Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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Nutrition Patterns, Metabolic and Psychological State Among High-Weight Young Adults: A Network Approach
(MDPI AG, 2026-01-01) Reivan Ortiz, Geovanny Genaro; Granero, Roser; Maraver Capdevila, Laura; Aguirre-Quejada, Alejandra
Background and Objectives: Studies suggest that overweight and obesity are major risk factors for various metabolic and psychological disorders, and that a better understanding of the interactions between these factors may lead to more effective intervention strategies. The main aim of this study is to examine the structure of interrelationships among sociodemographic characteristics, nutritional patterns (NP), metabolic indicators, and psychopathological measures using network analysis in a sample of young university students with overweight and obesity, and to identify the most central variables and their empirical groupings. Methods: N = 188 overweight/obese young adults participated, university students, men and women, aged 18 to 25 years. Results: The variable with the highest centrality (relevance and connectivity capacity) was stress level, identified as the bridge node. Two other important features were an NP characterized by vitamin and mineral consumption, and the presence of arterial hypertension (HTN). Three clusters of nodes emerged, grouping: (a) insulin, glucose and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR index); (b) cholesterol and triacylglycerol; and (c) sociodemographic profile, psychological state, BMI and HTN. Conclusions: The results highlight stress levels as a central factor influencing the metabolic and mental health of overweight/obese young adults. Interventions aimed at reducing stress and improving nutrition patterns are crucial for improving the overall wellbeing of these individuals.
Primary Humoral Immunodeficiencies and Bronchiectasis in Adults
(MDPI AG, 2025-12-26) Suárez Cuartín, Guillermo Rafael ; Lores, Carmen; Gómez Olivas, José Daniel; Oscullo, Grace; Martínez García, Miguel Ángel
Primary humoral immunodeficiencies are a heterogeneous group of disorders defined by quantitative and/or functional defects in one or more immunoglobulin classes, often with associated cellular immune abnormalities. Their link with bronchiectasis, whose prevalence varies across specific defects, is largely driven by recurrent respiratory infections. Selective Immunoglobulin-(Ig)A deficiency and IgG2 subclass deficiency are the most frequent forms, but common variable immunodeficiency (CVID) is the condition most often associated with bronchiectasis and is usually diagnosed earlier because of its characteristic phenotype. In contrast, the contribution of isolated IgA deficiency or selective IgG subclass deficiencies to bronchiectasis remains controversial. Other reported associations include X-linked agammaglobulinemia, selective IgM or IgG deficiency, and rarer entities such as selective IgE deficiency, unclassified hypogammaglobulinemia, specific antibody deficiency, specific polysaccharide antibody deficiency, and heavy- or light-chain deficiencies. Current bronchiectasis guidelines recommend measurement of serum immunoglobulins and IgG subclasses in patients with compatible features, recurrent infections, or no clear etiology before labeling disease as idiopathic. Identifying immunoglobulin defects is clinically important because they represent treatable traits. The potential role of emerging therapies such as the DPP1 inhibitor brensocatib in immunodeficiency-related bronchiectasis remains uncertain, and ongoing registries will be key to clarifying these relationships.
Clock gene influences on sleep quality and HPA axis in major depressive disorder
(Elsevier BV, 2025-12-17) Ferrer, Alex; Pelegrí, Ariadna; Labad, Javier; Sagues, Teresa; Salvat-Pujol, Neus; De Arriba Arnau, Aida; M. Menchón, José; Palao, Diego; Costas, Javier; Carracedo, Angel; Soria, Virginia
Background: Major Depressive Disorder (MDD) has been associated with disruptions in circadian rhythms and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Circadian rhythms are regulated by clock genes, including BMAL1, which are also implicated in HPA axis function. This study aimed to examine the association between BMAL1 polymorphisms and sleep quality, their interactions with sex and MDD diagnosis, and their potential influence on HPA axis activity in MDD. Methods: The sample included 84 patients with MDD and 120 healthy controls (HCs). Clinical and sociodemographic variables were assessed. HPA axis activity was measured using the cortisol awakening response (CAR) and diurnal cortisol slope. Six single nucleotide polymorphisms (SNPs) in the BMAL1 gene were analyzed. Multiple regression models were used, adjusting for relevant covariates. Results: The BMAL1 SNP rs11022778 was significantly associated with sleep quality in the total sample. Interaction analyses revealed that this association was specific to individuals with MDD. Additionally, rs11022778 was significantly associated with both CAR and slope measures among MDD patients. Conclusions: These findings highlight the potential role of BMAL1 gene variants in modulating biological and clinical phenotypes related to circadian and stress regulation. The rs11022778 variant may contribute to altered sleep quality and HPA axis activity in MDD. Future research should consider such genetic markers to inform more personalized approaches to MDD treatment.
