El índice de calidad antioxidante de la dieta (DAQS) está asociado con la masa ósea evaluada mediante ultrasonido cuantitativo en el calcáneo en mujeres jóvenes

Introduction: Evidence suggests that intake of antioxidants could positively infl uence bone mass by preventing bone metabolism against oxidative stress. Objective: We aimed to investigate the possible infl uence of single antioxidant intakes and dietary antioxidant quality score (DAQs) on calcaneal quantitative ultrasound (QUS) in a population of young adults. Methods: A total of 605 young Spanish adults participated in this study (median age 20.38 ± 2.67). Bone mass was measured by calcaneal QUS to determine broadband ultrasound attenuation (BUA, dB/MHz) parameter. Body composition was assessed by bioelectrical impedance analysis and dietary intakes were determined using a 72-hour diet recall interview. DAQs was applied to calculate antioxidant nutrients intake. Linear regression analyses were performed to investigate the possible infl uence of DAQs on calcaneal QUS. Results: Most of young adults showed a low-quality antioxidant intake (only 17.6% of women and 20.3% of men had a score of 4 or 5 in DAQs). A positive correlation between DAQs and BUA was observed in women (r = 0.117; p = 0.024). Linear regression analysis revealed that DAQs was signifi cantly associated with BUA parameter in women after adjusting by body weight, height, calcium intake and physical activity (PA) (p = 0.035). No signifi cant associations between single antioxidant and calcaneus QUS measurement were found. Conclusion: Our fi ndings suggest that high-quality antioxidant intakes could infl uence bone health in young women. Future studies should further investigate the protective role of antioxidant nutrients against osteoporosis

Analysis of lifestyle and bone mineralization in a population of Spanish young adults

Objective: To analyze the environmental factors (nutritional status, levels of physical activity and nutritional habits) and their possible association with bone mass in a population of young adults. Methods: The study population consisted of 200 subjects (117 women and 83 men) aged between 18 and 25 years (mean age 20.4 years ±2.2 years). Body composition parameters were measured by an electronic balance (TANITA BC-418MA), nutritional habits were estimated by 72-h dietary recall, level of physical activity was assessed by the International Physical Activity Questionnaire (IPAQ) and bone mass was measured by ultrasonography at the calcaneus. Results: There were significant differences in bone mass values according to gender (p= 0.013). Despite the fact that 70% of the subjects had a body mass index (BMI) within the normal range, 20% had overweight or obesity. 49% of the individuals had a moderate level of physical activity, although women had lower levels of physical activity than men (17.9% vs 8.4%). Most diets among young adults were hyperprotic, hyperlipidic and low-carbohydrates, with low-calcium and fiber intakes and high-phosphorus. Analysis of bone mass according to BMI showed higher values as the weight category rises, with significant differences in women. Higher values of bone mass were shown as the level of physical activity was higher, showing significant differences in males. Conclusion: Our results show that BMI and level of physical activity are significantly associated with bone health in a population of young adults, suggesting the relevance of promoting healthy lifestyles as a strategy for the early prevention of osteoporosis

The Association of Body Mass Index and Body Composition with Pain, Disease Activity, Fatigue, Sleep and Anxiety in Women with Fibromyalgia

