Eotaxin‑2 and eotaxin‑3 in malaria exposure and pregnancy

Background: Eotaxin-1 concentrations in plasma have been inversely associated with malaria exposure, malaria infection and pregnancy, but the effect of these conditions on the levels of the related chemokines eotaxin-2 and eotaxin-3 remains unknown. Methods: Eotaxin-2 and -3 concentrations were measured in 310 peripheral or placental plasma samples from pregnant and non-pregnant individuals from Papua New Guinea (malaria-endemic country) and Spain (malaria-naïve individuals) with previous data on eotaxin-1 concentrations. Correlations between eotaxin concentrations were examined with the Spearman’s test. Differences in eotaxin concentrations among groups were evaluated with the Kruskal–Wallis or Mann Whitney tests. The pairwise Wilcoxon test was performed to compare eotaxin-2 concentration between peripheral and placental matched plasmas. Univariable and multivariable linear regression models were estimated to assess the association between eotaxins and Plasmodium infection or gestational age. Results: Eotaxin-2 concentrations in plasma showed a weak positive correlation with eotaxin-3 (rho = 0.35, p < 0.05) concentrations. Eotaxin-2 concentrations in the malaria-exposed non-pregnant group were significantly lower than the in the malaria-naive non-pregnant and the malaria-exposed pregnant groups. Eotaxin-3 plasma concentrations were lower in malaria-exposed than in non-exposed groups (p < 0.05), but no differences were found associated to pregnancy. Eotaxin-2 and eotaxin-3 plasma concentrations were negatively correlated with anti-Plasmodium IgG levels: PfDBL5ε-IgG ( rhoEo2 = − 0.35, p = 0.005; rhoEo3 =− 0.37, p = 0.011), and eotaxin-3 was negatively correlated with PfDBL3x-IgG levels ( rhoEo3 =− 0.36; p = 0.011). Negative correlations of eotaxin-2 and 3 in plasma were also observed with atypical memory B cells ( rhoEo2 = − 0.37, p < 0.001; rhoEo3= − 0.28, p = 0.006), a B cell subset expanded in malaria-exposed individuals. In addition, a borderline negative association was observed between eotaxin-3 concentrations and Plasmodium infection (adjusted effect estimate, β = − 0.279, 95% CI − 0.605; 0.047, p = 0.091). Moreover, eotaxin-2 placental concentrations were significantly increased compared to peripheral concentrations in the malariaexposed pregnant group whereas the contrary was observed in the non-exposed pregnant group (p < 0.005). Conclusion: Although a clear epidemiological negative association is observed between eotaxins concentrations and malaria exposure and/or infection, pregnancy may alter this association for eotaxin-2. Further research is required to understand the role of these chemokines in this disease and in combination with pregnancy.European Commission PREGVAX FP7-EALTH-201588Malaria in Pregnancy Consortium (MiPc) through Bill & Melinda Gates Foundation 46099Government of Spain, Ramon y Cajal Fellowship RYC-2013-14512State Research Agency through the "Centro de Excelencia Severo Ochoa 2019-2023" Program CEX2018-000806-SGeneralitat de Catalunya through the CERCA ProgramFundacion Ramon ArecesMinistry of Science and Innovation, Spain (MICINN)Spanish Governmen

Psychological Impact of COVID-19 in the Setting of Dentistry: A Review Article

The worldwide pandemic has exposed healthcare professionals to a high risk of infection, exacerbating the situation of uncertainty caused by COVID-19. The objective of this review was to evaluate the psychological impact of the COVID-19 pandemic on dental professionals and their patients. A literature review was conducted using Medline-Pubmed, Web of Science, and Scopus databases, excluding systematic reviews, narratives, meta-analyses, case reports, book chapters, short communications, and congress papers. A modified version of the Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the selected studies. The search retrieved 3879 articles, and 123 of these were selected for the review (7 longitudinal and 116 cross-sectional studies). Elevated anxiety levels were observed in dental professionals, especially in younger and female professionals. Except for orthodontic treatments, patients reported a high level of fear that reduced their demand for dentist treatment to emergency cases alone. The results suggest that the COVID-19 pandemic has had psychological and emotional consequences for dental professionals and their patients. Further research is necessary to evaluate the persistence of this problem over time.Universidad de Granada, Plan Propio de Investigacion PPJIA2021-3

Factors associated with the development of second primary tumours in head and neck cancer patients

