Roberto Pastor-Barriuso

Instituto de Salud Carlos III, Madrid, Madrid, Spain

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Publications (42)245.1 Total impact

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    ABSTRACT: Purpose: To examine the longitudinal association between age and intraocular pressure (IOP) in a large sample of Korean men and women. Methods:We conducted a prospective cohort study of274,064young and middle age Korean adultswith normal fundoscopic findingsfollowed from January 1, 2002 to Feb 28, 2010.Health exams were scheduled annually or biennially. At each visit, IOP was measured in both eyes with automated noncontact tonometers. The longitudinal change in IOP with agewas evaluated using three-level mixed models for longitudinal paired-eye data accounting for correlations between pairedeyes and repeated measurements over time. Results:In fully adjusted models, the average longitudinal change in IOP per one-yearincrease in age was -0.065mm Hg (95% CI -0.068 to -0.063), with markedsex differences (P<0.001). In men, the average annual IOP change was -0.093 mm Hg (95% CI -0.096 to -0.091) throughout follow-up. In women, the average annual IOP change was -0.006 mm Hg (95% CI -0.010 to -0.003), with a relatively flat association in the middle-age range of 30-59 years and more marked annual decreases at younger and older ages. Conclusions: IOP was inversely associated with age in a large cohort of Korean adults attending health screening visits. For men, this inverse association was observed throughout the entire age range, while for women it was evident only in younger (<30 year of age) and older (≥60 years of age) women, with no association in women aged 30 to 59.Further research is needed to better understand the underlying mechanisms and to reconsider cutoffs for defining high IOP by age and sex groups in Asian populations.
    Investigative ophthalmology & visual science. 09/2014;
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    ABSTRACT: Overt and subclinical hypothyroidism are risk factors for atherosclerosis. It is unclear whether thyroid hormone levels within the normal range are also associated with atherosclerosis measured by coronary artery calcium (CAC).
    Arteriosclerosis Thrombosis and Vascular Biology 07/2014; · 6.34 Impact Factor
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    ABSTRACT: Overt and subclinical hypothyroidism are associated with higher levels of serum creatinine and with increased risk of chronic kidney disease (CKD). The prospective association between thyroid hormones and kidney function in euthyroid individuals, however, is largely unexplored.
    International Journal of Epidemiology 07/2014; · 6.98 Impact Factor
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    ABSTRACT: Although oral cavity, pharyngeal, oesophageal and gastric cancers share some risk factors, no comparative analysis of mortality rate trends in these illnesses has been undertaken in Spain. This study aimed to evaluate the independent effects of age, death period and birth cohort on the mortality rates of these tumours. Specific and age-adjusted mortality rates by tumour and sex were analysed. Age-period-cohort log-linear models were fitted separately for each tumour and sex, and segmented regression models were used to detect changes in period- and cohort-effect curvatures. Among men, the period-effect curvatures for oral cavity/pharyngeal and oesophageal cancers displayed a mortality trend that rose until 1995 and then declined. Among women, oral cavity/pharyngeal cancer mortality increased throughout the study period whereas oesophageal cancer mortality decreased after 1970. Stomach cancer mortality decreased in both sexes from 1965 onwards. Lastly, the cohort-effect curvature showed a certain degree of similarity for all three tumours in both sexes, which was greater among oral cavity, pharyngeal and oesophageal cancers, with a change point in evidence, after which risk of death increased in cohorts born from the 1910-1920s onwards and decreased among the 1950-1960 cohorts and successive generations. This latter feature was likewise observed for stomach cancer. While the similarities of the cohort effects in oral cavity/pharyngeal, oesophageal and gastric tumours support the implication of shared risk factors, the more marked changes in cohort-effect curvature for oral cavity/pharyngeal and oesophageal cancer could be due to the greater influence of some risk factors in their aetiology, such as smoking and alcohol consumption. The increase in oral cavity/pharyngeal cancer mortality in women deserves further study.
