EM22: "Alcala" Vascular Risk Study in the province of Cádiz

Provincial research group.

It brings together healthcare professionals from the three Management Areas. Multidisciplinary group with the presence of nurses, pharmacists and primary care, midwives, family doctors of primary care and emergencies and hospital physicians of clinical analysis and internal medicine.

Research objectives on vascular risk in the province of Cádiz, currently with lines of research focused on the study of the situation of diabetes.

• “Cádiz Diabetes Database” Line: Data of patients with diabetes treated in the SSP of the province from 2014 onwards have been recovered. Based on collecting demographic data, drug consumption and data from determinations made in clinical laboratories. It allows us to know the situation of the population with diabetes and its evolution. Now it will be expanded with the data on hypoglycemia treated (final project of family doctor residency for 2021) and with data from the retinographies performed. 3 publications and one in editorial process. 4 more posts in progress. The application of data engineering techniques would allow us to establish alliances with other groups for the development of this line.
• “Adherence and Persistence” Line: Coupled with the previous Line, the collection of data on the consumption of drugs used for diabetes, allows us to establish a new line for the evaluation of Adherence and Persistence to said medication. In addition, the special mechanism of action of some of the families of hypoglycemic drugs allows us a novel approach to assess adherence to these types of drugs. The application of AI techniques or "machine learning" and the development of electronic devices to combat lack of adherence, would allow us alliances with other groups to implement our studies in daily clinical practice.
• “Protein glycation” Line: The presence of glucose in body fluids leads to the glycation of proteins. Glycohemoglobin A1c is the most widely used, but so far few studies have been carried out to investigate the effect that certain parameters such as age, sex, presence of anemia, alteration of erythrocyte indices or presence of kidney disease have on their values.
  • We also propose the study of glycated albumin as a new glycemic marker and of the labile forms of both, hemoglobin and albumin, as a reflection of a time period different from that of their stable forms.
  • A mathematical model of Hb glycation has already been developed in collaboration with the Departments of Mathematics of the UCA and the UCLM. It is now in the phase of clinical application, on the one hand, and on the other, its extension to include other glycated proteins, until it forms what we have called the "Glycation Profile". Although there are already working alliances for this line, we are in talks to expand them in the way of determining the different glycated proteins.
• "Gestational Diabetes Mellitus" Line: Until now focused on the AGS Campo de Gibraltar. Different projects have been developed for:
  • Know the prevalence of GDM in our area.
  • Develop a research project on mathematical models that allow their early diagnosis using the usual determinations together with glycated proteins.
  • An innovative process is being designed to assess and act on the impact of the presence of GDM during pregnancy on the health of women after their pregnancy.
  • These projects have become the Final Residency Projects of the 2019 and 2020 promotions of family doctors in our AGS, in addition the project on early diagnosis has been submitted to the permanent call for research projects in Primary Care.

• Principal Investigators:
  • Alfredo Michán Doña (PI).
  • José Escribano Serrano (Co-PI).
• Primary health care (PHC):
  • Lourdes García Domínguez.
  • Juan Antonio Gómez Canto.
  • Antonio Zarallo Pérez.
  • Milagros Pérez López.
  • José Antonio Rosano Macías.
  • Marina Pérez Crespo.
• PHC Pharmacy:
  • Carolina Payá Giner.
  • María Isabel Méndez Esteban.
  • Manuela Márquez Ferrando.
  • Antonio García Bonilla.
• PHC Midwives:
  • Lilian de Cozar Perea.
  • Ana Pureza Jiménez Gómez.
  • Estefanía Bueno Montero.
  • María Jesús Espejo del Manzano.
• Clinical Analysis:
  • Cristina Casto Jarillo.
  • Enrique Jiménez Varo.
  • Enrique Berruguilla Pérez.
  • María Mercedes Calero Pérez.
  • María Luisa González Borrachero.
• Internal medicine:
  • Carmen Bocanegra Muñoz.
  • Daniel Marín Dueñas.
  • Patricia Rubio rín.

