Cabergoline as a Novel Strategy for Post-Pregnancy Breast Cancer Prevention in Mice and Human.

Post-pregnancy breast cancer often carries a poor prognosis, posing a major clinical challenge. The increasing trend of later-life pregnancies exacerbates this risk, highlighting the need for effective chemoprevention strategies. Current options, limited to selective estrogen receptor modulators, aromatase inhibitors, or surgical procedures, offer limited efficacy and considerable side effects. Here, we report that cabergoline, a dopaminergic agonist, reduces the risk of breast cancer post-pregnancy in a Brca1/P53-deficient mouse model, with implications for human breast cancer prevention. We show that a single dose of cabergoline administered post-pregnancy significantly delayed the onset and reduced the incidence of breast cancer in Brca1/P53-deficient mice. Histological analysis revealed a notable acceleration in post-lactational involution over the short term, characterized by increased apoptosis and altered gene expression related to ion transport. Over the long term, histological changes in the mammary gland included a reduction in the ductal component, decreased epithelial proliferation, and a lower presence of recombinant Brca1/P53 target cells, which are precursors of tumors. These changes serve as indicators of reduced breast cancer susceptibility. Additionally, RNA sequencing identified gene expression alterations associated with decreased proliferation and mammary gland branching. Our findings highlight a mechanism wherein cabergoline enhances the protective effect of pregnancy against breast cancer by potentiating postlactational involution. Notably, a retrospective cohort study in women demonstrated a markedly lower incidence of post-pregnancy breast cancer in those treated with cabergoline compared to a control group. Our work underscores the importance of enhancing postlactational involution as a strategy for breast cancer prevention, and identifies cabergoline as a promising, low-risk option in breast cancer chemoprevention. This strategy has the potential to revolutionize breast cancer prevention approaches, particularly for women at increased risk due to genetic factors or delayed childbirth, and has wider implications beyond hereditary breast cancer cases.

Prevalence of Depression and Fish Consumption among First Year Spanish University Students: UniHcos Project.

The World Health Organization estimates that one fifth of university students have experienced major depressive disorder at some point in their lives. Nutrition may be one of the modifiable factors that influence the development of depression. Specifically, low omega-3 fatty acid and vitamin D levels, both nutrients found in high quantities in fish, have been linked to depressive disorders. The main objective of this study was to evaluate the prevalence of depression among young Spanish university students, in addition to the pattern of fish consumption among students and the possible relationship between fish consumption and the presence of depression. Data were collected retrospectively from a nationally representative sample of 11,485 Spanish university students aged 18 years or older in 11 Spanish universities, from 2012 to 2022. The respondents were analyzed according to frequency of consumption and compliance with weekly recommendations for fish intake and the presence of depression. Regression models were also performed to determine students' odds of depression as a function of compliance with recommendations according to selected sociodemographic variables. The prevalence of depression was 10.5%; it was more prevalent in women, older students and in those with both high and low BMIs. In addition, it was also more prevalent in those that lived outside the family home, with roommates and those who were employed. Sixty-seven percent of the students met the fish intake recommendations. The most common frequency of fish consumption was 1-2 times/week (44.2%), and the least frequent was 2.3% daily fish consumption. Students from northern universities were more likely to consume fish (68.4%) than those from southern universities (66.4%). Non-consumption of fish was found to increase the risk of depression (ORa = 1.45 (1.28-1.64); AF = 31.0% (21.9-39.0)), but it was the student's own conditions that had the greatest influence on the development of the disorder. In summary, a lower consumption of fish seems to be associated with a higher incidence of depression in Spanish university students; however, other social factors of the student may influence the development of the disorder, and all of this should be taken into account for the development of prevention strategies.

Alcohol use and family-related factors among Spanish university students: the unHicos project.

BACKGROUND: During adolescence and youth there are relevant changes in the consolidation, gain or loss of consumption habits and lifestyles and the family factors has a fundamental role to development these habits. The study of the consumption of toxins, such as alcohol intake, is crucial at this stage due to the repercussions that said consumption presents in adulthood. Therefore, the objective of our study was to evaluate the associations between alcohol consumption patterns and related family factors (family functioning, family history of alcohol consumption) in Spanish university students. METHODS: Observational, descriptive, cross-sectional, multicenter study, carried out in first-year university students from 11 Spanish universities. Through an online questionnaire, alcohol consumption (risky consumption and intensive consumption or binge drinking), family functioning and history of alcohol in the family were evaluated. Risky alcohol consumption and binge drinking were assessed using the AUDIT test, and family functioning was assessed using the family APGAR questionnaire. A descriptive analysis of the data was performed, as well as the Chi-Square test and Student's T-Test, and non-conditional logistic regression models were carried out to examine this association. RESULTS: The prevalence of risky alcohol consumption identified in the 10,167 respondents was 16.9% (95% CI = 16.2-17.6), and that of BD was 48.8% (95% CI = 47.9-48.8). There is a significant association between risky alcohol consumption and family functioning in students of both sexes, with greater consumption in the face of severe dysfunctional support (men OR = 1.72; p < 0.001 and women OR = 1.74; p < 0.001) and family history of consumption (p = 0.005). Regarding the binge drinking pattern, no statistically significant differences were observed. CONCLUSIONS: Risky alcohol consumption in university students is associated with dysfunctional family support, unlike the binge drinking pattern, where there is no such association. The findings of this study show the importance of creating prevention programs focused on the family approach in university students, which include alcohol screening in the population with a family history of this substance, and greater social support from health services.

