IMIBIC - Instituto Maimónides de Investigación Biomédica de Córdoba (Andalucía)

Permanent URI for this collectionhttps://hdl.handle.net/20.500.12105/16982

El Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) es un Instituto Sanitario de Investigación creado el 24 de abril de 2008, a partir de un acuerdo entre la Consejería de Innovación, Ciencia y Empresa y la Consejería de Salud de la Junta de Andalucía, la Universidad de Córdoba, que ratificaron su compromiso para el afianzamiento del IMIBIC como centro de vanguardia y excelencia en biomedicina a través del nuevo convenio firmado el 2 de febrero de 2015 y prorrogado el 31 de enero de 2020. Es un espacio de investigación multidisciplinar en el que trabajan conjuntamente científicos procedentes del ámbito universitario y sanitario para la mejora de la salud de los ciudadanos y el desarrollo social y económico de la provincia de Córdoba. Su órgano de gestión es la Fundación para la Investigación Biomédica de Córdoba (FIBICO), creada el 27 de diciembre de 2007. Acreditado por el Instituto de Salud Carlos III como Instituto de Investigación Sanitaria en 2011, y renovando esta acreditación cada 5 años, forma parte así del total de 34 Institutos de Investigación Sanitaria acreditados existentes en la actualidad.

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Zoonosis screening in Spanish immunocompromised children and their pets
(Frontiers Media, 2024) Garcia-Sanchez, Paula; Romero-Trancón, David; Falces-Romero, Iker; Navarro Carrera, Paula; Ruiz-Carrascoso, Guillermo; Carmena, David; Casares Jiménez, María; Rivero-Juarez, Antonio; Moya, Laura; Rodón, Jaume; Esperón, Fernando; Pérez-Hernando, Belén; Sánchez-León, Rocío; Hurtado-Gallego, Jara; Alcolea, Sonia; Sainz, Talia; Calvo, Cristina; Méndez-Echevarría, Ana; Asociación Española de Pediatría; Fundación Mapfre; Ministerio de Ciencia e Innovación (España); Instituto de Salud Carlos III; Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); European Society for Paediatric Infectious Diseases; Centro de Investigación Biomédica en Red - CIBERINFEC (Enfermedades Infecciosas); Comunidad de Madrid (España); Regional Government of Andalusia (España)
Introduction: Although pets provide several social-emotional benefits for children, the risk of zoonosis must be considered among immunocompromised individuals. Methods: A prospective study was conducted in a tertiary hospital including immunocompromised patients younger than 20 years owning dogs and/or cats. Colonization and/or infection was evaluated by stool studies, bacterial swabs, blood polymerase chain reaction and serological studies in both patients and their pets, to evaluate potential zoonotic transmission occurrence. Results: We included 74 patients and their 92 pets (63 dogs, 29 cats). Up to 44.6% of the patients and 31.5% of the pets had at least 1 positive result. Up to 18.4% of pets' fecal samples were positive (bacteria, parasites or hepatitis E virus). No helminths were observed despite the high frequency of incorrect intestinal deworming practices. Among children, gastrointestinal microorganisms were found in 37.3% (primarily Clostridium difficile). Colonization by Staphylococcus pseudintermedius was common among pets (8.0%) but not among children (0.0%). No shared colonization between owners and pets was observed, except in one case (Blastocystis in both patient and pet feces). Among patients, serologies were positive for Strongyloides stercoralis (14.8%), Toxocara canis (3.2%), Bartonella henselae (19.1%) and hepatitis E (5.6%). Serology was positive for Rickettsia spp. (22.6%) and Babesia spp. (6.5%) in dogs and for Leishmania spp. (14.3%) and Toxoplasma spp. (14.3%) in cats. Conclusion: Exposure to zoonotic agents was detected in both patients and pets; however, shared colonization events were almost nonexistent. In our cohort, dogs and cats do not appear to entail high zoonosis transmission risk for immunocompromised patients.
Multicentric Study on Enteric Protists Occurrence in Zoological Parks in Portugal
(Multidisciplinary Digital Publishing Institute (MDPI), 2024-10-06) Mega, João; Moreira, Rafaela; Moreira, Guilherme; Silva-Loureiro, Ana; Gomes da Silva, Priscilla; Istrate, Claudia; Santos-Silva, Sérgio; Rivero-Juarez, Antonio; Carmena, David; Mesquita, João R; Fundação para a Ciência e Tecnologia (Portugal)
Parasitic infections of the gastrointestinal tract of domestic animals play a major role in the transmission of disease, which in turn may result in financial and productive losses. Notwithstanding, studies on the burden and distribution of diarrheagenic protists in zoological gardens are still insufficient. Given the close animal-animal and animal-human interaction in these settings, Public Health concerns under the One Health context are raised. Using molecular detection tools and phylogenetic analysis, the goal of this study was to assess the occurrence of four potentially zoonotic protists-Balantioides coli, Blastocystis sp., Cryptosporidium spp. and Giardia spp.-in animals residing in zoological parks in Portugal. Occurrence of Eimeria spp. was also assessed because of its veterinary relevance. Although Blastocystis sp. represents most of the positive samples obtained (11.6%; 95% CI: 0.08-0.17), all parasites were detected (B. coli (2.9%; 95% CI: 0.01-0.06), and Cryptosporidium spp., Eimeria spp. and Giardia spp. presented the same prevalence (0.5%; 95% CI: 0.00-0.03)). We also describe the first molecular detection of B. coli in a collared peccary (Tayassu tajacu), of Blastocystis sp. in three different python species, and G. muris in a central bearded dragon (Pogona vitticeps), suggesting the broadening of the host range for these parasites.
