[Incidence of pressure injuries associated with oxygen therapy devices in the neonatal intensive care unit]. / Incidencia de lesiones por presión asociadas a dispositivos de oxigenoterapia en la unidad de cuidados intensivos neonatales.

OBJECTIVE: The administration of oxygen therapy (O2) in neonatal intensive care units (NICU) increases the risk of developing pressure injuries (PBI). The aims of the study were to describe the incidence of PBI associated with O2 devices in the NICU, to identify, analyze and relate risk factors and the application of their preventive measures. METHODS: A retrospective, observational and analytical study of hospitalized neonates who developed PPL secondary to O2 devices in the NICU of the Miguel Servet University Hospital of Zaragoza was carried out. Socio-demographical, clinical, type of cot, humidity, temperature, type of oxygen therapy, ventilation mode, device and presence of ulcer (number, degree, location), and preventive measures were recorded. The study was approved by the Research Ethics Committee of the Autonomous Community of Aragon. Statistical analysis was performed using Jamovi 2.3.13®. RESULTS: A total of 191 neonates were included, of whom 158 (82.7%) received O2. Of those who received oxygen therapy, 64.10% (25) were infants, mean total age 5.20±8.46 days and mean weight 1,460.03±777.57 grams. 24.68% presented with device-associated PPL, with a mean number of days of admission at the time of onset of 3.98±5.03 days. 94.74% (36) of the lesions were grade I and 84.62% (33) were located in the nasal septum. CONCLUSIONS: The incidence of pressure injuries associated with different oxygen therapy devices increases with decreasing gestational age. The risk increases with hospital stay, with the presence of medical devices, in particular non-invasive mechanical ventilation, being the main causal relationship.

OBJETIVO: La administración de oxigenoterapia en las unidades de cuidados intensivos neonatales (UCIN) supone un aumento del riesgo de desarrollar lesiones por presión (LPP). Los objetivos de este trabajo fueron describir la incidencia de LPP asociadas a dispositivos de oxigenoterapia, así como identificar, analizar y relacionar los factores de riesgo y sus medidas preventivas. METODOS: Se realizó un estudio retrospectivo, observacional y analítico de neonatos hospitalizados que desarrollaran una LPP secundaria a dispositivos de O2 en la UCIN del Hospital Universitario Miguel Servet de Zaragoza. Las variables registradas fueron las sociodemográficas, las clínicas, el tipo de cuna, la humedad, la temperatura, el tipo de oxigenoterapia, el tipo de ventilación, el dispositivo utilizado, la presencia de úlcera (número, grado, localización) y las medidas preventivas aplicadas. El estudio fue aprobado por el Comité de Ética de la Investigación de la Comunidad Autónoma de Aragón. El análisis estadístico se realizó mediante Jamovi 2.3.13®. RESULTADOS: Se incluyeron 191 neonatos, de los cuales 158 (82,7%) recibieron oxigenoterapia. El 64,10% de ellos fueron niños, la media de edad fue de 5,20±8,46 días y la de peso de 1.460,0±777,57 gramos. El 24,68% presentaron LPP asociada a dispositivo, con una media de días de ingreso en el momento de la aparición de 3,98±5,03 días. El 94,74% de las lesiones fueron de grado I y el 84,62% se localizaron en tabique nasal. CONCLUSIONES: La incidencia de LPP asociada a los diferentes dispositivos de oxigenoterapia aumenta a medida que disminuye la edad gestacional. El riesgo aumenta con la estancia hospitalaria, siendo la presencia de dispositivos médicos, en particular la ventilación mecánica no invasiva, la principal causa.

Improving Quality of Life and Reducing Behavioral Problems of People With Intellectual and Developmental Disabilities Through Deinstitutionalization.

ANTECEDENTS: People with intellectual and developmental disability (IDD) with extensive support needs are more likely to live in segregated and highly institutionalized environments. The aim of this study was to analyze changes in functioning and quality of life for people with IDD and extensive support needs after transitioning to ordinary homes in the community. METHOD: The sample included 54 adults with IDD and extensive support needs, who were assessed at three time points: before transition, six months later, and one year after transition. The Resident Choice Scale, San Martin Quality of Life Scale, Active Support Participation Measure, and the Behavior Problem section of the Inventory for Client and Agency Planning were administered. Partial least squares-structural equation modeling (PLS-SEM) and t-tests for repeated measures were carried out. RESULTS: There were significant improvements in decision-making, participation and independence in daily activities and quality of life, as well as a reduction in the presence and intensity of behavioral problems. CONCLUSIONS: The benefits found in this study support transformation processes towards more inclusive services and professional practices that foster people's rights and feeling of belonging to the community.