Patterns of Alcohol Consumption and Use of Health Services in Spanish University Students: UniHcos Project.

The aim of the study was to examine the association of alcohol consumption patterns (hazardous alcohol use and binge drinking) and the use of emergency services and primary care consultations in university students. An observational, descriptive, cross-sectional study was conducted at eleven Spanish universities collaborating within the uniHcos Project. University students completed an online questionnaire that assessed hazardous alcohol use and binge drinking using the AUDIT questionnaire and evaluated the use of emergency services and primary care. A descriptive analysis of the data was performed, as well as the chi-squared test and Student's t-test and nonconditional logistic regression models to examine this association. Results: There were 10,167 participants who completed the questionnaire. The prevalence of hazardous alcohol use was 16.9% (95% CI: 16.2−17.6), while the prevalence of binge drinking was 48.8% (95% CI: 47.9−49.8). There were significant differences in the use of emergency services in those surveyed with hazardous alcohol use (p < 0.001) or binge drinking pattern (p < 0.001). However, no significant differences were observed in terms of attendance during primary care visits in individuals with hazardous alcohol use (p = 0.367) or binge drinking pattern (p = 0.755). The current study shows the association between university students with a pattern of hazardous alcohol use or binge drinking and greater use of emergency services. However, no significant association was observed between the said consumption patterns and the use of primary care services.

[Discrimination and its relationship with risk behaviors and perceived health in spanish university students: a cross-sectional study.] / Discriminación y su relación con las conductas de riesgo y la salud percibida en estudiantes universitarios españoles: un estudio transversal.

OBJECTIVE: Discrimination during vital moments, such as the university period, can generate a high impact on people's behavior and health. The aim of this study was to analyze the possible association of discrimination with perceived health and with different risk behaviors, as well as to describe gender differences in Spanish university students. Discrimination during vital moments, such as college, can have a high impact on people's behavior and health. METHODS: A cross-sectional study was carried out with data from first-year university students from 11 Spanish universities (n=9,862). Discrimination, perceived health, alcohol consumption, smoking, consumption of illegal substances, leisure time connected to the Internet, risky sexual relations, family function, risk of mental health problems and risk of eating disorders were assessed. Prevalences with their 95% confidence intervals were obtained and for quantitative variables the mean and standard deviation were calculated. Odds ratios with 95% confidence intervals were calculated to determine the relationship between discrimination and the other variables. RESULTS: An association was found between discrimination and fair or poor perceived health (OR: 1.7; p=0.0001), consumption of illegal substances (OR: 1.3; p=0.002), problematic internet use (OR: 1.3; p=0.004), family dysfunction (OR: 1.8; p=0.0001), risk of mental health problems (OR: 1.9; p=0.0001) and eating disorders (OR: 1.5; p=0.0001). Regarding gender differences, higher prevalence of discrimination was observed in men with health status perceived as fair or worse (OR: 2.2; p=0.0001), family dysfunction (OR: 1.8; p=0.0001), risk of mental health problems (OR: 2.2; p=0.0001) and eating disorders (OR: 1.9; p=0.002). Women, apart from the previous variables, presented association of discrimination with consumption of illegal substances (OR: 1.3; p=0.005) and problematic internet use (OR: 1.4; p=0.002). CONCLUSIONS: The study findings underline that there is an association between discrimination and risk behaviors among Spanish university students. In turn, discrimination was associated with poor or fair perceived health, this relationship being similar in both men and women.

