Guillen-Grima, F. (Francisco)

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    Deformaciones raquíticas de miembros inferiores en los niños congoleños
    (2008) Guillen-Grima, F. (Francisco); Aimé-Bazeboso, J. (Jacques); Echarri, J.J. (J.J.)
    Objetivo. Analizar algunos factores de riesgo en niños raquíticos congoleños con graves deformidades de miembros inferiores y describir las lesiones. Métodos. Los autores analizaron los parámetros obtenidos en una encuesta a dos grupos de niños: un grupo de 194 niños raquíticos con graves deformidades de los miembros y otro grupo control de 107 niños sanos de edades similares. Se describió el tipo de deformaciones y los grados de raquitismo. Resultados. La deformación más frecuente fue el genuvaro (58,2%), seguida del windsept (23,7%) y genuvalgo (13,9%). Entre 2-4 años el genuvaro predominó en las niñas (p=0,0025). Encontramos un raquitismo florido en el 19,1% de los casos, moderado en el 15,5%, mínimo en el 14,2% y solamente deformidades óseas sin raquitismo activo en el 41,2%. De los parámetros analizados, el factor de riesgo más importante fue ser gemelo (OR=25,43 ; 95% CI=3,76-1098,27), seguido de la falta de sol (OR=18,39, 95% CI=6,69-61,55) y tener un hermano raquítico. La alimentación con leche materna fue un factor de protección (OR=0,94, 95% CI=0,90-0,98). La prematuridad y el bajo peso al nacer no influyeron. La edad de la marcha fue de 15,4 meses en los raquíticos y de 12,4 meses en el grupo control (p<0,01). Conclusión. Las deformaciones graves de miembros inferiores secuelas de raquitismo son frecuentes, están asociadas a la gemelaridad, a la falta de sol y al destete precoz.
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    Prevalence of sleep disorders and their relationship with core symptoms of inattention and hyperactivity in children with attention-deficit/ hyperactivity disorder
    (Elsevier, 2016) Sanchez-Carpintero, R. (Rocío); Guillen-Grima, F. (Francisco); Crespo-Eguilaz, N. (Nerea); Vélez-Galarraga, M.R. (María del Rosario)
    Objectives: To determine the prevalence of sleep disorders in children with attention-deficit/hyperactivity disorder (ADHD) and in a control population. To examine the relationship between sleep disorders and symptoms of inattention, hyperactivity/impulsiveness and executive dysfunction. Materials and methods: We studied 126 children with ADHD and 1036 control children aged between 5 and 18 years old. Caregivers completed the Pediatric Sleep Questionnaire and the ADHD Rating Scale (ADHD-RS). Children with ADHD were subsequently assessed for executive function with the Conner's Continuous Performance Test (CPT) or with AULA Nesplora. Results: Children with ADHD slept less at night and were more likely to display sleep-related rhythmic movements. Children in the ADHD group who were under 12 years old and who had total ADHD-RS scores over the 90th percentile had more difficulty falling asleep than other children; there was also a relationship between total ADHD-RS scores over the 90th percentile and certain parasomnias in the control population. There was a correlation between shorter duration of night-time sleep and omission errors in children who were 12 or older and who were under pharmacological treatment for ADHD. Bedtime resistance and difficulty falling sleep were more frequent in children with ADHD whose symptoms were not treated pharmacologically, than in children receiving treatment. Interpretation: Symptoms of inattention and hyperactivity are correlated with impaired sleep duration and quality; specifically, there is an association between ADHD symptoms and problems falling asleep and parasomnias, however, the current study does not address the nature and direction of causality. Children with ADHD and receiving methylphenidate had fewer sleep disorders, suggesting that, at least in some children, stimulant treatment is associated with improvement of some aspects of sleep. Shorter sleep duration in adolescents under pharmacological treatment for ADHD tended to result in more errors of omission, suggesting that it is important to promote good sleep habits in this population.
