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Francisco Gude-Sampedro
Clinical Epidemiology Unit, Research Methods Group, Santiago Institute of Sanitary Research (IDIS), Complejo Hospitalario Universitario de Santiago, Travesía da Choupana, s/n, 157056 Santiago de Compostela, Spain

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Journal article
Published: 28 May 2021 in International Journal of Environmental Research and Public Health
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Introduction: We evaluated the effectiveness of an individual, group and community intervention to improve the glycemic control of patients with diabetes mellitus aged 45–75 years with two or three unhealthy life habits. As secondary endpoints, we evaluated the inverventions’ effectiveness on adhering to Mediterranean diet, physical activity, sedentary lifestyle, smoking and quality of life. Method: A randomized clinical cluster (health centers) trial with two parallel groups in Spain from January 2016 to December 2019 was used. Patients with diabetes mellitus aged 45–75 years with two unhealthy life habits or more (smoking, not adhering to Mediterranean diet or little physical activity) participated. Centers were randomly assigned. The sample size was estimated to be 420 people for the main outcome variable. Educational intervention was done to improve adherence to Mediterranean diet, physical activity and smoking cessation by individual, group and community interventions for 12 months. Controls received the usual health care. The outcome variables were: HbA1c (main), the Mediterranean diet adherence score (MEDAS), the international diet quality index (DQI-I), the international physical activity questionnaire (IPAQ), sedentary lifestyle, smoking ≥1 cigarette/day and the EuroQuol questionnaire (EVA-EuroQol5D5L). Results: In total, 13 control centers (n = 356) and 12 intervention centers (n = 338) were included with similar baseline conditions. An analysis for intention-to-treat was done by applying multilevel mixed models fitted by basal values and the health center: the HbA1c adjusted mean difference = −0.09 (95% CI: −0.29–0.10), the DQI-I adjusted mean difference = 0.25 (95% CI: −0.32–0.82), the MEDAS adjusted mean difference = 0.45 (95% CI: 0.01–0.89), moderate/high physical activity OR = 1.09 (95% CI: 0.64–1.86), not living a sedentary lifestyle OR = 0.97 (95% CI: 0.55–1.73), no smoking OR = 0.61 (95% CI: 0.54–1.06), EVA adjusted mean difference = −1.26 (95% CI: −4.98–2.45). Conclusions: No statistically significant changes were found for either glycemic control or physical activity, sedentary lifestyle, smoking and quality of life. The multicomponent individual, group and community interventions only showed a statistically significant improvement in adhering to Mediterranean diet. Such innovative interventions need further research to demonstrate their effectiveness in patients with poor glycemic control.

ACS Style

Francisco Represas-Carrera; Sabela Couso-Viana; Fátima Méndez-López; Bárbara Masluk; Rosa Magallón-Botaya; Jose Recio-Rodríguez; Haizea Pombo; Alfonso Leiva-Rus; Montserrat Gil-Girbau; Emma Motrico; Ruth Martí-Lluch; Francisco Gude; Ana Clavería. Effectiveness of a Multicomponent Intervention in Primary Care That Addresses Patients with Diabetes Mellitus with Two or More Unhealthy Habits, Such as Diet, Physical Activity or Smoking: Multicenter Randomized Cluster Trial (EIRA Study). International Journal of Environmental Research and Public Health 2021, 18, 5788 .

AMA Style

Francisco Represas-Carrera, Sabela Couso-Viana, Fátima Méndez-López, Bárbara Masluk, Rosa Magallón-Botaya, Jose Recio-Rodríguez, Haizea Pombo, Alfonso Leiva-Rus, Montserrat Gil-Girbau, Emma Motrico, Ruth Martí-Lluch, Francisco Gude, Ana Clavería. Effectiveness of a Multicomponent Intervention in Primary Care That Addresses Patients with Diabetes Mellitus with Two or More Unhealthy Habits, Such as Diet, Physical Activity or Smoking: Multicenter Randomized Cluster Trial (EIRA Study). International Journal of Environmental Research and Public Health. 2021; 18 (11):5788.

Chicago/Turabian Style

Francisco Represas-Carrera; Sabela Couso-Viana; Fátima Méndez-López; Bárbara Masluk; Rosa Magallón-Botaya; Jose Recio-Rodríguez; Haizea Pombo; Alfonso Leiva-Rus; Montserrat Gil-Girbau; Emma Motrico; Ruth Martí-Lluch; Francisco Gude; Ana Clavería. 2021. "Effectiveness of a Multicomponent Intervention in Primary Care That Addresses Patients with Diabetes Mellitus with Two or More Unhealthy Habits, Such as Diet, Physical Activity or Smoking: Multicenter Randomized Cluster Trial (EIRA Study)." International Journal of Environmental Research and Public Health 18, no. 11: 5788.

Journal article
Published: 07 April 2021 in Nutrients
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The Atlantic diet, the traditional dietary pattern in northern Portugal and northwest Spain, has been related to metabolic health and low ischemic heart disease mortality. The Galiat Study is a randomized controlled trial aimed to assess the effects of the Atlantic diet on anthropometric variables, metabolic profile, and nutritional habits. The dietary intervention was conducted in 250 families (720 adults and children) and performed at a primary care center. Over six months, families randomized to the intervention group received educational sessions, cooking classes, written supporting material, and foods that form part of the Atlantic diet, whereas those randomized to the control group followed their habitual lifestyle. 213 families (92.4%) completed the trial. Adults in the intervention group lost weight as opposed to controls who gained weight (adjusted mean difference −1.1 kg, p < 0.001) and total serum cholesterol (adjusted mean difference −5.2 mg/dL, p = 0.004). Significant differences in favor of the intervention were found in other anthropometric variables and low-density lipoprotein cholesterol, but changes in triglycerides, high-density lipoprotein cholesterol, inflammation markers, blood pressure, and glucose metabolism were not observed. A family-based nutritional intervention based on the Atlantic diet showed beneficial effects on adiposity and the lipid profile.

ACS Style

Mar Calvo-Malvar; Alfonso Benítez-Estévez; Juan Sánchez-Castro; Rosaura Leis; Francisco Gude. Effects of a Community-Based Behavioral Intervention with a Traditional Atlantic Diet on Cardiometabolic Risk Markers: A Cluster Randomized Controlled Trial (“The GALIAT Study”). Nutrients 2021, 13, 1211 .

AMA Style

Mar Calvo-Malvar, Alfonso Benítez-Estévez, Juan Sánchez-Castro, Rosaura Leis, Francisco Gude. Effects of a Community-Based Behavioral Intervention with a Traditional Atlantic Diet on Cardiometabolic Risk Markers: A Cluster Randomized Controlled Trial (“The GALIAT Study”). Nutrients. 2021; 13 (4):1211.

Chicago/Turabian Style

Mar Calvo-Malvar; Alfonso Benítez-Estévez; Juan Sánchez-Castro; Rosaura Leis; Francisco Gude. 2021. "Effects of a Community-Based Behavioral Intervention with a Traditional Atlantic Diet on Cardiometabolic Risk Markers: A Cluster Randomized Controlled Trial (“The GALIAT Study”)." Nutrients 13, no. 4: 1211.