Non-coronary atherosclerosis: a marker of poor prognosis in patients undergoing coronary artery bypass surgery.

Introduction: The presence of non-coronary atherosclerosis (NCA) in patients with coronary artery disease is associated with a poor prognosis. We have studied whether NCA is also a predictor of poorer outcomes in patients undergoing coronary artery bypass grafting (CABG). Materials and methods: This is an observational study involving 567 consecutive patients who underwent CABG. Variables and prognosis were analysed based on the presence or absence of NCA, defined as previous stroke, transient ischaemic attack (TIA), or peripheral artery disease (PAD) [lower extremity artery disease (LEAD), carotid disease, previous lower limb vascular surgery, or abdominal aortic aneurysm (AAA)]. The primary outcome was a combination of TIA/stroke, acute myocardial infarction, new revascularization procedure, or death. The secondary outcome added the need for LEAD revascularization or AAA surgery. Results: One-hundred thirty-eight patients (24%) had NCA. Among them, traditional cardiovascular risk factors and older age were more frequently present. At multivariate analysis, NCA [hazard ratio (HR) = 1.84, 95% confidence interval (CI) 1.27-2.69], age (HR = 1.35, 95% CI 1.09-1.67, p = 0.004), and diabetes mellitus (HR = 1.50, 95% CI 1.05-2.15, p = 0.025), were positively associated with the development of the primary outcome, while estimated glomerular filtration rate (HR = 0.86, 95% CI 0.80-0.93, p = 0.001) and use of left internal mammary artery (HR = 0.36, 95% CI 0.15-0.82, p = 0.035), were inversely associated with this outcome. NCA was also an independent predictor of the secondary outcome. Mortality was also higher in NCA patients (27.5% vs. 9%, p < 0.001). Conclusions: Among patients undergoing CABG, the presence of NCA doubled the risk of developing cardiovascular events, and it was associated with higher mortality.

Conocimientos sobre COVID-19 en población general adulta tras dos años de pandemia.

OBJETIVO: identificar el nivel de conocimientos sobre la COVID-19 que tiene la población adulta residente en Gijón (España) después de dos años de pandemia. MÉTODOS: se realizó un estudio descriptivo transversal entre marzo del 2021 y marzo del 2022. Los datos se obtuvieron mediante un cuestionario telefónico sobre una muestra estratificada de tres zonas básicas de salud de Gijón, España (Calzada, Zarracina y Parque-Somió). El tamaño muestral se compuso de 305 personas. Se empleó el análisis ji-cuadrado para estudiar la relación entre variables categóricas y ANOVA para comparar las medias de la puntuación total por zona básica. Se realizaron regresiones logísticas para calcular las odds ratio entre la variable dependiente (poseer conocimientos avanzados) y las independientes (variables sociodemográficas). Se construyó un modelo predictivo entre la existencia o no de conocimiento avanzado y las variables independientes mediante regresión logística. RESULTADOS: se encontraron diferencias en la puntuación media del nivel de conocimientos entre Parque-Somió y Calzada (p = 0.000) y Parque-Somió y Zarracina (p = 0.045), obteniendo mayor puntuación media la de Parque-Somió. Se observó una asociación entre el nivel de conocimientos y las variables medio de información utilizado (p = 0.018), edad (p = 0.036), zona básica de salud (p = 0.000), nivel educativo (p = 0.000) e historia previa de contacto estrecho (p = 0.004). CONCLUSIONES: el nivel de conocimientos avanzado se presenta sobre todo en las zonas básicas de salud con mayor nivel socioeconómico, población con nivel educativo alto, de 25 a 45 años, que se ha informado por su entorno y con historia previa de seguimiento por ser contacto estrecho.