Streptozotocin plus 5-fluorouracil followed by everolimus or the reverse sequence in patients with advanced pancreatic neuroendocrine tumors (SEQTOR-GETNE phase III study): a randomized clinical trial
(Elsevier, 2025-12) De Vos-Geelen, J.; Venerito, Marino; Von-Werder, Alezander; Jann, Henning; Rinke, Anja; Smith, D.; Hörsch, D.; Starling, Naureen; Ruszniewski, Philippe; Baudin, Eric; Metges, J.-P.; Caroli-Bosc, F.-X.; Reed, N.S.; Manzano, José Luis; Schrader, J.; Martín, M.; Navarro Perez, Valentin; Scarpa, A.; Valentí, Víctor; Lawlor, R.T.; Hernando, Jorge; Ragulan, C.; Colao, A.M.; Ps, H.; Vestermark, Lene; Sadanandam, A.; Carnaghi, Carlo; Knigge, U.P.; Capdevila, Jaume; Tafuto, Salvatore; Krogh, M.; Teulé-Vega, Àlex; Garcia Carbonero, Rocio; Klümpen, H.-J.; Cremer, B.; Sevilla, I.; Eriksson, B.; Tabaksblat, E.; Carmona Bayonas, Alberto; Salazar Soler, Ramón; Jiménez Fonseca, Paula; Benavent Viñuales, Marta
Background: Everolimus or streptozotocin plus 5-fluorouracil (STZ/5-FU) are approved treatments for patients with pancreatic neuroendocrine tumors (panNETs). The SEQTOR trial aimed to assess the optimal treatment sequence. Patients and methods: SEQTOR was an international, open-label, randomized, crossover, phase III trial that recruited adults with unresectable or metastatic, advanced, well-differentiated panNET. Patients received 10 mg/day of everolimus followed upon progression by STZ/5-FU; or the reverse sequence. The primary endpoint was the 35-month progression-free survival (PFS) rate after first- and second-line treatment; however, due to slow accrual and longer survival, it was changed to the 12-month PFS rate following first-line treatment (12-mPFS1). Results: Patients were randomized to everolimus (n = 72) or STZ/5-FU (n = 69) first. The 12-mPFS1 was 71.4% [95% confidence interval (CI) 59.4% to 81.6%] and 61.8% (95% CI 49.2% to 73.3%) (odds ratio 0.65, 95% CI 0.32-1.32) with a median PFS1 of 19.4 versus 22.7 months for everolimus and STZ/5-FU, respectively. STZ/5-FU achieved a significantly higher overall response rate in first-line (11.6% versus 30.3%, P = 0.012) and second-line (30.6% versus 9.1%, P = 0.072) treatments. No differences were shown in overall survival (median 61.7 versus 50.6 months in everolimus first and STZ/5-FU first, respectively; hazard ratio 1.43, 95% CI 0.86-2.37). Discontinuations of everolimus were more frequent. Conclusion: STZ/5-FU and everolimus were not statistically different in PFS rates, but STZ/5-FU achieved higher response rates. Keywords: 5-fluorouracil; advanced pancreatic neuroendocrine neoplasm; everolimus; panNET; sequential strategy; streptozotocin.
Salivary Characteristics and Other Risk Factors Associated with the Severity of Chemical and Mechanical Tooth Wear in At-Risk Groups: A Cross-Sectional Study.
(MDPI, 2025-10-14) Rius Bonet, Ona; Willaert Jiménez-Pajarero, Eva; Jiménez-Murcia, Susana; Diego Esteve, Guillem; Artero, Cristina; Sánchez Romero, Isabel; Baenas, Isabel; Peña Cala, Maria Carmen; Fernández Aranda, Fernando; Martínez Gomis, Jordi
L’objectiu de la recerca va ser explorar com els factors salivals influeixen en el desgast dental (TW) en persones amb malaltia per reflux gastroesofàgic (GERD), bruxisme del son (SB), trastorns de la conducta alimentària (ED) i ludopatia (GD), comparant-les amb un grup control sa. L’estudi, de disseny transversal, va incloure 147 adults dividits en aquests cinc grups. Es van recollir dades mèdiques, d’hàbits i d’estil de vida, i es va avaluar el desgast dental amb l’escala TWES 2.0, així com la força oclusal i les propietats de la saliva (pH, flux i capacitat tampó).Els resultats van mostrar que els grups amb GERD i ED presentaven el pH salival més baix i també el desgast químic i mecànic més elevat. El desgast químic i el mecànic estaven fortament correlacionats, i aquest últim augmentava amb l’edat. El pH salival i el grup de risc explicaven gairebé la meitat de la variabilitat del desgast químic, mentre que l’edat i la força de mossegada explicaven més de la meitat del desgast mecànic.En conclusió, el desgast químic està estretament relacionat amb el pH salival baix i amb pertànyer als grups de risc GERD o ED, mentre que el desgast mecànic depèn sobretot de l’edat i de la força de mossegada. Els autors recomanen estudis longitudinals futurs amb mostres més àmplies i metodologies estandarditzades per aprofundir en aquestes associacions.
Do national cancer control plans address care and research for children, adolescents, and young adults? A review of status, priorities, and recommendations across 41 European countries
(Elsevier Ltd., 2025) Borràs Andrés, Josep Maria; Vassal, Gilles; Prades, Joan; Kozhaeva, Olga; Otth, Maria; Kearns, Pamela; Ladenstein, Ruth; Rizzari, Carmelo; Heenen, Delphine; Dirksen, Uta; Owens, Cormac; Lazarov, Deyan; Sheehan, Ciara
Paediatric cancers, although rare, are the leading cause of disease-related mortality in European children above one year. A key pillar of the European Health Union, Europe’s Beating Cancer Plan (EBCP) puts a spotlight on childhood cancer. National Cancer Control Plans (NCCPs) have a key role but did not address childhood cancers sufficiently previously. This study considered the NCCPs of 41 European countries in relation to children and adolescents and young adults (AYAs). Twenty two NCCPs informed a structured narrative analysis. Four NCCPs were categorised as having comprehensive paediatric oncology content. Findings emphasise access to care through centralisation combined with local delivery of low-risk interventions and the role of multidisciplinary teams. Survivorship, AYA care, registries, and voluntary associations were addressed to varying degrees. Supportive care was among the weakest areas in the 22 NCCPs. Recommendations were presented to strengthen paediatric oncology in NCCPs and enrich the EBCP vision towards improved survival and reduced inequalities across Europe.
