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2. CDW signatures in the electronic structure of LaSb2 at 13 K and metal-insulator transition

Author

Palacio, I., Obando-Guevara, J., Chen, L., Nair, M. N., Barrio, M. A. González, Papalazarou, E., Fèvre, P. Le, Luccas, R. F., Suderow, H., Canfield, P., Taleb-Ibrahimi, A., Michel, E. G., Mascaraque, A., and Tejeda, A.

Subjects
Condensed Matter - Materials Science
Abstract

Light rare-earth antimonide LaSb2 is a material susceptible to nesting and exhibits a Charge Density Wave (CDW) at 355 K as well as superconductivity below 1.2 K. In the seek for additional CDW transitions, we have studied the temperature-dependent of LaSb2 at 200 and 13 K and infer CDW manifestations by combining angle-resolved photoemission spectroscopy (ARPES) measurements and density functional theory (DFT) calculations. ARPES measurements at 200 K show a metallic system while it appears to be semiconducting at 13 K, at odds with existing resistivity measurements. At 13 K, ARPES shows the band folding of the inner Fermi surface pockets, with considerable spectral weight on the folded band. We find a nesting vector at q = 0.25$\pm$0.02 {\AA} -1. In addition, we observe Umklapps of other bands due to the onset of the new periodicity, together with a semiconducting behavior in the whole reciprocal space. Calculations demonstrate that the folded band is associated with the La-Sb layer and that in-plane distortion is the most probable structural modification in the system, probably affecting the whole unit cell., Comment: In this work, the discussion presents two interpretations to explain the experimental results. We withdraw this work because after further discussions and data analysis we have concluded that only one of the two interpretations is consistent with the experimental results

Published
2022

3. Reversible Graphene decoupling by NaCl photo-dissociation

Author

Palacio, I., Aballe, L., Foerster, M., de Oteyza, D. G., García-Hernández, M., and Martín-Gago, J. A.

Subjects
Condensed Matter - Materials Science
Abstract

We describe the reversible intercalation of Na under graphene on Ir(111) by photo-dissociation of a previously adsorbed NaCl overlayer. After room temperature evaporation, NaCl adsorbs on top of graphene forming a bilayer. With a combination of electron diffraction and photoemission techniques we demonstrate that the NaCl overlayer dissociates upon a short exposure to an X-ray beam. As a result, chlorine desorbs while sodium intercalates under the graphene, inducing an electronic decoupling from the underlying metal. Low energy electron diffraction shows the disappearance of the moir\'e pattern when Na intercalates between graphene and iridium. Analysis of the Na 2p core-level by X-ray photoelectron spectroscopy shows a chemical change from NaCl to metallic buried Na at the graphene/Ir interface. The intercalation-decoupling process leads to a n-doped graphene due to the charge transfer from the Na, as revealed by constant energy angle resolved X-ray photoemission maps. Moreover, the process is reversible by a mild annealing of the samples without damaging the graphene.

Published
2019
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4. Structural characterization of as-grown and quasi-free standing graphene layers on SiC

Author

Bueno, R. A., Palacio, I., Munuera, C., Aballe, L., Foerster, M., Strupinski, W., Garcia-Hernandez, M., Martin-Gago, J. A., and Lopez, M. F.

Subjects
Condensed Matter - Materials Science
Abstract

We report on a comparative structural characterization of two types of high quality epitaxial graphene layers grown by CVD on 4H-SiC(0001). The layers under study are a single layer graphene on top of a buffer layer and a quasi-free-standing graphene obtained by intercalation of hydrogen underneath the buffer layer. We determine the morphology and structure of both layers by different complementary in-situ and ex-situ surface techniques. We found the existence of large islands in both samples but with different size distribution. Photoemission electron microscopy (PEEM) measurements were performed to get information about the chemical environment of the different regions. The study reveals that monolayer graphene prevails in most of the surface terraces, while a bilayer and trilayer graphene presence is observed at the steps, stripes along steps and islands., Comment: This manuscript version is made available under the CC-BY-NC-ND 4.0 license, http://creativecommons.org/licenses/by-nc-nd/4.0/

Published
2019
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6. Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial

Author

Coleman, Robert L, Oza, Amit M, Lorusso, Domenica, Aghajanian, Carol, Oaknin, Ana, Dean, Andrew, Colombo, Nicoletta, Weberpals, Johanne I, Clamp, Andrew, Scambia, Giovanni, Leary, Alexandra, Holloway, Robert W, Gancedo, Margarita Amenedo, Fong, Peter C, Goh, Jeffrey C, O'Malley, David M, Armstrong, Deborah K, Garcia-Donas, Jesus, Swisher, Elizabeth M, Floquet, Anne, Konecny, Gottfried E, McNeish, Iain A, Scott, Clare L, Cameron, Terri, Maloney, Lara, Isaacson, Jeff, Goble, Sandra, Grace, Caroline, Harding, Thomas C, Raponi, Mitch, Sun, James, Lin, Kevin K, Giordano, Heidi, Ledermann, Jonathan A, investigators, ARIEL3, Buck, M, Dean, A, Friedlander, ML, Goh, JC, Harnett, P, Kichenadasse, G, Scott, CL, Denys, H, Dirix, L, Vergote, I, Elit, L, Ghatage, P, Oza, AM, Plante, M, Provencher, D, Weberpals, JI, Welch, S, Floquet, A, Gladieff, L, Joly, F, Leary, A, Lortholary, A, Lotz, J, Medioni, J, Tredan, O, You, B, El-Balat, A, Hänle, C, Krabisch, P, Neunhöffer, T, Pölcher, M, Wimberger, P, Amit, A, Kovel, S, Leviov, M, Safra, T, Shapira-Frommer, R, Stemmer, S, Bologna, A, Colombo, N, Lorusso, D, Pignata, S, Sabbatini, RF, Scambia, G, Tamberi, S, Zamagni, C, Fong, PC, O'Donnell, A, Gancedo, M Amenedo, Herraez, A Casado, Garcia-Donas, J, Guerra, EM, Oaknin, A, Palacio, I, Romero, I, Sanchez, A, Banerjee, SN, Clamp, A, Drew, Y, Gabra, HG, Jackson, D, Ledermann, JA, McNeish, IA, Parkinson, C, and Powell, M

Subjects
Reproductive Medicine, Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Orphan Drug, Clinical Research, Cancer, Genetics, Clinical Trials and Supportive Activities, Ovarian Cancer, Rare Diseases, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, 6.2 Cellular and gene therapies, Aged, Disease-Free Survival, Double-Blind Method, Female, Follow-Up Studies, Humans, Indoles, Internationality, Maintenance Chemotherapy, Middle Aged, Molecular Targeted Therapy, Neoplasm Recurrence, Local, Ovarian Neoplasms, Poly(ADP-ribose) Polymerase Inhibitors, Risk Assessment, Survival Rate, Treatment Outcome, ARIEL3 investigators, Medical and Health Sciences, General & Internal Medicine, Biomedical and clinical sciences, Health sciences
Abstract

