Artículos de revista DCS - OZS Aldizkari artikuluak

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Open Access
CITA GO-ON study: a community based multidomain lifestyle intervention to prevent cognitive decline: protocol design and recruitment process
(Frontiers Media, 2025-06-16) Tainta, Mikel; Ecay-Torres, Mirian; Barandiaran, Myriam; Estanga, Ainara; López, Carolina; Altuna Azkargorta, Miren; Iriondo, Ane; Saldias, Jon; García-Sebastián, Maite; Cañada, Marta; Arriba, Maria de; Reparaz Escudero, Imanol; López Sáez de Asteasu, Mikel; Izquierdo Redín, Mikel; Balluerka, Nekane; Gorostiaga, Arantxa; Ros, Naia; Soroa, Goretti; Domper, Jara; Gayoso, Lucía; Arrizabalaga-López, María; Etxeberria, Usune; Torres, María Inés; Alberdi, Elena; Capetillo-Zarate, Estibaliz; Mateo-Abad, Maider; Vergara, Itziar; Mar, Javier; Martínez-Lage, Pablo; Ciencias de la Salud; Osasun Zientziak
Introduction: Growing research suggests that dementia is a complex disorder with multiple risk factors and causes. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) demonstrated that lifestyle interventions could confer cognitive benefits. Inspired by this, the GOIZ-ZAINDU (GZ) feasibility study adapted the FINGER approach to the Basque context. Building upon the GZ study, the CITA GO-ON trial aims to enhance and expand the evidence supporting dementia prevention through a multidomain intervention of risk factor management and resilience promotion. Methods: It is a two-year, population-based, randomized controlled trial to prevent cognitive decline in adults aged 60–85 years with Cardiovascular Risk Factors, Aging and Dementia (CAIDE) risk score ≥6, no dementia, and belowthan- expected performance on at least one of three cognitive screening tests. Participants are randomized (1:1) to receive either Regular Health Advice (RHA) or a Multidomain Intervention (MD-Int) that encompasses cognitive training, socio-emotional skills, multicomponent physical exercise, nutritional and culinary intervention, and monitoring for cardiovascular risks, pharmacological drug mismanagement, and comorbidities. The primary outcome is the efficacy of the intervention to reduce the risk of cognitive decline measured by the global composite z-score of the modified Neuropsychological Test Battery over two years. The secondary outcomes measure cost-effectiveness, quality of life, and functional abilities. Blood samples and brain imaging will also be collected to evaluate the effects of the intervention on brain structure and plasma biomarkers. Results: Recruitment has been completed with 1051 participants selected (mean age (standard deviation, SD) of 69.65 (6.36), 58,50 % female, and mean CAIDE (SD) of 7.62 (1.427). The final participant is expected to complete the last study visit by the autumn of 2026. Discussion: The CITA GO-ON Study, as a part of the World-Wide FINGERS network, is designed to validate the efficacy of a multidomain lifestyle intervention for dementia prevention and contribute valuable data to inform public health strategies fostering healthy, active aging.
Open Access
Investigación pediátrica en España: desafíos y oportunidades
(Elsevier, 2025-07-01) Moreno Galarraga, Laura; García Vera, César; Rivero-Calle, Irene; Martinón-Torres, Federico; Díez López, Ignacio; Cabañas, Fernando; Calvo, Cristina; INVEST-AEP; Ciencias de la Salud; Osasun Zientziak
Introducción: La investigación pediátrica es clave para mejorar el diagnóstico, tratamiento y prevención de las enfermedades pediátricas. A pesar de su importancia, sigue infradotada y subrepresentada frente a la investigación en adultos en España y frente a la investigación pediátrica en otros países. Objetivo: Identificar las principales barreras de la investigación pediátrica en España y proponer estrategias para fortalecer su desarrollo y su integración en el sistema sanitario. Métodos: El grupo de trabajo INVEST-AEP realizó un análisis del estado actual de la investigación pediátrica en España. Se identificaron barreras en financiación, formación, carga asistencial y burocracia, y se proponen estrategias de mejora. Resultados: Las principales barreras incluyen la baja financiación (5% de las ayudas nacionales ISCIII), la escasa formación en investigación (tanto en pregrado como durante la residencia MIR), la elevada carga asistencial sin tiempo protegido para investigar y la escasez de redes colaborativas. La situación es aún más crítica en atención primaria. Actualmente la investigación carece del reconocimiento suficiente en las oposiciones y en la carrera profesional. Se identificaron modelos de éxito, como mejoras en la formación de estudiantes de medicina y residentes, consolidación de redes estructuradas, financiación específica, tiempo protegido para la investigación, centralización de los comités de ética y reconocimiento de la investigación en concursos y oposiciones. Conclusiones: Es urgente implementar estrategias para fortalecer la investigación pediátrica en España que incluyan mayor inversión, programas formativos y redes colaborativas. El pediatra debe integrar asistencia, docencia e investigación. Pediatras, instituciones, universidades y gobiernos deben impulsar la investigación pediátrica para mejorar la salud infantil y posicionar a España como referente.