Executive Summary of the Spanish Guidelines for the Diagnosis and Management of Imported Febrile Illnesses from the Spanish Society of Tropical Medicine and International Health (SEMTSI), the Imported Pathology Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (GEPI-SEIMC), the Spanish Society of Family and Community Medicine (SEMFYC), the Spanish Society of Primary Care Physicians (SEMERGEN) and the Spanish Society of Emergency Medicine (SEMES)
(Elsevier, 2024) Camprubí-Ferrer, Daniel; Díaz Menendez, Marta; Crespillo-Andújar, Clara; Galparsoro, Harkaitz Azkune; Belhassen-García, Moncef; Cuadros González, Juan; Rubio Muñoz, Jose Miguel; Llenas-García, Jara; Oteo, José A; Gayoso Martín, Sara; Santos Larrégola, Laura; Salvador, Fernando; Rojo-Marcos, Gerardo; Balerdi-Sarasola, Leire; Kortajarena Urkola, Xabier; Soriano Pérez, Manuel Jesús; Onieva-García, María Ángeles; Alegría Coll, Iñaki; Arranz, Javier; Membrillo de Novales, Javier; Sociedad Española de Medicina Tropical y Salud Internacional
The Spanish Society of Tropical Medicine and International Health (SEMTSI), the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Emergency Medicine (SEMES), the Spanish Society of Primary Care Physicians (SEMERGEN) and the Spanish Society of Family and Community Medicine (SEMFYC) have prepared a consensus statement on the diagnosis and management of patients with imported febrile illnesses. Twenty authors with different backgrounds and representing different healthcare perspectives (ambulatory primary care, travel and tropical medicine specialists, emergency medicine, hospital care, microbiology and parasitology and public health), identified 39 relevant questions, which were organised in 7 thematic blocks. After a systematic review of the literature and a thoughtful discussion, the authors prepared 125 recommendations, as well as several tables and figures to be used as a consulting tool. The present executive summary shows a selection of some of the most relevant questions and recommendations included in the guidelines.
Epidemiological and clinical characterization of community, healthcare-associated and nosocomial colonization and infection due to carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in Spain
(Springer, 2024-12) Salamanca-Rivera, Elena; Palacios-Baena, Zaira R; Cañada-Garcia, Javier Enrique; Moure García, Zaira; Perez-Vazquez, Maria; Calvo-Montes, Jorge; Martínez-Martínez, Luis; Cantón, Rafael; Ruiz Carrascoso, Guillermo; Pitart, Cristina; Navarro, Ferran; Bou, Germán; Mulet, Xavier; González-López, Juan José; Sivianes, Fran; Delgado-Valverde, Mercedes; Pascual, Álvaro; Oteo-Iglesias, Jesus; Rodríguez-Baño, Jesús; GEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study Group; Instituto de Salud Carlos III; Ministerio de Ciencia e Innovación (España); Unión Europea. Comisión Europea. NextGenerationEU; Plan Nacional de I+D+i (España); Ministerio de Economía y Competitividad (España); Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Centro de Investigación Biomédica en Red - CIBERINFEC (Enfermedades Infecciosas)
Background: Community-acquired (CA) and healthcare-associated (HCA) infections caused by carbapenemase-producing Enterobacterales (CPE) are not well characterized. The objective was to provide detailed information about the clinical and molecular epidemiological features of nosocomial, HCA and CA infections caused by carbapenemase-producing Klebsiella pneumoniae (CP-Kp) and Escherichia coli (CP-Ec). Methods: A prospective cohort study was performed in 59 Spanish hospitals from February to March 2019, including the first 10 consecutive patients from whom CP-Kp or CP-Ec were isolated. Patients were stratified according to acquisition type. A multivariate analysis was performed to identify the impact of acquisition type in 30-day mortality. Results: Overall, 386 patients were included (363 [94%] with CP-Kp and 23 [6%] CP-Ec); in 296 patients (76.3%), the CPE was causing an infection. Acquisition was CA in 31 (8.0%) patients, HCA in 183 (47.4%) and nosocomial in 172 (48.3%). Among patients with a HCA acquisition, 100 (54.6%) had been previously admitted to hospital and 71 (38.8%) were nursing home residents. Urinary tract infections accounted for 19/23 (82.6%), 89/130 (68.5%) and 42/143 (29.4%) of CA, HCA and nosocomial infections, respectively. Overall, 68 infections (23%) were bacteremia (8.7%, 17.7% and 30.1% of CA, HCA and nosocomial, respectively). Mortality in infections was 28% (13%, 14.6% and 42.7% of CA, HCA and nosocomial, respectively). Nosocomial bloodstream infections were associated with increased odds for mortality (adjusted OR, 4.00; 95%CI 1.21-13.19). Conclusions: HCA and CA infections caused by CPE are frequent and clinically significant. This information may be useful for a better understanding of the epidemiology of CPE.
Prevalence and factors linked to renal involvement in prediabetes patients across Europe in the ePREDICE trial
(Nature Publishing Group, 2024-12-05) Más-Fontao, Sebastián; Civantos, Esther; Boukichou-Abdelkader, Nisa; Moreno, Juan A; Tuomilehto, Jaakko; Gabriel-Sanchez, Rafael; Egido, Jesús; Unión Europea. Comisión Europea. 7 Programa Marco; Instituto de Salud Carlos III; Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF); Centro de Investigación Biomédica en Red - CIBERDEM (Diabetes y Enfermedades Metabólicas asociadas); Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz; Merck KGaA; Boehringer Ingelheim Fonds
This sub-analysis of the ePREDICE trial, investigated the prevalence and determinants of renal complications, specifically glomerular hyperfiltration, albuminuria, and reduced kidney function, in individuals with prediabetes (PD). The cohort consisted of 967 participants from diverse backgrounds across seven countries. The kidney function was evaluated using the MDRD-4 equation, and the influence of various clinical and demographic factors on renal involvement was assessed by multivariable regression models. Additionally, insulinogenic and disposition indices were examined. Overall, the prevalence of renal abnormalities in this PD cohort was 9.2% (n = 89). Key findings included the detection of hyperfiltration in 20 (2%) individuals, albuminuria in 45 (4.7%), and CKD stage G3a in 29 (3%). Hyperfiltration was inversely correlated with age and height, while albuminuria showed a significant direct association with the disposition index (DI). Age and waist circumference were significantly and directly associated with estimated glomerular filtration rate (eGFR). The ePREDICE study highlights critical factors that affect renal involvement in PD individuals, revealing complex interactions among various parameters. These findings further emphasize the necessity for the search of early kidney abnormalities in people with PD especially in those in older age groups and with a large waist circumference.
