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Preconception and prenatal exposure to environmental contaminants may affect future health. Pregnancy and early life are critical sensitive windows of susceptibility. The aim of this review was to summarize current evidence on the toxic effects of environment exposure during pregnancy, the neonatal period, and childhood. Alcohol use is related to foetal alcohol spectrum disorders, foetal alcohol syndrome being its most extreme form. Smoking is associated with placental abnormalities, preterm birth, stillbirth, or impaired growth and development, as well as with intellectual impairment, obesity, and cardiovascular diseases later in life. Negative birth outcomes have been linked to the use of drugs of abuse. Pregnant and lactating women are exposed to endocrine-disrupting chemicals and heavy metals present in foodstuffs, which may alter hormones in the body. Prenatal exposure to these compounds has been associated with pre-eclampsia and intrauterine growth restriction, preterm birth, and thyroid function. Metals can accumulate in the placenta, causing foetal growth restriction. Evidence on the effects of air pollutants on pregnancy is constantly growing, for example, preterm birth, foetal growth restriction, increased uterine vascular resistance, impaired placental vascularization, increased gestational diabetes, and reduced telomere length. The advantages of breastfeeding outweigh any risks from contaminants. However, it is important to assess health outcomes of toxic exposures via breastfeeding. Initial studies suggest an association between pre-eclampsia and environmental noise, particularly with early-onset pre-eclampsia. There is rising evidence of the negative effects of environmental contaminants following exposure during pregnancy and breastfeeding, which should be considered a major public health issue.

Resumen: Objetivo: Este estudio evalúa la influencia del crecimiento de la población en la utilización del Servicio de Urgencias Pediátricas de un hospital universitario de Cantabria (España) entre enero de 2001 y diciembre de 2013. Material y métodos: Se realizó un estudio retrospectivo de todas las urgencias ocurridas durante 13 años. Se emplean modelos de regresión lineal simple y polinómica para analizar la relación entre la población y la frecuentación en 2 grupos de edad (0-2 y 3-14 años). Resultados: De 2001 a 2013, las urgencias aumentaron un 14,1% y la población pediátrica un 26,3%. Las tasas de presentación por persona fueron mayores en los menores de 3 años, 1,48 (IC 95% 1,40 a 1,56) frente a 0,46 (IC 95% 0,44 a 0,48) (p

We have developed a new extremely hydrophilic polymeric film suitable for the detection and quantification of chloride in human sweat directly on the skin. The film, or membrane, has chemically anchored 6-methoxyquinoline groups as chloride responsive fluorescent motifs. We have prepared the sensory material from a standard vinyl copolymer, by a convenient and easy solid-phase reaction. The sensory material has a water swelling percentage of 700%, facilitating an immediate detection of chloride, is reusable for at least 6 cycles and can be handled without care by unskilled persons. The initially high fluorescence of the material decreases in the presence of chloride, allowing the quantification of chloride concentration by using the colour definition of a digital picture or a fluorimeter. The suitability of the material to perform quantitative chloride analysis of human sweat by putting it in contact with the skin offers promise for its application in the sweat test used for the diagnosis of cystic fibrosis (CF)., FEDER and both the Spanish Ministerio de Economía y Competitividad (MAT2014-54137-R and MAT2017-84501-R) and the Consejería de Educación – Junta de Castilla y León (BU092U16 and BU061U16)

This study was supported by the National Drug Plan, Ministry of Health, Social Services and Equality of Spain (Grants: 2010|145 and 2013|034)., Pulses such as peas, beans or lentils are one of the most complete foods at the nutritional level, however, it is one of the most often neglected in the diets of university students. Entrance to university translates to 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 analyze 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 multicenter study of multipurpose prospective cohorts in 11 Spanish universities. Data from 9862 university students was 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. 75.8% of students 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 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., National Drug Plan, Ministry of Health, Social Services and Equality of Spain 2010|145 2013|034

This study sought to estimate the prevalence of maternal smoking and its association with exclusive breastfeeding vs. formula feeding. A cross-sectional study was performed on postpartum women at a public hospital in Spain, between January and August 2018. The main variables studied were their age, level of study, smoking habits, and chosen mode of infant feeding. In total, 948 postpartum women were included. Of these, 12.45% were smokers who smoked a mean of 7.23 cigarettes/day. Among the group of smokers, the probability of feeding the newborns with formula milk was multiplied by 2.32 ([95%CI 1.50&ndash, 3.58] p &lt, 0.001). When stratifying tobacco use into mild, moderate and severe, we found a statistically significant dose&ndash, response pattern. These associations and their statistical significance were maintained when adjusting by age and level of study. In conclusion, in the group of postpartum mothers who smoked, the probability of feeding the newborns with formula milk doubled. Our data highlight the need to improve health education programs in women of childbearing age, especially during pregnancy.

