A time series analysis of the relationship between apparent temperature, air pollutants and ischemic stroke in Madrid, Spain

The understanding of the role of environment on the pathogenesis of stroke is gaining importance in the context of climate change. This study analyzes the temporal pattern of ischemic stroke (IS) in Madrid, Spain, during a 13-year period (2001-2013), and the relationship between ischemic stroke (admissions and deaths) incidence and environmental factors on a daily scale by using a quasi-Poisson regression model. To assess potential delayed and non-linear effects of air pollutants and Apparent Temperature (AT), a biometeorological index which represents human thermal comfort on IS, a lag non-linear model was fitted in a generalized additive model. The mortality rate followed a downward trend over the studied period, however admission rates progressively increased. Our results show that both increases and decreases in AT had a marked relationship with IS deaths, while hospital admissions were only associated with low AT. When analyzing the cumulative effects (for lag 0-14 days), with an AT of 1.7?°C (percentile 5%) a RR of 1.20 (95% CI, 1.05-1.37) for IS mortality and a RR of 1.09 (95% CI, 0.91-1.29) for morbidity is estimated. Concerning gender differences, men show higher risks of mortality in low temperatures and women in high temperatures. No significant relationship was found between air pollutant concentrations and IS morbi-mortality, but this result must be interpreted with caution, since there are strong spatial fluctuations of the former between nearby geographical areas that make it difficult to perform correlation analyses

Forensic implications of the presence of chimerism after hematopoietic stem cell transplantation

Biological vestiges are used in forensic science to resolve a large number of cases by typing the genetic profile and identifying the individual to whom it belongs. However, chimeric persons that possess cells with two or more different DNA make these types of analyses difficult. This situation can occur naturally, by errors in the fertilization or early embryogenesis, or in an artificial way, for example after hematopoietic stem cell transplantation (HSCT), when host and donor cells coexist in the patient. In this paper, we will specially focus on the latter. The vestiges from transplant patients represent a challenge from a forensic perspective since the interpretation of the genetic fingerprint can be misleading because of the presence of chimerism. Due to the high number of transplant patients (and their increase over the years) and the existence of natural chimeras (probably many of them hidden), it is necessary to consider whether we are facing a possible chimeric person or someone who has been a donor of hematopoietic stem cells in a forensic context. In this review, the presence of donor bone marrow derived cells in some tissues of forensic interest will be discussed. Finally, to emphasize the importance of chimerism after HSCT in forensic genetics, some real-life cases will be examined

Epigenetic related changes on air quality

The exposure to airborne particulate matter (PM) increases the risk of developing human diseases. Epigenetic mechanisms have been related to environmental exposures and human diseases. The present review is focused on current available studies, which show the relationship between epigenetic marks, exposure to air pollution and human's health. Air contaminants involved in epigenetic changes have been related to different specific mechanisms (DNA methylation, post-translational histone modifications and non-coding RNA transcripts), which are described in separate sections. Several studies describe how these epigenetic mechanisms are influenced by environmental factors including air pollution. This interaction between PM and epigenetic factors results in an altered profile of these marks, in both, globally and locus specific. Following this connection, specific epigenetic marks can be used as biomarkers, as well as, to find new therapeutic targets. For this purpose, some significant characteristics have been highlighted, such as, the spatiotemporal specificity of these marks, the relevance of the collected tissue and the specific changes stability. Air pollution has been related to a higher mortality rate due to non-accidental deaths. This exposure to particulate matter induces changes to the epigenome, which are increasing the susceptibility of human diseases. In conclusion, as several epigenetic change mechanisms remain unclear yet, further analyses derived from PM exposure must be performed to find new targets and disease biomarkers

Scrutinizing the profile and risk factors of suicide: a perspective from a case–control study focused on a northern region of Spain

Suicide is a major public health problem the prevention of which has become a priority, and, to this end, knowledge of its risk factors is essential. This study aims to evaluate the impact of some social, medico-legal, and clinical issues on suicide deaths. A total of 135 cases were identified as suicides that occurred in a region of northern Spain between 2018 and 2020. Controls (three for each case) were matched by age, sex, and urban-rural areas. The information was collected retrospectively through electronic health record systems. A binary logistic regression analysis was performed to study the association between individual risk factors and suicide. Being male (78.5%), between 40 and 60 years of age, unmarried (70.9%), and unemployed (85%) were associated with suicide deaths. Although the existence of a previous self-harm attempt is presented as the most robust risk factor (OR 22.121 [8.997-54.389]), the presence of a psychiatric diagnosis (OR 12.583 [7.686-20.601]) and cancer (OR 3.729 [1.845-7.536]) also showed a significant relationship with suicide (p < 0.05). Defining and knowing the risk factors for suicide helps to better understand the profiles of those individuals who are vulnerable, and enables prevention actions to be taken in both social and medical spheres.Funding: This work was partially supported by the Government of Cantabria (CONTRATO PROGRAMA GOB. CANTABRIA-UC)