    BMC Cancer 04/2014; 14(1):254. · 3.33 Impact Factor
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    Roberto Pastor-Barriuso, Gonzalo López-Abente
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    ABSTRACT: In contrast to other haematological cancers, mortality from non-Hodgkin's lymphoma and multiple myeloma increased dramatically during the second half of the 20th century in most developed countries. This widespread upward trend remains controversial, as it may be attributable either to progressive improvements in diagnosis and certification or to increasing exposures to little-known but relevant risk factors. To assess the relative contribution of these factors, we analysed the independent effects of age, death period, and birth cohort on haematological cancer mortality rates in Spain across the period 1952-2006. Weighted joinpoint regression analyses were performed to detect and estimate changes in period and cohort curvatures. Although mortality rates were consistently higher among men, trends across periods and cohorts were virtually identical in both sexes. There was an early period trend reversal in the 1960s for Hodgkin's disease and leukaemia, which was delayed to the 1980s for multiple myeloma and the 1990s for non-Hodgkin's lymphoma. Birth cohort patterns showed a first downturn for generations born in the 1900s and 1910s for all haematological cancers, and a second trend reversal for more recent cohorts born in the 1950s and 1960s for non-Hodgkin's lymphoma and leukaemia. The sustained decline in Hodgkin's disease mortality and the levelling off in leukaemia seem to be driven by an early period effect linked to improvements in disease treatment, whereas the steep upward trends in non-Hodgkin's lymphoma and multiple myeloma mortality in Spain are more likely explained by a cohort effect linked to better diagnosis and death certification in the elderly. The consistent male excess mortality across all calendar periods and age groups points to the importance of possible sex-related genetic markers of susceptibility in haematological cancers.
    BMC Cancer 04/2014; 14(1):250. · 3.33 Impact Factor
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    ABSTRACT: Context: Hyperthyroidism and hypothyroidism, both overt and subclinical, are associated with all-cause and cardiovascular mortality. The association between thyroid hormones and mortality in euthyroid individuals, however, is unclear. Objective: To examine the prospective association between thyroid hormones levels within normal ranges and mortality endpoints. Design: Prospective cohort study from January 1, 2002 to December 31, 2009. Participants: 212,456 middle age South Korean men and women who had normal thyroid hormone levels and no history of thyroid disease at baseline. Exposures: Free thyroxin (FT4), free triiodothyronine (FT3), and thyroid-stimulating hormone (TSH) levels were measured by radioimmunoassay. Main outcomes: Vital status and cause of death ascertainment were based on linkage to the National Death Index death certificate records. Results: After a median follow-up of 4.3 years, 730 participants died (335 cancer deaths and 112 cardiovascular deaths). FT4 was inversely associated with all-cause mortality (HR = 0.77, 95% CI 0.63 to 0.95, comparing the highest vs. lowest quartile of FT4; P for linear trend = 0.01), and FT3 was inversely associated cancer mortality (HR = 0.62, 95% CI 0.45 to 0.85; P for linear trend = 0.001). TSH was not associated with mortality endpoints. Conclusions: In a large cohort of euthyroid men and women, FT4 and FT3 levels within the normal range were inversely associated with the risk of all-cause mortality and cancer mortality, particularly liver cancer mortality.
    The Journal of Clinical Endocrinology and Metabolism 04/2014; · 6.31 Impact Factor
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    ABSTRACT: World-wide controversy continues to surround the question of whether exposure to ionising radiations arising from nuclear power plants and radioactive fuel cycle facilities could increase the risk of cancer. The objective was to analyse cancer mortality in towns close to Spanish nuclear power plants and radioactive fuel cycle facilities by reference to their history of exposure to artificial radiation generated by such emissions. An ecological cancer mortality study was conducted to know the effect of artificial radiation, estimated taken into account the magnitude of emissions, in towns ≤30 km of any installation. A model of atmospheric and aquatic dispersion of radionuclides was used. As reference, towns within a 50–100 km radius were matched with exposed by socio-demographic characteristics. For analysis purposes, log-linear Poisson models were fitted. The cumulative effective dose was the measure of exposure. Mortality rates ratios were calculated for each tumour site. Natural radiation and socio-demographic matching variables were included in the models, with ‘installation’ as a random effects term. The estimated cumulative artificial radiation dose was below 350 μSv for all sites. For nuclear power plants overall, analysis showed no positive association with increases in the cumulative dose. In the joint analysis of radioactive fuel cycle facilities, however, mortality was observed to rise with increases in the estimated radiation dose in the case of lung, bone and colorectal cancer, and in breast cancer among women. These results would not appear to be due to exposure arising from the operation of the installations, since were not reproduced around installations of the same type.
