COVID-19 and the Use of Angiotensin II Receptor Blockers in Older Chronic Hypertensive Patients: Systematic Review and Meta-Analysis

Angiotensin II-converting enzyme inhibitors (ACEIs) and selective angiotensin II receptor antagonists (ARAIIs) are widely used antihypertensive agents. Their use has generated controversy due to their possible influence on the health status of chronic patients infected with COVID-19. The objective of this work is to analyze the influence of COVID-19 on chronic hypertensive patients treated with ACEI and ARAII inhibitors. A systematic review and meta-analysis in the databases Pubmed, Pro-Quest and Scopus were carried out. The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search equation descriptors were obtained from the Medical Subject Headings (MeSH) thesaurus. The search equation was: “Older AND hypertension AND (COVID-19 OR coronavirus) AND primary care” and its equivalent in Spanish. Nineteen articles were obtained, with n = 10,806,159 subjects. Several studies describe the COVID-19 association with ACEI or ARAII treatment in hypertension patients as a protective factor, some as a risk factor, and others without a risk association. In the case of ACEI vs. ARAII, the risk described for the former has an odds ratio (OR) of 0.55, and for ARAII, an OR of 0.59. Some authors talk about mortality associated with COVID-19 and ACEI with a half ratio (HR) of 0.97, and also associated ARAIIs with an HR of 0.98. It is recommended to maintain the use of the renin–angiotensin–aldosterone axis in the context of the COVID-19 diseas

Novel application assigned to toluquinol: inhibition of lymphangiogenesis by interfering with VEGF-C/VEGFR-3 signalling pathway

BACKGROUND AND PURPOSE Lymphangiogenesis is an important biological process associated with the pathogenesis of several diseases, including metastatic dissemination, graft rejection, lymphoedema and other inflammatory disorders. The development of new drugs that block lymphangiogenesis has become a promising therapeutic strategy. In this study, we investigated the ability of toluquinol, a 2-methyl-hydroquinone isolated from the culture broth of the marine fungus Penicillium sp. HL-85-ALS5-R004, to inhibit lymphangiogenesis in vitro, ex vivo and in vivo. EXPERIMENTAL APPROACH We used human lymphatic endothelial cells (LECs) to analyse the effect of toluquinol in 2D and 3D in vitro cultures and in the ex vivo mouse lymphatic ring assay. For in vivo approaches, the transgenic Fli1:eGFPy1 zebrafish, mouse ear sponges and cornea models were used. Western blotting and apoptosis analyses were carried out to search for drug targets. KEY RESULTS Toluquinol inhibited LEC proliferation,migration, tubulogenesis and sprouting of new lymphatic vessels. Furthermore, toluquinol induced apoptosis of LECs after 14 h of treatment in vitro, blocked the development of the thoracic duct in zebrafish and reduced the VEGF-C-induced lymphatic vessel formation and corneal neovascularization in mice. Mechanistically, we demonstrated that this drug attenuates VEGF-C-induced VEGFR-3 phosphorylation in a dose-dependentmanner and suppresses the phosphorylation of Akt and ERK1/2. CONCLUSIONS AND IMPLICATIONS Based on these findings, we propose toluquinol as a new candidate with pharmacological potential for the treatment of lymphangiogenesis-related pathologies. Notably, its ability to suppress corneal neovascularization paves the way for applications in vascular ocular pathologies.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. This work has been supported by personal funding by FP7-PEOPLE-2013-IEF Marie Curie Postdoctoral Fellowship (MGC). Acknowledged are the supporting grants from the Action de Recherche Concertée (ARC) (Université de Liège), the Fonds de la Recherche Scientifique-FNRS (F.R.S.-FNRS), the Foundation Against Cancer (foundation of public interest), the Centre Anticancéreux près l’Université de Liège, the Fonds Léon Fredericq (University of Liège), the Interuniversity Attraction Poles Programme-Belgian Science Policy (all from Belgium) and the Plan National Cancer (« Service Public Federal » from Belgium). Research in the lab of A.R.Q. and M.A.M. was supported by grants BIO2014-56092-R (MINECO and FEDER) and P12-CTS-1507 (Andalusian Government and FEDER)

