Cobertura vacunal de la gripe en el personal del Hospital Universitario de Fuenlabrada / Strategies and influenza vaccination coverage in the staff of Fuenlabrada Hospital Universitary

Objetivos: la gripe es una enfermedad que ocasiona un alto gasto sanitario, por lo que es necesario implementar todas las medidas necesarias para evitar su transmisión, una de ellas es la vacunación antigripal de los trabajadores del ámbito sanitario, que evita el contagio tanto del paciente hacia el personal, como del personal hacia el paciente. El objetivo principal del estudio fue conocer la cobertura vacunal antigripal entre el personal del Hospital Universitario de Fuenlabrada, así como los objetivos secundarios analizar la cobertura vacunal por profesión, edad y año de vacunación, y establecer estrategias de vacunación, para aumentar la adherencia del personal hospitalario. Material y Métodos: se realizó un estudio descriptivo longitudinal entre el año 2006 y 2015 en el Hospital Universitario de Fuenlabrada, que tuvo una media de 1.505 workers trabajadores entre los años 2006 a 2015.Variables de estudio: tipo de profesión, edad y número de vacunas administradas. Resultados: se vacunó un total de 2.749 personas en los años desde 2006-2015, con un índice general de cobertura vacunal de 18,25%. La cobertura vacunal total fue mayor en el año 2009, año de la epidemia de Gripe A (H1N1) donde en Índice de vacunación fue 38,36%, y el año 2007 con el más bajo registro vacunal, con un Índice de 13,95%. Por categorías profesionales el personal no sanitario se vacuna más (25,64%) que el personal sanitario (17,00%); y por rango de edades se vacuna más entre los 41-50 años y menos entre los menores e iguales a 30 años. Conclusiones: las coberturas vacunales se incrementan en los años en los que aparecen ondas epidémicas específicas, como la ocurrida en el año 2009. La modificación en la estrategia de vacunación, generando mayor adherencia del profesional, una educación específica y facilitando la accesibilidad de horario y acudiendo a sus unidades sin necesidad de desplazamiento del personal, ayudará significativamente al aumento de la aceptación de la vacunación (AU)

Objectives: the flu is a disease which causes a high health care costs. To avoid the contagion, both of the patient toward the staff and the staff to the patient, is the recommended influenza vaccination of healthcare workers. The main objective of the study was to assess the coverage of influenza vaccination in Fuenlabrada Hospital University of workers between the years 2006 to 2015. Secondary objectives: the analysis of the vaccination coverage by type of profession, age and year of vaccination, and finally to assess a strategic planning of flu vaccination. Material and methods: the hospital has an average population of 20171,505 workers, in the study period 2006-2015. Descriptive study was conducted by analyzing longitudinal vaccination coverage. Results: 2,749 healthcare workers ere vaccinated a total of in the years from 2006-2015, with a general index of vaccine coverage of 18.25%. The vaccine coverage was higher in the year 2009, the year of the last epidemic Influenza A (H1N1), with a vaccination in index of 38.36 %. The worst vaccine registry is obtained in the year 2007 with an index of 13.95 %. Professional categories non-health personnel is more vaccine (25.64 %) that the health personnel (17.00 %). Vaccine is more in the range between the ages of 41-50 years and less between minors and equal to 30 years. Conclusions: the vaccine coverage increases in those years in which specific epidemic waves appear, as occurred in the year 2009. It seems necessary a odification of the vaccination strategy, generating greater adhesion of the professional, a specific education and facilitating schedules and flocking to their units (AU)

Niveles de células progenitoras endoteliales circulantes en pacientes hipertensos tratados / Circulating endothelial progenitor cell levels in treated hypertensive patients