BackgroundRucaparib, a poly(ADP-ribose) polymerase inhibitor, has anticancer activity in recurrent ovarian carcinoma harbouring a BRCA mutation or high percentage of genome-wide loss of heterozygosity. In this trial we assessed rucaparib versus placebo after response to second-line or later platinum-based chemotherapy in patients with high-grade, recurrent, platinum-sensitive ovarian carcinoma.MethodsIn this randomised, double-blind, placebo-controlled, phase 3 trial, we recruited patients from 87 hospitals and cancer centres across 11 countries. Eligible patients were aged 18 years or older, had a platinum-sensitive, high-grade serous or endometrioid ovarian, primary peritoneal, or fallopian tube carcinoma, had received at least two previous platinum-based chemotherapy regimens, had achieved complete or partial response to their last platinum-based regimen, had a cancer antigen 125 concentration of less than the upper limit of normal, had a performance status of 0-1, and had adequate organ function. Patients were ineligible if they had symptomatic or untreated central nervous system metastases, had received anticancer therapy 14 days or fewer before starting the study, or had received previous treatment with a poly(ADP-ribose) polymerase inhibitor. We randomly allocated patients 2:1 to receive oral rucaparib 600 mg twice daily or placebo in 28 day cycles using a computer-generated sequence (block size of six, stratified by homologous recombination repair gene mutation status, progression-free interval after the penultimate platinum-based regimen, and best response to the most recent platinum-based regimen). Patients, investigators, site staff, assessors, and the funder were masked to assignments. The primary outcome was investigator-assessed progression-free survival evaluated with use of an ordered step-down procedure for three nested cohorts: patients with BRCA mutations (carcinoma associated with deleterious germline or somatic BRCA mutations), patients with homologous recombination deficiencies (BRCA mutant or BRCA wild-type and high loss of heterozygosity), and the intention-to-treat population, assessed at screening and every 12 weeks thereafter. This trial is registered with ClinicalTrials.gov, number NCT01968213; enrolment is complete.FindingsBetween April 7, 2014, and July 19, 2016, we randomly allocated 564 patients: 375 (66%) to rucaparib and 189 (34%) to placebo. Median progression-free survival in patients with a BRCA-mutant carcinoma was 16·6 months (95% CI 13·4-22·9; 130 [35%] patients) in the rucaparib group versus 5·4 months (3·4-6·7; 66 [35%] patients) in the placebo group (hazard ratio 0·23 [95% CI 0·16-0·34]; p

Published
2017

8. EE63 Cost-Effectiveness of Olaparib Plus Bevacizumab First-Line Maintenance in Ovarian Cancer Alongside the PAOLA-1 Trial

Author

Perrier, L., primary, Zarca, K., additional, Cadet, T., additional, Morelle, M., additional, Cropet, C., additional, Burges, A., additional, Cecere, S.C., additional, Palacio, I., additional, Polterauer, S., additional, Yoshida, H., additional, Vuylsteke, P., additional, Colombo, N., additional, Nøttrup, T.J., additional, Abdeddaim, C., additional, El-Balat, A., additional, Cinieri, S., additional, Herrero, A., additional, Kaminski, M.C., additional, Pujade-Lauraine, E., additional, Durand-Zaleski, I., additional, and Ray-Coquard, I., additional

Published
2023
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10. Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial

Author

Buck, M, Dean, A, Friedlander, M L, Goh, J C, Harnett, P, Kichenadasse, G, Scott, C L, Denys, H, Dirix, L, Vergote, I, Elit, L, Ghatage, P, Oza, A M, Plante, M, Provencher, D, Weberpals, J I, Welch, S, Floquet, A, Gladieff, L, Joly, F, Leary, A, Lortholary, A, Lotz, J, Medioni, J, Tredan, O, You, B, El-Balat, A, Hänle, C, Krabisch, P, Neunhöffer, T, Pölcher, M, Wimberger, P, Amit, A, Kovel, S, Leviov, M, Safra, T, Shapira-Frommer, R, Stemmer, S, Bologna, A, Colombo, N, Lorusso, D, Pignata, S, Sabbatini, R F, Scambia, G, Tamberi, S, Zamagni, C, Fong, P C, O'Donnell, A, Gancedo, M Amenedo, Herraez, A Casado, Garcia-Donas, J, Guerra, E M, Oaknin, A, Palacio, I, Romero, I, Sanchez, A, Banerjee, S N, Clamp, A, Drew, Y, Gabra, H G, Jackson, D, Ledermann, J A, McNeish, I A, Parkinson, C, Powell, M, Aghajanian, C, Armstrong, D K, Birrer, M J, Buss, M K, Chambers, S K, Chen, L-m, Coleman, R L, Holloway, R W, Konecny, G E, Ma, L, Morgan, M A, Morris, R T, Mutch, D G, O'Malley, D M, Slomovitz, B M, Swisher, E M, Vanderkwaak, T, Vulfovich, M, Coleman, Robert L, Oza, Amit M, Lorusso, Domenica, Aghajanian, Carol, Oaknin, Ana, Dean, Andrew, Colombo, Nicoletta, Weberpals, Johanne I, Clamp, Andrew, Scambia, Giovanni, Leary, Alexandra, Holloway, Robert W, Gancedo, Margarita Amenedo, Fong, Peter C, Goh, Jeffrey C, O'Malley, David M, Armstrong, Deborah K, Garcia-Donas, Jesus, Swisher, Elizabeth M, Floquet, Anne, Konecny, Gottfried E, McNeish, Iain A, Scott, Clare L, Cameron, Terri, Maloney, Lara, Isaacson, Jeff, Goble, Sandra, Grace, Caroline, Harding, Thomas C, Raponi, Mitch, Sun, James, Lin, Kevin K, Giordano, Heidi, and Ledermann, Jonathan A

Published
2017
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13. Giant electron-phonon interaction for a prototypical semiconductor interface: Sn/Ge(111)-(3 x 3)

Author

Nair, M. N, Palacio, I, Mascaraque Susunaga, Arantzazu, Michel, E. G., Taleb-Ibrahimi, A, Tejeda, A., González Pascual, César, Martin-Rodero, A., Ortega, J., Flores, F., Nair, M. N, Palacio, I, Mascaraque Susunaga, Arantzazu, Michel, E. G., Taleb-Ibrahimi, A, Tejeda, A., González Pascual, César, Martin-Rodero, A., Ortega, J., and Flores, F.

Abstract

©2023 American Physical Society This work was supported by the French Agence Nationale de la Recherche (ANR), project SurMott, Ref. No. NT-09-618999. We acknowledge financial support from the Spanish Ministry of Science and Innovation through Projects No. MAT2017-88258-R, No. PID2021-123295NB-I00, No. PID2020-117024GB-C43, No. PID2021-125604NB-I00, and No. CEX2018-000805-M (María de Maeztu Programme for Units of Excellence in R&D). We also acknowledge the technical support provided by the Centro de Computación Científica-UAM (CCC-UAM), Project No. BIOFAST. We thank Professor D. Farías for many helpful discussions., We report an experimental and theoretical study of the electron-phonon coupling for alpha-Sn/Ge(111), a prototypical triangular lattice surface, closely related to Sn/Si(111)-( √3 x √3), where recent experimental evidence has found superconductivity [X. Wu et al., Phys. Rev. Lett. 125, 117001 (2020)]. We concentrate our study on the (3 x 3) phase of alpha-Sn/Ge(111) that appears between 150 and 120 K and has a well-known geometry with a half-filled electronic band around the Fermi energy. We show that this surface presents a giant electron-phonon interaction that can be considered at least partially responsible for the different phases that this system shows at very low temperature. Our theoretical results indicate that indeed the electron-phonon interaction in alpha-Sn/Ge(111)-(3 x 3) is unusually large, since we find that lambda, the electron mass enhancement for the half-filled band, is lambda = 1.3. This result is in good agreement with the experimental value obtained from high-resolution angle-resolved photoemission spectroscopy measurements, which yield lambda = 1.45 +/- 0.1, Ministerio de Ciencia e Innovación (MICINN), Unidades de Excelencia María de Maeztu (MICINN), French Agence Nationale de la Recherche (ANR), Depto. de Física de Materiales, Fac. de Ciencias Físicas, TRUE, pub