Impact of the COVID-19 pandemic on the self-care and health condition of the older adults. CUIDAMOS+75. A mixed methods study protocol
(Frontiers Media, 2024) Rico-Blazquez, Milagros; Esteban-Sepúlveda, Silvia; Sánchez-Ruano, Raquel; Aritztegui-Echenique, Ana María; Artigues-Barbera, Eva María; Brito-Brito, Pedro-Ruymán; Casado-Ramirez, Elvira; Cidoncha-Moreno, María Ángeles; Fabregat-Julve, María Inmaculada; Feria-Raposo, Isabel; Hernandez-Pascual, Montserrat; Lozano-Hernández, Cristina; Moreno-Casbas, Teresa; Otones-Reyes, Pedro; Palmar-Santos, Ana María; Pedraz-Marcos, Azucena; Romero-Rodriguez, Esperanza María; Solé-Agustí, María Cristina; Taltavull-Aparicio, Joana María; Vidal-Thomàs, María Clara; González-Chordá, Víctor M; Cuidamos+75 Group; Instituto de Salud Carlos III; Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF)
Aims: To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain. Design: Multicentric, mixed method concurrent study. Methods: This work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with 18 months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022). Discussion: The study findings will reveal the long-term impact of the COVID-19 pandemic on the older adults and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic. Trial registration: Identifier: NCT05249868 [ClinicalTrials.gov].
Blastocystis occurrence and subtype diversity in European wild boar (Sus scrofa) from the Iberian Peninsula.
(BioMed Central (BMC), 2024-10-07) Köster, Pamela Carolina; Figueiredo, Ana M; Maloney, Jenny G; Dashti, Alejandro; Bailo-Barroso, Begoña; Torres, Rita T; Fonseca, Carlos; Mysterud, Atle; Habela, Miguel Ángel; Rivero-Juarez, Antonio; Vicente, Joaquín; Serrano, Emmanuel; Arnal, Maria C; Fernández de Luco, Daniel; Armenteros, José A; Balseiro, Ana; Cardona, Guillermo A; Carvalho, João; Hipólito, Dário; Fernandes, Joana; Palmeira, Josman D; Calero-Bernal, Rafael; Gonzalez-Barrio, David; Santín, Mónica; Carmena, David; Instituto de Salud Carlos III; Ministerio de Economía y Competitividad (España); United States Department of Agriculture; Fundação para a Ciência e Tecnologia (Portugal); Unión Europea. Fondo Social Europeo (ESF/FSE); Ministerio de Ciencia, Innovación y Universidades (España); Unión Europea. European Cooperation in Science and Technology (COST)
The ongoing increase in wild boar populations across Europe has fostered human-wildlife conflicts, including the transmission of emerging pathogens with zoonotic importance. Blastocystis is a ubiquitous, faecal-oral transmitted protist that can cause gastrointestinal illnesses and is observed in humans and animals worldwide. The role of wildlife in the epidemiology of Blastocystis is insufficiently understood. Thus, we investigated the occurrence and subtype diversity of Blastocystis in free-ranging wild boars from the Iberian Peninsula using conventional PCR and next-generation amplicon sequencing of a fragment of the ssu RNA gene. A total of 459 wild boar faecal samples were collected across Spain (n = 360) and Portugal (n = 99) between 2014 and 2021. Blastocystis was present in 15.3% (70/459; 95% CI 12.1-18.9) of the wild boars analysed, and its occurrence was significantly higher in Portugal (34.3%, 34/99; 95% CI 25.1-44.6) than in Spain (10.0%, 36/360; 95% CI 7.1-13.6). Seven Blastocystis subtypes (ST5, ST10b, ST13-ST15, ST24b, and ST43) were detected among the surveyed wild boar populations, with greater variability detected in Portuguese samples. ST5 was identified in all the Blastocystis-positive animals, whereas 14.3% of them harboured ST mixed colonisations. Our results demonstrate that Blastocystis ST5 is particularly adapted to infect wild boars. The additional identification of zoonotic STs reinforces the role of wild boars as spreaders of zoonotic infections with public health significance.
Gestational breast cancer: distinctive molecular and clinico-epidemiological features
(Springer, 2024-11-08) de la Haba-Rodríguez, J R; Mínguez, P; Rojo, F; Martín, M; Alba, E; Servitja, S; Prat, A; Pérez-Fidalgo, Jose Alejandro; Gavilá, J; Morales, C; Rodriguez-Lescure, A; Herrero, C; Peña-Enriquez, R; Herranz, J; Hernando, C; Hernández-Blanquisett, A; Guil-Luna, S; Martinez, M T; Blanch, S; Caballero, R; Martín, N; Pollan-Santamaria, Marina; Guerrero-Zotano, Ángel; Bermejo, B; Instituto de Salud Carlos III; University of Córdoba (España); Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF)
Gestational breast cancer (GBC), defined as breast cancer (BC) diagnosed during pregnancy or the first-year post-partum, accounts for 6-15% of BC cases in women aged 20-44 years. GBC has worse prognosis than non-GBC, but reasons behind are not clear. The GEICAM/2012-03 Study (Molecular Characterization of Gestational Breast Cancer) is a multicenter prospective/retrospective observational registry of patients diagnosed with GBC. From November 2014 to June 2015 seventy patients diagnosed with GBC were included in the study, 30 diagnosed during pregnancy and 40 after delivery. Our current study was aimed to explore differences in epidemiological, clinico-pathological and gene expression features of GBC tumors, from the GEICAM/2012-03 Study, compared to non-GBC tumors from patients of similar age (< 43 years) from six different GEICAM studies, used as non- GBC control population. As per the main objective, the study found multiple differences showing GBC tumors as a different biological entity. GBC showed a more aggressive biology, with higher Ki67 levels, higher incidence of breast and/or ovarian cancer family history, and germline deleterious BRCA1/2 mutations, and are enriched in basal-like intrinsic subtype. GBC patients showed a lower number of tumor infiltrating lymphocytes, while specific genetic signatures highlight differences in GBC´s distinctive transcriptome. Our study shows that GBC is potentially a clinically and molecularly different entity, with specific epidemiological, clinical, and histological features, as well as a distinctive altered immune state and genetic signature. Nevertheless, further studies are needed to better understand the biology of GBC and to identify new targets against which develop new, more effective, targeted therapies.