Improving Quality of Life and Reducing Behavioral Problems of People With Intellectual and Developmental Disabilities Through Deinstitutionalization / Mejoras en Calidad de Vida y Reducción de Problemas de Conducta en Personas con Discapacidad Intelectual y del Desarrollo tras un Proceso de Desinstitucionalización

Antecedents: People with intellectual and developmental disability (IDD) with extensive support needs are more likely to live in segregated and highly institutionalized environments. The aim of this study was to analyze changes in functioning and quality of life for people with IDD and extensive support needs after transitioning to ordinary homes in the community. Method: The sample included 54 adults with IDD and extensive support needs, who were assessed at three time points: before transition, six months later, and one year after transition. The Resident Choice Scale, San Martin Quality of Life Scale, Active Support Participation Measure, and the Behavior Problem section of the Inventory for Client and Agency Planning were administered. Partial least squares-structural equation modeling(PLS-SEM) and t-tests for repeated measures were carried out. Results: There were significant improvements in decision-making, participation and independence in daily activities and quality of life, as well as a reduction in the presence and intensity of behavioral problems. Conclusions: The benefits found in this study support transformation processes towards more inclusive services and professional practices that foster people’s rights and feeling of belonging to the community.(AU)

Antecedentes: Las personas con discapacidades intelectuales y del desarrollo (DID) con grandes necesidades de apoyo tienen más probabilidades de vivir en entornos segregados y altamente institucionalizados. Este estudio pretende analizar los cambios en el funcionamiento y calidad de vida de este colectivo tras la transición a viviendas ubicadas en la comunidad. Método: La muestra incluyó 54 adultos con DID con grandes necesidades de apoyo que fueron evaluados en tres momentos temporales: antes de la transición, seis meses y un año después de la misma. Se aplicaron los instrumentos Resident Choice Scale, la Escala de Calidad de Vida San Martín, Active Support Participation Measure y la sección de Problemas de Conducta del Inventory for Client and Agency Planning. Los datos fueron analizados a partir de modelos de ecuaciones estructurales de mínimos cuadrados parciales (PLS-SEM) y pruebas t para medidas repetidas. Resultados: Se observaron mejoras significativas en toma de decisiones, participación e independencia en actividades cotidianas y en calidad de vida, así como una reducción de los problemas de conducta. Conclusiones: Los beneficios encontrados apoyan la necesidad de llevar a cabo procesos de transformación hacia servicios y prácticas profesionales más inclusivas que fomenten los derechos y la pertenencia comunitaria.(AU)

Fear learning and aversive stimuli differentially change excitatory synaptic transmission in perisomatic inhibitory cells of the basal amygdala.

Inhibitory circuits in the basal amygdala (BA) have been shown to play a crucial role in associative fear learning. How the excitatory synaptic inputs received by BA GABAergic interneurons are influenced by memory formation, a network parameter that may contribute to learning processes, is still largely unknown. Here, we investigated the features of excitatory synaptic transmission received by the three types of perisomatic inhibitory interneurons upon cue-dependent fear conditioning and aversive stimulus and tone presentations without association. Acute slices were prepared from transgenic mice: one group received tone presentation only (conditioned stimulus, CS group), the second group was challenged by mild electrical shocks unpaired with the CS (unsigned unconditioned stimulus, unsigned US group) and the third group was presented with the CS paired with the US (signed US group). We found that excitatory synaptic inputs (miniature excitatory postsynaptic currents, mEPSCs) recorded in distinct interneuron types in the BA showed plastic changes with different patterns. Parvalbumin (PV) basket cells in the unsigned US and signed US group received mEPSCs with reduced amplitude and rate in comparison to the only CS group. Coupling the US and CS in the signed US group caused a slight increase in the amplitude of the events in comparison to the unsigned US group, where the association of CS and US does not take place. Excitatory synaptic inputs onto cholecystokinin (CCK) basket cells showed a markedly different change from PV basket cells in these behavioral paradigms: only the decay time was significantly faster in the unsigned US group compared to the only CS group, whereas the amplitude of mEPSCs increased in the signed US group compared to the only CS group. Excitatory synaptic inputs received by PV axo-axonic cells showed the least difference in the three behavioral paradigm: the only significant change was that the rate of mEPSCs increased in the signed US group when compared to the only CS group. These results collectively show that associative learning and aversive stimuli unpaired with CS cause different changes in excitatory synaptic transmission in BA perisomatic interneuron types, supporting the hypothesis that they play distinct roles in the BA network operations upon pain information processing and fear memory formation.

Risk of Ischemic Stroke Associated with Calcium Supplements and Interaction with Oral Bisphosphonates: A Nested Case-Control Study.