espanolIntroduccion: varios estudios han identificado la lactancia materna como un factor protector frente a la ganancia rapida de peso y la obesidad infantil, mientras que otros estudios han encontrado que este efecto protector podria ser el resultado de la interferencia de factores de confusion. Objetivos: evaluar las asociaciones entre el tipo de lactancia (leche materna versus lactantes alimentados con formula) durante la introduccion de la alimentacion complementaria, asi como: a) los patrones de ingesta de alimentos; y b) las trayectorias de crecimiento a los seis, nueve y 12 meses (z-score de peso, estatura e indice de masa corporal (IMC) y variaciones en estos z-score entre los seis y los 12 meses. Metodos: se midieron 203 neonatos seleccionados en centros de salud primaria espanoles. Los padres registraron el consumo de alimentos de todos los bebes durante tres dias (g/dia). Se aplicaron modelos de regresion lineal. Resultados: los bebes alimentados con leche materna tuvieron una menor ingesta de cereales, alimentos para bebes a base de frutas, verduras con carne/pescado, asi como una menor ingesta total de alimentos en comparacion con los bebes alimentados con formula a los nueve meses de edad. Despues de realizar el ajuste por sexo, educacion de los padres y consumo total de alimentos, los ninos alimentados con leche materna continuaron teniendo una menor ingesta de cereales (-5,82, IC 95%: -9,22, -2,43) y una ingesta total de alimentos mas baja (-301,23, IC 95%: -348,50, -253,96). Los bebes alimentados al pecho tuvieron un menor incremento en la puntuacion z-score de peso, talla e IMC entre los seis y los 12 meses de edad y estas diferencias se mantuvieron cuando se ajustaron para todos los factores de confusion. Conclusiones: los lactantes alimentados con formula durante el periodo de alimentacion complementaria tienen una mayor ingesta de alimentos y muestran tasas mas altas de ganancia de peso en comparacion con los lactantes alimentados con leche materna. Estas diferencias en las trayectorias de crecimiento en funcion del mantenimiento de la lactancia materna y la ingesta de alimentos durante los primeros anos de vida deben considerarse en la evaluacion del riesgo de adiposidad. EnglishIntroduction: several investigations have identified breastfeeding as a protective factor for rapid infant weight gain and childhood obesity while other studies have found that this protective effect could be the result of confounding factors. Objectives: to assess the associations between lactation practices (breast-fed vs formula-fed infants) during the introduction of complementary food period, as well as the following: a) patterns of food intake; and b) trajectories of growth at six, nine and 12 months (z-score of weight, height and body mass index [BMI] and changes in these z-scores from six to 12 months). Methods: two hundred and three infants randomly selected from Spanish Primary Health Centres were measured. Parents recorded all infant’s food consumption for three days (g/day). Linear regression models were applied. Results: breast-fed infants had a lower intake of cereals, fruit baby food, vegetables with meat/fish and a total intake of food compared to formula-fed infants at nine months of age. After adjusting for sex, parental education and total food intake, breastfed children continued to have lower intake of cereals (-5.82, 95% CI: -9.22, -2.43), and lower total food intake (-301.23, 95% CI: -348.50, -253.96). Breast-fed infants had a lower change in z-score of weight, height and BMI from six to 12 months of age and these differences remained when adjusting for all confounders. Conclusions: formula-fed infants during the complementary feeding period have a higher food intake and show higher rates of rapid infant weight gain compared to breast-fed infants. These differences in growth trajectories depending on breastfeeding maintenance and food intake during early life must be considered in adiposity risk evaluation.