Research article
Published: 24 March 2021 in Statistical Methods in Medical Research
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Biosensor data have the potential to improve disease control and detection. However, the analysis of these data under free-living conditions is not feasible with current statistical techniques. To address this challenge, we introduce a new functional representation of biosensor data, termed the glucodensity, together with a data analysis framework based on distances between them. The new data analysis procedure is illustrated through an application in diabetes with continuous-time glucose monitoring (CGM) data. In this domain, we show marked improvement with respect to state-of-the-art analysis methods. In particular, our findings demonstrate that (i) the glucodensity possesses an extraordinary clinical sensitivity to capture the typical biomarkers used in the standard clinical practice in diabetes; (ii) previous biomarkers cannot accurately predict glucodensity, so that the latter is a richer source of information and; (iii) the glucodensity is a natural generalization of the time in range metric, this being the gold standard in the handling of CGM data. Furthermore, the new method overcomes many of the drawbacks of time in range metrics and provides more in-depth insight into assessing glucose metabolism.

ACS Style

Marcos Matabuena; Alexander Petersen; Juan C Vidal; Francisco Gude. Glucodensities: A new representation of glucose profiles using distributional data analysis. Statistical Methods in Medical Research 2021, 30, 1445 -1464.

AMA Style

Marcos Matabuena, Alexander Petersen, Juan C Vidal, Francisco Gude. Glucodensities: A new representation of glucose profiles using distributional data analysis. Statistical Methods in Medical Research. 2021; 30 (6):1445-1464.

Chicago/Turabian Style

Marcos Matabuena; Alexander Petersen; Juan C Vidal; Francisco Gude. 2021. "Glucodensities: A new representation of glucose profiles using distributional data analysis." Statistical Methods in Medical Research 30, no. 6: 1445-1464.

Scientific letter
Published: 23 March 2021 in Archivos de Bronconeumología
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ACS Style

Nuria Rodríguez-Núñez; Francisco Gude; Adriana Lama; Carlos Rábade; Alfonso Varela; Romina Abelleira; Ana Casal; Vanessa Riveiro; Manuel Taboada; Antonio Pose; Luis Valdés. Health Indicators in Hospitalized Patients With SARS-CoV-2 Pneumonia: A Comparison Between the First and Second Wave. Archivos de Bronconeumología 2021, 1 .

AMA Style

Nuria Rodríguez-Núñez, Francisco Gude, Adriana Lama, Carlos Rábade, Alfonso Varela, Romina Abelleira, Ana Casal, Vanessa Riveiro, Manuel Taboada, Antonio Pose, Luis Valdés. Health Indicators in Hospitalized Patients With SARS-CoV-2 Pneumonia: A Comparison Between the First and Second Wave. Archivos de Bronconeumología. 2021; ():1.

Chicago/Turabian Style

Nuria Rodríguez-Núñez; Francisco Gude; Adriana Lama; Carlos Rábade; Alfonso Varela; Romina Abelleira; Ana Casal; Vanessa Riveiro; Manuel Taboada; Antonio Pose; Luis Valdés. 2021. "Health Indicators in Hospitalized Patients With SARS-CoV-2 Pneumonia: A Comparison Between the First and Second Wave." Archivos de Bronconeumología , no. : 1.

Original article
Published: 21 March 2021 in Journal of Arrhythmia
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Introduction The benefit of cardiac resynchronization therapy (CRT) in heart failure (HF) patients with reduced left ventricular ejection fraction (LVEF) have been observed in the first year. However, there are few data on long‐term follow‐up and the effect of changes of LVEF on mortality. This study aimed to assess the LV remodeling after CRT implantation and the probable effect of changes in LVEF with repeated measures on mortality over time in a real‐world registry. Methods Among our cohort of 328 consecutive CRT patients, mixed model effect analysis have been made to describe the temporal evolution of LVEF and LVESV changes over time up with several explanatory variables. Besides, the effect of LVEF along time on the probability of mortality was evaluated using joint modeling for longitudinal and survival data. Results The study population included 328 patients (253 men; 70.2 ± 9.5 years) in 4.2 (2.9) years follow‐up. There was an increase in LVEF of 11% and a reduction in LVESV of 42 mL during the first year. These changes are more important during the first year, but slight changes remain during the follow‐up. The largest reduction in LVESV occurred in patients with left bundle branch block (LBBB) and the smallest reduction in patients with NYHA IV. The smallest increase in LVEF was an ischemic etiology, longer QRS, and LV electrode in a nonlateral vein. Besides, the results showed that the LVEF profiles taken during follow‐up after CRT were associated with changes in the risk of death. Conclusion Reverse remodeling of the left ventricle is observed especially during the first year, but it seems to be maintained later after CRT implantation in a contemporary cohort of patients. Longitudinal measurements could give us additional information at predicting the individual mortality risk after adjusting by age and sex compared to a single LVEF measurement after CRT.

ACS Style

Belén Alvarez‐Alvarez Md; Javier García‐Seara Md; Jose L. Martínez‐Sande Md; Moisés Rodríguez‐Mañero Md; Xesús A. Fernández López; Laila González‐Melchor; Diego Iglesias‐Alvarez; Francisco Gude Md; Carla Díaz‐Louzao. Long‐term cardiac reverse remodeling after cardiac resynchronization therapy. Journal of Arrhythmia 2021, 37, 653 -659.

AMA Style

Belén Alvarez‐Alvarez Md, Javier García‐Seara Md, Jose L. Martínez‐Sande Md, Moisés Rodríguez‐Mañero Md, Xesús A. Fernández López, Laila González‐Melchor, Diego Iglesias‐Alvarez, Francisco Gude Md, Carla Díaz‐Louzao. Long‐term cardiac reverse remodeling after cardiac resynchronization therapy. Journal of Arrhythmia. 2021; 37 (3):653-659.

Chicago/Turabian Style

Belén Alvarez‐Alvarez Md; Javier García‐Seara Md; Jose L. Martínez‐Sande Md; Moisés Rodríguez‐Mañero Md; Xesús A. Fernández López; Laila González‐Melchor; Diego Iglesias‐Alvarez; Francisco Gude Md; Carla Díaz‐Louzao. 2021. "Long‐term cardiac reverse remodeling after cardiac resynchronization therapy." Journal of Arrhythmia 37, no. 3: 653-659.

Journal article
Published: 11 March 2021 in International Journal of Clinical and Health Psychology
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Background/Objective ‘Third-wave’ psychotherapies have shown effectiveness for treating psychopathological symptoms such as anxiety and depression. There is burgeoning interest in examining how these therapies’ core constructs produce their therapeutic benefits. This study explores the hypothetical mediating effect of resilience in the impact of mindfulness and self-compassion on anxiety and depressive symptoms. Method: Cross-sectional study design. The sample consisted of 860 Spanish general population participants. The measures included the Mindful Attention Awareness Scale (MAAS), the Self-Compassion Scale (SCS-12), the Connor-Davidson Resilience Scale (CD-RISC) and the Goldberg Anxiety and Depression Scale (GADS). Bivariate correlations were calculated, and path analysis models were performed. Results: Significant correlations were found between the study variables, always in the expected direction (all p values <.001). The path analysis models showed significant direct effects of mindfulness and self-compassion on anxiety and depression symptoms, but the only significant indirect effects through resilience were found on depression (MAAS: β = -.05, 95% CI = -.11 to -.02; SCS-12: β = -.06, 95% CI = -.33 to -.07). Conclusions: Resilience might partially mediate the effect of mindfulness and self-compassion on depression, but not on anxiety. Antecedentes/Objetivo: Las terapias de “tercera generación” han probado ser eficaces para tratar síntomas psicopatológicos como la ansiedad y la depresión. Hay un interés creciente en examinar cómo los constructos nucleares de estas terapias producen beneficios terapéuticos. Este estudio explora el hipotético efecto mediador de la resiliencia en la relación del mindfulness y la autocompasión sobre los síntomas de ansiedad y depresión. Método: Estudio de diseño transversal. Muestra formada por 860 participantes españoles de la población general. Las medidas incluidas fueron: MAAS, SCS-12, CD-RISC y GADS. Se calcularon correlaciones bivariadas y se realizaron modelos de análisis del camino. Resultados: Se hallaron correlaciones significativas entre las variables, siempre en la dirección esperada (p < 0,001). El modelo de análisis del camino mostró efectos directos significativos de mindfulness y autocompasión sobre síntomas de ansiedad y depresión, pero el único efecto indirecto significativo a través de la resiliencia se encontró en depresión (MAAS: β = -0,05, 95% CI = -0,11 ‒ -0,02; SCS-12: β = -0,06, 95% CI = -0,33 ‒ -0,07). Conclusiones: La resiliencia puede mediar parcialmente el efecto de mindfulness y autocompasión sobre la depresión, pero no sobre la ansiedad.