IBD and Motherhood: A Journey through Conception, Pregnancy and Beyond

Inflammatory Bowel Disease (IBD) presents distinct challenges during pregnancy due to its influence on maternal health and pregnancy outcomes. This literature review aims to dissect the existing scientific evidence on pregnancy in women with IBD and provide evidence-based recommendations for clinical management. A comprehensive search was conducted across scientific databases, selecting clinical studies, systematic reviews, and other pertinent resources. Numerous studies have underscored an increased risk of complications during pregnancy for women with IBD, including preterm birth, low birth weight, neonates small for gestational age, and congenital malformations. Nevertheless, it’s evident that proactive disease management before and throughout pregnancy can mitigate these risks. Continuation of IBD treatment during pregnancy and breastfeeding is deemed safe with agents like thiopurines, anti-TNF, vedolizumab, or ustekinumab. However, there’s a call for caution when combining treatments due to the heightened risk of severe infections in the first year of life. For small molecules, their use is advised against in both scenarios. Effective disease management, minimizing disease activity, and interdisciplinary care are pivotal in attending to women with IBD. The emphasis is placed on the continual assessment of maternal and infant outcomes and an expressed need for further research to enhance the understanding of the ties between IBD and adverse pregnancy outcomes

Telemedicine in Elderly Hypertensive and Patients with Chronic Diseases during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Background: One aspect of the distancing measures imposed in response to the COVID-19 pandemic is that telemedicine consultations have increased exponentially. Among these consultations, the assessment and follow-up of patients with chronic diseases in a non-presential setting has been strengthened considerably. Nevertheless, some controversy remains about the most suitable means of patient follow-up. Objective: To analyze the impact of the telemedicine measures implemented during the COVID-19 period on chronic patients. Material and Methods: A systematic review was carried out using the following databases: PubMed, Pro-Quest, and Scopus. The systematic review followed the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search equation utilized descriptors sourced from the Medical Subject Headings (MeSH) thesaurus. The search equation was: “hypertension AND older AND primary care AND (COVID-19 OR coronavirus)” and its Spanish equivalent. Results: The following data were obtained: 14 articles provided data on 6,109,628 patients and another 4 articles focused on a study population of 9684 physicians. Telemedicine was less likely to be used by elderly patients (OR 0.85; 95% C.I. 0.83–0.88; p = 0.05), those of Asian race (OR 0.69; 95% C.I. 0.66–0.73; p = 0.05), and those whose native language was not English (OR 0.89; 95% C.I. 0.78–0.9; p = 0.05). In primary care, lower use of telemedicine was associated with residents of rural areas (OR 0.81; p = 0.05), patients of African American race (OR 0.65, p = 0.05), and others (OR 0.64; p = 0.05). A high proportion (40%) of physicians had no prior training in telemedicine techniques. The highest quality in terms of telephone consultation was significantly associated with physicians who did not increase their prescription of antibiotherapy during the pandemic (OR = 0.30, p = 0.05) or prescribe more tests (OR 0.06 p = 0.05), i.e., who maintained their former clinical criteria despite COVID-19. Conclusions: Telemedicine is of proven value and has been especially useful in the COVID-19 pandemic. A mixed remote–presential model is most efficient. Appropriate training in this area for physicians and patients, together with correct provision, is essential to prevent errors in implementation and us

AD0157, a pyrrolidinedione fungal metabolite, inhibits angiogenesis by targeting the Akt signaling pathway