Changes in Alcohol Intake During Pregnancy in Spain, 1980 to 2014
(Wiley, 2019-11) Romero-Rodríguez, Esperanza; Cuevas Catalina, María Lourdes; Simon Mendez, Lorena; ECEMC Peripheral Group; Bermejo-Sanchez, Eva; Galan, Iñaki; Instituto de Salud Carlos III; Ministerio de Ciencia, Innovación y Universidades (España); Fundación 1000 sobre Defectos Congénitos; Plan Nacional de Drogas (España); Sociedad Española de Epidemiología
Background: Even small amounts of alcohol consumed during pregnancy can have adverse effects on the embryo and the fetus. We estimated how alcohol intake among pregnant women in Spain changed between 1980 and 2014, and identified factors associated with alcohol use. Methods: Data came from the Spanish Collaborative Study of Congenital Malformations (ECEMC). The sample includes ECEMC's control mothers, 40,268 pregnant women from all regions of Spain. We classified alcohol consumption during pregnancy into 3 categories: no consumption; sporadic consumption of small amounts of alcohol; and regular consumption, or sporadic but in large quantities including drunkenness. Independent variables included sociodemographic factors, planned/unplanned pregnancy, maternal chronic diseases, gestational diabetes, and tobacco and illegal drug use during pregnancy. Trend analyses were performed using data from 1980 to 2014. The multinomial logistic regression models designed to identify associated factors differentiated between 2 periods: 1994 to 2004 and 2005 to 2014. Results: Prevalence of alcohol consumption declined from 29.6% (95% CI: 27.1 to 32.2) in 1980 to 5.4% (95% CI: 3.7 to 7.6) in 2014, mostly due to the reduction in regular intake. This decline was especially acute between 1980 and 1994. Sporadic and regular consumption increased among women working outside the home, born outside Spain, those whose pregnancy was unplanned, and those reporting using tobacco or other drugs. Comparing 1994 to 2004 versus 2005 to 2014, a stronger association was observed between regular alcohol consumption and tobacco consumption in the latter period (interaction p = 0.003). Conclusions: Alcohol consumption among expectant mothers has declined substantially in the last 35 years. However, it is worth highlighting the significant and substantial associations between alcohol use and consumption of tobacco, which have become stronger in the most recent years.
Iberian wild leporidae as hosts of zoonotic enteroparasites in Mediterranean ecosystems of Southern Spain.
(Wiley, 2023-05) Rego, Laura; Castro-Scholten, Sabrina; Cano, Carmen; Jiménez-Martín, Débora; Köster, Pamela Carolina; Caballero-Gómez, Javier; Bailo-Barroso, Begoña; Dashti, Alejandro; Hernández-Castro, Carolina; Cano-Terriza, David; Vioque, Fátima; Maloney, Jenny G; Santín, Mónica; García-Bocanegra, Ignacio; Carmena, David; Gonzalez-Barrio, David; Ministerio de Ciencia, Innovación y Universidades (España); Ministerio de Ciencia e Innovación (España); Centro de Investigación Biomédica en Red - CIBERINFEC (Enfermedades Infecciosas); Instituto de Salud Carlos III; Unión Europea. Comisión Europea. NextGenerationEU; Ministerio de Economía y Competitividad (España); United States Department of Agriculture; Fundación Carolina; University of Antioquia (Colombia); Ministerio de Universidades (España); University of Córdoba (España)
Wild lagomorphs including rabbits and hares can act as natural carriers or reservoirs of bacterial and parasitic zoonotic diseases. However, little is known on the epidemiology and potential public health significance of intestinal eukaryotes in wild leporids. We examined faecal samples from European wild rabbits (Oryctolagus cuniculus, n = 438) and Iberian hares (Lepus granatensis, n = 111) collected in the Autonomous Region of Andalusia in southern Spain during 2012-2021. We searched for the presence of DNA from the main intestinal protist and microsporidial pathogens of veterinary and public health concerns using molecular methods (PCR followed by Sanger and next-generation sequencing). Giardia duodenalis was the most prevalent species found (27.8%, 153/550; 95% CI: 24.1-31.8), followed by Cryptosporidium spp. (1.3%, 7/550; 95% CI: 0.5-2.6), Blastocystis sp. (1.1%, 6/550; 95% CI: 0.4-2.4) and Encephalitozoon intestinalis (0.2%, 1/550; 95% CI: 0.0-10.1). All samples tested negative for Enterocytozoon bieneusi. Sequence analyses revealed the presence of sub-assemblage BIV (n = 1) within G. duodenalis, and Cryptosporidium cuniculus (n = 6) and Cryptosporidium andersoni (n = 1) within Cryptosporidium. The presence of ruminant-adapted C. andersoni is indicative of a potential cross-species transmission event, although a spurious infection (mechanical carriage) cannot be ruled out. Samples assigned to C. cuniculus belonged to the gp60 subtype families Va (n = 3) and Vb (n = 2). The six Blastocystis-positive samples were identified as ST2 (n = 3) and ST1 + ST2 (n = 3). Our molecular results suggest that wild rabbits and hares were primarily infected by leporid-adapted species of eukaryotic pathogens. However, the occasional findings of zoonotic G. duodenalis sub-assemblage BIV, Blastocystis sp. ST1 and ST2, and Encephalitozoon intestinalis could be of public health relevance.