Substantivity of mouth-rinse formulations containing cetylpyridinium chloride and O-cymen-5-ol: a randomized-crossover trial
(BioMed Central, 2022-12-27) Aguilera, Felipe-Rodrigo; Vinas, Miguel; Sierra, Josep M.; Vinuesa Aumedes, Teresa; Fernandez de Henestrosa, Antonio R.; Furmanczyk, Marta; Trullàs, Carles; Jourdan, Eric; López López, José, 1958-; Jorba Pedrosa, Marta
Background The efficacy of mouth-rinses strongly depends upon their substantivity. The use of natural and non-toxic products that avoid secondary effects is gaining interest in preventive dentistry. The purpose of this study was to evaluate the substantivity of two formulations of mouth-washing solutions based on cetylpyridinium (CPC) and O-cymen-5-ol. Methods This was a randomized, double-blind, crossover trial conducted at the Faculty of Medicine and Health Sciences of the University of Barcelona. Bacterial re-colonization was followed by live/dead (SYTOTM9 + propidium iodide) bacterial staining and measured by confocal laser scanning microscopy and fluorometry. Unstimulated saliva samples were collected from 16 healthy individuals at baseline saliva and then, at 15 min, 30 min and 1, 2, 3, and 4 h after the following mouth-rinses: (i) a single, 1-min mouth-rinse with 15 ml of placebo (negative control); (ii) a single, 1-min mouth-rinse with 15 ml of CPC (0.05%) ; (iii) a single, 1-min mouth-rinse with 15 ml of O-cymen-5-ol (0.09%); (iv) a single, 1-min mouth-rinse with 15 ml of CPC (0.05%) + O-cymen-5-ol (0.09%). Results Proportion of dead bacteria was significantly higher for all mouthrinses during the first 15 min compared to baseline (CPC = 48.0 ± 13.9; 95% CI 40.98–56.99; p < 0.001, O-cymen-5-ol = 79.8 ± 21.0; 95% CI 67.71–91.90; p < 0.05, CPC + O-cymen-5-ol = 49.4 ± 14; 95% CI 40.98–56.99; p < 0.001 by fluorometry and 54.8 ± 23.0; 95% CI 41.50–68.06; p < 0.001, 76.3 ± 17.1; 95% CI 66.36–86.14; p < 0.001, 47.4 ± 11.9; 95% CI 40.49–54.30; p < 0.001 by confocal laser scanning microscopy, respectively). Nevertheless, after 4 h, CPC + O-cymen-5-ol was the only one that obtained significant values as measured by the two quantification methods used (80.3 ± 22.8; 95% CI 67.15–93.50; p < 0.05 and 81.4 ± 13.8; 95% CI 73.45–89.43; p < 0.05). The combined use of CPC + O-cymen-5-ol increased the substantivity of the mouthrinse with respect to mouthrinses prepared with either of the two active products alone. Conclusion The synergistic interaction of CPC and O-cymen-5-ol prolongs their substantivity. The resulting formulation may be as effective as other antimicrobials, such as triclosan or chlorhexidine, but without their undesirable secondary effects. Thus, mouthrinsing products based on Combinations of CPC and O-cymen-5-ol may replace in the near future Triclosan and Chlorhexidine—based mouthrinses.
Europe’s beating cancer plan: Opening avenues for radiation oncology
(Elsevier España, 2025) Borràs Andrés, Josep Maria; Prades, Joan
Traditionally, healthcare policy and administration in the European Union (EU) have been firmly positioned under the remit of its Member States based on the principle of subsidiarity. However, in recent years, the division between European and national competencies in health care has become more porous, as evidenced by initiatives like the joint purchasing of vaccines for COVID-19 and the establishment of European Reference Networks for Rare Diseases (ERN) [1]. It is significant that the first EU healthcare plan focuses on cancer, underlining its high priority for countries and the shared perspective that European efforts in areas such as oncology can lead to significant improvements in the survival and quality of life for cancer patients in our countries.
