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Abstract Introduction Waning immunity after vaccination justifies the need for additional effective COVID‐19 treatments. Immunomodulation of local immune response at the oropharyngeal mucosa could hypothetically activate mucosal immunity, which can prevent SARS‐CoV‐2 main immune evasion mechanisms in early stages of the disease and send an effective warning to other components of immune system. Olive polyphenols are biologically active compounds with immunomodulatory activity. There are previous studies based on immunomodulation with olive polyphenols and respiratory infections using an enteral route, which point to potential effects on time to resolution of symptoms. The investigators sought to determine whether participants following immunomodulation with tiny quantities of high polyphenolic olive oil administered through an oromucosal route could have a better outcome in COVID‐19. Summary This pilot clinical trial investigated the effect of buccopharyngeal administered high polyphenolic olive oil on COVID‐19 incidence, duration, and severity. Importance Waning immunity after vaccination justifies the need of further research for additional effective treatments for COVID‐19. Objective Immunomodulation of local immune response at the buccopharyngeal mucosa could hypothetically activate mucosal immunity, which would in turn difficult SARS‐CoV‐2 immune evasion mechanisms in early stages of the disease and send an effective warning to other components of immune system. Olive polyphenols are biologically active compounds with immunomodulatory activity. There are previous studies based on immunomodulation with olive polyphenols and respiratory infections, using an enteral route, which suggest potential shortening of time to resolution of symptoms. The investigators sought to determine whether participants following immunomodulation with tiny quantities of high polyphenolic olive oil administered through an oromucosal route could have a better outcome in COVID‐19. Design, Setting, and Participants Double blind, randomized pilot clinical trial conducted at a single site, Talavera de la Reina, Spain. Potential study participants were identified by simple random sampling from the epidemiological database of contact patients recently diagnosed of COVID‐19 during the study period. A total of 88 adult participants were enrolled and 84 completed the 3‐month study, conducted between July 1, 2021 and August 31, 2022. Intervention Participants were randomized to receive oromucosal administered high polyphenolic olive oil, 2 mL twice a day for 3 months or no treatment. Main Outcome and Measures Primary outcomes were incidence, duration, and severity of COVID‐19 after intervention. Results There were no differences in incidence between both groups but there were significant differences in duration, the median time to resolution of symptoms was 3 days in the high polyphenolic olive oil group compared with 7 days in the no‐treatment group. Although time to resolution is directly related to severity, this study did not find any differences in severity. Conclusion and Relevance Among full‐vaccinated adults recent infected with COVID‐19, a daily intake of tiny quantities of oromucosal administered high polyphenolic olive oil before infection significantly improved the time to symptom resolution. This finding strongly support the appropriateness of further deep research on the use of oromucosal administered high polyphenolic olive oil as an effective immune strategy against COVID‐19.

This work is a bibliographic review. The search for the necessary information was carried out in the months of November 2022 and January 2023. The databases used were as follows: Pubmed, Academic Google, Scielo, Scopus, and Cochrane library. Results: In total, 101 articles were selected after a review of 486 articles from databases and after applying the inclusion and exclusion criteria. The update on the molecular mechanism of human coronavirus (HCoV) infection was reviewed, describing possible therapeutic targets in the viral response phase. There are different strategies to prevent or hinder the introduction of the viral particle, as well as the replicative mechanism ((protease inhibitors and RNA-dependent RNA polymerase (RdRp)). The second phase of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) involves the activation of hyperinflammatory cascades of the host’s immune system. It is concluded that there are potential therapeutic targets and drugs under study in different proinflammatory pathways such as hydroxychloroquine, JAK inhibitors, interleukin 1 and 6 inhibitors, and interferons.

Introduction: Psychotic disorders are a mental illness that affect 3% of the world’s population. The external (cannabis) and internal vulnerability factors (polymorphisms of the AKT1 gene, the COMT gene and the DAT1 gene) acquire special relevance in the appearance of psychosis; this is known as the vulnerability–stress model. Objective: To analyze the scientific evidence that reflects the relationship between the polymorphism of the AKT1 gene and the consumption of cannabis in the appearance of psychosis. Material and Methods: The bibliographic search was made using databases such as Scopus, WoS, Cochrane Library, TRIP Database, PubPsych and PubMed. The criteria of the “MeSH” terminology and the inclusion and exclusion criteria were followed, obtaining a total of 22 articles that comprises this narrative review. Results: The presence of genetic variation in the locus rs2494732 of the AKT1 gene in a cannabis user raises the risk of the appearance of psychosis, especially if homozygous with the C allele. Likewise, consumption entails a slowdown in the functionality of the AKT1 gene, releasing a greater amount of dopamine in the striatum through the involvement of indirect mechanisms. Similarly, the COMT gene and the interaction of the AKT1 gene with the DAT1 gene raise the risk of developing psychotic disorder. Conclusion: The genetic polymorphism rs2494732 of AKT1 is the main factor responsible for the appearance of psychosis, although polymorphisms of the COMT and DAT1 gene are also implicated. Regarding the AKT1 gene, subjects with two copies of the C allele have a higher risk of developing psychosis compared to subjects with two copies of the T allele. It should also be noted that the muscarinic receptors rs115455482 and rx74722579 are related to a greater vulnerability to psychosis and the development of psychotic disorders.

