortality/morbidity data, to perform an exploratory spatial analysis of association between them by type of industrial facility using distance as proxy of exposure. The application needs cartography of the country and a database of the annual observed deaths (mortality) or cases (morbidity) and population broken down by age groups and sex per municipality. With this it calculates the expected number of deaths, the distance from the municipal centroids to the industrial location (classifying municipalities as exposed or not exposed), and perform the statistical analyses. Municipal lung cancer deaths (2005-2009) in Spain provided by the National Institute of Statistics were analyzed with this application as an example.
Results
En-risk gives a table of Relative Risk of mortality/morbidity due to exposure to industrial pollution by industrial sector and sex. The analysis in lung cancer deaths showed an excess of mortality associated to proximity to several industrial sectors.
Conclusions
En-risk facilitates the study of the relationship between industrial pollution and health around Europe. It can be used by public health services to identify health problems.
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Affiliation(s)
- P Fernández-Navarro
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - B Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - T Gómez-García
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - R Sarmiento-Suárez
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - A Padrón-Monedero
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - M Ortiz-Pinto
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - I Galán
- National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - I Noguer
- National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain
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28
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Nuñez O, Rodríguez Barranco M, Fernández-Navarro P, Redondo Sanchez D, Luque Fernández MÁ, Pollán Santamaría M, Sánchez MJ. Deprivation gap in colorectal cancer survival attributable to stage at diagnosis: A population-based study in Spain. Cancer Epidemiol 2020; 68:101794. [PMID: 32795946 DOI: 10.1016/j.canep.2020.101794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/21/2020] [Accepted: 07/27/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Socioeconomic inequalities in colorectal cancer (CRC) survival are a major concern of the Spanish public health system. If these inequalities were mainly due to differences in stage at diagnosis, population-based screening programs might reduce them substantially. We aimed to determine to what extent adverse stage distribution contributed to survival inequalities in a Spanish region before the implementation of a CRC screening program. METHODS We analyzed data from a population-based cohort study that included all patients living in a region of southern Spain with CRC diagnosed between 2004 and 2013. The European Deprivation Index was used to assign each patient a socioeconomic level based on their area of residence. The role of tumor stage in survival disparities between socioeconomic groups was assessed using a causal mediation analysis. RESULTS A total of 2802 men and 1957 women were included in the study. For men, the adjusted difference in deaths between the most deprived and the most affluent areas was 131 deaths per 1000 person-years by the first year after diagnosis. Of these deaths, 42 (per 1000 person-years) were attributable to differences in stage at diagnosis. No socioeconomic disparities in survival were detected among female patients. CONCLUSIONS In this study, we mainly detected socioeconomic disparities in short term survival of male patients. More than two thirds of these inequalities could not be attributed to differences in stage at diagnosis. Our results suggest that in addition to a screening program, other public health interventions are necessary to reduce the deprivation gap in survival.
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Affiliation(s)
- Olivier Nuñez
- Cancer & Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Miguel Rodríguez Barranco
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Granada Cancer Registry, Andalusian School of Public Health, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Non-Communicable and Cancer Epidemiology Group, University of Granada, Spain
| | - Pablo Fernández-Navarro
- Cancer & Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - Daniel Redondo Sanchez
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Granada Cancer Registry, Andalusian School of Public Health, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Non-Communicable and Cancer Epidemiology Group, University of Granada, Spain
| | - Miguel Ángel Luque Fernández
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Granada Cancer Registry, Andalusian School of Public Health, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Non-Communicable and Cancer Epidemiology Group, University of Granada, Spain; London School of Hygiene and Tropical Medicine, Non-communicable Disease Epidemiology, London, UK
| | - Marina Pollán Santamaría
- Cancer & Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - María-José Sánchez
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Granada Cancer Registry, Andalusian School of Public Health, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Non-Communicable and Cancer Epidemiology Group, University of Granada, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
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29
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Ayuso-Álvarez A, García-Pérez J, Triviño-Juárez JM, Larrinaga-Torrontegui U, González-Sánchez M, Ramis R, Boldo E, López-Abente G, Galán I, Fernández-Navarro P. Association between proximity to industrial chemical installations and cancer mortality in Spain. Environ Pollut 2020; 260:113869. [PMID: 31991345 DOI: 10.1016/j.envpol.2019.113869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 12/17/2019] [Accepted: 12/20/2019] [Indexed: 06/10/2023]
Abstract
It is likely that pollution from chemical facilities will affect the health of any exposed population; however, the majority of scientific evidence available has focused on occupational exposure rather than environmental. Consequently, this study assessed whether there could have been an excess of cancer-related mortality associated with environmental exposure to pollution from chemical installations - for populations residing in municipalities in the vicinity of chemical industries. To this end, we designed an ecological study which assessed municipal mortality due to 32 types of cancer in the period from 1999 to 2008. The exposure to pollution was estimated using distance from the facilities to the centroid of the municipality as a proxy for exposure. In order to assess any increased cancer mortality risk in municipalities potentially exposed to chemical facilities pollution (situated at a distance of ≤5 km from a chemical installation), we employed Bayesian Hierarchical Poisson Regression Models. This included two Bayesian inference methods: Integrated Nested Laplace Approximations (INLA) and Markov Chain Monte Carlo (MCMC, for validation). The reference category consisted of municipalities beyond the 5 km limit. We found higher mortality risk (relative risk, RR; estimated by INLA, 95% credible interval, 95%CrI) for both sexes for colorectal (RR, 1.09; 95%CrI, 1.05-1.15), gallbladder (1.14; 1.03-1.27), and ovarian cancers (1.10; 1.02-1.20) associated with organic chemical installations. Notably, pleural cancer (2.27; 1.49-3.41) in both sexes was related to fertilizer facilities. Associations were found for women, specifically for ovarian (1.11; 1.01-1.22) and breast cancers (1.06; 1.00-1.13) in the proximity of explosives/pyrotechnics installations; increased breast cancer mortality risk (1.10; 1.03-1.18) was associated with proximity to inorganic chemical installations. The results suggest that environmental exposure to pollutants from some types of chemical facilities may be associated with increased mortality from several different types of cancer.
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Affiliation(s)
- Ana Ayuso-Álvarez
- National Center of Tropical Medicine, Network Collaborative Research in Tropical Diseases (RICET), Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Calle del Arzobispo Morcillo 4, PC, 28029, Madrid, Spain
| | - Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | | | - Unai Larrinaga-Torrontegui
- Medicina Preventiva OSI Debabarrena, Hospital de Mendaro, Calle Mendarozabal Kalea, s/n, 20850 Mendaro Gipuzkoa, Spain
| | - Mario González-Sánchez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain
| | - Rebeca Ramis
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - Elena Boldo
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - Gonzalo López-Abente
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - Iñaki Galán
- Department of Chronic Diseases. Nacional Center for Epidemiology, Institute of Health Carlos III, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; School of Medicine, Autonomous University of Madrid/IdiPAZ (Instituto de Investigación del Hospital Universitario La Paz/La Paz University Teaching Hospital Research Institute), Calle del Arzobispo Morcillo 4, PC 28029, Madrid, Spain
| | - Pablo Fernández-Navarro
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
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Dierssen-Sotos T, Gómez-Acebo I, Palazuelos C, Fernández-Navarro P, Altzibar JM, González-Donquiles C, Ardanaz E, Bustamante M, Alonso-Molero J, Vidal C, Bayo-Calero J, Tardón A, Salas D, Marcos-Gragera R, Moreno V, Rodriguez-Cundin P, Castaño-Vinyals G, Ederra M, Vilorio-Marqués L, Amiano P, Pérez-Gómez B, Aragonés N, Kogevinas M, Pollán M, Llorca J. Author Correction: Validating a breast cancer score in Spanish women. The MCC-Spain study. Sci Rep 2020; 10:5980. [PMID: 32238823 PMCID: PMC7113259 DOI: 10.1038/s41598-020-62511-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- Trinidad Dierssen-Sotos
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. .,University of Cantabria - IDIVAL, Santander, Spain.