Open Access
Comparación de pacientes reales y estandarizados en el Grado de Medicina: un estudio de intervención aleatorizado y controlado
(Elsevier, 2025-06-01) Díez, Nieves; Franchez, B.; Rodríguez Díez, María Cristina; Vidaurreta, Marta; Betés, Maite Teresa; Fernández, Secundino; Palacio, P.; Pueyo, Francisco Javier Olivera; Martín Calvo, Nerea; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC
Introducción: Los escenarios clínicos simulados permiten a los estudiantes aprender en un entorno seguro. Aunque se recomienda la participación de pacientes estandarizados (PE) en estos escenarios, existen pocos estudios que comparen el impacto en la educación médica entre PE y pacientes reales (PR). Métodos: Se seleccionaron 40 estudiantes de medicina por curso (4.º, 5.º y 6.º) y se asignaron aleatoriamente (1:1) a dos grupos: escenario con PR o con PE. Los estudiantes y el observador externo desconocían el tipo de paciente que participaba en el escenario. Los estudiantes completaron cuestionarios de sensaciones y conocimientos, y los profesores responsables y el observador externo, cuestionarios de sensaciones. La información cualitativa se recogió mediante grupos focales con los estudiantes. Resultados: No se encontraron diferencias significativas entre ambos grupos en las sensaciones percibidas ni en los conocimientos adquiridos, pero sí en la probabilidad de identificar correctamente el tipo de paciente (p < 0,001). La mayoría de los estudiantes del escenario con PE lo identificaron como PR. Tampoco se encontraron diferencias entre grupos, en los cuestionarios completados por profesores y observador externo. Los estudiantes se preparan e involucran más si creen estar ante un PR y consideran que el feedback del paciente es enriquecedor, independientemente del tipo de paciente. Conclusiones: Los estudiantes de medicina no diferencian a los PE de los PR en los escenarios, y los evalúan de manera similar. Ante la dificultad de disponer de PR con diversas patologías y niveles de gravedad, el PE es una buena alternativa para la formación de los estudiantes de medicina.
Open Access
Clinical outcomes of out-of-office versus in-office blood pressure monitoring in adults with hypertension
(Wiley, 2025-05-06) Roncal Belzunce, Victoria; Ramón Espinoza, Fernanda; Gutiérrez Valencia, Marta; Leache, Leire; Saiz Fernández, Luis Carlos; Erviti López, Juan; Ciencias de la Salud; Osasun Zientziak
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: to assess the effects of out-of-office compared to in-office blood pressure (BP) monitoring for improving clinical outcomes in adults with hypertension.
Open Access
Gastrosquisis simple complicada con múltiples perforaciones, abdomen congelado y pérdida de dominio abdominal
(Gobierno de Navarra, 2025-02-13) Cayetano Cabrera, Diana Alondra; Zalles Vidal, Cristian; Peñarrieta Daher, Alejandro Alberto; Moreno Alfonso, Julio César; Bautista Jiménez, Katherine; Meléndez Roque, María Lourdes; Ciencias de la Salud; Osasun Zientziak
La gastrosquisis es una malformación congénita caracterizada por una hernia visceral que representa una de las principales causas de síndrome de intestino corto de las series pediátricas. Puede ser secundaria a intestino corto congénito, pero también derivarse de complicaciones asociadas al manejo del defecto de pared abdominal. Presentamos el caso de un recién nacido a término con gastrosquisis simple que presentó múltiples complicaciones gastrointestinales adquiridas durante el manejo inicial. Ingresó en nuestra institución con abdomen abierto, congelado, con fístulas entero-atmosféricas y pérdida de dominio abdominal. Durante tres meses se emplearon distintas técnicas combinadas (suturas primarias intestinales, yeyunostomías con realimentación del estoma distal, toxina botulínica, construcción de silo de polipropileno) en respuesta a la aparición de complicaciones hasta la reconstrucción abdominal total. Tras una evolución favorable, el paciente fue dado de alta a los cinco meses de vida, con tolerancia oral y ganancia pondoestatural adecuada.
