Enfermedad pulmonar obstructiva crónica y salud respiratoria / Chronic obstructive pulmonary disease and respiratory health

La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad que cursa con manifestaciones multisistémicas y agudizaciones, y que conlleva una importante carga de morbilidad, mortalidad y costes sanitarios. Distintas medidas terapéuticas y de prevención juegan un papel importante en mejorar el pronóstico y la salud respiratoria de estos pacientes. Realizar actividad física de forma generalizada, llevar a cabo unos hábitos dietéticos y nutricionales adecuados, abandonar el consumo de tabaco y alcanzar un estado de inmunización óptimo son varias de las acciones de salud recomendadas. Estas también enlentecerán el proceso de envejecimiento. Además, se recomienda realizar políticas de salud pública para reducir la contaminación del aire y el cambio climático. Por último, debemos prestar especial atención a las características del sueño de estos pacientes y llevar a cabo un abordaje terapéutico que incluya una mejor calidad del sueño. (AU)

Chronic obstructive pulmonary disease (COPD) is a disease with multisystemic manifestations and exacerbations that lead to a significant burden of morbidity, mortality, and health care costs. Various therapeutic and preventive measures play an important role in improving the prognosis and respiratory health of the patients. General physical activity, proper dietary and nutritional habits, smoking cessation, and achieving an optimal immunization status are some of the recommended health actions. They also slow down the aging process. In addition, public health policies are recommended to reduce air pollution and climate change. Finally, we should pay special attention to the sleep characteristics of these patients and carry out a therapeutic approach that includes better sleep quality. (AU)

The Path Towards Effective Respiratory Syncytial Virus Immunization Policies: Recommended Actions

The respiratory syncytial virus (RSV) causes a substantial burden worldwide. After over six decades of research, there is finally a licensed immunization option that can protect the broad infant population, and other will follow soon. RSV immunization should be in place from season 2023/2024 onwards. Doing so requires thoughtful but swift steps. This paper reflects the view of four immunization experts on the efforts being made across the globe to accommodate the new immunization options and provides recommendations organized around five priorities: (I) documenting the burden of RSV in specific populations; (II) expanding RSV diagnostic capacity in clinical practice; (III) strengthening RSV surveillance; (IV) planning for the new preventive options; (V) achieving immunization targets. Overall, Spain has been a notable example of converting RSV prevention into a national desideratum and has pioneered the inclusion of RSV in some of the regional immunization calendars for infants facing their first RSV season. (AU)

Efectividad de las vacunas frente aSARS-CoV-2 utilizadas en España: infección, hospitalización y mortalidaden personas de cincuenta a cincuentay nueve años / Effectiveness of vaccines against SARS-CoV-2 used in Spain: infection, hospitalization and mortality in people aged fifty/fifty-nine

En este trabajo se comparó la efectividad de la vacuna contra la COVID-19 (EV) durante agosto de 2021, en personas nacidas entre 1962y 1971 y vacunadas durante junio, según la marca utilizada. La protección frente a infección por SARS-CoV-2 sintomática fue menorpara la vacuna de Janssen (56%; IC95%: 53-59) y AstraZeneca [Vaxzevria] (68%; IC95%: 65-70), en comparación con Pfizer [Comir-naty] (78%; IC95%: 77-78), AZ/Pfizer (86%; IC95%: 80-90) y Moderna [Spikevax] (89%; IC95%: 88-90). La EV contra la hospitalizaciónosciló entre el 86% de Janssen y el 97%-98% de las demás vacunas.(AU)

In this paper we compared brand-specific COVID-19 vaccine effectiveness (VE) during August 2021 in persons born 1962-1971 and vaccina-ted during June. For SARS-CoV-2 symptomatic infection, protection was lower for Janssen (56%; CI95%: 53-59) or AstraZeneca [Vaxzevria](68%; CI95%: 65-70), compared to Pfizer-BioNTech [Comirnaty] (78%; CI95%: 77-78), AstraZeneca/Pfizer (86%; CI95%: 80-90) or Moderna[Spikevax] (89%; CI95%: 88-90). VE against hospitalization was ranged 86% for Janssen to 97%-98% for other vaccines

