Influence of weather factors on the incidence of COVID-19 in Spain.

Introduction: Several studies have analyzed the influence of meteorological and geographical factors on the incidence of COVID-19. Seasonality could be important in the transmission of SARS-CoV-2. This study aims to evaluate the geographical pattern of COVID-19 in Spain and its relationship with different meteorological variables. Methods: A provincial ecological study analyzing the influence of meteorological and geographical factors on the cumulative incidence of COVID-19 in the 52 (24 coastal and 28 inland) Spanish provinces during the first three waves was carried out. The cumulative incidence was calculated with data from the National Statistical Institute (INE) and the National Epidemiological Surveillance Network (RENAVE), while the meteorological variables were obtained from the Spanish Meteorological Agency (AEMET). Results: The total cumulative incidence, in all three waves, was lower in the coastal provinces than in the inland ones (566 ± 181 vs. 782 ± 154; P = 2.5 × 10-5). The cumulative incidence correlated negatively with mean air temperature (r = -0.49; P = 2.2 × 10-4) and rainfall (r = -0.33; P = .01), and positively with altitude (r = 0.56; P = 1.4 × 10-5). The Spanish provinces with an average temperature <10 °C had almost twice the cumulative incidence than the provinces with temperatures >16 °C. The mean air temperature and rainfall were associated with the cumulative incidence of COVID-19, regardless of other factors (Beta Coefficient of -0.62; P = 3.7 × 10-7 and -0.47; P = 4.2 × 10-5 respectively). Conclusions: Meteorological and geographical factors could influence the evolution of the pandemic in Spain. Knowledge regarding the seasonality of the virus would help to predict new waves of COVID-19 infections.

Introducción: Varios estudios han analizado la influencia de factores meteorológicos y geográficos en la incidencia de COVID-19. La estacionalidad podría tener importancia en la transmisión de SARS-CoV-2. Nuestro estudio evalúa el patrón geográfico de la COVID-19 en España y su relación con las distintas variables meteorológicas. Métodos: Estudio ecológico a escala provincial que analiza la influencia de factores meteorológicos y geográficos en la incidencia acumulada de COVID-19 en las 52 provincias españolas (24 costeras y 28 del interior) durante las tres primeras olas. La incidencia acumulada se calculó con los datos del Instituto Nacional Estadística (INE) y la Red Nacional de Vigilancia Epidemiológica (RENAVE), las variables meteorológicas se obtuvieron de la Agencia estatal de meteorología (AEMET). Resultados: La incidencia acumulada total, en los tres periodos, fue menor en las provincias costeras que en las del interior (566 ± 181 vs. 782 ± 154; P = 2,5 × 10−5). La incidencia acumulada correlacionó negativamente con la temperatura media (r = −0,49; P = 2,2 × 10−4) y las precipitaciones (r = −0,33; P = ,01), y positivamente con la altitud (r = 0,56; P = 1,4 × 10−5). Las provincias españolas con una temperatura media <10 °C tuvieron casi el doble de incidencia acumulada que las provincias con temperaturas >16 °C. La temperatura media y las precipitaciones fueron las variables asociadas con la incidencia acumulada provincial de COVID-19, con independencia de otros factores (Coeficiente Beta de −0,62; P = 3,7 × 10−7 y −0,47; P = 4,2 × 10−5 respectivamente). Conclusiones: Los factores meteorológicos y geográficos podrían influir en la evolución de la pandemia en España. El reconocimiento de la estacionalidad del COVID-19 ayudaría a predecir nuevas olas.

Influencia de los factores meteorológicos en la incidencia de COVID-19 en España / Influence of weather factors on the incidence of COVID-19 in Spain