| | - Inés Gómez-Acebo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,University of Cantabria - IDIVAL, Santander, Spain
| | | | - Pablo Fernández-Navarro
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Jone M Altzibar
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Breast Cancer Screening Programme, Basque Health Department, Osakidetza, Spain
| | - Carmen González-Donquiles
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Grupo de Investigación Interacciones Gen-Ambiente y Salud, Universidad de León, León, Spain
| | - Eva Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Navarra Public Health Institute, Navarra, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Mariona Bustamante
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Centre for Genomic Regulation (CRG), the Barcelona Institute of Science and Technology, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - Carmen Vidal
- Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Juan Bayo-Calero
- Complejo Hospitalario Universitario de Huelva, Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Huelva, Spain
| | - Adonina Tardón
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,IUOPA, Universidad de Oviedo, Asturias, Spain
| | - Dolores Salas
- Valencia Cancer and Public Health Area, FISABIO - Public Health, Valencia, Spain.,General Directorate Public Health, Valencian Community, Valencia, Spain
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia and Descriptive Epidemiology, Genetics and Cancer Prevention Group [Girona Biomedical Research Institute (IdIBGi)], Catalan Institute of Oncology, Girona, Spain
| | - Víctor Moreno
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | | | - Gemma Castaño-Vinyals
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain
| | - María Ederra
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Navarra Public Health Institute, Navarra, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Laura Vilorio-Marqués
- Grupo de Investigación Interacciones Gen-Ambiente y Salud, Universidad de León, León, Spain
| | - Pilar Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Beatriz Pérez-Gómez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Nuria Aragonés
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Manolis Kogevinas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain.,School of Public Health, Athens, Greece
| | - Marina Pollán
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Javier Llorca
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,University of Cantabria - IDIVAL, Santander, Spain
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Silva JR, Da Silva R, Fernández-Navarro P, Rosa C, Gonçalves MM. Understanding Extreme Violent Behavior in Ultra Firms: Exploring Identity Fusion from a Dialogical Perspective. Journal of Constructivist Psychology 2020. [DOI: 10.1080/10720537.2019.1676342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- J. R. Silva
- INPP–Portucalense Institute for Human Development, Department of Psychology and Education, Portucalense University, Porto, Portugal
| | - R. Da Silva
- International Development Department, University of Birmingham, Birmingham, UK and CEI-IUL—Center for International Studies, ISCTE—Instituto Universitário de Lisboa, Lisbon, Portugal
| | - P. Fernández-Navarro
- CIPsi–Psychology Research Center, School of Psychology, University of Minho, Braga, Portugal
| | - C. Rosa
- Department of Education and Psychology and CINTESIS.UA—Center for Health Technology and Services Research, University of Aveiro, Aveiro, Portugal
| | - M. M. Gonçalves
- CIPsi–Psychology Research Center, School of Psychology, University of Minho, Braga, Portugal
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32
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Gonçalves MM, Fernández-Navarro P, Magalhães C, Braga C, Milhazes A, Batista J, Neimeyer RA. FIND: A Feedback Initiated Narrative Development Protocol to Elicit Resources in Psychotherapy. Journal of Constructivist Psychology 2020. [DOI: 10.1080/10720537.2020.1717139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | | | | | | | | | | | - Robert A. Neimeyer
- University of Memphis, USA and Portland Institute for Loss and Transition
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33
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Nasim R, Shimshi S, Ziv-Beiman S, Peri T, Fernández-Navarro P, Oliveira JT, Gonçalves MM. Exploring innovative moments in a brief integrative psychotherapy case study. Journal of Psychotherapy Integration 2019. [DOI: 10.1037/int0000148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Fernández-Navarro P, Ribeiro AP, Soylemez KK, Gonçalves MM. Innovative Moments as Developmental Change Levels: A Case Study on Meaning Integration in the Treatment of Depression. Journal of Constructivist Psychology 2019. [DOI: 10.1080/10720537.2019.1592037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Pablo Fernández-Navarro
- CIPsi - Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - António P. Ribeiro
- CIPsi - Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Kerem K. Soylemez
- CIPsi - Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Miguel M. Gonçalves
- CIPsi - Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
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Rodriguez-Sanchez L, Fernández-Navarro P, López-Abente G, Nuñez O, Fernández de Larrea-Baz N, Jimenez-Moleón JJ, Páez Borda Á, Pollán M, Perez-Gomez B. Different spatial pattern of municipal prostate cancer mortality in younger men in Spain. PLoS One 2019; 14:e0210980. [PMID: 30682085 PMCID: PMC6347247 DOI: 10.1371/journal.pone.0210980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/04/2019] [Indexed: 11/25/2022] Open
Abstract
Background Prostate cancer (PC) primarily affects elderly men. However, the specific features of cases diagnosed at younger ages (<65 years) suggest that they may represent a different clinical subtype. Our aim was to assess this suggestion by contrasting the geographical PC mortality and hospital admissions patterns in Spain for all ages to those in younger men. Methods The Spanish National Institute of Statistics supplied data on PC mortality, hospital admission, and population data. We estimated the expected town-specific number of deaths and calculated the standardized mortality ratios. Spatial autoregressive models of Besag-York-Mollié provided smoother municipal estimators of PC mortality risk (all ages; <65 years). We computed the provincial age-standardized rate ratios of PC hospital admissions (all men; <60 years) using Spanish rates as the reference. Results A total of 29,566 PC deaths (6% among those <65 years) were registered between 2010–2014, with three high-mortality risk zones: Northwest Spain; Southwest Andalusia & Granada; and a broad band extending from the Pyrenees Mountains to the north of Valencia. In younger men, the spatial patterns shared the high risk of mortality in the Northwest but not the central band. The PC hospital discharge rates confirmed a North-South gradient but also low mortality/high admission rates in Madrid and Barcelona and the opposite in Southwest Andalusia. Conclusion The consistent high PC mortality/morbidity risk in the Northwest of Spain indicates an area with a real excess of risk. The different spatial pattern in younger men suggests that some factors associated with geographical risk might have differential effects by age. Finally, the regional divergences in mortality and morbidity hint at clinical variability as a source of inequity within Spain.