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    Chromosomal abnormalities clustering in multiple myeloma reveals cytogenetic subgroups with nonrandom acquisition of chromosomal changes
    (Nature Publishing Group, 2004) Cigudosa, J.C. (Juan Cruz); Guillen-Grima, F. (Francisco); Harder, L. (Lana); Siebert, R. (Reiner); Prosper-Cardoso, F. (Felipe); Calasanz-Abinzano, M.J. (Maria Jose); Odero, M.D. (Maria Dolores); Martin-Subero, J.I. (Jose Ignacio); Saez, B. (Borja)
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    Self-reported drinking and driving amongst educated adults in Spain: The "Seguimiento Universidad de Navarra" (SUN) cohort findings
    (BioMed Central, 2007) Martinez-Gonzalez, M.A. (Miguel Ángel); Segui-Gomez, M. (María); Irala, J. (Jokin) de; Palma, S. (Silvia); Guillen-Grima, F. (Francisco)
    Background: The role of alcohol as a risk factor for motor vehicle crashes is long known. Yet, reports on the prevalence of drinking and driving suggest values between 20%–30% when the adult driving population is interviewed. We wondered whether these values hold true among European educated citizens and whether there are any significant differences in prevalence by age, gender, type of profession and other lifestyle indicators. Methods: Cross-sectional analyses of baseline data from a cohort of university graduates in Spain (SUN study). Answered questionnaires contained items on current drinking and driving practices, together with data on socio-demographic characteristics and lifestyle habits. Chi square, Fisher test, and multivariate logistic regression were used to investigate the impact of several variables on drinking and driving practices. Analyses were stratified by gender. Results: Almost 30% of the participants reported "sometimes" drinking and driving. This percent increased to 47% when "almost never" was also included as a positive answer to the drinking and driving practice question. These percentages varied significantly by gender, with up to 64% of men reporting "sometimes" or "almost never" vs. 36% of women doing so. Drinking and driving practices also differed by overall alcohol consumption habits, smoking, use of safety belts, and notably, type of profession. Conclusion: Our findings are amongst the first on the high prevalence of drinking and driving among Spanish. Particularly worrisome is the fact that health professionals reported this habit even at higher rates. Multidisciplinary interventions (e.g., legal, educational, economic) are needed to reduce this serious health risk.
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    Physical activity and sex modulate obesity risk linked to 3111T/C gene variant of the CLOCK gene in an elderly population: the SUN Project
    (Informa Healthcare, 2012) Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Galbete, C. (Cecilia); Contreras, R. (Rafael); Guillen-Grima, F. (Francisco); Marti-del-Moral, A. (Amelia)
    Genetic factors may interact with physical activity levels to modify obesity risk. Our aim was to explore the effect of rs1801260 SNP (3111T/C) of CLOCK gene, on obesity risk and to examine their interaction with lifestyle factors in an elderly population of the SUN Project. Subjects (n=903, aged 69±6) were recruited from the SUN (“Seguimiento Universidad de Navarra”) Project. DNA was obtained from saliva and lifestyle and dietary data were collected by validated self-reported questionnaires. Genotyping was assessed by RT-PCR plus allele discrimination. A significant interaction between the 3111T/C SNP of CLOCK gene and sex for overweight/obesity risk was observed (p for interaction [Sex*CLOCK] interaction <0.001). Our results showed that women carrying the C allele of CLOCK gene had a decreased overweight/obesity risk compared to non carrier -TT- subjects (OR 0.61, 95% CI: 0.36-1.04, p=0.069). Moreover, the protective effect of the 3111T/C gene variant may be enhanced in those women with a high physical activity practice. We found that women practicing more than 16.8 METs- h/week had a significantly lower overweight/obesity risk (OR 0.36, 95%CI: 0.17-0.79, p=0.011). A significant interaction between the 3111T/C gene variant and physical activity for overweight/obesity risk was observed in women (p for [PA x CLOCK] interaction=0.015). In conclusion, it appears that physical activity levels may act as an effect modifier for overweight/obesity risk linked to the 3111T/C SNP (rs1801260) of the CLOCK gene in an elderly population of the SUN Project.