Introducción: Varios estudios han analizado la influencia de factores meteorológicos y geográficos en la incidencia de COVID-19. La estacionalidad podría tener importancia en la transmisión de SARS-CoV-2. Nuestro estudio evalúa el patrón geográfico de la COVID-19 en España y su relación con las distintas variables meteorológicas.MétodosEstudio ecológico a escala provincial que analiza la influencia de factores meteorológicos y geográficos en la incidencia acumulada de COVID-19 en las 52 provincias españolas (24 costeras y 28 del interior) durante las tres primeras olas. La incidencia acumulada se calculó con los datos del Instituto Nacional de Estadística (INE) y la Red Nacional de Vigilancia Epidemiológica (RENAVE), las variables meteorológicas se obtuvieron de la Agencia Estatal de Meteorología (AEMET).ResultadosLa incidencia acumulada total, en los tres periodos, fue menor en las provincias costeras que en las del interior (566±181 vs. 782±154; p=2,5×10-5). La incidencia acumulada correlacionó negativamente con la temperatura media (r=-0,49; p=2,2×10-4) y las precipitaciones (r=-0,33; p=0,01), y positivamente con la altitud (r=0,56; p=1,4×10-5). Las provincias españolas con una temperatura media <10°C tuvieron casi el doble de incidencia acumulada que las provincias con temperaturas >16°C. La temperatura media y las precipitaciones fueron las variables asociadas con la incidencia acumulada provincial de COVID-19, con independencia de otros factores (Coeficiente Beta de -0,62; p=3,7×10-7 y -0,47; p=4,2x10-5, respectivamente).ConclusionesLos factores meteorológicos y geográficos podrían influir en la evolución de la pandemia en España. El reconocimiento de la estacionalidad del COVID-19 ayudaría a predecir nuevas olas. (AU)

Introduction: Several studies have analyzed the influence of meteorological and geographical factors on the incidence of COVID-19. Seasonality could be important in the transmission of SARS-CoV-2. This study aims to evaluate the geographical pattern of COVID-19 in Spain and its relationship with different meteorological variables.MethodsA provincial ecological study analyzing the influence of meteorological and geographical factors on the cumulative incidence of COVID-19 in the 52 (24 coastal and 28 inland) Spanish provinces during the first three waves was carried out. The cumulative incidence was calculated with data from the National Statistical Institute (INE) and the National Epidemiological Surveillance Network (RENAVE), while the meteorological variables were obtained from the Spanish Meteorological Agency (AEMET).ResultsThe total cumulative incidence, in all three waves, was lower in the coastal provinces than in the inland ones (566±181 vs. 782±154; p=2.5×10−5). The cumulative incidence correlated negatively with mean air temperature (r=−0.49; p=2.2×10−4) and rainfall (r=−0.33; p=0.01), and positively with altitude (r=0.56; p=1. 4×10−5). The Spanish provinces with an average temperature <10°C had almost twice the cumulative incidence than the provinces with temperatures >16°C. The mean air temperature and rainfall were associated with the cumulative incidence of COVID-19, regardless of other factors (Beta Coefficient of −0.62; p=3.7×10−7 and −0.47; p=4.2×10–5 respectively).ConclusionsMeteorological and geographical factors could influence the evolution of the pandemic in Spain. Knowledge regarding the seasonality of the virus would help to predict new waves of COVID-19 infections. (AU)

Influence of weather factors on the incidence of COVID-19 in Spain. / Influencia de los factores meteorológicos en la incidencia de COVID-19 en España.

INTRODUCTION: Several studies have analyzed the influence of meteorological and geographical factors on the incidence of COVID-19. Seasonality could be important in the transmission of SARS-CoV-2. This study aims to evaluate the geographical pattern of COVID-19 in Spain and its relationship with different meteorological variables. METHODS: A provincial ecological study analyzing the influence of meteorological and geographical factors on the cumulative incidence of COVID-19 in the 52 (24 coastal and 28 inland) Spanish provinces during the first three waves was carried out. The cumulative incidence was calculated with data from the National Statistical Institute (INE) and the National Epidemiological Surveillance Network (RENAVE), while the meteorological variables were obtained from the Spanish Meteorological Agency (AEMET). RESULTS: The total cumulative incidence, in all three waves, was lower in the coastal provinces than in the inland ones (566±181 vs. 782±154; p=2.5×10-5). The cumulative incidence correlated negatively with mean air temperature (r=-0.49; p=2.2×10-4) and rainfall (r=-0.33; p=0.01), and positively with altitude (r=0.56; p=1. 4×10-5). The Spanish provinces with an average temperature <10°C had almost twice the cumulative incidence than the provinces with temperatures >16°C. The mean air temperature and rainfall were associated with the cumulative incidence of COVID-19, regardless of other factors (Beta Coefficient of -0.62; p=3.7×10-7 and -0.47; p=4.2×10-5 respectively). CONCLUSIONS: Meteorological and geographical factors could influence the evolution of the pandemic in Spain. Knowledge regarding the seasonality of the virus would help to predict new waves of COVID-19 infections.

Smurf1 Silencing Using a LNA-ASOs/Lipid Nanoparticle System to Promote Bone Regeneration.