• Fundación Progreso Y Salud.Área Sanitaria Campo De Gibraltar Este. PI: Jose Escribano Serrano. AP-0236-2019. Predicción De La Diabetes Gestacional Mediante Un Modelo Multivariante Durante El Primner Trimestre De la Gestación.

1. Carmen Michán y Alfredo Michan-Doña. “Viruses: Friends or foes.” Microbial Biotechnology, (october 2021) 2022, 15, 88-90. DOI: 10.1111/1751-7915.13948. FI: 5,813 Q1.
2. Leopoldo Pérez de Isla, Gerald F Watts, Ovidio Muñiz-Grijalvo, …//…, Alfredo Michán, …, “A resilient type of familial hypercholesterolemia: case-control follow-up of genetically characterized older patients in the SAFEHEART cohort.” European Journal of Preventive Cardiology. December, 2021. Ahead of print. https://doi.org/10.1093/eurjpc/zwab185. FI: 7,804 Q1.
3. Orozco-Beltrán D, Cinza-Sanjurjo S, Escribano-Serrano J, López-Simarro F, Fernández G, Gómez-García A, Cedenilla-Horcajuelo M, Ferreira de Campos K. “Experience of Patients with Diabetes and Other Cardiovascular Risk Factors with Health Professionals and Healthcare in Spain”. J Clin Med. 2021 26;10(13):2831. doi: 10.3390/jcm10132831. PMID: 34206918; PMCID: PMC8267612. FI: 2,242 (2020) Q1.

1. Escribano-Serrano J, Casto-Jarillo C, Berruguilla-Pérez E, González-Borrachero M, Santotoribio JD, Cañavate-Solano C, Calero-Ruiz MM, Michán-Doña A. [Concordance between the equations "Chronic Kidney Disease Epidemiological Collaboration" and "Modification of Diet in Renal Disease" with the "Berlin Initiative Study" to estimate renal function in the elderly]. Semergen. 2019 May [Epub ahead of print].
2. Escribano Serrano J, Méndez-Esteban MI, García-Bonilla A, Márquez-Ferrando M, Casto-Jarillo C, Berruguilla Pérez E, Calero Ruiz MM, Gonzalez Borrachero ML, Santotoribio JD, Michán-Doña A. Prevalence of diabetes, use of antidiabetic drugs and degree of glycaemic control in the province of Cadiz (2014-2016): A population-based study. Rev Clin Esp. 2019 May;219(4):177-183. FI WOS (JCR) Category: MEDICINE, GENERAL & INTERNAL. Impact index: 1.399 Magazine within 25%: no 2018.

1. León-Triana O, Calvo GF, Belmonte-Beitia J, Rosa Durán M, Escribano-Serrano J, Michan-Doña A, Pérez-García VM. Labile haemoglobin as a glycaemic biomarker for patient-specific monitoring of diabetes: mathematical modelling approach. J R Soc Interface. 2018 May;15(142). FI WOS (JCR) Category: MULTIDISCIPLINARY SCIENCES. Impact index: 3.224 Magazine within 25%: yes. Q1.
2. Rubio-Marín P, Michán-Doña A, Maraver-Delgado J, Arroyo-Olivares R, Barrado Varea R, Pérez de Isla L, Mata P. Cascade screening program for familial hypercholesterolemia. Endocrinol Diabetes Nutr. 2018 May;65(5):280-286. FI WOS (JCR) Category: ENDOCRINOLOGY. Impact index: 0.934 Magazine within 25%: No. Q4.
3. Escribano Serrano J, Méndez Esteban MI, García Bonilla A, Michán Doña A. [Prevalence of diabetes mellitus in the province of Cádiz, Spain]. Semergen. 2018 Mar;44(2):81-e83. 2016.
4. Calvo Gómez C, Gómez-Huelgas R, Lima Ruiz J, Masmiquel Comas L, Michán Doña A, Zapatero Gaviria A. Expert consensus on the use of liraglutide in the treatment of diabetes in internal medicine. Int J Clin Pharmacol Ther. 2016;54(11):880-890. FI WOS (JCR) Category: PHARMACOLOGY. Impact index: 0.927 Magazine within 25%: No. Q3.