Areas for Improvement and Barriers Identified in Measuring the Quality of Nursing Care: Perceptions of Patients and Professionals
(Multidisciplinary Digital Publishing Institute (MDPI), 2024-10-09) Company-Sancho, María Consuelo; Rich-Ruiz, Manuel; Guillen Toledano, Marta; Cairós-Ventura, Luis-Miguel; Gil Perez, Josefa D; de Pascual y Medina, Ana María; Peláez Alba, María Pilar; Barreno Estévez, Ana Isabel; Alonso Poncelas, María Emma; Rodríguez Orihuela, Carolina; Brito-Brito, Pedro-Ruymán; Fundación Instituto Canario de Investigaciones Sanitarias
Background: Quality indicators in healthcare are essential to raising awareness about the appropriateness of nursing care. However, identifying the key indicators continues to pose a challenge, above all if one wants to include users and professionals. Aim: Identify which aspects of nursing care should be measured to assess the results of nursing care and how to do so. Methodology: Interpretive qualitative exploratory study. The participants were users and professionals of an autonomous regional health service in Spain. The information was collected by means of two focus groups and eight semi-structured interviews conducted between November 2022 and March 2024. The data were analysed thematically using the Braun and Clarke process. Results: The users and professionals agreed on the need to measure emotional skills and attitudes such as empathy, respect, and warmth when dealing with patients. The professionals highlighted workload and inefficiency of the current record system as barriers to adequately reflecting their work. They proposed improvements in the recording tool and the need for more human resources, as well as leadership that is more focused on quality. Conclusions: It is crucial to develop indicators that reflect both the emotional and technical aspects of nursing care. The participation by patients and professionals alike in this design and selection will make it possible to improve the quality of care and advances in the nursing profession. This study was not registered.
Metabolic and mitochondria alterations induced by SARS-CoV-2 accessory proteins ORF3a, ORF9b, ORF9c and ORF10
(Wiley, 2024-07) López-Ayllón, Blanca D; Marin, Silvia; Fariñas Fernández, Marco; García-García, Tránsito; Fernández-Rodríguez, Raúl; de Lucas-Rius, Ana; Redondo, Natalia; Mendoza-García, Laura; Foguet, Carles; Grigas, Juozas; Calvet, Alba; Villalba, José Manuel; Rodríguez, María Josefa; Megías, Diego; Mandracchia, Biagio; Luque, Daniel; Lozano, Juan José; Calvo, Cristina; Merino Herrán, Unai; Thomson, Timothy M; Garrido, Juan J; Cascante, Marta; Montoya, Maria; López-Ayllón, Blanca D; Marin, Silvia; Fariñas Fernández, Marco; García-García, Tránsito; Fernández-Rodríguez, Raúl; de Lucas-Rius, Ana; Redondo, Natalia; Mendoza-García, Laura; Foguet, Carles; Grigas, Juozas; Calvet, Alba; Villalba, José Manuel; Megías, Diego; Mandracchia, Biagio; Luque, Daniel; Lozano, Juan José; Calvo, Cristina; Merino Herrán, Unai; Thomson, Timothy M; Garrido, Juan J; Cascante, Marta; Montoya, María; Unión Europea. Comisión Europea. NextGenerationEU; Consejo Superior de Investigaciones Científicas (España); Regional Government of Andalusia (España); Ministerio de Ciencia (España); Agència de Gestió d´Ajuts Universitaris i de Recerca (AGAUR); Institució Catalana de Recerca i Estudis Avançats; Instituto de Salud Carlos III; Agencia Estatal de Investigación (España)
Antiviral signaling, immune response and cell metabolism are dysregulated by SARS-CoV-2, the causative agent of COVID-19. Here, we show that SARS-CoV-2 accessory proteins ORF3a, ORF9b, ORF9c and ORF10 induce a significant mitochondrial and metabolic reprogramming in A549 lung epithelial cells. While ORF9b, ORF9c and ORF10 induced largely overlapping transcriptomes, ORF3a induced a distinct transcriptome, including the downregulation of numerous genes with critical roles in mitochondrial function and morphology. On the other hand, all four ORFs altered mitochondrial dynamics and function, but only ORF3a and ORF9c induced a marked alteration in mitochondrial cristae structure. Genome-Scale Metabolic Models identified both metabolic flux reprogramming features both shared across all accessory proteins and specific for each accessory protein. Notably, a downregulated amino acid metabolism was observed in ORF9b, ORF9c and ORF10, while an upregulated lipid metabolism was distinctly induced by ORF3a. These findings reveal metabolic dependencies and vulnerabilities prompted by SARS-CoV-2 accessory proteins that may be exploited to identify new targets for intervention.
What is needed to achieve HCV microelimination among HIV-infected populations in Andalusia, Spain: a modeling analysis.