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Affiliation(s)
- Lara Rodriguez-Sanchez
- Urology Department, Fuenlabrada General Hospital, Fuenlabrada, Spain
- Rey Juan Carlos University, Móstoles, Spain
| | - Pablo Fernández-Navarro
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Gonzalo López-Abente
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Olivier Nuñez
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Nerea Fernández de Larrea-Baz
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Jose Juan Jimenez-Moleón
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Complejo Hospitales Universitarios, Granada, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Álvaro Páez Borda
- Urology Department, Fuenlabrada General Hospital, Fuenlabrada, Spain
- Rey Juan Carlos University, Móstoles, Spain
| | - Marina Pollán
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
| | - Beatriz Perez-Gomez
- Cancer & Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública—CIBERESP), Madrid, Spain
- Cardiovascular & Metabolic Diseases Unit, Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- * E-mail:
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36
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Gutiérrez-González E, Castelló A, Fernández-Navarro P, Castaño-Vinyals G, Llorca J, Salas D, Salcedo-Bellido I, Aragonés N, Fernández-Tardón G, Alguacil J, Gracia-Lavedan E, García-Esquinas E, Gómez-Acebo I, Amiano P, Romaguera D, Kogevinas M, Pollán M, Pérez-Gómez B. Dietary Zinc and Risk of Prostate Cancer in Spain: MCC-Spain Study. Nutrients 2018; 11:nu11010018. [PMID: 30577563 PMCID: PMC6356690 DOI: 10.3390/nu11010018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/11/2018] [Accepted: 12/18/2018] [Indexed: 02/05/2023] Open
Abstract
Zinc is a key trace element in normal prostate cell metabolism, and is decreased in neoplastic cells. However, the association between dietary zinc and prostate cancer (PC) in epidemiologic studies is a conflicting one. Our aim was to explore this association in an MCC-Spain case-control study, considering tumor aggressiveness and extension, as well as genetic susceptibility to PC. 733 incident cases and 1228 population-based controls were included for this study. Dietary zinc was assessed using a food frequency questionnaire, and genetic susceptibility was assessed with a single nucleotide polymorphisms (SNP)-based polygenic risk score (PRS). The association between zinc intake and PC was evaluated with mixed logistic and multinomial regression models. They showed an increased risk of PC in those with higher intake of zinc (Odds Ratio (OR) tertile 3vs1: 1.39; 95% Confidence interval (CI):1.00–1.95). This association was mainly observed in low grade PC (Gleason = 6 RRR tertile 3vs1: 1.76; 95% CI:1.18–2.63) as well as in localized tumors (cT1-cT2a RRR tertile 3vs1: 1.40; 95% CI:1.00–1.95) and among those with higher PRS (OR tertile 3vs1: 1.50; 95% CI:0.89–2.53). In conclusion, a higher dietary zinc intake could increase the risk of low grade and localized tumors. Men with higher genetic susceptibility might also have a higher risk of PC associated with this nutrient intake.
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Affiliation(s)
- Enrique Gutiérrez-González
- Public Health & Preventive Medicine Teaching Unit. National School of Public Health. Carlos III Institute of Health, 28029 Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
| | - Adela Castelló
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Department of Epidemiology of Chronic Diseases. National Centre for Epidemiology. Carlos III Institute of Health, 28029 Madrid, Spain.
- Faculty of Medicine, University of Alcalá, 28871 Alcalá de Henares, Spain.
| | - Pablo Fernández-Navarro
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Department of Epidemiology of Chronic Diseases. National Centre for Epidemiology. Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- ISGlobal, 08036 Barcelona, Spain.
- IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain.
| | - Javier Llorca
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Universidad de Cantabria-IDIVAL, 39011 Santander, Spain.
| | - Dolores Salas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Área de Cáncer y Salud Pública, FISABIO-Salud Pública, 46020 Valencia, Spain.
| | - Inmaculada Salcedo-Bellido
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Universidad de Granada-ibs.Granada, 18012 Granada, Spain.
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Cancer epidemiology Section, Public Health Division, Department of Health of Madrid, 28035 Madrid, Spain.
| | - Guillermo Fernández-Tardón
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Oncology Institute IUOPA (Instituto Universitario de Oncología del Principado de Asturias), Universidad de Oviedo, 33003 Asturias, Spain.
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, 21004 Huelva, Spain.
| | - Esther Gracia-Lavedan
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- ISGlobal, 08036 Barcelona, Spain.
- IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain.
| | - Esther García-Esquinas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, 28029 Madrid, Spain.
| | - Inés Gómez-Acebo
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Universidad de Cantabria-IDIVAL, 39011 Santander, Spain.
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Public Health Division of Gipuzkoa, BioDonostia Research Health Institute, 20014 San Sebastian, Spain.
| | - Dora Romaguera
- ISGlobal, 08036 Barcelona, Spain.
- Balearic Islands Health Research Institute (IdISBa), University Hospital Son Espases, 07120 Palma de Mallorca, Spain.
- CIBER Fisiopathology of Obesity and Nutrition (CIBER-OBN), Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- ISGlobal, 08036 Barcelona, Spain.
- IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain.
| | - Marina Pollán
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Department of Epidemiology of Chronic Diseases. National Centre for Epidemiology. Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Beatriz Pérez-Gómez
- Public Health & Preventive Medicine Teaching Unit. National School of Public Health. Carlos III Institute of Health, 28029 Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Department of Epidemiology of Chronic Diseases. National Centre for Epidemiology. Carlos III Institute of Health, 28029 Madrid, Spain.
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Gómez-Acebo I, Dierssen-Sotos T, Palazuelos C, Fernández-Navarro P, Castaño-Vinyals G, Alonso-Molero J, Urtiaga C, Fernández-Villa T, Ardanaz E, Rivas-del-Fresno M, Molina-Barceló A, Jiménez-Moleón JJ, García-Martinez L, Amiano P, Rodriguez-Cundin P, Moreno V, Pérez-Gómez B, Aragonés N, Kogevinas M, Pollán M, Llorca J. Pigmentation phototype and prostate and breast cancer in a select Spanish population-A Mendelian randomization analysis in the MCC-Spain study. PLoS One 2018; 13:e0201750. [PMID: 30106959 PMCID: PMC6091948 DOI: 10.1371/journal.pone.0201750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/20/2018] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Phototype has been associated with an increased risk of prostate cancer, and it is yet unknown if it is related to other hormone-dependent cancers, such as breast cancer or whether this association could be considered causal. METHODS We examined the association between the phototype and breast and prostate cancers using a Mendelian randomization analysis. We studied 1,738 incident cases of breast cancer and another 817 cases of prostate cancer. To perform a Mendelian randomization analysis on the phototype-cancer relationship, a genetic pigmentation score was required that met the following criteria: (1) the genetic pigmentation score was associated with phototype in controls; (2) the genetic pigmentation score was not associated with confounders in the relationship between phototype and cancer, and (3) the genetic pigmentation score was associated with cancer only through its association with phototype. Once this genetic score is available, the association between genetic pigmentation score and cancer can be identified as the association between phototype and cancer. RESULTS The association between the genetic pigmentation score and phototype in controls showed that a higher genetic pigmentation score was associated with fair skin, blond hair, blue eyes and the presence of freckles. Applying the Mendelian randomization analysis, we verified that there was no association between the genetic pigmentation score and cancers of the breast and prostate. CONCLUSIONS Phototype is not associated with breast or prostate cancer.
