PublicationUtility of PHQ-2, PHQ-8 and PHQ-9 for detecting major depression in primary health care: a validation study in Spain.(2022-10-19) Gómez-Gómez, Irene; Benítez, Isabel; Bellón, Juan; Moreno-Peral, Patricia; Oliván-Blázquez, Bárbara; Clavería, Ana; Zabaleta-Del-Olmo, Edurne; Llobera, Joan; Serrano-Ripoll, Maria J; Tamayo-Morales, Olaya; Motrico, EmmaPrimary health care (PHC) professionals may play a crucial role in improving early diagnosis of depressive disorders. However, only 50% of cases are detected in PHC. The most widely used screening instrument for major depression is the Patient Health Questionnaire (PHQ), including the two-, eight- and nine-item versions. Surprisingly, there is neither enough evidence about the validity of PHQ in PHC patients in Spain nor indications about how to interpret the total scores. This study aimed to gather validity evidence to support the use of the three PHQ versions to screen for major depression in PHC in Spain. Additionally, the present study provided information for helping professionals to choose the best PHQ version according to the context. The sample was composed of 2579 participants from 22 Spanish PHC centers participating in the EIRA-3 study. The reliability and validity of the three PHQ versions for Spanish PHC patients were assessed based on responses to the questionnaire. The PHQ-8 and PHQ-9 showed high internal consistency. The results obtained confirm the theoretically expected relationship between PHQ results and anxiety, social support and health-related QoL. A single-factor solution was confirmed. Regarding to the level of agreement with the CIDI interview (used as the criterion), our results indicate that the PHQ has a good discrimination power. The optimal cut-off values were: ⩾2 for PHQ-2, ⩾7 for PHQ-8 and ⩾8 for PHQ-9. PHQ is a good and valuable tool for detecting major depression in PHC patients in Spain. PublicationDrone Applications for Emergency and Urgent Care: A Systematic Review.(2022-06-09) Sanz-Martos, Sebastián; López-Franco, María Dolores; Álvarez-García, Cristina; Granero-Moya, Nani; López-Hens, José María; Cámara-Anguita, Sixto; Pancorbo-Hidalgo, Pedro Luis; Comino-Sanz, Inés MaríaIn recent years, the use of drones in health emergencies has increased. Among their main benefits are avoiding endangering rescuers, travelling long distances in a short time, or contacting victims in risky situations; but despite their multiple advantages, their use has not been fully demonstrated. This study aims to identify the available evidence on the use of drones in emergency health care compared to traditional health care. Systematic review of the literature was conducted. Search protocols were developed to locate studies that met the established selection criteria. Six experimental or quasi-experimental studies with high methodological quality published from the beginning of indexing until 2020 were included. Drones covered a significantly larger area than other traditional tracking methods and were very useful for performing preliminary triage, determining needs, and knowing the scene prior to the arrival of rescuers. In addition, drones reduced the time required to locate the victim. Drones are an element to be taken into account when attending health emergencies as they significantly improve the distance travelled to locate accident victims, have the possibility of performing triage prior to the arrival of the health care units, and improve the time and quality of the care provided. PublicationPublic Perception of Organ Donation and Transplantation Policies in Southern Spain.(2022-03-15) Díaz-Cobacho, Gonzalo; Cruz-Piqueras, Maite; Delgado, Janet; Hortal-Carmona, Joaquín; Martínez-López, M Victoria; Molina-Pérez, Alberto; Padilla-Pozo, Álvaro; Ranchal-Romero, Julia; Rodríguez-Arias, DavidThis research explores how public awareness and attitudes toward donation and transplantation policies may contribute to Spain's success in cadaveric organ donation. A representative sample of 813 people residing in Andalusia (Southern Spain) were surveyed by telephone or via Internet between October and December 2018. Most participants trust Spain's donation and transplantation system (93%) and wish to donate their organs after death (76%). Among donors, a majority have expressed their consent (59%), and few nondonors have expressed their refusal (14%). Only a minority are aware of the presumed consent system in force (28%) and feel sufficiently informed regarding the requirements needed to be an organ donor (16%). Participants mainly consider that relatives should represent the deceased's preferences and be consulted when the deceased's wishes are unknown, as is the case in Spain. Public trust in the transplant system may contribute to Spain's high performance in organ donation. High levels of societal support toward organ donation and transplantation do not correspond with similar levels of public awareness of donation and transplantation policies in Spain. PublicationChondroitin and Dermatan Sulfate Bioinks for 3D Bioprinting and Cartilage Regeneration.