Open Access
Chemerin is a new sex-specific target in aortic stenosis concomitant with diabetes regulated by the aldosterone/mineralocorticoid receptor axis
(American Physiological Society, 2025-01-20) Goñi Olóriz, Miriam; Garaikoetxea Zubillaga, Mattie; San Ildefonso-García, Susana; Fernández Celis, Amaya; Castillo, Paula; Navarro, Adela; Álvarez, Virginia ; Sádaba Sagredo, Rafael; Jover, Eva; Martín Núñez, Ernesto; López Andrés, Natalia; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Diabetes mellitus (DM) increases the risk of aortic stenosis (AS) and worsens its pathophysiology in a sex-specific manner. Aldosterone/mineralocorticoid receptor (Aldo/MR) pathway participates in the early stages of AS and in other diabetic-related cardiovascular complications. We aim to identify new sex-specific Aldo/MR targets in AS complicated with DM. We performed discovery studies using Olink Proteomics technology in 87 AS patient-derived aortic valves (AVs) (N ¼ 28 and N ¼ 19 nondiabetic and diabetic men; N ¼ 32 and N ¼ 8 nondiabetic and diabetic women, respectively) and human cytokine array (N ¼ 24 AVs/sex/condition). Both approaches revealed chemerin as a target differentially upregulated in AVs from male diabetic patients, further validated in a cohort of stenotic AVs (N ¼ 283, 27.6% DM, 59.4% men). Valvular chemerin levels are directly correlated with valve interstitial cell (VIC) activation, MR, inflammation, angiogenesis, and calcification markers exclusively in diabetic men. In vitro, Aldo (10-8 M) treatment exclusively increased chemerin levels in valve interstitial cells (VICs) from male patients with DM. Aldo also upregulated inflammatory, angiogenic, and osteogenic markers in DM and non-DM donors¿ VICs, which were prevented by MR antagonism. Increased glucose levels in cell media upregulated chemerin in VICs from male diabetic patients. Overall, RARRES2-knockdown in male diabetic VICs resulted in the downregulation of inflammatory, angiogenic, and osteogenic markers and blocked Aldo-induced responses in high glucose conditions. These data suggest the Aldo/MR pathway selectively increases chemerin in VICs from diabetic men, promoting inflammation, angiogenesis, and calcification associated with AS progression.
Open Access
Building a pan-European network to bridge gaps in geriatric medicine education: the PROGRAMMING COST Action 21,122-a call for endorsement
(Springer, 2025-04-01) Duque, Sofía; Piotrowicz, Karolina; Masud, Tahir; Wissendorff Ekdahl, Anne; Herghelegiu, Anna Marie; Pavic, Tajana; Kravvariti, Evrydiki; Bogdanović, Nenad; Bonin-Guillaume, Sylvie; Martínez Velilla, Nicolás; Roller Wirnsberger, Regina; Vassallo, Michael; Kossioni, Anastassia; Frost, Rachael; Macijauskiene, Jurate; Koca, Meltem; Benetos, Athanase; Petrovic, Mirko ; Kotsani, Marina; Ciencias de la Salud; Osasun Zientziak
Background: The growing challenges of population aging create a pressing need for specialized geriatric medicine services to effectively address the complex health needs of older adults and influence supportive healthcare policies. Older patients may present clinical complexity with multimorbidity, disability, and/or frailty, necessitating a shift from the traditional organ-oriented clinical approach to a holistic, patient-centered care model. Rationale of the action: Despite recommendations from the World Health Organization and scientific and professional societies, geriatric medicine is not universally recognized as a distinct specialty in Europe, and education in this field remains heterogeneous. A notable discrepancy in the availability of geriatric services and education in this field across European countries can be found. Many healthcare professionals lack basic training in geriatric medicine, contributing to fragmented care and poorer health outcomes. To address these challenges, it is essential to integrate geriatric medicine into undergraduate and postgraduate curricula for all healthcare professionals. Expected outcomes: The COST Action 21,122 PROGRAMMING (PROmoting GeRiAtric Medicine in countries where it is still eMergING) initiative aims to promote geriatric medicine by developing targeted educational goals and programs and fostering interdisciplinary collaboration. This initiative aims to assess the current state of geriatric medicine education and identify both global and local educational needs for developing clinical skills among healthcare professionals. In addition, it seeks to establish consensus on core curricula tailored to local contexts and disseminate findings and recommendations to stakeholders, policymakers, and the public. By uniting diverse stakeholders, PROGRAMMING aspires to create sustainable changes in geriatric care across Europe.
Open Access
Introducing the Trigemino-Vocal Reflex: new insights to assess brainstem connectivity under general anesthesia
(Elsevier, 2025-07-01) Urriza Mena, Francisco Javier; Fernandez-Conejero, Isabel ; Seidel, Kathleen ; Ulkatan, Sedat ; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Objective: This descriptive study aims to provide evidence of a newly described reflex, the Trigemino-Vocal Reflex (TVcR). It confirms the functional connectivity between trigeminal and vagal systems in humans under anesthesia. Methods: We stimulated the mental branch of the trigeminal nerve at the mandibular foramen in 47 patients undergoing different surgeries and recorded vocal cord muscle responses. Stimulation consisted of either a single electrical pulse or a train of 2–4 pulses, based on anesthesia depth. The recording was made by using an adhesive tube electrode. Results: A bilateral response was observed in 41 patients, while 2 showed only a unilateral response. All 43 exhibited an early potential (R1) with a latency of about 30 ms, and 24 also displayed a late potential (R2) with a latency of around 65 ms. Conclusions: We demonstrate the potential to record the newly described TVcR, recording vagal motor responses in the vocal cords following stimulation of the trigeminal nerve at the mandibular foramen in anesthetized patients. Significance: We introduce a newly described reflex that may be valuable in intraoperative neurophysiological monitoring and could enhance our understanding of brainstem physiology.