    International journal of Environmental Science and Technology 02/2014; · 1.84 Impact Factor
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    ABSTRACT: A total of 2,514,346 metric tons (Mt) of asbestos were imported into Spain from 1906 until the ban on asbestos in 2002. Our objective was to study pleural cancer mortality trends as an indicator of mesothelioma mortality and update mortality predictions for the periods 2011--2015 and 2016--2020 in Spain. Log-linear Poisson models were fitted to study the effect of age, period of death and birth cohort (APC) on mortality trends. Change points in cohort- and period-effect curvatures were assessed using segmented regression. Fractional power-link APC models were used to predict mortality until 2020. In addition, an alternative model based on national asbestos consumption figures was also used to perform long-term predictions. Pleural cancer deaths increased across the study period, rising from 491 in 1976--1980 to 1,249 in 2006--2010. Predictions for the five-year period 2016--2020 indicated a total of 1,319 pleural cancer deaths (264 deaths/year). Forecasts up to 2020 indicated that this increase would continue, though the age-adjusted rates showed a levelling-off in male mortality from 2001 to 2005, corresponding to the lower risk in post-1960 generations. Among women, rates were lower and the mortality trend was also different, indicating that occupational exposure was possibly the single factor having most influence on pleural cancer mortality. The cancer mortality-related consequences of human exposure to asbestos are set to persist and remain in evidence until the last surviving members of the exposed cohorts have disappeared. It can thus be assumed that occupationally-related deaths due to pleural mesothelioma will continue to occur in Spain until at least 2040.
    BMC Cancer 11/2013; 13(1):528. · 3.33 Impact Factor
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    Javier Virues-Ortega, Flávia M Julio, Roberto Pastor-Barriuso
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    ABSTRACT: The intervention program for autism known as Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH) is considered an emerging practice for autism. In the present study we used state-of-the-art meta-analytical procedures to examine the pooled clinical effects of TEACCH in a variety of outcomes. A total of 13 studies were selected for meta-analysis totaling 172 individuals with autism exposed to TEACCH. Standardized measures of perceptual, motor, adaptive, verbal and cognitive skills were identified as treatment outcomes. We used inverse-variance weighted random effects meta-analysis supplemented with quality assessment, sensitivity analysis, meta-regression, and heterogeneity and publication bias tests. The results suggested that TEACCH effects on perceptual, motor, verbal and cognitive skills were of small magnitude in the meta-analyzed studies. Effects over adaptive behavioral repertoires including communication, activities of daily living, and motor functioning were within the negligible to small range. There were moderate to large gains in social behavior and maladaptive behavior. The effects of the TEACCH program were not moderated by aspects of the intervention such as duration (total weeks), intensity (hours per week), and setting (home-based vs. center-based). While the present meta-analysis provided limited support for the TEACCH program as a comprehensive intervention, our results should be considered exploratory owing to the limited pool of studies available.