Atogepant after anti-CGRP monoclonal antibodies failure in migraine: a multicenter real-world study of effectiveness, safety, persistence and predictors of response
(Springer Science and Business Media LLC, 2025-11-28) Muñoz Vendrell, Albert ; Campoy Diaz, Sergio; Valín-Villanueva, Paloma; Casas Limón, Javier ; Fernández Lázaro, Iris; González García, Nuria; Santos Lasaosa, Sonia; González Osorio, Yésica; González Martínez, Alicia ; Campdelacreu, Jaume; Portocarrero Sánchez, Leonardo; Cano Sánchez, Luis Miguel; García Sánchez, Sonia María; Pérez de la Parte, Alba; Morollón Sánchez-Mateos, Noemí; López Bravo, Alba; Mínguez Olaondo, Ane; Sánchez Soblechero, Antonio; Lozano Ros, Alberto; Morales Hernández, Cristian; Andrés López, Alberto; Layos Romero, Almudena; Caronna, Edoardo; Torres Ferrús, Marta; Alpuente, Alicia; Pozo Rosich, Patricia ; Belvís, Robert; Garcia Azorin, David; Díaz de Terán, Javier; Guerrero Peral, Ángel Luis; Gago Veiga, Ana Beatriz; Huerta Villanueva, Mariano
Background Atogepant is approved for migraine prevention and has shown strong efficacy in clinical trials. However, its effectiveness following failure of anti-CGRP monoclonal antibodies (MAbs) has not been evaluated in large real-world populations. Methods This multicenter observational study conducted across Spanish headache units included adults with migraine who initiated atogepant after failure of >= 1 anti-CGRP MAb and had >= 3 months of follow-up. Baseline demographic and clinical variables were collected prospectively, with follow-up assessments at months 3 and 6. The primary outcome was the proportion of patients achieving a >= 50% reduction in monthly migraine days (MMD) at three months. Secondary outcomes included >= 30%, >= 75%, and 100% response rates; changes in headache days, pain intensity, acute medication use, and patient-reported outcomes; adverse events; treatment persistence; and factors associated with response. Results A total of 252 patients were included (mean age 48.9 +/- 12 years; 83.3% female; 80.6% with chronic migraine; 45.6% with continuous daily headache). Prior to atogepant, 39.7% had failed one anti-CGRP MAb, 27.0% two, 20.2% three, and 13.1% four. Median baseline MMD was 16, monthly headache days 27, and acute medication days 20. At 3 months, 44.4% achieved a >= 30% reduction in MMD, 29.7% >= 50%, and 11.7% >= 75%. Adverse events were reported in 52.5% of patients, most commonly constipation (30%) and nausea (25%). At three months, 26.2% had discontinued treatment (65.1% due to inefficacy, 28.8% due to intolerance). Treatment persistence at 180 days was 61% (95% CI 54 to 69%). A higher number of previously failed MAbs was independently associated with reduced odds of >= 50% response (RR 0.79, 95% CI 0.64 to 0.97). Moreover, a higher number of previously failed MAbs was associated with diminished improvements across multiple clinical endpoints, including headache frequency, intensity, acute medication use, and disability measures. Conclusion Atogepant may represent a viable treatment option for patients with migraine who have failed anti-CGRP MAbs. In this large real-world cohort, approximately one-third of patients achieved a >= 50% response, despite a treatment-refractory profile. However, the likelihood of response decreases with a higher number of previously failed MAbs, and mild adverse events are frequent.
Ritlecitinib: Efficacy of a Novel Therapy for Severe Alopecia Areata in Patients Aged 12 Years and Older
(Elsevier BV, 2025-12-02) Vañó-galván, S.; Figueras-nart, I.; Serrano, C.; Fortes, M.p.; Herrera-lasso, V.; Botella-estrada, R.
Alopecia areata (AA) is a dermatological disease of immune origin characterized by partial or total hair loss of the scalp (alopecia totalis) or the whole body (alopecia universalis). Current therapeutic options, both topical and systemic, use nonspecific immunosuppressive or immunomodulatory management strategies. The crucial role of Janus kinases (JAK) in the pathogenesis of the disease has led to a change in the therapeutic landscape, opening new approaches in the management of this disease. Ritlecitinib, a JAK3/TEC kinase inhibitor, has recently been approved for the treatment of severe AA in patients aged 12 and older. This review analyses the mechanism of action of ritlecitinib and the evidence for its safety and efficacy profile in patients with severe AA.
A deficit in semantic word learning in Huntington's disease
(Elsevier BV, 2025-12-20) De Diego-balaguer, R.; Olivé, G.; Mestres-missé, A.; Alvarez-martin, C.; Lemoine, L.; Nogueira-teixeira, E.; Rodriguez-fornells, A.; Bachoud-lévi, A.c.
Previous studies investigating language deficits in Huntington's disease (HD) have reported relatively preserved lexical and semantic systems. Nevertheless, some aspects such as semantic word learning have never been previously explored. With this aim, in two experiments we used a well-known contextual word-learning paradigm to study two groups of early-stage HD patients with matched controls. The task required participants to infer the meaning of new words by extracting and integrating semantic cues from different sentences in a selfpaced reading paradigm. The results showed that patients displayed difficulties to learn the meaning of new words from the context of the sentences (Exp. 1), which was reflected as more errors and null responses compared to controls, as well as increased reading times in conditions where meaning had to be integrated. Besides, we explored to which degree these learning differences could be attributed to working memory (WM) deficits. In Exp. 2 we ruled out this hypothesis, showing that semantic word learning was still impaired when reducing WM load. As a control condition, we also reported that these deficits remained even though patients had no impairment accessing synonyms or semantically related words of real words. These results strongly suggest a semantic learning impairment despite apparently preserved semantic processing abilities in HD patients. This research adds to growing evidence on the existence of subtle language-related impairments in HD patients, more specifically in complex language learning tasks.