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Affiliation(s)
- Inés Gómez-Acebo
- CIBER Epidemiología y Salud Pública (CIBERESP),Spain
- University of Cantabria–IDIVAL, Santander, Spain
- * E-mail:
| | - Trinidad Dierssen-Sotos
- CIBER Epidemiología y Salud Pública (CIBERESP),Spain
- University of Cantabria–IDIVAL, Santander, Spain
| | | | - Pablo Fernández-Navarro
- CIBER Epidemiología y Salud Pública (CIBERESP),Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Gemma Castaño-Vinyals
- CIBER Epidemiología y Salud Pública (CIBERESP),Spain
- ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain
| | | | - Carmen Urtiaga
- Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Tania Fernández-Villa
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Eva Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP),Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | | | - Ana Molina-Barceló
- Área de Cáncer y Salud Pública, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Salud Pública), Valencia, Spain
| | - José-Juan Jiménez-Moleón
- CIBER Epidemiología y Salud Pública (CIBERESP),Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Lidia García-Martinez
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Pilar Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP),Spain
- Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | | | - Víctor Moreno
- CIBER Epidemiología y Salud Pública (CIBERESP),Spain
- Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Spain
- Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Beatriz Pérez-Gómez
- CIBER Epidemiología y Salud Pública (CIBERESP),Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Nuria Aragonés
- CIBER Epidemiología y Salud Pública (CIBERESP),Spain
- Subdirección General de Epidemiología, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, Spain
| | - Manolis Kogevinas
- CIBER Epidemiología y Salud Pública (CIBERESP),Spain
- ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain
- School of Public Health, Athens, Greece
| | - Marina Pollán
- CIBER Epidemiología y Salud Pública (CIBERESP),Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Javier Llorca
- CIBER Epidemiología y Salud Pública (CIBERESP),Spain
- University of Cantabria–IDIVAL, Santander, Spain
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Fernández-Navarro P, Rosa C, Sousa I, Moutinho V, Antunes A, Magalhães C, Ribeiro AP, Gonçalves MM. Reconceptualization innovative moments as a predictor of symptomatology improvement in treatment for depression. Clin Psychol Psychother 2018; 25:765-773. [PMID: 29989260 DOI: 10.1002/cpp.2306] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/23/2018] [Accepted: 05/23/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES In previous studies, reconceptualization innovative moments were associated with successful psychotherapy. Reconceptualization has two components-(a) a positive temporal contrast between the past self and the present self (contrasting self [CS]) and (b) a description of how and/or why this change has occurred (change process [CP])-from the perspective of the client. The aim of this study is to analyse if CS and CP have the same association with outcomes as reconceptualization. METHOD Sixteen cases of clients with major depression (305 sessions) were analysed. Longitudinal regression models were used to explore if proportions of CS, CP, and reconceptualization predicted outcome measures and if outcome measures predicted CS, CP, and reconceptualization. RESULTS Reconceptualization is less frequent than CS and CP taken separately, but reconceptualization was a better predictor of treatment outcomes than were its separate components. Moreover, symptom improvement did not predict reconceptualization. CONCLUSION The construction of new meanings is important in improving depressive symptomatology. Psychotherapists can elicit these new meanings in their regular practice by posing questions that may help clients to conceptualize what is changing in themselves (CS) and questions of how this change is occurring (CP). The construction of an integrative account of these new meanings is associated with psychotherapeutic gains, and thus, reconceptualizing change could improve symptoms of depression.
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Affiliation(s)
- Pablo Fernández-Navarro
- CIPsi-Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Catarina Rosa
- CIPsi-Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal.,Center for Health Technology and Services Research (CINTESIS.UA), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Inês Sousa
- Department of Mathematics and Applications, University of Minho, Braga, Portugal
| | - Vanessa Moutinho
- CIPsi-Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Ana Antunes
- CIPsi-Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Carina Magalhães
- CIPsi-Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - António P Ribeiro
- CIPsi-Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Miguel M Gonçalves
- CIPsi-Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
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Fernández-Navarro P, Sanz-Anquela JM, Sánchez Pinilla A, Arenas Mayorga R, Salido-Campos C, López-Abente G. Detection of spatial aggregation of cases of cancer from data on patients and health centres contained in the Minimum Basic Data Set. Geospat Health 2018; 13:616. [PMID: 29772880 DOI: 10.4081/gh.2018.616] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 01/05/2018] [Accepted: 01/06/2018] [Indexed: 06/08/2023]
Abstract
The feasibility of the Minimum Basic Data Set (MBDS) as a tool in cancer research was explored monitoring its incidence through the detection of spatial clusters. Case-control studies based on MBDS and marked point process were carried out with the focus on the residence of patients from the Prince of Asturias University Hospital in Alcalá de Henares (Madrid, Spain). Patients older than 39 years with diagnoses of stomach, colorectal, lung, breast, prostate, bladder and kidney cancer, melanoma and haematological tumours were selected. Geocoding of the residence address of the cases was done by locating them in the continuous population roll provided by the Madrid Statistical Institute and extracting the coordinates. The geocoded control group was a random sample of 10 controls per case matched by frequency of age and sex. To assess case clusters, differences in Ripley K functions between cases and controls were calculated. The spatial location of clusters was explored by investigating spatial intensity and its ratio between cases and controls. Results suggest the existence of an aggregation of cancers with a common risk factor such as tobacco smoking (lung, bladder and kidney cancers). These clusters were located in an urban area with high socioeconomic deprivation. The feasibility of designing and carrying out case-control studies from the MBDS is shown and we conclude that MBDS can be a useful epidemiological tool for cancer surveillance and identification of risk factors through case-control spatial point process studies.
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Affiliation(s)
- Pablo Fernández-Navarro
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP).
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López-Nieva P, Fernández-Navarro P, Vaquero-Lorenzo C, Villa-Morales M, Graña-Castro O, Cobos-Fernández MÁ, López-Lorenzo JL, Llamas P, González-Sanchez L, Sastre I, Pollan M, Malumbres M, Santos J, Fernández-Piqueras J. RNA-Seq reveals the existence of a CDKN1C-E2F1-TP53 axis that is altered in human T-cell lymphoblastic lymphomas. BMC Cancer 2018; 18:430. [PMID: 29661169 PMCID: PMC5902834 DOI: 10.1186/s12885-018-4304-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 03/26/2018] [Indexed: 01/04/2023] Open
Abstract
Background Precursor T-cell lymphoblastic lymphomas (T-LBL) are rare aggressive hematological malignancies that mainly develop in children. As in other cancers, the loss of cell cycle control plays a prominent role in the pathogenesis in these malignancies that is primarily attributed to loss of CDKN2A (encoding protein p16INK4A). However, the impact of the deregulation of other genes such as CDKN1C, E2F1, and TP53 remains to be clarified. Interestingly, experiments in mouse models have proven that conditional T-cell specific deletion of Cdkn1c gene may induce a differentiation block at the DN3 to DN4 transition, and that the loss of this gene in the absence of Tp53 led to aggressive thymic lymphomas. Results In this manuscript, we demonstrated that the simultaneous deregulation of CDKN1C, E2F1, and TP53 genes by epigenetic mechanisms and/or the deregulation of specific microRNAs, together with additional impairing of TP53 function by the expression of dominant-negative isoforms are common features in primary human T-LBLs. Conclusions Previous experimental work in mice revealed that T-cell specific deletion of Cdkn1c accelerates lymphomagenesis in the absence of Tp53. If, as expected, the consequences of the deregulation of the CDKN1C-E2F1-TP53 axis were the same as those experimentally demonstrated in mouse models, the disruption of this axis might be useful to predict tumor aggressiveness, and to provide the basis towards the development of potential therapeutic strategiesin human T-LBL. Electronic supplementary material The online version of this article (10.1186/s12885-018-4304-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pilar López-Nieva
- Department of Cellular Biology and Immunology, Severo Ochoa Molecular Biology Center (CBMSO), CSIC-Madrid Autonomous University, 28049, Madrid, Spain.,Institute of Health Research, Jiménez Díaz Foundation, Madrid, Spain.,Consortium for Biomedical Research in Rare Diseases (CIBERER), Carlos III Institute of Health, Madrid, Spain
| | - Pablo Fernández-Navarro
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Concepción Vaquero-Lorenzo
- Department of Cellular Biology and Immunology, Severo Ochoa Molecular Biology Center (CBMSO), CSIC-Madrid Autonomous University, 28049, Madrid, Spain
| | - María Villa-Morales
- Department of Cellular Biology and Immunology, Severo Ochoa Molecular Biology Center (CBMSO), CSIC-Madrid Autonomous University, 28049, Madrid, Spain.,Institute of Health Research, Jiménez Díaz Foundation, Madrid, Spain.,Consortium for Biomedical Research in Rare Diseases (CIBERER), Carlos III Institute of Health, Madrid, Spain
| | - Osvaldo Graña-Castro
- Bioinformatics Unit, Structural Biology and Biocomputing Programme, Spanish National Cancer Research Center (CNIO), Madrid, Spain
| | - María Ángeles Cobos-Fernández
- Department of Cellular Biology and Immunology, Severo Ochoa Molecular Biology Center (CBMSO), CSIC-Madrid Autonomous University, 28049, Madrid, Spain.,Institute of Health Research, Jiménez Díaz Foundation, Madrid, Spain
| | | | - Pilar Llamas
- Institute of Health Research, Jiménez Díaz Foundation, Madrid, Spain
| | - Laura González-Sanchez
- Department of Cellular Biology and Immunology, Severo Ochoa Molecular Biology Center (CBMSO), CSIC-Madrid Autonomous University, 28049, Madrid, Spain.,Institute of Health Research, Jiménez Díaz Foundation, Madrid, Spain.,Consortium for Biomedical Research in Rare Diseases (CIBERER), Carlos III Institute of Health, Madrid, Spain
| | - Isabel Sastre
- Department of Cellular Biology and Immunology, Severo Ochoa Molecular Biology Center (CBMSO), CSIC-Madrid Autonomous University, 28049, Madrid, Spain
| | - Marina Pollan
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marcos Malumbres
- Cell Division and Cancer Group, Molecular Oncology Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Javier Santos
- Department of Cellular Biology and Immunology, Severo Ochoa Molecular Biology Center (CBMSO), CSIC-Madrid Autonomous University, 28049, Madrid, Spain. .,Institute of Health Research, Jiménez Díaz Foundation, Madrid, Spain. .,Consortium for Biomedical Research in Rare Diseases (CIBERER), Carlos III Institute of Health, Madrid, Spain.