    Clinical psychology review 07/2013; 33(8):940-953. · 7.18 Impact Factor
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    ABSTRACT: The Gail model for predicting the absolute risk of invasive breast cancer has been validated extensively in US populations, but its performance in the international setting remains uncertain. We evaluated the predictive accuracy of the Gail model in 54,649 Spanish women aged 45-68 years who were free of breast cancer at the 1996-1998 baseline mammographic examination in the population-based Navarre Breast Cancer Screening Program. Incident cases of invasive breast cancer and competing deaths were ascertained until the end of 2005 (average follow-up of 7.7 years) through linkage with population-based cancer and mortality registries. The Gail model was tested for calibration and discrimination in its original form and after recalibration to the lower breast cancer incidence and risk factor prevalence in the study cohort, and compared through cross-validation with a Navarre model fully developed from this cohort. The original Gail model overpredicted significantly the 835 cases of invasive breast cancer observed in the cohort (ratio of expected to observed cases 1.46, 95 % CI 1.36-1.56). The recalibrated Gail model was well calibrated overall (expected-to-observed ratio 1.00, 95 % CI 0.94-1.07), but it tended to underestimate risk for women in low-risk quintiles and to overestimate risk in high-risk quintiles (P = 0.01). The Navarre model showed good cross-validated calibration overall (expected-to-observed ratio 0.98, 95 % CI 0.92-1.05) and in different cohort subsets. The Navarre and Gail models had modest cross-validated discrimination indexes of 0.542 (95 % CI 0.521-0.564) and 0.544 (95 % CI 0.523-0.565), respectively. Although the original Gail model cannot be applied directly to populations with different underlying rates of invasive breast cancer, it can readily be recalibrated to provide unbiased estimates of absolute risk in such populations. Nevertheless, its limited discrimination ability at the individual level highlights the need to develop extended models with additional strong risk factors.
    Breast Cancer Research and Treatment 02/2013; · 4.47 Impact Factor
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    ABSTRACT: INTRODUCTION: It is not clear whether high mammographic density (MD) is equally associated with all subtypes of breast cancer (BC). We investigated the association between MD and subsequent BC, considering invasiveness, means of detection, pathologic subtype and the time elapsed since mammographic exploration and BC diagnosis. METHODS: BC cases occurring in the population of women who attended screening from 1997 through 2004 in Navarre, a Spanish region with a fully consolidated screening program, were identified via record-linkage with the Navarre Cancer Registry (N=1,172). Information was extracted from the records of their first attendance at screening in that period. For each case, we randomly selected four controls, matched by screening round, year of birth, and place of residence. Cases were classified according to invasiveness (ductal carcinoma in situ (DCIS) versus invasive tumors), pathologic subtype (considering hormonal receptors and HER2), and type of diagnosis (screen-detected versus interval cases). MD was evaluated by a single, experienced radiologist using a semiquantitative scale. Data on BC risk factors were obtained by the screening program in the corresponding round. The association between MD and tumor subtype was assessed using conditional logistic regression. RESULTS: MD was clearly associated with subsequent BC. The odds ratio (OR) for the highest MD category (MD>75%) compared to the reference category (MD<10%) was similar for DCIS (OR=3.47; 95%CI=1.46-8.27) and invasive tumors (OR=2.95; 95%CI=2.01-4.35). The excess risk was particularly high for interval cases (OR=7.72; 95%CI=4.02-14.81) in comparison to screened detected tumors (OR=2.17; 95%CI=1.40-3.36). Sensitivity analyses excluding interval cases diagnosed in the first year after MD assessment or immediately after an early recall to screening yielded similar results. No differences were seen regarding pathologic subtypes. The excess risk associated with MD persisted for at least 7-8 years after mammographic exploration. CONCLUSIONS: Our results confirm that MD is an important risk factor for all types of breast cancer. High breast density strongly increases the risk of developing an interval tumor and this excess risk is not completely explained by a possible masking effect.
