The current research describe variables illness discrimination, social support, physical well-bei... more The current research describe variables illness discrimination, social support, physical well-being, barrier to medical services and health programs, coping, and physician patient relationship; and the relation between these variables with Life Quality in children between 7 and 12 years old who are being treated for cancer in a Pediatric Hematooncology Unit in Cartagena. The conclusion was derived by using the information given for 19 children with cancer, finding an existing relation between variables illness discrimination, social support, coping and physician patient relationship with Life Quality; in the remaining variables a negative correlation was found.
Introduccion Aunque la actual vacuna antineumococica 23-valente (VAN-23s) esta disponible desde l... more Introduccion Aunque la actual vacuna antineumococica 23-valente (VAN-23s) esta disponible desde los anos ochenta, esta resultando dificil alcanzar altas coberturas en las diferentes poblaciones diana. Este estudio tuvo como objetivo conocer el grado de implementacion de la recomendacion de la VAN-23s y evaluar las tasas de vacunacion antineumococica entre la poblacion mayor de 65 anos en funcion de la presencia de patologias o factores de riesgo para padecer neumonia. Metodos Estudio observacional transversal, en el que se analizaron 11.241 personas mayores de 65 anos adscritas a 8 centros de Atencion Primaria de Tarragona-Valls. Mediante revision de historias clinicas informatizadas y del registro informatico de vacunaciones, se valoro en cada paciente si habia recibido la VAN-23s, asi como la presencia de enfermedades o factores de riesgo para sufrir neumonia. Resultados La cobertura vacunal global fue 44,4% (intervalo de confianza [IC] 95%: 43,9-44,9). El 63,2% del total de vacunaciones antineumococicas se habia administrado durante los meses de octubre o noviembre. Las coberturas variaban significativamente con la edad (p Conclusiones A pesar de una cobertura global aceptable, existen amplias bolsas de pacientes con alto riesgo de sufrir neumonia que no han recibido la vacuna antineumococica.
This study assessed the relationship between the reception of conventional inactivated influenza ... more This study assessed the relationship between the reception of conventional inactivated influenza vaccine and winter mortality in a prospective cohort that included 11,240 Spanish community-dwelling elderly individuals followed from January 2002 to April 2005. Annual influenza vaccine status was a time-varying condition and primary outcome was all-cause death during study period. Multivariable Cox proportionalhazard models adjusted by age, sex and co-morbidity were used to evaluate vaccine effectiveness. Influenza vaccination was associated with a significant reduction of 23% in winter mortality risk during overall influenza periods. The attributable mortality risk in non-vaccinated people was 24 deaths per 100,000 persons-week within influenza periods, the prevented fraction for the population was 14%, and one death was prevented for every 239 annual vaccinations (ranging from 144 in Winter 2005 to 1748 in Winter 2002).
Although there is a general agreement for the recommendation of the influenza vaccine to persons ... more Although there is a general agreement for the recommendation of the influenza vaccine to persons with chronic obstructive pulmonary disease (COPD), the magnitude of clinical effectiveness and benefit from the annual vaccination is controversial. We assessed the effects of annual influenza vaccination on winter mortality in older adults with COPD. This prospective cohort study included 1298 Spanish community-dwelling individuals aged 65 years or older with a diagnosis of COPD followed from 1 January 2002 to 30 April 2005. The primary outcome was all-cause death during influenza periods (January-April). Multivariable Cox proportional hazard models adjusted by age, sex and comorbidity were used to evaluate vaccine effectiveness. Influenza vaccination was associated with a non-statistically significant 16% reduction in winter mortality among vaccinated COPD patients [unadjusted hazard ratio (HR): 0.84; 95% confidence interval (CI): 0.60-1.17]. Multivariable analysis showed that there was an insignificant trend towards a reduced mortality in the vaccinated group considering overall influenza periods 2002-2005 (adjusted HR: 0.76; 95% CI: 0.52-1.06; p=0.098). We estimated that, in the total COPD population, one death was prevented for every 187 annual vaccinations (95% CI: 62 to infinity). Our data suggest benefit from the influenza vaccination and support an annual vaccination strategy for elderly COPD patients.
