Papers by Francisco Guillen-Grima
Journal of Clinical Medicine, 2021
Background: We analyzed the relationship between the prevalence of schizophrenia and the season o... more Background: We analyzed the relationship between the prevalence of schizophrenia and the season of birth and gestation during a period of an influenza pandemic. Methods: Cross-sectional analysis of a prospective population-based cohort of 470,942 adults. We fitted multivariant logistic regression models to determine whether the season of birth and birth in an influenza-pandemic year (1957, 1968, 1977) was associated with schizophrenia. Results: 2077 subjects had been diagnosed with schizophrenia. Logistic regression identified a significantly greater prevalence of schizophrenia in men than in women (OR = 1.516, CI 95% = 1.388–1.665); in those born in the winter or spring than in those born in the summer or autumn (OR = 1.112, CI 95% = 1.020–1.212); and in those born in a period of an influenza pandemic (OR = 1.335, CI 95% = 1.199–1.486). The increase in risk was also significant when each influenza pandemic year was analyzed separately. However, neither month of birth nor season of ...
International Journal of Environmental Research and Public Health
Mortality due to cardiovascular disease (CVD), including cerebrovascular disease (CED) and ischae... more Mortality due to cardiovascular disease (CVD), including cerebrovascular disease (CED) and ischaemic heart disease (IHD), was considerably different in eight municipalities of the province of Castellón, Community of Valencia (Spain) during the period of 1991–2011. In addition, these villages showed differences in agricultural practices and production. Since high vegetable consumption has been linked to decreased all-cause, CVD, and CED mortalities, we hypothesized that the diversity in vegetable and artichoke production, used as proxies for their consumption, could be associated with the diversity of mortality rates. In order to test our hypothesis, we estimated the smoothed standardized mortality ratios (SMRs) of CVD, CED, and IHD mortalities and a directed, age-adjusted mortality rate (AMR). We used a multilevel linear regression analysis to account for the ecological nature of our study. After adjustment, the CVD and CED SMRs were inversely associated with vegetable and artichoke...
Anales de Pediatría
Background: Infant mortality is an indicator of child health, and an explanatory variable to refl... more Background: Infant mortality is an indicator of child health, and an explanatory variable to reflect the socioeconomic development of a country. We aimed to examine the changes and trends of infant mortality in the European Union (EU) and its 28 member states in the 1994-2015 period. Methods: We extracted data of deaths in children aged less than one year between 1994 and 2015 from the Eurostat database. We analysed secular variation in the EU overall, by country and by geographical region using joinpoint regression analysis. We conducted additional analyses to examine neonatal and early neonatal mortality trends. Results: Infant mortality in the EU has declined significantly from 8.3 to 3.6 per 1000 live births (annual percent change = −3.8%; 95% confidence interval, −4.1 to −3.6). Among EU countries, we found the highest mortality rates throughout the study period in Romania and Bulgaria, and the lowest rates in Scandinavian countries (Finland, Sweden). There were significant decreasing trends in every country of the EU, which were most pronounced in former Soviet Baltic states and Eastern European countries, and least pronounced in Western European countries. Mortality rates have increased significantly in Greece in the last years, and plateaued in the United Kingdom and Ireland.
American journal of Alzheimer's disease and other dementias, 2018
Alzheimer's disease (AD) has become a concerning public health issue. We aimed to analyze the... more Alzheimer's disease (AD) has become a concerning public health issue. We aimed to analyze the trends of hospital morbidity from AD in the European Union (EU) in the period 2000 to 2014. Data from hospital discharges of men and women over 50 years old hospitalized due to AD in the EU were extracted from Eurostat database. We tested for secular trends computing anual percent change, and identified significant changes in the linear slope of the trend. Hospital morbidity from AD showed a 0.8% (95% confidence intervals -2.2 to 0.6) slight declining trend in the EU. In men and women, we recorded a -0.5% and -1.0% decrease in hospital morbidity rates, respectively. Several countries showed changing trends during the study period. Alzheimer's disease hospital morbidity has slightly declined in the entire EU in the past years. Eastern European countries showed steadily increasing trends, whereas in western and Mediterranean countries the rates decreased or leveled off.