Published
2023

14. Formation of titanium monoxide (001) single-crystalline thin film induced by ion bombardment of titanium dioxide (110)

Author

Martínez Pabón, María Beatriz, Beltrán Finez, Juan Ignacio, Sánchez Santolino, Gabriel, Palacio, I., López Sánchez, Jesús, Rubio Zuazo, J., Rojo Alaminos, Juan Manuel, Ferrer, P., Mascaraque Susunaga, Arantzazu, Muñoz, M. C., Varela del Arco, María, Castro, G. R., Rodríguez de la Fuente, Óscar, Martínez Pabón, María Beatriz, Beltrán Finez, Juan Ignacio, Sánchez Santolino, Gabriel, Palacio, I., López Sánchez, Jesús, Rubio Zuazo, J., Rojo Alaminos, Juan Manuel, Ferrer, P., Mascaraque Susunaga, Arantzazu, Muñoz, M. C., Varela del Arco, María, Castro, G. R., and Rodríguez de la Fuente, Óscar

Abstract

© 2015 Macmillan Publishers Limited. Financial support from the Spanish Ministry of Economy and Competitiveness under projects MAT2012-38045-C04-03 and MAT2012-38045-C04-04 is acknowledged. A.M. also acknowledges project MAT2010-21156-C03-02 for financial support. We thank A. Tejeda for critical discussions. We acknowledge the Spanish Ministry of Economy and Competitiveness and Consejo Superior de Investigaciones Científicas for both financial support under project PIE 201060E013 and provision of synchrotron radiation facilities. We would also like to thank the SpLine beamline staff for their assistance during the SR experiments. GSS and the microscopy effort were supported by the ERC starting Investigator Award, grant #239739 STEMOX. Electron microscopy observations were carried out at the Centro Nacional de Microscopía Electrónica, CNME-UCM. Part of the XRD measurements were performed at the C.A.I. de Difracción de Rayos X-UCM. Computational calculations were performed at the Supercomputing Centre of Galicia (CESGA). Author contributions: O.R.d.l.F. conceived the project and coordinated the research. B.M., I.P. and O.R.d.l.F. prepared the samples and performed the Auger and LEED measurements and the ion beam modifications. B.M., I.P., A.M., J.L.-S, O.R.d.l.F., J.R.-Z., P.F. and G.C. performed the X ray diffraction measurements. G.S.-S. and M.V. performed the STEM measurements. J.I.B. and M.C.M. carried out the Density Functional Theory calculations. All authors wrote and revised the manuscript and extensively discussed the results and their interpretation. Supplementary Information: accompanies this paper at http://www.nature.com/ naturecommunications., A plethora of technological applications justify why titanium dioxide is probably the most studied oxide, and an optimal exploitation of its properties quite frequently requires a controlled modification of the surface. Low-energy ion bombardment is one of the most extended techniques for this purpose and has been recently used in titanium oxides, among other applications, to favour resistive switching mechanisms or to form transparent conductive layers. Surfaces modified in this way are frequently described as reduced and defective, with a high density of oxygen vacancies. Here we show, at variance with this view, that high ion doses on rutile titanium dioxide (110) induce its transformation into a nanometric and single-crystalline titanium monoxide (001) thin film with rocksalt structure. The discovery of this ability may pave the way to new technical applications of ion bombardment not previously reported, which can be used to fabricate heterostructures and interfaces., Unión Europea. FP7, Ministerio de Economía y Competitividad (MINECO), España, Consejo Superior de Investigaciones Científicas (CSIC), España, ERC starting Investigator Awards, European Research Council (ERC), Depto. de Estructura de la Materia, Física Térmica y Electrónica, Fac. de Ciencias Físicas, TRUE, pub

Published
2023

15. Spanish translation of the ABC taxonomy for medication adherence.

Author

Garcia-Cardenas, V, Hughes, D, Aguilar-Palacio, I, Benrimoj, SI, Rabanaque, MJ, Martinez-Martinez, F, Malo, S, Garcia-Cardenas, V, Hughes, D, Aguilar-Palacio, I, Benrimoj, SI, Rabanaque, MJ, Martinez-Martinez, F, and Malo, S

Abstract

BACKGROUND: The Ascertaining Barriers to Compliance (ABC) taxonomy was developed aiming at systematizing definitions and operationalizations of medication adherence. Its translation is crucial to improve the generalizability, application and comparison of study findings. OBJECTIVE: To provide a consensus translation of the ABC taxonomy from English to Spanish. METHODS: A two-phased approach was used, according to the Preferred Methods for the Translation of the ABC Taxonomy for Medication Adherence. Two literature reviews were conducted: to identify Spanish synonyms and definitions of the ABC taxonomy, and to identify a panel of Spanish-speaking experts in medication adherence. A Delphi survey was designed based on the synonyms and definitions found. The experts previously identified were invited to participate in the Delphi. A consensus of ≥85% was established for the first round. A moderate consensus (50-75%), a consensus (75-95%) or a strong consensus (>95%) were considered to be necessary in the second round. RESULTS: Forty potential synonyms of the ABC taxonomy terms were identified from a total of 270 papers. The response rate during the first Delphi round was 32% (63/197) and in the second round 86% (54/63). A strong consensus was reached for the term "inicio del tratamiento" (96%) and consensus for the term "implementación" (83%). A moderate consensus was obtained for "adherencia a la medicación" (70%), "interrupción del tratamiento" (52%), "manejo de la adherencia" (54%) and "disciplinas relacionadas con la adherencia" (74%). No consensus was reached for the term persistence. Five out of the seven definitions reached a consensus in the first round, and two definitions a moderate consensus after the second round. CONCLUSION: The adoption of the Spanish taxonomy will increase transparency, comparability and transferability of results in the field of medication adherence. This may facilitate benchmarking of adherence strategies between Spanish-speaking researc

Published
2023

19. Facilitation of Insulin Effects by Ranolazine in Astrocytes in Primary Culture

Author

Jorda A, Aldasoro M, Campo-Palacio I, Vila J, Aldasoro C, Campos-Campos J, Colmena C, Singh S, Obrdor E, and Valles S

Subjects
insulin, antioxidants, inflammation, astrocytes, ranolazine
Abstract

Ranolazine (Rn) is a drug used to treat persistent chronic coronary ischemia. It has also been shown to have therapeutic benefits on the central nervous system and an anti-diabetic effect by lowering blood glucose levels; however, no effects of Rn on cellular sensitivity to insulin (Ins) have been demonstrated yet. The present study aimed to investigate the permissive effects of Rn on the actions of Ins in astrocytes in primary culture. Ins (10(-8) M), Rn (10(-6) M), and Ins + Rn (10(-8) M and 10(-6) M, respectively) were added to astrocytes for 24 h. In comparison to control cells, Rn and/or Ins caused modifications in cell viability and proliferation. Rn increased protein expression of Cu/Zn-SOD and the pro-inflammatory protein COX-2 was upregulated by Ins. On the contrary, no significant changes were found in the protein expression of NF-kappa B and I kappa B. The presence of Rn produced an increase in p-ERK protein and a significant decrease in COX-2 protein expression. Furthermore, Rn significantly increased the effects of Ins on the expression of p-AKT, p-eNOS, p-ERK, Mn-SOD, and PPAR-gamma. In addition, Rn + Ins produced a significant decrease in COX-2 expression. In conclusion, Rn facilitated the effects of insulin on the p-AKT, p-eNOS, p-ERK, Mn-SOD, and PPAR-gamma signaling pathways, as well as on the anti-inflammatory and antioxidant effects of the hormone.

