Artículos de revista DCS - OZS Aldizkari artikuluak

Permanent URI for this collection

http://hdl.handle.net/2454/10466

Browse

Now showing 1 - 20 of 1323

Open Access
The presence of adipose tissue in aortic valves influences inflammation and extracellular matrix composition in chronic aortic regurgitation
(MDPI, 2025-03-28) Sádaba, Alba; Garaikoetxea Zubillaga, Mattie; Tiraplegui, Carolina; San Ildefonso-García, Susana; Goñi Olóriz, Miriam; Fernández Celis, Amaya; Martín Núñez, Ernesto; Castillo, Paula; Álvarez, Virginia; Sádaba Sagredo, Rafael; Jover, Eva; Navarro, Adela; López Andrés, Natalia; Ciencias de la Salud; Osasun Zientziak
Adipose tissue is present in aortic valves (AVs). Valve interstitial cells (VICs) could differentiate into adipogenic lineages. We here characterize whether the presence of adipose tissue in the AV influences inflammation and extracellular matrix (ECM) composition in patients with aortic regurgitation (AR). A total of 144 AVs were analyzed by histological and molecular techniques. We performed discovery studies using Olink Proteomics® technology in 40 AVs (N = 16 without and N = 24 with adipose tissue). In vitro, human white adipocytes (HWAs) or VICs were cultured with adipogenic media and co-cultured with control VICs. Of Avs, 67% presented white-like adipocytes within the spongiosa. Discovery studies revealed increased levels of inflammatory and ECM molecules in AVs containing adipocytes. Interestingly, the presence of adipocytes was associated with greater AV thickness, higher inflammation, and ECM remodeling, which was characterized by increased proinflammatory molecules, collagen, fibronectin, proteoglycans, and metalloproteinases. AV thickness positively correlated with markers of adipose tissue, inflammation, and ECM. In vitro, adipocyte-like VICs expressed higher levels of adipocyte markers, increased cytokines, fibronectin, decorin, and MMP-13. Analyses of supernatants from co-cultured control VICs with HWA or adipocyte-like VICs showed higher expression of inflammatory mediators, collagen type I, proteoglycans, and metalloproteinases. AVs presenting adipocytes were thicker and exhibited changes characterized by increased inflammation accompanied by aberrant expression of collagen, proteoglycans, and metalloproteinases. VICs could differentiate into adipogenic pathway, affect neighbor VICs, and contribute to inflammation, collagen and proteoglycan accumulation, as well as to metalloproteinases secretion. In summary, the presence of adipose tissue in AV could modify its composition, favoring inflammation and remodeling with an impact on AV thickness.
Embargo
What does really matter in the premorbid background of psychosis leading to long-term disability? a 21-year follow-up cohort study of first-episode psychosis
(Elsevier, 2025-05-01) Peralta Martín, Víctor; García de Jalón, Elena; Moreno-Izco, Lucía; Sánchez Torres, Ana María; Gil Berrozpe, Gustavo José; Peralta, David; Janda-Galán, Lucía; Cuesta, Manuel J.; SEGPEPs Group; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Background: clinicians are currently unable to predict which patients are at higher risk of long-term disability based on premorbid factors. We aimed to determine the extent to which premorbid factors could prospectively predict long-term disability in patients with first-episode psychosis. Methods: we assessed 12 potential premorbid risk factors in 243 individuals with first-episode psychosis reassessed 21 years later for several domains of psychosocial disability. Hierarchical multivariate regression and Directed Acyclic Graphs (DAGs) were used sequentially to investigate independent and causal associations between risk factors and long-term disability. Results: the familial load of schizophrenia, lower parental SES, obstetric complications, early neurodevelopmental delay, childhood adversity, and poor adolescence social networks were independent predictors of long-term disability, accounting for 40.6 % of the variability. The DAGs analysis showed that both familial risk of schizophrenia and lower SES had statistically significant direct and indirect effects on later disability. The indirect effects were mediated by the variables indexing impaired development, although childhood adversity and poor adolescence social networks also had significant direct effects on disability. Early neurodevelopmental delay was the only developmental marker present in all statistically significant indirect paths from familial background factors to long-term disability, suggesting that it is a key component of the causal chain that leads to later disability. Conclusions: in individuals with psychotic disorders, familial background factors appear to trigger a complex and multidetermined cascade of risk factors across developmental stages that interact iteratively, leading to long-term disability.
