Martin-Calvo, N. (Nerea)
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- Flow cytometric characterization of cecal appendix lymphocyte subpopulations in children: a pilot study(Springer, 2023) Ros-Briones, R. (Raquel); Martin-Calvo, N. (Nerea); López, A. (Andrés); Arredondo-Montero, J. (Javier); Hurtado-Ilzarbe, G. (Guillermina); Lopez-Andres, N. (Natalia); Antona, G. (Giuseppa)Introduction: Scientific literature regarding the characterization of lymphocyte subpopulations of the cecal appendix is sparse, with few precedents limited to immunohistochemical techniques. Methods: We conducted a prospective pilot study to characterize lymphocyte subpopulations of the cecal appendix in children. Participants were divided into three groups: (1) patients without histological acute appendiceal inflammation, (2) patients with histological uncomplicated acute appendicitis, and (3) patients with histological complicated acute appendicitis (gangrenous, perforated). A fresh sample of the base of the appendix was taken from all patients and a flow cytometric study was performed. Quantitative variables were compared using Kruskal-Wallis test and Mann-Whitney U test. Results: This study included 57 patients divided into Group 1 (n = 5), Group 2 (n = 37), and Group 3 (n = 15). Median values (IQR) of the percentage of B-lymphocytes were 67.8 [66.8-68.1] in group 1, 61.15 [53.74-66.4] in group 2, and 52.1 [33-62.02] in group 3 (p = 0.02). Median values (IQR) of the percentage of NK-lymphocytes were 0.26 [0.2-0.3] in group 1, 0.55 [0.37-0.66] in group 2, and 0.84 [0.35-1.45] in group 3 (p = 0.008). Median values (IQR) of the percentage of T-lymphocytes were 31.9 [31.7-33.1] in group 1, 37.68 [32.15-45.69] in group 2, and 46.9 [37.03-67] in group 3 (p = 0.02). Pair comparisons of groups 2 and 3 also showed significant differences in the percentage of B lymphocytes (p = 0.03) and NK-lymphocytes (p = 0.02). Conclusions: Significant differences in lymphocyte subpopulations were identified according to the histologic grade of the cecal appendix. More specifically, a lower percentage of B-lymphocytes and a higher percentage of T- and NK-lymphocytes were observed in cases of acute appendicitis. These findings must be confirmed and their etiopathogenic, diagnostic, and prognostic implications elucidated in future studies with larger sample sizes.
- The effects of COVID-19 lockdown on the sleep quality of children(MDPI, 2023) Moreno-Galarraga, L. (Laura); Martinez-Gonzalez, M.A. (Miguel Ángel); Martin-Calvo, N. (Nerea); Lopez-Iracheta, R. (Roberto); Moreno-Villares, J.M. (José Manuel); Emilio-Bueso, Ó. (Óscar)Introduction: The COVID-19 lockdown has caused important changes in children's routines, especially in terms of nutrition, physical activity, screen time, social activity, and school time. Regarding these changes, recent studies show that the COVID-19 lockdown is associated with higher levels of anxiety and depression in children. The objective of this study was to assess changes in sleep quality in Spanish children during the lockdown decreed by the Spanish government between March and June 2020. Methodology: We compared the BEAR (bedtime, excessive daytime sleepiness, awakening during the night, and regularity and duration of sleep) scores of 478 participants (median age = 7.5 years; 48% girls) in the SENDO project during the periods before, during, and after lockdown. The questionnaires were filled out by one of the parents. We used hierarchical models with two levels of clustering to account for the intra-cluster correlation between siblings. The interaction of time with a set of a priori selected variables was assessed by introducing the interaction term into the model and calculating the likelihood ratio test. Results: The mean scores in the BEAR questionnaire referred to the periods before, during, and after lockdown were 0.52 (sd 1.25), 1.43 (sd 1.99), and 1.07 (sd 1.55), respectively. These findings indicate a deterioration in sleep quality during the period of confinement. Parental level of education was found to be an effect modifier (p for interaction = 0.004). Children whose parents had higher education (university graduates or higher) showed a smaller worsening than those without. Conclusion: Our study shows that the COVID-19 lockdown was associated with a significant worsening of sleep quality. Moreover, although the end of the lockdown brought about a slight improvement, mean scores on the BEAR scale remained significantly higher than before the lockdown, suggesting that the consequences for sleep quality could persist over time. This worsening was higher in children whose parents had lower educational degrees. Helping children maintain healthy sleeping habits despite the circumstances and providing early psychological support when needed is important to prevent negative psycho-physical symptoms due to lockdown that could persist over the years.