Published
2022

20. 674 Niraparib as maintenance therapy in platinum-sensitive recurrent ovarian cancer: a GEICO study within the Spanish extended access program

Author

Cueva Bañuelos, JF, primary, Palacio, I, additional, Churruca, C, additional, Herrero-Ibáñez, A, additional, Pardo, B, additional, Constenla, M, additional, Santaballa, A, additional, Manso, L, additional, Estévez, P, additional, Maximiano, C, additional, Legerén, M, additional, Marquina, G, additional, De Juan, A, additional, Quindós, M, additional, Sánchez, L, additional, Barquin, A, additional, Fernández Pérez, I, additional, Martín-Lorente, C, additional, Juárez, A, additional, and González-Martín, A, additional

Published
2021
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21. Prospective Association of Maternal Educational Level with Child's Physical Activity, Screen Time, and Diet Quality

Author

Cárdenas-Fuentes G, Homs C, Ramírez-Contreras C, Juton C, Casas-Esteve R, Grau M, Aguilar-Palacio I, Fitó M, Gomez SF, and Schröder H

Subjects
prospective cohort study, sedentary behaviors, lifestyle behaviors in children, physical activity, diet quality, maternal educational level
Abstract

Evidence has identified unhealthy lifestyle behaviors as the main contributors to obesity in children, so it is essential to identify factors that could influence children's lifestyles. The objective of the present study was to analyze the association of baseline maternal educational level with child's physical activity, screen time, and dietary habits at follow-up. This community-based cohort study was carried out between 2012 and 2014 and included 1405 children aged 8 to 10 years old. Maternal educational level was used as an indicator of child's socioeconomic status. Physical activity, screen time, and dietary habits were assessed by validated questionnaires. The odds of having commercially baked goods for breakfast [OR 1.47 (95% CI 1.03 to 2.10)], going more than once a week to a fast-food restaurant [OR 1.64 (95% CI 1.20 to 2.26)], and taking sweets and candys several times a day [OR 3.23 (95% CI 2.14 to 4.87) were significantly higher among children whose mothers had a lower educational level compared to their peers whose mothers had a higher level. These associations held for taking sweets and candy several times a day after additional adjustment for the corresponding dietary behavior at baseline. Maternal educational level was inversely associated (p < 0.001) with child's screen time at follow up and being in the lowest maternal educational category was associated with an increased odds of surpassing the maximum recommended time of screen time of 120 min per day (OR (95% CI) 1.43 (1.07 to 1.90), p = 0.016). Maternal education is a predictor for unhealthy dietary habits and high screen time in children.

Published
2021

22. Pharmacological Primary Cardiovascular Prevention and Subclinical Atherosclerosis in Men: Evidence from the Aragon Workers' Health Study.

Author

Aguilar-Palacio, I, Malo, S, Jarauta, E, Moreno-Franco, B, Maldonado, L, Compés, L, Rabanaque, MJ, Casasnovas, JA, Aguilar-Palacio, I, Malo, S, Jarauta, E, Moreno-Franco, B, Maldonado, L, Compés, L, Rabanaque, MJ, and Casasnovas, JA

Abstract

The objective of this study is to describe the profile of primary preventive treatment for cardiovascular disease in adult males and to analyze the association between treatment profile and subclinical atherosclerosis. We selected male workers who had undergone ultrasound imaging and had no previous history of cardiovascular disease (n = 2138). Data on the consumption of primary cardiovascular drugs from the previous year were obtained. We performed bivariate analyses to compare patient characteristics according to cardiovascular treatment and the presence of subclinical atherosclerosis, and logistic regression models to explore the association between these two variables. Among participants with no personal history of cardiovascular disease, subclinical atherosclerosis was present in 77.7% and 31.2% had received some form of preventive treatment. Of those who received no preventive treatment, 73.6% had subclinical atherosclerosis. Cardiovascular preventive treatment was associated only with CACS > 0 (odds ratio (OR), 1.37; 95% confidence interval (95% CI), 1.06-1.78). Statin treatment was associated with a greater risk of any type of subclinical atherosclerosis (OR, 1.73) and with CACS > 0 (OR, 1.72). Subclinical atherosclerosis existed in almost 75% of men who had no personal history of cardiovascular disease and had not received preventive treatment for cardiovascular disease.

Published
2021

23. Persistence as a Robust Indicator of Medication Adherence-Related Quality and Performance.

Author

Menditto, E, Cahir, C, Malo, S, Aguilar-Palacio, I, Almada, M, Costa, E, Giardini, A, Gil Peinado, M, Massot Mesquida, M, Mucherino, S, Orlando, V, Parra-Calderón, CL, Pepiol Salom, E, Kardas, P, Vrijens, B, Menditto, E, Cahir, C, Malo, S, Aguilar-Palacio, I, Almada, M, Costa, E, Giardini, A, Gil Peinado, M, Massot Mesquida, M, Mucherino, S, Orlando, V, Parra-Calderón, CL, Pepiol Salom, E, Kardas, P, and Vrijens, B

Abstract

Medication adherence is a priority for health systems worldwide and is widely recognised as a key component of quality of care for disease management. Adherence-related indicators were rarely explicitly included in national health policy agendas. One barrier is the lack of standardised adherence terminology and of routine measures of adherence in clinical practice. This paper discusses the possibility of developing adherence-related performance indicators highlighting the value of measuring persistence as a robust indicator of quality of care. To standardise adherence and persistence-related terminology allowing for benchmarking of adherence strategies, the European Ascertaining Barriers for Compliance (ABC) project proposed a Taxonomy of Adherence in 2012 consisting of three components: initiation, implementation, discontinuation. Persistence, which immediately precedes discontinuation, is a key element of taxonomy, which could capture adherence chronology allowing the examination of patterns of medication-taking behaviour. Advances in eHealth and Information Communication Technology (ICT) could play a major role in providing necessary structures to develop persistence indicators. We propose measuring persistence as an informative and pragmatic measure of medication-taking behaviour. Our view is to develop quality and performance indicators of persistence, which requires investing in ICT solutions enabling healthcare providers to review complete information on patients' medication-taking patterns, as well as clinical and health outcomes.

