Francisco Caamaño-Isorna

A meta-analysis of coffee drinking, cigarette smoking, and the risk of Parkinson's disease.

We conducted a systematic review to summarize the epidemiological evidence on the association between cigarette smoking, coffee drinking, and the risk of Parkinsons disease. Case–control and cohort studies that reported the relative risk of physician‐confirmed Parkinsons disease by cigarette smoking or coffee drinking status were included. Study‐specific log relative risks were weighted by the inverse of their variances to obtain a pooled relative risk and its 95% confidence interval (CI). Results for smoking were based on 44 case–control and 4 cohort studies, and for coffee 8 case–control and 5 cohort studies. Compared with never smokers, the relative risk of Parkinsons disease was 0.59 (95% CI, 0.54–0.63) for ever smokers, 0.80 (95% CI, 0.69–0.93) for past smokers, and 0.39 (95% CI, 0.32–0.47) for current smokers. The relative risk per 10 additional pack‐years was 0.84 (95% CI, 0.81–0.88) in case–control studies and 0.78 (95% CI, 0.73–0.84) in cohort studies. Compared with non–coffee drinkers, relative risk of Parkinsons disease was 0.69 (95% CI, 0.59–0.80) for coffee drinkers. The relative risk per three additional cups of coffee per day was 0.75 (95% CI, 0.64–0.86) in case–control studies and 0.68 (95% CI, 0.46–1.00) in cohort studies. This meta‐analysis shows that there is strong epidemiological evidence that smokers and coffee drinkers have a lower risk of Parkinsons disease. Further research is required on the biological mechanisms underlying this potentially protective effect.

Education and Dementia: A Meta-Analytic Study

Considerable controversy exists about the role of education in the risk of dementia. Individual studies have not been conclusive so far. To examine the hypothesis that lower education is associated with a higher risk of dementia, we carried out a meta-analysis. Observational studies published as of October 2005 that examined the association between education and risk of dementia were systematically reviewed. Relative risks (RRs) and odds ratios were extracted from cohort and case-control studies. We first compared the risk of dementia in subjects with high level of education with the risk of dementia in those with low educational level. In a subsequent analysis, we compared the risk of persons with high education with the risk of subjects with education level other than high (medium, low). We weighted log RRs for cohort studies or odds ratios by the inverse of their variances. Nineteen studies were included in our meta-analysis (13 cohort and 6 case-control studies). RRs for low versus high education level were: Alzheimer’s disease (AD) 1.80 (95% CI: 1.43–2.27); non-AD dementias, 1.32 (95% CI: 0.92–1.88), and all dementias 1.59 (95% CI: 1.26–2.01). For low and medium versus high education level, the RRs were: AD 1.44 (95% CI: 1.24–1.67); non-AD 1.23 (95% CI: 0.94–1.61), and all dementias 1.33 (95% CI: 1.15–1.54). These results confirm that low education may be a risk factor for dementia, especially for AD.

Hyperactivation of right inferior frontal cortex in young binge drinkers during response inhibition: a follow-up study.

AIMS The objective of this study was to examine brain activity, with particular attention to prefrontal function, during response execution and inhibition in youths who have engaged in binge drinking (BD) for at least 2 years. DESIGN Event-related potentials (ERPs) were recorded twice within 3 years, during performance of a Go/NoGo task. SETTING The study was part of a longitudinal study of the neurocognitive effects of BD. PARTICIPANTS A total of 48 undergraduate students, 25 controls (14 females) and 23 binge drinkers (10 females), with no personal or family history of alcoholism or psychopathological disorders. MEASUREMENTS The Go-P3 and NoGo-P3 components of the ERPs were examined by principal component analysis and exact low-resolution tomography analysis (eLORETA). FINDINGS Binge drinkers showed larger Go-P3 amplitudes than controls in the first and second evaluations (P = 0.019). They also showed larger NoGo-P3 amplitude in the second evaluation (P = 0.002). eLORETA analyses in the second evaluation revealed significantly greater activation of the right inferior frontal cortex (rIFC) in binge drinkers than in controls during successful inhibition (P < 0.05). CONCLUSIONS Young binge drinkers appear to show abnormal brain activity as measured by event-related potentials during response execution and inhibition which may represent a neural antecedent of difficulties in impulse control.

Psychological factors are associated with changes in the health-related quality of life in inflammatory bowel disease.