OBJETIVO: La discriminación durante los momentos vitales, como el periodo universitario, puede generar un alto impacto en la conducta y en el estado de salud de las personas. El estudio tuvo como objetivo analizar la posible asociación de la discriminación con la salud percibida y con distintas conductas de riesgo, así como describir las diferencias de género en estudiantes universitarios españoles. METODOS: Se realizó un estudio transversal con datos de estudiantes universitarios de primera matrícula de primer curso de 11 universidades españolas (n=9.862). Se valoró la discriminación, la salud percibida, el consumo de alcohol, el hábito tabáquico, el consumo de sustancias ilegales, el tiempo de ocio conectado a internet, la práctica de relaciones sexuales de riesgo, la función familiar, el riesgo de problemas de salud mental y el riesgo de trastornos de la conducta alimentaria. Se obtuvieron las prevalencias con sus intervalos de confianza al 95% y para las variables cuantitativas la media y desviación estándar. Se calcularon las Odds Ratio con los intervalos de confianza al 95% para conocer la relación entre la discriminación y las otras variables. RESULTADOS: Se encontró asociación entre la discriminación y una regular o mala salud percibida (OR: 1,7; p=0,0001), el consumo de sustancias ilegales (OR: 1,3; p=0,002), el uso problemático de internet (OR: 1,3; p=0,004), la disfunción familiar (OR: 1,8; p=0,0001), el riesgo de problemas de salud mental (OR: 1,9; p=0,0001) y de trastornos de la conducta alimentaria (OR: 1,5; p=0,0001). En cuanto a las diferencias de género, se apreciaron mayores prevalencias de discriminación en hombres con estado de salud percibida como regular o peor (OR: 2,2; p=0,0001), disfunción familiar (OR: 1,8; p=0,0001), riesgo de problemas de salud mental (OR: 2,2; p=0,0001) y de trastornos de la conducta alimentaria (OR: 1,9; p=0,002). Las mujeres, además de las variables anteriores, mostraron asociación de la discriminación con el consumo de sustancias ilegales (OR: 1,3; p=0,005) y el uso problemático de internet (OR: 1,4; p=0,002). CONCLUSIONES: Los hallazgos del estudio subrayan que existe asociación entre la discriminación y las conductas de riesgo de los estudiantes universitarios españoles. A su vez, la discriminación se asoció con una mala o regular salud percibida, siendo esta relación similar tanto en hombres como en mujeres.

[Declared experiences of risky sexual behaviors in relation to alcohol consumption in the first year of college.] / Experiencias declaradas de conductas sexuales de riesgo en relación con el consumo de alcohol en el primer año de universidad.

OBJECTIVE: In college students, higher risk alcohol consumption (drunkenness and binge drinking-BD) has negative consequences on their development and and probably facilitates risk sexual behaviors. The objective was to study if risky sexual behaviors when consuming alcohol (RSBA) are associated with higher risk consumption. METHODS: Cross-sectional multicenter study with UniHcos Project, 1st year university students from 11 universities in Spain, academic years 2011-2012 to 2017-2018 data. This data were collected by self-administered questionnaire. A uni and bivariate analysis was performed, evaluated the statistical significance of the differences in prevalence with chi-square. Mean and standard deviation were used for quantitative variables and Student's t test statistic was used. RESULTS: 9,862 subjects (72.2% women). 90.3% reported having consumed alcohol and 60.9% had drunk the last year, 49% BD in last month. It was deteded in men, significantly higher consumption in the last month and drunkenness. Last month consumption and drunkenness were significantly higher in men and in <21 years. The RSBA were significantly higher among who were drunk (15.7% unprotected sex, 1.9% sexual abuse and 0.7% taking sexual advantage) and had BD (17.1%, 1.9% and 0.7 %). Women with both risk consumptions had more sexual abuse (2.2%), and men had greater behaviors of taking sexual advantage of someone (drunk: 1.2%; BD: 1.3%). CONCLUSIONS: Alcohol consumption was above similar groups. BD consumption was similar by gender and age. Risk sexual behaviors appear mainly in problematic consumption. Gender differences are not detected in alcohol consumers in unprotected sex but deteded in the rest.