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    Performance of SAPS3, compared with APACHE II and SOFA, to predict hospital mortality in a general ICU in Southern Europe
    (Wolters Kluwer, 2009) Vives, M. (Marc); Yepes, M.J. (María J.); Mbongo, C. (C.); Monedero, P. (Pablo); Guillen-Grima, F. (Francisco); Echarri, G. (Gemma)
    Background and objective Simplified Acute Physiology Score (SAPS3) has not been validated in Southern European countries. The purpose of this study was to validate the ability of SAPS3 to predict hospital mortality in adult patients in an interdisciplinary intensive care unit in Southern Europe, compared with Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA). Methods This is a cohort study of 864 patients with a prospective collection of SAPS3 and SOFA variables and retrospective analysis of APACHE II in a mixed intensive care unit at a teaching hospital in Spain throughout 2006. The performance of the systems was determined by examining their discrimination and calibration. Results The discrimination of SAPS3 was excellent, with an area under the receiver operating characteristic curve of 0.916, similar to APACHE II (area under the receiver operating characteristic curve = 0.893) or SOFA (area under the receiver operating characteristic curve = 0.846). The calibration was good for SAPS3 but insufficient for APACHE II. Hospital death rates were lower than those that were predicted by the models. Conclusion Our data demonstrate a better calibration of SAPS3 than APACHE II. Calibration was sufficient only for SAPS3. Hospital mortality was lower than predicted by both models. The discrimination of SAPS3 is excellent, and, when it is customized for Southern Europe, SAPS3 accurately predicts mortality risk in our adult mixed-case ICU.
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    Identification of TNF-alpha and MMP-9 as potential baseline predictive serum markers of sunitinib activity in patients with renal cell carcinoma using a human cytokine array
    (Nature Publishing Group, 2009) Gil-Bazo, I. (Ignacio); Prior, C. (Celia); Perez-Gracia, J.L. (Jose Luis); Gonzalez-Hernandez, A. (Alvaro); Gurpide, A. (Alfonso); Guillen-Grima, F. (Francisco); Melero, I. (Ignacio); Panizo, A. (Ángel); Grande-Pulido, E. (E.); Segura, V. (Víctor); Calvo-González, A. (Alfonso)
    BACKGROUND: Several drugs are available to treat metastatic renal-cell carcinoma (MRCC), and predictive markers to identify the most adequate treatment for each patient are needed. Our objective was to identify potential predictive markers of sunitinib activity in MRCC. METHODS: We collected sequential serum samples from 31 patients treated with sunitinib. Sera of six patients with extreme phenotypes of either marked responses or clear progressions were analysed with a Human Cytokine Array which evaluates 174 cytokines before and after treatment. Variations in cytokine signal intensity were compared between both groups and the most relevant cytokines were assessed by ELISA in all the patients. RESULTS: Twenty-seven of the 174 cytokines varied significantly between both groups. Five of them (TNF-alpha, MMP-9, ICAM-1, BDNF and SDF-1) were assessed by ELISA in 21 evaluable patients. TNF-alpha and MMP-9 baseline levels were significantly increased in non-responders and significantly associated with reduced overall survival and time-to-progression, respectively. The area under the ROC curves for TNF-alpha and MMP-9 as predictive markers of sunitinib activity were 0.83 and 0.77. CONCLUSION: Baseline levels of TNF-alpha and MMP-9 warrant further study as predictive markers of sunitinib activity in MRCC. Selection of patients with extreme phenotypes seems a valid method to identify potential predictive factors of response.
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    Placebo-controlled trial of nimodipine in the treatment of acute ischemic cerebral infarction
    (American Heart Association, 1990) Matias-Guiu, J. (Jordi); Martinez-Lage, J.M. (José M.); Villanueva, J.A. (José A.); Guillen-Grima, F. (Francisco); Martinez-Vila, E. (Eduardo); Bigorra, J. (Joan); Carbonell, A. (Antonio); Gil, P. (Pedro)
    Nimodipine is a 1,4-dihydropyridine derivative that shows a preferential cerebrovascular activity in experimental animals. Clinical data suggest that nimodipine has a beneficial effect on the neurologic outcome of patients suffering an acute ischemic stroke. Our double-blind placebo-controlled multicenter trial was designed to assess the effects of oral nimodipine on the mortality rate and neurologic outcome of patients with an acute ischemic stroke. One hundred sixty-four patients were randomly allocated to receive either nimodipine tablets (30 mg q.i.d.) or identical placebo tablets for 28 days. Treatment was always started less than or equal to 48 hours after the acute event. The Mathew Scale, slightly modified by Gelmers et al, was used for neurologic assessment. Mortality rate and neurologic outcome after 28 days were used as evaluation criteria. We considered 123 patients to be valid for the analysis of efficacy. Mortality rates did not differ significantly between groups. Neurologic outcome after 28 days of therapy did not differ between groups. However, when only those patients most likely to benefit from any intervention (Mathew Scale sum score of less than or equal to 65 at baseline) were analyzed separately in post hoc-defined subgroups, the nimodipine-treated subgroups showed a significantly better neurologic outcome. This result suggests that some patients with acute ischemic stroke will benefit from treatment with nimodipine tablets.