| | - José Fernández-Piqueras
- Department of Cellular Biology and Immunology, Severo Ochoa Molecular Biology Center (CBMSO), CSIC-Madrid Autonomous University, 28049, Madrid, Spain. .,Institute of Health Research, Jiménez Díaz Foundation, Madrid, Spain. .,Consortium for Biomedical Research in Rare Diseases (CIBERER), Carlos III Institute of Health, Madrid, Spain.
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López-Abente G, Locutura-Rupérez J, Fernández-Navarro P, Martín-Méndez I, Bel-Lan A, Núñez O. Compositional analysis of topsoil metals and its associations with cancer mortality using spatial misaligned data. Environ Geochem Health 2018; 40:283-294. [PMID: 28155030 PMCID: PMC5797570 DOI: 10.1007/s10653-016-9904-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 11/29/2016] [Indexed: 05/20/2023]
Abstract
The presence of toxic metals in soil per se, and in soil impacted by mining, industry, agriculture and urbanisation in particular, is a major concern for both human health and ecotoxicology. The dual aim of this study was: to ascertain whether topsoil composition could influence the spatial distribution of mortality due to different types of cancer and to identify possible errors committed by epidemiological studies which analyse soil composition data as a closed number system. We conducted an ecological cancer mortality study, covering 861,440 cancer deaths (27 cancer sites) in 7917 Spanish mainland towns, from 1999 to 2008. Topsoil levels of Al, As, Cd, Cr, Cu, Fe, Mn, Ni, Pb and Zn were determined by ICP-MS at 13,317 sampling points. We transformed the topsoil data in two ways, i.e. log transformation and centred logratio transformation. Principal factor analysis was performed to obtain independent latent factors for the transformed variables. To estimate the effect on mortality of topsoil factor loadings, we fitted Besag, York and Mollié models embedded in geostatistical-spatial models. This model included soil sample locations and town centroids (non-aligned data), fitted using the integrated nested Laplace approximation (INLA) as a tool for Bayesian inference and stochastic partial differential equations (SPDE). All results were adjusted for socio-demographic variables. The results indicated that soil composition could have an influence on the spatial distribution and mortality patterns of cancer. The analysis adjusted for socio-demographic variables showed excess male mortality due to digestive system tumours in areas with soils containing higher Cd, Pb, Zn, Mn and Cu concentrations, bladder cancer in areas with soils containing higher Cd concentrations, and brain cancer in areas with soils containing As. In both sexes, cancer of oesophagus was associated with soils containing a higher lead content, while lung cancer was associated with soils containing a higher copper content. Stress should be laid on the importance of taking into account the compositional nature of the data in this type of analysis.
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Affiliation(s)
- Gonzalo López-Abente
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029, Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
| | - Juan Locutura-Rupérez
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003, Madrid, Spain
| | - Pablo Fernández-Navarro
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Iván Martín-Méndez
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003, Madrid, Spain
| | - Alejandro Bel-Lan
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003, Madrid, Spain
| | - Olivier Núñez
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
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López-Abente G, Núñez O, Fernández-Navarro P, Barros-Dios JM, Martín-Méndez I, Bel-Lan A, Locutura J, Quindós L, Sainz C, Ruano-Ravina A. Residential radon and cancer mortality in Galicia, Spain. Sci Total Environ 2018; 610-611:1125-1132. [PMID: 28847132 DOI: 10.1016/j.scitotenv.2017.08.144] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 08/14/2017] [Accepted: 08/14/2017] [Indexed: 06/07/2023]
Abstract
Residential radon exposure is a serious public health concern, and as such appears in the recommendations of European Code Against Cancer. The objective of this study was to assess the association between residential radon levels and mortality due to different types of cancer, using misaligned data analysis techniques. Mortality data (observed cases) for each of the 313 Galician municipalities were drawn from the records of the National Statistics Institute for the study period (1999-2008). Expected cases were computed using Galician mortality rates for 14 types of malignant tumors as reference, with a total of 56,385 deaths due to the tumors analyzed. The effect estimates of indoor radon (3371 sampling points) were adjusted for sociodemographic variables, altitude, and arsenic topsoil levels (1069 sampling points), using spatial/geostatistical models fitted with stochastic partial differential equations and integrated nested Laplace approximations. These models are capable of processing misaligned data. The results showed a statistical association between indoor radon and lung, stomach and brain cancer in women in Galicia. Apart from lung cancer (relative risk (RR)=1.09), in which a twofold increase in radon exposure led to a 9% rise in mortality, the association was particularly relevant in stomach (RR=1.17) and brain cancer (RR=1.28). Further analytical epidemiologic studies are needed to confirm these results, and an assessment should be made of the advisability of implementing interventions targeting such exposure in higher-risk areas.