Vacunación frente a hepatitis B en pacientes con enfermedad inflamatoria intestinal: respuesta inmunitaria y factores asociados / Vaccination against hepatitis B in patients with inflammatory bowel disease: immune response and associated factors

Fundamentos: Los pacientes con Enfermedad Inflamatoria Intestinal (EII) tienen más riesgo de infección por el virus de la hepatitis B (VHB) así como menor respuesta frente a la vacunación. El objetivo de este estudio fue analizar la respuesta inmunitaria tras la vacunación frente al VHB en los pacientes diagnosticados de EII y sus factores asociados. Métodos: Se realizó un estudio observacional retrospectivo sobre los pacientes con EII atendidos en la consulta de vacunas de pacientes de riesgo en el Complejo Hospitalario Universitario de Albacete durante el período 2011-2018. Se determinó la respuesta serológica tras la vacunación y los factoresasociados mediante modelos de regresión logística. Resultados: Se incluyeron 231 pacientes. La vacunación frente al VHB tuvo una respuesta inmunitaria óptima en un 82,7% de los pacientes. La probabilidad de respuesta a la vacunación aumentó en aquellos diagnosticados de colitis ulcerosa (OR 2,90; IC95% 1,11-7,61) y se redujo con la edad (80% menor en los de 40-55 años (OR 0,20; IC95% 0,05-0,83) y 88% menor en mayores de 55 años (OR 0,12; IC95% 0,03-0,53) frente a los menores de 40 años) y con la inmunosupresión farmacológica (OR 0,20; IC95% 0,58-0,71). Conclusiones: La disminución de la inmunogenicidad de la vacuna frente a la hepatitis B en los pacientes con EII tras el inicio del tratamiento inmunosupresor, así como con la edad, hacen prioritaria la vacunación temprana en este tipo de pacientes.(AU)

Background: Patients with Inflammatory Bowel Disease (IBD) are at increased risk of hepatitis B virus (HBV) infection as well as a lower response to vaccination. This study aimed to analyze the immune response after vaccination against HBV in patients diagnosed with IBD and its associated factors. Methods: A retrospective observational study was conducted on patients with IBD treated at the vaccination clinic for at-risk patients at the Complejo Hospitalario Universitario de Albacete during the period 2011-2018. Immune response after vaccination and associated factors were determined using logistic regression models. Results: 231 patients were included. HBV Vaccination had an optimal immune response in 82.7% of the patients. The likelihood of response to vaccination increased in those diagnosed with ulcerative colitis (OR 2.90; 95% CI 1.11-7.61) and decreased with age (80% lower in those aged 40- 55 years (OR 0.20; 95% CI 0.05-0.83) and 88% lower in those over 55 years of age (OR 0.12; 95% CI 0.03-0.53) compared to those under 40 years of age) and pharmacological immunosuppression (OR 0.20; 95% CI 0.58-0.71). Conclusions: The decrease in the immunogenicity of the vaccine against hepatitis B in patients with IBD after the beginning of immunosuppressive treatment, as well as with age, make early vaccination a priority in this kind of patients.(AU)

The role of pharmacists in providing immunization to the general population: Are Lebanese pharmacists ready for this role?