Background Kawasaki disease (KD) is an acute systemic vasculitis of unknown aetiology which can lead to coronary aneurysm (CA) formation in 15-20% of patients. Long-term rates of adverse cardiac events are not well-known. Objectives: a) to compare demographic, clinical and laboratory features of patients who developed coronary aneurysm with patients who did not. b) to assess long-term cardiovascular outcomes in the subgroup of patients who developed cardiac aneurysms. Methods Single center study of 55 patients with KD who were diagnosed between 1994-2009. KD diagnosis was based on the classic classification criteria1. We considered two groups: a) patients who presented CA at diagnosis. b) patients who did not present CA. Statistical analysis was performed with SPSS. Student’s t test or Mann-Whitney U test was used to compare continuous variables, and Chi-squared test or Fisher’s exact test for categorical variables as appropriate. Results Out of 55 patients with KD, 8 patients (3 men/5 women) presented CA at diagnosis. Differences between the two groups mentioned above are shown in Table 1. Mean age at diagnosis was lower in patients who presented CA (1.74 vs 3.88 years; p=0.044). The duration of symptoms was longer in patients with CA (14.0 vs 12.0 days; p=0.015), however there were no qualitative differences in the symptomatology. Regarding laboratory markers, C- reactive protein (CRP) levels were significantly higher in patients who developed CA (17.0 vs 10.8 mg/dL; p=0.047). There was also a tendency to higher levels of erythrocyte sedimentation rate (ERS) and higher platelet count. All patients received intravenous immunoglobulin (IVIG) and antiplatelet agents at the time of diagnosis. Some of the patients with CA required glucocorticoids and anti-TNF agents. Table 2 shows the characteristics of the 8 patients with CA who were followed-up for a mean of 13.7 ± 7.8 years. The mean size of the aneurysms was 5.6 ± 2.3 mm. Left coronary artery was the most common location (n=5). In two patients, cardiac arrhytmia was described. Five patients underwent ergometry tests being negative for ischemia in all of them. Coronary tomography was performed in other two patients observing persistence of CA in just one of the patients after 131 months of follow-up. Conclusion In our cohort, patients with KD who presented CA at the time of diagnosis were younger, had a longer duration of symptoms and higher levels of CRP. All patients received early treatment with IVIG and antiplatelet agents. At long-term follow up, persistent coronary affection was reported in just one of the patients. No severe cardiovascular outcomes were shown. References [1] Wood LE, et al. Expert Rev Cardiovasc Ther. 2007; 5: 553-61 Disclosure of Interests D. Prieto-Pena: None declared, Jose Luis Martin-Varillas: None declared, Lara Sanchez Bilbao: None declared, Eva Pena Sainz-Pardo: None declared, Monica Calderon-Goercke: None declared, Natalia Palmou-Fontana: None declared, Maria Teresa Viadero: None declared, Maria Jesus Cabero: None declared, Miguel A Gonzalez-Gay Grant/research support from: Prof. MA Gonzalez-Gay received grants/research supports from Abbvie, MSD, Jansen and Roche., Speakers bureau: Consultation fees/participation in company sponsored speaker’s bureau from Pfizer, Lilly, Sobi, Celgene, Novartis, Roche and Sanofi., Ricardo Blanco Grant/research support from: Abbvie, MSD, and Roche, Consultant for: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen

Background:Interferon signaling pathway plays a relevant role in autoimmunity. Genetic variants in theinterferon regulatory factor (IRF) 5gene, that encodes the major regulator of the type I interferon induction [1], have been related to the development of several inflammatory diseases [2].Objectives:To determine the influence ofIRF5on Immunoglobulin-A vasculitis (IgAV), an inflammatory vascular disease.Methods:ThreeIRF5polymorphisms (rs2004640, rs2070197 and rs10954213) representative of 3 different haplotype blocks were genotyped in 372 Caucasian patients with IgAV and 876 sex and ethnically matched healthy controls.Results:No statistically significant differences between patients with IgAV and controls were observed when eachIRF5polymorphism was analyzed independently. Similarly, no statistically significant differences between patients with IgAV and controls were found whenIRF5polymorphisms were evaluated combined conforming haplotypes. Additionally, there were no statistically significant differences in genotype, allele and haplotype frequencies ofIRF5when patients with IgAV were stratified according to the age at disease onset or to the presence/absence of gastrointestinal or renal manifestations.Conclusion:Our results do not support an influence ofIRF5on the pathogenesis of IgAV.References:[1]Nat Immunol 2011; 12: 231-8;[2]Arthritis Res Ther 2014; 16: R146.Acknowledgments:This study was supported by European Union FEDER funds and “Fondo de Investigaciones Sanitarias” (grant PI18/00042) from ‘Instituto de Salud Carlos III’ (ISCIII, Health Ministry, Spain). RL-M is a recipient of a Miguel Servet type I programme fellowship from the ISCIII, co-funded by the European Social Fund (ESF, `Investing in your future´) (grant CP16/00033). SR-M is supported by funds of the RETICS Program (RD16/0012/0009) (ISCIII, co-funded by the European Regional Development Fund (ERDF)). VP-C is supported by a pre-doctoral grant from IDIVAL (PREVAL 18/01). LL-G is supported by funds of PI18/00042 (ISCIII, co-funded by ERDF).Disclosure of Interests:Sara Remuzgo Martinez: None declared, Fernanda Genre: None declared, Verónica Pulito-Cueto: None declared, D. Prieto-Peña: None declared, Belén Atienza-Mateo: None declared, Belén Sevilla: None declared, Javier Llorca: None declared, Norberto Ortego: None declared, Leticia Lera-Gómez: None declared, Maite Leonardo: None declared, Ana Peñalba: None declared, María Jesús Cabero: None declared, Luis Martín-Penagos: None declared, Jose Alberto Miranda-Filloy: None declared, Antonio Navas Parejo: None declared, Javier Sanchez Perez: None declared, Maximiliano Aragües: None declared, Esteban Rubio: None declared, MANUEL LEON LUQUE: None declared, Juan María Blanco-Madrigal: None declared, E. Galindez: None declared, Javier Martin Ibanez: None declared, Santos Castañeda: None declared, Ricardo Blanco Grant/research support from: Abbvie, MSD and Roche, Consultant of: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Lilly and MSD, Miguel A González-Gay Grant/research support from: Pfizer, Abbvie, MSD, Speakers bureau: Pfizer, Abbvie, MSD, Raquel López-Mejías: None declared