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Affiliation(s)
- Gonzalo López-Abente
- Cancer and Environmental Epidemiology Unit, National Epidemiology Center, Carlos III, Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Olivier Núñez
- Cancer and Environmental Epidemiology Unit, National Epidemiology Center, Carlos III, Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - Pablo Fernández-Navarro
- Cancer and Environmental Epidemiology Unit, National Epidemiology Center, Carlos III, Institute of Health, Avda. Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - Juan M Barros-Dios
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, School of Medicine, San Francisco Street, 15782 Santiago de Compostela, Galicia, Spain; Preventive Medicine Unit, Santiago de Compostela Clinic University Hospital, Santiago de Compostela, Galicia, Spain
| | - Iván Martín-Méndez
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003 Madrid, Spain
| | - Alejandro Bel-Lan
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003 Madrid, Spain
| | - Juan Locutura
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003 Madrid, Spain
| | - Luis Quindós
- RADON Group, Faculty of Medicine, University of Cantabria, c/Cardenal Herrera Oria s/n, 39011 Santander, Cantabria, Spain
| | - Carlos Sainz
- RADON Group, Faculty of Medicine, University of Cantabria, c/Cardenal Herrera Oria s/n, 39011 Santander, Cantabria, Spain
| | - Alberto Ruano-Ravina
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, School of Medicine, San Francisco Street, 15782 Santiago de Compostela, Galicia, Spain; Preventive Medicine Unit, Santiago de Compostela Clinic University Hospital, Santiago de Compostela, Galicia, Spain
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Fernández-Navarro P, García-Pérez J, Ramis R, Boldo E, López-Abente G. Industrial pollution and cancer in Spain: An important public health issue. Environ Res 2017; 159:555-563. [PMID: 28889025 DOI: 10.1016/j.envres.2017.08.049] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 07/18/2017] [Accepted: 08/24/2017] [Indexed: 06/07/2023]
Abstract
Cancer can be caused by exposure to air pollution released by industrial facilities. The European Pollutant Release and Transfer Register (E-PRTR) has made it possible to study exposure to industrial pollution. This study seeks to describe the industrial emissions in the vicinity of Spanish towns and their temporal changes, and review our experience studying industrial pollution and cancer. Data on industrial pollutant sources (2007-2010) were obtained from the E-PRTR registries. Population exposure was estimated by the distance from towns to industrial facilities. We calculated the amount of carcinogens emitted into the air in the proximity (<5km) of towns and show them in municipal maps. We summarized the most relevant results and conclusions reported by ecological E-PRTR-based on studies of cancer mortality and industrial pollution in Spain and the limitations and result interpretations of these types of studies. There are high amounts of carcinogen emissions in the proximity of towns in the southwest, east and north of the country and the total amount of emitted carcinogens is considerable (e.g. 20Mt of arsenic, 63Mt of chromium and 9Mt of cadmium). Although the emissions of some carcinogens in the proximity of certain towns were reduced during the study period, emissions of benzene, dioxins+furans and polychlorinated biphenyls rose. Moreover, the average population of towns lying within a 5km radius from emission sources of carcinogens included in the International Agency for Research on Cancer list of carcinogens was 9 million persons. On the other hand, the results of the reviewed studies suggest that those Spanish regions exposed to the pollution released by certain types of industrial facilities have around 17% cancer excess mortality when compared with those unexposed. Moreover, excess mortality is focused on digestive and respiratory tract cancers, leukemias, prostate, breast and ovarian cancers. Despite their limitations, ecological studies are a useful tool in environmental epidemiology, not only for proposing etiological hypotheses about the risk of living close to industrial pollutant sources, but also for providing data to account for situations of higher mortality in specific areas. Nevertheless, the reduction of emissions should be a goal, with special relevance given to establishing limits for known carcinogens and other toxic substances in the environs of population centers, as well as industry-specific emission limits.
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Affiliation(s)
- Pablo Fernández-Navarro
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - Rebeca Ramis
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - Elena Boldo
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | - Gonzalo López-Abente
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
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44
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Batista J, Silva J, Freitas S, Alves D, Machado A, Sousa I, Fernández-Navarro P, Magalhães C, Gonçalves MM. Relational schemas as mediators of innovative moments in symptom improvement in major depression. Psychother Res 2017; 29:58-69. [PMID: 28782433 DOI: 10.1080/10503307.2017.1359427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES Innovative moments (IMs) are exceptions to the maladaptive framework of meaning that typically motivates clients to seek psychotherapy, and previous studies have shown that IMs are associated with psychotherapy outcomes. While IMs are exceptions that occur at the level of the therapeutic conversation, relational schemas are more stable patterns, and their increased flexibility may facilitate change during psychotherapy. With this in mind, we tested the hypothesis that IMs contribute to outcomes by improving the flexibility of relational schemas. METHOD The Core Conflictual Relationship Theme (CCRT) was used to assess relational schemas. IMs were evaluated using the Innovative Moments Coding System. The sample included 22 clients diagnosed with major depressive disorder. The flexibility of the three components of the CCRT (Wishes, responses of the self (RS), and responses of others (RO)) were tested as mediators between IMs and outcomes. RESULTS The flexibility of the RS was a mediator between IMs and outcomes, but Wishes and RO were not. CONCLUSION These findings align with previous research showing that RS is the component most open to change, whereas the other components seem less sensitive to change during brief therapy. Clinical or methodological significance of this article: This study shows the mediation role of relational schemas in the association between in-session events (innovative moments (IMs)) and the symptoms improvement. It contributes to the literature that emphasizes the importance of relational schemas in psychotherapy by using a mediation model, which has rarely been tested.
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Affiliation(s)
- João Batista
- a Psychotherapy and Psychopathology Research Unit, School of Psychology, CIPsi - Psychology Research Center , University of Minho , Braga , Portugal
| | - Joana Silva
- a Psychotherapy and Psychopathology Research Unit, School of Psychology, CIPsi - Psychology Research Center , University of Minho , Braga , Portugal
| | - Sara Freitas
- a Psychotherapy and Psychopathology Research Unit, School of Psychology, CIPsi - Psychology Research Center , University of Minho , Braga , Portugal
| | - Daniela Alves
- a Psychotherapy and Psychopathology Research Unit, School of Psychology, CIPsi - Psychology Research Center , University of Minho , Braga , Portugal
| | - Anabela Machado
- a Psychotherapy and Psychopathology Research Unit, School of Psychology, CIPsi - Psychology Research Center , University of Minho , Braga , Portugal
| | - Inês Sousa
- b Department of Mathematics , University of Minho , Braga , Portugal
| | - Pablo Fernández-Navarro
- a Psychotherapy and Psychopathology Research Unit, School of Psychology, CIPsi - Psychology Research Center , University of Minho , Braga , Portugal
| | - Carina Magalhães
- a Psychotherapy and Psychopathology Research Unit, School of Psychology, CIPsi - Psychology Research Center , University of Minho , Braga , Portugal
| | - Miguel M Gonçalves
- a Psychotherapy and Psychopathology Research Unit, School of Psychology, CIPsi - Psychology Research Center , University of Minho , Braga , Portugal
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45
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Barrigón ML, Berrouiguet S, Carballo JJ, Bonal-Giménez C, Fernández-Navarro P, Pfang B, Delgado-Gómez D, Courtet P, Aroca F, Lopez-Castroman J, Artés-Rodríguez A, Baca-García E. User profiles of an electronic mental health tool for ecological momentary assessment: MEmind. Int J Methods Psychiatr Res 2017; 26:e1554. [PMID: 28276176 PMCID: PMC6877232 DOI: 10.1002/mpr.1554] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/19/2016] [Accepted: 12/03/2016] [Indexed: 11/10/2022] Open
Abstract
Ecological momentary assessment (EMA) is gaining importance in psychiatry. This article assesses the characteristics of patients who used a new electronic EMA tool: the MEmind Wellness Tracker. Over one year, 13811 adult outpatients in our Psychiatry Department were asked to use MEmind. We collected information about socio-demographic data, psychiatric diagnoses, illness severity, stressful life events and suicidal thoughts/behavior. We compared active users (N = 2838) and non-active users (N = 10,973) of MEmind and performed a Random Forest analysis to assess which variables could predict its use. Univariate analyses revealed that MEmind-users were younger (42.2 ± 13.5 years versus 48.5 ± 16.3 years; χ2 = 18.85; P < 0.001) and more frequently diagnosed with anxiety related disorders (57.9% versus 46.7%; χ2 = 105.92; P = 0.000) than non-active users. They were more likely to report thoughts about death and suicide (up to 24% of active users expressed wish for death) and had experienced more stressful life events than non-active users (57% versus 48.5%; χ2 = 64.65; P < 0.001). In the Random Forest analysis, 31 variables showed mean decrease accuracy values higher than zero with a 95% confidence interval (CI), including sex, age, suicidal thoughts, life threatening events and several diagnoses. In the light of these results, strategies to improve EMA and e-Mental Health adherence are discussed.