Introduction: Diabetic foot is the infection, ulceration or destruction of the deep tissues of the foot in patients with diabetes mellitus. This pathology occurs when there are high levels of glucose in the blood, as well as other factors such as high blood pressure and hypercholesterolemia. These factors cause damage to the vessels and nerves, producing medium and long-term complications. This is a health problem that affects diabetic patients throughout their lives. Objective: To know the different techniques and strategies that allow to carry out an appropriate management of the diabetic foot. Methodology: A narrative review was carried out between November 2021 and July 2022 in the different databases of Pubmed (Medline), Scielo, Scopus and Web of Science (WOS), with a search string that combined the keywords derived from thesauri, namely Descriptors of Health Sciences (DeCS) and Medical Subject Headings (MeSH), combined with the Boolean operators “AND”, “NOT” and “NOT”. Results: After applying the article selection criteria and evaluating the quality of the methodology, a total of 22 articles were obtained. The results affirm the existence of promising therapies for the treatment of diabetic foot ulcers such as negative-pressure therapy and hyperbaric oxygen therapy. It is highlighted that the use of therapeutic footwear and health education are deficient aspects that must be reinforced. Conclusions: After comparing the different articles, it was possible to determine that negative-pressure therapy and hyperbaric oxygen therapy should be promoted as they are suitable for the treatment of diabetic foot ulcers. In addition, therapeutic footwear is a baseline in the diabetic foot approach. On the other hand, it is necessary to reinforce interdisciplinary work in this area and health education for patients suffering from this disease.

Introduction: Ventilator-associated pneumonia (VAP) constitutes a real iatrogenic health problem, which can lead to a higher rate of hospital admission days associated with the morbidity and mortality that it could cause. Objective: To study and learn about the different preventive measures used to reduce the incidence of VAP, as well as to study the microorganisms that most frequently cause VAP. To determine the nursing staff’s knowledge of this phenomenon and the social and health care costs derived from the disease. Methodology: The bibliographic search of the existing literature was carried out between November 2021 and June 2022. In order to gather all the necessary information, different databases were searched. For this purpose, a search strategy was developed using keywords included in “DeCS” and “MeSH” and using boolean operators such as “AND and OR”, and all articles meeting the chosen inclusion criteria were included. Results: After applying the article selection criteria and assessing the quality of the methodology, a total of 33 articles were finally included for systematic review. The results show the usefulness of various preventive measures against the micro-organisms that most frequently cause this type of pneumonia, as well as the true cost associated with this pathology and the still insufficient knowledge of healthcare personnel about it. Conclusion: Although many advances have reduced the incidence and mortality of this pathology, further research, training of healthcare personnel and implementation of new protocols are still required.

Abstract Background Hereditary angioedema due to C1 inhibitor deficiency (HAE-C1INH) is a genetic rare disease characterized by recurrent, transient and unpredictable episodes of cold, non-pruriginous oedema without associated urticaria. The characteristics of the disease have a considerable impact on the quality of life of patients. The aim of this study was to increase understanding of the patient journey of HAE in Spain. Methods A multidisciplinary committee of 16 HAE experts (allergy, immunology, emergency department, hospital pharmacy and nursing) and 3 representatives of the Spanish Hereditary Angioedema Patient Association (AEDAF) who were patients or caregivers participated in the study. A review of the publications on HAE treatment was performed. Semi-structured interviews were performed to HAE experts, patients, or caregivers. Three meetings with the experts, patients and caregivers were held to share, discuss, and validate data obtained from literature and interviews and to build the model. Results Throughout the project, the patient journey has been drawn up, dividing it into the stages of pre-diagnosis, diagnosis and treatment/follow-up. Some areas for improvement have been identified. Firstly, there is a need to enhance awareness and training on HAE among healthcare professionals, with a particular emphasis on primary care and emergency department personnel. Secondly, efforts should be made to minimize patient referral times to allergy/immunology specialists, ensuring timely access to appropriate care. Thirdly, it is crucial to encourage the study of the relatives of diagnosed patients to early identify potential cases. Fourthly, equitable access to self-administered treatments should be ensured, facilitated by systems that enable medication delivery at home and proper education and training for patients. Equitable access to long-term prophylactic treatment should also be prioritized for all patients in need. To standardize HAE management, the development of consensus guidelines that reduce variability in clinical practice is essential. Lastly, promoting research studies to enhance knowledge of the disease and align its treatment with new developments in the healthcare field should be encouraged. Conclusions The knowledge of the patient journey in HAE allowed us to identify improvement areas with the final aim to optimize the disease management.