In the course of a screening program for the inhibitors of angiogenesis from marine sources, AD0157, a pyrrolidinedione fungal metabolite, was selected for its angiosupressive properties. AD0157 inhibited the growth of endothelial and tumor cells in culture in the micromolar range. Our results show that subtoxic doses of this compound inhibit certain functions of endothelial cells, namely, differentiation, migration and proteolytic capability. Inhibition of the mentioned essential steps of in vitro angiogenesis is in agreement with the observed antiangiogenic activity, substantiated by using two in vivo angiogenesis models, the chorioallantoic membrane and the zebrafish embryo neovascularization assays, and by the ex vivo mouse aortic ring assay. Our data indicate that AD0157 induces apoptosis in endothelial cells through chromatin condensation, DNA fragmentation, increases in the subG1 peak and caspase activation. The data shown here altogether indicate for the first time that AD0157 displays antiangiogenic effects, both in vitro and in vivo, that are exerted partly by targeting the Akt signaling pathway in activated endothelial cells. The fact that these effects are carried out at lower concentrations than those required for other inhibitors of angiogenesis makes AD0157 a new promising drug candidate for further evaluation in the treatment of cancer and other angiogenesis-related pathologies. [Our experimental work is supported by grant P12-CTS-1507 (Andalusian Government and FEDER) and funds from group BIO-267 (Andalusian Government). The "CIBER de Enfermedades Raras" is an initiative from the ISCIII (Spain). This communication has the support of a travel grant "Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech"].Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tec

Prevalence of Depression and Related Factors among Patients with Chronic Disease during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

The management of chronic diseases in the midst of the COVID-19 pandemic is especially challenging, and reducing potential psychological harm is essential. This review aims to determine the prevalence of depression during the COVID-19 pandemic in patients with chronic disease, and to characterize the impacts of related factors. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The meta-analysis was performed using StatsDirect software. The review identified 33 articles with a total of 50,905 patients with chronic diseases. Four meta-analyses were performed to estimate the prevalence of depression. In diabetic patients, the prevalence ranged from 17% (95% CI = 7–31) (PHQ-9) to 33% (95% CI = 16–51) (PHQ-8); in obese patients, the prevalence was 48% (95% CI = 26–71); and in hypertensive patients, the prevalence was 18% (95% CI = 13–24). The factors significantly associated with depression were female sex, being single, deterioration in the clinical parameters of diabetes, a decrease in self-care behavior, reduced physical activity and sleep time and fear of contagion. The COVID-19 pandemic has significantly increased levels of depression among persons with chronic disease. Pandemics and other emergency events have a major impact on mental health, so early psychological interventions and health management policies are needed to reinforce chronic patients’ physical and mental health

Antiangiogenic potential of an anthraquinone metabolite isolated from a marine fungus.

This is a communication in the format of a posterThe potential of marine organisms to yield bioactive molecules is vast and largely unexplored. Significantly, certain bioactive compounds derived from the marine environment have already received approval as anticancer drugs1. Among the multitude of bioactive compounds found in marine organisms, anthraquinones represent a notable class of molecules, with over 200 structurally related compounds having been isolated from diverse species of marine fungi2. Danthron (1,8-dihydroxy-9,10-anthraquinone) serves as an exemplary member of anthraquinones, possessing anti-tumoral and anti-angiogenic properties that have yet to be fully elucidated. Therefore, the primary objective of this study was to comprehensively investigate and understand these specific properties.Funding: Funding: Projects PID2019-105010RB-I00 (Ministry of Science and Innovation, Government of Spain), UMA18-FEDERJA-220 and P20_00257 (Junta de Andalucía-FEDER) The assistance to the congress has an help from the Plan Propio de Investigación (UMA). Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Antioxidant potential of an anthraquinone metabolite isolated from a marine fungus.

