Publicacions

CD68 and CD83 immune populations in non-metastatic axillary lymph nodes are of prognostic value for the survival and relapse of breast cancer patients

C. LOPEZ, R. BOSCH, A. KORZYNSKA, M. GARCIA-ROJO, G. BUENO, J. GARCIA-FONTGIVELL, S. GONZALEZ, A. NAVARRO, E. COLON, J. RIBES, L. ROSZKOWIAK, D. MATA, M. ARENAS, J. GOMEZ, A. ROSO, M. BERENGUER, S. REVERTE-VILLARROYA, M. LLOBERA, J. BAUCELLS and M. LEJEUNE
Aten Primaria.2022 Aug; 54(9):102437.doi:10.1007/s12282-022-01336-2 PMID:35137329

Background The foremost cause of death of breast cancer (BC) patients is metastasis, and the first site to which BC predominantly metastasizes is the axillary lymph node (ALN). Thus, ALN status is a key prognostic indicator at diagnosis. The immune system has an essential role in cancer progression and dissemination, so its evaluation in ALNs could have significant applications. In the present study we aimed to investigate the association of clinical-pathological and immune variables in the primary tumour and non-metastatic ALNs (ALNs(-)) of a cohort of luminal A and triple-negative BC (TNBC) patients with cancer-specific survival (CSS) and time to progression (TTP). Methods We analysed the differences in the variables between patients with different outcomes, created univariate and multivariate Cox regression models, validated them by bootstrapping and multiple imputation of missing data techniques, and used Kaplan-Meier survival curves for a 10-years follow-up. Results We found some clinical-pathological variables at diagnosis (tumour diameter, TNBC molecular profile and presence of ALN metastasis), and the levels of several immune markers in the two studied sites, to be associated with worse CSS and TTP. Nevertheless, only CD68 and CD83 in ALNs(-) were confirmed as independent prognostic factors for TTP. Conclusions The study identified the importance of macrophage and dendritic cell markers as prognostic factors of relapse for BC. We highlight the importance of studying the immune response in ALNs(-), which could be relevant to the prediction of BC patients’ outcome.

Previous treatment with oral anticoagulant is not a protective factor for thromboembolic events in patients with COVID-19

R. FERNANDEZ, C. URGELL, J. VICENTE and G. PERA
Aten Primaria.2022 Aug; 54(9):102437.doi:10.1016/j.aprim.2022.102371 PMID:35636020

ADAPT, a score incorporating PRO-C3, for the early detection of liver fibrosis in a large population-based study

A. MA, G. PERA, M. PEREZ, M. NIELSEN, M. KARSDAL, D. LEEMING, C. EXPOSITO, A. MARTINEZ-ESCUDE, I. GRAUPERA, M. THIELE, A. KRAG, N. FABRELLAS, L. CABALLERIA and P. GINES
Aten Primaria.2022 Aug; 54(9):102437.doi: PMID:

Neurocognitive Profile of the Post-COVID Condition in Adults in Catalonia-A Mixed Method Prospective Cohort and Nested Case-Control Study: Study Protocol

R. DACOSTA-AGUAYO, N. LAMONJA-VICENTE, C. CHACON, L. CARRASCO-RIBELLES, P. MONTERO-ALIA, A. COSTA-GARRIDO, R. GARCIA-SIERRA, V. LOPEZ-LIFANTE, E. MORENO-GABRIEL, M. MASSANELLA, J. PUIG, J. MUNOZ-MORENO, L. MATEU, A. PRATS, C. RODRIGUEZ, M. MATARO, J. PRADO, E. MARTINEZ-CACERES, C. VIOLAN and P. TORAN-MONSERRAT
Aten Primaria.2022 Aug; 54(9):102437.doi:10.3390/vaccines10060849 PMID:35746457

The diagnosis of the post-COVID condition is usually achieved by excluding other diseases; however, cognitive changes are often found in the post-COVID disorder. Therefore, monitoring and treating the recovery from the post-COVID condition is necessary to establish biomarkers to guide the diagnosis of symptoms, including cognitive impairment. Our study employs a prospected cohort and nested case-control design with mixed methods, including statistical analyses, interviews, and focus groups. Our main aim is to identify biomarkers (functional and structural neural changes, inflammatory and immune status, vascular and vestibular signs and symptoms) easily applied in primary care to detect cognitive changes in post-COVID cases. The results will open up a new line of research to inform diagnostic and therapeutic decisions with special considerations for cognitive impairment in the post-COVID condition.