Research protocol for BootStRaP assessment phase: A nine-nation study on boosting societal adaptation and mental health in a rapidly digitalising, post-pandemic Europe
(Elsevier BV, 2025-12-19) A. Fineberg, Naomi; Brandtner, Annika; Löchner, Nana; Kannen, Christopher; Smith, Megan; Foster, Simon; Meinke, Anita; Mosler, Kristin; Fine, Shai; Carmi, Lior; Friedman, Talia; Demetrovics, Zsolt; Sales, Célia; Jones, Julia; Oliveira, Hernâni; R. Chamberlain, Samuel; Ioannidis, Konstantinos; Felvinczi, Katalin; Zohar, Joseph; Roman-urrestarazu, Andres; Susi, Mart; Burkauskas, Julius; Lindenberg, Katajun; Neumann, Ina; Huizink, Anja; Moreno, Carmen; Corazza, Ornella; Silva Dias, Teresa; Mohler-kuo, Meichun; Purper-ouakil, Diane; Fongaro, Erica; Fally, Sara; Pallanti, Stefano; Morgan, Nicholas; Czakó, Andrea; Yucel, Murat; Rumpf, Hans-jürgen; Walitza, Susanne; Wellsted, David; M. Menchon, Jose; Montag, Christian; Hall, Natalie; Brand, Matthias
Background: There is increasing global concern about the harms associated with problematic usage of the internet (PUI) affecting young people. Various risk factors have been proposed, but there is a scarcity of reliable evidence on the extent of the problem, who is most at risk of developing PUI and why, and how best to tackle it. Objectives: BootStRaP (ISRCTN59576080) is a five-year multinational research programme designed to boost young people's health and resilience by determining, through prospective longitudinal assessment, the risk factors associated with PUI and its health economic impact and designing and testing preventative self-management interventions tailored to individual risk factors. Methods: This paper describes the first phase of the project (i.e., Cohort 1). A sample of over 2500 schoolchildren aged 12-16 years was recruited across nine European countries. They were prospectively monitored over a 6month period using a dedicated smartphone application (BootstrApp), through which their internet use habits, health and wellbeing were measured. Young people were involved in the co-design of aspects of the protocol including the recruitment plan and elements of the app design. The components of the assessment battery were chosen to investigate specific individual, clinical, cognitive and environmental risk determinants as defined a priori in an evidence-based logic-model. Participants were assessed using a combination of standardised demographic and clinical questionnaires, ambulatory assessment techniques, cognitive testing and passive digital monitoring. Multimodal data is analysed according to machine learning and structured equation modelling. Expected outcomes: Our findings will contribute toward A) developing algorithms for predicting individuals at risk for PUI, B) identifying actionable variables for application to subjects as interventions for testing in the second phase of the project, C) validating risk hypotheses stated in the logic model of PUI including the interplay between predisposing risk factors (e.g., impulsivity, compulsivity), affective and cognitive processes (e.g., reward-related attentional biases), and executive functions (e.g., inhibitory control), D) calculating the health economic cost and impact of PUI in young people across Europe.
Association between type 2 diabetes and depressive symptoms after a 1-year follow-up in an older adult Mediterranean population
(Springer Nature, 2024-01-13) Baenas, Isabel; Camacho Barcia, Lucía; Granero, Roser; Razquin, Cristina; Corella Piquer, Dolores; Gómez Martínez, Carlos; Castañer Niño, Olga; Martínez, J. Alfredo; Alonso Gómez, Ángel M.; Wärnberg, Julia; Vioque, Jesús; Romaguera, Dora; López Miranda, José; Estruch Riba, Ramon; Tinahones, Francisco J.; Lapetra, José; Serra Majem, Lluís; Cano-Ibañez, Naomi; Tur Marí, Josep A. (Josep Antoni); Martín Sánchez, Vicente; Pintó Sala, Xavier; Gaforio, José Juan; Matía Martín, Pilar; Vidal i Cortada, Josep; Vázquez, Clotilde; Daimiel, Lidia; Ros Rahola, Emilio; Jiménez-Murcia, Susana; Dalsgaard, Søren; García Arellano, Ana; Babio, Nancy; Sorlí, José V.; Lassale, Camille; García de la Hera, Manuela; Gómez García, Enrique; Zulet, M. Angeles; Konieczna, Jadwiga; Martín-Peláez, Sandra; Tojal Sierra, Lucas; Basterra Gortari, F. Javier; Heras Delgado, Sara de las; Portolés, Olga; Muñoz Pérez, Miguel Ángel; Arenas Larriva, Antonio P.; Compañ Gabucio, Laura; Eguaras, Sonia; Shyam, Sangeetha; Fitó Colomer, Montserrat; Baños Rivera, Rosa María; Salas-Salvadó J; Fernández Aranda, Fernando