Introducción: Muchos pacientes hipertensos óptimamente tratados de sus factores de riesgo cardiovascular (FRCV) siguen presentando complicaciones cardiovasculares. Las células progenitoras endoteliales (CPE) han demostrado ser fundamentales para la reparación del daño endotelial en tejidos isquémicos. Por ello, hemos estudiado los niveles de CPE y del factor de crecimiento del endotelio vascular (VEGF) en pacientes hipertensos en tratamiento con buen control de la presión arterial (PA). Material y métodos: Se recogió una muestra de sangre de pacientes hipertensos tratados que presentaban unas cifras de PA adecuadas para los objetivos individuales. Los niveles plásticos de CPE CD34+/KDR+ y CD34+/VE-cadherina+ se midieron mediante citometría de flujo. La concentración de VEGF se cuantificó mediante ELISA. Como controles se incluyó un grupo de sujetos sin FRCV tradicionales. Resultados: Hemos incluido 108 pacientes (61 ± 12 años, 47,2% hombres), de los cuales un 82,4% presentaba PA < 140/90 mmHg, un 91,7% control de la diabetes (HbA1c < 7%), el 81,5% cLDL < 130 o 100 mg/dl y el 85,2% no fumaba, aunque el 45,4% presentaba obesidad (IMC ≥ 30 kg/m2). A pesar de que, en conjunto, sus parámetros bioquímicos no diferían de los del grupo control, los pacientes hipertensos presentaban una disminución significativa de los niveles plasmáticos de células CD34+/KDR+ y CD34+/VE-cadherina+, aunque la concentración plasmática de VEGF era significativamente mayor en los pacientes hipertensos que en los sujetos control. Conclusiones: Los pacientes hipertensos tratados muestran una disminución significativa de los niveles plasmáticos de CPE que podría ser responsable, al menos en parte, del riesgo residual que presentan estos pacientes, sugiriéndose que las CPE podrían ser una importante diana terapéutica

Introduction: Most optimally treated hypertensive patients still have an around 50% increased risk of any cardiovascular event, suggesting the possible existence of unidentified risk factors. In the last years there has been evidence of the essential role of circulating endothelial progenitor cells (EPCs) in the maintenance of endothelial integrity and function, increasing the interest in their involvement in cardiovascular disease. In this study, the circulating levels of EPCs and vascular endothelial growth factor (VEGF) are investigated in treated hypertensive patients with adequate control of blood pressure (BP). Material and methods: Blood samples were collected from treated hypertensive patients with controlled BP. Plasma levels of EPCs CD34+/KDR+ and CD34+/VE-cadherin+ were quantified by flow cytometry. Plasma concentration of VEGF was determined by ELISA. A group of healthy subjects without cardiovascular risk factors was included as controls. Results: A total of 108 hypertensive patients were included (61±12 years, 47.2% men) of which 82.4% showed BP < 140/90 mmHg, 91.7% and 81.5% controlled diabetes (HbA1c <7%) and cLDL (<130 or 100 mg/dL), respectively, and 85.2% were non-smokers. Around 45% of them were obese. Although patients had cardiovascular parameters within normal ranges, they showed significantly lower levels of CD34+/KDR+ and CD34+/VE-cadherin+ compared with healthy control group, although plasma VEGF concentration was higher in patients than in controls. Conclusions: Despite an optimal treatment, hypertensive patients show a decreased number of circulating EPCs that could be, at least in part, responsible for their residual cardiovascular risk, suggesting that these cells could be a therapeutic target

[Circulating endothelial progenitor cell levels in treated hypertensive patients]. / Niveles de células progenitoras endoteliales circulantes en pacientes hipertensos tratados.

INTRODUCTION: Most optimally treated hypertensive patients still have an around 50% increased risk of any cardiovascular event, suggesting the possible existence of unidentified risk factors. In the last years there has been evidence of the essential role of circulating endothelial progenitor cells (EPCs) in the maintenance of endothelial integrity and function, increasing the interest in their involvement in cardiovascular disease. In this study, the circulating levels of EPCs and vascular endothelial growth factor (VEGF) are investigated in treated hypertensive patients with adequate control of blood pressure (BP). MATERIAL AND METHODS: Blood samples were collected from treated hypertensive patients with controlled BP. Plasma levels of EPCs CD34+/KDR+ and CD34+/VE-cadherin+ were quantified by flow cytometry. Plasma concentration of VEGF was determined by ELISA. A group of healthy subjects without cardiovascular risk factors was included as controls. RESULTS: A total of 108 hypertensive patients were included (61±12 years, 47.2% men) of which 82.4% showed BP<140/90 mmHg, 91.7% and 81.5% controlled diabetes (HbA1c <7%) and cLDL (<130 or 100 mg/dL), respectively, and 85.2% were non-smokers. Around 45% of them were obese. Although patients had cardiovascular parameters within normal ranges, they showed significantly lower levels of CD34+/KDR+ and CD34+/VE-cadherin+ compared with healthy control group, although plasma VEGF concentration was higher in patients than in controls. CONCLUSIONS: Despite an optimal treatment, hypertensive patients show a decreased number of circulating EPCs that could be, at least in part, responsible for their residual cardiovascular risk, suggesting that these cells could be a therapeutic target.