    Breast cancer research: BCR 01/2013; 15(1):R9. · 5.87 Impact Factor
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    ABSTRACT: BACKGROUND: Falls have enormous impact in older adults. Yet, there is insufficient evidence regarding the effectiveness of preventive interventions in this setting. The objectives were to measure the frequency of falls and associated factors among older people living institutions. METHODS: Data were obtained from a survey on a probabilistic sample of residents aged >=65 years, drawn in 1998-99 from institutions of Madrid (Spain). Residents, their caregivers, and facility physicians were interviewed. Fall rates were computed based on the number of physician-reported falls in the preceding 30 days. Adjusted rate ratios were computed using negative binomial regression models, including age, sex, cognitive status, functional dependence, number of diseases, and polypharmacy. RESULTS: The final sample comprised 733 residents. The fall rate was 2.4 falls per person-year (95% confidence interval [CI], 2.04-2.82). The strongest risk factor was number of diseases, with an adjusted rate ratio (RR) of 1.32 (95% CI, 1.17-1.50) for each additional diagnosis. Other variables associated with falls were: urinary incontinence (RR = 2.56 [95% CI, 1.32-4.94]); antidepressant use (RR = 2.32 [95% CI, 1.22-4.40]); arrhythmias (RR = 2.00 [95% CI, 1.05-3.81]); and polypharmacy (RR = 1.07 [95% CI, 0.95-1.21], for each additional medication). The attributable fraction for number of diseases (with reference to those with <= 1 condition) was 84% (95% CI, 45-95%). CONCLUSIONS: Number of diseases was the main risk factor for falls in this population of institutionalized older adults. Other variables associated with falls, probably more amenable to preventive action, were urinary incontinence, antidepressants, arrhythmias, and polypharmacy.Virtual slides: The virtual slide(s) for this article can be found here:http://www.diagnosticpathology.diagnomx.eu/vs/3916151157277337.
    BMC Geriatrics 01/2013; 13(1):6. · 2.34 Impact Factor
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    ABSTRACT: Little is known about the dose-response relationship between physical activity and health benefits among young people. Our objective was to analyse the association between the frequency of undertaking moderate-to-vigorous physical activity (MVPA) and the self-reported health status of the adolescent population. Cross-sectional study. All regions of Spain. Students aged 11-18 years participating in the Spanish Health Behaviour in School-aged Children survey 2006. A total of 375 schools and 21 188 students were selected. The frequency of undertaking MVPA was measured by a questionnaire, with the following four health indicators: self-rated health, health complaints, satisfaction with life and health-related quality of life. Linear and logistic regression models were used to analyse the association, adjusting for potential confounding variables and the modelling of the dose-response relationship. As the frequency of MVPA increased, the association with health benefits was stronger. A linear trend (p<0.05) was found for self-rated health and health complaints in males and females and for satisfaction with life among females; for health-related quality of life this relationship was quadratic for both sexes (p<0.05). For self-reported health and health complaints, the effect was found to be of greater magnitude in males than in females and, in all scales, the benefits were observed from the lowest frequencies of MVPA, especially in males. A protective effect of MVPA was found in both sexes for the four health indicators studied, and this activity had a gradient effect. Among males, health benefits were detected from very low levels of physical activity and the magnitude of the relationship was greater than that for females.
    BMJ Open 01/2013; 3(5). · 2.06 Impact Factor
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    ABSTRACT: Human biomonitoring (HBM), defined as the measurement of concentrations of chemicals or of their metabolites in human biological matrices, is considered the method of choice for determining internal exposures in individuals. HBM is part of environmental exposure surveillance systems in several countries. In 2007, the Ministry of Agriculture, Food and Environment promoted BIOAMBIENT.ES project, a national-level HBM study on environmental pollutants carried out in Spain to estimate levels of heavy metals, persistent organic pollutants, and other substances on the Spanish active workforce. BIOAMBIENT.ES is a nationwide cross-sectional study, with a stratified cluster sampling designed to cover all geographical areas, sex and occupational sectors, and aimed to obtain a representative sample of the Spanish workforce. Participants were recruited among people residing in Spain for 5 years or more, which underwent their annual occupational medical check-up in the health facilities of the Societies for Prevention of IBERMUTUAMUR, MUTUALIA, MC-PREVENCIÓN, MUGATRA, UNIMAT PREVENCIÓN, and PREVIMAC (March 2009-July 2010). A total of 1,892 subjects fulfilled the criteria for inclusion, donated biological samples (1,880 blood, 1,770 urine, and 577 hair) and completed a short self-administrated epidemiological questionnaire on environmental and lifestyle-related exposures. Additionally, clinical information from participant's health exams was obtained. This project will provide a first overview of the body burden of selected pollutants in a representative sample of the Spanish-occupied population. This information will be useful to establish reference values of the studied population and, eventually, to evaluate temporal trends and the effectiveness of environmental and health policies.