Published
2021

29. 236O Olaparib (ola) plus bevacizumab (bev) as maintenance (mx) therapy in patients (pts) with newly diagnosed advanced ovarian carcinoma (OC): Japan subset of the PAOLA-1 trial

Author

Fujiwara, K., primary, Fujiwara, H., additional, Yoshida, H., additional, Satoh, T., additional, Yonemori, K., additional, Nagao, S., additional, Matsumoto, T., additional, Kobayashi, H., additional, Bourgeois, H., additional, Harter, P., additional, Mosconi, A.M., additional, Palacio, I., additional, Reinthaller, A., additional, Fujita, T., additional, Bloomfield, R., additional, Pujade-Lauraine, E., additional, and Ray-Coquard, I.L., additional

Published
2020
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30. 1118P Retrospective analysis of safety in elderly BRAF V600 mutation-positive advanced melanoma patients treated with dabrafenib (D) and trametinib (T) and correlation with non-elderly patients

Author

García-Castaño, A., primary, González-Barrallo, I., additional, Rubio, V.E. Castellón, additional, Martínez, J. Medina, additional, Mozo, J.L. Manzano, additional, Mujika, K., additional, Tarruella, M. Majem, additional, Aguado de La Rosa, C., additional, Suárez, M.A. Cabrera, additional, Palacio, I., additional, Osterloh, L., additional, and Fernandez, A. Martinez, additional

Published
2020
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36. Utilización de servicios sanitarios en ancianos (España 2006-2012): influencia del nivel de salud y de la clase social

Author

Aguilar-Palacio I, Carrera-Lasfuentes P, Solsona S, Sartolo MT, and Rabanaque MJ.

Abstract

Objetivo Conocer la utilización de servicios sanitarios de Atención Primaria (AP), Atención Especializada (AE), hospitalizaciones, Hospital de Día y Urgencias, y la hiperfrecuentación en ancianos en España, analizando la influencia del estado de salud, sexo, clase social y evolución temporal. Diseño Estudio transversal en 2 fases. Emplazamiento España. Participantes Personas encuestadas en la Encuesta Nacional de Salud 2006 y 2011-12. Mediciones principales Como variables de salud se utilizaron la salud percibida y diagnosticada (número y tipo de diagnósticos). La clase social se obtuvo a partir de la última ocupación del sustentador principal (clases manuales y no manuales). Se realizaron análisis de regresión logística, ajustando por sexo, edad, nivel de salud, clase social y año, calculando su capacidad predictiva. ResultadosEl porcentaje de población mayor que utiliza consultas médicas descendió en el periodo estudiado. Las mujeres trabajadoras manuales presentaron la mayor prevalencia de mala salud (mala salud percibida en el 2006: 70,6%). La mala salud se asoció a mayor utilización de servicios sanitarios. La salud percibida fue mejor predictor de utilización de servicios y de hiperfrecuentación que la diagnosticada, con la mayor capacidad predictiva para AE (C = 0,676). Los ancianos de clases sociales bajas utilizaron con más frecuencia AP y Urgencias, mientras que la utilización de AE y Hospital de Día fue mayor en clases altas. Conclusiones Existen diferencias en salud y utilización de servicios sanitarios en mayores según clase social. Resulta necesario prestar atención a la salud percibida como predictor de la utilización de servicios sanitarios y revisar la accesibilidad-equidad de nuestros servicios.

Published
2016

37. Treatment patterns of adjuvant interferon-alpha 2b for high-risk melanoma: a retrospective study of the Grupo Espanol Multidisciplinar de Melanoma - Prima study

Author

Espinosa, E, Soriano, V, Malvehy, J, Berrocal, A, de Prado, PM, Quindos, M, Soria, A, Marquez-Rodas, I, Palacio, I, Cerezuela, P, Lopez-Vivanco, G, Alonso, L, Samaniego, E, Ballesteros, A, Puertolas, T, Diaz-Beveridge, R, de la Cruz-Merino, L, Castro, RL, Lopez, RL, Stevinson, K, del Barrio, P, Tornamira, MV, Guillem, V, and Martin-Algarra, S

Subjects
adjuvant treatment, melanoma, tolerability, compliance, interferon-alpha 2b
Abstract

Adjuvant interferon-alpha 2b (IFN-alpha 2b) has been studied extensively in clinical trials, but there have been few studies of real-world use. The aim of this study is to describe the IFN-alpha 2b real-world patterns in patients with high-risk melanoma in Spain. This was a retrospective and multicentre chart review study of an unselected cohort of patients with melanoma at high risk for relapse (stage IIB/IIC/III) treated with IFN-alpha 2b. Patterns were assessed in terms of dose and compliance to planned treatment. A survival analysis was carried out for the full population and according to Kirkwood scheme compliance and the presence of ulceration. Of 327 patients treated with IFN-alpha 2b, 318 received a high-dose regimen following the standard Kirkwood scheme; thus, patterns are described for this regimen. A total of 121 (38%) and 88 (28%) patients had at least one dose reduction during the induction and maintenance phases, respectively. Dose delay was required in fewer than 10% of patients. A total of 78, 40 and 38% of the patients completed the induction phase, maintenance phase and completed treatment, respectively. The median progression-free and overall survival for the full population were 3.2 and 10.5 years, respectively. There were no differences in progression-free survival and overall survival according to Kirkwood scheme compliance and the presence of ulceration. The most frequent adverse events were neutropenia (31%) and fatigue (30%). High-dose IFN alpha 2b is the most frequently used regimen in Spain as an adjuvant systemic treatment for high-risk melanoma. Despite poor compliance, in this retrospective study, IFN alpha 2b treatment provided a benefit consistent with that described previously. (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

Published
2016

39. Comorbilidad como predictor de utilización de servicios sanitarios y mortalidad en pacientes con diabetes

Author

Carrera-Lasfuentes, P., Abad, J.M., Aguilar-Palacio, I., and Rabanaque, M.J.

Abstract

Las enfermedades crónicas son la principal causa de mortalidad en el mundo. El estudio de las enfermedades más prevalentes resulta fundamental, así como disponer de un indicador de frecuentación sanitaria y mortalidad para estos colectivos. El objetivo de este estudio es identificar aquella medida de comorbilidad que predice mejor la utilización de servicios sanitarios y la mortalidad de los pacientes con diabetes mellitus en nuestro medio. Métodos: Estudio longitudinal de una cohorte de pacientes diagnosticados de diabetes mellitus en 2006 en Zaragoza, seguidos hasta 2010. Se realizaron modelos predictivos de regresión logística. Como medidas de comorbilidad se utilizaron el número de diagnósticos, el número de Grupos de Diagnóstico Ambulatorio (ADG) y el número de Grupos de Diagnóstico Ambulatorio Mayores (MADG), los dos últimos del sistema ACG (Ambulatory Care Groups). Se consideró como medida de validez la mejora en la capacidad explicativa del modelo (estadístico c). Resultados: Se observó una prevalencia de diabetes mellitus del 8,8%. Tanto el número de diagnósticos como la comorbilidad se relacionaron con la utilización de servicios sanitarios y con la mortalidad. En cuanto a la mortalidad, la mejor medida de comorbilidad fue el número de MADG (c = 0,763). El modelo con las variables sexo, edad, número de MADG y número de ingresos tuvo la mayor capacidad explicativa (c = 0,818). Conclusiones: El sistema ACG permite predecir el consumo de recursos y la mortalidad de este colectivo en nuestro medio. Este estudio confirma la importante carga asistencial que generan los enfermos de diabetes mellitus y subraya la necesidad de tomar medidas al respecto.