The link between fibromyalgia syndrome (FMS) and obesity has not been thoroughly investigated. The purpose of this study was to examine the relationships among body mass index (BMI) and body composition parameters, including fat mass, fat mass percentage, and visceral fat, as well as FMS features, such as tender point count (TPC), pain, disease activity, fatigue, sleep quality, and anxiety, in a population of FMS women and healthy controls. A total of seventy-three women with FMS and seventy-three healthy controls, matched on weight, were included in this cross-sectional study. We used a body composition analyzer to measure fat mass, fat mass percentage, and visceral fat. Tender point count (TPC) was measured by algometry pressure. The disease severity was measured with the Fibromyalgia Impact Questionnaire (FIQ-R) and self-reported global pain was evaluated with the visual analog scale (VAS). To measure the quality of sleep, fatigue, and anxiety we used the Pittsburgh Sleep Quality Questionnaire (PSQI), the Spanish version of the multidimensional fatigue inventory (MFI), and the Beck Anxiety Inventory (BAI), respectively. Of the women in this study, 38.4% and 31.5% were overweight and obese, respectively. Significant differences in FIQ-R.1 (16.82 +/- 6.86 vs. 20.66 +/- 4.71, p = 0.030), FIQ-R.3 (35.20 +/- 89.02 vs. 40.33 +/- 5.60, p = 0.033), and FIQ-R total score (63.87 +/- 19.12 vs. 75.94 +/- 12.25, p = 0.017) among normal-weight and overweight FMS were observed. Linear analysis regression revealed significant associations between FIQ-R.2 ( (95% CI) = 0.336, (0.027, 0.645), p = 0.034), FIQ-R.3 ( (95% CI) = 0.235, (0.017, 0.453), p = 0.035), and FIQ-R total score ( (95% CI) = 0.110, (0.010, 0.209), p = 0.032) and BMI in FMS women after adjusting for age and menopause status. Associations between sleep latency and fat mass percentage in FMS women ( (95% CI) = 1.910, (0.078, 3.742), p = 0.041) and sleep quality and visceral fat in healthy women ( (95% CI) = 2.614, (2.192, 3.036), p = 0.008) adjusted for covariates were also reported. The higher BMI values are associated with poor FIQ-R scores and overweight and obese women with FMS have higher symptom severity. The promotion of an optimal BMI might contribute to ameliorate some of the FMS symptoms

COVID‑19 vaccine literacy in patients with systemic autoimmune diseases

Funding for open access charge: Universidad de Granada/CBUA.COVID-19 related infodemic is a threat to the successful COVID-19 vaccination campaigns. This might be especially apparent for patients with autoimmune diseases since there is no data available about the balance between benefits and risks of the newly developed COVID-19 vaccines in this population. We aim (i) to evaluate vaccine literacy skills in a population of patients with systemic autoimmune diseases, (ii) to examine the potential associations between vaccine literacy skills and sociodemographic characteristics and (iii) to analyze the relationships between attitudes, perceptions and beliefs about current vaccinations and vaccine literacy skills and sociodemographic characteristics. A cross-sectional study was conducted among 319 patients with systemic autoimmune diseases (92% females; 49.5% of patients in the 31–50 years age category). The vaccine literacy levels were determined using the Health Literacy about Vaccination in adulthood in Italian (HLVa-IT). Sociodemographic characteristics including gender, age, country and area of residence, civil status, socioeconomic status, educational attainment and occupational status were evaluated. The mean vaccine literacy functional and interactive-critical scores were 2.59 ± 0.74 and 3.07 ± 0.60, respectively. The vaccine literacy interactive-critical score was higher in females than in males (p = 0.048). Interactive-critical scores were associated with the area of residence, civil status and socioeconomic status, with the highest score in urban area of ≥ 100.000 inhabitants (p = 0.045), in widow patients (p = 0.023) and in patients with high socioeconomic status (p = 0.018). Significant differences were observed between the different education levels, for both the functional and the interactive-critical scores (p = 0.002 and p < 0.001, respectively), the highest score was observed in patients who completed a university degree. The level of vaccine literacy for functional and interactive-critical scales were medium. Area of residence, civil status and socioeconomic status represented determinants of vaccine literacy interactive-critical scale. Educational attainment also contributes to vaccine literacy functional scale. Insight into these factors is required to ensure an optimal vaccine literacy level in patients with autoimmune diseases.Universidad de Granada/CBU

The Prognostic Nutritional Index and Nutritional Risk Index Are Associated with Disease Activity in Patients with Systemic Lupus Erythematosus