ACS Style

Adrián Pérez-Aranda; Javier García-Campayo; Francisco Gude; Juan V. Luciano; Albert Feliu-Soler; Arturo González-Quintela; Yolanda López-Del-Hoyo; Jesus Montero-Marin. Impact of mindfulness and self-compassion on anxiety and depression: The mediating role of resilience. International Journal of Clinical and Health Psychology 2021, 21, 100229 .

AMA Style

Adrián Pérez-Aranda, Javier García-Campayo, Francisco Gude, Juan V. Luciano, Albert Feliu-Soler, Arturo González-Quintela, Yolanda López-Del-Hoyo, Jesus Montero-Marin. Impact of mindfulness and self-compassion on anxiety and depression: The mediating role of resilience. International Journal of Clinical and Health Psychology. 2021; 21 (2):100229.

Chicago/Turabian Style

Adrián Pérez-Aranda; Javier García-Campayo; Francisco Gude; Juan V. Luciano; Albert Feliu-Soler; Arturo González-Quintela; Yolanda López-Del-Hoyo; Jesus Montero-Marin. 2021. "Impact of mindfulness and self-compassion on anxiety and depression: The mediating role of resilience." International Journal of Clinical and Health Psychology 21, no. 2: 100229.

Journal article
Published: 08 December 2020 in International Journal of Epidemiology
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Background The prognosis of patients with COVID-19 infection is uncertain. We derived and validated a new risk model for predicting progression to disease severity, hospitalization, admission to intensive care unit (ICU) and mortality in patients with COVID-19 infection (Gal-COVID-19 scores). Methods This is a retrospective cohort study of patients with COVID-19 infection confirmed by reverse transcription polymerase chain reaction (RT-PCR) in Galicia, Spain. Data were extracted from electronic health records of patients, including age, sex and comorbidities according to International Classification of Primary Care codes (ICPC-2). Logistic regression models were used to estimate the probability of disease severity. Calibration and discrimination were evaluated to assess model performance. Results The incidence of infection was 0.39% (10 454 patients). A total of 2492 patients (23.8%) required hospitalization, 284 (2.7%) were admitted to the ICU and 544 (5.2%) died. The variables included in the models to predict severity included age, gender and chronic comorbidities such as cardiovascular disease, diabetes, obesity, hypertension, chronic obstructive pulmonary disease, asthma, liver disease, chronic kidney disease and haematological cancer. The models demonstrated a fair–good fit for predicting hospitalization {AUC [area under the receiver operating characteristics (ROC) curve] 0.77 [95% confidence interval (CI) 0.76, 0.78]}, admission to ICU [AUC 0.83 (95%CI 0.81, 0.85)] and death [AUC 0.89 (95%CI 0.88, 0.90)]. Conclusions The Gal-COVID-19 scores provide risk estimates for predicting severity in COVID-19 patients. The ability to predict disease severity may help clinicians prioritize high-risk patients and facilitate the decision making of health authorities.

ACS Style

Francisco Gude-Sampedro; Carmen Fernández-Merino; Lucía Ferreiro; Óscar Lado-Baleato; Jenifer Espasandín-Domínguez; Xurxo Hervada; Carmen M Cadarso; Luis Valdés. Development and validation of a prognostic model based on comorbidities to predict COVID-19 severity: a population-based study. International Journal of Epidemiology 2020, 50, 64 -74.

AMA Style

Francisco Gude-Sampedro, Carmen Fernández-Merino, Lucía Ferreiro, Óscar Lado-Baleato, Jenifer Espasandín-Domínguez, Xurxo Hervada, Carmen M Cadarso, Luis Valdés. Development and validation of a prognostic model based on comorbidities to predict COVID-19 severity: a population-based study. International Journal of Epidemiology. 2020; 50 (1):64-74.

Chicago/Turabian Style

Francisco Gude-Sampedro; Carmen Fernández-Merino; Lucía Ferreiro; Óscar Lado-Baleato; Jenifer Espasandín-Domínguez; Xurxo Hervada; Carmen M Cadarso; Luis Valdés. 2020. "Development and validation of a prognostic model based on comorbidities to predict COVID-19 severity: a population-based study." International Journal of Epidemiology 50, no. 1: 64-74.

Journal article
Published: 13 November 2020 in Scientific Reports
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The prognosis of a patient with COVID-19 pneumonia is uncertain. Our objective was to establish a predictive model of disease progression to facilitate early decision-making. A retrospective study was performed of patients admitted with COVID-19 pneumonia, classified as severe (admission to the intensive care unit, mechanic invasive ventilation, or death) or non-severe. A predictive model based on clinical, laboratory, and radiological parameters was built. The probability of progression to severe disease was estimated by logistic regression analysis. Calibration and discrimination (receiver operating characteristics curves and AUC) were assessed to determine model performance. During the study period 1152 patients presented with SARS-CoV-2 infection, of whom 229 (19.9%) were admitted for pneumonia. During hospitalization, 51 (22.3%) progressed to severe disease, of whom 26 required ICU care (11.4); 17 (7.4%) underwent invasive mechanical ventilation, and 32 (14%) died of any cause. Five predictors determined within 24 h of admission were identified: Diabetes, Age, Lymphocyte count, SaO2, and pH (DALSH score). The prediction model showed a good clinical performance, including discrimination (AUC 0.87 CI 0.81, 0.92) and calibration (Brier score = 0.11). In total, 0%, 12%, and 50% of patients with severity risk scores ≤ 5%, 6–25%, and > 25% exhibited disease progression, respectively. A risk score based on five factors predicts disease progression and facilitates early decision-making according to prognosis.

ACS Style

Francisco Gude; Vanessa Riveiro; Nuria Rodríguez-Núñez; Jorge Ricoy; Óscar Lado-Baleato; Tamara Lourido; Carlos Rábade; Adriana Lama; Ana Casal; Romina Abelleira-París; Lucía Ferreiro; Juan Suárez-Antelo; María E. Toubes; Cristina Pou; Manuel Taboada-Muñiz; Felipe Calle-Velles; Plácido Mayán-Conesa; María L. Pérez Del Molino; Cristóbal Galbán-Rodríguez; Julián Álvarez-Escudero; Carmen Beceiro-Abad; Sonia Molinos-Castro; Néstor Agra-Vázquez; María Pazo-Núñez; Emilio Páez-Guillán; Pablo Varela-García; Carmen Martínez-Rey; Hadrián Pernas-Pardavila; María J. Domínguez-Santalla; Martín Vidal-Vázquez; Ana T. Marques-Afonso; Arturo González-Quintela; José R. González-Juanatey; Antonio Pose; Luis Valdés. Development and validation of a clinical score to estimate progression to severe or critical state in COVID-19 pneumonia hospitalized patients. Scientific Reports 2020, 10, 1 -10.