Noise disturbance and well-being in the north of Spain

Environmental noise is considered one of the main risks for physical and mental health and well-being, with a significant associated burden of disease in Europe. This work aims to explore the main sources of noise exposure at home and its effect on well-being in northern Spain. A transversal opinion study has been performed through a closed questionnaire. The questionnaire included three different parts: sociodemographic data, noise disturbance, and the 5-item World Health Organization Well-Being Index (WHO-5). A Binary Logistics Regression model was performed to analyze the relationship between noise exposure and well-being. Overall, 16.6% of the participants consider that the noise isolation of their homes is bad or very bad. The noise generated by the neighbors (air and impact noise) is considered the most disturbing indoor noise source, while street works are the most disturbing outdoor noise source in urban areas and road traffic is the most disturbing in rural areas. People who indicate that noise interferes with their life at home have a worse score on the WHO-5 (decreased perception of well-being). The exposure to outdoor noise (specifically the noise coming from the street and trains), internal impact noise produced by neighbors, and in general, the noise that wakes you up, is related to receiving a worse score in the WHO-5 (p &lt; 0.05). Administrative bodies must ensure that laws regulating at-home noise levels, which are continually being updated with stricter restrictions, are enforced.Funding: This work was partially supported by the Government of Cantabria (CONTRATO PROGRAMA GOB. CANTABRIA-UC)

Suicide methods in Spain: poisoning and non-toxic violent agents

RESUMEN: Introducción: El suicidio es en todo el mundo la segunda causa de muerte en adultos jóvenes, y en España es la principal causa de muerte violenta. Los métodos para llevarlo a cabo varían según factores demográficos y geográficos. En el presente estudio se analiza de manera global el método de suicidio empleado en España, y se detalla el análisis en la región de Cantabria. Material y métodos: Estudio retrospectivo en el que se clasifican los suicidios en dos grupos según el método, por envenenamiento y por agentes violentos no tóxicos. Se evaluó la tendencia en los métodos elegidos para provocar la muerte, así como las diferencias según la edad y el sexo. Resultados: El patrón geográfico en los suicidios según el método es heterogéneo. Los suicidios por agentes violentos no tóxicos fueron los más frecuentes, representando el 90,2% del total, si bien cabe destacar que este grupo ha sufrido un descenso en los últimos años (p = 0,002). Los agentes tóxicos estuvieron presentes en el 9,8% de los suicidios, siendo más usados por las mujeres. En Cantabria, el ahorcamiento fue el principal método elegido (50,2% del total). Conclusiones: Los tóxicos son agentes poco presentes en las muertes autoinfligidas, lo que podría atribuirse a su menor letalidad (respecto a otros métodos activos, como la precipitación o el ahorcamiento) y a la efectividad de las medidas sanitarias ante un envenenamiento. El Boletín Estadístico de Defunción Judicial no es del todo fiable como fuente de datos para la realización de estudios epidemiológicos, lo que puede deberse a que es rellenado por personal no sanitario que no tiene acceso a la historia del paciente.ABSTRACT: Introduction: Suicide is the second leading cause of death in young adults worldwide and the leading cause of violent death in Spain. Methods for committing suicide vary due to demographic and geographic factors. The present study analyzes the methods of suicide used over 13 years throughout Spain, and in particular in the region of Cantabria. Material and methods: A retrospective study was carried out to study the methods of suicide chosen in Spain. Temporal trends were analyzed throughout the period, as well as differences according to age and sex. Results: Toxic agents were present in 9.8% of recorded suicides, being more commonly used by the women. Suicide by non-toxic violent agents have declined in recent years (p = 0.002). The geographical pattern in suicides according to the chosen method is heterogeneous. In Cantabria, suicide by hanging was the most commonly chosen method (50.2% of the total). Conclusions: Toxic agents are relatively infrequent in self-inflicted deaths, which could be attributed to their lower lethality (compared to other active methods such as jumping from height or hanging) and to the effectiveness of medical measures against poisoning. The Boletín Estadístico de Defunción Judicial may not be a completely reliable source for conducting epidemiological studies, due to the cause of death being recorded by non-medical personnel without access to the full medical history of the patient

Exposure to particulate matter: direct and indirect role in the COVID-19 pandemic

Knowing the transmission factors and the natural environment that favor the spread of a viral infection is crucial to stop outbreaks and develop effective preventive strategies. This work aims to evaluate the role of Particulate Matter (PM) in the COVID-19 pandemic, focusing especially on that of PM as a vector for SARS-CoV-2. Exposure to PM has been related to new cases and to the clinical severity of people infected by SARS-CoV-2, which can be explained by the oxidative stress and the inflammatory response generated by these particles when entering the respiratory system, as well as by the role of PM in the expression of ACE-2 in respiratory cells in human hosts. In addition, different authors have detected SARS-CoV-2 RNA in PM sampled both in outdoor and indoor environments. The results of various studies lead to the hypothesis that the aerosols emitted by an infected person could be deposited in other suspended particles, sometimes of natural but especially of anthropogenic origin, that form the basal PM. However, the viability of the virus in PM has not yet been demonstrated. Should PM be confirmed as a vector of transmission, prevention strategies ought to be adapted, and PM sampling in outdoor environments could become an indicator of viral load in a specific area.“This work has been carried out within the framework of the project “Air pollution and COVID-19: what can we learn from this pandemic?” of the Call for Grants from the BBVA Foundation to Scientific Research Teams in SARS-CoV-2 and COVID-19, in the area of Ecology and Veterinary Medicine