Gaceta sanitaria, Jan 24, 2018
To compare the Spanish version of the modified Telephone Interview of Cognitive Status (STICS-m) ... more To compare the Spanish version of the modified Telephone Interview of Cognitive Status (STICS-m) with the Mini-Mental State Examination (MMSE) and predict its ability to detect the development of dementia. 106 participants in a dietary intervention trial underwent face-to-face evaluation with the MMSE, and phone interview with the STICS-m. The correlation between STICS-m and MMSE was assessed with the intraclass correlation coefficient (ICC) of consistency. Secondly, 932 participants over 55 years old from the "Seguimiento Universidad de Navarra" cohort were evaluated with the STICS-m and data on dementia diagnosis were gathered (median follow-up time of 6.5 years). A logistic regression model evaluated the association between STICS-m score or 2-year changes in STICS-m score and risk of developing dementia, adjusting for ApoE, age and years of university education. The ICC between the MMSE and the STICS-m was 0.31 (95% confidence interval [95%CI]: 0.13-0.48). The adjusted ...
Clinical endocrinology, Jan 12, 2018
To study the prevalence of thyroid dysfunction in a very large unselected population. To determin... more To study the prevalence of thyroid dysfunction in a very large unselected population. To determine the prevalence of abnormal thyroid function and evaluate potential modulatory factors. The Estudio de Atención Primaria de Navarra, The APNA Study, is a cross-sectional study conducted in northern Spain. It involved 303 883 people, of 20 years of age and older, who live in the Navarra region. Participants are covered by the public healthcare system and medical records are digitalized. The information was gathered from e-registered data regarding serum thyrotropin (TSH), thyroid hormones, thyroid antibody concentration and clinical context. Measurements were logged (demographic information and potential thyroid function modulatory factors). Serum TSH (mU/L) normal range was established at 0.7-4.28. At the time of the study, 87% of the Navarra population had a TSH level within the normal range. Mean serum TSH in euthyroid individuals was higher in women (2.15) than in men (1.96) (P < ...
Journal of plastic surgery and hand surgery, Jan 24, 2017
Breast reduction is a procedure with a high rate of patient satisfaction. Many techniques can be ... more Breast reduction is a procedure with a high rate of patient satisfaction. Many techniques can be used for this type of surgery; patient satisfaction can vary from one technique to another. The main aim of this study was to use Breast-Q for initial evaluation of patient satisfaction after breast reduction by either vertical or inverted-T technique and then determine if the quantity of breast tissue removed had any influence on patient satisfaction. Eighty-four out of 288 patients operated on between 2000 and 2013 anonymously completed the post-operative version of Breast-Q Reduction/Mastopexy. Inverted T technique: 55 patients; vertical technique: 29 patients. Statistical significance was set at p < 0.05. Comparison of mean scores of all Breast-Q scales showed no significant differences between the two techniques. With regard to satisfaction and quantity of removed tissue, statistically significant differences were observed in some scales, with positive correlations in the inverte...
Primary care diabetes, Jan 18, 2017
Assess compliance with the IDF recommendations for patients with Diabetes Type2 (DM2), and its va... more Assess compliance with the IDF recommendations for patients with Diabetes Type2 (DM2), and its variability, by groups of doctors and nurses who provide primary care services in Navarre (Spain). A cross-sectional study of a population of 462,568 inhabitants, aged ≥18 years in 2013, attended by 381 units of doctor/nurse (quota). Clinical data were collected retrospectively through electronic records. Using cluster analysis, we identified two groups of units according to the score for each indicator. We calculated the Odds Ratio, adjusted for age sex, BMI, socioeconomic status and smoking, for complying with each recommendation whether a patient was treated by one of the quota from the highest score to the lowest. 30,312 patients with DM2 were identified: prevalence: 6.39%; coefficient of variation between UDN: 22.8%; biggest cluster 7.7% and smallest 5.3%; OR=1.54 (1.50-1.58). The HbA1c control at ≤8% was 82.8% (82.2-83.3) and >9% was 7.6% (7.3-8.0), with OR 1.79 (1.69-1.89) and 2....