Open Access
Mediation of obesity-related variables in the association between physical fitness and cardiometabolic risk in children and adolescents: a systematic review and meta-analysis
(BMJ, 2025-04-03) Castro Silveira, João Francisco de; López Gil, José Francisco; Reuter, Cézane Priscila; Sehn, Ana Paula; Borfe, Letícia; Carvas Junior, Nelson; Pfeiffer, Karin Allor; Guerra, Paulo Henrique; Andersen, Lars Bo; García Hermoso, Antonio; Gaya, Anelise; Ciencias de la Salud; Osasun Zientziak
Objective. To examine the mediation of obesity-related variables in the association between physical fitness and cardiometabolic risk in children and adolescents. Design. Systematic review and meta-analysis. Data sources. Studies from electronic databases from inception to 31 December 2023. Eligibility criteria for selecting studies. Included were 123 observational studies (cross-sectional and longitudinal) that assessed risk by constructing a continuous score incorporating cardiometabolic parameters. Studies were considered if they evaluated at least one fitness component as an exposure in children and adolescents (5–19 years). Thirty-one were included in the main meta-analyses. Results. Cross-sectional findings indicate that cardiorespiratory fitness is modestly but beneficially associated with cardiometabolic risk, either indirectly via obesity-related variables (indirect standardized beta coefficient [βIndirect]=−0.17; 95% confidence interval [CI] −0.23; −0.11; inconsistency index [I2]=94.4%) or directly and independently from obesity-related variables (r=−0.11; 95% CI −0.15; −0.07; I2=87.4%), whereas muscular fitness seems to be associated with risk only via obesity-related variables (βIndirect=−0.34; 95% CI −0.47; −0.20; I2=85.1%). There was no cross-sectional difference between biological sexes (p≥0.199). Longitudinal findings indicate no total (r=−0.12; 95% CI −0.24; 0.01; I2=23.1%) and direct (r=−0.03; 95% CI −0.08; 0.03; I2=0%) associations. Conclusion. The association between fitness and risk appears to take place either indirectly through the reduction of obesity-related levels or directly by influencing risk. The latter underscores that the inverse association extends beyond a mere reduction in obesity-related variables, encompassing specific enhancements linked to exercise training, including increased metabolic efficiency, and cardiovascular capacity. PROSPERO registration number. CRD42022354628.
Open Access
Lifestyle habits, problem behaviors and non-suicidal self-injury in adolescents: a systematic review with meta-analysis of longitudinal studies
(Springer, 2025-09-01) Goñi-Sarriés, Adriana; Gutiérrez Valencia, Marta; Morata-Sampaio, Leticia; Saiz Fernández, Luis Carlos; Leache, Leire; Sánchez Villegas, María Almudena; Ciencias de la Salud; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Some lifestyle habits and problematic behaviors have been associated to non-suicidal self-injury (NSSI) in adolescents in cross-sectional studies but their role as individual risk factors needs to be analyzed through proper longitudinal designs. The objective is to analyze and summarize the evidence on the association of lifestyle habits and problem behaviors with NSSI in adolescents. Longitudinal studies were searched in Medline, Embase and APA PsycInfo without date or language restrictions. Adolescents with and without exposure factors were compared. Out of 5295 identified records, 13 longitudinal studies were included (39,575 participants). Studies included different age ranges (10-20 years, mean 14.3, SD 2.4), and 78% were female. Results showed a statistically significant increased risk of NSSI with regular smoking, alcohol use, early cannabis use, and poor physical activity. Inconsistent results were found for use of technology and sleep habits, and no studies analyzed dietary habits or gambling. Most studies were of moderate or high quality but certainty of the evidence was very low according to GRADE criteria. Longitudinal evidence suggests that some lifestyle habits and problem behaviors are risk factors for NSSI in adolescents. These findings highlight the importance of developing strategies to promote healthy lifestyles in adolescents.