Background: Vaccination rates remain suboptimal in multiple areas around the world in spite of evidence that immunization is one of the most effective interventions for precluding morbidity and mortality. Non-traditional vaccine providers are proposed to augment immunization coverage. Pharmacists can have multiple vital roles to educate, facilitate and immunize against vaccine-preventable diseases. Limited data are available around the expertise and practices of Lebanese pharmacists in providing immunization services. Objective: This study aimed to determine predictors that are associated with vaccine administration by pharmacists in Lebanon, and to assess experiences and practices in providing immunization. Methods: This is a cross-sectional study that included pharmacists from all over Lebanon. A web-based self-administered validated questionnaire was adapted with permission. A snowball sampling technique was used to collect data through an electronic self-administered questionnaire between March and June 2021. The web-link to the survey was also shared by the Order of Pharmacists of Lebanon with all registered pharmacists to gather a sample from different districts all over Lebanon. Results: A total of 315 pharmacists were included. A significant positive association was found between completion of an immunization training program (ORa = 2.085, [95%CI 1.006:4.322], P = 0.048), full-time pharmacists (ORa = 2.504, [95%CI 1.156:5.426], P = 0.02), 1 to 4 years of practice experience (ORa = 3.855, [95%CI 1.849:8.039], P < 0.0001), geographic area of practice (ORa = 3.201, [95%CI 1.242:8.249], P = 0.016; ORa = 5.373, [95%CI 1.859:15.530], P = 0.002 for Beirut and Mount Lebanon respectively), educating the public about immunization (ORa = 3.012, [95%CI 1.281:7.083], P = 0.011); and vaccine administration (AU)

Evaluating the knowledge, attitudes, and uptake of the influenza vaccine in healthcare professionals: A cross-sectional study from the United E

Background: Influenza, a yearly epidemic, can present with a wide array of symptoms ranging from mild rhinorrhoea and cough to life-threatening superadded bacterial infections. It affects the lives of around 12.5% of the world’s population every year and accounts for almost half a billion deaths. With growing populations, these numbers will follow a similar growth resulting in increased morbidity and mortality. Currently, the recommended method to prevent influenza is through the administration of a yearly vaccine that entails the suspected strains of the virus for the year and region. Objective: This study aims to explore the knowledge, attitudes, and practices of the health care professionals in the United Arab Emirates (UAE) regarding Influenza vaccination. Methods: A cross-sectional study, utilizing a self-administered questionnaire, was distributed amongst health care professionals in the four largest emirates in the UAE, via convenience sampling. 417 responses were completed and analysed using SPSS-24. Results: 54.1% (n=225) of participants continue going to work while being sick despite 67.6% (n=282) reporting they are aware of the recommendations published by the Centers for Disease Control and Prevention (CDC). Multiple linear regression showed that age and profession were the only significant predictor of influenza vaccine knowledge. 54.2% (n=226) of the participants reported receiving the vaccine; of those, only 38.9% (n=88) receive it annually. One of the most commonly reported barriers to taking the vaccine was the uncertainty of its effectiveness. Those using a reminder system were 2.044 times more likely to take the vaccine regularly. Conclusion: This study demonstrates that the attitudes and practices towards taking the influenza vaccine as recommended are suboptimal. Campaigns targeting health care professionals regarding the influenza vaccine and the CDC recommendations would perhaps positively skew the results in the future (AU)

Immunization training for pharmacy students: a student-centered evaluation

Background: Persistent and emerging public health challenges mean Pharmacy students require training in immunization services. Curtin University, Australia, integrated blended-delivery immunization training into the final-year Bachelor of Pharmacy (Hons) and graduate-entry Master of Pharmacy curricula in 2019 and 2020, utilizing materials licenced from the Pharmaceutical Society of Australia. Objective: This study evaluated changes in students’ attitude, confidence, self-perceived knowledge and self-perceived skills pre- and post-training delivered in 2020. Methods: Pre- and post-training questionnaires featured 42 opinion statements grouped under headings ‘Attitudes’, ‘Confidence’, ‘Self-Perceived Knowledge’ and ‘Self-Perceived Skills’, and answered using five-point Likert scales (1 = strongly disagree to 5 = strongly agree). Completed pre- and post-training questionnaires were matched using respondent-generated codes. Data were subjected to descriptive and multivariate regression analysis to test pre-post changes and associations and changes in mean scores. Results: 128 (95.5%) and 132 (98.5%) students completed the pre- and post-training questionnaires, respectively. Immunization training resulted in significant (p<0.05) improvement in students’ mean Confidence score (3.33 vs 3.96), Self-Perceived Knowledge score (3.08 vs 4.47) and Self-Perceived Skills score (2.81 vs 4.55). Improvement in students’ mean Attitude score was also statistically significant (4.45 vs 4.61), yet more positively skewed pre-training. No significant pre-post differences were found between the Bachelor and Master students. Post-training, all respondents agreed that the training program increased their attitude, confidence, perceived knowledge and perceived skills, rating the training experience as either Excellent (91.6%) or Good (8.4%) (AU)