ACKNOWLEDGEMENTS Funding for open access charge: Universidad de Granada/CBUA. Study concepts: RBR. Study design: RBR, ISB, PR. Acquisition of data: RM, COR, ROR, MLL. Data analysis and interpretation: RBR, ISB, PR y JPA. Manuscript preparation: ISB, PR, RBR. Manuscript review: ISB, PR, RM, COR, ROR, MLL, JPA, RBR. Manuscript final approval: ISB, PR, RM, COR, ROR, MLL, JPA, RBR. Being accountable for all aspects of the work: ISB, PR, RM, COR, ROR, MLL, JPA, RBR.Introduction: The development of second primary tumours (SPTs) is one of the main causes of low survival in patients with head and neck cancer (HNC). The aim of this study was to review the evidence about factors associated with developing SPTs in patients with HNC. Methods: An updated systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, and the search was performed in Pubmed and Scopus. Only original articles with a cohort or case-control design were included. Article quality was assessed with the Newcastle-Ottawa scale. Results: Thirty-six and two case-control studies were included, with quality medium (n = 5) to high (n = 33). Tobacco showed a significant association with SPT development, with risks ranging from 1.41 (95%CI: 1.04-1.91) to 5.52 (95%CI: 2.91-10.49). Regarding alcohol, risks ranged from 1.46 (95%CI: 1.12-1.91) to 21.3 (95%CI: 2.9-156). Location of the index tumour in the hypopharynx/oropharynx, absence of human papillomavirus and presence of a premalignant lesion also increased the risk of SPTs. More controversy was found for sex, age and other clinical factors of the tumour. Conclusion: Toxic lifestyle habits and clinical factors were associated with the risk of SPTs in HNC patients. These findings may improve individualised prevention strategies in its follow-up.Spanish Ministry of Science, Innovation and Universities through the grant ‘Ramon y Cajal’Universidad de Granada/CBUA (Funding for open access charge

Actividad docente de gamificación para estudio epidemiológico de un brote de COVID-19

La aplicación práctica de la epidemiología en el estudio de brotes epidémicos puede resultar ardua para el estudiantado. El uso de metodologías innovadoras podría facilitar la comprensión de la materia y ayudar a visualizar su utilidad e importancia. Por ese motivo, se ha diseñado una actividad docente en modo de juego que simula un brote de COVID-19, y que pretende ayudar a los alumnos en su aprendizaje de conceptos relacionados con la epidemiología de enfermedades transmisibles.Plan FIDO - Universidad de Granada. Proyecto de innovación docente 20-13

Associations of accumulated persistent organic pollutants in breast adipose tissue with the evolution of breast cancer after surgery

Dr. JP Arrebola is under contract within the Ramón y Cajal Program (RYC-2016-20155, Ministerio de Economía, Industria y Competitividad, Spain). This study was supported by research grants from Instituto de Salud Carlos III, Junta de Andalucía and European Regional Development Fund – FEDER (PI-0513/2012, PI16/01858, PI18/01573, PI20/01568).Chronic exposure to persistent organic pollutants (POPs) is suspected to contribute to the onset of breast cancer, but the impact on the evolution of patients after diagnosis is unclear. We aimed to analyze the contribution of long-term exposure to five POPs to overall mortality, cancer recurrence, metastasis, and development of second primary tumors over a global follow-up of 10 years after surgery in breast cancer patients in a cohort study. Between 2012 and 2014, a total of 112 newly diagnosed breast cancer patients were recruited from a public hospital in Granada, Southern Spain. Historical exposure to POPs was estimated by analyzing their concentrations in breast adipose tissue samples. Sociodemographic data were collected through face-to-face interviews, while data on evolution tumor were retrieved from clinical records. Statistical analyses were performed using Cox regression (overall survival, breast cancer recurrence or metastasis) and binary logistic regression models (joint outcome variable). We also tested for statistical interactions of POPs with age, residence, and prognostic markers. The third vs first tertile of hexachlorobenzene concentrations was associated with a lower risk of all-cause mortality (Hazard Ratio, HR = 0.26; 95 % Confidence Interval, CI = 0.07-0.92) and of the appearance of any of the four events (Odds Ratio = 0.37; 95 % CI = 0.14-1.03). Polychlorinated biphenyl 138 concentrations were significantly and inversely associated with risk of metastasis (HR = 0.65; 95 % CI = 0.44-0.97) and tumor recurrence (HR = 0.69; 95 % CI = 0.49-0.98). Additionally, p,p & PRIME;dichlorodiphenyldichloroethylene showed inverse associations with risk of metastasis in women with ER-positive tumors (HR = 0.49; 95 % CI = 0.25-0.93) and in those with a tumor size <2.0 cm (HR = 0.39; 95 % CI = 0.18-0.87).Ministerio de Economía, Industria y Competitividad, Spain RYC-2016-20155Instituto de Salud Carlos IIIJunta de AndalucíaEuropean Regional Development Fund – FEDER (PI-0513/2012, PI16/01858, PI18/01573, PI20/01568)University of Granada / CBU