Conflicting results about the association of calcium supplements (CS) with ischemic stroke (IS) have been reported. We tested this hypothesis by differentiating between CS alone (CaM) and CS with vitamin D (CaD) and between cardioembolic and non-cardioembolic IS. We examined the potential interaction with oral bisphosphonates (oBs). A nested case-control study was carried out. We identified incident IS cases aged 40-90 and randomly sampled five controls per case matched by age, sex, and index date. Current users were compared to non-users. An adjusted odds ratios (AOR) and 95% CI were computed through conditional logistic regression. Only new users were considered. We included 13,267 cases (4400 cardioembolic, 8867 non-cardioembolic) and 61,378 controls (20,147 and 41,231, respectively). CaM use was associated with an increased risk of cardioembolic IS (AOR = 1.88; 95% CI: 1.21-2.90) in a duration-dependent manner, while it showed no association with non-cardioembolic IS (AOR = 1.05; 95% CI: 0.74-1.50); its combination with oBs increased the risk of cardioembolic IS considerably (AOR = 2.54; 95% CI: 1.28-5.04), showing no effect on non-cardioembolic. CaD use was not associated with either cardioembolic (AOR = 1.08; 95% CI: 0.88-1.31) or non-cardioembolic IS (AOR = 0.98; 95% CI: 0.84-1.13) but showed a small association with cardioembolic IS when combined with oBs (AOR = 1.35; 95% CI: 1.03-1.76). The results support the hypothesis that CS increases the risk of cardioembolic IS, primarily when used concomitantly with oBs.

Association of oral bisphosphonates with cardioembolic ischemic stroke: a nested case-control study.

Background: Bisphosphonates have been reported to increase the risk of atrial fibrillation. Therefore, it is conceivable that they may increase the risk of cardioembolic ischemic stroke (IS). However, most epidemiological studies carried out thus far have not shown an increased risk of IS, though none separated by the main pathophysiologic IS subtype (cardioembolic and non-cardioembolic) which may be crucial. In this study, we tested the hypothesis that the use of oral bisphosphonates increases specifically the risk of cardioembolic IS, and explored the effect of treatment duration, as well as the potential interaction between oral bisphosphonates and calcium supplements and anticoagulants. Methods: We performed a case-control study nested in a cohort of patients aged 40-99 years, using the Spanish primary healthcare database BIFAP, over the period 2002-2015. Incident cases of IS were identified and classified as cardioembolic or non-cardioembolic. Five controls per case were randomly selected, matched for age, sex, and index date (first recording of IS) using an incidence-density sampling. The association of IS (overall and by subtype) with the use of oral bisphosphonates within the last year before index date was assessed by computing the adjusted odds ratios (AOR) and their 95% CI using a conditional logistic regression. Only initiators of oral bisphosphonates were considered. Results: A total of 13,781 incident cases of IS and 65,909 controls were included. The mean age was 74.5 (SD ± 12.4) years and 51.6% were male. Among cases, 3.15% were current users of oral bisphosphonates, while among controls they were 2.62%, yielding an AOR of 1.15 (95% CI:1.01-1.30). Of all cases, 4,568 (33.1%) were classified as cardioembolic IS (matched with 21,697 controls) and 9,213 (66.9%) as non-cardioembolic IS (matched with 44,212 controls) yielding an AOR of 1.35 (95% CI:1.10-1.66) and 1.03 (95% CI: 0.88-1.21), respectively. The association with cardioembolic IS was clearly duration-dependent (AOR≤1 year = 1.10; 95% CI:0.82-1.49; AOR>1-3 years = 1.41; 95% CI:1.01-1.97; AOR>3 years = 1.81; 95% CI:1.25-2.62; p for trend = 0.001) and completely blunted by anticoagulants, even in long-term users (AOR>1 year = 0.59; 0.30-1.16). An interaction between oral bisphosphonates and calcium supplements was suggested. Conclusion: The use of oral bisphosphonates increases specifically the odds of cardioembolic IS, in a duration-dependent manner, while leaves materially unaffected the odds of non-cardioembolic IS.

A community living experience: Views of people with intellectual disability with extensive support needs, families, and professionals.