- Vitamin C intake is inversely associated with cardiovascular mortality in a cohort of spanish graduates: the SUN project(MDPI, 2017) Martinez-Gonzalez, M.A. (Miguel Ángel); Martin-Calvo, N. (Nerea)Observational studies have found a protective effect of vitamin C on cardiovascular health. However, results are inconsistent, and residual confounding by fiber might be present. The aim of this study was to assess the association of vitamin C with the incidence of cardiovascular disease (CVD) and cardiovascular mortality (CVM) while accounting for fiber intake and adherence to the Mediterranean dietary pattern. We followed up 13,421 participants in the Seguimiento Universidad de Navarra (University of Navarra follow-up) (SUN) cohort for a mean time of 11 years. Information was collected at baseline and every two years through mailed questionnaires. Diet was assessed with a validated semi-quantitative food frequency questionnaire. Incident CVD was defined as incident fatal or non-fatal myocardial infarction, fatal or non-fatal stroke, or death due to any cardiovascular cause. CVM was defined as death due to cardiovascular causes. Events were confirmed by physicians in the study team after revision of medical records. Cox proportional hazard models were fitted to assess the associations of (a) energy-adjusted and (b) fiber-adjusted vitamin C intake with CVD and CVM. We found energy-adjusted vitamin C was inversely associated with CVD and CVM after adjusting for several confounding factors, including fiber from foods other than fruits and vegetables, and adherence to the Mediterranean dietary pattern. On the other hand, when vitamin C was adjusted for total fiber intake using the residuals method, we found a significant inverse association with CVM (HR (95% confidence interval (CI)) for the third tertile compared to the first tertile, 0.30 (0.12-0.72), but not with CVD in the fully adjusted model.
- Association of dairy consumption with respiratory infections. Myth or reality?(Asociación Española de Pediatría de Atención Primaria, 2018) Moreno-Galarraga, L. (Laura); Martin-Calvo, N. (Nerea); García-Blanco, L. (Lorena); Zazpe, I. (Itziar); Alvarez-Zallo, N. (Noelia); Peñafiel-Freire, D.M. (Diego Mauricio)Introducción: la leche y los derivados lácteos son alimentos importantes para el desarrollo. Sin embargo, la creencia de que se asocian con infecciones respiratorias está provocando que se limite su consumo o se sustituya por bebidas vegetales. El objetivo del estudio fue analizar si el consumo de lácteos se asocia con determinadas infecciones respiratorias en la infancia. Material y métodos: estudio transversal con 169 voluntarios de entre 4 y 7 años. Información recogida mediante cuestionarios en papel. Información dietética recogida mediante cuestionario de frecuencia de consumo de alimentos semicualitativo de 151 ítems. Se valoró la asociación del consumo de leches, quesos y yogures con determinadas enfermedades respiratorias (otitis media aguda, sinusitis, mastoiditis, neumonía), comparando dos categorías de consumo definidas a partir de la mediana de cada alimento, mediante regresión logística multivariable. Resultados: no se encontraron asociaciones entre el consumo de lácteos y las enfermedades respiratorias analizadas (odds ratio: 0,85; intervalo de confianza del 95%: 0,44 a 1,64]). Al analizar cada lácteo por separado, se encontró una asociación inversa entre el consumo de quesos y las enfermedades respiratorias en conjunto (odds ratio: 0,50; intervalo de confianza del 95%: 0,26 a 0,98), pero no para cada una de las infecciones por separado (otitis media aguda ni neumonía). No se encontró asociación significativa con los desenlaces para ningún otro derivado lácteo (leche o yogures). Conclusiones: los resultados no apoyan una asociación directa entre el consumo de leche y derivados con infecciones respiratorias en la infancia. Con los datos actuales no está justificado restringir el consumo de leche o derivados en niños en edad escolar.