(2020-08-08) Skaathun, Britt; Borquez, Annick; Rivero-Juarez, Antonio; Mehta, Sanjay R; Tellez, Francisco; Castaño-Carracedo, Manuel; Merino, Dolores; Palacios, Rosario; Mac�as, Juan; Rivero, Antonio; Martin, Natasha K
Background: Scale-up of hepatitis C virus (HCV) treatment for HIV/HCV coinfected individuals is occurring in Spain, the vast majority (> 85%) with a reported history of injecting drug use and a smaller population of co-infected men who have sex with men (MSM). We assess impact of recent treatment scale-up to people living with HIV (PLWH) and implications for achieving the WHO HCV incidence elimination target (80% reduction 2015-2030) among PLWH and overall in Andalusia, Spain, using dynamic modeling. Methods: A dynamic transmission model of HCV/HIV coinfection was developed. The model was stratified by people who inject drugs (PWID) and MSM. The PWID component included dynamic HCV transmission from the HCV-monoinfected population. The model was calibrated to Andalusia based on published data and the HERACLES cohort (prospective cohort of HIV/HCV coinfected individuals representing > 99% coinfected individuals in care in Andalusia). From HERACLES, we incorporated HCV treatment among diagnosed PLWH of 10.5%/year from 2004 to 2014, and DAAs at 33%/year from 2015 with 94.8% SVR. We project the impact of current and scaled-up HCV treatment for PLWH on HCV prevalence and incidence among PLWH and overall. Results: Current treatment rates among PLWH (scaled-up since 2015) could substantially reduce the number of diagnosed coinfected individuals (mean 76% relative reduction from 2015 to 2030), but have little impact on new diagnosed coinfections (12% relative reduction). However, DAA scale-up to PWLH in 2015 would have minimal future impact on new diagnosed coinfections (mean 9% relative decrease from 2015 to 2030). Similarly, new cases of HCV would only reduce by a mean relative 29% among all PWID and MSM due to ongoing infection/reinfection. Diagnosing/treating all PLWH annually from 2020 would increase the number of new HCV infections among PWLH by 28% and reduce the number of new HCV infections by 39% among the broader population by 2030. Conclusion: Targeted scale-up of HCV treatment to PLWH can dramatically reduce prevalence among this group but will likely have little impact on the annual number of newly diagnosed HIV/HCV coinfections. HCV microelimination efforts among PWLH in Andalusia and settings where a large proportion of PLWH have a history of injecting drug use will require scaled-up HCV diagnosis and treatment among PLWH and the broader population at risk.
E-cadherin expression is associated with somatostatin analogue response in acromegaly.
(2019-03-06) Venegas-Moreno, Eva; Flores-Martinez, Alvaro; Dios, Elena; Vazquez-Borrego, Mari C; Ibañez-Costa, Alejandro; Madrazo-Atutxa, Ainara; Japón, Miguel A; Castaño, Justo P; Luque, Raúl M; Cano, David A; Soto-Moreno, Alfonso
Acromegaly is a rare disease resulting from hypersecretion of growth hormone (GH) and insulin-like growth factor 1 (IGF1) typically caused by pituitary adenomas, which is associated with increased mortality and morbidity. Somatostatin analogues (SSAs) represent the primary medical therapy for acromegaly and are currently used as first-line treatment or as second-line therapy after unsuccessful pituitary surgery. However, a considerable proportion of patients do not adequately respond to SSAs treatment, and therefore, there is an urgent need to identify biomarkers predictors of response to SSAs. The aim of this study was to examine E-cadherin expression by immunohistochemistry in fifty-five GH-producing pituitary tumours and determine the potential association with response to SSAs as well as other clinical and histopathological features. Acromegaly patients with tumours expressing low E-cadherin levels exhibit a worse response to SSAs. E-cadherin levels are associated with GH-producing tumour histological subtypes. Our results indicate that the immunohistochemical detection of E-cadherin might be useful in categorizing acromegaly patients based on the response to SSAs.
Role of p63 and p73 isoforms on the cell death in patients with hepatocellular carcinoma submitted to orthotopic liver transplantation.
(2017-03-28) González, Raúl; De la Rosa, Ángel J; Rufini, Alessandro; Rodríguez-Hernández, María A; Navarro-Villarán, Elena; Marchal, Trinidad; Pereira, Sheila; De la Mata, Manuel; Müller-Schilling, Martina; Pascasio-Acevedo, Juan M; Ferrer-Ríos, María T; Gómez-Bravo, Miguel A; Padillo, Francisco J; Muntané, Jordi
Background & aims: Patients with hepatocellular carcinoma (HCC) submitted to orthotopic liver transplantation (OLT) have a variable 5-year survival rate limited mostly by tumor recurrence. The etiology, age, sex, alcohol, Child-Pugh, and the immunesuppressor have been associated with tumour recurrence. The expression of ΔNp73 is related to the reduced survival of patients with HCC. The study evaluated the expression of p63 and p73 isoforms and cell death receptors, and their relation to tumour recurrence and survival. The results were in vitro validated in HCC cell lines. Methods: HCC sections from patients submitted to OLT were used. The in vitro study was done in differentiated hepatitis B virus (HBV)-expressing Hep3B and control HepG2 cells. The expression of cell death receptors and cFLIPS/L, caspase-8 and -3 activities, and cell proliferation were determined in control and p63 and p73 overexpressing HCC cells. Results: The reduced tumor expression of cell death receptors and TAp63 and TAp73, and increased ΔNp63 and ΔNp73 expression were associated with tumor recurrence and reduced survival. The in vitro study demonstrated that HBV-expressing Hep3B vs HepG2 cells showed reduced expression of p63 and p73, cell death receptors and caspase activation, and increased cFLIPL/cFLIPS ratio. The overexpression of TAp63 and TAp73 exerted a more potent pro-apoptotic and anti-proliferative effects in Hep3B than HepG2-transfected cells which was related to cFLIPL upregulation. Conclusions: The reduction of TAp63 and TAp73 isoforms, rather than alteration of ΔN isoform expression, exerted a significant functional repercussion on cell death and proliferation in HBV-expressing HepB cells.