BACKGROUND: Despite the benefits of community living for people with intellectual disabilities (ID) and extensive support needs, they remain highly institutionalized. AIMS: To qualitatively analyze the perceptions of people with ID, including those with extensive support needs, professionals, and family members six months after the implementation of 11 community homes for 47 people in different regions of Spain METHODS: Thematic analysis of 77 individual interviews conducted with 13 people with ID, 30 professionals and 34 family members was performed using Nvivo12. RESULTS: Seven themes were found: (1) "the room as I like it", (2) "sometimes I don't obey", (3) "here I do a bit of everything", (4) "lots of people love me here", (5) "all thanks to them, who have helped me" (6) "I miss my mom", and (7) "I'm happy here". IMPLICATIONS: Transitioning into the community has shown a clear positive change in emotional well-being, opportunities to participate in activities or exercise control over one's life. Nevertheless, certain restrictions were still present in people's lives, which significantly limit their right to independent living. While many of these restrictions may disappear, professional practices typical of a medical model can be recreated in services located in the community.

El estilo transformacional del entrenador/a como facilitador de la identidad social de jóvenes jugadores/as de baloncesto: el papel mediador de las necesidades psicológicas básicas / O estilo transformador do treinador como facilitador da identidade social dos jovens jogadores de basquetebol: o papel mediador das necessidades psicológicas básicas / Coach’s transformational leadership style as a facilitator of the social identity of young basketball players: the mediating role of the basic psychological needs

El objetivo del estudio fue explorar la asociación entre el estilo de liderazgo transformacional de entrenadores/as y la identidad social de los/as deportistas, explorando el papel mediador de la satisfacción/frustración de las necesidades psicológicas básicas de los/as deportistas. Participaron 524 jugadores de baloncesto (325 chicos, 180 chicas) con edades comprendidas entre los 11 y los 17 años (M = 13.85; DT = 1.56) pertenecientes a diferentes clubes de la provincia de Valencia (España). Los resultados mostraron asociaciones significativas entre todas las variables del estudio. Asimismo, se confirmó el papel mediador de la satisfacción de las necesidades psicológicas básicas entre el liderazgo transformacional del entrenador/a y la identidad social de los/as deportistas. La mediación de la frustración de dichas necesidades no resultó significativa. Los resultados resaltan la importancia de los entrenadores/as en el desarrollo psicosocial del equipo, y apoyan la necesidad de formarles en el uso de estilos de liderazgo transformacional, que incidan sobre la satisfacción de las necesidades psicológicas básicas para promover la identidad social de los y las deportistas. (AU)

The aim of this study was to explore the association between coaches’ transformationalleadership style and athletes’ social identity, exploring the mediating role of satisfaction/frustration of athletes’ basic psychological needs. Participants were 524 basketball players (325 boys, 180 girls) aged between 11 and 17 years (Mage= 13.85; SD= 1.56) belonging to different clubs in the province of Valencia (Spain). The results showed significant associations between all the study variables. Furthermore, results confirmed the mediating role of the satisfaction of basic psychological needs between the transformational leadership of the coach and the social identity of the athletes, whereas the mediating role of the frustration of the basic psychological needs was not significant. The results highlight the importance of coaches in the psychosocial development of the team, and support the need to prepare them in the use of transformational leadership styles, which affect satisfaction of basic psychological needs to promote the social identity of the athletes. (AU)

O objectivo do estudo era explorar a associação entre o estilo de liderança transformacional dos treinadores e a identidade social dos atletas, explorando o papel mediador da satisfação/frustraçãodas necessidades psicológicas básicas dos atletas. Um total de 524 jogadores de basquetebol (325 rapazes, 180 raparigas) com idades compreendidas entre os 11 e os 17 anos (Midade= 13.85; TD= 1.56) de diferentes clubes da província de Valência (Espanha) participou. Os resultados mostraram associações significativas entre todas as variáveis do estudo. Do mesmo modo, foi confirmado o papel mediador da satisfação das necessidades psicológicas básicas entre a liderança transformacional do treinador e a identidade social dos atletas. A mediação da frustração destas necessidades não foi significativa. Os resultados salientam a importância dos treinadores no desenvolvimento psicossocial da equipa, e apoiam a necessidade de os treinar na utilização de estilos de liderança transformacional, que influenciam a satisfação das necessidades psicológicas básicas para promover a identidade social dos atletas. (AU)

The association of lipid transfer protein VPS13A with endosomes is mediated by sorting nexin SNX5.