1. Ena J, Gómez-Huelgas R, Sánchez-Fuentes D, Camafort-Babkowsk M, Formiga F, Michán-Doña A, Casariego E; Working Group of Diabetes and Obesity of Spanish Society of Internal Medicine. Management of patients with type 2 diabetes and multiple chronic conditions: A Delphi consensus of the Spanish Society of Internal Medicine. Eur J Intern Med. 2016 Jan; 27:31-6. FI WOS (JCR) Category: MEDICINE, GENERAL & INTERNAL. Impact index: 2.960 Magazine within 25%: yes. Q1.
2. Escribano-Serrano J, Mancera-Romero J, Santos-Sánchez V, Payá-Giner C, Méndez-Esteban MI, García-Bonilla A, Márquez-Ferrando M, Hormigo-Pozo A, Michán-Doña A. Prevalencia de Hipotiroidismo en Andalucía, España, Determinada por consumo Hormona Tiroidea. Rev Esp Salud Publica. 2016; 90: e1-e12. FI WOS (JCR) Category: PUBLIC &OCCUPATIONAL HEALTH. Impact index: 0.6 Magazine within 25%: No. Q4. 2015.

1. Pérez-Ramírez C, Cañadas-Garre M, Jiménez-Varo E, Faus-Dáder MJ, Calleja-Hernández MÁ. MET: a new promising biomarker in non-small-cell lung carcinoma. Pharmacogenomics. 2015;16(6):631-47. FI WOS (JCR) Category: PHARMACOLOGY. Impact index: 2.710 Magazine within 25%: No.
2. Jiménez-Varo E, Cañadas-Garre M, Garcés-Robles V, Gutiérrez-Pimentel MJ, Calleja-Hernández MÁ. Extrapolation of acenocoumarol pharmacogenetic algorithms. Vascul Pharmacol. 2015; 74:151-157. FI WOS (JCR) Category: PHARMACOLOGY. Impact index: 2.500 Magazine within 25%: No. Q2.
3. González Borrachero ML, de la Fuente-Gonzalo F, González FA, Nieto JM, Villegas A, Ropero P. [Delta⁰-thalassemia by insertion of 27 base pairs in δ-globin gene with decreased hemoglobin A₂ levels]. Med Clin (Barc). 2015 Apr 8;144(7):312-6. FI WOS (JCR) Category: MEDICINE, GENERAL & INTERNAL. Impact index: 1.399 Magazine within 25%: No.

1. Jiménez-Varo E, Cañadas-Garre M, Henriques CI, Pinheiro AM, Gutiérrez-Pimentel MJ, Calleja-Hernández MÁ. Pharmacogenetics role in the safety of acenocoumarol therapy. Thromb Haemost. 2014 2;112(3):522-36. FI WOS (JCR) Category: MEDICINE, GENERAL & INTERNAL. Impact index: 1.399 Magazine within 25%: No.
2. Jiménez-Varo E, Cañadas-Garre M, Gutiérrez-Pimentel MJ, Calleja-Hernández MA. Prediction of stable acenocoumarol dose by a pharmacogenetic algorithm. Pharmacogenet Genomics. 2014 Oct;24(10):501-13. FI WOS (JCR) Category: MEDICINE, GENERAL & INTERNAL. Impact index: 2.857 Magazine within 25%: No. Q2.
3. Escribano-Serrano J; Paya-Giner C; Méndez Esteban MI; Márquez-Ferrando M; Zarallo-Pérez A; Michán-Doña A. [Different methods used to estimate the prevalence of hypothyroidism, Cadiz, Spain]. Rev Esp Salud Publica. 2014; 88, 629 - 38. FI WOS (JCR) Category: PUBLIC & OCCUPATIONAL HEALTH. Impact index: 0.6 Magazine within 25%: No.
4. Toledo-Pastrana T, Zapata-López A, Michán-Doña A. Urethral discharge and mucocutaneous involvement. Rev Clin Esp. 2014 Oct;214(7): e91-2. FI WOS (JCR) Category: MEDICINE, GENERAL & INTERNAL. Impact index: 1.063 Magazine within 25%: No. Q3.