Embargo
Physical activity is related to lower levels of neurofilament light and plasma tau protein: a 22-year follow-up study from adolescence to adulthood
(Elsevier, 2025-06-01) Ezzatvar, Yasmin; López Gil, José Francisco; Yáñez-Sepúlveda, Rodrigo; Olivares-Arancibia, Jorge; Páez-Herrera, Jacqueline; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Purpose: To investigate the association between physical activity (PA) and neurodegeneration biomarkers from adolescence to adulthood by examining tau protein and neurofilament light chain (NfL) levels in blood samples. Methods: The study analyzed data from adolescents aged 12–19 years who participated in Waves I (1994–1996) and V (2016–2018) of the Add Health study over a span of 22 years. It assessed PA through self-reported questionnaires. Neurodegeneration measures at Wave V used venous blood collected via phlebotomy. Samples were analyzed using single-molecule array (Simoa) technology on a Quanterix HD-1 analyzer, using digital enzyme-linked immunosorbent assay to quantify NfL and tau proteins from serum and plasma samples. Results: In the present study, 3,182 individuals participated, with females comprising 61% of the sample. Participants adhering to the PA guidelines in both waves reported lower levels of NfL (−0.583 pg/mL, 95% bias-corrected and accelerated (BCa) confidence interval (CI): −1.235 to −0.068) and tau protein levels (−0.244 pg/mL, 95% BCa CI: −0.405 to −0.078). Adjusted analyses confirmed significant lower levels of tau protein (−0.210 pg/mL, 95% BCa CI: −0.350 to −0.072) for Wave I adherents and even lower levels in NfL (−0.421 pg/mL, 95% BCa CI: −0.929 to −0.007) and tau protein levels (−0.229 pg/mL, 95% BCa CI: −0.412 to −0.053) for active participants in both waves. Discussion: Our findings suggest that consistent engagement in PA may reduce certain neurodegenerative biomarkers, potentially influencing neurological health outcomes.
Open Access
Development and validation of a scale measuring perceived barriers to physical activity in Spanish for children and adolescents with type 1 diabetes: the Physical Activity Barriers Scale for pediatric type 1 diabetes (PABS-1) questionnaire
(Elsevier, 2025-06-01) García Hermoso, Antonio; Huerta Uribe, Nidia; Hormazábal Aguayo, Ignacio; Muñoz Pardeza, Jacinto; Chueca-Guindulain, María J.; Burillo Sánchez, Elisabeth; Ezzatvar, Yasmin; López Gil, José Francisco; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Aims: To develop and validate the psychometric properties, reliability, and criterion validity of the Physical Activity Barriers Scale for pediatric type 1 diabetes (PABS-1) in Spanish-speaking children and adolescents with type 1 diabetes. Method: A cross-sectional study was conducted with a sample of 93 Spanish-speaking children and adolescents with type 1 diabetes. The PABS-1 questionnaire was developed by experts and refined with patient feedback. Its validity was assessed by comparing results with accelerometer data, linking scores to objective physical activity measures. Results: The PABS-1 showed good internal consistency, with a Cronbach’s alpha (α) coefficient of 0.89, indicating strong reliability. Confirmatory factor analysis supported a four-factor structure, with physical, diabetes-related, psychological, and environmental barriers showing good fit indices (comparative fit index [CFA] = 0.94, root mean square error of [RMSEA] = 0.06, standardized root mean square residual [SRMR] = 0.05). Although the associations were small, the total PABS-1 score was significantly negatively correlated with cardiorespiratory fitness (Spearman’s rho [ρ]= -0.15, p = 0.035) and moderate-to-vigorous physical activity (ρ = − 0.12, p = 0.039). Among the four factors, motivational barriers exhibited the strongest associations with physical activity and fitness, showing significant negative correlations. Conclusions: The PABS-1 is a valid and reliable tool for assessing perceived barriers to physical activity in Spanish-speaking children and adolescents with type 1 diabetes.
Open Access
Mediterranean diet and obesity polygenic risk interaction on adiposity in European children: the IDEFICS/I.Family Study
(Wiley, 2025-05-19) Seral-Cortes, Miguel; Drouard, Gabin; Masip, Guiomar; Bogl, Leonie H.; Henauw, Stefaan de; Foraita, Ronja; Intemann, Timm; Lissner, Lauren; Molnar, Dénes; Nagrani, Rajini; Pala, Valeria; Picó, Catalina; Russo, Paola; Tognon, Gianluca; Tornaritis, Michael; Veidebaum, Toomas; Wright, Marvin N.; Miguel-Etayo, Pilar de; Moreno, Luis A.; Labayen Goñi, Idoia; Ciencias de la Salud; Osasun Zientziak
Background and objectives: to examine whether changes in the Mediterranean Diet (MD) or any of its MD food groups modulate the genetic susceptibility to obesity in European youth, both in cross-sectional and longitudinal analyses. Methods: for cross-sectional analysis, 1982 participants at baseline, 1649 in follow-up 1 (FU1) and 1907 in follow-up 2 (FU2), aged 2–16 years of the IDEFICS/I.Family studies were considered. For the longitudinal design, 1254 participants were included. Adherence to MD was assessed using the Mediterranean Diet Score (MDS), and genetic susceptibility to high BMI was assessed with a polygenic risk score (BMI-PRS). Multiple linear regression models were fitted to estimate gene × MD effects on markers of obesity. Results: in cross-sectional analyses, at baseline, higher MDS was associated with higher BMI in children with high genetic susceptibility (β = 0.12; 95% CI = [0.01, 0.24]). However, 6 years later, at FU2, higher MDS was associated with lower BMI (β = −0.19; 95% CI = [−0.38, −0.01]) in children with high genetic susceptibility, showing an attenuating MDS effect. Also in FU2, vegetables and legumes (V&L) showed inverse associations with BMI (β = −0.01; CI = [−0.02, −0.00]) and WC (β = −0.02; CI = [−0.03, −0.00]) regardless of the obesity genetic risk, although the effect sizes were small. In the longitudinal analyses, no MDS-obesity associations or gene × diet interaction effects were observed. Conclusions: in cross-sectional analysis (baseline and FU2), the MD modulated the association between obesity susceptibility and adiposity indicators in European youth, having an exacerbating effect in children measured during infancy years and an attenuating effect in early adolescent years.