Enfermedades infecciosas y microbiologia clinica, Jan 18, 2017
The objective of this study was to update and analyze tuberculosis (TB) mortality data in the Eur... more The objective of this study was to update and analyze tuberculosis (TB) mortality data in the European Union between 2000 and 2010 separately for men and women and try to detect if there have been any changes in trends in each country and the association with the economic situation and inequalities. Data were extracted for tuberculosis deaths in 2000-2010 for 29 European Union countries and for Switzerland, via the World Health Organization (WHO) European detailed mortality database (DMDB), using the Mortality tabulation list 1 (MTL1) codes for men and women separately for one age group (20-85+). We estimated age-standardised mortality rates, and analyzed data using the Joinpoint Regression Program for men and women separately in the European Union overall and by individual country for each year. Between 2000 and 2010, there were 68,771 recorded tuberculosis deaths in the European Union and the mortality rates were higher for men than women in the entire study zone. Overall, TB mort...
Revista medica de Chile, 2017
College students are in a critical stage in their life style due to the transition between high s... more College students are in a critical stage in their life style due to the transition between high school and university and they may be prone to develop cardiovascular diseases. To compare the prevalence of cardiovascular risk factors (CVRF) in students from first and third year at the University of La Frontera, Temuco-Chile, according to faculty, gender and socioeconomic status (SES). Cross-sectional study. Anthropometry, blood pressure, lipid profile, blood glucose, insulin resistance (IR), sedentary lifestyle, tobacco and alcohol consumption were evaluated during 2014 in randomly selected 163 freshmen aged 19.2 ± 1.8 years and 163 third year students aged 21.7 ± 2.5 years (49% females), stratified by faculty, career and gender. 32.4% of students had prehypertension, 30.6% abdominal obesity, 26.3% insulin resistance, 25.7% dyslipidemia and 8.9% metabolic syndrome. Third grade students had higher prevalence of elevated total and LDL cholesterol and higher alcohol consumption, especia...
Archivos de Bronconeumología, 2017
El asma, entendida como (tos, disnea y sibilancias) es la enferedad crónica más prevalente en la ... more El asma, entendida como (tos, disnea y sibilancias) es la enferedad crónica más prevalente en la infancia1. En el mundo, se stima que hay unos 300 millones de personas afectadas por esta nfermedad2. Además produce un enorme gasto sanitario, pérdida n la productividad del trabajo en el adulto y una gran alteración amiliar en el caso del asma infantil3. El asma es una enfermedad infradiagnosticada e infratratada por o que los cuestionarios estandarizados que utilizan como marcaores de la enfermedad la existencia de síntomas compatibles con sma, han resultado la herramienta de elección para la identificaión del asma en estudios descriptivos4,5. El cuestionario ISAAC ha ido utilizado para conocer la prevalencia de asma en todos ellos portando datos en diversos estudios. A partir de estos estudios se abe que la prevalencia del asma asciende a un 11,7% en niños y a n 14,1% en adolescentes5. En Navarra según un estudio realizado en 20156 se observó na prevalencia de asma del 10,1% en los niños y del 10,6% en os adolescentes. En cambio, los niños presentaron una prevalenia de «sibilancias alguna vez» mayor que los adolescentes (22,7 y 2,9%, respectivamente). Este estudio se realizó en el área metropoitana de Pamplona, siendo una zona urbana con localidades con un ínimo de 10.000 habitantes. En Navarra no se han realizado estuios en el área rural sobre asma infantil previamente. En Galicia, e realizó un estudio en el año 2010 en la población rural infantil y dolescente obteniéndose los siguientes resultados7. La prevalenia de asma en la infancia y en la adolescencia fue de 6,3 y 15,3%, espectivamente. En el grupo de 6-7 años un 38% tuvo sibilancias alguna vez y n 13,2% sibilancias recientes. Un 21,9% tuvo tos nocturna reciente un 6,3% sibilancias con el ejercicio recientes. En el grupo de 134 años un 20,1% tuvo sibilancias alguna vez y un 11% sibilancias ecientes. Teniendo en cuenta los datos reflejados anteriormente ste estudio pretende conocer la prevalencia síntomas compatibles on asma en zonas con características rurales de Navarra, aportando atos novedosos al estudio ISAAC. Para la realización del estudio se utilizó la versión validada del uestionario del estudio ISAAC en euskera y en castellano según el odelo lingüístico del mismo a través de la realización del mismo
Journal of immunological methods, Mar 29, 2016
Bone marrow (BM) aspirates used for flow-cytometry (FCM) studies are usually obtained from a seco... more Bone marrow (BM) aspirates used for flow-cytometry (FCM) studies are usually obtained from a second aspiration, as the primary aspirate is used for morphological assessment. For this reason, the FCM samples unavoidably contain some blood; although, good-quality samples contain only a small amount. It is of utmost importance to assess the quality of samples prior to FCM analysis; yet, contamination with peripheral blood (PB) is not evaluated in most laboratories, possibly because the methods available are either qualitative or too complex for daily practice. Here, we propose a simple FCM method to quantitatively evaluate PB contamination in BM aspirates, by analyzing the percentage of plasma cells and CD34(+) cells - two cell populations nearly absent from PB - and CD10(+) granulocytes, which comprise the majority of the PB granulocyte population. We analyzed these three populations in 122 BM aspirates from subjects without hematological disease, and identified samples with PB contam...