To examine the cross-sectional association between baseline depressive symptoms and the presence of type 2 diabetes (T2D), and its association with glycated hemoglobin (HbA1c) and other metabolic variables, and the prospective association of depressive symptoms and HbA1c after 1 year of follow-up. Methods: n = 6224 Mediterranean older adults with overweight/obesity and metabolic syndrome (48% females, mean age 64.9 ± 4.9 years) were evaluated in the framework of the PREDIMED-Plus study cohort. Depressive symptoms were assessed using the Beck Depression Inventory-II and HbA1c was used to measure metabolic control.Results: The presence of T2D increased the likelihood of higher levels of depressive symptoms (χ2 = 15.84, p = 0.001). Polynomial contrast revealed a positive linear relationship (χ2 = 13.49, p = 0.001), the higher the depressive symptoms levels, the higher the prevalence of T2D. Longitudinal analyses showed that the higher baseline depressive symptoms levels, the higher the likelihood of being within the HbA1c ≥ 7% at 1-year level (Wald-χ2 = 24.06, df = 3, p < .001, for the full adjusted model). Additionally, depressive levels at baseline and duration of T2D predicted higher HbA1c and body mass index, and lower physical activity and adherence to Mediterranean Diet at 1 year of follow-up. Conclusions: This study supports an association between T2D and the severity of depressive symptoms, suggesting a worse metabolic control from mild severity levels in the short-medium term, influenced by lifestyle habits related to diabetes care. Screening for depressive symptoms and a multidisciplinary integrative therapeutic approach should be ensured in patients with T2D
Prevalence of dental attrition and its relationship with Sent dental erosion and salivary function in young adults
(Quintessence Publishing Group, 2023-01-01) Rius Bonet, Ona; Roca Obis, Paula; Zamora Olave, Carla; Willaert, Eva; Martínez Gomis, Jordi
Objectives: The aim of this study was to estimate the prevalence of dental attrition in a young adult population and to explore associated factors. Method and materials: Dental students aged 18 to 40 years old with a minimum of 24 natural teeth were invited to take part in this cross-sectional study. Their demographic information, medical history, perceived stress, frequency of dietary acid intake, and frequency of oral habits were obtained through several questionnaires. Assessment of each type of tooth wear (erosion, attrition, and abrasion) was performed according to the tooth wear evaluation system (TWES 1.0). All participants underwent salivary tests. Statistical analysis was performed by chi-squared or Mann–Whitney tests and logistic regression models. Results: In total, 178 participants (88 women and 90 men) with a median age of 22 years were included and of those 74.7% (95% confidence interval [CI], 68% to 81%) had dental attrition. Univariate analysis revealed pos- itive associations for male sex, age, body mass index, awake bruxism frequency, and erosive tooth wear with the presence of dental attrition. Multivariable logistic regression (Nagelkerke r2 = 0.31) indicated that dental attrition was associated with ero- sive tooth wear (adjusted odds ratio [aOR], 6.3; 95% CI, 2.8 to 14.2), body mass index (aOR, 1.3; 95% CI, 1.1–1.5), and age (aOR, 1.2; 95% CI 1.0 to 1.3). Conclusion: Dental attrition is present in most young adults of Catalonia. The associated factors were erosive tooth wear, body mass index, and age. Slight alterations of salivary parameters do not seem to predict dental attrition.
Immunological and tissue reactions to titanium particles generated by the mechanical decontamination of dental implants: In vitro and in vivo study
(Medicina Oral, S.L., 2025-10-17) Gil, J.; Fonseca, D.; Fernández-domínguez, M.; Fernández-domínguez, P.; Akagi-camacho, S.; Toledano-serrabona, J.; Vegas-bustamante, E.; Camps-font, O.; Sánchez-garcés, MÁ.; Aragoneses, Jm.
Background: Mechanical decontamination of biofilm, or implantoplasty, is a commonly employed technique for managing peri-implantitis. However, the inflammatory response and in vivo behavior of titanium (Ti) particles released during this procedure remain underexplored. This study aimed to evaluate the cytotoxic, inflammatory, and osteogenic effects of Ti particles released during implantoplasty, as well as their in vivo behavior Material and Methods: Titanium particles were generated by following a standardized protocol using drills on 150 commercially pure Ti implants. Cytotoxicity thresholds were determined using THP-1 macrophages and bone marrow-derived mesenchymal stem cells (BM-MSCs). These cells were subsequently cultured with Ti particle-conditioned medium, and inflammatory responses were analyzed using RT-qPCR for markers such as CCR7, TNF-alpha, IL-1 beta (pro-inflammatory), and CD206, TGF-beta, IL-10 (anti-inflammatory). Cytokine levels were quantified using ELISA. Osteogenic responses in BM-MSCs were assessed by analyzing Runx2, alkaline phosphatase (ALP), and osteocalcin (OC) expression, and ALP activity was measured colorimetrically. In vivo, Ti particles were introduced into mandibular defects in 20 Wistar rats, with histological analysis performed 20 days post-implantation Results: Ti particles elicited a pro-inflammatory response in macrophages, with increased expression of TNF-alpha and reduced expression of TGF-beta and CD206. Cytokine analysis confirmed elevated IL-1 beta and reduced IL-10 levels. No significant changes in ALP activity were observed. Conclusions: Titanium particles released during implantoplasty induce pro-inflammatory responses.
Epidemiological evolution and healthcare services utilization in elderly dementia patients of Catalonia
(BioMed Central, 2025-11-12) Clèries, Montse; Melendo Azuela, Eva Maria; Lladó, Albert; Vela, Emili; Mariscal, Sonia; Piñol Ripoll, Gerard; Santaeugènia Gonzàlez, Sebastià J.