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Affiliation(s)
- María Luisa Barrigón
- Department of Psychiatry, IIS-Jimenez Diaz Foundation, Madrid, Spain.,Autonoma University, Madrid, Spain
| | - Sofian Berrouiguet
- Department of Psychiatry, IIS-Jimenez Diaz Foundation, Madrid, Spain.,Department of Psychiatry, Brest Medical University Hospital at Brest, IMT atlantique UMR CNRS 6285 Lab-STICC, Institut Mines-Telecom, ERCR SPURBO, Université de Bretagne occidentale, France
| | - Juan José Carballo
- Department of Psychiatry, IIS-Jimenez Diaz Foundation, Madrid, Spain.,Autonoma University, Madrid, Spain.,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Pablo Fernández-Navarro
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
| | - Bernadette Pfang
- Department of Internal Medicine, IIS-Jimenez Diaz Foundation, Madrid, Spain
| | | | - Philippe Courtet
- Département d'Urgences & Post-Urgences Psychiatriques, CHU Montpellier, Université Montpellier, France
| | - Fuensanta Aroca
- Instituto de Matemáticas, Universidad Nacional Autónoma de México, México City, Mexico
| | | | - Antonio Artés-Rodríguez
- Department of Signal Theory and Communications, Universidad Carlos III, Madrid, Spain.,Gregorio Marañón Health Research Institute, Madrid, Spain.,CIBERSAM (Centro de Investigación en Salud Mental), Carlos III Institute of Health, Madrid, Spain
| | - Enrique Baca-García
- Department of Psychiatry, IIS-Jimenez Diaz Foundation, Madrid, Spain.,Autonoma University, Madrid, Spain.,CIBERSAM (Centro de Investigación en Salud Mental), Carlos III Institute of Health, Madrid, Spain.,Department of Psychiatry, University Hospital Rey Juan Carlos, Móstoles, Spain.,Department of Psychiatry, General Hospital of Villalba, Madrid, Spain.,Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain
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- Department of Psychiatry, IIS-Jimenez Diaz Foundation, Madrid, Spain.,Department of Psychiatry, University Hospital Rey Juan Carlos, Móstoles, Spain.,Department of Psychiatry, General Hospital of Villalba, Madrid, Spain.,Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain.,AGC Salud Mental, Área Sanitaria 3, Avilés, Asturias, Spain.,Hospital 12 de Octubre, Madrid, Spain
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46
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Núñez O, Fernández-Navarro P, Martín-Méndez I, Bel-Lan A, Locutura Rupérez JF, López-Abente G. Association between heavy metal and metalloid levels in topsoil and cancer mortality in Spain. Environ Sci Pollut Res Int 2017; 24:7413-7421. [PMID: 28108922 PMCID: PMC5383678 DOI: 10.1007/s11356-017-8418-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/05/2017] [Indexed: 05/03/2023]
Abstract
Spatio-temporal cancer mortality studies in Spain have revealed patterns for some tumours which display a distribution that is similar across the sexes and persists over time. Such characteristics would be common to tumours that shared risk factors, including the geochemical composition of the soil. The aim of this study was to assess the possible association between heavy metal and metalloid levels in topsoil (upper soil horizon) and cancer mortality in mainland Spain. Ecological cancer mortality study at a municipal level, covering 861,440 cancer deaths (27 different tumour locations) in 7917 Spanish mainland towns, from 1999 to 2008. The elements included in this analysis were Al, As, Cd, Cr, Cu, Fe, Mn, Ni, Pb and Zn. Topsoil levels (partial extraction) were determined by ICP-MS at 13,317 sampling points. For the analysis, the data on the topsoil composition have been transformed by the centred logratio (clr-transformation). Principal factor analysis was performed to obtain independent latent factors for the transformed variables. To estimate the effect of heavy metal levels in topsoil composition on mortality, we fitted Besag, York and Mollié models, which included each town's factor scores as the explanatory variable. Integrated Nested Laplace Approximation (INLA) was used as a tool for Bayesian inference. All results were adjusted for sociodemographic variables. The results showed an association between trace contents of heavy metals and metalloids in topsoil and mortality due to tumours of the digestive system in mainland Spain. This association was observed in both sexes, something that would support the hypothesis that the incorporation of heavy metals into the trophic chain might be playing a role in the aetiology of some types of cancer. Topsoil composition and the presence of potentially toxic elements in trace concentrations might be an additional component in the aetiology of some types of cancer, and go some way to determine the ensuing geographic differences in mortality in Spain. The results support the interest of inclusion of heavy metal levels in topsoil as a hypothesis in analytical epidemiological studies using biological markers of exposure to heavy metals and metalloids.
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Affiliation(s)
- Olivier Núñez
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Pablo Fernández-Navarro
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Iván Martín-Méndez
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003, Madrid, Spain
| | - Alejandro Bel-Lan
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003, Madrid, Spain
| | - Juan F Locutura Rupérez
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003, Madrid, Spain
| | - Gonzalo López-Abente
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029, Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
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47
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Núñez O, Fernández-Navarro P, Martín-Méndez I, Bel-Lan A, Rupérez JFL, López-Abente G. Erratum to: Association between heavy metal and metalloid levels in topsoil and cancer mortality in Spain. Environ Sci Pollut Res Int 2017; 24:7422. [PMID: 28164247 PMCID: PMC6828084 DOI: 10.1007/s11356-017-8507-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Olivier Núñez
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Pablo Fernández-Navarro
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Iván Martín-Méndez
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003, Madrid, Spain
| | - Alejandro Bel-Lan
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003, Madrid, Spain
| | - Juan F Locutura Rupérez
- Department of Geochemistry and Mineral Resources, Spanish Geological and Mining Institute (Instituto Geológico y Minero de España/IGME), Ríos Rosas, 23, 28003, Madrid, Spain
| | - Gonzalo López-Abente
- Environmental and Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos 5, 28029, Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
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48
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Ibáñez-Sanz G, Díez-Villanueva A, Alonso MH, Rodríguez-Moranta F, Pérez-Gómez B, Bustamante M, Martin V, Llorca J, Amiano P, Ardanaz E, Tardón A, Jiménez-Moleón JJ, Peiró R, Alguacil J, Navarro C, Guinó E, Binefa G, Fernández-Navarro P, Espinosa A, Dávila-Batista V, Molina AJ, Palazuelos C, Castaño-Vinyals G, Aragonés N, Kogevinas M, Pollán M, Moreno V. Risk Model for Colorectal Cancer in Spanish Population Using Environmental and Genetic Factors: Results from the MCC-Spain study. Sci Rep 2017; 7:43263. [PMID: 28233817 PMCID: PMC5324108 DOI: 10.1038/srep43263] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/20/2017] [Indexed: 12/20/2022] Open
Abstract
Colorectal cancer (CRC) screening of the average risk population is only indicated according to age. We aim to elaborate a model to stratify the risk of CRC by incorporating environmental data and single nucleotide polymorphisms (SNP). The MCC-Spain case-control study included 1336 CRC cases and 2744 controls. Subjects were interviewed on lifestyle factors, family and medical history. Twenty-one CRC susceptibility SNPs were genotyped. The environmental risk model, which included alcohol consumption, obesity, physical activity, red meat and vegetable consumption, and nonsteroidal anti-inflammatory drug use, contributed to CRC with an average per factor OR of 1.36 (95% CI 1.27 to 1.45). Family history of CRC contributed an OR of 2.25 (95% CI 1.87 to 2.72), and each additional SNP contributed an OR of 1.07 (95% CI 1.04 to 1.10). The risk of subjects with more than 25 risk alleles (5th quintile) was 82% higher (OR 1.82, 95% CI 1.11 to 2.98) than subjects with less than 19 alleles (1st quintile). This risk model, with an AUROC curve of 0.63 (95% CI 0.60 to 0.66), could be useful to stratify individuals. Environmental factors had more weight than the genetic score, which should be considered to encourage patients to achieve a healthier lifestyle.