- Parent-reported birth information: birth weight, birth length and gestational age. Validation study in the SENDO project(Sociedad Española de Salud Publica y Administración Sanitaria, 2021) Moreno-Galarraga, L. (Laura); Martinez-Gonzalez, M.A. (Miguel Ángel); Martin-Calvo, N. (Nerea); Oliver, A. (Asier); Miranda-Ferreiro, G. (Genoveva); Alvarez-Zallo, N. (Noelia)Objective: To test the validity of parent-reported birth information obtained through an online, self-administered questionnaire. Method: The SENDO project is a prospective and dynamic paediatric cohort of Spanish children aged 4 to 6 years old at recruitment. Objective data from medical birth records were compared to parent-reported data getting intra-class correlation coefficients (ICC) for quantitative variables and weighted Kappa Index for qualitative ones. Percentage of responders and of total agreement was also evaluated. Results: Parental response rate was over 99% for birth weight and gestational age and 76% for birth length. ICC for birth weight was 0.95 (95% confidence interval [95%CI]: 0.94-0.96) and 0.78 (95%CI: 0.73-0.83) for birth length, both showing very high correlations. The total agreement percentage for gestational age was 97%, and Kappa weighted index was 0.90 (95%CI: 0.89-0.90), showing a very high agreement as well. Conclusions: We found high correlations and excellent agreement in parent-reported birth data 4 to 6 years after delivery. Our results show parent-reported birth data, especially birth weight, are valid for use in epidemiological research.
- Coffee consumption and the risk of depression in a middle-aged cohort: the SUN project(2018) Navarro-Echeverría, A. M. (Adela María); Martinez-Gonzalez, M.A. (Miguel Ángel); Martin-Calvo, N. (Nerea); Toledo, E. (Estefanía); Sanchez-Villegas, A. (Almudena); Abasheva, D. (Daria); Ruiz-Estigarribia, L. (Liz)Coffee is one of the most widely consumed drinks around the world, while depression is considered the major contributor to the overall global burden of disease. However, the investigation on coffee consumption and depression is limited and results may be confounded by the overall dietary pattern. We assessed the relationship between coffee intake and the risk of depression, controlling for adherence to the Mediterranean diet. We studied 14,413 university graduates of the Seguimiento Universidad de Navarra' (SUN) cohort, initially free of depression. We evaluated coffee consumption using a validated food-frequency questionnaire (FFQ). Incident depression cases were adjudicated only if the participant met two criteria simultaneously: (a) validated physician-diagnosed depression together with (b) new onset of habitual antidepressant use. Both criteria were needed; participants meeting only one of them were not classified as cases. Participants who drank at least four cups of coffee per day showed a significantly lower risk of depression than participants who drank less than one cup of coffee per day (HR: 0.37 (95% CI 0.15-0.95)). However, overall, we did not observe an inverse linear dose-response association between coffee consumption and the incidence of depression (p for trend = 0.22).
- Television watching during meals is associated with higher ultra-processed food consumption and higher free sugar intake in childhood(John Wiley & Sons, 2024) López-Gil, J.F. (José Francisco); Martin-Calvo, N. (Nerea); Usechi, A. (Ane); Felipe-Gómez, S. (Santiago); Fabios, E. (Elise)Background: The consumption of ultra-processed foods (UPFs) is associated with an increased risk of noncommunicable diseases and mortality in adults. The aim of this study was to analyse the association between mealtime television (TV) watching and UPF consumption in childhood. Materials and methods: Participants in the SENDO project recruited in 2015-2023 were classified into three categories based on the frequency at which they watched TV during meals. Dietary information was collected with a validated 147-item semi-quantitative food frequency questionnaire. Generalized mixed models were used to compare mean UPF consumption between groups after accounting for the main confounders. The predictive margins of participants who had a free sugar intake >10% of their energy intake in each category were also calculated. Results: Totally 970 subjects (482 girls) with a mean age of 5.00 years (SD = 0.85) were studied. Children who watched TV during meals ≥4 times/week consumed a mean of 4.67% more energy from UPF than those who watch TV <3 times/month. The adjusted proportions of children who had a free sugar intake >10% of their energy intake in the categories of <3 times/month, 1-3 times/week and ≥4 times/week exposure to TV during meals were 44.9%, 45.9% and 58.7%, respectively. Conclusion: TV watching during meals is associated with higher consumption of UPFs and a higher risk of exceeding 10% of TEI in free sugar intake in childhood.