Human VPS13 proteins are implicated in severe neurological diseases. These proteins play an important role in lipid transport at membrane contact sites between different organelles. Identification of adaptors that regulate the subcellular localization of these proteins at specific membrane contact sites is essential to understand their function and role in disease. We have identified the sorting nexin SNX5 as an interactor of VPS13A that mediates its association with endosomal subdomains. As for the yeast sorting nexin and Vps13 endosomal adaptor Ypt35, this association involves the VPS13 adaptor-binding (VAB) domain in VPS13A and a PxP motif in SNX5. Notably, this interaction is impaired by mutation of a conserved asparagine residue in the VAB domain, which is also required for Vps13-adaptor binding in yeast and is pathogenic in VPS13D. VPS13A fragments containing the VAB domain co-localize with SNX5, whereas the more C-terminal part of VPS13A directs its localization to the mitochondria. Overall, our results suggest that a fraction of VPS13A localizes to junctions between the endoplasmic reticulum, mitochondria, and SNX5-containing endosomes.

Influenza Vaccination and Risk of Ischemic Stroke: A Population-Based Case-Control Study.

BACKGROUND AND OBJECTIVES: To assess the relationship between influenza vaccination in the general population and risk of a first ischemic stroke (IS) during pre-epidemic, epidemic and post-epidemic periods. METHODS: A nested case-control study was carried out in a Spanish primary care database over 2001-2015. Subjects aged 40-99 years with at-least 1-year registry and no history of stroke or cancer were selected to conform the source cohort, from which incident IS cases were identified and classified as cardioembolic or non-cardioembolic. Five controls per case were randomly selected, individually matched with cases for exact age, sex and date of stroke diagnosis (index date). A patient was considered vaccinated when he/she had a recorded influenza vaccination at least 14 days before the index date within the same season. Adjusted odds ratios (AOR) and their respective 95% confidence intervals (CI) were computed through a conditional logistic regression. Pneumococcal vaccination was used as a negative control. RESULTS: From a cohort of 3,757,621 patients, we selected 14,322 incident IS cases (9,542 non-cardioembolic and 4,780 cardioembolic) and 71,610 matched controls. Of them, 41.4% and 40.5%, respectively, were vaccinated yielding a crude OR of 1.05(95%CI:1.01-1.10). Vaccinated subjects presented a higher prevalence of vascular risk factors, diseases and comedication than non-vaccinated and, after full adjustment, the association of influenza vaccination with IS yielded an AOR of 0.88(95%CI:0.84-0.92) was found, appearing early (AOR15-30 days=0.79;95%CI:0.69-0.92) and slightly declining over time (AOR>150 days=0.92;95%CI:0.87-0.98). A reduced risk of similar magnitude was observed with both types of IS, in the three epidemic periods and in all subgroups analyzed (men, women, subjects below and over 65 years of age, and subjects with intermediate and high vascular risk). By contrast, pneumococcal vaccination was not associated with a reduced risk of IS (AOR=1.08;95%CI:1.04-1.13). DISCUSSION: Results are compatible with a moderate protective effect of influenza vaccine on IS appearing early after vaccination. The finding that a reduced risk was also observed in pre-epidemic periods suggests that either the "protection" is not totally linked to prevention of influenza infection, or it may be partly explained by unmeasured confounding factors.

Risk of ischaemic stroke among new users of glucosamine and chondroitin sulphate: a nested case-control study.

Background: Several studies have reported that the use of chondroitin sulphate (CS) and glucosamine may reduce the risk of acute myocardial infarction. Although it is thought that this potential benefit could be extended to ischaemic stroke (IS), the evidence is scarce. Objective: To test the hypothesis that the use of prescription glucosamine or CS reduces the risk of IS. Design: Case-control study nested in an open cohort. Methods: Patients aged 40-99 years registered in a Spanish primary healthcare database (BIFAP) during the 2002-2015 study period. From this cohort, we identified incident cases of IS, applying a case-finding algorithm and specific validation procedures, and randomly sampled five controls per case, individually matched with cases by exact age, gender and index date. Adjusted odds ratios (AORs) and 95% confidence interval (CI) were computed through a conditional logistic regression. Only new users of glucosamine or CS were considered. Results: A total of 13,952 incident cases of IS and 69,199 controls were included. Of them, 106 cases (0.76%) and 803 controls (1.16%) were current users of glucosamine or CS at index date, yielding an AOR of 0.66 (95% CI: 0.54-0.82) (for glucosamine, AOR: 0.55; 95% CI: 0.39-0.77; and for CS, AOR: 0.77; 95% CI: 0.60-0.99). The reduced risk among current users was observed in both sexes (men, AOR: 0.69; 95% CI: 0.49-0.98; women, AOR: 0.65; 95% CI: 0.50-0.85), in individuals above and below 70 years of age (AOR: 0.69; 95% CI: 0.53-0.89 and AOR: 0.59; 95% CI: 0.41-0.85, respectively), in individuals with vascular risk factors (AOR: 0.53; 95% CI: 0.39-0.74) and among current/recent users of nonsteroidal anti-inflammatory drugs (NSAIDs) (AOR: 0.71; 95% CI: 0.55-0.92). Regarding duration, the reduced risk was observed in short-term users (<365 days, AOR: 0.61; 95% CI: 0.48-0.78) while faded and became nonsignificant in long-term users (>364 days AOR: 0.86; 95% CI: 0.57-1.31). Conclusions: Our results support a protective effect of prescription CS and glucosamine in IS, which was observed even in patients at vascular risk. Mini abstract: Our aim was to analyse whether the use of glucosamine or chondroitin sulphate (CS) reduces the risk of ischaemic stroke (IS). We detected a significant decrease.