(2022-01-22) Lafuente-Merchan, Markel; Ruiz-Alonso, Sandra; Zabala, Alaitz; Gálvez-Martín, Patricia; Marchal, Juan Antonio; Vázquez-Lasa, Blanca; Gallego, Idoia; Saenz-Del-Burgo, Laura; Pedraz, Jose LuisCartilage is a connective tissue which a limited capacity for healing and repairing. In this context, osteoarthritis (OA) disease may be developed with high prevalence in which the use of scaffolds may be a promising treatment. In addition, three-dimensional (3D) bioprinting has become an emerging additive manufacturing technology because of its rapid prototyping capacity and the possibility of creating complex structures. This study is focused on the development of nanocellulose-alginate (NC-Alg) based bioinks for 3D bioprinting for cartilage regeneration to which it is added chondroitin sulfate (CS) and dermatan sulfate (DS). First, rheological properties are evaluated. Then, sterilization effect, biocompatibility, and printability on developed NC-Alg-CS and NC-Alg-DS inks are evaluated. Subsequently, printed scaffolds are characterized. Finally, NC-Alg-CS and NC-Alg-DS inks are loaded with murine D1-MSCs-EPO and cell viability and functionality, as well as the chondrogenic differentiation ability are assessed. Results show that the addition of both CS and DS to the NC-Alg ink improves its characteristics in terms of rheology and cell viability and functionality. Moreover, differentiation to cartilage is promoted on NC-Alg-CS and NC-Alg-DS scaffolds. Therefore, the utilization of MSCs containing NC-Alg-CS and NC-Alg-DS scaffolds may become a feasible tissue engineering approach for cartilage regeneration. PublicationPatient access to and ethical considerations of the application of the European Union hospital exemption rule for advanced therapy medicinal products.(2022-05-08) Cuende, Natividad; Ciccocioppo, Rachele; Forte, Miguel; Galipeau, Jacques; Ikonomou, Laertis; Levine, Bruce L; Srivastava, Alok; Zettler, Patricia JHospital exemption (HE) is a regulated pathway that allows the use of advanced therapy medicinal products (ATMPs) within the European Union (EU) under restrictive conditions overseen by national medicine agencies. In some EU countries, HE is granted for ATMPs with no demonstrated safety and efficacy; therefore, they are equivalent to investigational drugs. In other countries, HE is granted for ATMPs with demonstrated quality, safety and efficacy and for which centralized marketing authorization has not been requested. The Committee on the Ethics of Cell and Gene Therapy of the International Society for Cell & Gene Therapy reflects here on the ethical issues concerning HE application from the perspective of the patient, including risk-benefit balance, accessibility and transparency, while providing evidence that HE must not be regarded as a conduit for unproven and unethical ATMP-based interventions. Indeed, HE represents a legal instrument under which a patient's need for access to novel ATMPs is reconciled with ethics. Moreover, for some unmet medical needs, HE is the only pathway for accessing innovative ATMPs. Nonetheless, HE harmonization across EU Member States and limitations of ATMP use under the HE rule when similar products have already been granted centralized marketing authorization to avoid a parallel regulatory pathway are controversial issues whose political and economic consequences are beyond the scope of this review. Finally, the institution of an EU registry of HE applications and outcomes represents a priority to improve transparency, reduce patient risks, increase efficiency of health systems, facilitate company awareness of business opportunities and boost progressive entry of ATMPs into the therapeutic repertoire of health systems. PublicationTelemedicine management of systemic therapy with isotretinoin of patients with moderate-to-severe acne during the COVID-19 pandemic: A longitudinal prospective feasibility study.(2022-03-07) Moreno-Ramírez, David; Duarte-Ferreras, Miguel A; Ojeda-Vila, Teresa; García-Morales, Irene; Conejo-Mir, Maria D; Fernández-Orland, Almudena; Sánchez-Del-Campo, Ana I; Eiris, Noemí; Carrizosa, Ana M; Ruiz-de-Casas, Andrés; de-la-Torre, Jose M; Herrerías-Esteban, Juan M; Ferrándiz, Lara PublicationPatients with periodontitis and erectile dysfunction suffer a greater incidence of major adverse cardiovascular events: A prospective study in a Spanish population.