- Pregestational BMI and higher offspring’s risk of overweight/obesity in smoker and non-smoker mothers(Cambridge University Press, 2021) Martinez-Gonzalez, M.A. (Miguel Ángel); Martin-Calvo, N. (Nerea); Santiago, S. (Susana); Segura, G. (Gloria); Fernández-Lázaro, C.I. (César I.); Barbería-Latasa, M. (María)Objective: To assess the association between pregestational BMI and offspring's risk of overweight/obesity after accounting for the most important confounders, especially maternal smoking habit. Design: Prospective cohort study. Setting: The Seguimiento Universidad de Navarra (SUN) study is a prospective cohort of Spanish graduates with more than 22 000 participants nationwide. Recruitment started in 1999, and it is permanently open. Data on diet, lifestyle and clinical diagnoses are collected at baseline and every 2 years. Participants: Women from the SUN cohort who reported at least one pregnancy during follow-up (n 3496) were invited to this study. Among them, 1527 agreed to participate and completed an additional more detailed online questionnaire on their pregnancy history and their offspring's nutritional status. Results: After excluding 165 children, we analysed data of 2791 participants born to 1485 mothers and observed that each 5 kg/m2 increase in pregestational BMI was associated with a 0·22 (95 % CI 0·15, 0·29) higher z-score in offspring's BMI and higher risk of overweight/obesity (multivariable-adjusted relative risk (RR) 1·57 (95 % CI 1·39, 1·77)) in childhood or adolescence. Furthermore, we observed stronger association in children born to smoker mothers (RR 1·91; 95 % CI 1·48, 2·46) than from non-smoker mothers (RR 1·51; 95 % CI 1·31, 1·73) (Pfor interaction = 0·02). Conclusions: We found a synergistic interaction between pregestational BMI and maternal smoking habit on offspring's z-score of the BMI and in their risk of overweight/obesity. Although further research is needed to analyse dose-response relationships, these findings reinforce the importance of promoting healthy lifestyles in pregnant women in order to prevent childhood obesity.
- Metastasis of spindle cell malignant melanoma in gallbladder(Springer, 2022) Bronte-Anaut, M. (Mónica); Martin-Calvo, N. (Nerea); Recreo-Baquedano, A.C. (Ana Cristina); Arredondo-Montero, J. (Javier)Malignant melanoma is an aggressive neoplasm with a high tendency to metastasize. Gastrointestinal metastases, although described in the literature, are infrequent. We present the case of a 51-year-old male patient with a surfcial spreading melanoma stage IIIc with BRAF mutation who presented a gallbladder outgrowth lesion, compatible with a polyp. A signifcant growth of the lesion was observed in subsequent TC studies and a laparoscopic cholecystectomy was performed. The anatomopathological study of the specimen confrmed the diagnosis of gallbladder metastasis due to epithelioid and spindle cell malignant melanoma. The presence of a gallbladder lesion in the context of a patient diagnosed with melanoma should establish the diagnostic suspicion of metastasis, and an early extension study and laparoscopic cholecystectomy should be considered. The palliative surgical approach to avoid hepatobiliary symptomatology can be considered.
- Adherence to Mediterranean diet is inversely associated with the consumption of ultra-processed foods among Spanish children: the SENDO project(Cambridge University Press, 2021) Martinez-Gonzalez, M.A. (Miguel Ángel); Ciriza-Barea, E. (Edurne); Romanos-Nanclares, A. (Andrea); Martin-Calvo, N. (Nerea); Rico-Campà, A. (Anais); Santos-da-Rocha, B.R. (Bárbara Rafaela); Ferreira-Barbosa, K.B. (Kiriaque Barra)Objective: To assess whether higher adherence to the traditional Mediterranean diet (MedDiet) was associated with lower consumption of ultra-processed foods (UPF) and lower free sugar intake. Design: Cross-sectional analysis of baseline information among participants in the SENDO project, a Spanish paediatric cohort. Dietary information was collected through a semi-quantitative FFQ. Food items were classified according to the NOVA classification. Adherence to the MedDiet was evaluated through the KIDMED index. Setting: Spain. Participants: Three hundred eight-six children (52 % boys) with a mean age of 5·3 years old (sd 1·0) were included in the analysis. Results: 74·4 % of the children had moderate adherence to the MedDiet (mean KIDMED score: 5·9 points; sd 1·7) and overall, 32·2 % of the total energy intake came from UPF. Each two additional points in the KIDMED score was associated with 3·1 % (95 % CI 2·1, 4·0) lower energy intake from UPF. Compared to those with low adherence to the MedDiet, children with medium and high adherence reported 5·0 % (95 % CI 2·2, 7·7) and 8·5 % (95 % CI 5·2, 11·9) lower energy intake from UPF, respectively. We also found that 71·6 % of the variability in free sugar intake was explained by the variability in UPF consumption. Conclusions: Adherence to the traditional MedDiet was inversely associated with energy intake from UPF. Furthermore, most of the variability in free sugar intake was explained by the variability of UPF consumption. Public health strategies are needed to strengthen the adherence to the MedDiet in pre-schoolers while regulating the production, marketing and advertising of UPF.