Open Access
Proteomics and recurrence of atrial fibrillation: a pilot study nested in the PREDIMAR trial
(Karger, 2025-01-24) Razquin, Cristina; Fernández Irigoyen, Joaquín; Barrio-López, María Teresa; López, Begoña ; Ravassa, Susana; Ramos, Pablo; Macías-Ruiz, Rosa; Ibáñez Criado, Alicia; Santamaría Martínez, Enrique; Goñi, Leticia; Castellanos, Eduardo; Ibáñez Criado, José Luis; Tercedor, Luis ; García-Bolao, Ignacio; Martínez González, Miguel Ángel; Almendral, Jesús; Ruiz Canela, Miguel; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Introduction: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide. Although catheter ablation is the most efficacious therapy, relapses occur frequently (30%) in the first year after ablation. Novel biomarkers of recurrence are needed for a better prediction of recurrence and management of AF. In this pilot study, we aimed to analyze the baseline proteome of subjects included in a case-control study to find differential proteins associated with AF recurrence. Methods: Baseline serum proteomics (354 proteins) data from 16 cases (recurrent AF) and 17 controls (non-recurrent) were obtained using MS/MS analysis. A false discovery rate was performed using a nonlinear fitting method for the selection of proteins. Logistic regression models were used to further analyze the association between differentially expressed proteins and AF recurrence. Results: Ten proteins were differentially represented in cases vs. controls. Two were upregulated in the cases compared to the controls: keratin type I cytoskeletal 17 (Fold-change [FC] = 2.14; p = 0.017) and endoplasmic bifunctional protein (FC = 1.65; p = 0.032). Eight were downregulated in the cases compared to the controls: C4bpA (FC = 0.64; p = 0.006), coagulation factor XI (FC = 0.83; p = 0.011), CLIC1 (FC = 0.62; p = 0.017), haptoglobin (FC = 0.37; p = 0.021), Ig alpha-2 chain C region (FC = 0.49; p = 0.022), C4bpB (FC = 0.73; p = 0.028), N-acetylglucosamine-1- phosphotransferase subunit gamma (FC = 0.61; p = 0.033), and platelet glycoprotein Ib alpha chain (FC = 0.84; p = 0.038). Conclusion: This pilot study identifies ten differentially expressed serum proteins associated with AF recurrence, offering potential biomarkers for improved prediction and management.
Open Access
Sex differences in aortic valve inflammation and remodeling in chronic severe aortic regurgitation
(American Physiological Society, 2025-03-01) Tiraplegui, Carolina; Garaikoetxea Zubillaga, Mattie; Sádaba, Alba ; San Ildefonso-García, Susana; Goñi Olóriz, Miriam; Fernández Celis, Amaya; Martín Núñez, Ernesto; Álvarez, Virginia; Sádaba Sagredo, Rafael; Anand, Vidhu; Jover, Eva; Navarro, Adela; López Andrés, Natalia; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Aortic regurgitation (AR) is more prevalent in males, although cellular and molecular mechanisms underlying the sex differences in prevalence and pathophysiology are unknown. This study evaluates the impact of sex on aortic valve (AV) inflammation and remodeling and the cellular differences in valvular interstitial cells (VICs) and valvular endothelial cells (VECs) in patients with AR. A total of 144 patients (27.5% female) with severe chronic AR were included. AVs were analyzed by imaging, histological, and molecular biology techniques (ELISA, RT-PCR). VICs and VECs isolated from patients with AR were characterized and further treated with transforming growth factor (TGF)-β. Anatomically, male had smaller index aortic dimensions and greater AV thickness. Proteome profiler analyzes in AVs (n = 40/sex) evidenced higher expression of inflammatory markers in male and that was further validated (interleukins, chemokines). Histological composition showed higher expression of inflammatory mediators and collagen thick fibers in AVs from male. Male VICs and VECs secreted higher levels of inflammatory markers than female cells. Interestingly, male VICs produced higher amounts of collagen type I and lower fibronectin and aggrecan, whereas male VECs secreted lower decorin. TGF-β exclusively enhanced inflammation in male VICs and decorin and aggrecan in female VICs. Compared with male, AVs from female were thinner, less inflamed, and fibrotic. VICs seem to be the key cell type responsible for the sex-differences. Valvular inflammation associated with an active remodeling process could be a key pathophysiological process involved in AR.