Background:The effect of different sociodemographic and clinical variables on the health-related quality of life (HRQOL) of patients with inflammatory bowel disease (IBD) is currently known, but the influence of psychological factors has not been sufficiently explored. The objective of this study was to identify psychological predictors of HRQOL in patients with IBD. Methods:A cross-sectional prospective study was undertaken including 875 consecutive IBD patients. Independent variables were measured using a sociodemographic and clinical questionnaire, the Hospital Anxiety and Depression Scale (HADS) questionnaire, the Perceived Stress Scale (PSS) questionnaire, and the COPE questionnaire. Dependent variables were measured using the Short Form 36 Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ-36). Logistic regression was performed to identify factors associated with HRQOL. Results:The participation rate was 91.3%. Patients with IBD had a poorer HRQOL than the general population except on the Physical Function, Social Function, and Emotional Function Scale. Moreover, high levels of anxiety, depression, and stress were found to be associated with low levels in all quality of life measurements. No significant relationship was found between HRQOL and coping strategies. Conclusions:In patients with IBD, stress, anxiety and depression are important determinants of HRQOL and should therefore be considered in the management of this patient population.

Binge drinking trajectory and neuropsychological functioning among university students: A longitudinal study

BACKGROUND Adolescence is a time of considerable neurodevelopment. Binge drinking (BD) during this period increases the vulnerability to its neurotoxic effects. This longitudinal study aimed to investigate the relationship between BD trajectory over university years and neuropsychological functioning. METHODS Cohort-study. Two-year follow-up. A total of 89 university students were assessed: 40 Non-BD (at Initial and Follow-up), 16 Ex-BD (BD at Initial but not at Follow-up) and 33 BD (at both times). Neuropsychological assessment of working memory, episodic memory and executive abilities was carried out during their first (Initial) and third (Follow-up) academic year at the University of Santiago de Compostela. RESULTS BD subjects performed less well on the Wechsler Memory Scale-III (WMS-III) Logical Memory Subtest (immediate theme recall, P=.034; delayed theme recall, P=.037; and percent retention, P=.035) and committed more perseverative errors on the Self-Ordered Pointing Task (SOPT) (P=.021) than Non-BD. There were no differences between Ex-BD and Non-BD. CONCLUSIONS Binge drinking trajectory during adolescence is associated with neuropsychological performance. Persistent BD, but not Ex-BD, is associated with verbal memory and monitoring difficulties. This is compatible with the hypothesis that heavy alcohol use during adolescence may affect cognitive functions that rely on the temporomesial and dorsolateral prefrontal cortex.

Binge Drinking and Declarative Memory in University Students

BACKGROUND Binge drinking (BD), which is characterized by sporadic consumption of large quantities of alcohol in short periods, is prevalent among university students. Animal studies have shown that BD is associated with damage to the hippocampus, a region of the brain that plays a key role in learning and memory. The temporal cortex undergoes structural and functional changes during adolescence. The aim of the present study was to examine the association between BD and declarative memory in male and female university students. METHODS The participants were 122 students (between 18 and 20 years of age): 62 BD (30 women) and 60 non-BD (29 women). The neuropsychological assessment included the Rey Auditory Verbal Learning Test (RAVLT) and Weschler Memory Scale-3rd ed. (WMS-III) Logical Memory subtest, to evaluate verbal declarative memory, and the WMS-III Family Pictures subtest, to measure visual declarative memory. RESULTS The BD students remembered fewer words in the interference list and displayed greater proactive interference in the RAVLT; they performed worse in the Logical Memory subtest, both on immediate and delayed recall. There were no differences between the groups in performance of the Family Pictures subtest. No significant interactions were observed between BD and sex. CONCLUSIONS Binge drinking is associated with poorer verbal declarative memory, regardless of sex. The findings are consistent with the vulnerability of the adolescent hippocampus to the neurotoxic effects of alcohol. Longitudinal studies will help determine the nature of this relationship, the neurodevelopmental trajectories for each sex, and the repercussions on academic performance.