Published
2015

40. Salud percibida y nivel educativo en España: tendencias por comunidades autónomas y sexo (2001-2012)

Author

Aguilar-Palacio, I, Carrera-Lasfuentes, P, and Rabanaque, MJ

Subjects
Social determinants of health, Educational status, Health surveys, Nivel educativo, Determinantes sociales de la salud, Encuestas de salud
Abstract

Objetivo Conocer la evolución de la prevalencia de mala salud percibida en España por comunidades autónomas (CC.AA.) para el periodo 2001-2012, las diferencias por sexo y edad, y la influencia del nivel educativo. Método Estudio transversal de la Encuesta Nacional de Salud de 2001 a 2011-12, y de la Encuesta Europea de 2009. Se realizó un estudio descriptivo por sexo, edad, nivel educativo y C.A. de residencia ajustado por edad. Se utilizaron análisis de regresión logística para estudiar la evolución temporal y conocer la asociación entre el nivel educativo y la salud percibida, calculando su capacidad predictiva mediante el estadístico C. Resultados La prevalencia de mala salud percibida fue mayor en las mujeres con nivel educativo bajo y mejoró en las de nivel educativo alto (18,6% en 2001 y 14,6% en 2012). La mayor prevalencia de mala salud percibida se observó en Andalucía, Canarias, Galicia y Murcia, con diferencias por sexo. El nivel educativo bajo se asoció con una peor salud percibida en la mayoría de las CC.AA., con buena capacidad predictiva. En todas las CC.AA., excepto Asturias, existió una mayor percepción de mala salud en las mujeres que en los hombres. En España, la prevalencia de mala salud percibida se mantuvo sin cambios en el periodo analizado, pero mejoró en Baleares, Cataluña y Madrid. Conclusiones En España existen diferencias en la prevalencia de mala salud percibida por CC.AA. Aunque no varía en el periodo analizado, se observan desigualdades en su evolución según el nivel educativo y el sexo, que podrían conllevar un aumento de las desigualdades en mujeres según el nivel educativo. Objective To identify the trend in self-rated health in Spain by autonomous communities (AC) in the period 2001-2012, as well as differences by gender and age, and the influence of educational level. Methods A cross sectional study was carried out using data from the National Health Surveys from 2001 to 2011-12 and the 2009 European Survey. A descriptive analysis was conducted that included gender, age, educational level, and the AC of residence. Logistic regression analyses were developed to explore the temporal trend and the association between educational level and self-rated health. The predictive capacity of the model was calculated using the C statistic. Results The prevalence of low self-rated health was higher in women with low educational level. Self-rated health improved in women with high educational level (2001:18.6% vs. 2012:14.6%). The highest prevalence of low self-rated health was observed in Andalusia, the Canary Islands, Galicia and Murcia, with differences by gender. Low educational level was associated with low self-rated health in most AC, with good predictive capacity. In all AC except Asturias, low self-rated health was more frequent in women than in men. In Spain, the prevalence of self-rated health showed no variations in the period analyzed and improved in the Balearic Islands, Catalonia, and Madrid. Conclusions The prevalence of self-rated health in Spain differed by AC. Although health was unchanged during the period considered, inequalities were found in its temporal trend by educational level and gender, which could lead to an increase in health inequalities in women according educational level.

Published
2015

41. Morbidity and drug consumption: comparison of results between the National Health Survey and electronic medical records

Author

Aguilar-Palacio, I., Carrera-Lasfuentes, P., Poblador-Plou, B., Prados-Torres, A., and Rabanaque-Hernández, M.J.

Subjects
Historia clínica electrónica, Consumo de fármacos, Health surveys, Prevalence, Drug utilization, Encuestas de salud, Morbilidad, Morbidity, Prevalencia, Electronic medical records
Abstract

Objetivo: Comparar la prevalencia de enfermedad y consumo de fármacos obtenida en la Encuesta Nacional de Salud (ENS) con los resultados de los registros de la historia clínica electrónica de atención primaria (HCE) y del Sistema de Información de Consumo Farmacéutico de Aragón (Farmasalud), en población adulta de la provincia de Zaragoza. Métodos: Estudio transversal para comparar la prevalencia de enfermedad obtenida en la ENS-2006 y en la HCE, y de consumo de fármacos en la ENS-2006 y Farmasalud. Se obtuvieron los intervalos de confianza del 95% (IC95%) estratificados por sexo y grupos de edad. Se comprobó la comparabilidad entre ambas poblaciones de referencia. Resultados: El 81,8% de los adultos de Zaragoza visitaron a algún médico durante 2006 según la ENS, y el 61,4% a su médico de atención primaria según la HCE. La hipertensión fue la enfermedad más prevalente en ambas fuentes de información (ENS: 21,5%, IC95%: 19,4-23,9; HCE: 21,6%, IC95%: 21,3-21,8). Las mayores diferencias entre la ENS y la HCE se observaron en la prevalencia de depresión, ansiedad u otros trastornos mentales (ENS: 10,9%; HCE: 26,6%). Los analgésicos fueron los más consumidos. La prevalencia de consumo varió según la fuente, con las mayores diferencias en los analgésicos (ENS: 23,3%; Farmasalud: 63,8%) y los antibióticos (ENS: 3,4%; Farmasalud: 41,7%). Las diferencias se mantuvieron al estratificar por sexo, y fueron mayores en el grupo de edad >75 años. Conclusiones: Hay diferencias en la prevalencia de morbilidad y en el consumo de fármacos según la fuente de información utilizada. Resulta aconsejable utilizar de manera complementaria diversas fuentes para estimar prevalencias reales en salud. Objective: To compare the prevalence of disease and drug consumption obtained by using the National Health Survey (NHS) with the information provided by the electronic medical records (EMR) in primary health care and the Pharmaceutical Consumption Registry in Aragon (Farmasalud) in the adult population in the province of Zaragoza. Methods: A cross-sectional study was performed to compare the prevalence of diseases in the NHS-2006 and in the EMR. The prevalence of drug consumption was obtained from the NHS-2006 and Farmasalud. Estimations using each database were compared with their 95% confidence intervals (95% CI) and the results were stratified by gender and age groups. The comparability of the databases was tested. Results: According to the NHS, a total of 81.8% of the adults in the province of Zaragoza visited a physician in 2006. According to the EMR, 61.4% of adults visited a primary care physician. The most prevalent disease in both databases was hypertension (NHS: 21.5%, 95% CI: 19.4-23.9; EMR: 21.6%, 95% CI: 21.3-21.8). The greatest differences between the NHS and EMR was observed in the prevalence of depression, anxiety, and other mental illnesses (NHS: 10.9%; EMR: 26.6%). The most widely consumed drugs were analgesics The prevalence of drug consumption differed in the two databases, with the greatest differences being found in pain medication (NHS: 23.3%; Farmasalud: 63.8%) and antibiotics (NHS: 3.4%; Farmasalud: 41.7%). These differences persisted after we stratified by gender and were especially important in the group aged more than 75 years. Conclusions: The prevalence of morbidity and drug consumption differed depending on the database employed. The use of different databases is recommended to estimate real prevalences.