The prognostic nutritional index (PNI), controlling nutritional status (CONUT) score and nutritional risk index (NRI) have been described as useful screening tools for patient prognosis in several diseases. The aim of this study was to examine the relationship between PNI, CONUT and NRI with clinical disease activity and damage in 173 patients with systemic lupus erythematous (SLE). Disease activity was assessed with the SLE disease activity index (SLEDAI-2K), and disease-related organ damage was assessed using the SLICC/ACR damage index (SDI) damage index. PNI and NRI were significantly lower in active SLE patients than in inactive SLE patients (p < 0.001 and p = 0.012, respectively). PNI was inversely correlated with the SLEDAI score (p < 0.001) and NRI positively correlated with SLEDAI and SDI scores (p = 0.027 and p < 0.001). Linear regression analysis adjusting for age, sex and medications showed that PNI was inversely correlated with SLEDAI ( (95% CI) = -0.176 (-0.254, -0.098), p < 0.001) and NRI positively correlated with SLEDAI ( (95% CI) = 0.056 (0.019, 0.093), p = 0.003) and SDI ( (95% CI) = 0.047 (0.031, 0.063), p < 0.001). PNI (odds ratio (OR) 0.884, 95% confidence interval (CI) 0.809–0.967, p = 0.007) and NRI ((OR) 1.067, 95% CI 1.028–1.108, p = 0.001) were independent predictors of active SLE. These findings suggest that PNI and NRI may be useful markers to identify active SLE in clinical practice.This study was supported by the grant PI0523-2016 from “Consejería de igualdad, salud y políticas sociales” (Junta de Andalucía) and is part of the research group LyDIMED “Lupus y Dieta Mediterránea”. G. Pocovi-Gerardino is a predoctoral fellow from the doctoral program “Medicina clínica y salud pública” of the University of Granad

Effectiveness of video-assisted debriefing versus oral debriefing in simulation-based interdisciplinary health professions education: A randomized trial

* Corresponding author at: Department of Nursing, Faculty of Health Sciences, University of Granada, Granada 18016, Spain. E-mail address: [email protected] (R. Gil-Gutiérrez).Aim We aimed to compare the debriefing experience, simulation assessment, reflection, anxiety and simulation satisfaction of using oral debriefing versus video-assisted debriefing after a simulated clinical session in an interdisciplinary cohort of health sciences students. Background Debriefing is a reflective process that takes place after a clinical simulation and that can be performed either in a traditional way (oral) or using video-assisted debriefing. Design A randomized controlled trial was conducted in 143 health sciences students (35.7% male, 61.5% female). Methods The simulation scenario was designed to evaluate the procedure for donning and doffing personal protective equipment. Differences in debriefing experience, simulation assessment, reflection, anxiety and satisfaction were assessed. Results Regarding debriefing experience, significant differences were observed for the category “learning” (34.9 (6.13) vs. 36.7 (3.89); p = 0.039). For simulation assessment, significantly higher scores for all categories were identified in video-assisted debriefing compared with oral debriefing (p<0.001). There were also significant differences between the oral debriefing versus video-assisted debriefing for the overall score of reflection ability (86.97 (10.55) vs. 90.74 (9.67); p=0.028) as well as for the category “reflective communication” (24.72 (3.77) vs 26.04 (4.07); p=0.047). Perceived satisfaction was significantly higher in the video-assisted debriefing group compared with oral debriefing group (p <0.001). For anxiety, no significant differences were observed between debriefing groups. Conclusion Video-assisted debriefing after a simulated clinical session improves debriefing experience, simulation assessment, reflection and simulation satisfaction, but does not increase anxiety compared with oral debriefing among health sciences students.*Funding for open access charge: Univeresidad de Granada/CBUA

The levels of bone mineralization are influenced by body composition in children and adolescents