Open Access
Impact of resistance and high-intensity interval training on body composition, physical function, and temporal dynamics of adaptation in older women with impaired cardiometabolic health: a randomized clinical trial
(BMC, 2025-04-11) Cano Montoya, Johnattan; Rojas-Vargas, Marcela; Báez Vargas, Sebastián; Núñez Vergara, Carolina; Martínez-Huenchullán, Sergio; Gallegos, Fernando; Álvarez, Cristian; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Purpose: Physical inactivity is associated with reduced physical fitness (PF) in older women with impaired cardiometabolic health. Although exercise has been shown to improve PF, interindividual variability in response and adaptation changes over time remain unclear. This study evaluated the effects of eight weeks of resistance training (RT) and high-intensity interval training (HIIT) on body composition, isometric strength, and the 6-minute walk test (6MWT) in older women with impaired cardiometabolic health. Additionally, the study explored the reduction of non-responders (NRs) and adaptation changes over time. Methods: This randomized clinical trial involved 36 older women (64 ± 8.4 years; BMI: 31.8 ± 5.5) with impaired cardiometabolic health, divided into RT-G (n = 12; 62 ± 7 years; BMI: 32.2 ± 4.1), HIIT-G (n = 12; 66 ± 10 years; BMI: 31.2 ± 4.1), and CG (n = 12; 64 ± 9 years; BMI: 31.8 ± 6) groups. RT-G performed elastic band exercises, and HIIT-G performed cycle ergometer intervals. BMI, body fat, lean mass, isometric strength, and 6MWT were measured at baseline and at four and eight weeks. The Student’s t-test was applied for normally distributed variables and the Mann–Whitney U test for non-normal variables. Intra- and inter-group differences were analyzed using a two-way repeated measures ANOVA, considering group, time, and their interaction. Post-hoc comparisons were conducted using the Bonferroni test. Individual responses (IR) were calculated using the equation proposed by Hopkins: SDIR = √(SDExp2 − SDCon2). The prevalence of responders (Rs) and non-responders (NRs) was expressed as a percentage, and percentage changes from baseline to weeks four and eight were used to evaluate adaptations dynamics. Results: By week eight, isometric strength in RT-G significantly improved from 21.3 ± 4.4 to 24.37 ± 3.99 kg (p = 0.027; 95% CI: 1.8, 4.3 kg; Cohen’s d = 0.731) and 6MWT distance in HIIT-G increased from 441.0 ± 48.9 to 480.0 ± 53.0 m. (p = 0.002; 95% CI: 22, 55 m; Cohen’s d = 0.757). Both protocols reduced NRs for body fat, lean mass, and 6MWT. Responders showed greater adaptations in the first four weeks, stabilizing by week eight. Conclusion: RT and HIIT improved PF in older women with impaired cardiometabolic health, reducing NRs in terms of body composition and 6MWT over eight weeks, with similar adaptation changes over time among the responders. These findings highlight the importance of individualized exercise interventions to maximize health benefits. Trial registration: This study was part of a trial registered at ClinicalTrials.gov (ID: NCT06201273). Date: 22/12/2023.