OBJETIVO: En universitarios, el consumo de alcohol de mayor riesgo (borracheras y binge drinking (BD), tiene consecuencias negativas sobre su desarrollo y probablemente facilita conductas sexuales de riesgo. El objetivo de este trabajo fue estudiar si las conductas sexuales de riesgo al consumir alcohol (CSRA) se asocian a los consumos de mayor riesgo. METODOS: Estudio multicéntrico transversal con datos del Proyecto uniHcos, de universitarios de 1er año de 11 universidades españolas, entre los cursos 2011-2012 y 2017-2018. Datos recogidos mediante cuestionario autoadministrado. Se realizó un análisis uni y bivariable, evaluando la significación estadística de las diferencias de prevalencia con chi-cuadrado. Se utilizó media y desviación típica para variables cuantitativas y como estadístico de contraste t de Student. RESULTADOS: 9.862 participantes (72,2% mujeres). El 90,3% consumió alcohol y el 60,9% tuvo borracheras en último año; el 49% tuvo BD en el último mes. El consumo en el último mes y las borracheras fueron mayores en hombres y <21 años. Las CSRA fueron superiores entre los que se emborracharon (15,7% sexo sin protección, 1,9% abuso sexual y 0,7% aprovecharse sexualmente) y consumieron en BD (17,1%, 1,9% y 0,7%). Las mujeres con ambos consumos de riesgo presentaron más abusos sexuales (2,2%), y los hombres fueron quienes más se aprovecharon sexualmente de otros (borracheras:1,2%; BD: 1,3%). CONCLUSIONES: El consumo de alcohol está por encima de grupos similares. El BD tiene un patrón similar por género y edad. Las CSRA se asocian a los consumos de mayor riesgo, no detectándose en este grupo diferencias por género en sexo sin protección, sí en otras CSRA.

Adherence to recommended intake of pulses and related factors in university students in the UniHcos project.

Pulses such as peas, beans or lentils are one of the most complete foods at the nutritional level; however, they are one of the most often neglected foods in the diets of university students. Entrance to university translates into a major lifestyle change for many young people, and the habits acquired or cemented at this time will remain into adulthood. The objective of this study is to analyse the association between personal/sociodemographic factors, dietary intake of other food groups and the consumption of pulses in first-year university students. This cross-sectional study is part of the UniHcos project, a multicentre study of multipurpose prospective cohorts in eleven Spanish universities. Data from 9862 university students were collected through an online self-questionnaire completed by all students who met the selection criteria and agreed to participate in the project during the 2011-2018 academic years. Of students, 75·8 % presented an inadequate (≤2 times/week) consumption of pulses. Living outside the family home in either a student residence (OR 0·76; 95 % CI 0·69, 0·84) or rental (OR 0·81; 95 % CI 0·70, 0·95) decreased the compliance with recommendations on the consumption of pulses. Low consumption of pulses is seemingly not restricted to a specific profile or dietary pattern among university students, and no specific focus group for intervention can be identified. Policies promoting the consumption of pulses among the university population as a whole are necessary to increase compliance rates with the dietary recommendations.

Menstrual Problems and Lifestyle among Spanish University Women.

Menstrual problems affect many young women worldwide, conditioning both their academic performance and quality of life. This study sought to analyse the prevalence of menstrual problems and their possible relationship with lifestyle among Spanish university women, as part of a research project (UniHcos Project) involving a cohort of 11 Spanish universities with 7208 university students. A descriptive analysis was performed using the bivariate chi-square test and the Student's t-test together with a binary logistic regression, in which the dependent variable was 'suffering from menstrual problems'. Menstrual problems were identified in 23.8% of the students, representing women who paid more visits to the doctor and to emergency rooms, and who consumed more painkillers and contraceptives. In relation to dietary preferences, menstrual problems were 1.39 (CI 95% 1.22-1.61; p = 0.000) times more likely among women classified as high-risk alcohol users according to the AUDIT questionnaire, and 1.187 (CI 95% 1.029-1.370; p = 0.019) times greater among those who consumed sweets daily, 1.592 (CI 95% 1.113-2.276; p = 0.011) times more frequent among those who eat fish daily, and 1.199 (CI 95% 1.004-1.432; p = 0.045) times greater among those who were dieting. Menstrual problems affect many college students and potentially modifiable lifestyle variables exist which may influence their prevalence. It would be interesting to develop programmes to promote women's health in the university context.

Use of Virtual Reality for the Management of Anxiety and Pain in Dental Treatments: Systematic Review and Meta-Analysis.

(1) Background: Dental treatments often cause pain and anxiety in patients. Virtual reality (VR) is a novel procedure that can provide distraction during dental procedures or prepare patients to receive such type of treatments. This meta-analysis is the first to gather evidence on the effectiveness of VR on the reduction of pain (P) and dental anxiety (DA) in patients undergoing dental treatment, regardless of age. (2) Methods: MEDLINE, CENTRAL, PubMed, EMBASE, Wiley Library and Web of Science were searched for scientific articles in November 2019. The keywords used were: "virtual reality", "distraction systems", "dental anxiety" and "pain". Studies where VR was used for children and adults as a measure against anxiety and pain during dental treatments were included. VR was defined as a three-dimensional environment that provides patients with a sense of immersion, transporting them to appealing and interactive settings. Anxiety and pain results were assessed during dental treatments where VR was used and in standard care situations. (3) Results: 32 studies were identified, of which 8 met the inclusion criteria. The effect of VR in children was significant, both for anxiety (standardized mean difference (SMD) = -1.75) and pain (SMD = -1.46). (4) Conclusions: The findings of the meta-analysis show that VR is an effective distraction method to reduce pain and anxiety in patients undergoing a variety of dental treatments; however, further research on VR as a tool to prepare patients for dental treatment is required because of the scarcity of studies in this area.