Marine ecosystem is a fruitful source of many pharmacologically active. In particular, a number of marine anthraquinones and their derivatives, have been studied for their potential as anticancer and antimetastatic agents, although little is known about their antiangiogenic activities. In addition, there is some controversy regarding the poor antioxidant effect of these marine secondary metabolites. In this study, we describe for the first time the antiangiogenic activity of an anthraquinone, isolated from a marine fungus, which was evidenced in vitro by the inhibition of the activated endothelial cells survival, proliferation, and differentiation into tubelike structures. Furthermore, we have demonstrated its protective effect against reactive oxygen species (ROS), especially in presence of hydrogen peroxide, a potent prooxidant agent. These results were evidenced by a reduced ROS production and an increased redox capacity of cells after treatment with this anthraquinone, evidenced through the staining with DCFHDA and the sulfhydryl groups determination, respectively. The observation that this compound appears to present a more potent effect in tumor than in endothelial cells, suggests a putative selectivity. All these results highlight the need for further study of this molecule as a potential therapeutic agent for cancer and other angiogenesisdependent diseases.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Evolution of Acute Respiratory Distress Syndrome in Emergency and Critical Care: Therapeutic Management before and during the Pandemic Situation

Background and Objectives: Acute respiratory distress syndrome is a life-threatening lung condition that prevents enough oxygen from getting to the lungs and blood. The causes can be varied, although since the COVID-19 pandemic began there have been many cases related to this virus. The management and evolution of ARDS in emergency situations in the last 5 years was analyzed. Materials and Methods: A systematic review was carried out in the PubMed and Scopus databases. Using the descriptors Medical Subject Headings (MeSH), the search equation was: “Emergency health service AND acute respiratory distress syndrome”. The search was conducted in December 2021. Quantitative primary studies on the care of patients with ARDS in an emergency setting published in the last 5 years were included. Results: In the initial management, adherence to standard treatment with continuous positive airway pressure (CPAP) is recommended. The use of extracorporeal membrane reduces the intensity of mechanical ventilation or as rescue therapy in acute respiratory distress syndrome (ARDS). The prone position in both intubated and non-intubated patients with severe ARDS is associated with a better survival of these patients, therefore, it is very useful in these moments of pandemic crisis. Lack of resources forces triage decisions about which patients are most likely to survive to start mechanical ventilation and this reflects the realities of intensive care and emergency care in a resource-limited setting. Conclusions: adequate prehospital management of ARDS and in emergency situations can improve the prognosis of patients. The therapeutic options in atypical ARDS due to COVID-19 do not seem to vary substantially from conventional ARDS

Bringing Light to Science Undergraduate Students: A Successful Laboratory Experiment Illustrating the Principles and Applications of Bioluminescence

Although many laboratory experiments are available to illustrate spectrophotometric or fluorometric methods, few of them introduce the use of luminometry to students. Bioluminescence, a subtype of chemiluminescence, is produced when an enzyme-catalyzed chemical reaction gives rise to light emission. Despite the advantages of bioluminescent methods, including sensitivity and specificity, and their increasing use in experimental sciences and biomedical laboratories, their presence in courses is almost nonexistent. The luciferase-catalyzed enzymatic reaction has generated a myriad of practical applications, including those derived from the measurement of the ATP consumed in the reaction. In particular, the measurement of ATP levels in drinking or stored waters directly correlates with their bacteria content, facilitating the development of rapid methods for detecting bacterial contamination. This avoids the long waiting time associated with traditional microbiological methods, based on the growth of the microorganisms in a suitable culture medium. Over the past two years at the University of Malaga, we have implemented a new laboratory experiment for undergraduate chemistry and biochemistry students. In this experiment, students detected bacterial contamination in water by quantifying ATP with the luciferase-catalyzed reaction. The experiment was successfully implemented in two different formats, either as a full project developed by students throughout the entire duration of the academic course, or as a short protocol, carried out in a single laboratory session. Between them, a whole range of intermediate options could be arranged by educators to suit their course requirements and the learning objectives to be achieved by students.This work was supported by the University of Malaga (Spain) funds granted to the educational innovation projects PIE19-086 and PIE19-057, and the Spanish Ministry of Science, Innovation and Universities Grant EDU2017-82197-P