Despite the great advance of bone tissue engineering in the last few years, repair of bone defects remains a major problem. Low cell engraftment and dose-dependent side effects linked to the concomitant administration of bone morphogenetic proteins (BMPs) are the main problems currently hindering the clinical use of mesenchymal stem cell (MSC)-based therapies in this field. We have managed to bypass these drawbacks by combining the silencing the Smurf1 ubiquitin ligase in MSCs with the use of a scaffold that sustainably releases low doses of BMP-2. In this system, Smurf1 silencing is achieved by using GapmeRs, a clinically safe method that avoids the use of viral vectors, facilitating its translation to the clinic. Here, we show that a single transient transfection with a small quantity of a Smurf1-specific GapmeR is able to induce a significant level of silencing of the target gene, enough to prime MSCs for osteogenic differentiation. Smurf1 silencing highly increases MSCs responsiveness to BMP-2, allowing a dramatic reduction of the dose needed to achieve the desired therapeutic effect. The combination of these primed cells with alginate scaffolds designed to sustainably and locally release low doses of BMP-2 to the defect microenvironment is able to induce the formation of a mature bone matrix both in an osteoporotic rat calvaria system and in a mouse ectopic model. Importantly, this approach also enhances osteogenic differentiation in MSCs from osteoporotic patients, characterized by a reduced bone-forming potential, even at low BMP doses, underscoring the regenerative potential of this system. Stem Cells Translational Medicine 2019;8:1306&1317.

Salud ósea en el síndrome de Down / Bone health in Down syndrome

Las personas con síndrome de Down podrían tener un mayor riesgo de osteoporosis debido a un envejecimiento precoz, alteraciones en el desarrollo o la presencia de factores de riesgo como baja actividad física, menor exposición solar, elevada comorbilidad o el uso de tratamientos que afectan al metabolismo óseo. Además, tienen peculiaridades antropométricas y de composición corporal que podrían influir en su masa ósea. Los estudios en adultos vienen a decir que tienen una densidad mineral ósea en g/cm2 inferior a la de la población general, pero la mayoría no tienen en cuenta el menor tamaño de sus huesos, de tal manera que cuando se ajusta por el mismo (densidad mineral ósea volumétrica g/cm3), estas diferencias se reducen o desaparecen. Los estudios sobre niveles de 25(OH)D, parámetros de remodelación ósea o prevalencia de fracturas no son concluyentes (AU)

Patients with Down syndrome have a number of risk factors that theoretically could predispose them to osteoporosis, such as early aging, development disorders, reduced physical activity, limited sun exposure, frequent comorbidities and use of drug therapies which could affect bone metabolism. In addition, the bone mass of these people may be affected by their anthropometric and body composition peculiarities. In general terms, studies in adults with Down syndrome reported that these people have lower areal bone mineral density (g/cm2) than the general population. However, most of them have not taken the smaller bone size of people with Down syndrome into account. In fact, when body mineral density is adjusted by bone size and we obtain volumetric body mineral density (g/cm3), the difference between both populations disappears. On the other hand, although people with Down syndrome have risk factor of hypovitaminosis D, the results of studies regarding 25(OH)D in this population are not clear. Likewise, the studies about biochemical bone markers or the prevalence of fractures are not conclusive (AU)

Bone health in Down syndrome. / Salud ósea en el síndrome de Down.

Patients with Down syndrome have a number of risk factors that theoretically could predispose them to osteoporosis, such as early aging, development disorders, reduced physical activity, limited sun exposure, frequent comorbidities and use of drug therapies which could affect bone metabolism. In addition, the bone mass of these people may be affected by their anthropometric and body composition peculiarities. In general terms, studies in adults with Down syndrome reported that these people have lower areal bone mineral density (g/cm2) than the general population. However, most of them have not taken the smaller bone size of people with Down syndrome into account. In fact, when body mineral density is adjusted by bone size and we obtain volumetric body mineral density (g/cm3), the difference between both populations disappears. On the other hand, although people with Down syndrome have risk factor of hypovitaminosis D, the results of studies regarding 25(OH)D in this population are not clear. Likewise, the studies about biochemical bone markers or the prevalence of fractures are not conclusive.

Genetic Variants Associated with Circulating Parathyroid Hormone.