Selective Serotonin Reuptake Inhibitors and Risk of Noncardioembolic Ischemic Stroke: A Nested Case-Control Study.

BACKGROUND: Multiple studies have reported that the use of selective serotonin reuptake inhibitors (SSRIs) is associated with an increased risk of ischemic stroke; however, this finding may be the result of a confounding by indication. We examined the association using different approaches to minimize such potential bias. METHODS: A nested case-control study was carried out in a Spanish primary health-care database over the study period 2001 to 2015. Cases were patients sustaining an ischemic stroke with no sign of cardioembolic or unusual cause. For each case, up to 5 matched controls (for exact age, sex, and index date) were randomly selected. Antidepressants were divided in 6 pharmacological subgroups according to their mechanism of action. The current use of SSRIs (use within a 30-day window before index date) was compared with nonuse, past use (beyond 365 days) and current use of other antidepressants through a conditional logistic regression model to obtain adjusted odds ratios and 95% CI. Only initiators of SSRIs and other antidepressants were considered. RESULTS: A total of 8296 cases and 37 272 matched controls were included. Of them, 255 (3.07%) were current users of SSRIs among cases and 834 (2.24%) among controls, yielding an adjusted odds ratio of 1.14 (95% CI, 0.97-1.34) as compared with nonusers, 0.94 (95% CI, 0.77-1.13) as compared with past-users and 0.74 (95% CI, 0.58-0.93) as compared with current users of other antidepressants. No relevant differences were found by duration (≤1, >1 year), sex, age (<70, ≥70 years old) and background vascular risk. CONCLUSIONS: The use of SSRIs was not associated with an increased risk of noncardioembolic ischemic stroke. On the contrary, as compared with other antidepressants, SSRIs appeared to be protective.

A Dictyostelium model for BPAN disease reveals a functional relationship between the WDR45/WIPI4 homolog Wdr45l and Vmp1 in the regulation of autophagy-associated PtdIns3P and ER stress.

PROPPINs are conserved PtdIns3P-binding proteins required for autophagosome biogenesis that fold into a characteristic group of seven-bladed beta-propellers. Mutations in WDR45/WIPI4, a human member of this family, lead to BPAN, a rare form of neurodegeneration. We have generated mutants for the two PROPPIN proteins present in the model system Dictyostelium discoideum (Atg18 and Wdr45l) and characterized their function. Lack of Wdr45l greatly impairs autophagy, while Atg18 only causes subtle defects in the maturation of autolysosomes. The strong phenotype of the Wdr45l mutant is strikingly similar to that observed in Dictyostelium cells lacking Vmp1, an ER protein required for omegasome formation. Common phenotypes include impaired growth in axenic medium, lack of aggregation, and local enrichment of PtdIns3P as determined by the use of lipid reporters. In addition, Vmp1 and Wdr45l mutants show a chronically active response to ER stress. For both mutants, this altered PtdIns3P localization can be prevented by the additional mutation of the upstream regulator Atg1, which also leads to recovery of axenic growth and reduction of ER stress. We propose that, in addition to an autophagy defect, local autophagy-associated PtdIns3P accumulation might contribute to the pathogenesis of BPAN by disrupting ER homeostasis. The introduction of BPAN-associated mutations in Dictyostelium Wdr45l reveals the impact of pathogenic residues on the function and localization of the protein.