Published
2014

44. Formation of titanium monoxide (001) single-crystalline thin film induced by ion bombardment of titanium dioxide (110)

Author

Pabón, B.M., primary, Beltrán, J.I., additional, Sánchez-Santolino, G., additional, Palacio, I., additional, López-Sánchez, J., additional, Rubio-Zuazo, J., additional, Rojo, J.M., additional, Ferrer, P., additional, Mascaraque, A., additional, Muñoz, M.C., additional, Varela, M., additional, Castro, G.R., additional, and de la Fuente, O. Rodríguez, additional

Published
2015
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45. Treatment Patterns of Adjuvant Interferon Alfa-2B (Ifn-&Agr;2B) for High-Risk Melanoma. a Retrospective Study of the Grupo Español Multidisciplinar De Melanoma (Gem)

Author

Martin-Algarra, S., primary, Soriano, V., additional, Malvehy, J., additional, Berrocal, A., additional, Quindos, M., additional, Martinez Del Prado, P., additional, Soria, A., additional, Márquez-Rodas, I., additional, Palacio, I., additional, Cerezuela, P., additional, Alonso, L., additional, López-Vivanco, G., additional, Nocea, G., additional, Stevinson, K., additional, Del Barrio, P., additional, Tornamira, M.V., additional, Guillem Porta, V., additional, and Espinosa, E., additional

Published
2014
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46. Initial stages of FeO growth on Ru(0001)

Author

Palacio, I., Monti, Matteo, Marco, J.F., McCarty, K.F., de la Figuera, Juan, Palacio, I., Monti, Matteo, Marco, J.F., McCarty, K.F., and de la Figuera, Juan

Abstract

We study how FeO wüstite films on Ru(0001) grow by oxygen-assisted molecular beam epitaxy at elevated temperatures (800-900 K). The nucleation and growth of FeO islands are observed in real time by low-energy electron microscopy (LEEM). When the growth is performed in an oxygen pressure of 10 -6 Torr, the islands are of bilayer thickness (Fe-O-Fe-O). In contrast, under a pressure of 10-8 Torr, the islands are a single FeO layer thick. We propose that the film thickness is controlled by the concentration of oxygen adsorbed on the Ru. More specifically, when monolayer growth increases the adsorbed oxygen concentration above a limiting value, its growth is suppressed. Increasing the temperature at a fixed oxygen pressure decreases the density of FeO islands. However, the nucleation density is not a monotonic function of oxygen pressure. © 2013 IOP Publishing Ltd.

Published
2013

49. Estudi de la reactivitat plaquetària en la gestació normal i en els trastorns hipertensius de l'embaràs

Author

Palacio i Riera, Montserrat, Torres i Pons, Pere-Joan, and Universitat de Barcelona. Departament d'Obstetrícia i Ginecologia, Pediatria i Radiologia i Medicina Física

Subjects
Hypertension in pregnancy, Blood platelets, Pregnancy, Embaràs, Hipertensió, Hipertensió en l'embaràs, Plaquetes sanguínies, Ciències de la Salut
Abstract