Background Assessing the dynamics and burden of dementia is necessary to improve healthcare plans. This study aimed to describe the epidemiology and characteristics of dementia diagnoses in Catalonia (North-East of Spain) and evaluate healthcare services utilization and associated expenditures in people with dementia compared with people without. Methods Retrospective study including all the dementia population (2013–2020) using data from an administrative database, the Catalan Health Surveillance System, covering a 7.5–7.7-million population. Data included demographic, clinical, healthcare services utilization, and morbidity-associated risk variables, and was analyzed according to dementia type, including Alzheimer’s disease (AD), vascular dementia (VD), frontotemporal dementia (FTD), dementia with Lewy bodies (LBD), and unspecified dementia (UD). We compared comorbidities and morbidity-associated risk, healthcare services utilization and associated expenditures, and mortality rates between people with dementia and the population without dementia adjusted for age, sex, and income level. Results During the study period, dementia prevalence remained stable, and incidence modestly decreased. AD and VD incidence rates decreased, whereas UD modestly increased, being the highest in 2019. Patients with dementia had a higher prevalence of comorbidities, morbidity-associated risk, healthcare services utilization, specially admissions in nursing homes and intermediate care, healthcare-associated expenditures, and mortality than people without dementia adjusted by age, sex, and income level in 2019. An expenditure €1311.7 per person per year was attributable to dementia, representing an increase of 44.1% of total healthcare costs. Compared to other dementia types, AD and VD had increased admissions, and VD had the highest expenditures. The use of antidepressants and benzodiazepines progressively decreased. Conclusions Using a population dataset, this study showed that dementia is associated with a high burden and healthcare needs, providing useful information to design improved healthcare plans.
Cancer incidence and survival in Lynch syndrome patients receiving colonoscopic and gynaecological surveillance: first report from the prospective Lynch syndrome database.
(BMJ Publishing Group, 2017-03) Møller, Pal; Seppälä, Toni T.; Bernstein, Inge; Holinski-Feder, Elke; Sala, Paola; Evans, D. Gareth; Lindblom, Annika; Macrae, Finlay; Blanco, Ignacio; Sijmons, Rolf; Jeffries, Jacqueline; Vasen, Hans; Burn, John; Nakken, Sigve; Hovig, Eivind; Rødland, Einar Andreas; Tharmaratnam, Kukatharmini; de Vos Tot Nederveen Cappel, Wouter H.; Hill, James; Wijnen, Juul; Green, Kate; Lalloo, Fiona; Sunde, Lone; Mints, Miriam; Bertario, Lucio; Pineda Riu, Marta; Navarro, Matilde; Morak, Monika; Renkonen-Sinisalo, Laura; Frayling, Ian M.; Plazzer, John Paul; Pylvänäinen, Kirsi; Sampson, Julian R.; Capellá, G. (Gabriel); Mecklin, Jukka Pekka; Möslein, Gabriela; Mallorca Group
Objective Estimates of cancer risk and the effects of surveillance in Lynch syndrome have been subject to bias, partly through reliance on retrospective studies. We sought to establish more robust estimates in patients undergoing prospective cancer surveillance. Design We undertook a multicentre study of patients carrying Lynch syndrome-associated mutations affecting MLH1, MSH2, MSH6 or PMS2. Standardised information on surveillance, cancers and outcomes were collated in an Oracle relational database and analysed by age, sex and mutated gene. Results 1942 mutation carriers without previous cancer had follow-up including colonoscopic surveillance for 13 782 observation years. 314 patients developed cancer, mostly colorectal (n=151), endometrial (n=72) and ovarian (n=19). Cancers were detected from 25 years onwards in MLH1 and MSH2 mutation carriers, and from about 40 years in MSH6 and PMS2 carriers. Among first cancer detected in each patient the colorectal cancer cumulative incidences at 70 years by gene were 46%, 35%, 20% and 10% for MLH1, MSH2, MSH6 and PMS2 mutation carriers, respectively. The equivalent cumulative incidences for endometrial cancer were 34%, 51%, 49% and 24%; and for ovarian cancer 11%, 15%, 0% and 0%. Ten-year crude survival was 87% after any cancer, 91% if the first cancer was colorectal, 98% if endometrial and 89% if ovarian. Conclusions The four Lynch syndrome-associated genes had different penetrance and expression. Colorectal cancer occurred frequently despite colonoscopic surveillance but resulted in few deaths. Using our data, a website has been established at http://LScarisk.org enabling calculation of cumulative cancer risks as an aid to genetic counselling in Lynch syndrome.
A structured-data algorithm for semiautomated surveillance of surgical site infection after colorectal surgery: A diagnostic accuracy study.
(Elsevier Ltd., 2026-01-11) Casanova Portoles, Daniel; Badia, Josep M.; Forero, Carlos G.; Sánchez-Martínez, Néstor; Romero, Manel; Alonso-Solís, Toni; Limón, Enrique; Pujol, Miquel; Sancho, Juan
Background. Manual surveillance of surgical site infections (SSIs) after colorectalsurgery is resource-intensive, limiting scalability. Semiautomated algorithms based onstructured electronic health record (EHR) data may maintain high case-findingsensitivity while reducing workload.Methods. A retrospective diagnostic-accuracy study was conducted in a teachinghospital participating in a nationwide SSI surveillance programme. All electivecolorectal procedures performed between January 2010 and December 2023 wereincluded. SSIs were classified according to CDC-NHSN/ECDC criteria. Eight binaryEHR-derived “alerts” were combined into a composite rule (any alert positive). Manualsurveillance served as the reference standard. Performance was assessed overall, bySSI depth (superficial, deep, organ/space), and by procedure type (colon vs rectal).Discrimination (AUC), sensitivity, specificity, positive predictive value (PPV), andnegative predictive value (NPV) were calculated with 95% confidence intervals (CIs).Results. A total of 1,213 patients (1,085 colon; 128 rectal) were included. The overallSSI incidence was 11.2% (3.1% superficial, 1.2% deep, 6.8% organ/space). Thecomposite alert achieved an AUC of 0.859 (95% CI 0.838–0.878) for any SSI, withsensitivity 0.721, specificity 0.876, PPV 0.424, and NPV 0.961. At this operating point,19% of procedures would be flagged for manual verification, corresponding to anestimated 81% reduction in full chart reviews. Discrimination was highest fororgan/space infections (AUC 0.919; sensitivity 0.831; specificity 0.911). Performancefor deep SSI was intermediate (AUC 0.805), and for superficial SSI, more limited (AUC0.571). Sensitivity was higher for colon surgery (AUC 0.853) and specificity higher forrectal surgery (AUC 0.881).Conclusions. The structured-data algorithm demonstrated strong overall discriminationand excellent performance for organ/space infections, supporting the feasibility ofsemiautomated surveillance without compromising detection quality. External andprospective validation, definition of diagnostic safety thresholds, and workloadreductionanalyses are required to optimise implementation. Exploration of NLP addonsmay be considered where resources permit. ClinicalTrials.gov: NCT07130656.