Open Access
Evaluating the usability of Diactive-1: mHealth for personalized exercise and education in children and adolescents with type 1 diabetes
(AME Publishing Company, 2025-03-10) Hormazábal Aguayo, Ignacio; Muñoz Pardeza, Jacinto; Huerta Uribe, Nidia; Ezzatvar, Yasmin; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Background: Managing physical activity alongside glucose levels is challenging for children and adolescents with type 1 diabetes mellitus (T1DM). This study aimed to evaluate the usability of the Diactive-1 app, which was designed to support muscle-strengthening training in children and adolescents with T1DM in accordance with guidelines from the International Society for Pediatric and Adolescent Diabetes (ISPAD) and the American Diabetes Association (ADA). Methods: Twenty-seven patients aged 8–18 years with T1DM were randomly selected. Recruitment was conducted through the Pediatric Endocrinology Unit of the University Hospital of Navarra (Spain). All participants were enrolled in a randomized controlled trial and used the Diactive-1 app during the intervention. The study lasted 24 weeks, during which the app provided personalized muscle-strengthening exercise sessions, glucose monitoring, and motivational features such as gamification. Usability of the app was assessed using the User Version of the Mobile Application Rating Scale (uMARS). Results: The Diactive-1 app demonstrated high usability, with an overall quality mean score of 4.33 [standard deviation (SD) =0.36] out of 5.00. uMARS objective domains ratings were: functionality [4.52 (SD =0.40)], aesthetics [4.43 (SD =0.45)], engagement [4.07 (SD =0.51)], information quality [4.29 (SD =0.75)], and subjective quality score was 3.94 (SD =0.61). Usability scores showed no meaningful variation across patient demographics, including sex, age, glycated hemoglobin, engagement in muscle-strengthening activities, and fear of hypoglycemia, suggesting consistent app performance among different user groups. Conclusions: The Diactive-1 app is a promising tool for integrating muscle-strengthening training and educating patients about safe physical exercise into the management of T1DM in children and adolescents. Its high usability and positive user feedback underscore its potential as an effective supportive strategy for managing the disease in this population. Further refinement of personalization features may enhance its effectiveness.
Embargo
Twenty-four-hour movement guidelines and depressive symptoms: association, temporal trends and moderators over a ten-year period among 45,297 US adolescents
(Springer, 2025-02-24) López Gil, José Francisco; Solmi, Marco; García Hermoso, Antonio; Vancampfort, Davy; Fabiano, Nicholas; Schuch, Felipe; Stubss, Brendon; Smith, Lee; Torous, John; Firth, Joseph; Ciencias de la Salud; Osasun Zientziak
The aims of the present study were: (1) to examine the association between meeting the 24-h movement guidelines and depressive symptoms among U.S. adolescents; (2) to analyze the temporal trends of this association; and (3) to test whether sex, age, or race/ethnicity moderate these associations. This is a cross-sectional study using repeated data collection from the high school Youth Risk Behavior Surveys (YRBS), involving 45,297 adolescents in the US (49.7% females). Data were collected bi-annually between 2011 and 2021. These surveys represent cross-sectional snapshots rather than a longitudinal study, capturing data at distinct points in time across multiple years. The three 24-h movement guidelines, including guidelines for physical activity, screen time, and sleep duration were assessed by self-reported questions. Depressive symptoms were assessed by the question “During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing your usual activities?” with yes/no answer options. A generalized linear mixed model (GLMM) was employed to gauge the association between adherence to the 24-h movement guidelines (exposure) and the likelihood of having depressive symptoms (outcome). The year of data collection was included as a random intercept in the mixed-effects model to account for potential variations in depressive symptoms across different time points. The model was further adjusted for covariates, including sex, age, race/ethnicity, alcohol and tobacco consumption, school bullying, cyberbullying, and excess weight. Adolescents meeting all three 24-h movement guidelines (physical activity, screen time, and sleep) had the lowest probability of depressive symptoms (21.3%, 95% CI 17.3–25.3%) compared to those meeting none (37.6%, 95% CI 33.4–41.8%). Significant protective effects were observed across all adherence levels (p < 0.05). Over the 2011–2021 period, adherence remained consistently associated with reduced depressive symptoms, with the strongest effects seen in 2019 and 2021. Younger adolescents, males, and White individuals showed the greatest benefits, while females, older adolescents, Black, Hispanic/Latino, and individuals from other racial/ethnic groups exhibited weaker protective effects despite adherence. Findings from the present study highlight the importance of encouraging adherence to 24-h movement guidelines as a potential strategy to reduce depressive symptoms in adolescents. Notably, the protective effects of adherence varied across sociodemographic groups, with younger adolescents, females, and White individuals experiencing the greatest benefits.
