Villares, P. (Paula)
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- Antioxidant lifestyle, co-morbidities and quality of life empowerment concerning liver fibrosis(MDPI, 2020) Martinez, J.A. (José Alfredo); Suárez-del-Villar, R. (Rafael); Daimiel, L. (Lidia); San-Cristobal, R. (Rodrigo); Villares, P. (Paula); Martinez-Urbistondo, D. (Diego); Ramos-López, O. (Omar); Argemí, J. (Josepmaria)The assessment of liver fibrosis has gained importance since the progression of non-alcoholic fatty liver disease (NAFLD). Indeed, the description of the association between undetected liver fibrosis and lifestyle in terms of antioxidant habits, comorbidity and quality of life (QoL) domains may help in the characterization of subjects with NAFLD. A cross-sectional evaluation of (n = 116) consecutive patients from an Internal Medicine ambulatory evaluation was performed. Demographic data, lifestyle, co-morbidity, QoL (according to the SF-36 index) and analytical values to calculate the oxidative related Fibrosis-4 (FIB-4) index were recorded. The association between FIB-4 and co-morbidity, antioxidant habits in QoL was assessed in univariate analysis (p < 0.05) and confirmed in multivariable analysis for 4 of the 8 SF-36 categories: Physical QoL, Physical role, Social QoL and General QoL, as well as in the Physical summary of SF-36 (p < 0.05). Finally, interactions were assessed between co-morbidity, FIB-4 and antioxidant habits showed in the prediction of mean SF-36 (p < 0.01). Liver fibrosis assessed by the oxidative surrogate index FIB-4 is associated with the interaction between antioxidant lifestyle, co-morbidity and physical, social and general aspects of QoL in apparent liver disease-free individuals, generating a proof of concept for health empowerment and personalized medicine.
- Interactions of comorbidity and five simple environmental unhealthy habits concerning physical and mental quality of life in the clinical setting(MDPI, 2021) Martínez‑Urbistondo, D. (Diego); Suárez-del-Villar, R. (Rafael); Ramos-López, O. (Omar); Agud-Fernández, M. (María); Costa-Segovia, R. (Ramón); Domínguez, A. (Andrea); García-de-la-Garza, R. (Rocío); López-Cano-Gómez, M. (María); Prósper-Ramos, L. (Laura); San-Cristobal, R. (Rodrigo); Daimiel, L. (Lidia); Villares, P. (Paula); Martinez, J.A. (José Alfredo)The objective of this study was to examine the interactions between comorbidity and five lifestyle single habits concerning different subscales of quality of life (QoL). For the study, 302 patients were consecutively recruited at the internal medicine department of a tertiary teaching hospital. Lifestyle habits, comorbidities and QoL were recorded according to validated questionnaires. Five single unhealthy habits, such as tobacco consumption, dietary intake of ultra-processed pastries, raw nuts or carbonated drinks, sleep time and physical activity patterns were selected according to previously published data. The main outcomes of the study were the scores of the eight subscales of the SF-36 QoL survey. The aggregate of unhealthy habits showed statistically significant association to every category in the SF-36 questionnaire, both in the univariate and the multivariate analysis when adjusting by age, sex and comorbidity. An interaction was found between comorbidity and unhealthy habits in both physical and mental summaries of SF-36. In conclusion, the lifestyle assessment according to five unhealthy habits is associated with a worse QoL. The interaction between comorbidity and unhealthy habits is especially clear in diseased patients due to the interplay between illness and lifestyle in the prediction of QoL.
- Randomized phase II clinical trial of ruxolitinib plus simvastatin in COVID19 clinical outcome and cytokine evolution(Frontiers, 2023) Garcia-Donas, J. (Jesús); Martínez‑Urbistondo, D. (Diego); Villares, P. (Paula); Barquín, A. (Aranzazu); Domínguez, A. (Andrea); Rodríguez-Moreno, J.F. (Juan Francisco); Caro, E. (Elena); Suárez-del-Villar, R. (Rafael); Nistal-Villan, E. (Estanislao); Yagüe, M. (Mónica); Ortiz, M. (María); Barba, M. (María); Ruiz-Llorente, S. (Sergio); Quiralte, M. (Miguel); Zanin, M. (Massimiliano); Rodriguez, C. (Cristina); Navarro, P. (Paloma); Berraondo, P. (Pedro); Madurga, R. (Rodrigo)Background: Managing the inflammatory response to SARS-Cov-2 could prevent respiratory insufficiency. Cytokine profiles could identify cases at risk of severe disease. Methods: We designed a randomized phase II clinical trial to determine whether the combination of ruxolitinib (5 mg twice a day for 7 days followed by 10 mg BID for 7 days) plus simvastatin (40 mg once a day for 14 days), could reduce the incidence of respiratory insufficiency in COVID-19. 48 cytokines were correlated with clinical outcome. Participants: Patients admitted due to COVID-19 infection with mild disease. Results: Up to 92 were included. Mean age was 64 ± 17, and 28 (30%) were female. 11 (22%) patients in the control arm and 6 (12%) in the experimental arm reached an OSCI grade of 5 or higher (p = 0.29). Unsupervised analysis of cytokines detected two clusters (CL-1 and CL-2). CL-1 presented a higher risk of clinical deterioration vs CL-2 (13 [33%] vs 2 [6%] cases, p = 0.009) and death (5 [11%] vs 0 cases, p = 0.059). Supervised Machine Learning (ML) analysis led to a model that predicted patient deterioration 48h before occurrence with a 85% accuracy. Conclusions: Ruxolitinib plus simvastatin did not impact the outcome of COVID-19. Cytokine profiling identified patients at risk of severe COVID-19 and predicted clinical deterioration. Trial registration: https://clinicaltrials.gov/, identifier NCT04348695.