Learning, internalisation and integration of the COVID-19 pandemic in healthcare workers: A qualitative document analysis
(Wiley, 2024-09-19) Abad-Corpa, Eva; Rich-Ruiz, Manuel; Sánchez-López, Dolores; Solano Ruiz, Carmen; Casado-Ramirez, Elvira; Arregui-Gallego, Beatriz; Moreno-Casbas, Teresa; Muñoz-Jiménez, Daniel; Vidal-Thomàs, María Clara; Company-Sancho, María Consuelo; Orts-Cortes, Maria Isabel; Fundación BBVA
The COVID-19 pandemic triggered an unprecedented health crisis that impacted healthcare systems worldwide. This study explores how Spanish healthcare workers learned, internalised and integrated values and work behaviours during the COVID-19 pandemic and their impact on the personal sphere. This documentary research, using images, narratives and audiovisual content, was framed within the interpretative hermeneutic paradigm. Categories and subcategories emerged after a final theoretical sampling that focused on the analysis. Data triangulation between researchers favoured theoretical saturation. A total of 117 images and 27 texts were selected. The analysis identified three stages: bewilderment, seeking functionality in the chaos and integrating chaos into care. The data reflects how the need for security and knowledge, and the exhaustion and frustration caused by the initial working conditions, prompted adaptive responses. These responses involved focusing on problem-solving and strengthening group sentiments and solidarity. Subsequently, the data indicates the acceptance of new structural, organisational and communication aspects. The findings of the analysis will contribute towards finding a framework that can help understand community health crisis events.
Efficacy of the Otago-Exercise-Programme to reduce falls in community-dwelling adults aged 65-80 when delivered as group or individual training: Non-inferiority-clinical-trial
(BioMed Central (BMC), 2024-10-01) Albornos-Muñoz, Laura; Blanco-Blanco, Joan; Cidoncha-Moreno, María Ángeles; Abad-Corpa, Eva; Rivera-Álvarez, Araceli; López-Pisa, Rosa María; Caperos, José-Manuel; Otago Project Working Group Consortium; Moreno-Casbas, Teresa; Rich-Ruiz, Manuel; Rodriguez Baz; Agencia Estatal de Investigación (España); Instituto de Salud Carlos III; Fundación para la Formación e Investigación Sanitarias de la Región de Murcia; Basque Foundation for Health Innovation and Research
Background: The Otago Exercise Programme is an effective intervention for falls prevention. However, there is limited evidence in relation to studies that compare efficacy for falls prevention when delivered Otago Exercise Programme in a group or individual format in a primary care context. Objective: To compare the Otago Exercise Programme delivered as a group vs. individual format for community dwelling older adults, over a one year period. The hypothesis was that neither format would be inferior to the other. Methods: DESIGN: A four-year multicentre, randomized, non-inferiority clinical trial, with two arms- Otago Exercise Programme group training and individual Otago exercise training. Setting(s): 21 primary healthcare centers. Participants: A sample size of 728 participants was established. Participants were aged between 65 and 80 years; living in the community; able to walk independently; and agreed to take part in the study and provided signed informed consent. Intervention: The Otago Exercise Programme was delivered mainly by nurses in primary care, with five face to face sessions, and a reinforcement 6 months later. Participants were encouraged to exercise at home between face to face sessions. Data collection: at baseline and after 6 and 12 months from October 2017 to 2020. Primary outcome: people who reported at least one fall. Secondary outcomes: number of falls, cause of falls, consequences and assistance, adherence and satisfaction. Group allocation was blinded to the researchers involved in analysis. Reporting: Consolidated Standards of Reporting Trials recommendations for the Statement for Randomized Trials of Nonpharmacologic Treatments. Results: Eight hundred twenty-seven participants were randomized (226 were allocated in group training and 272 in individual training). The analysis of the proportion of people who reported at least one fall and number of falls showed no differences between individual and group training. Assessment of the equivalence between the interventions at 12 months showed that the confidence interval for the difference of people who reported at least one fall was found to be within the equivalence limit of 10% considered. However, in those participants with a previous history of falls, group format showed potentially greater benefit. The participants in individual training presented higher scores on the Exercise Adherence Rating Scale test. No differences were found in satisfaction between the groups. Conclusions: The group Otago Exercise Programme is equivalent to individually delivered Otago Exercise Programme in terms of prevention of falls over a 12-month follow up. Adherence was higher in individual training. Implications: Healthcare professionals could offer either Otago Exercise Programme format dependent on patient preference and be confident that that standardized intervention provides patient benefit. Trial registration: ClinicalTrials.gov (NCT03320668). Data registration 31/10/2017.
Active listening, shared decision-making and participation in care among older women and primary care nurses: a critical discourse analysis approach from a gender perspective
(BioMed Central (BMC), 2024-06-17) Martínez-Angulo, Pablo; Rich-Ruiz, Manuel; Jiménez-Mérida, M Rocío; López-Quero, Salvador
Background: Nursing care for older women represent a challenge worldwide due to its characteristics. When communication is impaired between primary care nurses and older women living alone, an imbalance in power relations occurs. The main objective of this study is to analyse the power relations between older women and primary care nurses in situations of active listening, shared decision-making and participation in care. Methods: We developed a qualitative study in southern Spain using a discursive and gender approach. We used purposeful sampling to interview older women who lived alone and received home nursing care. Simultaneously, we conducted focus groups with primary care nurses who provided home care to older women. A linguistic analysis of the transcripts was carried out. Results: Nine semi-structured face-to-face interviews were conducted with older women who lived alone and two face-to-face focus groups with four primary care nurses in each. The discourse of the participants demonstrated an imbalance in power relations. Influenced by work overload, active listening was considered a privilege in primary care nurses´ discourse. Regarding shared decision-making, older women´s discourses revealed "mirages" of real situations where they thought they were deciding. Participation in care was difficult since older women saw themselves as a nuisance in nurses´ presence, and primary care nurses did not facilitate older women's engagement. Older women weren´t considered when organising home visits and had interiorised a subordinated feeling. Similarly, a strict sense of identity made primary care nurses feel powerful in their relationships with older women. Conclusions: The discourse of older women represented them as victims of a hostile panorama whilst they were sometimes satisfied with the deficient care received. The discourse of primary care nurses used more discursive strategies to represent themselves as professionals committed to caring. However, it also revealed deficiencies in care, discriminatory elements, and feelings of being limited by their working conditions. Active listening to older women and engagement in decision-making readjust empower the older women. Attending to the needs and concerns of primary care nurses could recalibrate the power imbalance between them and healthcare organisations.