    Environmental Science and Pollution Research 11/2012; · 2.76 Impact Factor
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    ABSTRACT: Urine cadmium concentrations were associated with all-cause and cardiovascular mortality in men in the 1988-1994 U.S. National Health and Nutrition Examination Survey (NHANES) population. Since 1988, cadmium exposure has decreased substantially in the United States. The associations between blood and urine cadmium and cardiovascular disease (CVD) mortality at more recent levels of exposure are unknown. We evaluated the prospective association of blood and urine cadmium concentrations with all-cause and CVD mortality in the 1999-2004 U.S. population. We followed 8,989 participants who were ≥ 20 years of age for an average of 4.8 years. Hazard ratios for mortality end points comparing the 80th to the 20th percentiles of cadmium distributions were estimated using Cox regression. The multivariable adjusted hazard ratios [95% confidence intervals (CIs)] for blood and urine cadmium were 1.50 (95% CI: 1.07, 2.10) and 1.52 (95% CI: 1.00, 2.29), respectively, for all-cause mortality, 1.69 (95% CI: 1.03, 2.77) and 1.74 (95% CI: 1.07, 2.83) for CVD mortality, 1.98 (95% CI: 1.11, 3.54) and 2.53 (95% CI: 1.54, 4.16) for heart disease mortality, and 1.73 (95% CI: 0.88, 3.40) and 2.09 (95% CI: 1.06, 4.13) for coronary heart disease mortality. The population attributable risks associated with the 80th percentile of the blood (0.80 μg/L) and urine (0.57 μg/g) cadmium distributions were 7.0 and 8.8%, respectively, for all-cause mortality and 7.5 and 9.2%, respectively, for CVD mortality. We found strongly suggestive evidence that cadmium, at substantially low levels of exposure, remains an important determinant of all-cause and CVD mortality in a representative sample of U.S. adults. Efforts to further reduce cadmium exposure in the population could contribute to a substantial decrease in CVD disease burden.
    Environmental Health Perspectives 04/2012; 120(7):1017-22. · 7.26 Impact Factor
  • Ana Maria Pedraza, Marina Pollán, Roberto Pastor-Barriuso, Anna Cabanes
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    ABSTRACT: In recent decades, breast cancer cases have increased steadily worldwide. However, the increases do not hold across all demographics and breast cancer cases in low and middle income countries have increased much faster than the global trend. Colombia is not an exception. Breast cancer was the most frequent tumor and the second cause of cancer-related deaths in women in 2008, with an estimated of 6,700 new cases and 2,100 deaths. We present here an analysis of breast cancer mortality rates and trends in Colombia, over the period 1985-2008. We studied overall and age-specific changes in breast cancer mortality using change-point Poisson regression models. Between 1985 and 2008, there were 32,375 breast cancer deaths in women in Colombia. Breast cancer mortality increased since 1985, although the annual increase varied between age groups and socioeconomic levels. Only in women aged 45-64 years old that live in areas of high socioeconomic levels, breast cancer mortality was stable or decreasing. Hence, successful cancer control is possible in middle income countries, as shown by the progress observed in certain groups. The development of an integrated strategy of early detection and early access to proper treatment, suitable for areas with limited resources, is an urgent necessity.
    Breast Cancer Research and Treatment 03/2012; 134(3):1199-207. · 4.47 Impact Factor
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    ABSTRACT: Animal-assisted therapy (AAT) may affect health via an increase in perceived social support and social interaction. A meta-analysis was conducted to determine its effects on selected populations with poor social functioning. Studies involving elderly participants and those with depression and schizophrenia were searched in Medline, PsycINFO and Cochrane up to January 2009. Matched or controlled trials incorporating pre- and post-test outcome measures and with at least five participants subjected to a multiple-day AAT intervention were selected (n=21). Participants' characteristics, study design, intervention features, outcome variables, reported effects and study quality were retrieved. Design-specific effect sizes were pooled using random-effects models. Heterogeneity of effects by study characteristics, including target population and intervention features, was explored through meta-regression. Pooled effect sizes were calculated for social functioning, depression, anxiety, behavioural disturbances, loneliness, daily living skills and cognitive status. As hypothesised, AAT improved social functioning (pooled effect size = 1.06, n=275). Moderate effects were found for depression (−0.34, n=447), anxiety (−0.29, n=291) and behavioural disturbances (−0.32, n=367). Effects on social functioning and depression were larger in individuals with psychiatric conditions while behavioural disturbances were reduced in patients with dementia. The inconsistent methodological characteristics of the studies meta-analysed suggest a conservative interpretation of these findings.