AMA Style

Francisco Gude, Vanessa Riveiro, Nuria Rodríguez-Núñez, Jorge Ricoy, Óscar Lado-Baleato, Tamara Lourido, Carlos Rábade, Adriana Lama, Ana Casal, Romina Abelleira-París, Lucía Ferreiro, Juan Suárez-Antelo, María E. Toubes, Cristina Pou, Manuel Taboada-Muñiz, Felipe Calle-Velles, Plácido Mayán-Conesa, María L. Pérez Del Molino, Cristóbal Galbán-Rodríguez, Julián Álvarez-Escudero, Carmen Beceiro-Abad, Sonia Molinos-Castro, Néstor Agra-Vázquez, María Pazo-Núñez, Emilio Páez-Guillán, Pablo Varela-García, Carmen Martínez-Rey, Hadrián Pernas-Pardavila, María J. Domínguez-Santalla, Martín Vidal-Vázquez, Ana T. Marques-Afonso, Arturo González-Quintela, José R. González-Juanatey, Antonio Pose, Luis Valdés. Development and validation of a clinical score to estimate progression to severe or critical state in COVID-19 pneumonia hospitalized patients. Scientific Reports. 2020; 10 (1):1-10.

Chicago/Turabian Style

Francisco Gude; Vanessa Riveiro; Nuria Rodríguez-Núñez; Jorge Ricoy; Óscar Lado-Baleato; Tamara Lourido; Carlos Rábade; Adriana Lama; Ana Casal; Romina Abelleira-París; Lucía Ferreiro; Juan Suárez-Antelo; María E. Toubes; Cristina Pou; Manuel Taboada-Muñiz; Felipe Calle-Velles; Plácido Mayán-Conesa; María L. Pérez Del Molino; Cristóbal Galbán-Rodríguez; Julián Álvarez-Escudero; Carmen Beceiro-Abad; Sonia Molinos-Castro; Néstor Agra-Vázquez; María Pazo-Núñez; Emilio Páez-Guillán; Pablo Varela-García; Carmen Martínez-Rey; Hadrián Pernas-Pardavila; María J. Domínguez-Santalla; Martín Vidal-Vázquez; Ana T. Marques-Afonso; Arturo González-Quintela; José R. González-Juanatey; Antonio Pose; Luis Valdés. 2020. "Development and validation of a clinical score to estimate progression to severe or critical state in COVID-19 pneumonia hospitalized patients." Scientific Reports 10, no. 1: 1-10.

Other
Published: 11 June 2020
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After the rapid spread with severe consequences in Europe and China, the SARS-CoV-2 virus is now manifesting itself in more vulnerable countries, including those in Latin America. In order to guide political decision-making via epidemiological criteria, it is crucial to assess the real impact of the epidemic. However, the use of large-scale population testing is unrealistic or not feasible in some countries. Based on a newly developed mathematical model, we estimated the seroprevalence of SARS-CoV-2 in Latin American countries. The results show that the virus spreads unevenly across countries. For example, Ecuador and Brazil are the most affected countries, with approximately 3% of the infected population. Currently, the number of new infections is increasing in all countries examined, with the exception of some Caribbean countries as Cuba. Moreover, in these countries, the peak of newly infected patients has not yet been reached.

ACS Style

Marcos Matabuena; Pablo Rodríguez-Mier; Carlos Meijide-García; Víctor Leborán; Francisco Gude. Mathematical estimation of COVID-19 prevalence in Latin America. 2020, 1 .

AMA Style

Marcos Matabuena, Pablo Rodríguez-Mier, Carlos Meijide-García, Víctor Leborán, Francisco Gude. Mathematical estimation of COVID-19 prevalence in Latin America. . 2020; ():1.

Chicago/Turabian Style

Marcos Matabuena; Pablo Rodríguez-Mier; Carlos Meijide-García; Víctor Leborán; Francisco Gude. 2020. "Mathematical estimation of COVID-19 prevalence in Latin America." , no. : 1.

Original research
Published: 01 December 2019 in Psychology Research and Behavior Management
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Purpose: Health factors that enhance an individual’s ability to perceive and maintain health and well-being are referred to as “health assets”. Of these assets, resilience, mindfulness and self-compassion are considered to be of special importance. The objective of this study was to analyze the association between these psychological constructs on the perception of physical and mental health in a general population. Patients and methods: A descriptive and analytical cross-sectional study was conducted with 845 participating subjects. The outcome variable was the individual´s perception of physical and mental health, measured using the SF-36 questionnaire. The independent variables were: sociodemographic variables, medical information, physical activity performance (using the International Physical Activity Questionnaire), tobacco and alcohol consumption, anxiety and/or depression (using the Goldberg Anxiety and Depression Scale), resilience (using the Connor-Davidson Resilience Scale), mindfulness (with the Five Facets of Mindfulness Questionnaire Short Form) and self-compassion (using the Self-compassion scale-short form). A correlation analysis, simple linear regression and multiple linear regression were carried out, controlling for the influence of the distinct independent variables. Results: The constructs of resilience, mindfulness and self-compassion are significant, in the perception of both physical and mental health. Other factors appearing in the multiple regression are gender, age, educational level, physical activity and tobacco consumption, in a positive or negative sense. Conclusion: The study of these associations is fundamental for the understanding of underlying regulation processes of healthy lifestyles in the general population.

ACS Style

Angela Asensio-Martínez; Bárbara Oliván-Blázquez; Jesús Montero-Marin; Bárbara Masluk; Ricardo Fueyo-Diaz; Santiago Gascón-Santos; Francisco Gudé; Arturo Gónzalez-Quintela; Javier García-Campayo; Rosa Magallón-Botaya. Relation of the Psychological Constructs of Resilience, Mindfulness, and Self-Compassion on the Perception of Physical and Mental Health. Psychology Research and Behavior Management 2019, ume 12, 1155 -1166.

AMA Style

Angela Asensio-Martínez, Bárbara Oliván-Blázquez, Jesús Montero-Marin, Bárbara Masluk, Ricardo Fueyo-Diaz, Santiago Gascón-Santos, Francisco Gudé, Arturo Gónzalez-Quintela, Javier García-Campayo, Rosa Magallón-Botaya. Relation of the Psychological Constructs of Resilience, Mindfulness, and Self-Compassion on the Perception of Physical and Mental Health. Psychology Research and Behavior Management. 2019; ume 12 ():1155-1166.

Chicago/Turabian Style

Angela Asensio-Martínez; Bárbara Oliván-Blázquez; Jesús Montero-Marin; Bárbara Masluk; Ricardo Fueyo-Diaz; Santiago Gascón-Santos; Francisco Gudé; Arturo Gónzalez-Quintela; Javier García-Campayo; Rosa Magallón-Botaya. 2019. "Relation of the Psychological Constructs of Resilience, Mindfulness, and Self-Compassion on the Perception of Physical and Mental Health." Psychology Research and Behavior Management ume 12, no. : 1155-1166.