Combining Virtual Reality and Machine Learning for Leadership Styles Recognition

E. PARRA, A. DELGADO, L. CARRASCO-RIBELLES, I. GIGLIOLI, J. MARIN-MORALES, C. GIGLIO and M. RAYA
Aten Primaria.2022 Aug; 54(9):102437.doi:10.3389/fpsyg.2022.864266 PMID:35712148

The aim of this study was to evaluate the viability of a new selection procedure based on machine learning (ML) and virtual reality (VR). Specifically, decision-making behaviours and eye-gaze patterns were used to classify individuals based on their leadership styles while immersed in virtual environments that represented social workplace situations. The virtual environments were designed using an evidence-centred design approach. Interaction and gaze patterns were recorded in 83 subjects, who were classified as having either high or low leadership style, which was assessed using the Multifactor leadership questionnaire. A ML model that combined behaviour outputs and eye-gaze patterns was developed to predict subjects’ leadership styles (high vs low). The results indicated that the different styles could be differentiated by eye-gaze patterns and behaviours carried out during immersive VR. Eye-tracking measures contributed more significantly to this differentiation than behavioural metrics. Although the results should be taken with caution as the small sample does not allow generalization of the data, this study illustrates the potential for a future research roadmap that combines VR, implicit measures, and ML for personnel selection.

SARS-CoV-2 infection in occupational settings in Catalonia

M. BIARNES-MARTINEZ, M. FABREGAS, E. COMA, G. PERA, F. FINA, A. RIVERA-ARCO, C. GUIRIGUET, L. MENDEZ-BOO and M. MEDINA
Aten Primaria.2022 Aug; 54(9):102437.doi: PMID:35506485

BACKGROUND // The aim of this paper was to estimate the SARS-CoV-2 infection incidence regarding the occupation in Catalonia, globally and in the different waves of the pandemic.
METHODS // We performed a retrospective cohort study. We included all people between 16 and 65 years old with an occupation identified from the sick leave recorded in the primary care electronic health records of the Institut Catala de la Salut (ICS) (total n=2,199,745 people). The study period was from March 1d, 2020 to September 16th, 2021.
RESULTS // Healthcare workers had the highest incidence, with an age and sex adjusted cumulative rate of 27.7% [95% CI: 27.3%-28.1%]:29.4% in nursing assistants, 27.3% in medical professions and 26.3% in nursing professionals; followed by the elementary occupations group with an adjusted incidence of 16.9% [95% CI:16.7%-17%] such as the agricultural laborers (23% [95% CI: 21%-25.1%]) and rural occupations (19.1% [95% CI: 18.3%19.8%) -especially during the 2020 summer period-, the domestic employees (20.5% [95% CI: 18.9%-222%]) and cleaning professionals (17.5% [95% CI:17.2%-17.9%]).
CONCLUSIONS // Healthcare workers are the hardest hit during the pandemic. On the other hand, the less qualified professions have high incidences, highlighting the different inequities in access to telework, working conditions and other social determinants of health.

Comparison between mid-nasal swabs and buccal swabs for SARS-CoV-2 detection in mild COVID-19 patients

I. BLANCO, C. VIOLAN, C. SUNER, J. GARCIA-PRIETO, M. ARGERICH, M. RODRIGUEZ-ILLANA, N. MORENO, P. CARDONA, A. BLANCO, P. TORAN-MONSERRAT, B. CLOTET, J. BONET and N. PRAT
Aten Primaria.2022 Aug; 54(9):102437.doi:10.1016/j.jinf.2022.02.008 PMID:35172195

Effect of bisphosphonate withdrawal: Follow-up of a cohort of patients

C. URGELL, J. VICENTE, R. FERNANDEZ, G. BLANCO, C. NAVAJAS, A. SISO, J. MERINO and R. LEDESMA
Aten Primaria.2022 Aug; 54(9):102437.doi: PMID:

Molecular and Brain Volume Changes Following Aerobic Exercise, Cognitive and Combined Training in Physically Inactive Healthy Late-Middle-Aged Adults: The Projecte Moviment Randomized Controlled Trial

A. CASTELLS-SANCHEZ, F. ROIG-COLL, R. DACOSTA-AGUAYO, N. LAMONJA-VICENTE, P. TORAN-MONSERRAT, G. PERA, A. GARCIA-MOLINA, J. TORMOS, P. MONTERO-ALIA, A. HERAS-TEBAR, J. SORIANO-RAYA, C. CACERES, S. DOMENECH, M. VIA, K. ERICKSON and M. MATARO
Aten Primaria.2022 Aug; 54(9):102437.doi:10.3389/fnhum.2022.854175 PMID:35529777

Behavioral interventions have shown promising neuroprotective effects, but the cascade of molecular, brain and behavioral changes involved in these benefits remains poorly understood. Projecte Moviment is a 12-week (5 days per week-45 min per day) multi-domain, single-blind, proof-of-concept randomized controlled trial examining the cognitive effect and underlying mechanisms of an aerobic exercise (AE), computerized cognitive training (CCT) and a combined (COMB) groups compared to a waitlist control group. Adherence was > 80% for 82/109 participants recruited (62% female; age = 58.38 +/- 5.47). In this study we report intervention-related changes in plasma biomarkers (BDNF, TNF-alpha, HGF, ICAM-1, SDF1-alpha) and structural-MRI (brain volume) and how they related to changes in physical activity and individual variables (age and sex) and their potential role as mediators in the cognitive changes. Our results show that although there were no significant changes in molecular biomarker concentrations in any intervention group, changes in ICAM-1 and SDF1-alpha were negatively associated with changes in physical activity outcomes in AE and COMB groups. Brain volume changes were found in the CCT showing a significant increase in precuneus volume. Sex moderated the brain volume change in the AE and COMB groups, suggesting that men may benefit more than women. Changes in molecular biomarkers and brain volumes did not significantly mediate the cognitive-related benefits found previously for any group. This study shows crucial initial molecular and brain volume changes related to lifestyle interventions at early stages and highlights the value of examining activity parameters, individual difference characteristics and using a multi-level analysis approach to address these questions.

The Tilburg Frailty Indicator: A psychometric systematic review

J. ZAMORA-SANCHEZ, A. URPI-FERNANDEZ, M. SASTRE-RUS, I. LUMILLO-GUTIERREZ, V. GEA-CABALLERO, L. JODAR-FERNANDEZ, I. JULIAN-ROCHINA and E. ZABALETA-DEL-OLMO
Aten Primaria.2022 Aug; 54(9):102437.doi:10.1016/j.arr.2022.101588 PMID:35150901

Background: The Tilburg Frailty Indicator (TFI) is one of the most prominent multidimensional frailty assessment instruments. This review aimed to critically appraise and summarise its measurement properties. Methods: Reports were eligible if they included results of studies aimed at developing the TFI or evaluating its measurement properties. We performed a literature search in MEDLINE, CINAHL, and PsycINFO databases from their inception until December 8, 2021. We also searched grey literature databases. We assessed the methodological quality of the included studies using the “COSMIN Risk of Bias”. The measurement properties were evaluated using specific criteria. We graded the quality of the evidence using a GRADE approach. Results: Sixty-three studies were included. We found moderate sufficient evidence for TFI content validity, although it is still insufficient for the comprehensiveness of its items. TFI construct validity was based on sufficient evidence from two studies of its structural validity as well as multiple hypothesis-testing for construct validity studies with inconsistent results. We did not find any studies that assessed cross-cultural validity. Only one of TFI’s three dimensions showed sufficient evidence for the internal consistency of its scores, and results in test-retest reliability were inconsistent. The TFI showed high sufficient concurrent validity with the comprehensive geriatric assessment. We identified several studies assessing its predictive validity for adverse frailty related outcomes, although most of the evidence from these studies was insufficient. We did not find any studies that assessed the responsiveness of TFI scores.

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