Tocilizumab in COVID-19: Factors Associated With Mortality Before and After Treatment

We thank Pablo Lardelli Claret for his helpful advice in statistical methods. We also acknowledge the staff of Hospital Universitario Virgen de las Nieves who took (and are taking) care of the COVID-19 patients.Tocilizumab (TCZ) has been administered in SARS-CoV-2 pneumonia but the factors associated with mortality before and after treatment remain unclear. Cox regression models were used to estimate the predictors of time to death in a cohort of hospitalized patients with COVID-19 receiving TCZ. In addition, the mean differences between discharged and deceased patients in laboratory parameters measured before and 3, 6 and 9 days after TCZ administration were estimated with weighted generalized estimation equations. The variables associated with time to death were immunosuppression (Hazard Ratio-HR 3.15; 95% confidence interval-CI 1.17, 8.51), diabetes mellitus (HR 2.63; 95% CI 1.23–5.64), age (HR 1.05; 95% CI 1.02–1.09), days since diagnosis until TCZ administration (HR 1.05, 95% CI 1.00–1.09), and platelets (HR 0.27; 95% CI: 0.11, 0.69). In the post-TCZ analysis and compared to discharged patients, deceased patients had more lactate dehydrogenase (p 0.013), troponin I (p 0.013), C-reactive protein (p 0.013), neutrophils (p 0.024), and fewer platelets (p 0.013) and lymphocytes (p 0.013) as well as a lower average PaO2/FiO2 ratio. In conclusion, in COVID-19 diagnosed patients receiving TCZ, early treatment decreased the risk of death, while age, some comorbidities and baseline lower platelet counts increased that risk. After TCZ administration, lower platelet levels were again associated with mortality, together with other laboratory parameters

Influence of diet in COVID-19 infection and severity risk: a systematic review

Universidad de Granada. Plan Propio de Investigación. Proyectos de Investigación Precompetitivos para Jóvenes Investigadores del Plan Propio 2021. PPJIA2021-36. El financiador no participó en el proceso de revisión, solo en la financiación de las cuotas de la revista.Introducción: el riesgo y/o el pronóstico de la COVID-19, causado por el virus SARS-CoV-2, se han relacionado con enfermedades crónicas como obesidad, diabetes mellitus y enfermedades cardiovasculares, siendo la dieta de mala calidad un factor predisponente para estas enfermedades. Objetivo: sintetizar la evidencia científica sobre el efecto de la dieta en el riesgo de infección por SARS-CoV-2 y de COVID-19 grave. Métodos: revisión sistemática realizada siguiendo las guías PRISMA. La búsqueda bibliográfica se hizo en las bases de datos Web of Science, Scopus y Medline (a través del buscador PubMed). El análisis del riesgo de sesgo se realizó mediante las escalas Newcastle-Ottawa y Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Resultados: se incluyeron 14 estudios. Una buena adherencia a la dieta mediterránea se asoció con una disminución del riesgo de infección por SARS-CoV-2 (razón de momios RM = 0,44; IC 95 %: 0,22-0,88, para adherencia alta versus baja, y RM significativas de 0,88 y 0,95 en los estudios que analizaron la adherencia de forma cuantitativa) pero no con la gravedad de la COVID-19. Una dieta basada en plantas presentó una asociación protectora frente a la infección y la enfermedad grave. Concretamente, un alto consumo de verdura, legumbres y cereales, y una baja ingesta de lácteos y carnes rojas mostraron un efecto protector frente a la infección y/o la COVID-19 grave, según el estudio. Los suplementos vitamínicos y probióticos también disminuyeron el riesgo de infección. Conclusión: la evidencia disponible sugiere que una dieta saludable, basada en un patrón de dieta mediterránea o en alimentos vegetales, con consumo de lácteos y carnes rojas moderado, ejerce un efecto protector frente a la COVID-19.Introduction: the risk and/or prognosis of COVID-19, caused by the SARS-CoV-2 virus, have been related to chronic diseases such as obesity, diabetes mellitus, and cardiovascular diseases, with poor-quality diet being a predisposing factor for these diseases.Objective: to synthesize the scientific evidence on the effect of diet on the risk of SARS-CoV-2 infection and severe COVID-19. Methods: a systematic review was carried out following the PRISMA guidelines. The bibliographic search was made in the databases Web of Science, Scopus and Medline (through the PubMed search engine). Risk of bias analysis was performed using the Newcastle-Ottawa and Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies scales.Results: 14 studies were included. Good adherence to the Mediterranean diet was associated with a decreased risk of SARS-CoV-2 infection (OR = 0.44; 95 % CI, 0.22-0.88, for high versus low adherence, and significant ORs of 0.88 and 0.95 in studies that analyzed adherence quantitatively) but not with the severity of COVID-19. A plant-based diet also had a protective association against both COVID-19 infection and severity. Specifically, a high consumption of vegetables, legumes and cereals, and a low intake of dairy products and red meat showed a protective effect against infection and/or COVID-19 severity, depending on the study. Vitamin and probiotic supplements also lowered the risk of infection. Conclusion: the available evidence suggests that a healthy diet, based on a Mediterranean or plant-based diet, with moderate consumption of dairy and red meat, exerts a protective effect against COVID-19.Universidad de Granada PPJIA2021-3