Open Access
The association between internet-use-disorder symptoms and loneliness: a systematic review and meta-analysis with a categorical approach
(Cambridge University Press, 2025-03-24) Mestre-Bach, Gemma; Paiva, Ursula; San Martín Iniguez, Leyre; Beranuy Fargues, Marta; Martín-Vivar, María; Mallorquí-Bagué, Nuria; Normand, Enrique; Contreras Chicote, María; Potenza, Marc N.; Arrondo Ostiz, Gonzalo; Ciencias de la Salud; Osasun Zientziak
Loneliness may lead individuals to spend more time on the internet and increase the likelihood of experiencing internet-use disorders. Similarly, individuals with internet-use disorders may feel lonelier. In the present systematic review and meta-analysis, pre-registered in PROSPERO (CRD42023390483), we quantified associations between internet-use-disorder symptoms (e.g. internet gaming disorder and online gambling disorder) and loneliness. We searched PubMed, Web of Science, and an institutional database aggregator for references that compared degrees of loneliness in groups of individuals with and without symptoms of internet-use disorder. Means and standard deviations of loneliness, or alternatively, odds ratios, were transformed into Cohen's d for statistical pooling through a random-effects model. After screening 2,369 reports, we extracted data from 23 studies. The total number of individuals across the studies was 36,484. Participants were between 13 and 30 years of age (median 20). The pooled difference between those with and without internet-use-disorder symptoms yielded a standardized effect (Cohen's d) of 0.53 (95% CI 0.35-0.7). While heterogeneity was high, there was no indication of publication or small sample biases. Similar effect sizes were found when limiting to specific types of internet-use disorder symptoms. Moreover, meta-regressions did not show an effect of age, sex, or sample size. Individuals with symptoms of internet-use disorders scored 49.35 (43.84-54.85) points on the UCLA-Loneliness scale on average, compared to 43.78 (37.47-50.08) in individuals without symptoms of internet-use disorders (Standardized Mean Difference: 5.18, 95% CI = 2.05-8.34). Individuals with internet-use-disorder symptoms experience greater loneliness. The effect appears moderately sized.
Open Access
Perfil físico en futbolistas de categoría amateur de acuerdo a la posición que ocupan en el campo
(Consejo General de Colegios Oficiales de la Educación Física y Deportiva de España (Consejo COLEF), 2016-10-28) Azcárate Jiménez, Unai Xabier; Yanci Irigoyen, Javier; Ciencias de la Salud; Osasun Zientziak
Los objetivos del presente estudio fueron, por un lado, evaluar la antropometría, el rendimiento en el sprint en línea recta, la capacidad de cambio de dirección (CODA), la capacidad cardiovascular, el salto vertical, el salto horizontal y la capacidad de repetir esprines en jugadores de fútbol amateur, y por otro, examinar las diferencias en estas variables teniendo en cuenta el puesto que ocupan en el campo. En este estudio participaron 59 jugadores de fútbol amateur (edad = 23,41 ± 3,54 años, masa = 73,61 ± 6,51 kg, talla = 1,76 ± 0,06 m, porcentaje de grasa = 12,49 ± 3,02%, índice de masa corporal = 23,67 ± 1,65 kg/m2, masa ósea = 3,31 ± 0,31 kg, masa muscular = 61,87 ± 5,00 kg, porcentaje de agua = 63,13 ± 3,00%) pertenecientes a tres equipos que competían en las categorías de Primera Regional, Regional Preferente y Tercera División de la liga de fútbol profesional (LFP). No se encontraron diferencias significativas por puestos en los test de antropometría, Modified Agility T-test (MAT) y test intermitente de resistencia Yo-Yo nivel 1 (YYIR1), pero si en la capacidad de aceleración en SP10m y SP20m donde el grupo de delanteros (DEL) fue el más rápido y el grupo de porteros (P) el más lento. Sin embargo, en el salto vertical bilateral con contra movimiento y manos libres (VCMJAS) y en el salto horizontal con manos libres bilateral (HCMJAS) y con la pierna izquierda (HCMJASI) fue el grupo P el que más saltó y el grupo de medios centros (MC) los que menos. En el test de esprines repetidos (RSA30m) se observo como el grupo DEL era el más rápido y el grupo MC el más lento. Debido a los resultados obtenidos, creemos que sería interesante implantar programas de entrenamiento específicos para cada puesto que se ocupa en el campo ya que los roles de los jugadores son diferentes.