Retraction: López-Valverde, N.; et al. Use of Virtual Reality for the Management of Anxiety and Pain in Dental Treatments: Systematic Review and Meta-Analysis. J. Clin. Med. 2020, 9, 1025.

The authors of a recent published paper [...].

Use of Virtual Reality for the Management of Anxiety and Pain in Dental Treatments: Systematic Review and Meta-Analysis.

BACKGROUND: Dental treatments often cause pain and anxiety in patients. Virtual reality (VR) is a novel procedure that can provide distraction during dental procedures or prepare patients to receive such type of treatments. This meta-analysis is the first to gather evidence on the effectiveness of VR on the reduction of pain (P) and dental anxiety (DA) in patients undergoing dental treatment, regardless of age. METHODS: MEDLINE, CENTRAL, PubMed, EMBASE, Wiley Library and Web of Science were searched for scientific articles in November 2019. The keywords used were: "virtual reality", "distraction systems", "dental anxiety" and "pain". Studies where VR was used for children and adults as a measure against anxiety and pain during dental treatments were included. VR was defined as a three-dimensional environment that provides patients with a sense of immersion, transporting them to appealing and interactive settings. Anxiety and pain results were assessed during dental treatments where VR was used, and in standard care situations. RESULTS: 31 studies were identified, of which 14 met the inclusion criteria. Pain levels were evaluated in four studies (n = 4), anxiety levels in three (n = 3) and anxiety and pain together in seven (n = 7). Our meta-analysis was based on ten studies (n = 10). The effect of VR was studied mainly in the pediatric population (for pain SMD = -0.82). In the adult population, only two studies (not significant) were considered. CONCLUSIONS: The findings of the meta-analysis show that VR is an effective distraction method to reduce pain and anxiety in patients undergoing a variety of dental treatments; however, further research on VR as a tool to prepare patients for dental treatment is required because of the scarcity of studies in this area.

Factors Associated with Meat Consumption in Students of Spanish Universities: UniHcos Project.

The level of meat consumption is one of the main deviations from the Mediterranean diet pattern in Spanish university students. The objective of this cross-sectional descriptive study is to analyze the association between sociodemographic factors and the consumption of fresh and processed meat in Spanish university students. This study is part of a cohort of 11 Spanish universities with 9862 university students (UniHcos Project). A descriptive analysis and a chi2 test were carried out to assess differences between personal and sociodemographic variables and meat consumption, and binary logistic regression analysis to assess factors associated with consumption; 19.9% and 73.5% met the recommendations for meat-fresh and meat-processed consumption, respectively. Only 3.8% of students meet the recommendations for both fresh and processed meat. Statistically significant differences were found between sex, BMI, employment, housing, and coexistence regarding compliance with recommendations. Female employed students living in rental accommodations with a partner are more likely to meet the recommendations for fresh meats while male, normal weight, employed students living in rental accommodations with a partner are more likely to meet the recommendations for processed meats. There is a lack of compliance with the recommendations for consumption of fresh meat in Spanish university students, differences in compliance among students of differing regions and an association with sex, employment, housing, and coexistence regarding compliance.

Cambios en la epidemiología de la infección por Clostridium difficile durante 2005-2014 en Salamanca, España / Changes in the epidemiology of Clostridium difficile infection during 2005-2014 in Salamanca, Spain

Introducción. Conocer los rasgos epidemiológicos más relevantes de la infección por Clostridium difficile (ICD) ocurrida en la provincia de Salamanca (España) entre 2005-2014. Métodos. Estudio descriptivo transversal realizado a partir del archivo informático del Servicio de Microbiología del Complejo Asistencial Universitario de Salamanca. La detección se realizó según la metodología habitual. Resultados. El 2,6% de las muestras de heces analizadas para detección de toxinas de C. difficile (9.103) fueron positivas. La prevalencia media global fue de 6,8 casos por 100.000 habitantes y año. La media de edad fue de 65 ± 21,4 años y la mediana 70 años. El 59% de los casos se produjo en mayores de 64 años, con una prevalencia media anual de 16,5 (4 veces superior a la del grupo de 15-64). La mayoría de casos (86.4%) se produjeron en pacientes hospitalizados, siendo el grupo de mayores de 64 años el de mayor porcentaje de ICD hospitalaria, con un 55%. Conclusiones. Se observa un incremento significativo del número de peticiones y de la prevalencia de ICD a lo largo de la década estudiada y unas tasas de prevalencia bastante inferiores a las de otros estudios. El porcentaje de ICD aumentó de manera significativa tanto en pacientes hospitalizados como en los comunitarios. La edad y la hospitalización fueron factores de riesgo para desarrollar ICD. Tras la introducción de una técnica molecular de detección en 2014, la prevalencia aumentó, siendo 2.5 veces superior a la del 2013 (AU)