(2022-01-19) Mesa, Francisco; Arrabal-Polo, Miguel Angel; Magan-Fernandez, Antonio; Arrabal, Miguel; Martin, Amada; Muñoz, Ricardo; Rodriguez-Agurto, Alejandro; Bravo, ManuelPeriodontitis and erectile dysfunction (ED) have been linked with cardiovascular disease. The association of periodontitis and ED with the occurrence of major adverse cardiovascular events has not been previously assessed. The aim of this study was to determine if the presence of periodontitis and ED has any effect on the incidence of major adverse cardiovascular events. Male patients that attended the Urology service were enrolled in a prospective study. Erectile dysfunction was diagnosed according to the International Index of Erectile Function. Sociodemographic data and periodontal clinical parameters were gathered (pocket probing depth, clinical attachment loss, bleeding on probing (BoP), plaque index and number of teeth) at baseline. Major adverse cardiovascular events occurred both before and during the follow-up time were registered. Bivariate analyses, as well as a multivariate analysis were performed, adjusting for potential confounders. A total of 158 patients were included, with a mean follow-up of 4.2 years. A greater number of major adverse cardiovascular events occurred in the group that presented periodontitis and ED (P = 0.038). After adjusting by age and previous cardiovascular disease in the multivariate analysis, the annual major adverse cardiovascular event rate was estimated to be 3.7 times higher in the same group (P = 0.049). Other periodontal clinical variables together with ED supported these results and were close to statistical significance. Patients with periodontitis and ED, adjusted by age and a cardiovascular disease, showed 3.7 times more risk of suffering major adverse cardiovascular events after mean follow-up of 4.2 years. PublicationAssociation of Rare APOE Missense Variants V236E and R251G With Risk of Alzheimer Disease.(2022) Le Guen, Yann; Belloy, Michael E; Grenier-Boley, Benjamin; de Rojas, Itziar; Castillo-Morales, Atahualpa; Jansen, Iris; Nicolas, Aude; Bellenguez, Céline; Dalmasso, Carolina; Küçükali, Fahri; Eger, Sarah J; Rasmussen, Katrine Laura; Thomassen, Jesper Qvist; Deleuze, Jean-François; He, Zihuai; Napolioni, Valerio; Amouyel, Philippe; Jessen, Frank; Kehoe, Patrick G; van Duijn, Cornelia; Tsolaki, Magda; Sánchez-Juan, Pascual; Sleegers, Kristel; Ingelsson, Martin; Rossi, Giacomina; Hiltunen, Mikko; Sims, Rebecca; van der Flier, Wiesje M; Ramirez, Alfredo; Andreassen, Ole A; Frikke-Schmidt, Ruth; Williams, Julie; Ruiz, Agustín; Lambert, Jean-Charles; Greicius, Michael D; Members of the EADB, GR@ACE, DEGESCO, DemGene, GERAD, and EADI Groups; Arosio, Beatrice; Benussi, Luisa; Boland, Anne; Borroni, Barbara; Caffarra, Paolo; Daian, Delphine; Daniele, Antonio; Debette, Stéphanie; Dufouil, Carole; Düzel, Emrah; Galimberti, Daniela; Giedraitis, Vilmantas; Grimmer, Timo; Graff, Caroline; Grünblatt, Edna; Hanon, Olivier; Hausner, Lucrezia; Heilmann-Heimbach, Stefanie; Holstege, Henne; Hort, Jakub; Jürgen, Deckert; Kuulasmaa, Teemu; van der Lugt, Aad; Masullo, Carlo; Mecocci, Patrizia; Mehrabian, Shima; de Mendonça, Alexandre; Moebus, Susanne; Nacmias, Benedetta; Nicolas, Gael; Olaso, Robert; Papenberg, Goran; Parnetti, Lucilla; Pasquier, Florence; Peters, Oliver; Pijnenburg, Yolande A L; Popp, Julius; Rainero, Innocenzo; Ramakers, Inez; Riedel-Heller, Steffi; Scarmeas, Nikolaos; Scheltens, Philip; Scherbaum, Norbert; Schneider, Anja; Seripa, Davide; Soininen, Hilkka; Solfrizzi, Vincenzo; Spalletta, Gianfranco; Squassina, Alessio; van Swieten, John; Tegos, Thomas J; Tremolizzo, Lucio; Verhey, Frans; Vyhnalek, Martin; Wiltfang, Jens; Boada, Mercè; García-González, Pablo; Puerta, Raquel; Real, Luis M; Álvarez, Victoria; Bullido, María J; Clarimon, Jordi; García-Alberca, José María; Mir, Pablo; Moreno, Fermin; Pastor, Pau; Piñol-Ripoll, Gerard; Molina-Porcel, Laura; Pérez-Tur, Jordi; Rodríguez-Rodríguez, Eloy; Royo, Jose Luís; Sánchez-Valle, Raquel; Dichgans, Martin; Rujescu, DanThe APOE ε2 and APOE ε4 alleles are the strongest protective and risk-increasing, respectively, genetic variants for late-onset Alzheimer disease (AD). However, the mechanisms linking APOE to AD-particularly the apoE protein's role in AD pathogenesis and how this is affected by APOE variants-remain poorly understood. Identifying missense variants in addition to APOE ε2 and APOE ε4 could provide critical new insights, but given the low frequency of additional missense variants, AD genetic cohorts have previously been too small to interrogate this question robustly. To determine whether rare missense variants on APOE are associated with AD risk. Association with case-control status was tested in a sequenced discovery sample (stage 1) and followed up in several microarray imputed cohorts as well as the UK Biobank whole-exome sequencing resource using a proxy-AD phenotype (stages 2 and 3). This study combined case-control, family-based, population-based, and longitudinal AD-related cohorts that recruited referred and volunteer participants. Stage 1 included 37 409 nonunique participants of European or admixed European ancestry, with 11 868 individuals with AD and 11 934 controls passing analysis inclusion criteria. In stages 2 and 3, 475 473 participants were considered across 8 cohorts, of which 84 513 individuals with AD