Open Access
Diferencias en la capacidad de aceleración, cambio de dirección y resistencia cardiovascular entre jugadores de fútbol amateur de distinta categoría competitiva
(Instituto Universitario Asociación Cristiana de Jóvenes - IUACJ, 2016-11-30) Azcárate Jiménez, Unai Xabier; Los Arcos Larumbe, Asier; Yanci Irigoyen, Javier; Ciencias de la Salud; Osasun Zientziak
Los objetivos del presente estudio fueron, por un lado, evaluar la capacidad de aceleración en línea recta, la capacidad de cambio de dirección (CODA) y la capacidad car-diovascular en jugadores de fútbol amateur, y por otro, analizar las diferencias en estas capacidades entre jugadores amateurs de diferente categoría (TD, Tercera División vs. RP, Regional Preferente). En este estudio participaron 36 jugadores de fútbol amateur (20,10 ± 1,47 años, 75,67 ± 8,38 kg, 1,80 ± 0,07 m, 23,41 ± 1,74 kg/m2) pertene-cientes a dos equipos de un mismo club que competían en las categorías de TD y RP. No se encontraron diferencias significativas (p > 0,05) entre el grupo TD y el RP en el test de aceleración en línea recta (SP20m y SP30m), CODA (505 agility Test) y test de resistencia (UMT, test de la Universidad de Montreal). Sin embargo, a efectos prácticos, el grupo TD obtuvo mejores resultados (TE, tamaño del efecto = 0,67, moderado) que el RP en el 505 agility Test. La ausencia de diferencias significativas entre ambos grupos, puede poner de manifiesto que la condición física no es el aspecto más relevante para la selección de jugadores que promocionan a tercera división.
Open Access
Systematic review of clinical practice guidelines for long-term breast cancer survivorship: assessment of quality and evidence-based recommendations
(Springer Nature, 2025-05-17) Pimentel Parra, Gustavo Adolfo; García Vivar, Cristina; Escalada Hernández, Paula; Santos Martín, José Luis; Soto Ruiz, María Nelia; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC
BACKGROUND: Breast cancer is the most common cancer among women, with improved survival rates due to advances in early diagnosis and therapies. However, long-term survivors (≥5 years post-treatment, disease-free) face persistent physical, psychological, and social challenges requiring tailored, evidence-based care. Despite the growing survivor population, no systematic evaluation of Clinical Practice Guidelines (CPGs) for this group has been conducted. This study assesses the quality of CPGs and their evidence-based recommendations. METHODS: A systematic review was conducted in PubMed, CINAHL, and Cochrane Library (2015–2023), including guidelines from major oncology organisations. The AGREE II instrument evaluated CPG quality across six domains, and recommendations were classified using a Primary Care survivorship framework: prevention, surveillance, care coordination, and long-term effect management. RESULTS: Ten CPGs met inclusion criteria, with 7 classified as high quality. Most recommendations focused on prevention (adjuvant therapy, alcohol) and surveillance (follow-up, mammography), while gaps remained in lifestyle guidance, psychosocial support, and management of complications (lymphedema, osteoporosis, cognitive dysfunction). Care coordination and psychosocial interventions were inconsistently addressed. CONCLUSIONS: Current CPGs inadequately cover the complex needs of long-term survivors, particularly in psychosocial care. Evidence-based, patient-centred guidelines are urgently needed to optimise long-term outcomes and quality of life.
Open Access
Implantación piloto de dos programas basados en la evidencia (SafeCare e Incredible Years) en los Servicios de Protección Infantil de Gipuzkoa (España)
(Colegio Oficial de la Psicología de Madrid, 2015-08-01) Paúl, Joaquín de; Arruabarrena, Ignacia; Indias, Sílvia; Ciencias de la Salud; Osasun Zientziak
El presente artículo describe el proceso de implantación de dos la primera letra de las tres palabras minúscula en el Sistema de Protección Infantil de Gipuzkoa (España): SafeCare e incredible years. El primero es un programa de intervención en el domicilio para familias negligentes o en riesgo de negligencia con niños menores de 5 años. El segundo es un programa terapéutico grupal para familias con niños entre 4 y 8 años con problemas de comportamiento cuyos padres tienen dificultades significativas para su manejo. Se describe el proceso por el que las instituciones responsables de la protección infantil en Gipuzkoa iniciaron un cambio desde los modelos actuales de intervención hacia programas más estructurados, focalizados y breves que han mostrado resultados positivos en aplicaciones previas en otros países. Se tratan cuestiones relacionadas con la adaptación de los programas, la selección y formación de profesionales y se presentan los resultados pre y post obtenidos en la aplicación preliminar de ambos programas a un número limitado de familias. Se presenta el diseño de la siguiente fase del proceso (implantación piloto con diseño experimental para evaluación de resultados). Se discuten cuestiones relevantes de este proceso, que pueden ser de utilidad para aquellas administraciones e instituciones que pretendan llevar a cabo un proceso similar.