Microbial Phenolic Metabolites Are Associated with Improved Cognitive Health
(Wiley, 2024-01) Domínguez-López, Inés; Galkina, Polina; Parilli-Moser, Isabella; Arancibia-Riveros, Camila; Martínez-González, Miguel Ángel; Salas-Salvado, Jordi; Corella, Dolores; Malcampo, Mireia; Martínez, J Alfredo; Tojal-Sierra, Lucas; Wärnberg, Julia; Vioque, Jesus; Romaguera, Dora; López-Miranda, José; Estruch, Ramon; Tinahones, Francisco J; Santos-Lozano, José Manuel; Serra-Majem, Lluis; Bueno-Cavanillas, Aurora; Tur, Josep A; Rubín-García, María; Pintó, Xavier; Fernández-Aranda, Fernando; Delgado-Rodríguez, Miguel; Barabash-Bustelo, Ana; Vidal, Josep; Vazquez, Clotilde; Daimiel, Lidia; Ros, Emilio; Toledo, Estefanía; Atzeni, Alessandro; Asensio, Eva M; Vera, Natàlia; Garcia-Rios, Antonio; Torres-Collado, Laura; Pérez-Farinós, Napoleón; Zulet, Marian; Chaplin, Alice; Casas, Rosa; Martín-Peláez, Sandra; Vaquero-Luna, Jessica; Gómez-Pérez, Ana Maria; Vazquez-Ruiz, Zenaida; Shyam, Sangeetha; Ortega-Azorín, Carolina; Talens, Natàlia; Peña-Orihuela, Patricia J; Oncina-Canovas, Alejandro; Diez-Espino, Javier; Babio, Nancy; Fitó, Montserrat; Lamuela-Raventós, Rosa M
Scope: Diets rich in polyphenols has been associated with better cognitive performance. The aim of this study is to assess the relationship between microbial phenolic metabolites (MPM) in urine and cognition in the context of an older population at high cardiovascular risk. Methods and results: A cross-sectional analysis is conducted in 400 individuals of the PREDIMED-Plus study. Liquid chromatography coupled to mass spectrometry is used to identify urinary MPM. Mediterranean diet (MedDiet) adherence is estimated with a 17-item questionnaire and cognitive function is evaluated with a battery of neuropsychological tests. Multivariable-adjusted linear regression models are fitted to assess the relationship of urinary MPM with the MedDiet and cognitive tests. Protocatechuic acid and enterolactone glucuronide are associated with higher adherence to the MedDiet. Regarding cognitive function, protocatechuic acid, vanillic acid glucuronide, 3-hydroxybenzoic acid, enterodiol glucuronide, and enterolactone glucuronide are directly associated with a global composite score of all the cognitive tests. Furthermore, protocatechuic acid and enterolactone glucuronide are associated with higher scores in the Mini-Mental State Examination, whereas enterodiol glucuronide is associated with improved Clock Drawing Test scores. Conclusions: These results suggest that the MedDiet is linked to MPM associated with better cognitive performance in an older population.
Association between type 2 diabetes and depressive symptoms after a 1-year follow-up in an older adult Mediterranean population
(Springer, 2024-01-13) Baenas, I; Camacho-Barcia, L; Granero, R; Razquin, C; Corella, D; Gómez-Martínez, Carlos; Castañer-Niño, O; Martínez, JA; Alonso-Gómez, ÁM; Wärnberg, Julia; Vioque, Jesus; Romaguera, Dora; López-Miranda, J; Estruch, R; Tinahones, Francisco J; Lapetra, J; Serra-Majem, Lluis; Cano-Ibáñez, N; Tur, Josep A; Martín-Sánchez, V; Pintó, X; Gaforio, J J; Matía-Martín, P; Vidal, Josep; Vazquez, Clotilde; Daimiel, L; Ros, Emilio; Jiménez-Murcia, S; Dalsgaard, S; Garcia-Arellano, A; Babio, N; Sorli, Jose V; Lassale, C; García-de-la-Hera, M; Gómez-García, E; Zulet, MA; Konieczna, Jadwiga; Martín-Peláez, S; Tojal-Sierra, Lucas; Basterra-Gortari, FJ; de Las Heras-Delgado, S; Portoles, O; Muñoz-Pérez, MÁ; Arenas-Larriva, AP; Compañ-Gabucio, L; Eguaras, S; Shyam, Sangeetha; Fitó, M; Baños, RM; Salas-Salvado, Jordi; Fernández-Aranda, F
Objectives: To examine the cross-sectional association between baseline depressive symptoms and the presence of type 2 diabetes (T2D), and its association with glycated hemoglobin (HbA1c) and other metabolic variables, and the prospective association of depressive symptoms and HbA1c after 1 year of follow-up. Methods: n = 6224 Mediterranean older adults with overweight/obesity and metabolic syndrome (48% females, mean age 64.9 ± 4.9 years) were evaluated in the framework of the PREDIMED-Plus study cohort. Depressive symptoms were assessed using the Beck Depression Inventory-II and HbA1c was used to measure metabolic control. Results: The presence of T2D increased the likelihood of higher levels of depressive symptoms (χ2 = 15.84, p = 0.001). Polynomial contrast revealed a positive linear relationship (χ2 = 13.49, p = 0.001), the higher the depressive symptoms levels, the higher the prevalence of T2D. Longitudinal analyses showed that the higher baseline depressive symptoms levels, the higher the likelihood of being within the HbA1c ≥ 7% at 1-year level (Wald-χ2 = 24.06, df = 3, p < .001, for the full adjusted model). Additionally, depressive levels at baseline and duration of T2D predicted higher HbA1c and body mass index, and lower physical activity and adherence to Mediterranean Diet at 1 year of follow-up. Conclusions: This study supports an association between T2D and the severity of depressive symptoms, suggesting a worse metabolic control from mild severity levels in the short-medium term, influenced by lifestyle habits related to diabetes care. Screening for depressive symptoms and a multidisciplinary integrative therapeutic approach should be ensured in patients with T2D.

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