Background. To know the most relevant epidemiological features of Clostridium difficile infection (CDI) between 2005-2014 in the province of Salamanca (Spain). Methods. Descriptive cross-sectional study carried out through review of the clinical microbiologic records at Complejo Asistencial Universitario de Salamanca. Detection was performed according to standard methodology. Results. 2.6% of stool samples analyzed for detection of C. difficile toxins (9.103) were positive. The average prevalence was 6.8 cases per 100,000 people per year. The mean age was 65 ± 21.4 years and the median 70 years. 59% of cases occurred in patients over 64 years, with an average prevalence of 16.5 (4 times higher than the 15-64 group). Most cases (86.4%) occurred in hospitalized patients, and the group of over 64 had the highest percentage of hospital CDI, with 55%. Conclusions. A significant increase in the number of requests and in the prevalence of CDI over the decade studied is observed, and prevalence rates were significantly lower than those of other studies. The percentage of CDI increased significantly in both inpatient and community. Age and hospitalization were risk factors for developing CDI. After the introduction of a molecular detection technique in 2014, the prevalence increased, being 2.5 times higher than 2013 (AU)

Cambios en la epidemiología de las gastroenteritis causadas por Salmonella durante 2005-2014 en Salamanca, España / Changes in the epidemiology of gastroenteritis caused by Salmonella during 2005-2014 in Salamanca, Spain

Introducción. En España no abundan estudios poblacionales actualizados sobre salmonelosis, a pesar de ser una de las etiologías de gastroenteritis agudas (GEAs) bacterianas más habituales en el mundo. El objetivo fue conocer los rasgos epidemiológicos más relevantes de las GEAs producidas por Salmonella spp. entre 2005-2014 en Salamanca (España). Métodos. Estudio descriptivo transversal realizado a partir del archivo informático del Servicio de Microbiología del Complejo Asistencial Universitario de Salamanca. El cultivo, aislamiento, identificación y serotipificación se realizaron según la metodología habitual. Resultados. Salmonella se aisló en 1.477 pacientes, representando el 47,7% del total de coprocultivos positivos y el 53,3% de todos los ingresos por GEA bacteriana. La prevalencia media fue de 42,1 casos/100.000 habitantes y año. La media de edad fue de 23 ± 28 años y la mediana 7 años. El 40,2% de todos los aislamientos se produjo en menores de 5 años, con una prevalencia media de 45,1 casos/10.000 habitantes y año. Globalmente, el serotipo aislado con más frecuencia fue S. Typhimurium con un 57%, seguido por S. Enteritidis con un 35,8%. Conclusiones. La prevalencia de Salmonella disminuyó a lo largo del tiempo. El grupo entre 0-4 años presentó la tasa más alta durante todo el periodo. Sin embargo, produjo el mayor porcentaje de hospitalizaciones por GEA bacteriana. El serotipo S. Typhimurium ha reemplazado en los últimos años al serotipo S. Enteritidis y predomina en pacientes de menor edad. Se aprecia una infranotificación de los casos de salmonelosis producidos en Salamanca a pesar de ser obligatoria su declaración desde 2007 (AU)

Background. In Spain there are not many updated population studies about salmonellosis, despite being one of the most common etiologies of acute gastroenteritis (AGEs) caused by bacteria in the world. The aim of the study was to know the most relevant epidemiological features of AGEs produced by Salmonella spp. between 2005 and 2014 in Salamanca (Spain). Methods. Descriptive cross-sectional study carried out through review of the clinical microbiologic records at Complejo Asistencial Universitario de Salamanca. Culture, isolation, identification and serotyping were performed according to standard methodology. Results. Salmonella was isolated in 1,477 patients, representing 47.7% of all positive stool cultures and 53.3% of all income bacterial AGE. The average prevalence was 42.1 cases/100,000 people per year. The mean age was 23 ± 28 years and the median 7 years. 40.2% of all isolates occurred in children under 5 years, with an average prevalence of 45.1 cases/ 10,000 people per year. Overall, the most frequently isolated serotype was S. Typhimurium with 57%, followed by S. Enteritidis with 35.8%. Conclusions. The prevalence of Salmonella decreased over time. The group aged 0-4 years had the highest rate throughout the period. However, Salmonella produced the highest percentage of hospitalizations for bacterial AGE. In recent years, S. Typhimurium serotype has replaced S. Enteritidis serotype and predominates in younger patients. It is observed under-reporting of cases of salmonellosis produced in Salamanca despite being mandatory notification of these since 2007 (AU)

[Changes in the epidemiology of gastroenteritis caused by Salmonella during 2005-2014 in Salamanca, Spain]. / Cambios en la epidemiología de las gastroenteritis causadas por Salmonella durante 2005-2014 en Salamanca, España.