Journal article
Published: 17 July 2019 in Nutrition & Metabolism
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There is a growing interest in the pathopysiological consequences of postprandial hyperglycemia. It is well known that in diabetic patients 2 h plasma glucose is a better risk predictor for coronary heart disease than fasting plasma glucose. Data on the glycemic response in healthy people are scarce. To evaluate the effect of macronutrients (carbohydrates, fats, and proteins) and fiber on postprandial glycemic response in an observational study of a non-diabetic adult population. Cross-sectional study. 150 non-diabetic adults performed continuous glucose monitoring for 6 days. During this period they recorded food and beverage intake. The participants were instructed not to make changes in their usual diet and physical exercise. Variables analyzed included clinical parameters (age, sex, body weight, height, body mass index, blood pressure, and waist measurement), meal composition (calories, carbohydrates, fats, proteins, and fiber) and glycemic postprandial responses separated by sexes. The study period was defined from the start of dinner to 6 h later. A total of 148 (51% women) subjects completed all study procedures. Dinner intake was higher in males than in females (824 vs 531 kcal). Macronutrient distribution was similar in both sexes. No significant differences were found in fiber intake between men and women (5.5 g vs 4.5 g). In both sexes, the higher intake of carbohydrates corresponded to a significantly higher glycemic response (p = 0.0001 in women, p = 0.022 in men). Moreover, in women, as fat intake was higher, a flattening of the postprandial glycemic curve was observed (p = 0.003). With respect to fiber, a significantly lower glycemic response was observed in the group of women whose fiber intake at dinner was higher (p = 0.034). Continuous glucose monitoring provides important information about glucose levels after meals. In this study, the postprandial glycemic response in women was different from that of men, and carbohydrates were the main determinant of elevated postprandial glucose levels.

ACS Style

María González-Rodríguez; Marcos Pazos-Couselo; José M. García-López; Santiago Rodríguez-Segade; Javier Rodríguez-García; Carmen Túñez-Bastida; Francisco Gude. Postprandial glycemic response in a non-diabetic adult population: the effect of nutrients is different between men and women. Nutrition & Metabolism 2019, 16, 1 -9.

AMA Style

María González-Rodríguez, Marcos Pazos-Couselo, José M. García-López, Santiago Rodríguez-Segade, Javier Rodríguez-García, Carmen Túñez-Bastida, Francisco Gude. Postprandial glycemic response in a non-diabetic adult population: the effect of nutrients is different between men and women. Nutrition & Metabolism. 2019; 16 (1):1-9.

Chicago/Turabian Style

María González-Rodríguez; Marcos Pazos-Couselo; José M. García-López; Santiago Rodríguez-Segade; Javier Rodríguez-García; Carmen Túñez-Bastida; Francisco Gude. 2019. "Postprandial glycemic response in a non-diabetic adult population: the effect of nutrients is different between men and women." Nutrition & Metabolism 16, no. 1: 1-9.

Original article
Published: 21 May 2019 in International Journal of Earth Sciences
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To investigate, in a sample of nondiabetic adults from a Spanish community, the differences between prediabetes as defined by HbA1c (“H-prediabetes”) and by fasting plasma glucose (FPG) (“F-prediabetes”) in regard to prevalence and the influence of potential risk factors, adjusting the latter for confounders. A total of 1328 nondiabetic participants aged ≥ 18 years were classified as normoglycemic, H-prediabetic [HbA1c 5.7–6.4% (39–47 mmol/mol)] or F-prediabetic (FPG 5.6–6.9 mmol/L). Multivariable analyses were used to compare the impacts of risk factors on the prevalence of H-prediabetes, F-prediabetes and their conjunctive and disjunctive combinations (“HaF-prediabetes” and “HoF-prediabetes,” respectively). Some 29.9% of participants were HoF-prediabetic, 21.7% H-prediabetic, 16.3% F-prediabetic and only 8.1% HaF-prediabetic. Whatever the definition of prediabetes, increasing age, fasting insulin and LDL cholesterol were each a risk factor after adjustment for all other variables. Increasing BMI and decreasing mean corpuscular hemoglobin (MCH) were additional risk factors for H-prediabetes; male sex and increasing uric acid for F-prediabetes and increasing BMI for HaF-prediabetes. The participants satisfying the compound condition “hypertension or hyperlipidemia or obesity or hyperuricemia” (59.9% of the whole study group) included 83.1% of all subjects with HoF-prediabetes. In this population, the most sensitive risk factor for detection of prediabetes was age, followed by fasting insulin, LDL cholesterol, BMI, MCH, male sex and uric acid, with differences depending on the definition of prediabetes. MCH, an indirect measure of erythrocyte survival, significantly influences the prevalence of HbA1c-defined prediabetes. This study suggests that screening of individuals with selected risk factors may identify a high proportion of prediabetic persons.

ACS Style

Santiago Rodriguez-Segade; Javier Rodriguez; Félix Camiña; Luís Sanmartín-Portas; Josefa Gerpe-Jamardo; Marcos Pazos-Couselo; Jose M. García-López; Manuela Alonso-Sampedro; Arturo González-Quintela; Francisco Gude. Prediabetes defined by HbA1c and by fasting glucose: differences in risk factors and prevalence. International Journal of Earth Sciences 2019, 56, 1023 -1030.

AMA Style

Santiago Rodriguez-Segade, Javier Rodriguez, Félix Camiña, Luís Sanmartín-Portas, Josefa Gerpe-Jamardo, Marcos Pazos-Couselo, Jose M. García-López, Manuela Alonso-Sampedro, Arturo González-Quintela, Francisco Gude. Prediabetes defined by HbA1c and by fasting glucose: differences in risk factors and prevalence. International Journal of Earth Sciences. 2019; 56 (9):1023-1030.

Chicago/Turabian Style

Santiago Rodriguez-Segade; Javier Rodriguez; Félix Camiña; Luís Sanmartín-Portas; Josefa Gerpe-Jamardo; Marcos Pazos-Couselo; Jose M. García-López; Manuela Alonso-Sampedro; Arturo González-Quintela; Francisco Gude. 2019. "Prediabetes defined by HbA1c and by fasting glucose: differences in risk factors and prevalence." International Journal of Earth Sciences 56, no. 9: 1023-1030.

Randomized controlled trial
Published: 18 January 2019 in BMC Family Practice
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Fostering a culture of safety is an essential step in ensuring patient safety and quality in primary care. We aimed to evaluate the effectiveness of an educational intervention to improve the safety culture in the family and community medicine teaching units in an Atlantic European Region. Randomized study conducted in family and community medicine teaching units in Galicia (Spain). Participants were all fourth-year residents and their tutors (N = 138). Those who agreed to participate were randomized into one of two groups (27 tutors/26 residents in the intervention group, 23 tutors/ 23 residents in the control one).All were sent the Survey on Patient Safety Culture. After that, the intervention group received specific training in safety; they also recorded incidents over 15 days, documented them following a structured approach, and had feedback on their performance. The control group did not receive any action. All participants completed the same survey four months later. Outcome measures were the changes in safety culture as quantified by the results variables of the Survey: Patient Safety Grade and Number of events reported. We conducted bivariate and adjusted analyses for the outcome measures. To explore the influence of participants' demographic characteristics and their evaluation of the 12 dimensions of the safety culture, we fitted a multivariate model for each outcome. Trial followed published protocol. There were 19 drop outs. The groups were comparable in outcome and independent variables at start. The experiment did not have any effect on Patient safety grade (- 0.040) in bivariate analysis. The odds of reporting one to two events increased by 1.14 (0.39-3.35), and by 13.75 (2.41-354.37) the odds of reporting 3 or more events. Different dimensions had significant independent effects on each outcome variable. A educational intervention in family and community medicine teaching units may improve the incidents reported. The associations observed among organizational dimensions and outcomes evidence the complexity of patient safety culture measurement and, also, show the paths for improvement. In the future, it would be worthwhile to replicate this study in teaching units from different settings and with different health professionals engaged. It was retrospectively registered with ( ISRCTN41911128 , 31/12/2010).