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Affiliation(s)
- Gemma Ibáñez-Sanz
- Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Anna Díez-Villanueva
- Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - M Henar Alonso
- Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Francisco Rodríguez-Moranta
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Gastroenterology Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Beatriz Pérez-Gómez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Environmental and Cancer Epidemiology Department, National Center of Epidemiology - Instituto de Salud Carlos III, Madrid, Spain.,Oncology and Hematology Area, IIS Puerta De Hierro, Cancer Epidemiology Research Group, Madrid, Spain
| | - Mariona Bustamante
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Vicente Martin
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Biomedicina (IBIOMED). Grupo de investigación en interacciones gen ambiente y salud. Universidad de León, León, Spain
| | - Javier Llorca
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universidad de Cantabria - IDIVAL, Santander, Spain
| | - Pilar Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain
| | - Eva Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Navarra Public Health Institute, Navarra, Spain
| | - Adonina Tardón
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,University Institute of Oncology of Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
| | - Jose J Jiménez-Moleón
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Hospitales Universitarios de Granada, Granada, Spain
| | - Rosana Peiró
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana FISABIO-Salud Pública, Valencia
| | - Juan Alguacil
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Centre for Research in Health and Environment (CYSMA), Universidad de Huelva, Huelva, Spain
| | - Carmen Navarro
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Epidemiology, IMIB-Arrixaca and Department of Health and Social Sciences, Murcia Regional Health Council, Universidad de Murcia, Murcia, Spain
| | - Elisabet Guinó
- Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Binefa
- Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pablo Fernández-Navarro
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Environmental and Cancer Epidemiology Department, National Center of Epidemiology - Instituto de Salud Carlos III, Madrid, Spain.,Oncology and Hematology Area, IIS Puerta De Hierro, Cancer Epidemiology Research Group, Madrid, Spain
| | - Anna Espinosa
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Verónica Dávila-Batista
- Instituto de Biomedicina (IBIOMED). Grupo de investigación en interacciones gen ambiente y salud. Universidad de León, León, Spain
| | - Antonio José Molina
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Biomedicina (IBIOMED). Grupo de investigación en interacciones gen ambiente y salud. Universidad de León, León, Spain
| | | | - Gemma Castaño-Vinyals
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Nuria Aragonés
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Environmental and Cancer Epidemiology Department, National Center of Epidemiology - Instituto de Salud Carlos III, Madrid, Spain.,Oncology and Hematology Area, IIS Puerta De Hierro, Cancer Epidemiology Research Group, Madrid, Spain
| | - Manolis Kogevinas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,School of Public Health, Athens, Greece
| | - Marina Pollán
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Environmental and Cancer Epidemiology Department, National Center of Epidemiology - Instituto de Salud Carlos III, Madrid, Spain.,Oncology and Hematology Area, IIS Puerta De Hierro, Cancer Epidemiology Research Group, Madrid, Spain
| | - Victor Moreno
- Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. .,Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
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49
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Fernández-Navarro P, Villanueva CM, García-Pérez J, Boldo E, Goñi-Irigoyen F, Ulibarrena E, Rantakokko P, García-Esquinas E, Pérez-Gómez B, Pollán M, Aragonés N. Chemical quality of tap water in Madrid: multicase control cancer study in Spain (MCC-Spain). Environ Sci Pollut Res Int 2017; 24:4755-4764. [PMID: 27981479 DOI: 10.1007/s11356-016-8203-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 12/01/2016] [Indexed: 06/06/2023]
Abstract
Chronic consumption of water, which contains contaminants, may give rise to adverse health effects. The Madrid region, covered by the population-based multicase-control (MCC-Spain) study, includes two drinking water supply areas. The different sources of the water, coupled together with the possible differences in water management, mean that there may be differences in drinking water quality. In the context of the MCC study, our aims were to describe contaminant concentrations in tap water drawn from various sampling points distributed around the region, assess these concentrations by reference to guideline values and study possible differences between the two supply areas. Tap water samples were collected from 34 sampling points in 7 towns in the Madrid region (19-29 April 2010), and 23 contaminants (metals, nitrates, disinfection by-product and Mutagen X levels) were quantified. We undertook a descriptive analysis of the contaminant concentrations in the water and compared them between the two water supply areas (Wilcoxon test). We created maps representing the distribution of the concentrations observed at water sampling points and assessed the correlations (Spearman's coefficient) between the different parameters measured. The concentrations of the contaminants were below guideline values. There were differences between the two supply areas in concentration of nitrates (p value = 0.0051) and certain disinfection by-products. While there were positive correlations (rho >0.70) among some disinfection by-products, no correlations were found in metals or nitrates. The differences in nitrate levels could be linked to differences in farming/industrial activities in the catchment areas and in disinfection by-products might be related to the existence of different treatment systems or bromine content in source waters.
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Affiliation(s)
- Pablo Fernández-Navarro
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain.
| | - Cristina M Villanueva
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Elena Boldo
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Fernando Goñi-Irigoyen
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Laboratory of Public Health of Gipuzkoa, Avda. de Navarra, 4, 20013, Donostia-San Sebastián, Spain
- Biodonostia Health Research Institute, San Sebastian, Spain
| | - Enrique Ulibarrena
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Laboratory of Public Health of Gipuzkoa, Avda. de Navarra, 4, 20013, Donostia-San Sebastián, Spain
| | - Panu Rantakokko
- National Institute for Health and Welfare (THL), Chemicals and Health Unit, P.O. Box 95, 70701, Kuopio, FI, Finland
| | - Esther García-Esquinas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid, IdiPaz, Madrid, Spain
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Nuria Aragonés
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
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Gonçalves MM, Ribeiro AP, Mendes I, Alves D, Silva J, Rosa C, Braga C, Batista J, Fernández-Navarro P, Oliveira JT. Three narrative-based coding systems: Innovative moments, ambivalence and ambivalence resolution. Psychother Res 2016; 27:270-282. [PMID: 27855544 DOI: 10.1080/10503307.2016.1247216] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Narrative and dialogical perspectives suggest that personal meaning systems' flexibility is an important resource for change in psychotherapy. Drawn from these theoretical backgrounds, a research program focused on the identification of Innovative Moments (IMs)-exceptions to the inflexible meaning systems present in psychopathological suffering-has been carried out. For this purpose, three process-oriented coding systems were developed: The IMs Coding System, the Ambivalence Coding System, and the Ambivalence Resolution Coding System. They allow, respectively, for the study of change, ambivalence, and ambivalence resolution in therapy. This paper presents these coding systems, the main findings that resulted from their application to different samples and therapeutic models, the main current and future lines of research, as well as the clinical applications of this research program.
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Affiliation(s)
| | | | - Inês Mendes
- a School of Psychology , University of Minho , Braga , Portugal.,b ISMAI - University Institute of Maia , Maia , Portugal
| | - Daniela Alves
- a School of Psychology , University of Minho , Braga , Portugal
| | - Joana Silva
- a School of Psychology , University of Minho , Braga , Portugal
| | - Catarina Rosa
- c Department of Education and Psychology , University of Aveiro , Aveiro , Portugal.,d IBILI - Institute for Biomedical Imaging and Life Sciences , University of Coimbra , Coimbra , Portugal
| | - Cátia Braga
- a School of Psychology , University of Minho , Braga , Portugal
| | - João Batista
- a School of Psychology , University of Minho , Braga , Portugal
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