OBJECTIVE: In Spain there are not many updated population studies about salmonellosis, despite being one of the most common etiologies of acute gastroenteritis (AGEs) caused by bacteria in the world. The aim of the study was to know the most relevant epidemiological features of AGEs produced by Salmonella spp. between 2005 and 2014 in Salamanca (Spain). METHODS: Descriptive cross-sectional study carried out through review of the clinical microbiologic records at Complejo Asistencial Universitario de Salamanca. Culture, isolation, identification and serotyping were performed according to standard methodology. RESULTS: Salmonella was isolated in 1,477 patients, representing 47.7% of all positive stool cultures and 53.3% of all income bacterial AGE. The average prevalence was 42.1 cases/100,000 people per year. The mean age was 23 ± 28 years and the median 7 years. 40.2% of all isolates occurred in children under 5 years, with an average prevalence of 45.1 cases/ 10,000 people per year. Overall, the most frequently isolated serotype was S. Typhimurium with 57%, followed by S. Enteritidis with 35.8%. CONCLUSIONS: The prevalence of Salmonella decreased over time. The group aged 0-4 years had the highest rate throughout the period. However, Salmonella produced the highest percentage of hospitalizations for bacterial AGE. In recent years, S. Typhimurium serotype has replaced S. Enteritidis serotype and predominates in younger patients. It is observed under-reporting of cases of salmonellosis produced in Salamanca despite being mandatory notification of these since 2007.

Cognitive impairment and dependence of patients with diabetes older than 65 years old in an urban area (DERIVA study).

BACKGROUND: We analyzed the associations between diabetes and cognitive impairment (CI) and dependence in a population of patients 65 years or older. METHODS: Cross-sectional study. We randomly selected 311 participants over the age of 65 living in an urban area of Spain. The mean age of the cohort was 75.89 ± 7.12 years, and 69 of the individuals (22.2%) had diabetes. Two questionnaires were used to assess cognitive performance (MMSE and Seven Minute Screen Test), and two assessments were used to evaluate patient dependence (Barthel Index and Lawton-Brody Index). Clinical information and sociodemographic data were also gathered. RESULTS: Nearly one quarter of patients with diabetes (21.7%) lived alone. Diabetic patients were more sedentary (p = .033) than non-diabetic patients. Roughly one sixth (15.3%) of the diabetics and 10.1% of the non-diabetics were depressed (p = .332). CI was present in 26.1% of the diabetics and 14.5% of non-diabetics (p = .029). Diabetic patients had a MMSE score that was significantly worse than non-diabetics (24.88 ± 4.74 vs 26.05 ± 4.03; p <.05), but no differences were found in the Seven Minute Screen Test. Logistic regressions revealed that the presence of diabetes was independently associated with CI (adjusted for age, gender, years of education, sedentary lifestyle, body mass index, diastolic blood pressure, cholesterol, and depression (OR = 2.940, p = .013). Patients with diabetes showed greater dependence, as measured by the Barthel Index (p = .03) and Lawton-Brody Index (p <.01). Nevertheless, when dependence (dependence or not dependence for each questionnaire) used as a dependent variable in the logistic regression analyses, no significant association with diabetes was found, after adjusting for confounding variables. CONCLUSIONS: Diabetic patients over the age of 65 are more likely to present CI but not dependence. These findings support the need to include both a functional and cognitive assessment as necessary components in a standard evaluation in both clinical guides and randomized trials of therapeutic interventions in patients with diabetes.