and proxy-AD and 328 372 controls passed inclusion criteria. Selection criteria were cohort specific, and this study was performed a posteriori on individuals who were genotyped. Among the available genotypes, 76 195 were excluded. All data were retrieved between September 2015 and November 2021 and analyzed between April and November 2021. In primary analyses, the AD risk associated with each missense variant was estimated, as appropriate, with either linear mixed-model regression or logistic regression. In secondary analyses, associations were estimated with age at onset using linear mixed-model regression and risk of conversion to AD using competing-risk regression. A total of 544 384 participants were analyzed in the primary case-control analysis; 312 476 (57.4%) were female, and the mean (SD; range) age was 64.9 (15.2; 40-110) years. Two missense variants were associated with a 2-fold to 3-fold decreased AD risk: APOE ε4 (R251G) (odds ratio, 0.44; 95% CI, 0.33-0.59; P = 4.7 × 10-8) and APOE ε3 (V236E) (odds ratio, 0.37; 95% CI, 0.25-0.56; P = 1.9 × 10-6). Additionally, the cumulative incidence of AD in carriers of these variants was found to grow more slowly with age compared with noncarriers. In this genetic association study, a novel variant associated with AD was identified: R251G always coinherited with ε4 on the APOE gene, which mitigates the ε4-associated AD risk. The protective effect of the V236E variant, which is always coinherited with ε3 on the APOE gene, was also confirmed. The location of these variants confirms that the carboxyl-terminal portion of apoE plays an important role in AD pathogenesis. The large risk reductions reported here suggest that protein chemistry and functional assays of these variants should be pursued, as they have the potential to guide drug development targeting APOE. PublicationOutbreak of Yersinia pseudotuberculosis in capybaras (Hydrochoerus hydrochaeris) kept in captivity.(2022-04-08) Cano-Terriza, David; Beato-Benítez, Adrián; Rodríguez-Sánchez, Belén; Agulló-Ros, Irene; Guerra, Rafael; Jiménez-Martín, Débora; Barbero-Moyano, Jesús; García-Bocanegra, IgnacioOn January 2020, an outbreak of acute mortality was detected in the capybara (Hydrochoerus hydrochaeris) population kept in the Cordoba Zoo Conservation Center (CZCC) in Spain. Morbidity and mortality rates were 71%, and the fatality rate was 100%. Macroscopic examination revealed multifocal nodular lesions with fibrinonecrotic exudate in lungs and mesenteric lymph nodes. Microscopic lesions were characterized as severe acute fibrinopurulent bronchopneumonia and generalized vascular changes. Cultures and biochemical analyses yielded Yersinia pseudotuberculosis (YPT). This species was confirmed by both PCR and MALDI-TOF. This report describes the first outbreak of fatal YPT infection in zoo animals in Spain and confirms that capybaras are highly susceptible to this pathogen, which could be of animal health, conservation, and public health concern. Future studies are warranted to determine potential sources of YTP infection in zoos to prevent future cases in susceptible species, including humans. Publication[Genetic protocol in primary care for rare diseases: Wolfram syndrome as a prototype].(2022-03-16) Esteban-Bueno, Gema; Díaz-Anadón, Lucas Ramón; Rodríguez González, Antonio; Navarro Cabrero, Miguel; Berenguel Hernández, Aída MaríaRare diseases, despite their individual low frequency, affect 7% of the population all combined. Consequently, every primary care practitioner (PCP) will have several of these patients under his care. 80% of rare diseases are genetically determined, which makes genetic counseling fundamental in these cases. The follow-up of patients with Wolfram syndrome (WS) can be used to design a protocol to support these patients, with the participation of researchers and healthcare professionals specialized in WS, the patients themselves and their familial environment. This protocol can be suitable for the diagnosis and management of other diseases as well. The main steps of every genetic clinical procedure are developed in this article, emphasizing the role of PCP in supporting patients and their families and in transmitting genetic information in a comprehensible manner. PublicationDuration of Treatment for Pseudomonas aeruginosa Bacteremia: a Retrospective Study.