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    Modification of breast cancer milieu with chemotherapy plus dendritic cell vaccine: an approach to select best therapeutic strategies
    (2023) Hato-Álvaro, L. (Laura); Espinos, J. (Jaime); Lozano, M.D. (María Dolores); Pérez-Solans, B. (Belén); Lopez-Diaz-de-Cerio, A. (Ascensión); Córdoba-Iturriagagoitia, A. (Alicia); Santisteban, M. (Marta); Inoges, S. (Susana); Guillen-Grima, F. (Francisco); Mejías-Sosa, L.D. (Luis D.); Idoate, M.A. (Miguel Ángel); Sala-Elarre, P. (Pablo); Cruz, S. (S.) de la; López-Janeiro, Á. (Álvaro)
    Background: The addition of dendritic cell vaccines (DCV) to NAC could induce immune responses in those patients with residual disease (RD) by transforming the tumor microenvironment. Methods: Core diagnostic biopsies and surgical specimens from 80 patients (38 in the vaccinated group plus NAC (VG) and 42 in the control group (CG, treated only with NAC) were selected. We quantify TILs (CD8, CD4 and CD45RO) using immunohistochemistry and the automated cellular imaging system (ACIS III) in paired samples. Results: A CD8 rise in TNBC samples was observed after NAC plus DCV, changing from 4.48% in the biopsy to 6.70% in the surgical specimen, not reaching statistically significant differences (p = 0.11). This enrichment was seen in up to 67% of TNBC patients in the experimental arm as compared with the CG (20%). An association between CD8 TILs before NAC (4% cut-off point) and pathological complete response in the VG was found in the univariate and multivariate analysis (OR = 1.41, IC95% 1.05-1.90; p = 0.02, and OR = 2.0, IC95% 1.05-3.9; p = 0.03, respectively). Conclusion: Our findings suggest that patients with TNBC could benefit from the stimulation of the antitumor immune system by using DCV together with NAC.
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    Coverage and development of specialist palliative care services across the World Health Organization European Region (2005-2012): Results from a European Association for Palliative Care Task Force survey of 53 countries
    (SAGE, 2015-07-31) Garralda, E. (Eduardo); Centeno, C. (Carlos); Carrasco-Gimeno, J.M. (José Miguel); Guillen-Grima, F. (Francisco); Lynch, T. (Thomas); Clark, D. (David)
    BACKGROUND:The evolution of the provision of palliative care specialised services is important for planning and evaluation. AIM: To examine the development between 2005 and 2012 of three specialised palliative care services across the World Health Organization European Region - home care teams, hospital support teams and inpatient palliative care services. DESIGN AND SETTING: Data were extracted and analysed from two editions of the European Association for Palliative Care Atlas of Palliative Care in Europe. Significant development of each type of services was demonstrated by adjusted residual analysis, ratio of services per population and 2012 coverage (relationship between provision of available services and demand services estimated to meet the palliative care needs of a population). For the measurement of palliative care coverage, we used European Association for Palliative Care White Paper recommendations: one home care team per 100,000 inhabitants, one hospital support team per 200,000 inhabitants and one inpatient palliative care service per 200,000 inhabitants. To estimate evolution at the supranational level, mean comparison between years and European sub-regions is presented. RESULTS: Of 53 countries, 46 (87%) provided data. Europe has developed significant home care team, inpatient palliative care service and hospital support team in 2005-2012. The improvement was statistically significant for Western European countries, but not for Central and Eastern countries. Significant development in at least a type of services was in 21 of 46 (46%) countries. The estimations of 2012 coverage for inpatient palliative care service, home care team and hospital support team are 62%, 52% and 31% for Western European and 20%, 14% and 3% for Central and Eastern, respectively. CONCLUSION: Although there has been a positive development in overall palliative care coverage in Europe between 2005 and 2012, the services available in most countries are still insufficient to meet the palliative care needs of the population.