Introducción: Existe controversia acerca del efecto del sobrepeso y la obesidad en la mineralización ósea en la adolescencia. Objetivo: El objetivo de este estudio fue valorar el nivel de densidad mineral ósea (DMO) en una población de adolescentes y estudiar su relación con la composición corporal. Material y método: La población de estudio estuvo constituida por 157 adolescentes (93 mujeres y 64 varones) de la provincia de Granada (España). La edad media fue de 14,22 ± 1,41 años. Se valoró la DMO mediante osteosonografía del calcáneo. Los parámetros densitométricos fueron: coeficiente de atenuación de banda ancha (BUA), T-score yZ-score. La composición corporal se determinó con bioimpedanciómetro. Resultados: Los sujetos con obesidad y sobrepeso presentaron valores mayores en el BUA frente a los sujetos con normopeso (95,4± 17,77 y 90,0±1,08 vs. 81,1±17,79) encontrándose diferencias significativas (p<0.001 y p<0.05, respectivamente). Tras el ajuste por masa magra y masa grasa se mantuvieron las diferencias en los sujetos con sobrepeso y obesidad (p<0.001 y p<0.001).La correlación con la masa magra fue mayor que con la masa grasa (B=,402 p<0.000 y B=,228 p<0.002). Conclusiones: Los adolescentes con sobrepeso y/o obesidad presentan mejores niveles de DMO incluso después del ajuste por masa grasa y masa muscular. Nuestros resultados sugieren que la DMO aumenta en respuesta al incremento de la masa muscular en los adolescentes con sobrepeso y/o obesidad.Introduction: There is controversy over the effect of overweight and obesity in bone mineralization in adolescence. Objective: The aim of this study was to assess the level of bone mineral density (BMD) in a population of adolescents and study its relationship with body composition. Methods: The study population consisted of 157 adolescents (93 women and 64 men) of the province of Granada (Spain). The mean age was 14.22 ± 1.41 year. BMD was assessed by calcaneal osteosonography. The densitometric parameters were: Broadbandultrasound attenuation( BUA), T -score and Z -score. Body composition was determined with bio-electrical Impedance analyser. Results: The overweight and obese adolescents had higher values in the BUA versus normal-weighted adolescents (95.4 ± 17.77 and 90.0 ± 1.08 vs 81.1 ± 17.79), showing significant differences(p < 0.001 and p < 0.05, respectively). Even after adjustment for lean mass and fat mass, differences remained in overweight and obese subjects (p < 0.001 and p < 0.001). Correlation with lean mass was greater than with fat mass (B =, 402 p < 0.000 and B =, 228 p < 0.002). Conclusions: Adolescents with overweight and/or obesity have higher levels of BMD even after adjustment for fat mass and muscle mass. Our results suggest that BMD increases in response to increased muscle mass in adolescents with overweight and/or obesity.Proyecto financiado en el marco del Campus de Excelencia Internacional Proyecto GREIB, subprograma START-UP PROJECTS FOR YOUNG RESEARCHERS (GREIB.PYR_2011_27)

The TT Genotype of the STAT4 rs7574865 Polymorphism Is Associated with High Disease Activity and Disability in Patients with Early Arthritis