Vacunación antigripal en estudiantes de enfermería durante la temporada 2014-2015 / Influenza vaccination among nursing students from a University of Castilla-León, Spain, for the 2014-2015 season

Fundamentos: Los estudiantes en prácticas en centros sanitarios de Castilla-León están incluidos como grupo diana de vacunación antigripal desde la temporada 2012-2013. Nuestro objetivo fue conocer la cobertura de vacunación antigripal de estudiantes de enfermería y los factores determinantes de la vacunación. Métodos: Estudio analítico transversal que incluyó a todos los estudiantes matriculados en la carrera de enfermería de una Universidad castellano-leonesa durante el año académico 2014-2015. Para obtener la información se utilizó un cuestionario autocumplimentado que recogió estatus vacunal frente a gripe 2014-2015, razones para vacunarse y 10 preguntas sobre conocimientos generales de vacunas. Se calcularon frecuencias absolutas y relativas. La significación estadística se estudió utilizando la prueba chi-cuadrado y regresión logística múltiple. Resultados: De los 340 estudiantes incluidos respondieron 227 (66,8%). El 5,3% refirió haberse vacunado. Las principales razones para vacunarse fueron: autoprotección (75%), protección de familiares y amigos (58,3%) y protección a pacientes (50%). Como motivos para no vacunarse destacaron: nadie me ha ofrecido vacunarme (59,2%) y no presentar ningún riesgo de tener gripe o sus complicaciones (40,8%). El 22,0% contestó adecuadamente 8 o más preguntas. Conocer que los componentes de las vacunas no son peligrosos se asoció con vacunarse (p=0,023). Conclusiones: La cobertura fue baja respecto a la descrita en trabajadores sanitarios. El nivel de conocimientos es mejorable. Además, conocer que las dosis de sustancias químicas de las vacunas no son peligrosas se asoció con vacunarse (AU)

Background: Trainee students in healthcare settings of Castilla-León have been included as target group for influenza vaccination since 2012-2013 season. Our aim was to determine vaccination coverage against seasonal influenza virus among nursing students and to identify its determining factors after the implementation of such indication. Methods: An analytical cross-sectional study was performed during the 2014-2015 school year. It included all enrolled nursing students from a university of Castilla-León. The information (2014-2015 influenza vaccination status, reasons and 10 questions about knowledge of vaccines) was obtained by a self-administered questionnaire. Absolute and relative frequencies were calculated and the associations were evaluated using a Chi-square test and logistic regression. Results: 227 students of the 340 (66.8%) completed the questionnaire. 5.3% of them reported having been vaccinated. The main reasons to be vaccinated were: self-protection (75%), protection of family/friends (58.3%) and protection of patients (50%). The main reasons to be unvaccinated were: nobody has offered to vaccinate me (59.2%) and not having risk of influenza or its complications (40.8%). At least 8 knowledge questions were answered correctly by 22.0% of students. Being aware that vaccines components are not dangerous was associated with vaccination (p=0.023). Conclusions: The coverage was low regarding rates in health-care workers. Therefore, it is necessary to develop strategies to promote and raise awareness regarding vaccination in this group. The level of knowledge was improvable. Since the knowledge that the doses of chemical substances in vaccines are not dangerous was associated with vaccination, specific educational programs should be carried out at universities to improve/reinforce the students’ knowledge regarding vaccines (AU)

[Influenza vaccination among nursing students from a university of Castilla-León for the 2014-2015 season after their inclusion as target group for vaccination]. / Vacunación antigripal en estudiantes de enfermería durante la temporada 2014-2015.

BACKGROUND: Trainee students in healthcare settings of Castilla-León have been included as target group for influenza vaccination since 2012-2013 season. Our aim was to determine vaccination coverage against seasonal influenza virus among nursing students and to identify its determining factors after the implementation of such indication. METHODS: An analytical cross-sectional study was performed during the 2014-2015 school year. It included all enrolled nursing students from a university of Castilla-León. The information (2014-2015 influenza vaccination status, reasons and 10 questions about knowledge of vaccines) was obtained by a self-administered questionnaire. Absolute and relative frequencies were calculated and the associations were evaluated using a Chi-square test and logistic regression. RESULTS: 227 students of the 340 (66.8%) completed the questionnaire. 5.3% of them reported having been vaccinated. The main reasons to be vaccinated were: self-protection (75%), protection of family/friends (58.3%) and protection of patients (50%). The main reasons to be unvaccinated were: nobody has offered to vaccinate me (59.2%) and not having risk of influenza or its complications (40.8%). At least 8 knowledge questions were answered correctly by 22.0% of students. Being aware that vaccines components are not dangerous was associated with vaccination (p=0.023). CONCLUSIONS: The coverage was low regarding rates in health-care workers. Therefore, it is necessary to develop strategies to promote and raise awareness regarding vaccination in this group. The level of knowledge was improvable. Since the knowledge that the doses of chemical substances in vaccines are not dangerous was associated with vaccination, specific educational programs should be carried out at universities to improve/reinforce the students' knowledge regarding vaccines.

Conocimientos, actitudes y percepciones de los estudiantes de medicina sobre el cigarrillo electrónico / Knowledge, attitudes and perceptions of medical students about the electronic cigarette

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