Background:Cytokines signaling pathway genes represent a key component of the genetic network implicated in the pathogenesis of Immunoglobulin-A vasculitis (IgAV) [1], an inflammatory vascular pathology.Interleukin (IL)17Ais a genetic risklocusfor autoimmune diseases, such as giant cell arteritis [2] and spondyloarthritis [3].Objectives:To determine the potential influence ofIL17Aon IgAV.Methods:FiveIL17Atag polymorphisms (rs4711998, rs8193036, rs3819024, rs2275913 and rs7747909) were genotyped in 360 Caucasian patients with IgAV and 1,003 sex and ethnically matched healthy controls.Results:No statistically significant differences between patients with IgAV and healthy controls were observed when eachIL17Agenetic variant was analyzed independently. Similarly, no statistically significant differences between patients with IgAV and healthy controls were found when the fiveIL17Apolymorphisms were evaluated combined conforming haplotypes. In addition, there were no statistically significant differences in genotype, allele and haplotype frequencies ofIL17Awhen patients with IgAV were stratified according to the age at disease onset or to the presence/absence of gastrointestinal or renal manifestations.Conclusion:Our results do not support an influence ofIL17Aon the pathogenesis of IgAV.References:[1]Autoimmun Rev 2018; 17: 301-15[2]Ann Rheum Dis 2014; 73: 1742-5[3]Mediators Inflamm 2018; 2018: 1395823.Acknowledgments:This study was supported by European Union FEDER funds and “Fondo de Investigaciones Sanitarias” (grant PI18/00042) from ‘Instituto de Salud Carlos III’ (ISCIII, Health Ministry, Spain). RL-M is a recipient of a Miguel Servet type I programme fellowship from the ISCIII, co-funded by the European Social Fund (ESF, `Investing in your future´) (grant CP16/00033). SR-M is supported by funds of the RETICS Program (RD16/0012/0009) (ISCIII, co-funded by the European Regional Development Fund (ERDF)). VP-C is supported by a pre-doctoral grant from IDIVAL (PREVAL 18/01). LL-G is supported by funds of PI18/00042 (ISCIII, co-funded by ERDF).Disclosure of Interests:Fernanda Genre: None declared, Sara Remuzgo Martinez: None declared, Verónica Pulito-Cueto: None declared, D. Prieto-Peña: None declared, Belén Atienza-Mateo: None declared, Belén Sevilla: None declared, Javier Llorca: None declared, Norberto Ortego: None declared, Leticia Lera-Gómez: None declared, Maite Leonardo: None declared, Ana Peñalba: None declared, María Jesús Cabero: None declared, Luis Martín-Penagos: None declared, Jose Alberto Miranda-Filloy: None declared, Antonio Navas Parejo: None declared, Diego de Argila: None declared, Maximiliano Aragües: None declared, Esteban Rubio-Romero: None declared, MANUEL LEON LUQUE: None declared, Juan María Blanco-Madrigal: None declared, E. Galindez: None declared, Javier Martin Ibanez: None declared, Santos Castañeda: None declared, Ricardo Blanco Grant/research support from: Abbvie, MSD and Roche, Consultant of: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Lilly and MSD, Miguel A González-Gay Grant/research support from: Pfizer, Abbvie, MSD, Speakers bureau: Pfizer, Abbvie, MSD, Raquel López-Mejías: None declared