Open Access
Novel FKBP prolyl isomerase 1A (FKBP12) ligand promotes functional improvement in SOD1G93A amyotrophic lateral sclerosis (ALS) mice
(Wiley, 2025-06-01) Moreno-Martínez, Laura; Gaja-Capdevila, Núria; Mosqueira-Martín, Laura; Herrando-Grabulosa, Mireia; Rodríguez-Gómez, Laura; González-Imaz, Klaudia; Calvo, Ana C.; Sagartzazu-Aizpurua, Maialen; Moreno-García, Leticia; Fuentes, José Manuel; Acevedo-Arozena, Abraham; Aizpurua, Jesús M.; Miranda, José Ignacio; López de Muniain, Adolfo; Vallejo-Illarramendi, Ainara; Navarro, Xavier; Osta, Rosario; Gil Bea, Francisco Javier; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Background and Purpose: Amyotrophic lateral sclerosis (ALS) is a devastating neu-rodegenerative disease with limited treatment options. ALS pathogenesis involvesintricate processes within motor neurons, characterized by dysregulated Ca 2+ influxand buffering in early ALS-affected motor neurones. This study proposes the modu-lation of ryanodine receptors (RyRs), key mediators of intracellular Ca 2+, as a thera-peutic target.Experimental Approach: A novel class of novel FKBP12 ligands that show activityas cytosolic calcium modulators through stabilizing RyR channel activity, weretested in the superoxide dismutase 1 (SOD1) G93A mouse model of ALS. Differentoutcomes were used to assess treatment efficacy, including electrophysiology, his-topathology, neuromuscular function and survival.Key Results: Among the novel FKBP12 ligands, MP-010 was chosen for its centralnervous system availability and favourable in vitro pharmaco-toxicological profile.Chronic administration of MP-010 to SOD1 G93A mice produced preservation ofmotor nerve conduction, with the 61-mg kg 1 dose significantly delaying the onsetof motor impairment. This was accompanied by improved motor coordination,increased innervated endplates and significant preservation of motor neurones inthe spinal cord of treated mice. Notably, MP-010 treatment significantly extendedlifespan by an average of 10 days compared to vehicle.Conclusions and Implications: FKBP12 ligands, particularly MP-010, exhibit prom-ising neuroprotective effects in ALS, highlighting their potential as novel therapeuticagents. Further investigations into the molecular mechanisms and clinical translat-ability of these compounds are needed for their application in ALS treatment.
Open Access
Effect of a 24-week supervised concurrent exercise intervention on fecal microbiota diversity and composition in young sedentary adults: the ACTIBATE randomized controlled trial
(Elsevier, 2025-06-01) Martínez Téllez, Borja; Xu, Huiwen; Ortiz Álvarez, Lourdes; Rodríguez-García, Carmen; Schönke, Milena; Jurado Fasoli, Lucas; Osuna Prieto, Francisco J.; Alcántara Alcántara, Juan Manuel; Acosta, Francisco M.; Amaro Gahete, Francisco J.; Folkerts, Gert ; Vilchez-Vargas, Ramiro; Link, Alexander; Plaza-Díaz, Julio; Gil, Ángel; Labayen Goñi, Idoia; Fernández-Veledo, Sonia; Rensen, Patrick C. N.; Ruiz, Jonatan R.; Ciencias de la Salud; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Background: Numerous physiological responses to exercise are observed in humans, yet the effects of long-term exercise and varying intensities on the diversity and composition of human fecal microbiota remain unclear. We investigated the effect of a 24-week supervised concurrent exercise intervention, at moderate and vigorous intensities, on fecal microbiota diversity and composition in young adults. Methods: This ancillary study was based on data from the ACTIBATE randomized controlled trial (ClinicalTrials.gov ID: NCT02365129), and included adults (aged 18–25 years, 70 % female) that were randomized to (i) a control group (CON: no exercise, n = 20), (ii) a moderate-intensity exercise group (MOD-EX, n = 21), and (iii) a vigorous-intensity exercise group (VIG-EX, n = 20). Fecal samples were collected before and after the 24-week exercise intervention, and the diversity and composition of the fecal microbiota were analyzed by 16S rRNA sequencing. Inferential functional profiling of the fecal microbiota was performed and correlations between microbial changes and cardiometabolic outcomes were assessed. Results: Exercise did not modify beta or alpha diversities regardless of the intensity (all P ≥ 0.062). The relative abundance of the Erysipelotrichaceae family (Bacillota phylum) (−0.3 ± 1.2 %; P = 0.031) was however reduced in the VIG-EX group. Coprococcus was the only genus showed a significant difference between MOD-EX and VIG-EX after the intervention, with its relative abundance increasing in MOD-EX (+0.4 ± 0.6 %; P = 0.005). None of these changes were related to the exercise-induced cardiometabolic benefits (all P ≥ 0.05). Conclusions: In young adults, a 24-week supervised concurrent exercise program, at moderate and vigorous intensities, resulted in minor changes in fecal microbiota composition, while neither alpha nor beta diversities were affected. Clinical trial registration: ClinicalTrials.gov ID: NCT02365129.