Impact of clinical and dosimetric factors on severe oral mucositis in head and neck cancer: insights from a phase II clinical trial
(Frontiers Media SA, 2025-11-17) Lozano-borbalas, Alicia; Jordi-ollero, Olivia; Marruecos, Jordi; Farre, Nuria; Planas, Isabel; Dolores Toledo, Maria; Mesia, Ricard; Navarro-martin, Arturo
Introduction Oral mucositis (OM) is the most common acute treatment-limiting adverse effect in patients with head and neck cancer (HNC), particularly following concomitant radiotherapy (RT) and systemic therapy. However, the effects of clinical and dosimetric parameters on the onset of severe OM remain controversial. We aimed to determine the association between clinical and dosimetric parameters and severe OM in the oral and pharyngeal mucosae in a randomized phase II clinical trial. Patients and methods A subgroup analysis of data from a clinical trial was conducted to assess the efficacy of a 3% melatonin oral gel (MucomelR) to prevent OM in patients with HNC. A total of 54 patients treated with intensity-modulated radiotherapy (IMRT) (66-69.96 Gy/33 fractions) plus concomitant systemic therapy (cisplatin or cetuximab) +/- melatonin rinses were included. The association between clinical and dosimetric parameters and grade (G) >= 3 OM was determined. For this analysis, the oral mucosa was divided into the oral and pharyngeal mucosae. Results The following variables were significantly associated with G3 OM in the oral mucosa: oropharyngeal localization (p = 0.03), treatment with cetuximab (p = 0.01), oral mucosa volume included in low planning target volume (PTV) (PTV1: 54.12 Gy) and intermediate treatment doses (PTV2: 60 Gy), V35 >70% (p = 0.007), and a median RT dose of 56.6 Gy (p = 0.02). The absolute healthy volume of the oral mucosa was a significant protective factor (p = 0.03; McFadden's pseudo-R-2 = 0.46). None of the clinical or dosimetric variables was significantly associated with G3 OM in the pharyngeal mucosa. Conclusion Oropharyngeal cancer, cetuximab, and low and intermediate RT dose to the oral cavity mucosa were significantly associated with the onset of severe oral mucositis. Given the association between these previous factors with a higher risk of G3 OM, they should be considered during treatment planning and dosimetry in patients treated with cetuximab for oropharyngeal cancer.
Observational study on the safety and effectiveness of SARS-CoV-2 vaccination in patients with lung cancer
(Elsevier BV, 2025-03-14) Nadal, E.; Morán, T.; Estival, A.; Sala, M.Á.; Antoñanzas, M.; González, J.g.; Diz-taín, M.p.; Martínez, M.; Azcona, E.; Baena, J.; Campos, B.; Cumplido, J.d.; Cerezo, S.; Díaz-serrano, A.; Guirado, M.; Mielgo, X.; Saigí, M.; Vidales, Z.
Background: We aimed to determine the safety and effectiveness of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in terms of protection from infection and reduced coronavirus disease 2019 (COVID-19) severity in lung cancer patients. We also analysed the toxicities related to antineoplastic treatments and the influence of infection before or after vaccination on overall survival (OS). Patients and methods: This cohort, multicentric, retrospective study was carried out between April 2021 and January 2022 in 27 Spanish hospitals. We included all patients >18 years old with lung cancer of any histology and stage who received a European Medicines Agency-approved (up to January 2022) SARS-CoV-2 vaccine. We collected patient followup data up to 3 months after vaccination. Results: Seven hundred and ninety-four patients were included in the analysis. Most patients were male (511, 64.4%) and the mean age was 66.0 years (standard deviation: 9.9 years). Five hundred and ninety-three (74.7%) patients received three vaccine doses. Two hundred and thirty-five (29.6%) patients reported vaccine-related adverse events. No grade 5 and only one grade 4 vaccine-related adverse event was observed. Two hundred and sixty-two (33.0%) patients had at least one adverse event related to cancer treatment; no grade 5 adverse events were reported and 21 grade 4 were observed. Fifty-eight (7.3%) patients were infected with SARS-CoV-2 after being vaccinated; 10 (17.2%) required hospitalisation and none of them needed intensive care nor died. No significant difference was observed between the OS of patients infected by SARS-CoV-2 before receiving the first vaccine dose and those not infected (P=0.441). Conclusions: Our real-world data supported the safety and effectiveness of SARS-CoV-2 vaccines in patients with lung cancer. SARS-CoV-2 vaccines protected most of our population from infection, and those infected developed mild-tomoderate disease.

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