ACS Style

Clara González-Formoso; Ana Clavería; M.J. Fernández-Domínguez; F.L. Lago-Deibe; Luis Hermida-Rial; Antonio Rial; Francisco Gude-Sampedro; Salvador Pita-Fernández; Victoria Martín-Miguel. Effectiveness of an educational intervention to improve the safety culture in primary care: a randomized trial. BMC Family Practice 2019, 20, 15 .

AMA Style

Clara González-Formoso, Ana Clavería, M.J. Fernández-Domínguez, F.L. Lago-Deibe, Luis Hermida-Rial, Antonio Rial, Francisco Gude-Sampedro, Salvador Pita-Fernández, Victoria Martín-Miguel. Effectiveness of an educational intervention to improve the safety culture in primary care: a randomized trial. BMC Family Practice. 2019; 20 (1):15.

Chicago/Turabian Style

Clara González-Formoso; Ana Clavería; M.J. Fernández-Domínguez; F.L. Lago-Deibe; Luis Hermida-Rial; Antonio Rial; Francisco Gude-Sampedro; Salvador Pita-Fernández; Victoria Martín-Miguel. 2019. "Effectiveness of an educational intervention to improve the safety culture in primary care: a randomized trial." BMC Family Practice 20, no. 1: 15.

Original article
Published: 07 August 2018 in Journal of Arrhythmia
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Cardiac resynchronization therapy (CRT) is indicated in symptomatic heart failure (HF) patients after achieving optimal medical therapy (OMT). However, many patients may not be under OMT when the CRT device is implanted. Here, we evaluate the long‐term benefits of CRT in symptomatic HF patients receiving or not OMT. We investigated the effect of OMT on HF developing or death in 328 consecutive patients with a CRT device implanted between 2005 and 2015 in a single tertiary center. After the CRT implant, we categorized the patients into three groups: no OMT, OMT at baseline and after 1 year of follow‐up, and OMT only at the 1‐year follow‐up but not at baseline. We used multivariate Cox proportional hazards model to determine the effect of OMT on clinical outcomes. One hundred and twenty‐two patients (37.2%) received OMT prior to CRT. OMT at baseline was not associated with a reduced risk of death or HF (HR 0.72; 95% CI 0.50‐1.02; P = 0.067) compared with no‐basal‐OMT patients. After CRT, patients without OMT had a higher risk of death or HF than patients who received OMT in follow‐up (HR 1.72, 95% CI 1.07‐2.78, P = 0.025), and the risk of the patients who received OMT at baseline and at the 1‐year follow‐up was similar to that of the patients who achieved OMT at the 1‐year follow‐up (HR 0.90, 95% CI 0.54‐1.50, P = 0.682). Basal OMT prior to CRT is not associated with better outcomes in terms of HF/death compared with no basal OMT. The subgroup of patients who achieved OMT at the 1‐year follow‐up exhibited a reduced risk of HF and death compared with patients who did not.

ACS Style

Belén Alvarez-Alvarez; Javier García-Seara; Jose L. Martínez-Sande; Moisés Rodríguez-Mañero; Xesús A. Fernández López; Laila González-Melchor; Rosa M. Agra Bermejo; Diego Iglesias-Alvarez; Francisco Gude Sampedro; Carla Díaz-Louzao; José Ramón González Juanatey. Cardiac resynchronization therapy outcomes in patients under nonoptimal medical therapy. Journal of Arrhythmia 2018, 34, 548 -555.

AMA Style

Belén Alvarez-Alvarez, Javier García-Seara, Jose L. Martínez-Sande, Moisés Rodríguez-Mañero, Xesús A. Fernández López, Laila González-Melchor, Rosa M. Agra Bermejo, Diego Iglesias-Alvarez, Francisco Gude Sampedro, Carla Díaz-Louzao, José Ramón González Juanatey. Cardiac resynchronization therapy outcomes in patients under nonoptimal medical therapy. Journal of Arrhythmia. 2018; 34 (5):548-555.

Chicago/Turabian Style

Belén Alvarez-Alvarez; Javier García-Seara; Jose L. Martínez-Sande; Moisés Rodríguez-Mañero; Xesús A. Fernández López; Laila González-Melchor; Rosa M. Agra Bermejo; Diego Iglesias-Alvarez; Francisco Gude Sampedro; Carla Díaz-Louzao; José Ramón González Juanatey. 2018. "Cardiac resynchronization therapy outcomes in patients under nonoptimal medical therapy." Journal of Arrhythmia 34, no. 5: 548-555.

Journal article
Published: 25 May 2018 in Diabetes Research and Clinical Practice
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To investigate whether continuous glucose monitoring (CGM) reveals patterns of glycaemic behaviour, the detection of which might improve early diagnosis of dysglycaemia. A total 1521 complete days of valid CGM data were recorded under real-life conditions from a healthy sample of a Spanish community, as were matching FPG and HbA1C data. No participant was pregnant, had a history of kidney or liver disease, or was taking drugs known to affect glycaemia. CGM and fingerstick measurements showed a mean relative absolute difference of 6.9 ± 2.2%. All subjects were normoglycaemic according to FPG and HbA1C except 21% who were prediabetic. The normoglycaemic subjects had a 24-hour mean blood glucose concentration (MBG) of 5.7 ± 0.4 mmol/L, spending a median of 97% of their time within the target range (3.9-7.8 mmol/L). 73% of them experienced episodes with blood glucose levels above the threshold for impaired glucose tolerance, and 5% levels above the threshold for diabetes. These normoglycaemic participants with episodes of high glycaemia had glycaemic variabilities similar to those of prediabetic subjects with episodes of similar intensity or combined duration. CGM is a better indicator of possible early dysglycaemia than either FPG or HbA1c.

ACS Style

Santiago Rodríguez-Segade; Javier Rodríguez; Felix Camiña; Manuel Fernández-Arean; Vanessa García-Ciudad; Marcos Pazos-Couselo; Josè M. Garcìa-Lòpez; Manuela Alonso-Sampedro; Arturo Gonzalez-Quintela; Francisco Gude. Continuous glucose monitoring is more sensitive than HbA1c and fasting glucose in detecting dysglycaemia in a Spanish population without diabetes. Diabetes Research and Clinical Practice 2018, 142, 100 -109.

AMA Style

Santiago Rodríguez-Segade, Javier Rodríguez, Felix Camiña, Manuel Fernández-Arean, Vanessa García-Ciudad, Marcos Pazos-Couselo, Josè M. Garcìa-Lòpez, Manuela Alonso-Sampedro, Arturo Gonzalez-Quintela, Francisco Gude. Continuous glucose monitoring is more sensitive than HbA1c and fasting glucose in detecting dysglycaemia in a Spanish population without diabetes. Diabetes Research and Clinical Practice. 2018; 142 ():100-109.

Chicago/Turabian Style

Santiago Rodríguez-Segade; Javier Rodríguez; Felix Camiña; Manuel Fernández-Arean; Vanessa García-Ciudad; Marcos Pazos-Couselo; Josè M. Garcìa-Lòpez; Manuela Alonso-Sampedro; Arturo Gonzalez-Quintela; Francisco Gude. 2018. "Continuous glucose monitoring is more sensitive than HbA1c and fasting glucose in detecting dysglycaemia in a Spanish population without diabetes." Diabetes Research and Clinical Practice 142, no. : 100-109.