Open Access
Exploring (de-)motivating teaching profiles from a fine-grained directiveness approach: differences in students' need-based experiences
(Elsevier, 2025-06-01) Diloy-Peña, Sergio; García-González, Luis; Haerens, Leen; De Cocker, Katrien; Burgueño, Rafael ; Abós, Ángel; Ciencias de la Salud; Osasun Zientziak
The aim was to examine how structuring and controlling approaches (high directiveness), and autonomy-supportive and chaotic approaches (low directiveness) were combined and related to students’ needs in physical education. In a sample of 1124 secondary school students, this cross-sectional study conducted two sets of profile analyses, respectively for high and low directiveness, were conducted. The latent profile analyses (LPA) revealed four high-directiveness profiles, with “very high structure-very high control” being the most adaptive and “low structure–low control” the most maladaptive in terms of need-based experiences. Four low directiveness profiles were identified, with “very high autonomy support-very low chaos” being the most adaptive and “low autonomy support-moderate chaos” the most maladaptive.
Embargo
Feasibility, acceptability, and effectiveness of physically active lessons in secondary education: ACTIVE CLASS pilot study
(Wolters Kluwer, 2025-02-10) Ruiz-Hermosa, Abel; Sánchez-Oliva, David; Grao-Cruces, Alberto; Medrano Echeverría, María; González-Pérez, María; Martín-Acosta, Fátima; Camiletti-Moirón, Daniel; Ciencias de la Salud; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Introduction: the aim of this study was to test the feasibility, acceptability, and effectiveness of a physically active learning (PAL) intervention (ACTIVE CLASS pilot study) to improve physical health and cognitive and academic performance, increase physical activity (PA) levels, and reduce sedentary time (ST) in adolescents, and to analyze the distribution of activity intensity during a PAL lesson and assess differences with physical education lessons. Methods: a quasi-experimental study was conducted including 77 students aged 12-14 yr from two Spanish secondary schools. The ACTIVE CLASS pilot program consisted of integrating a weekly PAL lesson into mathematics lessons for 4 wk. Changes in body composition (body mass index and waist circumference), physical fitness (cardiorespiratory and muscular fitness), executive functions (inhibition, working memory, and cognitive flexibility), and mathematical fluency were measured. Accelerometer-based ST and PA were measured in the intervention group. The feasibility and acceptability of the intervention were assessed using self-reported questionnaires for teachers and students. Repeated-measures analyses of variance were used to test the effects of the intervention. Results: there were no significant improvements in body composition, fitness, and cognitive and academic performance when comparing the intervention and control groups. The inclusion of the PAL intervention significantly increased average PA levels and reduced ST during the school day, and no significant differences were found in accelerometer-based variables between physical education and PAL lessons. In fact, PAL lessons could provide up to 17 min of moderate/vigorous PA. In addition, teachers and students reported good feasibility and acceptability of the PAL intervention. Conclusion: the findings support further research with a longer-term intervention and a larger sample size to determine the true potential of PAL for adolescents' physical health, cognition, and academic performance.
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.