El tema sobre el qual es desenvolupa aquesta tesi doctoral és l'estudi de l'activitat plaquetària en la gestació normal i en els trastorns hipertensius de l'embaràs. La importància d'aquest tema ve donada, per una banda, per l'impacte que els trastorns hipertensius de l'embaràs tenen sobre l'Obstetrícia d'avui en dia. En un país com el nostre, els trastorns hipertensius de l'embaràs (THE) són la primera causa de morbimortalitat tant materna com fetal. Per altra banda, aquesta és una entitat clínica per la qual no disposem de diagnòstic precoç perquè desconeixem en gran part la fisiopatologia d'aquest procés.L'equilibri tromboxà-prostaciclina (TXA-PGI) i els nivells de calci intraplaquetari han estat relacionats amb la fisiopatologia d'aquest procés. Les discrepàncies presents a la literatura envers aquests paràmetres vindrien donades: l) perquè s'utilitzen diferents mètodes per valorar aquesta reactivitat ja que no disposem d'un mètode estandaritzat; 2) perquè la majoria de treballs són de disseny transversal i utilitzen diferents setmanes gestacionals, i 3) perquè els criteris de selecció de les pacients, sobre tot les del grup de THE són diferents d'un autor a l'altre.Els objectius que ens vam plantejar van ser els seguents:1.- Establir una cronologia o perfil de comportament plaquetari en el decurs de l'embaràs en la dona gestant sense patologia en cada un dels tests.2.- Establir una cronologia o perfil de comportament plaquetari en el decurs de l'embaràs en la dona gestant amb THE en cada un dels tests.3.- Comparar els dos perfils (gestació norma1-gestació patològica) per establir si hi ha diferències significatives en els tests descrits entre els dos grups de gestants.4.- Establir en quin moment cronològic de la gestació amb THE es presenten les modificacions del comportament plaquetari detectades per ambdós mètodes experimentals.5.- Desenvolupar un test de laboratori de relativa simplicitat que sigui útil per demostrar diferències en el comportament plaquetari entre els diferents grups d'estudi.6.- Calcular el valor predictiu ajustat que pot tenir aquest test en el primer o segon trimestre aplicat a la població gestant, per detectar la pacient amb risc de patir algun dels trastorns hipertensius de l'embaràs.El disseny de l'estudi i la selecció de pacients va ser la següent: En l'estudi longitudinal. es va comparar un grup de gestants normals amb un grup de no gestants. Les pacients gestants es van estudiar en el 1er.(Els mètodes utilitzats van ser els seguents:Per tant, les conclusions de l'estudi longitudinal són les següents:Test de sensibilitat a la PGEI: Es comprova que el plasma ric en plaquetes de la pacient respón adequadament a l'agregació induïda per l'AA i s'obté una corba on l'agregació és màxima als 5 minuts. Un cop comprovat això, repetiem l'agregació però afegint prèviament dosis de PGEI fins que s'aconsegueix inhibir l'agregació per sota el 20% als 5 minuts obtenint una corba com aquesta. La dosi mínima de PGEI necessària per inhibir l'agregació és la vanable que estudiem.Quant al calci intrapiaquetari: s'obté una suspensió de plaquetes a la que se li afegeix Fura2. que és un marcador fluorescent que s'uneix al calci. Podem medir així l'emissió de fluorescència de la mostra bé sigui en condicions basals o després d'afegir agonistes, trombina o vasopressina.Els diferents grups d'estudi estàven formats de 30 gestants normals en el grup control, 20 pacients formaven el grup de no gestants i 44 pacients el de THE, les quals es poden dividir en trastorns gcstacionals i crònics o proteinúrics i no proteinúrics segons els criteris de Davey i McGillivray.Resultats de l'estudi longitudinal:- En primer lloc, els resultats del Test de la Sensibilitat a la PGEI van demostrar una predominància de les pacients responedores sobre les no responedorcs en tots els trimestres de la gestació, en el postpart i en el grup no gestant.No va haver-hi diferències significatives entre els diferents trimestres de la gestació, ni entre el postpart i les no gestants.- En segon lloc, la medició del calci en condicions basals va demostrar un augment significatiu dels nivells de calci en la gestació respecte al postpart i d'aquest respecte a la població no gestant. No vam trobar diferències entre els diferents trimestres de la gestació.Quant als nivells de calci després de l'estimulació amb trombina, també es van demostrar diferències entre la gestació i el postpart, però no vam trobar diferències entre els diferents trimestres.Fínalment, els nivells de calci després de l'estimulació amb vasopressina van demostrar, per una banda, i en la mateixa línia que els altres dos paràmetres, un increment de la gestació respecte al postpart i a més, a diferència dels altres paràmetres, trobem un increment significatiu de calci en el segon trimestre.Per tant, les conclusions de l'estudi longitudinal són les següents:1. El text de sensibilitat a la PGEI no demostra canvis significatius respecte a les pacients no gestants i es manté estable durant la gestació normal. 2. El calci intraplaquetari basal està elevat a la gestació respecte a les pacients no gestants i es manté estable durant la gestació.3. El calci intraplaquetari Postrombina està elevat en la gestació respecte a les no gestants i es manté estable durant la gestació.4. El calci intraplaquetari Postvasopresina està elevat en la gestació respecte a les no gestants i augmenta en el segon trimestre de la gestació.5. Tots els paràmetres en el postpart són comparables als que presenta el grup no gestant. En l'estudi transversal els resultats van ser els següents:En el Test de Sensibilitat a la PGEI, quan comparem els resultats del grup amb THE respecte al grup control trobem un augment dramàtic de la població no responedora a cada un dels trimestres. En el postpart, la proporció de pacients no responedores és similar en el grup hipertensiu i en el control. Quan estudiem els subgrups de THE per separat, observem que aquest augment de pacients no responedores no és a expenses de cap subgrup d'hipertensió en concret.Podem aprofitar aquest canvi de patró de comportament plaquetari per utilitzar el Test de Sensibilitat a la PGEI com a test de "screening". Si comparem la S.E., el VPP i el VPN respecte a altres proves proposades com a tests pronòstics en la literatura, trobem que el Test de Sensibilitat a la PGEI presenta una bona sensibilitat i un alt VPN ajustat que ens permet descartar amb tranquilitat del grup de risc les pacients que siguin responedores a la PGEI. Per tant, suggerim que el Test de Sensibilitat a la PGEI podria ser un bon mètode de "screening".Quant al calci intracel.lular en condicions basals, la comparació de la concentració basal entre els grups control i hipertensiu, no presenta diferències significatives en cap trimestre. Si desglobem el grup hipertensiu en els diferents subgrups, tampoc trobem diferències.Pel que fa al calci posttrombina, només trobem diferències significatives entre els grups control i el de THE en el segon trimestre.Finalment, quan valorem els nivells de calci després de l'estimulació amb vasopressina, trobem un increment significatiu en tots els trimestres, el postpart inclòs.Per tant, les condicions de l'estudi transversal són les següents:1. El Test de Sensibilitat a la PGEI en el THE mostra una reducció dràstica en la sensibilitat a aquest inhibidor respecte a les gestants normals.2. Suggerim per tant utilitzar el Test de Sensibilitat a la PGEI com a test de "screening" al primer i segon trimestres en la població general per la predicció de THE.3. El Calci Intraplaquetari Basal en els THE és comparable al de les gestants normals en tots els trimestres.4. El Calci Intraplaquetari Posutrombina en THE està més elevat en el segon trimestre respecte a les gestants normals.5. El Calci Intraplaquetari Postvasopressina en els THE presenta un augment significatiu en tots els trimestres respecte a les gestants normals.6. Tots els paràmetres en el postpart són comparables als que presenten el grup gestant normal excepte en el Calci Vasopressina que està elevat., BACKGROUND: From data available in the literature, we know that platelets are very much involved in the physiopathology oftlhe hypertensive disorders of pregnancy (HDP). The prostacyclin (PGI2)-thromboxane (TXA2) balance and the intraplatelet calcium seems to be altered in the pregnant with HDP compared to the normal pregnant. Indeed, these changes appear to happen early in the pregnancy.AIM: To study changes in the platelet sensitivity to the inhibitory effect of PGEl (a prostacyclin analogue) and in the levels of intraplatelet calcium either in basal conditions or after thrombin and vasopressin simulation.DESIGN: Longitudinal study: 30 healthy pregnant women were tested at 1st, 2nd, 3rd trimesters and postpartum. The results were compared to 20 non-pregnant women. Cross sectional study: the results of 44 hypertensive pregnants were compared with the healthy pregnant group of women.METHODS: 1. Platelet sensitivity to PGE1 inhibition of the aggreggation induced by arachidonic acid was determined; 2. Basal and thrombin and vasopressin-simulated levels of intraplatelet calcium were also determined.RESULTS: Longitudinal study: The distribution between responders and non-responders to the effect of the PGE1 did not change in the pregnant women compared to the non-pregnant group. The basal and thrombin-simulated levels of intraplatelet calcium are increased in pregnant compared to the non-pregnant and remains stable through the pregnancy. When using vasopressin (a weak simulator), intrcalcium levels was increased only in the second trimester. All parameters went back to normal after 6 weeks postpartum. Cross-sectional study: hypertensive pregnant had a dramatic decrease in the sensitivity to the PGEI. Basal calcium levels did not change while when simulating with thrombin the levels in hypertensive patients increased significantly only in the 2nd trimester. When using vasopressin, the platelet intracalciun levels were increased in all trimesters.DISCUSSION: platelet sensitivity to PGE1 could be a useful test for detecting pregnant at risk for HDP. Features in the profile of the intraplatelet calcium levels suggest that calcium availability is greater in pregnancy compared to non-pregnant and even greater in the HDP patients. Second trimester seems to be the period where this change occur more dramatically.

Published
1995

50. Orientación en el tiempo y deterioro cognitivo

Author

Aguilar-Palacio I, L F Pascual-Millán, C Pérez-Lázaro, Fernández-Turrado T, Burriel-Rosello A, and Santolaria-Martinez L

Subjects
Neurology (clinical), General Medicine
Abstract

Introduccion. La orientacion temporal forma parte de la mayoria de los tests de cribado para el diagnostico de deterioro cognitivo. Una orientacion temporal correcta implica activar tanto informacion semantica (conceptos de la fecha del calendario) como episodica (recuerdo de la fecha actual). Objetivo. Evaluacion de la utilidad diagnostica de una tecnica de valoracion de la orientacion temporal, basada en una consigna abierta, y puntuacion de la informacion semantica y episodica generadas (0-10 puntos). Sujetos y metodos. Se evaluo un total de 24 sujetos sin deterioro, 77 pacientes con deterioro cognitivo leve (DCL) y 62 pacientes con demencia, mediante test minimental/miniexamen cognitivo de 30 puntos, test de fluidez verbal semantica, escala de deterioro global, orientacion temporal tipo minimental y orientacion temporal tipo abierto. Se han analizado las areas bajo la curva (aROC), sensibilidad y especificidad para la demencia y el deterioro cognitivo en cualquier grado (DCL y demencia). Resultados. La orientacion temporal tipo abierto presento la mayor area bajo la curva (aROC = 0,90) para la discriminacion entre pacientes con demencia y sin demencia (DCL y sin deterioro) y un aROC = 0,83 para discriminar entre pacientes con DCL o demencia y sin deterioro. Para la demencia, con un punto de corte igual o inferior a 6, presento una sensibilidad de 0,96 y una especificidad de 0,68, y para DCL y demencia, con un punto de corte igual o inferior a 7, una sensibilidad de 0,72 y una especificidad de 0,92. Conclusiones. Esta tecnica es adecuada como instrumento de cribado en el deterioro cognitivo por su utilidad, brevedad y posicion estrategica en la exploracion del estado mental. Presenta alta sensibilidad con baja especificidad para la demencia y baja sensibilidad con alta especificidad para el deterioro en cualquier grado.

Published
2011
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