Fonaments bàsics de les vacunes contra la covid-19 / Fundamentos básicos de las vacunas contra la covid-19 / Basics of covid-19 vaccines

A començaments de l’any 2020 s’estén arreu del món unapandèmia provocada pel SARS-CoV-2, un virus respiratoriemergent procedent de la Xina i causant de la malaltiaconeguda com a covid-19. D’aleshores ençà, l’obtenciód’una vacuna ha esdevingut una cursa contrarellotge arreudel món. Equips d’investigació d’universitats i farmacèuti-ques assagen vacunes basades en diferents tecnologies,algunes ja utilitzades històricament i altres de nova gene-ració. Actualment n’hi ha centenars en diferents fasesd’investigació. Això, juntament amb el gran impacte quegenera la malaltia a la societat, fa que estiguem sotmesosa una allau constant d’informació sobre les vacunes contrala covid-19. Aquest treball de revisió pretén aclarir algunsconceptes que ens permetin ser crítics amb la informaciórebuda i, al mateix temps, aclarir termes i generalitats so-bre els diferents tipus de vacunes, la seva regularització,producció i efectes secundaris.(AU)

A comienzos de 2020 se extiende por el mundo una pandemiaprovocada por el virus SARS-CoV-2, un virus respiratorio emer-gente procedente de China y causante de la enfermedad conocidacomo covid-19. A partir de entonces, la obtención de una vacunase ha convertido en una carrera contrarreloj alrededor del mundo.Equipos de investigación de universidades y farmacéuticas ensa-yan vacunas basadas en diferentes tecnologías, algunas ya utiliza-das históricamente y otras de nueva generación. Actualmente haycentenares en diferentes fases de investigación. Esto, junto con elgran impacto que genera la enfermedad en la sociedad, hace queestemos sometidos a un alud constante de información sobre lasvacunas contra la covid-19. Este trabajo de revisión pretende acla-rar algunos conceptos que nos permitan una lectura crítica de lainformación y aclarar simultáneamente términos y generalidadessobre los diferentes tipos de vacunas, su regularización, produc-ción y efectos secundarios.(AU)

Early in 2020, a pandemic caused by a new respiratory virus na-med SARS-CoV-2 -causing the COVID-19 disease- extended aroundthe world from China. From that moment on a global race for thevaccine commenced at universities and the pharmaceutical indus-try using different methods and technologies, including both tradi-tional and new generation strategies. Nowadays, hundreds of themare under different phases of development. This, along with thestrong social impact of the disease, floods social media with infor-mation about the progresses of the different working groups. Thispaper sheds light on concepts that allow one to scrutinize suchinformation critically and clarify terms and generalities about diffe-rent vaccines, their regularization, production and side effects.(AU)

Adherencia a las recomendaciones actuales de inmunización en pacientes con artritis reumatoide en México / Adherence to Current Vaccination Recommendations for Patients With Rheumatoid Arthritis in Mexico