Streptococcus pneumoniae, the most common cause of community-acquired pneumonia, remains a major ... more Streptococcus pneumoniae, the most common cause of community-acquired pneumonia, remains a major cause of morbidity and mortality worldwide. The presence of chronic respiratory illness is a major risk factor for pneumonia, and smoking (the most common cause of chronic obstructive pulmonary disease) is also an important risk factor for pneumonia and invasive pneumococcal disease. There are currently three established approaches to antipneumococcal vaccination: capsular polysaccharide pneumococcal vaccines (recommended for adults and some children at risk), protein-polysaccharide conjugate pneumococcal vaccines (classically recommended for infants and young children and currently under evaluation for adults aged 50 years or older for the prevention of invasive disease) and experimental protein-based pneumococcal vaccines (under investigation in animal models). Although patients with chronic respiratory diseases are commonly described as an at-risk population for pneumococcal infections, studies on pneumococcal vaccination efficacy in such patients are very limited and vaccination effectiveness remains controversial. This paper reviews available data on the efficacy and effectiveness of polysaccharide pneumococcal vaccination among adults with chronic respiratory diseases.
Although there is general agreement for the recommendation of the influenza vaccine to elderly an... more Although there is general agreement for the recommendation of the influenza vaccine to elderly and high-risk adults, the magnitude of clinical effectiveness and benefit from the annual vaccination is controversial. In this study, we have assessed the effects of annual influenza vaccination on winter mortality in older adults with chronic heart disease. Methods and results Cohort study that included 1340 Spanish community-dwelling individuals 65 years or older who had chronic heart disease (congestive heart failure or coronary artery disease) followed from January 2002 to April 2005. Annual influenza vaccine status was a time-varying condition and primary outcome was all-cause death during the study period. Multivariable Cox proportional-hazard models adjusted by age, sex, and comorbidity were used to evaluate vaccine effectiveness. Influenza vaccination was associated with a significant reduction of 37% in the adjusted risk of winter mortality during the overall period 2002-2005. The attributable mortality risk reduction in vaccinated people was 8.2 deaths per 1000 person-winters. We estimated that one death was prevented for every 122 annual vaccinations (ranging between 49 in Winter 2005 and 455 in Winter 2003). Conclusion Our results suggest a benefit from the influenza vaccination and support an annual vaccination strategy for elderly people with cardiac diseases.
The current research describe variables illness discrimination, social support, physical well-bei... more The current research describe variables illness discrimination, social support, physical well-being, barrier to medical services and health programs, coping, and physician patient relationship; and the relation between these variables with Life Quality in children between 7 and 12 years old who are being treated for cancer in a Pediatric Hematooncology Unit in Cartagena. The conclusion was derived by using the information given for 19 children with cancer, finding an existing relation between variables illness discrimination, social support, coping and physician patient relationship with Life Quality; in the remaining variables a negative correlation was found.
Introduccion Aunque la actual vacuna antineumococica 23-valente (VAN-23s) esta disponible desde l... more Introduccion Aunque la actual vacuna antineumococica 23-valente (VAN-23s) esta disponible desde los anos ochenta, esta resultando dificil alcanzar altas coberturas en las diferentes poblaciones diana. Este estudio tuvo como objetivo conocer el grado de implementacion de la recomendacion de la VAN-23s y evaluar las tasas de vacunacion antineumococica entre la poblacion mayor de 65 anos en funcion de la presencia de patologias o factores de riesgo para padecer neumonia. Metodos Estudio observacional transversal, en el que se analizaron 11.241 personas mayores de 65 anos adscritas a 8 centros de Atencion Primaria de Tarragona-Valls. Mediante revision de historias clinicas informatizadas y del registro informatico de vacunaciones, se valoro en cada paciente si habia recibido la VAN-23s, asi como la presencia de enfermedades o factores de riesgo para sufrir neumonia. Resultados La cobertura vacunal global fue 44,4% (intervalo de confianza [IC] 95%: 43,9-44,9). El 63,2% del total de vacunaciones antineumococicas se habia administrado durante los meses de octubre o noviembre. Las coberturas variaban significativamente con la edad (p Conclusiones A pesar de una cobertura global aceptable, existen amplias bolsas de pacientes con alto riesgo de sufrir neumonia que no han recibido la vacuna antineumococica.