    Health Psychology Review 01/2012; 6(2):197-221. · 2.06 Impact Factor
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    ABSTRACT: Evidence that selenium affects the risk of type-2 diabetes is conflicting, with observational studies and a few randomized trials showing both lower and higher risk linked to the level of selenium intake and status. We investigated the effect of selenium supplementation on the risk of type-2 diabetes in a population of relatively low selenium status as part of the UK PRECISE (PREvention of Cancer by Intervention with SElenium) pilot study. Plasma adiponectin concentration, a recognised independent predictor of type-2 diabetes risk and known to be correlated with circulating selenoprotein P, was the biomarker chosen. In a randomized, double-blind, placebo-controlled trial, five hundred and one elderly volunteers were randomly assigned to a six-month intervention with 100, 200 or 300 µg selenium/d as high-selenium or placebo yeast. Adiponectin concentration was measured by ELISA at baseline and after six months of treatment in 473 participants with one or both plasma samples available. Mean (SD) plasma selenium concentration was 88.5 ng/g (19.1) at baseline and increased significantly in the selenium-treatment groups. In baseline cross-sectional analyses, the fully adjusted geometric mean of plasma adiponectin was 14% lower (95% CI, 0-27%) in the highest than in the lowest quartile of plasma selenium (P for linear trend = 0.04). In analyses across randomized groups, however, selenium supplementation had no effect on adiponectin levels after six months of treatment (P = 0.96). These findings are reassuring as they did not show a diabetogenic effect of a six-month supplementation with selenium in this sample of elderly individuals of relatively low selenium status. Controlled-Trials.com ISRCTN25193534.
    PLoS ONE 01/2012; 7(9):e45269. · 3.53 Impact Factor
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    ABSTRACT: High selenium status has been linked to elevated blood cholesterol levels in cross-sectional studies. To investigate the effect of selenium supplementation on plasma lipids. Randomized, placebo-controlled, parallel-group study stratified by age and sex. Participants, research nurses, and persons assessing outcomes were blinded to treatment assignment. (International Standard Randomised Controlled Trial Number Register registration number: ISRCTN25193534) 4 general practices in the United Kingdom. 501 volunteers aged 60 to 74 years. Participants received selenium, 100 mcg/d (n = 127), 200 mcg/d (n = 127), or 300 mcg/d (n = 126), as high-selenium yeast or a yeast-based placebo (n = 121) for 6 months. Total and high-density lipoprotein (HDL) cholesterol concentrations were measured in nonfasting plasma samples stored from participants in the UK PRECISE (United Kingdom PREvention of Cancer by Intervention with SElenium) Pilot Study at baseline (n = 454) and at 6 months (n = 394). Non-HDL cholesterol levels were calculated. Mean plasma selenium concentration was 88.8 ng/g (SD, 19.2) at baseline and increased statistically significantly in the treatment groups. The adjusted difference in change in total cholesterol levels for selenium compared with placebo was -0.22 mmol/L (-8.5 mg/dL) (95% CI, -0.42 to -0.03 mmol/L [-16.2 to -1.2 mg/dL]; P = 0.02) for 100 mcg of selenium per day, -0.25 mmol/L (-9.7 mg/dL) (CI, -0.44 to -0.07 mmol/L [-17.0 to -2.7 mg/dL]; P = 0.008) for 200 mcg of selenium per day, and -0.07 mmol/L (-2.7 mg/dL) (CI, -0.26 to 0.12 mmol/L [-10.1 to 4.6 mg/dL]; P = 0.46) for 300 mcg of selenium per day. Similar reductions were observed for non-HDL cholesterol levels. There was no apparent difference in change in HDL cholesterol levels with 100 and 200 mcg of selenium per day, but the difference was an adjusted 0.06 mmol/L (2.3 mg/dL) (CI, 0.00 to 0.11 mmol/L [0.0 to 4.3 mg/dL]; P = 0.045) with 300 mcg of selenium per day. The total-HDL cholesterol ratio decreased progressively with increasing selenium dose (overall P = 0.01). The duration of supplementation was limited, as was the age range of the participants. Selenium supplementation seemed to have modestly beneficial effects on plasma lipid levels in this sample of persons with relatively low selenium status. The clinical significance of the findings is unclear and should not be used to justify the use of selenium supplementation as additional or alternative therapy for dyslipidemia. This is particularly true for persons with higher selenium status, given the limitations of the trial and the potential additional risk in other metabolic dimensions. The Cancer Research Campaign (now Cancer Research UK) and the University of Surrey.