Memoria proyecto innovación docente: Diseño y aplicación de dos juegos de simulación de epidemia: toxiinfección alimentaria y COVID-19.

En las asignaturas que imparte el profesorado perteneciente al departamento de Medicina Preventiva y Salud Pública de la UGR, la materia de epidemiología y el estudio de epidemias o brotes resulta algo ardua para los alumnos. Por ello, la implantación de metodologías innovadoras podría facilitar la comprensión de la materia y ayudar a visualizar su utilidad práctica. En este proyecto de innovación docente se han implementado dos juegos para simular dos tipos de epidemias con una transmisión muy diferenciada: una toxiinfección alimentaria y una enfermedad transmitida por el aire, como el COVID-19. Juego 1: brote de COVID-19 Durante los primeros meses, se diseñó un brote de COVID-19. Inventamos la historia de 26 individuos que se relacionaban entre ellos en diversos modos (cena, cine, encuentro casual de corta duración, compartir trayecto de bus...). Con estas historias lo alumnos debían actuar como rastreadores, y decidir si debían o no pedir una PCR a los sujetos, y si estos debían hacer cuarentena o aislamiento. Cuando todas las historias de los individuos estaban completas, los alumnos trabajan en grupo para realizar un informe epidemiológico, donde calculaban ciertos parámetros que se le había enseñado en clase de teoría. Este juego se ha aplicado durante dos cursos en las siguientes asignaturas. Salud Pública, Grado en Ciencia y Tecnología de los Alimentos. Curso 2021-2022 Salud Pública y Epidemiología, Grado en Odontología, Cursos 2020-2021 y 2021-2022 Salud Pública Especial, Grado en Nutrición Humana y Dietética, Cursos 2020-2021 y 2021-2022 Salud Pública, Grado en Farmacia, Curso 2021-2022 Salud Pública, Grado en Enfermería, Curso 2021-2022 En todos estos cursos, la participación en el juego se ha evaluado como parte de la evaluación continua de los alumnos. Además se ha pasado a los alumnos una encuesta de satisfacción validada, para conocer su opinión sobre esta actividad docente, e investigar que características de los alumnos (nota media, sexo, haber pasado previamente el covid) puede influir más o menos en la aceptación de esta actividad. Además, a lo largo de estos dos cursos, hemos ido mejorando el juego y las historias de los sujetos, y en muchas de estas asignaturas se seguirá aplicando esta actividad docente incluso cuando termine la ejecución de este proyecto. Juego 2: brote de toxiinfección alimentaria Este juego no lo hemos desarrollado nosotros, sino que viendo que existía un juego diseñado en la red, lo hemos aprovechado y lo hemos implementado en las siguientes asignaturas. Salud Pública, Grado en Ciencia y Tecnología de los Alimentos. Curso 2021-2022 Salud Pública Especial, Grado en Nutrición Humana y Dietética, Cursos 2020-2021 y 2021-2022 Este juego quedará implementado en la práctica docente habitual de estas dos asignaturas.In the subjects taught by the professors belonging to the Department of Preventive Medicine and Public Health of the UGR, the subject of epidemiology and the study of epidemics or outbreaks is somewhat arduous for the students. Therefore, the implementation of innovative methodologies could facilitate the understanding of the subject and help visualize its practical utility. In this teaching innovation project, two games have been implemented to simulate two types of epidemics with very different transmission: a food poisoning and an airborne disease, such as COVID-19. Game 1: COVID-19 outbreak During the first few months, an outbreak of COVID-19 was engineered. We invented the story of 26 individuals who related to each other in various ways (dinner, cinema, short casual encounter, sharing a bus ride...). With these stories, the students had to act as trackers, and decide whether or not they should request a PCR from the subjects, and whether they should quarantine or isolate. When all the histories of the individuals were complete, the students worked in groups to make an epidemiological report, where they calculated certain parameters that had been taught in theory class. This game has been applied during two courses in the following subjects. Public Health, Degree in Food Science and Technology. Course 2021-2022 Public Health and Epidemiology, Degree in Dentistry, Courses 2020-2021 and 2021-2022 Special Public Health, Degree in Human Nutrition and Dietetics, Courses 2020-2021 and 2021-2022 Public Health, Degree in Pharmacy, Course 2021-2022 Public Health, Degree in Nursing, Course 2021-2022 In all these courses, the participation in the game has been evaluated as part of the continuous evaluation of the students. In addition, a validated satisfaction survey has been passed to the students, to find out their opinion about this teaching activity, and to investigate what characteristics of the students (average grade, gender, having previously passed the covid) can more or less influence the acceptance of this activity. In addition, throughout these two courses, we have been improving the game and the stories of the subjects, and in many of these subjects this teaching activity will continue to be applied even when the execution of this project ends. Game 2: food poisoning outbreak We have not developed this game ourselves, but seeing that there was a game designed on the network, we have taken advantage of it and have implemented it in the following subjects. Public Health, Degree in Food Science and Technology. Course 2021-2022 Special Public Health, Degree in Human Nutrition and Dietetics, Courses 2020-2021 and 2021-2022 This game will be implemented in the usual teaching practice of these two subjects

