01.01. Investigación y comunicación científica

Impact of the COVID-19 Pandemic on the Outcomes of a Multifaceted Program on Antibiotic Prescribing in Primary Care Among Children Under Three Years of Age

2026-01-19T00:00:00Z

Impact of the COVID-19 Pandemic on the Outcomes of a Multifaceted Program on Antibiotic Prescribing in Primary Care Among Children Under Three Years of Age Martín-Ayala, Gema; Alfayate-Miguélez, Santiago; Jiménez-Guillén, Casimiro; AlcarazQuiñonero, Manuel; Iofrio-de-Arce, Antonio; Arnau-Sánchez, José Background/objective: Inappropriate antibiotic use in paediatric populations is a leading driver of antimicrobial resistance. In the Murcia Region, Spain, the Purapi program promotes the rational use of antibiotics among children under 3 years of age. This study aimed to analyse antibiotic use in this age group during the pandemic period (2020-2023) and to assess the impact of the COVID-19 pandemic on the effectiveness of a multifaceted program promoting appropriate antibiotic use. Methods: A retrospective, multicentre, population-based study was conducted in primary care using data from 2019 to 2024. Systemic antibiotic use (ATC J01 group) among children under three years was measured as defined daily doses per 1000 inhabitants per day (DHD). Differences across years and healthcare areas were assessed using analysis of variance (ANOVA) with Bonferroni correction. Results: Antibiotic consumption decreased by 49% in 2020 compared to 2019, coinciding with the implementation of national COVID-19 containment measures. From 2021 onward, a gradual increase was observed; however, by 2024, levels remained 9% below pre-pandemic values. Penicillins account for 75% of prescriptions, mainly amoxicillin and amoxicillin-clavulanic acid. While variability across healthcare areas decreased during the pandemic, variability among primary care centres increased. Conclusions: The pandemic resulted in a temporary reduction in antibiotic use, followed by a partial rebound. Ongoing educational and stewardship interventions within the Purapi framework were instrumental in maintaining rational prescribing and may have contributed to maintaining reduced antibiotic consumption among children under three years of age during and after the pandemic. Strengthening and harmonising these initiatives is essential to ensure consistent paediatric antibiotic stewardship in primary care.

Development of a blood-based lipidomic fat quality score for the risk of ischemic stroke

2026-01-01T00:00:00Z

Development of a blood-based lipidomic fat quality score for the risk of ischemic stroke Lazaro, Iolanda; Lujan-Barroso, Leila; Soldevila-Domenech, Natalia; Amor, Antonio-J; Ortega, Emilio; Ros, Emilio; Sánchez, María-José; Rodríguez-Barranco, Miguel; Guevara, Marcela; Moreno-Iribas, Conchi; Schroder, Helmut; Fito, Montserrat; Tintle, Nathan-L; Ryder, Nathan; Harris, William-S; Agudo, Antonio; Sala-Vila, Aleix Introduction: Poor-quality diets promote ischemic stroke. Red blood cell fatty acids (RBC-FAs) are objective, longterm biomarkers of diet. In a case-control study nested in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain, we developed a blood-based lipidomic fat quality (LFQ) score considering pre-defined RBC-FA diet-related biomarkers, and examined whether LFQ score relates to the risk of ischemic stroke. Patients and methods: We determined the RBC-FAs (n = 438 cases of incident ischemic stroke, n= 438 matched controls). For each participant, we scored 1 for each beneficial metric (C15:0+C17:0; C18:2n-6; C18:3n-3; C20:5n-3; C22:6n-3) >= the median of the control group; and 1 for each detrimental metric (C16:0; C16:1n-7; C18:0) < the median of the control group. LFQ score resulted from the 8-component sum (range = 0-8; higher values, higher fat quality). We explored the validity of findings in a different background (n = 2468 participants from the Framingham Offspring Study without ischemic stroke at baseline, 12-year median follow-up, n= 121 cases). Results: In a fully adjusted model, the Odds Ratio (OR) for ischemic stroke was 0.86 (95% confidence interval [CI] = 0.77-0.95) for each 1-unit increase of the LFQ score. Compared to individuals at the lowest category of LFQ score (0-3 points), those at the top category (5-8 points) had lower odds (OR = 0.64, 95% CI = 0.44-0.94). The findings were similar in the Framingham Offspring Study (Hazard Ratio [HR] for each 1-unit increase = 0.83; 95% CI = 0.70-0.99; HR for those at top category = 0.49; 95% CI = 0.29-0.84, compared to those at the lowest category). Conclusion: Low blood-based LFQ scores relate to a high risk of ischemic stroke.