Journal article
Published: 19 April 2018 in Diabetology & Metabolic Syndrome
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A significant association is known between increased glycaemic variability and mortality in critical patients. To ascertain whether glycaemic profiles during the first week after liver transplantation might be associated with long-term mortality in these patients, by analysing whether diabetic status modified this relationship. Observational long-term survival study includes 642 subjects undergoing liver transplantation from July 1994 to July 2011. Glucose profiles, units of insulin and all variables with influence on mortality are analysed using joint modelling techniques. Patients registered a survival rate of 85% at 1 year and 65% at 10 years, without differences in mortality between patients with and without diabetes. In glucose profiles, however, differences were observed between patients with and without diabetes: patients with diabetes registered lower baseline glucose values, which gradually rose until reaching a peak on days 2–3 and then subsequently declined, diabetic subjects started from higher values which gradually decreased across the first week. Patients with diabetes showed an association between mortality and age, Model for End-Stage Liver Disease score (MELD) score and hepatitis C virus; among non-diabetic patients, mortality was associated with age, body mass index, malignant aetiology, red blood cell requirements and parenteral nutrition. Glucose profiles were observed to be statistically associated with mortality among patients without diabetes (P = 0.022) but not among patients who presented with diabetes prior to transplantation (P = 0.689). Glucose profiles during the first week after liver transplantation are different in patients with and without diabetes. While glucose profiles are associated with long-term mortality in patients without diabetes, after adjusting for potential confounding variables such as age, cause of transplantation, MELD, nutrition, immunosuppressive drugs, and units of insulin administered, this does not occur among patients with diabetes.

ACS Style

Elena Giráldez; Evaristo Varo; Ipek Guler; Carmen Cadarso-Suarez; Santiago Tomé; Patricia Barral; Antonio Garrote; Francisco Gude. Post-operative stress hyperglycemia is a predictor of mortality in liver transplantation. Diabetology & Metabolic Syndrome 2018, 10, 35 .

AMA Style

Elena Giráldez, Evaristo Varo, Ipek Guler, Carmen Cadarso-Suarez, Santiago Tomé, Patricia Barral, Antonio Garrote, Francisco Gude. Post-operative stress hyperglycemia is a predictor of mortality in liver transplantation. Diabetology & Metabolic Syndrome. 2018; 10 (1):35.

Chicago/Turabian Style

Elena Giráldez; Evaristo Varo; Ipek Guler; Carmen Cadarso-Suarez; Santiago Tomé; Patricia Barral; Antonio Garrote; Francisco Gude. 2018. "Post-operative stress hyperglycemia is a predictor of mortality in liver transplantation." Diabetology & Metabolic Syndrome 10, no. 1: 35.

Journal article
Published: 09 April 2018 in Indian Pacing and Electrophysiology Journal
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Cardiac resynchronization therapy (CRT) is indicated in symptomatic heart failure (HF) patients after achieving optimal medical therapy. However, there are still a large percentage of patients who do not respond to CRT. Malnutrition is a frequent comorbidity in patients with HF, and it is associated with a poorer prognosis. Here, we evaluate the nutritional status of patients assessed by Controlling Nutritional Status (CONUT) score and its association with structural remodeling and cardiovascular events. We investigated the effect of CONUT on HF/death in 302 consecutive patients with a CRT device implanted between 2005 and 2015 in a single tertiary center. We categorized the patients into three groups: normal nutritional status (CONUT 0–1), mild malnutrition (CONUT 2–4) and moderate-severe malnutrition (CONUT ≥ 5). Changes in nutritional status were assessed in patients with mild-to-severe malnutrition prior to CRT. One hundred and forty-eight patients exhibited normal nutritional status (49.0%), 99 patients exhibited mild malnutrition (32.8%) and 55 patients exhibited moderate-severe malnutrition (18.2%). CONUT scores of at least 2 were associated with higher risk of HF/death compared with CONUT 0–1. Significant left ventricular (LV) reverse remodeling was noted in patients with better nutritional status. In addition, those malnutrition patients at baseline that improved nutritional state exhibited fewer HF/death events at follow-up. CONUT score prior to CRT was an independent risk factor of death/HF and was correlated with LV reverse remodeling. Improvements in CONUT score during long-term follow-up were associated with a reduction in the rate of HF/death.

ACS Style

Belén Alvarez-Alvarez; Javier García- Seara; Moisés Rodríguez-Mañero; Diego Iglesias-Alvarez; Jose L. Martínez-Sande; Rosa M. Agra-Bermejo; Xesús A. Fernández López; Laila González-Melchor; Francisco Gude Sampedro; Carla Díaz-Louzao; José R. González-Juanatey. Prognostic value of nutrition status in the response of cardiac resynchronization therapy. Indian Pacing and Electrophysiology Journal 2018, 18, 133 -139.

AMA Style

Belén Alvarez-Alvarez, Javier García- Seara, Moisés Rodríguez-Mañero, Diego Iglesias-Alvarez, Jose L. Martínez-Sande, Rosa M. Agra-Bermejo, Xesús A. Fernández López, Laila González-Melchor, Francisco Gude Sampedro, Carla Díaz-Louzao, José R. González-Juanatey. Prognostic value of nutrition status in the response of cardiac resynchronization therapy. Indian Pacing and Electrophysiology Journal. 2018; 18 (4):133-139.

Chicago/Turabian Style

Belén Alvarez-Alvarez; Javier García- Seara; Moisés Rodríguez-Mañero; Diego Iglesias-Alvarez; Jose L. Martínez-Sande; Rosa M. Agra-Bermejo; Xesús A. Fernández López; Laila González-Melchor; Francisco Gude Sampedro; Carla Díaz-Louzao; José R. González-Juanatey. 2018. "Prognostic value of nutrition status in the response of cardiac resynchronization therapy." Indian Pacing and Electrophysiology Journal 18, no. 4: 133-139.

Journal article
Published: 01 April 2018 in Spatial Statistics
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Recently, physicians in an area of northwestern Spain became concerned about the large number of patients whose serum potassium concentrations were above the normal range, as well as differences in the values recorded from one area to another. With the aim of identifying geographical differences in both mean and variability of potassium levels, analyses were performed using modern flexible regression techniques based on a structured additive distributional regression model. In this type of model, every parameter of a response distribution - rather than just the mean - is related to a structured additive predictor. After adjusting for variables such as age, sex, clot-contact time and spatial effects, differences in potassium concentrations were confirmed. The type of distributional regression model used permitted the mean and variance of the potassium concentrations to be modelled using additive predictors that allow for different types of covariate effects. A variety of complex distributions were contemplated. In general, higher concentrations and greater variability were recorded in areas further from the hospital laboratory responsible for the analyses, although some that were nearby also returned high values. Further actions are required to confirm whether these differences reflect reality or non-optimum pre-analytical handling (resulting in pseudohyperkalaemia) in certain districts.

ACS Style

Jenifer Espasandín-Domínguez; Alfonso Javier Benítez-Estévez; Carmen Cadarso-Suárez; Thomas Kneib; Tegra Barreiro-Martínez; Balbina Virginia Casas Méndez; Francisco Gude. Geographical differences in blood potassium detected using a structured additive distributional regression model. Spatial Statistics 2018, 24, 1 -13.