Parathyroid hormone (PTH) is a primary calcium regulatory hormone. Elevated serum PTH concentrations in primary and secondary hyperparathyroidism have been associated with bone disease, hypertension, and in some studies, cardiovascular mortality. Genetic causes of variation in circulating PTH concentrations are incompletely understood. We performed a genome-wide association study of serum PTH concentrations among 29,155 participants of European ancestry from 13 cohort studies (n=22,653 and n=6502 in discovery and replication analyses, respectively). We evaluated the association of single nucleotide polymorphisms (SNPs) with natural log-transformed PTH concentration adjusted for age, sex, season, study site, and principal components of ancestry. We discovered associations of SNPs from five independent regions with serum PTH concentration, including the strongest association with rs6127099 upstream of CYP24A1 (P=4.2 × 10-53), a gene that encodes the primary catabolic enzyme for 1,25-dihydroxyvitamin D and 25-dihydroxyvitamin D. Each additional copy of the minor allele at this SNP associated with 7% higher serum PTH concentration. The other SNPs associated with serum PTH concentration included rs4074995 within RGS14 (P=6.6 × 10-17), rs219779 adjacent to CLDN14 (P=3.5 × 10-16), rs4443100 near RTDR1 (P=8.7 × 10-9), and rs73186030 near CASR (P=4.8 × 10-8). Of these five SNPs, rs6127099, rs4074995, and rs219779 replicated. Thus, common genetic variants located near genes involved in vitamin D metabolism and calcium and renal phosphate transport associated with differences in circulating PTH concentrations. Future studies could identify the causal variants at these loci, and the clinical and functional relevance of these variants should be pursued.

Perfil clínico de los pacientes con hematomas retroperitoneales espontáneos / Clinical spectrum of patients with spontaneous retroperitoneal hematomas

Introducción y objetivo: Los hematomas retroperitoneales espontáneos (HRE)son una complicación del tratamiento anticoagulante. Material y métodos: Revisión retrospectiva de los HRE en el Hospital Universitario Marqués de Valdecilla (Santander, España) desde el año 2003 al 2013. Se excluyen los traumatismos, los procedimientos invasivos o las roturas de un aneurisma aórtico. Comparamos esta serie con la descrita previamente en nuestro hospital. Resultados: Identificamos 34 HRE (64% mujeres) con una media de edad de 65 años (23-88 años). El 44% estaban anticoagulados por enfermedad cardiaca (81%). Un tercio tenía insuficiencia renal, y el 15%, cáncer. El dolor abdominal se describe en el 85%. La TC se realiza en el 82%. El 32% ingresa en UCI y solo el 20% requiere cirugía. La mortalidad relacionada fue del 21% (media de supervivencia de 5 días; 1-15 días). El 66% reinicia la anticoagulación a los 19 días (2-90 días), sin complicaciones posteriores. Se incrementan los casos no anticoagulados en un 47%. Conclusión: En los casos anticoagulados, la reintroducción del tratamiento, tras la resolución del hematoma, parece una práctica relativamente segura. Se incrementan los casos en pacientes no anticoagulados (AU)

Introduction and objective: Spontaneous retroperitoneal hematoma (SRH) is a potentially fatal clinical entity requiring immediate recognition and intervention. Material and methods: The clinical records of 18-year-old and older patients admitted to the University Hospital Marqués de Valdecilla from 2003 to 2013 were reviewed. “Spontaneous” was defined as unrelated to trauma, invasive procedures or bleeding due to aortic aneurysm rupture. Results: Thirty-four patients with SRH (44% were on anticoagulant drugs). One-third of cases had chronic renal insufficiency. Abdominal pain was the most common symptom both in anticoagulated and non-anticoagulated patients (80% in anticoagulated and 89% in non-anticoagulated patients). About one half of the patients developed shock. A CT scan was the most commonly performed diagnostic test, followed by abdominal ultrasound. Most cases were managed conservatively (80%). More than half of the patients (66%) restarted anticoagulation therapy after the acute event with a mean delay of 19 days (range 2-90 days). None of them suffered a new bleeding episode. Conclusion: Restarting the anticoagulation treatment after hematoma resolution seems to be a safe practice. There is an increasing frequency of SRH in non-anticoagulated patients (AU)

[Clinical spectrum of patients with spontaneous retroperitoneal hematomas]. / Perfil clínico de los pacientes con hematomas retroperitoneales espontáneos.