Genome-wide interaction analysis of long-term trihalomethane exposure in drinking water and colorectal cancer risk in a Spanish Multicenter Case-Control Study (MCC-Spain)

2026-01-01T00:00:00Z

Genome-wide interaction analysis of long-term trihalomethane exposure in drinking water and colorectal cancer risk in a Spanish Multicenter Case-Control Study (MCC-Spain) Moratalla-Navarro, Ferrán; Obon-Santacana, Mireia; Rius-Sansalvador, Blanca; Guino, Elisabet; Moragas, Nuria; Donat-Vargas, Carolina; Fernández-de-Larrea-Baz, Nerea; Molina-Barcelo, Ana; Guevara, Marcela; Morón-Durán, Francisco-D; Dierssen-Sotos, Trinidad; Tardon, Adonina; Castaño-Vinyals, Gemma; Cabrera-Castro, Natalia; Molina, Antonio-José; Aizpurua, Amaia; Morales-Suarez-Varela, María-M; Martín, Vicente; Fernández-Navarro, Pablo; Villanueva, Cristina-M; Moreno, Victor We conducted a genome-wide interaction analysis between long-term exposure to trihalomethanes in drinking water and colorectal cancer (CRC) risk in a multicenter case-control study in Spain, including 1037 CRC cases and 2100 controls. Exposure categories were estimated based on sex-specific median and quartile values of total trihalomethanes (TTHM), chloroform (CHCl3), and brominated trihalomethanes (Br-THMs) among controls. In addition, TTHM exposure was assessed relative to the WHO guideline thresholds. Gene-environment interaction models were computed with the GxEScanR package. To explore biological plausibility, relevant results were inspected in search of expression quantitative trait loci (eQTLs) in two independent resources: BarcUVaSeq and the Genome Tissue Expression (GTEx) v8. Finally, we searched the Comparative Toxicogenomics Database to identify candidate genes previously linked to trihalomethane exposure, retrieved their eQTLs, and evaluated gene-environment interactions with TTHM levels. We found three variants that modulated CRC risk in relation to CHCl3 and TTHM exposure: rs77985109 near LRRC8B, chr15:28997737 near WHAMMP2, and rs7890183 near MAGEB2. Two additional variants were specifically found for women and one for rectal cancer. Functional assessment suggested a regulatory role of rs77985109 in LRRC8B expression. Moreover, eQTL analysis of candidate genes revealed an additional variant associated with CCL2 which could modulate CRC risk under different TTHM exposure levels. The present study identified novel loci potentially influencing CRC susceptibility under THM exposure, highlighting the importance of integrating environmental and genetic data to better understand environmental driven cancer risks. Further research is needed to confirm these results and clarify underlying mechanisms.

Interactions between genetic predisposition to obesity, insulin resistance and type 2 diabetes risk, and food or beverage intake for incident type 2 diabetes: European Prospective Investigation into Cancer (EPIC) InterAct case-cohort study.

2026-03-01T00:00:00Z

Interactions between genetic predisposition to obesity, insulin resistance and type 2 diabetes risk, and food or beverage intake for incident type 2 diabetes: European Prospective Investigation into Cancer (EPIC) InterAct case-cohort study. Li, Sherly-X; Imamura, Fumiaki; Sharp, Stephen-J; Schulze, Matthias-B; Zheng, Ju-Sheng; Amiano, Pilar; Ardanaz, Eva; Bergmann, Manuela-M; Chirlaque-López, María-Dolores; Fagherazzi, Guy; Franks, Paul-W; Grioni, Sara; Ibsen, Daniel-B; Jakszyn, Paula; Johansson, Ingegerd; Katzke, Verena-A; Laouali, Nasser; Mancini, Francesca-R; Overvad, Kim; Palli, Domenico; Panico, Salvatore; Redondo-Sánchez, Daniel; Ricceri, Fulvio; Rolandsson, Olov; Srour, Bernard; Tjonneland, Anne; Tong, Tammy-Yn; van-der-Schouw, Yvonne-T; Riboli, Elio; Langenberg, Claudia; Forouhi, Nita-G; Wareham, Nick-J BACKGROUND: Limited evidence exists for effect modification of genetic characteristics on the associations of food consumption and incident type 2 diabetes (T2D).OBJECTIVES: We aimed to investigate whether the food-T2D association would vary by genetic susceptibility to metabolic traits.METHODS: We analyzed data from 9542 incident T2D cases and a subcohort of 12,477 participants nested within the 340,234-participant cohort recruited in 1991-1998 and followed up for 10.9 y on average in 8 European countries. Polygenic risk scores (PRSs) for higher body mass index, insulin resistance, and T2D were constructed. Fifteen dietary variables potentially associated with T2D, obtained with cohort-specific self-reported dietary assessment, were examined: fruits, green leafy vegetables, root vegetables, wholegrains, rice, legumes, nuts and seeds, fermented dairy, red meat, processed meat, fish, eggs and egg products, sugar-sweetened beverages, coffee, and tea. A cross-product term between each PRS and each food/beverage was evaluated by genotyping chip and country with Prentice-weighted Cox regression for incident T2D, and stratum-specific estimates were meta analyzed, followed by Benjamini-Yekutieli multiple-testing correction.RESULTS: Accounting for multiple tests of 3 PRSs * 15 dietary items, no evidence of statistical interaction was evident on either a multiplicative or additive scale, with exp(beta for a multiplicative interaction) (95% confidence interval) ranging from 0.84 (0.64, 1.10) (root vegetables and PRS for T2D) to 1.45 (0.78-2.76) (fish and PRS for T2D).CONCLUSIONS: Genetic susceptibility to high-risk metabolic traits did not modify the diet-T2D associations in European populations. Acknowledging the limitations of current PRS-based methods to detect gene-diet interactions, research should continue into the potential for precision nutrition and tailored food-based dietary guidance for T2D prevention.