Journal of Studies on Alcohol and Drugs, 2016
Perceptions of peer behavior and attitudes exert considerable social pressure on young adults to ... more Perceptions of peer behavior and attitudes exert considerable social pressure on young adults to use substances. This study investigated whether European students perceive their peers' cannabis use and approval of cannabis use to be higher than their own personal behaviors and attitudes, and whether estimations of peer use and attitudes are associated with personal use and attitudes. Method: University students (n = 4,131) from Belgium, Denmark, Germany, the Slovak Republic, Spain, Turkey, and the United Kingdom completed an online survey as part of the Social Norms Intervention for Polysubstance usE in students (SNIPE) Project, a feasibility study of a web-based normative feedback intervention for substance use. The survey assessed students' (a) personal substance use and attitudes and (b) perceptions of their peers' cannabis use (descriptive norms) and attitudes (injunctive norms). Results: Although most respondents (92%) did not personally use cannabis in the past 2 months, the majority of students thought that the majority of their peers were using cannabis and that their peers had more permissive attitudes toward cannabis than they did. When we controlled for students' age, sex, study year, and religious beliefs, perceived peer descriptive norms were associated with personal cannabis use (odds ratio [OR] = 1.42; 95% CI [1.22, 1.64]) and perceived injunctive norms were associated with personal attitudes toward cannabis use (OR = 1.46; 95% CI [1.09, 1.94]). Conclusions: European students appear to possess similar discrepancies between personal and perceived peer norms for cannabis use and attitudes as found in North American students. Interventions that address such discrepancies may be effective in reducing cannabis use.
European Journal of Paediatric Neurology, 2016
To determine the prevalence of sleep disorders in children with attention-deficit/hyperactivity d... more 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. 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&amp;amp;amp;amp;#39;s Continuous Performance Test (CPT) or with AULA Nesplora. 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. 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.
Revista espanola de salud publica, Jan 23, 2016
A suitable environment can encourage the practice of physical activity, being an easy option for ... more A suitable environment can encourage the practice of physical activity, being an easy option for the population, for this reason the main objective was to determine the influence of the urban environmental characteristics relate with the physical activity on adult people living on the Pamplona Area. Cross-sectional study based on the International Physical Activity and the Environment Network (IPEN Adult). Participants were selected in random and stratified from the Basic areas of health attached to resident's population in the Pamplona area, aged ranged between 18-65years old. A self-administered questionnaire was used, including a complete version of the Neighborhood Environment Walkability Scale scale, to evaluate the perception of the urban environmental factors. In addition, the extended version of International Physical Activity Questionnaire for the physical activity data collection was employed. Chi square test was calculated and a multi variable analysis using non-condi...
Surgical Oncology, 2016
To assess the cost-effectiveness of the sentinel node biopsy with lymphadenectomy for nodal metas... more To assess the cost-effectiveness of the sentinel node biopsy with lymphadenectomy for nodal metastases (SNB) in patients with primary cutaneous melanoma (CM) of different Breslow thickness (intermediate, thick, thin). Decision tree models were constructed to compare two different strategies of management of patients with CM, wide excision of the primary lesion and SNB and wide excision only (WE). Tree models were created for every Breslow thickness over 1-, 5- and 10-year time horizons. Mean and total direct healthcare costs, life years saved (LYSs), quality-adjusted life years (QALYs), cost effectiveness ratio (CER), and incremental cost effectiveness ratio (ICER) were estimated. Every model was considered as a base case, and its results tested with sensitivity analyses. Base case analyses showed that the best results were obtained for intermediate CM over 10-year time horizon. In this case, ICER for SNB was 130,508€/QALY, well over the threshold of acceptance (30,000€/QALY). In patients with intermediate CM over 1 and 5 years, and for those with thick and thin CM at any time horizon, negative ICER values were estimated since SNB was proved to be more expensive and less effective than WE. Sensitivity analyses confirmed the robustness of our results. SNB caused no improvement in health outcomes in terms of LYSs and QALYs in patients with thick and thin CM, and only a slight benefit in those with intermediate CM. WE was more cost-effective compared with SNB for any CM thickness over any time horizon up to 10 years.