INTRODUCTION AND OBJECTIVE: Spontaneous retroperitoneal hematoma (SRH) is a potentially fatal clinical entity requiring immediate recognition and intervention. MATERIAL AND METHODS: The clinical records of 18-year-old and older patients admitted to the University Hospital Marqués de Valdecilla from 2003 to 2013 were reviewed. "Spontaneous" was defined as unrelated to trauma, invasive procedures or bleeding due to aortic aneurysm rupture. RESULTS: Thirty-four patients with SRH (44% were on anticoagulant drugs). One-third of cases had chronic renal insufficiency. Abdominal pain was the most common symptom both in anticoagulated and non-anticoagulated patients (80% in anticoagulated and 89% in non-anticoagulated patients). About one half of the patients developed shock. A CT scan was the most commonly performed diagnostic test, followed by abdominal ultrasound. Most cases were managed conservatively (80%). More than half of the patients (66%) restarted anticoagulation therapy after the acute event with a mean delay of 19 days (range 2-90 days). None of them suffered a new bleeding episode. CONCLUSION: Restarting the anticoagulation treatment after hematoma resolution seems to be a safe practice. There is an increasing frequency of SRH in non-anticoagulated patients.

The deleterious effect of bariatric surgery on cortical and trabecular bone density in the femurs of non-obese, type 2 diabetic Goto-Kakizaki rats.

BACKGROUND: The effects of type 2 diabetes on bone mass and microstructure are not clear. The aim of this study was to evaluate bone microstructural properties and volumetric bone mineral density (vBMD) in type 2 diabetic Goto-Kakizaki non-obese rats after gastrojejunal bypass and their relationship with hormonal parameters. METHODS: We designed an experimental study in Goto-Kakizaki rats with and without gastrojejunal bypass, performing densitometric and microstructural studies of the distal femur using X-ray computed microtomography (micro-CT). Levels of insulin, glucagon, leptin, and glucagon-like peptide-1 (GLP-1) were also determined. RESULTS: We observed reduced cortical (1,488.92 ± 98.2 vs. 1,727.92 ± 133.45 mg/cm(3), p = 0.028) and trabecular (180.8 ± 9 vs. 261.23 ± 45.54 mg/cm(3), p = 0.036) vBMD in operated rats. Bone volume fraction (BV/TV) and trabecular connectivity were reduced in operated rats, while there was a reduction in cortical thickness and an increase in rod-like trabeculae at the expense of plate-like trabeculae. Leptin was reduced (1,042 ± 549 vs. 2,447 ± 1,035 pg/ml, p = 0.05) and GLP-1 increased (1.62 ± 0.32 vs. 0.96 ± 0.1 ng/ml, p = 0.008) but only leptin showed a significant association with vBMD CONCLUSIONS: In type 2 diabetic Goto-Kakizaki rats, gastrojejunal bypass produces a reduction in cortical and trabecular bone mineral density and a deterioration in bone quality that could be explained, in part, by the reduction in leptin levels.

A GEP-ISFG collaborative study on the optimization of an X-STR decaplex: data on 15 Iberian and Latin American populations.

In a collaborative work carried out by the Spanish and Portuguese ISFG Working Group (GEP-ISFG), a polymerase chain reaction multiplex was optimized in order to type ten X-chromosome short tandem repeats (STRs) in a single reaction, including: DXS8378, DXS9902, DXS7132, DXS9898, DXS6809, DXS6789, DXS7133, GATA172D05, GATA31E08, and DXS7423. Using this X-decaplex, each 17 of the participating laboratories typed a population sample of approximately 200 unrelated individuals (100 males and 100 females). In this work, we report the allele frequencies for the ten X-STRs in 15 samples from Argentina (Buenos Aires, Córdoba, Río Negro, Entre Ríos, and Misiones), Brazil (São Paulo, Rio de Janeiro, Paraná, and Mato Grosso do Sul), Colombia (Antioquia), Costa Rica, Portugal (Northern and Central regions), and Spain (Galicia and Cantabria). Gene diversities were calculated for the ten markers in each population and all values were above 56%. The average diversity per locus varied between 66%, for DXS7133, and 82%, for DXS6809. For this set of STRs, a high discrimination power was obtained in all populations, both in males (> or =1 in 5 x 10(5)) and females (> or =1 in 3 x 10(9)), as well as high mean exclusion chance in father/daughter duos (> or =99.953%) and in father/mother/daughter trios (> or =99.999%). Genetic distance analysis showed no significant differences between northern and central Portugal or between the two Spanish samples from Galicia and Cantabria. Inside Brazil, significant differences were found between Rio de Janeiro and the other three populations, as well as between São Paulo and Paraná. For the five Argentinean samples, significant distances were only observed when comparing Misiones with Entre Ríos and with Río Negro, the only two samples that do not differ significantly from Costa Rica. Antioquia differed from all other samples, except the one from Río Negro.