Factores asociados con el control del asma en pacientes de atención primaria en España: el estudio CHAS

BACKGROUND Asthma control is inadequate in all populations studied to date, leading to a major part of the cost of the disease. The aim of our study was to evaluate the prevalence of uncontrolled asthma in primary care patients and identify the associated factors. METHODS We carried out a cross-sectional study of the population of primary care asthmatic patients over 18 years old in Spain (n=2159). Asthma control was measured with the Asthma Control Questionnaire (ACQ). The sociodemographic variables and treatment compliance were measured using a questionnaire. We built logistic-regression models using Asthma control, a dichotomous variable generated from ACQ score. RESULTS The prevalence of uncontrolled asthma was 63.9%. Treatment with oral corticosteroids (OCS) (OR=6.55), greater asthma severity (OR=3.11), presence of a distressing event (OR=2.44), lower significance given to treatment compliance (OR=1.66) and living in a rural area (OR=1.29) are associated with uncontrolled asthma. On the contrary, sex, age, obesity, smoking, alcohol intake and educational level had no effect on asthma control. CONCLUSIONS In Spain asthma is still uncontrolled and some factors leading to this situation appear to be modifiable by the health system.

Increased amplitude of P3 event-related potential in young binge drinkers.

The aim of the present study was to determine how binge drinking (BD) affects brain functioning in male and female university students during the performance of a visual discrimination task. Thirty two binge drinkers and 53 controls (non binge drinkers), with no history of other drug use, personal or family history of alcoholism or psychopathological disorders, were selected. Event-related potentials (ERPs) were recorded during the performance of a visual oddball task. The latency and amplitude of the N2 and P3b components of the ERPs were analyzed. There were no differences between the groups in behavioral measures, but P3b amplitudes were significantly larger in binge drinkers than controls. This may suggest the presence of anomalies in neural processes mediating attention processing, or an imbalance (increased) of neuronal activity in P3b generators caused by the presence of BD pattern for a long time.

Factors associated with health-related quality of life in adults with asthma. A cross-sectional study

BackgroundThe measurement of health-related quality of life (HRQoL) is increasingly recognized as an important endpoint, as a reflection of the effects of the disease from a patient perspective. Our aim was to evaluate the factors determining the HRQoL in patients with asthma, according to the EQ-5D questionnaire.MethodsPatients were included using multi-stage sampling, from Primary Care clinics from all the Autonomous Communities in Spain. The patients included were: over 18 years-old, with a confirmed diagnosis of asthma for at least one year, and had visited a Health Centre in the previous 2 years. The characteristics of the asthma disease, the adherence to treatment, the socio-demographic variables, the smoking habits, and the asthma control were collected using a questionnaire. The influence of the different variables included in the study on the EQ-5D was evaluated using multivariate logistic regression analysis.ResultsA total of 2,125 patients were finally included (57.7% females, mean age 48 years). The response rate was 95.4%. Some factors showed a considerable detrimental effect on the HRQoL of asthmatics. Advanced age, lower educational level and poor control of asthma are significantly associated with a worse quality of life in all the dimensions assessed by the EQ-5D scale. The baseline severity of the asthma, and having been admitted to hospital are related to a worse quality of life in 5 of the 6 dimensions analyzed.ConclusionIn our study, we could identify some factors related to quality of life in asthma patients. The most important were advanced age, lower education level, and poor control of the asthma.

Respiratory and mental health effects of wildfires: an ecological study in Galician municipalities (north-west Spain)

BackgroundDuring the summer of 2006, a wave of wildfires struck Galicia (north-west Spain), giving rise to a disaster situation in which a great deal of the territory was destroyed. Unlike other occasions, the wildfires in this case also threatened farms, houses and even human lives, with the result that the perception of disaster and helplessness was the most acute experienced in recent years. This study sought to analyse the respiratory and mental health effects of the August-2006 fires, using consumption of anxiolytics-hypnotics and drugs for obstructive airway diseases as indicators.MethodsWe conducted an analytical, ecological geographical- and temporal-cluster study, using municipality-month as the study unit. The independent variable was exposure to wildfires in August 2006, with municipalities thus being classified into the following three categories: no exposure; medium exposure; and high exposure. Dependent variables were: (1) anxiolytics-hypnotics; and (2) drugs for obstructive airway diseases consumption. These variables were calculated for the two 12-month periods before and after August 2006. Additive models for time series were used for statistical analysis purposes.ResultsThe results revealed a higher consumption of drugs for obstructive airway diseases among pensioners during the months following the wildfires, in municipalities affected versus those unaffected by fire. In terms of consumption of anxiolytics-hypnotics, the results showed a significant increase among men among men overall -pensioners and non-pensioners- in fire-affected municipalities.ConclusionsOur study indicates that wildfires have a significant effect on population health. The coherence of these results suggests that drug utilisation research is a useful tool for studying morbidity associated with environmental incidents.