Sars-Cov-2 Infection in Patients on Long-Term Treatment with Macrolides in Spain: A National Cross-Sectional Study.

The aim of this study was to know the prevalence and severity of COVID-19 in patients treated with long-term macrolides and to describe the factors associated with worse outcomes. A cross-sectional study was conducted in Primary Care setting. Patients with macrolides dispensed continuously from 1 October 2019 to 31 March 2020, were considered. Main outcome: diagnosis of coronavirus disease-19 (COVID-19). Secondary outcomes: symptoms, severity, characteristics of patients, comorbidities, concomitant treatments. A total of 3057 patients met the inclusion criteria. Median age: 73 (64-81) years; 55% were men; 62% smokers/ex-smokers; 56% obese/overweight. Overall, 95% of patients had chronic respiratory diseases and four comorbidities as a median. Prevalence of COVID-19: 4.8%. This was in accordance with official data during the first wave of the pandemic. The most common symptoms were respiratory: shortness of breath, cough, and pneumonia. Additionally, 53% percent of patients had mild/moderate symptoms, 28% required hospital admission, and 19% died with COVID-19. The percentage of patients hospitalized and deaths were 2.6 and 5.8 times higher, respectively, in the COVID-19 group (p < 0.001). There was no evidence of a beneficial effect of long-term courses of macrolides in preventing SARS-CoV-2 infection or the progression to worse outcomes in old patients with underlying chronic respiratory diseases and a high burden of comorbidity.

The WIPI Gene Family and Neurodegenerative Diseases: Insights From Yeast and Dictyostelium Models.

WIPIs are a conserved family of proteins with a characteristic 7-bladed ß-propeller structure. They play a prominent role in autophagy, but also in other membrane trafficking processes. Mutations in human WIPI4 cause several neurodegenerative diseases. One of them is BPAN, a rare disease characterized by developmental delay, motor disorders, and seizures. Autophagy dysfunction is thought to play an important role in this disease but the precise pathological consequences of the mutations are not well established. The use of simple models such as the yeast Saccharomyces cerevisiae and the social amoeba Dictyostelium discoideum provides valuable information on the molecular and cellular function of these proteins, but also sheds light on possible pathways that may be relevant in the search for potential therapies. Here, we review the function of WIPIs as well as disease-causing mutations with a special focus on the information provided by these simple models.

Clinical value of baseline 18F-FDG PET/CT in soft tissue sarcomas.

BACKGROUND: The use of 18F-FDG Positron emission tomography/Computed tomography (PET/CT) in the initial staging of many cancers is clearly established. Most soft tissue sarcoma (STS) has a high affinity for 18F-FDG, which is why 18F-FDG PET/CT has been proposed as a non-invasive method, useful in diagnosis and follow-up. The standardized uptake value values (SUV), the volume-based metabolic parameters MTV (metabolic tumor volume), and TLG (total lesion glycolysis) determine tumor viability and provide its total volume and the total activity of metabolically active tumor cells. The histological grade is the most important predictor of metastases and mortality associated with STS, and a significant relationship between the metabolic parameters of 18F-FDG PET/CT and the histological grade has been described. METHODS: A retrospective study was conducted on STS patients, who had histological grade according to the FNCLCC (Fédération Nationale des Centres de Lutte Contre Le Cancer) criteria, as well as a baseline PET/CT. SUV (SUVmax, SUVmean, and SUVpeak), MTV, and TLG were quantified. A T-student test was performed to establish the relationship between the metabolic biomarkers and the histological grade. Their usefulness as predictors of the histological grade was verified using receiver operator characteristic (ROC) curves. A survival function study was performed using the Kaplan-Meier method. To assess the prognostic utility of the metabolic biomarkers we use the Log-Rank method. RESULTS: The SUV values were useful to discriminate high-grade STS. We found a significant relationship between the histological grade and the SUV values. SUVmax, SUVpeak, MTV, and TLG were predictors of overall survival (OS). There were no significant differences in the OS for the SUVmean, or in the disease-free survival (DFS) for SUVmax, SUVmean, SUVpeak, MTV, and TLG. CONCLUSIONS: The SUVmax, SUVmean, and SUVpeak values correlate with the HG and are useful to discriminate high-grade from low-grade STS. Patients with high SUVmax, SUVpeak, MTV, and TLG have a significantly lower OS.