Calcium (hydrogen-1-malate) hexahydrate on Echeveria gibbiflora leaves and its effect on sperm cells.

Echeveria gibbiflora is a plant widely used for its contraceptive activity in traditional Mexican medicine. Data on calcium crystals in plants are not outstanding. In the case of the Echeveria gibbiflora leaves, however, its quality, quantity, and salt type are quite surprising; one striking result of its X-ray crystallographic data shows the presence of calcium bis (hydrogen-1-malate) hexahydrate [2(C4H5O(5)1), Ca(1)2+, 6(H2O1)]. This highly soluble compound might explain the rapid shape changes of calcium crystals. Because SEM-EDS analysis shows that calcium malate crystals were obtained in a highly pure state and the immobilization and agglutination pattern that OBACE show on human and bull spermatozoa are not found even when high concentrations of calcium bis (hydrogen-1-malate) hexahydrate salt are present it is not feasible to involucrate molecules as calcium malate as part of the OBACE contraceptive activity.

Conformational study of galphimines A and B.

A conformational study has been performed for galphimines A and B, which differ from each other only in an acetate moiety on ring B of galphimine A. Mechanical molecular calculations showed that the predominant conformers in a Boltzman distribution are those which establish an intramolecular hydrogen bond between the hydroxyls on rings A and B, keeping a similar conformation on the rest of the molecule. The existence of these conformers was confirmed by NMR spectroscopy in (D6) DMSO solution. Furthermore, an unbound hydrogen conformation was found. These types of conformations very probably coexist in solution, for both types of galphimines A and B. Additional experiments suggest that the acetate group on galphimine A does not distort rings B and A, neither does it disturb the intramolecular hydrogen bond formation that also shows galphimine B. Finally, it does not present a steric effect on ring A to avoid any type of interaction of the functional groups on this ring with the biological receptor. The acetate group, which is responsible for the lost of activity of galphimine A very probably prevent that the hydroxyls OH4 and OH7 from interacting, either in a hydrogen bounded or free form, with the receptor, indicating the importance that these hydroxyls play in the biological activity of the molecule.

Male contraception, IV: hypotonic-like effect from Echeveria gibbiflora on human sperm.

At present there is no accepted method for the regulation of male fertility. The most appropriate form of contraception would undoubtedly be to develop from traditional plant-derived folk drugs a contraceptive male method. Hypoosmotic shock is used for validate plasma membrane function and its fertilizing capacity of human sperm. Such effect is induced in human sperm in the presence of a purified fraction from Echeveria gibbiflora (PFEG) aqueous crude extract. The hypotonic-like effect included a distension of the plasma membrane over the acrosome region and in some occasions around the sperm middle piece. An enhanced activity of the immobilizing and agglutination effects was induced instantaneously after the addition of PEFG versus aqueous crude extract activity (OBACE). Using electron microscopy it was possible to observe a deposit of a "sticky" dense material intercalated along the plasma membrane. The membrane was sealed making it impossible to measure the viability or metabolic activity of the treated sperm by the fluorescence (FDA-IP) technique. It was also possible to corroborate the dispersion of the acrosomal content and the disappearance of the acrosomal and nuclear membrane. Results that makes PFEG hypotonic-like effect a serious candidate to conduct a study to determine the predicting capacity of this compound in human infertility and suggest that the plant may yield a compound suitable for use as male contraceptive agent.

Effects of a purified fraction from Echeveria gibbiflora aqueous crude extract on guinea-pig spermatozoa.

Guinea-pig spermatozoa in the presence of a purified fraction from Echeveria gibbiflora aqueous crude extract suffer a hypotonic-like effect. The phenomena exhibited included a distension of the plasma membrane over the acrosome region, inducing the formation of a huge 'head-bubble'. The agglutination effect was so enhanced that instead of inducing sperm clusters, it produced cane-like 'stalk' structures. The immobilizing activity was induced instantaneously after the addition of the purified fraction. At electron microscope level it was possible to observe a heavy amount of electron dense material of the purified fraction embedded or intercalated along the plasma membrane. It was also possible to corroborate the dispersion of the acrosomal content and the disappearance of the external acrosome membrane. The purified fraction induced loosening of the plasma membrane all along the sperm cell, however, the distension of the membrane was only produced in the apical portion of the sperm head and not in the post equatorial region. The results suggest that the plant may yield a compound suitable for use as a vaginal barrier or male contraceptive agent.