This study assessed the relationship between the reception of conventional inactivated influenza ... more This study assessed the relationship between the reception of conventional inactivated influenza vaccine and winter mortality in a prospective cohort that included 11,240 Spanish community-dwelling elderly individuals followed from January 2002 to April 2005. Annual influenza vaccine status was a time-varying condition and primary outcome was all-cause death during study period. Multivariable Cox proportionalhazard models adjusted by age, sex and co-morbidity were used to evaluate vaccine effectiveness. Influenza vaccination was associated with a significant reduction of 23% in winter mortality risk during overall influenza periods. The attributable mortality risk in non-vaccinated people was 24 deaths per 100,000 persons-week within influenza periods, the prevented fraction for the population was 14%, and one death was prevented for every 239 annual vaccinations (ranging from 144 in Winter 2005 to 1748 in Winter 2002).
Although there is a general agreement for the recommendation of the influenza vaccine to persons ... more Although there is a general agreement for the recommendation of the influenza vaccine to persons with chronic obstructive pulmonary disease (COPD), the magnitude of clinical effectiveness and benefit from the annual vaccination is controversial. We assessed the effects of annual influenza vaccination on winter mortality in older adults with COPD. This prospective cohort study included 1298 Spanish community-dwelling individuals aged 65 years or older with a diagnosis of COPD followed from 1 January 2002 to 30 April 2005. The primary outcome was all-cause death during influenza periods (January-April). Multivariable Cox proportional hazard models adjusted by age, sex and comorbidity were used to evaluate vaccine effectiveness. Influenza vaccination was associated with a non-statistically significant 16% reduction in winter mortality among vaccinated COPD patients [unadjusted hazard ratio (HR): 0.84; 95% confidence interval (CI): 0.60-1.17]. Multivariable analysis showed that there was an insignificant trend towards a reduced mortality in the vaccinated group considering overall influenza periods 2002-2005 (adjusted HR: 0.76; 95% CI: 0.52-1.06; p=0.098). We estimated that, in the total COPD population, one death was prevented for every 187 annual vaccinations (95% CI: 62 to infinity). Our data suggest benefit from the influenza vaccination and support an annual vaccination strategy for elderly COPD patients.
Streptococcus pneumoniae, the most common cause of community-acquired pneumonia, remains a major ... more Streptococcus pneumoniae, the most common cause of community-acquired pneumonia, remains a major cause of morbidity and mortality worldwide. The presence of chronic respiratory illness is a major risk factor for pneumonia, and smoking (the most common cause of chronic obstructive pulmonary disease) is also an important risk factor for pneumonia and invasive pneumococcal disease. There are currently three established approaches to antipneumococcal vaccination: capsular polysaccharide pneumococcal vaccines (recommended for adults and some children at risk), protein-polysaccharide conjugate pneumococcal vaccines (classically recommended for infants and young children and currently under evaluation for adults aged 50 years or older for the prevention of invasive disease) and experimental protein-based pneumococcal vaccines (under investigation in animal models). Although patients with chronic respiratory diseases are commonly described as an at-risk population for pneumococcal infections, studies on pneumococcal vaccination efficacy in such patients are very limited and vaccination effectiveness remains controversial. This paper reviews available data on the efficacy and effectiveness of polysaccharide pneumococcal vaccination among adults with chronic respiratory diseases.
Although there is general agreement for the recommendation of the influenza vaccine to elderly an... more Although there is general agreement for the recommendation of the influenza vaccine to elderly and high-risk adults, the magnitude of clinical effectiveness and benefit from the annual vaccination is controversial. In this study, we have assessed the effects of annual influenza vaccination on winter mortality in older adults with chronic heart disease. Methods and results Cohort study that included 1340 Spanish community-dwelling individuals 65 years or older who had chronic heart disease (congestive heart failure or coronary artery disease) followed from January 2002 to April 2005. Annual influenza vaccine status was a time-varying condition and primary outcome was all-cause death during the study period. Multivariable Cox proportional-hazard models adjusted by age, sex, and comorbidity were used to evaluate vaccine effectiveness. Influenza vaccination was associated with a significant reduction of 37% in the adjusted risk of winter mortality during the overall period 2002-2005. The attributable mortality risk reduction in vaccinated people was 8.2 deaths per 1000 person-winters. We estimated that one death was prevented for every 122 annual vaccinations (ranging between 49 in Winter 2005 and 455 in Winter 2003). Conclusion Our results suggest a benefit from the influenza vaccination and support an annual vaccination strategy for elderly people with cardiac diseases.
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