European Journal of Endocrinology, 2016
ContextThe natural history of advanced thyroid malignancies is largely unknown. The outcome of pa... more ContextThe natural history of advanced thyroid malignancies is largely unknown. The outcome of patients included in the placebo arm of clinical trials could be reflective of their therapy-free evolution.ObjectiveTo analyze the response rate, symptoms and adverse effects of locally advanced or metastatic differentiated (DTC) and medullary thyroid cancer (MTC) in patients treated with placebo in clinical trials.DesignPubMed (MEDLINE) and SCOPUS databases were searched through September 2015 to identify high-quality randomized controlled clinical trials. We included studies that recruited patients with DTC or MTC with a placebo arm.MethodsWe conducted a meta-analysis for each category of response rate, adherence to treatment, and adverse events. An empirical Bayesian random-effect model was used.ResultsWe identified five clinical trials. DTC and MTC were independently analyzed. In the placebo arm, no complete response was observed; partial response occurred in 1.6% (0.6–3) and 6.4% (3....
SE HA REALIZADO UN ESTUDIO BIBLIOMETRICO DE LOS LIBROS Y ARTICULOS ESPANOLES DE SALUD PUBLICA APA... more SE HA REALIZADO UN ESTUDIO BIBLIOMETRICO DE LOS LIBROS Y ARTICULOS ESPANOLES DE SALUD PUBLICA APARECIDOS EN EL SIGLO XVIII ASI COMO UN ESTUDIO LINGUISTICO Y UN ESTUDIO PROSOPOGRAFICO SOBRE LOS AUTORES. COMO RESULTADO DE ESTA INVESTIGACION SE PUEDE CONCLUIR QUE DURANTE EL SIGLO XVIII SE REALIZA EN ESPANA UN ESFUERZO IMPORTANTE POR INCORPORAR TANTO LOS CONCEPTOS TEORICOS COMO POR LLEVAR A CABO LAS APLICACIONES PRACTICA QUE EL INCIPIENTE PENSAMIENTO SALUBRISTADESARROLLA EN EUROPA. LA CREACION DE LA JUNTA DE SANIDAD LA PROMULGACION DE LEGISLACION SANITARIA LOS INSPECTORES DE EPIDEMIAS QUE RECORRIERON LA GEOGRAFIAESPANOLA LUCHANDO CONTRA LAS ENFERMEDADES LA REALIZACION DE TOPOGRAFIAS MEDICAS EL INERES POR EL MEDIO AMBIENTE LA SALUD MATERNO-INFANTIL EL INTERES POR LA EDUCACION SANITARIA SON SIGNOS DE ESTE AVANCE. SIN EMBARGO LAS INSTITUCIONES TRADICIONALES (PROTOMEDICATO UNIVERSIDADES ETC.) SIGUEN SIENDO PODEROSAS Y LOS POLITICOS ILUSTRADOS QUE NO SE ATREVEN O NO PUEDEN ENFRENTARSE DIRECTAMENTE CON ELLAS CREAN INSTITUCIONES PARALELAS QUE DESEMPENAN LAS MISMAS FUNCIONES (ACADEMIAS COLEGIOS DE CIRUGIA ETC.) A TRAVES DE LOS QUE SE INTRODUCEN LAS NUEVAS CORRIENTES MEDICAS Y JUNTO CON ELLAS LA MODERNA SALUD PUBLICA. SE PUEDE AFIRMAR QUE AL FINAL DEL SIGLO ESPANA PARTICIPA CASI EN IGUALDAD DE CONDICIONES DE LAS PREOCUPACIONES HIGIENISTICAS QUE EXISTEN EN EUROPA.
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Papers by Francisco Guillen-Grima