[Background] The number of copies of the HLA-DRB1 shared epitope, and the minor alleles of the STAT4 rs7574865 and the PTPN22 rs2476601 polymorphisms have all been linked with an increased risk of developing rheumatoid arthritis. In the present study, we investigated the effects of these genetic variants on disease activity and disability in patients with early arthritis. [Methodology and Results] We studied 640 patients with early arthritis (76% women; median age, 52 years), recording disease-related variables every 6 months during a 2-year follow-up. HLA-DRB1 alleles were determined by PCR-SSO, while rs7574865 and rs2476601 were genotyped with the Taqman 5′ allelic discrimination assay. Multivariate analysis was performed using generalized estimating equations for repeated measures. After adjusting for confounding variables such as gender, age and ACPA, the TT genotype of rs7574865 in STAT4 was associated with increased disease activity (DAS28) as compared with the GG genotype (β coefficient [95% confidence interval] = 0.42 [0.01–0.83], p = 0.044). Conversely, the presence of the T allele of rs2476601 in PTPN22 was associated with diminished disease activity during follow-up in a dose-dependent manner (CT genotype = −0.27 [−0.56– −0.01], p = 0.042; TT genotype = −0.68 [−1.64– −0.27], p = 0.162). After adjustment for gender, age and disease activity, homozygosity for the T allele of rs7574865 in STAT4 was associated with greater disability as compared with the GG genotype. [Conclusions] Our data suggest that patients with early arthritis who are homozygous for the T allele of rs7574865 in STAT4 may develop a more severe form of the disease with increased disease activity and disability.This work was partially supported by the RETICS (Redes Tematicas de Investigación Cooperativa, Cooperative Research Thematic Networks) Program, RD08/0075 (RIER) and FIS (Fondo de Investigación en Salud) Health Research Fund grant FIS 08/0754 to IG-A from Instituto de Salud Carlos III (ISCIII; www.isciii.es) and by grants from the European Innovative Medicines Initiative and BTCure Program (http://www.life-sciences-europe.com/orga​nisation/btcure-project-imi-efpia-201103​-innovative-medicines-initiative-2001-28​657.html). The work of IG-A was in part supported by a Research Intensification Grant from the National Health Care System (Instituto Carlos III; www.isciii.es), Madrid, Spain

Analysis of SNP-SNP interactions and bone quantitative ultrasound parameter in early adulthood

Background: Osteoporosis individual susceptibility is determined by the interaction of multiple genetic variants and environmental factors. The aim of this study was to conduct SNP-SNP interaction analyses in candidate genes influencing heel quantitative ultrasound (QUS) parameter in early adulthood to identify novel insights into the mechanism of disease. Methods: The study population included 575 healthy subjects (mean age 20.41; SD 2.36). To assess bone mass QUS was performed to determine Broadband ultrasound attenuation (BUA, dB/MHz). A total of 32 SNPs mapping to loci that have been characterized as genetic markers for QUS and/or BMD parameters were selected as genetic markers in this study. The association of all possible SNP pairs with QUS was assessed by linear regression and a SNP-SNP interaction was defined as a significant departure from additive effects. Results: The pairwise SNP-SNP analysis showed multiple interactions. The interaction comprising SNPs rs9340799 and rs3736228 that map in the ESR1 and LRP5 genes respectively, revealed the lowest p value after adjusting for confounding factors (p-value = 0.001, β (95% CI) = 14.289 (5.548, 23.029). In addition, our model reported others such as TMEM135-WNT16 (p = 0.007, β(95%CI) = 9.101 (2.498, 15.704), ESR1-DKK1 (p = 0.012, β(95%CI) = 13.641 (2. 959, 24.322) or OPG-LRP5 (p = 0.012, β(95%CI) = 8.724 (1.936, 15.512). However, none of the detected interactions remain significant considering the Bonferroni significance threshold for multiple testing (p<0.0001). Conclusion: Our analysis of SNP-SNP interaction in candidate genes of QUS in Caucasian young adults reveal several interactions, especially between ESR1 and LRP5 genes, that did not reach statistical significance. Although our results do not support a relevant genetic contribution of SNP-SNP epistatic interactions to QUS in young adults, further studies in larger independent populations would be necessary to support these preliminary findings.This study was supported by a grant PI-0414-2014 from Consejería de Salud (Junta de Andalucía, Spain). Correa-Rodríguez M is a predoctoral fellow (FPU13/ 00143) from the Ministerio de Educación, Cultura y Deporte (Programa de Formación del Profesorado Universitario)

Mis casos clínicos de especialidades odontológicas

Libro que muestra la atención de casos clínicos particulares referente a las diferentes especialidades odontológicasLibro que muestra la atención de casos clínicos particulares referente a las diferentes especialidades odontológicasUniversidad Autónoma de Campeche Universidad Autónoma del Estado de Hidalgo Universidad Autónoma del Estado de Méxic