    Annals of internal medicine 05/2011; 154(10):656-65. · 13.98 Impact Factor
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    ABSTRACT: Mammographic density (MD), or the proportion of the breast with respect to its overall area that is composed of dense tissue, is a strong risk factor for breast cancer. Studies support a positive association of mammographic density and alcohol drinking. This was a cross-sectional multicenter study based on 3584 women, aged 45–68years, recruited from seven screening centers within the Spanish breast cancer screening program network. The association between MD, alcohol consumption and tobacco use was evaluated by using ordinal logistic models with random center-specific intercepts. We found a weak positive association between current alcohol intake and higher MD, with current alcohol consumption increasing the odds of high MD by 13% (OR=1.13; 95% CI 0.99–1.28) and high daily grams of alcohol being positively associated with increased MD (P for trend=0.045). There were no statistically significant differences in MD between smokers and non-smokers. Nevertheless, increased number of daily cigarettes and increased number of accumulated lifetime cigarettes were negatively associated with high MD (P for trend 0.017 and 0.021). The effect of alcohol on MD was modified by menopausal status and tobacco smoking: whereas, alcohol consumption and daily grams of alcohol were positively associated with higher MD in postmenopausal women and in women who were not currently smoking, alcohol consumption had no effect on MD in premenopausal women and current smokers. Our results support an association between recent alcohol consumption and high MD, characterized by a modest increase in risk at low levels of current consumption and a decrease in risk among heavier drinkers. Our study also shows how the effects of alcohol in the breast can be modified by other factors, such as smoking. KeywordsMammographic density–Alcohol–Smoking–Breast cancer–Ordinal logistic models
    Breast Cancer Research and Treatment 01/2011; 129(1):135-147. · 4.47 Impact Factor

Publication Stats

2k Citations
245.10 Total Impact Points

Institutions

  • 2003–2014
    • Instituto de Salud Carlos III
      • • Area of Environmental Epidemiology and Cancer
      • • Centro Nacional de Epidemiología (CNE)
      Madrid, Madrid, Spain
  • 2013
    • University of Manitoba
      • Department of Psychology
      Winnipeg, Manitoba, Canada
  • 2006–2012
    • Johns Hopkins Bloomberg School of Public Health
      • • Department of Epidemiology
      • • Department of Environmental Health Sciences
      Baltimore, MD, United States
    • Ministry of Health, Madrid
      Madrid, Madrid, Spain
  • 2011
    • University of Surrey
      • Faculty of Health and Medical Sciences
      Guildford, ENG, United Kingdom
  • 2005–2010
    • Johns Hopkins Medicine
      • • Department of Epidemiology
      • • Welch Center for Prevention, Epidemiology and Clinical Research
      Baltimore, Maryland, United States
    • Hospital de Txagorritxu
      Vitoria, Basque Country, Spain
    • Yonsei University
      • Graduate School of Public Health
      Seoul, Seoul, South Korea
  • 2009
    • Johns Hopkins University
      • Department of Environmental Health Sciences
      Baltimore, MD, United States