AMA Style

Jenifer Espasandín-Domínguez, Alfonso Javier Benítez-Estévez, Carmen Cadarso-Suárez, Thomas Kneib, Tegra Barreiro-Martínez, Balbina Virginia Casas Méndez, Francisco Gude. Geographical differences in blood potassium detected using a structured additive distributional regression model. Spatial Statistics. 2018; 24 ():1-13.

Chicago/Turabian Style

Jenifer Espasandín-Domínguez; Alfonso Javier Benítez-Estévez; Carmen Cadarso-Suárez; Thomas Kneib; Tegra Barreiro-Martínez; Balbina Virginia Casas Méndez; Francisco Gude. 2018. "Geographical differences in blood potassium detected using a structured additive distributional regression model." Spatial Statistics 24, no. : 1-13.

Study protocol
Published: 11 November 2016 in BMC Pulmonary Medicine
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Due to the heterogeneous and systemic nature of the chronic obstructive pulmonary disease (COPD), the new guidelines are oriented toward individualized attention. Multidimensional scales could facilitate its proper clinical and prognostic assessment, but not all of them were validated in an international primary care cohort, different from the original ones used for model development. Therefore, our main aim is to assess the prognostic capacity of the ADO, BODEx and DOSE indices in primary care for predicting mortality in COPD patients and to validate the models obtained in subgroups of patients, classified by revised Global Initiative for Chronic Obstructive Lung Disease (2011) and updated Spanish Guideline (2014). Besides, we want to confirm that the prognostic capacity of all indices increases if the number of exacerbations is substituted by the interval between them and to assess the impact on health of the patient’s lifestyle, social network and adherence to treatment. Design: External validation of scales, open and prospective cohort study in primary care. Setting: 36 health centres in 6 European high, medium and low income countries. Subjects: 477 patients diagnosed with COPD, captured in clinical visit by their General Practitioner/Nurse. Predictors: Detailed patient history, exacerbations, lung function test and questionnaires at baseline. Outcomes: Exacerbations, all-cause mortality and specific mortality, within 5 years of recruitment. Analysis: Multivariate logistic regression and Cox regression will be used. Possible non-linear effect of the indices will be studied by using Structured Additive Regression models with penalised splines. Subsequently, we will assess different aspects of the regression models: discrimination, calibration and diagnostic precision. Clinical variables modulated in primary care and the interval between exacerbations will be considered and incorporated into the analysis. The Research Agenda for General Practice/Family Medicine highlights that the evidence on predictive values of prognostic indices in primary care is scarce. A prospective cohort like that of PROEPOC/COPD provides good opportunities for research into COPD and make communication easier between family practitioners, nursing staff, pneumologists and other professionals, supporting a multi-disciplinary approach to the treatment of these patients. ISRCTN52402811 . Date: 15/01/2015. Prospectively registered.

ACS Style

Maite Espantoso-Romero; On behalf of the PROEPOC/COPD study group; Miguel Román Rodríguez; Ana Duarte-Pérez; Jaime Gonzálvez-Rey; Pedro A. Callejas-Cabanillas; Durdica Kasuba Lazic; Berta Anta-Agudo; Pere Torán Monserrat; Rosa Magallon-Botaya; Biljana Gerasimovska Kitanovska; Heidrun Lingner; Radost S. Assenova; Claudia Iftode; Francisco Gude-Sampedro; Ana Clavería. External validation of multidimensional prognostic indices (ADO, BODEx and DOSE) in a primary care international cohort (PROEPOC/COPD cohort). BMC Pulmonary Medicine 2016, 16, 1 -9.

AMA Style

Maite Espantoso-Romero, On behalf of the PROEPOC/COPD study group, Miguel Román Rodríguez, Ana Duarte-Pérez, Jaime Gonzálvez-Rey, Pedro A. Callejas-Cabanillas, Durdica Kasuba Lazic, Berta Anta-Agudo, Pere Torán Monserrat, Rosa Magallon-Botaya, Biljana Gerasimovska Kitanovska, Heidrun Lingner, Radost S. Assenova, Claudia Iftode, Francisco Gude-Sampedro, Ana Clavería. External validation of multidimensional prognostic indices (ADO, BODEx and DOSE) in a primary care international cohort (PROEPOC/COPD cohort). BMC Pulmonary Medicine. 2016; 16 (1):1-9.

Chicago/Turabian Style

Maite Espantoso-Romero; On behalf of the PROEPOC/COPD study group; Miguel Román Rodríguez; Ana Duarte-Pérez; Jaime Gonzálvez-Rey; Pedro A. Callejas-Cabanillas; Durdica Kasuba Lazic; Berta Anta-Agudo; Pere Torán Monserrat; Rosa Magallon-Botaya; Biljana Gerasimovska Kitanovska; Heidrun Lingner; Radost S. Assenova; Claudia Iftode; Francisco Gude-Sampedro; Ana Clavería. 2016. "External validation of multidimensional prognostic indices (ADO, BODEx and DOSE) in a primary care international cohort (PROEPOC/COPD cohort)." BMC Pulmonary Medicine 16, no. 1: 1-9.

Study protocol
Published: 18 August 2016 in BMC Public Health
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The traditional diet of northwestern Spain and northern Portugal follows an ‘Atlantic diet’ pattern. Adherence to the Atlantic diet has been related to the good metabolic health and low coronary mortality recorded for these regions. The GALIAT (Galicia Alimentación Atlántica [Galicia Atlantic Diet]) study is a randomised, controlled, dietary intervention clinical trial designed to examine the effect of the Atlantic diet on the lipid profile, glucose metabolism, inflammation makers and adiposity of the general population. The trial involved 250 randomly selected families (715 adults and children over 3 years of age) from a town in Spain’s northwest, randomly allocated to follow either a control diet (C group) or the Atlantic diet (AD group) for a period of 6 months. The families of the AD group received educational sessions on food, diet and gastronomy and were provided written supporting material with nutritional recommendations and recipes for the preparation of menus. They also attended cooking classes. Throughout the study period, these families were provided a range of foods (free of charge) that form part of the traditional Atlantic diet. The C group families took part in none of the above activities, nor were they provided with any food. Lipid profile variables (primary variables), and anthropometric, inflammation marker and glucose metabolism status (secondary variables), were measured at baseline, three and six months. The GALIAT study is the first clinical trial to examine the effects of the Atlantic diet on metabolic and cardiovascular health and adiposity. If the study hypothesis is confirmed, this dietary pattern could be included in strategies to promote health. ClinicalTrials.gov, NCT02391701 on March 18, 2015.

ACS Style

Maria Del Mar Calvo-Malvar; Rosaura Leis; Alfonso Javier Benítez-Estévez; Juan Sánchez-Castro; Francisco Gude. A randomised, family-focused dietary intervention to evaluate the Atlantic diet: the GALIAT study protocol. BMC Public Health 2016, 16, 1 -9.

AMA Style

Maria Del Mar Calvo-Malvar, Rosaura Leis, Alfonso Javier Benítez-Estévez, Juan Sánchez-Castro, Francisco Gude. A randomised, family-focused dietary intervention to evaluate the Atlantic diet: the GALIAT study protocol. BMC Public Health. 2016; 16 (1):1-9.

Chicago/Turabian Style

Maria Del Mar Calvo-Malvar; Rosaura Leis; Alfonso Javier Benítez-Estévez; Juan Sánchez-Castro; Francisco Gude. 2016. "A randomised, family-focused dietary intervention to evaluate the Atlantic diet: the GALIAT study protocol." BMC Public Health 16, no. 1: 1-9.