(2022-05-25) Babich, Tanya; Naucler, Pontus; Valik, John Karlsson; Giske, Christian G; Benito, Natividad; Cardona, Ruben; Rivera, Alba; Pulcini, Celine; Fattah, Manal Abdel; Haquin, Justine; Macgowan, Alasdair; Grier, Sally; Chazan, Bibiana; Yanovskay, Anna; Ami, Ronen Ben; Landes, Michal; Nesher, Lior; Zaidman-Shimshovitz, Adi; McCarthy, Kate; Paterson, David L; Tacconelli, Evelina; Buhl, Michael; Mauer, Susanna; Rodríguez-Baño, Jesús; de Cueto, Marina; Oliver, Antonio; de Gopegui, Enrique Ruiz; Cano, Angela; Machuca, Isabel; Gozalo-Marguello, Monica; Martinez-Martinez, Luis; Gonzalez-Barbera, Eva M; Alfaro, Iris Gomez; Salavert, Miguel; Beovic, Bojana; Saje, Andreja; Mueller-Premru, Manica; Pagani, Leonardo; Vitrat, Virginie; Kofteridis, Diamantis; Zacharioudaki, Maria; Maraki, Sofia; Weissman, Yulia; Paul, Mical; Dickstein, Yaakov; Leibovici, Leonard; Yahav, DafnaThere is no consensus regarding optimal duration of antibiotic therapy for Pseudomonas aeruginosa bacteremia. We aimed to evaluate the impact of short antibiotic course. We present a retrospective multicenter study including patients with P. aeruginosa bacteremia during 2009-2015. We evaluated outcomes of patients treated with short (6-10 days) versus long (11-15 days) antibiotic courses. The primary outcome was a composite of 30-day mortality or bacteremia recurrence and/or persistence. Univariate and inverse probability treatment-weighted (IPTW) adjusted multivariate analysis for the primary outcome was performed. To avoid immortal time bias, the landmark method was used. We included 657 patients; 273 received a short antibiotic course and 384 a long course. There was no significant difference in baseline characteristics of patients. The composite primary outcome occurred in 61/384 patients in the long-treatment group (16%) versus 32/273 in the short-treatment group (12%) (p = 0.131). Mortality accounted for 41/384 (11%) versus 25/273 (9%) of cases, respectively. Length of hospital stay was significantly shorter in the short group [median 13 days, interquartile range (IQR) 9-21 days, versus median 15 days, IQR 11-26 days, p = 0.002]. Ten patients in the long group discontinued antibiotic therapy owing to adverse events, compared with none in the short group. On univariate and multivariate analyses, duration of therapy was not associated with the primary outcome. In this retrospective study, 6-10 days of antibiotic course for P. aeruginosa bacteremia were as effective as longer courses in terms of survival and recurrence. Shorter therapy was associated with reduced length of stay and less drug discontinuation. PublicationRisk factors associated with early mortality after recovery from severe listeriosis: a multicentre 17-year longitudinal study.(2022-06-26) Rivera-Izquierdo, Mario; Galicia-García, María Dolores; Láinez-Ramos-Bossini, Antonio Jesús; Redruello-Guerrero, Pablo; Fernández-Martínez, Nicolás FranciscoListeriosis presents high rates of mortality but prognostic factors for early prevention are not well established. The aim of this study was to analyse factors associated with in-hospital and early mortality of adults after recovery from severe infection caused by Listeria monocytogenes. All cases of listeriosis notified in the province of Granada from January 2005 to December 2021, including 9 centres, were included. Only laboratory confirmed non-neonatal cases were considered. Follow-up was conducted by accessing medical records and epidemiological data. Bivariate and multivariate analyses were conducted to detect potential risk factors associated to in-hospital mortality, 1-year, and 5-year early death after recovery. Multivariate Cox regression models were performed. A total of 206 patients were identified. The mean age was 62.6 years (sd, 18.8). A high frequency of comorbidities (88.3%) was observed, and 42 patients (20.4%) died during hospitalisation. Of the patients who recovered from acute infection, 26 (15.9%) died during the following year and 47 (28.7%) died during the following 5 years. The main factors associated with early mortality after recovery were age (HR: 1.03; 95% CI 1.02-1.07), diabetes mellitus (HR 1.86, 95% CI 1.01-3.44), chronic kidney disease (HR 3.96, 95% CI 1.87-8.38), liver disease (HR 3.62, 95% CI 1.64-8.51), and cancer (HR 3.76, 95% CI 1.90-7.46). Listeriosis is associated with high early post-recovery mortality. Our study describes the main prognostic factors, which may help to improve preventive follow-up strategies of adults with severe listeriosis. PublicationRecent Advances in the Surface Functionalization of PLGA-Based Nanomedicines(Mdpi, 2022-02-01) El-Hammadi, Mazen M.; Arias, Jose L.; [El-Hammadi, Mazen M.] Univ Seville, Fac Pharm, Dept Pharm & Pharmaceut Technol, E-41012 Seville, Spain; [Arias, Jose L.] Univ Granada, Fac Pharm, Dept Pharm & Pharmaceut Technol, E-18071 Granada, Spain; [Arias, Jose L.] Univ Granada, Ctr Biomed Res CIBM, Inst Biopathol & Regenerat Med IBIMER, Granada 18100, Spain; [Arias, Jose L.] Univ Granada, Biosanit Res Inst Granada Ibs GRANADA, Andalusian Hlth Serv SAS, E-18071 Granada, SpainTherapeutics are habitually characterized by short plasma half-lives and little affinity for targeted cells. To overcome these challenges, nanoparticulate systems have entered into the disease arena. Poly( D,L-lactide-co-glycolide) (PLGA) is one of the most relevant biocompatible materials to construct drug nanocarriers. Understanding the physical chemistry of this copolymer and current knowledge of its biological fate will help in engineering efficient PLGA-based