Local sclerotherapy with Polydocanol (Aethoxysklerol®) for the treatment of Epistaxis in Rendu-Osler-Weber or Hereditary Hemorrhagic Telangiectasia (HHT): 15 years of experience*

Producción CientíficaHereditary Haemorrhagic Telangiectasia or Rendu-Osler-Weber syndrome is a rare autosomal dominant vascular disease characterized by mucocutaneous and gastrointestinal telangiectases and localized arteriovenous malformations in lung, brain and liver. Epistaxis, due to rupture of telangiectases of the nasal mucosa, is the most frequent clinical manifestation, leading in many cases to severe impairment of the quality of life in the patients. Though several treatments have been used to reduce epistaxis, none have been completely effective, with the exception of polydocanol (Aethoxysklerol®) in submucosal or subpericondrial injections, which was first presented in 2000 with very good results. After fifteen years using polydocanol in submucosal injections on 45 patients and with nearly 300 injections, we have observed that in 95% of all cases, their nose bleeds improved with respect to frequency and quantity without any important side effects. There was just one case of septal perforation, another with increased septal perforation, and one patient who suffered from dizziness and blurred vision for a few minutes. In this paper the results obtained using this technique over a fifteen-year period will be presented and evaluated

Satellite Glial Cells of the Dorsal Root Ganglion: A New ?Guest/Physiopathological Target? in ALS

Introduction: Amyotrophic lateral sclerosis (ALS) might not only be circumscribed to the motor system but also involves other neuronal systems including sensory abnormalities. In line with this notion, we aimed to assess the pathophysiology of sensory disturbances in the SOD1G93A mouse model of ALS, focusing on the satellite glial cells (SGCs) at the dorsal root ganglion (DRG) as a new potential target of the disease. MaterialandMethods: Thepresenceofsensorydisturbanceswasevaluatedusingvon Frey, hot plate, and hot water tail immersion tests at 75 days old, which represented the motor-pre-symptomatic stage. Cell biology analysis was performed at 75 and 95 days old and included conventional histology, immuno?uorescence, and electron microscopy of sensory neuron-SGC unit dissociates as a well as western blotting from DRG lysates. Results: At 75 days old, von Frey and hot plate tests demonstrated clear thermoalgesic disturbances in ALS transgenic mice. Histological studies of the SN-SGC units revealed abnormal SOD1 accumulation, which was associated with nitro-oxidative stress and biogenesis of lipid droplets in SGCs. Interestingly, these alterations led to a progressive lysosomal storage disorder and occasionally vacuolar degeneration in SGCs. Conclusions: SGCs emerge as a primary pathophysiological target in the SOD1 transgenic murine model of ALS, clearly reinforcing the pathogenic role of glial cells in motor neuron disease. Presymptomatic alterations of SGCs, might not only be responsibleofsensorydisturbancesinALS,butduetospinalcordsensory-motorcircuits could also contribute to anterior horn motor disturbance

Neuroprotective Effect of Bexarotene in the SOD1(G93A) Mouse Model of Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by progressive weakness and muscle atrophy related to the loss of upper and lower motor neurons (MNs) without a curative treatment. There is experimental evidence suggesting that retinoids may be involved in ALS pathogenesis. Bexarotene (Bxt) is a retinoid-X receptor agonist used in the treatment of cutaneous lymphoma with a favorable safety profile whose effects have been recently investigated in other neurodegenerative diseases. In this study, we analyze the potential therapeutic effect of Bxt in the SOD1(G93A) mouse model of ALS. Mice were treated with Bxt or vehicle five times per week from day 60 onward. Survival, weight, and neuromuscular function studies together with histological and biochemical analyses were performed. Bxt significantly delayed motor function deterioration, ameliorated the loss of body weight, and extended mice survival up to 30% of the symptomatic period. Histological analyses of the lumbosacral spinal cord revealed that Bxt markedly delayed the early motor-neuron degeneration occurring at presymptomatic stages in ALS-transgenic mice. Bxt treatment contributed to preserve the MN homeostasis in the SOD1(G93A) mice. Particularly, it reduced the neuronal loss and the chromatolytic response, induced nucleolar hypertrophy, decreased the formation of ubiquitylated inclusions, and modulated the lysosomal response. As an agonist of the retinoic-X receptor (RXR) pathway, Bxt notably increased the nuclear expression of the RXRα throughout transcriptionally active euchromatin domains. Bxt also contributed to protect the MN environment by reducing reactive astrogliosis and preserving perisomatic synapsis. Overall, these neuroprotective effects suggest that treatment with Bxt could be useful in ALS, particularly in those cases related to SOD1 mutations