Antecedentes: Los pacientes con artritis reumatoide (AR) presentan un incremento de 2 a 4 veces del riesgo de infecciones comparado con la población general. Por esta razón existen recomendaciones sobre la aplicación de vacunas de gripe, neumococo y herpes zóster en todos los pacientes con AR, previo al inicio del tratamiento. Varios estudios han demostrado la baja prevalencia de vacunación, así como la adherencia a las recomendaciones actuales de inmunización por los reumatólogos. Objetivo: El objetivo de este estudio fue determinar el conocimiento de las recomendaciones actuales de inmunización en pacientes con AR por los reumatólogos miembros del Colegio Mexicano de Reumatología, así como identificar las barreras en su aplicación en dicha población. Métodos: Se realizó un estudio transversal por medio de una encuesta a 577 reumatólogos de México en enero 2017. Resultados: Se obtuvieron 122 respuestas, representando el 21,14% de los 577 reumatólogos. El 50,82% respondió que recomendaba al 76-100% de sus pacientes la vacuna de la gripe, el 36,07% recomendaba al 76-100% de sus pacientes la vacuna de neumococo y con respecto a la vacuna del herpes zóster el 69,67% respondió que no la recomendaba rutinariamente a sus pacientes. Conclusiones: De acuerdo a los datos obtenidos en este estudio, no existe información adecuada acerca de la importancia de la vacunación en pacientes con AR. También muestra que el grado de adherencia a las recomendaciones de vacunación, así como el conocimiento sobre seguridad y tiempo óptimo de administración de las vacunas son bajos en México.(AU)

Background: Patients with RA have a two to four-fold increased risk of developing infections compared to the general population. For this reason, the administration of influenza, pneumococcal and shingles vaccines is recommended for all patients with RA, preferably prior to initiating treatment, Previous studies have demonstrated the low prevalence of vaccination as well as adherence to current recommendations by rheumatologists in other regions. Objective: To determine the knowledge and adherence to the current vaccination recommendations for patients with RA by rheumatology members of the Mexican College of Rheumatology (MCR), and to identify barriers to their application in this population. Methods:mA cross-sectional study was conducted through a survey sent to 577 rheumatologists from Mexico in January 2017. Results: We received completed surveys from 122 individuals, representing 21.14% of the 577 rheumatologists in our registry. Fifty percent responded that they recommended immunization against influenza to 76%-100% of their patients, 36.07% recommended immunization against pneumococcus to 76%-100% of their patients, and 69.67% of the survey responders did not recommend shingles immunization routinely to their patients. Conclusions: The data collected in this study show there is poor adherence to immunization schedules recommended for the RA population. This data suggests there is misinformation about the effectiveness, safety and optimal timing of immunization in patients with RA in Mexico.(AU)

Inmunidad frente a SARS-CoV-2: caminando hacia la vacunación / Immunity against SARS-CoV-2: walking to the vaccination

Los coronavirus (CoVs) son un amplio grupo de virus en el que se encuentra el SARS-CoV-2 (familia Coronaviridae, subfamilia Coronavirinae, género Betacoronavirus y subgénero Sarbecovirus). Sus principales proteínas estructurales son la de membrana (M), la de envoltura (E), la nucleocápside (N) y la espicular (S). La respuesta inmune frente a SARS-CoV-2 implica la vertiente celular y humoral, con anticuerpos neutralizantes potencialmente defensivos fundamentalmente dirigidos frente al antígeno S. Aunque los datos de seroprevalencia se asumen muy frecuentemente como marcadores de protección, no necesariamentelo son. En España se estima que al menos cuatro quintas partes de la población deberían estar inmuno-protegidas para asegurar la inmunidad de grupo. Dada la alta tasa de letalidad por COVID-19, la adquisición de esta protección únicamente mediante el contagio natural no es asumible y se debe abogar por otras medidas como puede ser la inmunización masiva. En la actualidad existen varios prototipos de vacunas (que incluyen virus vivos, vectores virológicos, péptidos y proteínas y ácidos nucleicos) en diversas etapas de evaluación clínica. Se prevé que en breve alguna de estas nuevas vacunas se encuentre ya disponible en el mercado. En este texto se revisan aspectos relacionados con estos asuntos