nanomedicines. Surface modification of the nanoparticle structure has been proposed as a required functionalization to optimize the performance in biological systems and to localize the PLGA colloid into the site of action. In this review, a background is provided on the properties and biodegradation of the copolymer. Methods to formulate PLGA nanoparticles, as well as their in vitro performance and in vivo fate, are briefly discussed. In addition, a special focus is placed on the analysis of current research in the use of surface modification strategies to engineer PLGA nanoparticles, i.e., PEGylation and the use of PEG alternatives, surfactants and lipids to improve in vitro and in vivo stability and to create hydrophilic shells or stealth protection for the nanoparticle. Finally, an update on the use of ligands to decorate the surface of PLGA nanomedicines is included in the review. PublicationEssential Topics for the Regulatory Consideration of Phages as Clinically Valuable Therapeutic Agents: A Perspective from Spain(Mdpi, 2022-04-01) Vazquez, Roberto; Diez-Martinez, Roberto; Domingo-Calap, Pilar; Garcia, Pedro; Gutierrez, Diana; Muniesa, Maite; Ruiz-Ruigomez, Maria; Sanjuan, Rafael; Tomas, Maria; Angeles Tormo-Mas, Maria; Garcia, Pilar; [Vazquez, Roberto] Univ Ghent, Dept Biotechnol, B-9000 Ghent, Belgium; [Diez-Martinez, Roberto] Telum Therapeut SL, Noain 31110, Spain; [Gutierrez, Diana] Telum Therapeut SL, Noain 31110, Spain; [Domingo-Calap, Pilar] Univ Valencia, Inst Integrat Syst Biol, CSIC, Paterna 46980, Spain; [Sanjuan, Rafael] Univ Valencia, Inst Integrat Syst Biol, CSIC, Paterna 46980, Spain; [Garcia, Pedro] Ctr Biol Res Margarita Salas CIB CSIC, Madrid 28040, Spain; [Garcia, Pedro] Ctr Invest Biomed Red Enfermedades Resp CIBERES, Madrid 28040, Spain; [Muniesa, Maite] Univ Barcelona, Dept Genet Microbiol & Stat, Barcelona 08028, Spain; [Ruiz-Ruigomez, Maria] Hosp Univ 12 Octubre, Infect Dis Unit, Internal Med, Madrid 28041, Spain; [Tomas, Maria] Hosp Univ A Coruna INIBIC CHUAC, Dept Microbiol, SERGAS, La Coruna 15006, Spain; [Tomas, Maria] Soc Infect Dis & Clin Microbiol SEIMC, Study Grp Mech Act & Resistance Antimicrobials GE, Madrid 28003, Spain; [Tomas, Maria] Spanish Network Res Infect Dis REIPI, Seville 41071, Spain; [Tomas, Maria] Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Infecciosas CI, Madrid 28029, Spain; [Angeles Tormo-Mas, Maria] Hosp Univ & Politecn La Fe, Hlth Res Inst Hosp La Fe, IISLaFe, Severe Infect Grp, Valencia 46026, Spain; [Garcia, Pilar] IPLA CSIC, Dairy Res Inst Asturias, Villaviciosa 33300, Spain; [Garcia, Pilar] Hlth Res Inst Asturias ISPA, DairySafe Grp, Oviedo 33011, Spain; MCIN/AEI; Research Foundation-Flanders (FWO); Spanish Ministry of Science and Innovation; Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), an initiative of the Instituto de Salud Carlos III; Ramon y Cajal contract - MCIN/AEI; ESF Invest in your future - Conselleria d'Innovacio, Universitats, Ciencia i Societat Digital (Generalitat Valenciana); VLC-Biomed (UV-La Fe 2020 Programa Acciones Preparatorias); Spanish Ministry of Science and Innovation/Agencia Estatal de Investigacion (AEI)/European regional fund (ERF)Antibiotic resistance is one of the major challenges that humankind shall face in the short term. (Bacterio)phage therapy is a valuable therapeutic alternative to antibiotics and, although the concept is almost as old as the discovery of phages, its wide application was hindered in the West by the discovery and development of antibiotics in the mid-twentieth century. However, research on phage therapy is currently experiencing a renaissance due to the antimicrobial resistance problem. Some countries are already adopting new ad hoc regulations to favor the short-term implantation of phage therapy in clinical practice. In this regard, the Phage Therapy Work Group from FAGOMA (Spanish Network of Bacteriophages and Transducing Elements) recently contacted the Spanish Drugs and Medical Devices Agency (AEMPS) to promote the regulation of phage therapy in Spain. As a result, FAGOMA was asked to provide a general view on key issues regarding phage therapy legislation. This review comes as the culmination of the FAGOMA initiative and aims at appropriately informing the regulatory debate on phage therapy. PublicationInfluence of Maternal and Paternal History of Mental Health in Clinical, Social Cognition and Metacognitive Variables in People with First-Episode Psychosis.