Associations of accumulated selected persistent organic pollutants in adipose tissue with insulin sensitivity and risk of incident type-2 diabetes

Continuous exposure to low doses of persistent organic pollutant (POPs), such as those occurring in the general population, might contribute to the burden of type 2 diabetes mellitus (T2DM). However, evidences from longitudinal studies are scarce. We aimed to explore the associations of accumulated POP exposure with the development of T2DM by means of 1) longitudinal associations with the 16-year incidence of the disease, and 2) complementary cross-sectional analyses with markers of glucose homeostasis at recruitment. Organochlorine pesticide and polychlorinated biphenyl (PCB) concentrations were analyzed in adipose tissue samples and incident T2DM cases were retrieved from clinical records. Homeostatic model assessment values of insulin sensitivity/resistance and β-cell function at recruitment were calculated. Linear and Cox-regression models were performed. In individuals with normal weight/overweight (n = 293), we observed positive dose–response relationships between the studied POPs and T2DM risk, particularly for hexachlorobenzene (HCB) [hazard ratio (HR): 3.96 for 4th quartile versus 1st quartile (Q1); confidence interval (CI) 95%: 0.79, 19.71]. PCB-180 showed a positive but seemingly non-linear association with T2DM risk [HR of 3er quartile (Q3) versus Q1: 6.48; CI 95%: 0.82, 51.29]. Unadjustment for body mass index considerably increased the magnitude of the associations. In the cross-sectional study (n = 180), HCB and PCB-180 were inversely associated with insulin sensitivity and positively associated with insulin resistance parameters. Our results suggest that a higher burden of specific POPs in adipose tissue may disrupt glucose homeostasis, possibly contributing to increase T2DM risk, especially in nonobese adults.Ramon y Cajal Program (Ministerio de Economia, Industria y Competitividad, Spain) RYC-2016-20155Instituto de Salud Carlos IIIEuropean Commission PI16/01858 PI18/01573 PI20/0156