to examine if those adolescents who dislike physical education classes get better results on academic and cognitive performance than their peers.participants included 4 226 adolescents from the AVENA, AFINOS and UPDOWN studies. Physical education enjoyment was assessed with a 7-point Likert scale. Cognitive performance in the AVENA study was assessed using the Spanish version of the SRA Test of Educational Ability. Academic performance in the AFINOS and UPDOWN studies was assessed through Mathematics and Language grades and the average of both subjects.in the AVENA study we found differences in verbal ability among girls who dislike physical education and their peers (P = 0.033). In the AFINOS study, boys who dislike physical education had higher scores in Language than their peers (P = 0.024). In the UPDOWN study girls who disliked physical education had higher scores in Language and in the average of Language and Mathematics than their peers (P0.001).in the AVENA and AFINOS studies adolescents who disliked physical education had similar results in cognitive and academic performance than their peers, but in the UPDOWN study girls who disliked physical education showed higher results in academic performance than their peers.Objetivo: conocer si a aquellos adolescentes que no les gusta la educación física obtienen mejores resultados en rendimiento académico y cognitivo que sus compañeros. Métodos: los participantes incluyen 4.226 adolescentes de los estudios AVENA, AFINOS y UPDOWN. El gusto por la educación física se valoró con una escala Likert de 7 puntos. El rendimiento cognitivo se valoró en el estudio AVENA usando la versión española del SRA Test of Educational Ability. El rendimiento académico se valoró en los estudios AFINOS y UPDOWN con las notas de Matemáticas, Lengua y la media de Lengua y Matemáticas. Resultados: en el estudio AVENA encontramos diferencias en la habilidad verbal entre las chicas a las que no les gustaba la educación física y sus compañeros (P = 0,033). En el estudio AFINOS los chicos a los que no les gustaba la educación física tenían mejores notas en Lengua que sus compañeros (P = 0,024). En el estudio UPDOWN las chicas a las que no les gustaba la educación física obtuvieron mejores resultados en Lengua y en la media de Lengua y Matemáticas (P0,001).en los estudios AVENA y AFINOS los adolescentes a los que no les gusta la educación física obtuvieron resultados similares a los que sus compañeros, mientras que en el estudio UPDOWN las chicas a las que no les gustaba la educación física obtuvieron mejores resultados en rendimiento académico que sus compañeros.

In the physical education context a well- known myth suggest that obese and unfit youth dislike physical education.To examine if adolescents who dislike physical education have higher levels of fatness and lower of fitness than their peers.Participants included 2606 (49.3% girls) adolescents from AVENA and UPDOWN studies. physical education enjoyment was assessed with a 7-point Likert scale. Fatness was assessed with BMI, skinfolds and waist circumference. Physical fitness was assessed with cardiorespiratory, motor and muscular fitness tests.Boys who dislike physical education had similar levels of fatness and fitness than their peers (all P0.05). Adolescent girls who dislike physical education had higher levels in body fat (P=0.035), and lower levels in muscular (P=0.007) and motor (P=0.007) fitness than their peers.Since only girls who dislike physical education seem to have, albeit weak, higher levels of fatness and lower of fitness than their peers, it partially confirms the myth in adolescent girls.En el contexto de la EF (educación física), un mito bien conocido podría sugerir que a los jóvenes obesos y con baja condición física no les gusta la EF.Examinar si a los adolescentes a los que no les gusta la EF tienen niveles más altos de obesidad y niveles más bajos de forma física que sus compañeros.Se tomó a 2606 participantes (49.3% chicas) adolescentes de los estudios AVENA y UPDOWN. El disfrute de la EF se evaluó empleando una escala Likert de 7 puntos. La obesidad se evaluó mediante el IMC, pliegues cutáneos y circunferencia de la cintura. La condición física fue evaluada mediante pruebas cardiorespiratorias, motoras y musculares.Los chicos a los que no les gusta la EF presentaron niveles similares de obesidad que sus compañeros (total P0.05). Las chicas adolescentes a las que no les gusta la EF presentaron niveles más altos de grasa corporal (P=0.035), y niveles más bajos en condición física muscular (P=0.007) y motora (P=0.007) que sus compañeros.Dado que solo las chicas a las que no les gusta la EF parecen presentar, sin bien levemente, niveles más altos de obesidad y niveles menores de forma física que sus compañeros, el mito se confirma parcialmente para las chicas adolescentes.