(2022-10-18) Mendoza-García, Sara; García-Mieres, Helena; Lopez-Carrilero, Raquel; Sevilla-Lewellyn-Jones, Julia; Birulés, Irene; Barajas, Ana; Lorente-Rovira, Ester; Gutiérrez-Zotes, Alfonso; Grasa, Eva; Pousa, Esther; Pelaéz, Trini; Barrigón, Maria Luisa; González-Higueras, Fermin; Ruiz-Delgado, Isabel; Cid, Jordi; Montserrat, Roger; Martin-Iñigo, Laia; Moreno-Kustner, Berta; Vila-Bbadía, Regina; Díaz-Cutraro, Luciana; Verdaguer-Rodríguez, Marina; Ferrer-Quintero, Marta; Punsoda-Puche, Paola; Barrau-Sastre, Paula; Moritz, Steffen; Ochoa, SusanaThis study investigates, for the first time, clinical, cognitive, social cognitive and metacognitive differences in people diagnosed with first-episode of psychosis (FEP) with and without a family history of mental disorder split by maternal and paternal antecedents. A total of 186 individuals with FEP between 18 and 45 years old were recruited in community mental-health services. A transversal, descriptive, observational design was chosen for this study. Results suggest that there is a higher prevalence of maternal history of psychosis rather than paternal, and furthermore, these individuals exhibit a specific clinical, social and metacognitive profile. Individuals with a maternal history of mental disorder scored higher in delusional experiences, inhibition of the response to a stimulus and higher emotional irresponsibility while presenting a poorer overall functioning as compared to individuals without maternal history. Individuals with paternal history of mental disorder score higher in externalizing attributional bias, irrational beliefs of need for external validation and high expectations. This study elucidates different profiles of persons with FEP and the influence of the maternal and paternal family history on clinical, cognitive, social and metacognitive variables, which should be taken into account when offering individualized early treatment. PublicationAnxiety, Distress and Stress among Patients with Diabetes during COVID-19 Pandemic: A Systematic Review and Meta-Analysis.(2022-08-30) García-Lara, Rubén A; Gómez-Urquiza, José L; Membrive-Jiménez, María José; Velando-Soriano, Almudena; Granados-Bolivar, Monserrat E; Romero-Béjar, José L; Suleiman-Martos, NoraThe prevalence of mental health disorders has increased during the COVID-19 pandemic. Patients with chronic diseases, such as diabetes, are a particularly vulnerable risk group. This study aims to assess the levels and prevalence of anxiety, distress, and stress in patients with diabetes during the COVID-19 pandemic. A systematic review was conducted in CINAHL, Cochrane, LILACS, Medline, SciELO, and Scopus in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Thirty-seven articles with a total of 13,932 diabetic patients were included. Five meta-analyses were performed. The prevalence of anxiety was 23% (95% CI = 19-28) in T1DM and 20% (95% CI = 6-40) in T2DM patients. For diabetes distress it was 41% (95% CI = 24-60) for T1DM and 36% in T2DM patients (95% CI = 2-84). For stress, the prevalence was 79% (95% CI = 49-98) in T1DM patients. People with diabetes have significant psychiatric comorbidity as well as psychological factors that negatively affect disease management, increasing their vulnerability in an emergency situation. To establish comprehensive care in diabetic patients addressing mental health is essential, as well as including specific policy interventions to reduce the potential psychological harm of the COVID-19 pandemic. PublicationComorbidity Patterns in Patients with Atopic Dermatitis Using Network Analysis in the EpiChron Study.(2022-10-29) Almenara-Blasco, Manuel; Carmona-Pírez, Jonás; Gracia-Cazaña, Tamara; Poblador-Plou, Beatriz; Pérez-Gilaberte, Juan Blas; Navarro-Bielsa, Alba; Gimeno-Miguel, Antonio; Prados-Torres, Alexandra; Gilaberte, YolandaBackground: Atopic dermatitis (AD) is associated with different comorbidities. Methods: Retrospective, observational study based on clinical information from the individuals of the EpiChron Cohort Study (Aragon, Spain) with a diagnosis of AD between 1 January 2010 and 31 December 2018. We calculated the tetrachoric correlations of each pair of comorbidities to analyze the weight of the association between them. We used a cut-off point for statistical significance of p-value PublicationImpact of the COVID-19 Pandemic on the Perceived Quality of Palliative Care in Nursing Homes.(2022-10-06) Mota-Romero, Emilio; Campos-Calderon, Concepcion Petra; Puente-Fernandez, Daniel; Hueso-Montoro, Cesar; Esteban-Burgos, Ana A; Montoya-Juarez, RafaelThe Nursing Homes End-of-life Programme (NUHELP) was developed in 2017 and is based on quality standards of palliative care, but it was not implemented due to the outbreak of the COVID-19 pandemic. To describe perceptions among staff at nursing homes and primary health care (PHC) centres regarding the relevance, feasibility, and degree of achievement of quality standards for palliative care in nursing homes and to determine the differences in these perceptions before and after the pandemic. Cross-sectional descriptive study. Professionals at eight nursing homes and related PHC centres who participated in NUHELP development assessed 42 palliative care standards at two time points (2018 and 2022). The Mann-Whitney U test was applied to analyse differences in the scores between these two times and between perceptions at nursing homes and at PHC centres. The study