The coronavirus are a wide group of viruses among that the SARS-CoV-2 is included (family Coronaviridae, subfamily Coronavirinae, genus Betacoronavirus and subgenus Sarbecovirus). Its main structural proteins are the membrane (M), the envelope (E), the nucleocapsid (N) and spike (S). The immune response to SARS-CoV-2 involves the cellular and the humoral sides, with neutralizing antibodies fundamentally directed against the S antigen. Although the seroprevalence data are frequently assumed as protection markers, no necessarily they are. In Spain, it is estimated that, to assure the herd immunity, at least four-fifths of the population should be immunoprotected. Due the high fatality rate of COVID-19, the acquisition of the protection only by the natural infection it not assumable and other measures as the mass immunization are required. Currently, there are several vaccine prototypes (including life virus, viral vectors, peptides and proteins and nucleic acid) in different phase of clinical evaluation. Foreseeably, some of these news vaccines would be soon commercially available. In this text, aspects related to these issues are reviewed

Sensitisation to aeroallergens in relation to asthma and other allergic diseases in Angolan children: a cross-sectional study

INTRODUCTION AND OBJECTIVES: In Africa, few studies of sensitisation profiles have been performed in children or adolescents and, in Angola, there are none. The objectives of the present study were to assess the sensitisation profile of Angolan schoolchildren and to determine the relationship between that pattern, sociodemographic factors, asthma and other allergic diseases. MATERIALS AND METHODS: Cross-sectional, observational study in 5-14-year-old children, performed between September and November 2017, in the Province of Bengo, Angola. Five schools (15%) were randomly selected in the geographical area of the study: three from an urban area, and two from a rural area. Data were collected using the Portuguese versions of the ISAAC questionnaires for children and adolescents, regarding asthma, rhinitis and eczema. Skin prick tests (SPT) were performed with a battery of 12 aeroallergens. Stools were assessed for the presence of helminths. Descriptive statistics were used, as well as univariate calculation of odds ratios. RESULTS: Sensitisation to aeroallergens was low (8%) and most sensitised children were asymptomatic. Most frequent sensitisations involved house dust mites, cockroach or fungi, and a high proportion of children (78.1%) were monosensitised. No relationship was detected between sensitisations and asthma, rhinitis or eczema. Place of residence, gender, age or helminthic infection did not affect the probability of having positive SPTs. CONCLUSIONS: The most frequent sensitisations in children from Bengo Province in Angola involve house dust mites, followed by cockroach and fungi. No relationship was found between atopic sensitisation and asthma or other allergic diseases

No disponible

Associations between serum 25-hydroxyvitamin D levels and allergic sensitization in early childhood

Background and objectives: Vitamin D status may be related to allergen sensitizations, but the evidence is inconsistent. The objective of this study was to assess whether serum 25-hydroxyvitamin D (25(OH)D) levels were associated with allergic sensitizations in early childhood. Methods: Data were collected from 2642 children who visited the Guangdong Women and Children's Hospital from January 2016 to May 2017 for routine health check-ups. Serum 25(OH)D levels were tested by electrochemiluminescence immunoassay. Allergic sensitizations including food and inhalant allergens were tested for specific IgE antibodies at one year (12 months 0 days through 12 months 30 days) and two years (24 months 0 days through 24 months 30 days) of age. Results: The mean level of serum 25(OH)D was 86.47 ± 27.55 nmol/L, with a high prevalence of vitamin D insufficiency (< 75 nmol/L) in children aged 0-2 years (36.8%). Lower 25(OH)D levels with serum total IgE of more than 200IU/mL (81.54 ± 25.53 nmol/L) compared with less than 100 IU/mL (87.92 ± 28.05 nmol/L). The common sensitization to allergens in children aged one and two years were milk (44.2%), cat epithelium (26.4%), egg (13.1%), dog epithelium (12.7%) and Dermatophagoides farinae (6.7%). After multivariate adjustment, data in 25(OH)D treated as a continuous variable or categories, no consistent associations were found between 25(OH)D levels and allergen-specific IgEs. Conclusions: Serum 25(OH)D level showed an inverse relationship with total IgE level in early childhood. However, there is lack of evidence to support associations between low 25(OH)D levels and allergic sensitization to various allergens

No disponible

Pollen-induced allergic asthma and rhinoconjunctivitis: differences in outcome between seasonal and nonseasonal exposure to allergens under real-life conditions (The LANDSCAPE Study)

No disponible

Buckwheat: an emerging allergen

No disponible