population consisted of 58 professionals in 2018 and 50 in 2022. The standard regarding communication with persons affected by the death of a family member was considered less relevant (p = 0.05), and that concerning the culturally sensitive and dignified treatment of the body was less fully achieved (p = 0.03) in 2022 than in 2018. Social support (p = 0.04), sharing information among the care team (p = 0.04), patient participation (p = 0.04) and information about the treatment provided (p = 0.03) were all more poorly achieved in 2022 than in 2018. The perceptions of nursing home and PHC workers differed in several respects. Professional intercommunication and social support should be reinforced, and residents should be more actively involved in decision-making. PublicationPsychometric Properties of the Spanish Version of the Fatigue Assessment Scale in Caregivers of Palliative Care Patients.(2022-07-11) Esteban-Burgos, Ana A; Fernández-Alcántara, Manuel; Escribano, Silvia; Perpiñá-Galvañ, Juana; Campos-Calderón, Concepción Petra; Cabañero-Martínez, María JoséSymptoms of fatigue and lack of energy are very common in caregivers of palliative care (PC) patients, traditionally associated with variables such as burden or depression. There are no Spanish-language instruments validated for assessing fatigue levels in this population. The Fatigue Assessment Scale (FAS) is a useful and simple instrument for assessing fatigue in this group. The aim of this study was to examine its psychometric properties (factor structure, reliability and validity) in a sample of caregivers of PC patients. Instrumental design for instrument validation was performed. One hundred and eight caregivers of PC patients participated and completed measures of fatigue, family functioning, life satisfaction, caregiver burden, anxiety, depression, resilience and quality of life. A confirmatory factor analysis was performed; non-linear reliability coefficient and Pearson correlations and t-tests were conducted to assess evidence of reliability and validity. The Spanish version of the FAS was found to have a one-dimensional structure. Reliability was 0.88. Validity evidence showed that FAS scores were positively associated with levels of burden, anxiety and depression. They were negatively associated with family functioning, life satisfaction, resilience and quality of life. The Spanish version of the FAS in caregivers of PC patients shows adequate psychometric properties. PublicationValidation and Cross-Cultural Adaptation of the Spanish Version of the Pain Sensitivity Questionnaire (PSQ-S)(Mdpi, 2022-01-01) Ibancos-Losada, Maria del Rocio; Osuna-Perez, Maria Catalina; Cortes-Perez, Irene; Montoro-Cardenas, Desiree; Diaz-Fernandez, Angeles; [Ibancos-Losada, Maria del Rocio] Univ Jaen, Dept Hlth Sci, Campus Las Lagunillas S-N, Jaen 23071, Spain; [Osuna-Perez, Maria Catalina] Univ Jaen, Dept Hlth Sci, Campus Las Lagunillas S-N, Jaen 23071, Spain; [Cortes-Perez, Irene] Univ Jaen, Dept Hlth Sci, Campus Las Lagunillas S-N, Jaen 23071, Spain; [Montoro-Cardenas, Desiree] Univ Jaen, Dept Hlth Sci, Campus Las Lagunillas S-N, Jaen 23071, Spain; [Diaz-Fernandez, Angeles] Univ Jaen, Dept Hlth Sci, Campus Las Lagunillas S-N, Jaen 23071, Spain; [Cortes-Perez, Irene] Andalusian Hlth Serv, Granada Northeast Hlth Dist, St San Miguel 2, Guadix 18500, SpainExperimental pain testing requires specific equipment and may be uncomfortable for patients. The Pain Sensitivity Questionnaire (PSQ) was developed to assess pain sensitivity, based on the pain intensity ratings (range: 0-10) of painful situations that occur in daily life. The main objective of this study was to carry out a cross-cultural adaptation and validation of the Spanish version of the PSQ (PSQ-S). A total of 354 subjects (296 healthy and 58 chronic pain patients) filled in the PSQ-S. A subgroup of 116 subjects performed experimental pain testing, including two modalities (cold and pressure), with different measures: pain intensity rating, pressure pain threshold, and tolerance. The validation results showed two factors: PSQ-S-moderate and PSQ-S-minor and, for the total scale and the two factors, an excellent internal consistency (Cronbach's alpha coefficient > 0.9) and a substantial reliability (Intraclass Correlation Coefficient > 0.8). We obtained strong correlations with all the experimental pain rating parameters, catastrophizing, and depression variables, as well as moderate correlations with anxiety, central sensibilization, and impact on the quality of life. Chronic pain patients received elevated PSQ-S scores compared to healthy controls, and three cut-off values (PSQ-S-total = 7.00, PSQ-S-moderate = 7.57, and PSQ-S-minor = 6.29) based on ROC curve analyses were shown to be able to discriminate between healthy adults and adults with chronic pain. Therefore, PSQ-S may be a simple alternative to experimental pain procedures for clinical and experimental pain research.