Effectiveness of cell culture-based influenza vaccines compared with egg-based vaccines: What does the literature say?

OBJECTIVE: Influenza vaccination is an effective way of reducing the burden of seasonal influenza. Chicken egg embryos are the most common source of influenza vaccines, but cell culture production has emerged as an alternative that could be advantageous. This article reviews the available literature on the efficacy/effectiveness of cell culture-based influenza vaccines compared with egg-based vaccines. METHODS: We conducted a review of the actual literature and analyzed those studies comparing the effectiveness of cell culture-based and egg-based vaccines in the last ten years. RESULTS: Eight studies were analyzed; 1 was a clinical trial and 7 were retrospective cohort studies. The clinical trial found no significant differences in the efficacy of both vaccines with respect to placebo. The results of the observational studies were inconsistent and relative effectiveness varied among studies, even though most were performed during the same season, and in some cases, in the same region and using the same data records. Furthermore, in most studies, the comparisons between vaccines were not statistically significant. CONCLUSIONS: There is insufficient evidence that cell culture-based vaccines are superior to egg-based vaccines in terms of efficacy/effectiveness.

Influenza vaccination during the first 6 months after solid organ transplantation is efficacious and safe.

Preventing influenza infection early after transplantation is essential, given the disease's high mortality. A multicentre prospective cohort study in adult solid organ transplant recipients (SOTR) receiving the influenza vaccine during four consecutive influenza seasons (2009-2013) was performed to assess the immunogenicity and safety of influenza vaccination in SOTR before and 6 months after transplantation. A total of 798 SOTR, 130 of them vaccinated within 6 months of transplantation and 668 of them vaccinated more than 6 months since transplantation. Seroprotection was similar in both groups: 73.1% vs. 76.5% for A/(H1N1)pdm (p 0.49), 67.5% vs. 74.1% for A/H3N2 (p 0.17) and 84.2% vs. 85.2% for influenza B (p 0.80), respectively. Geometric mean titres after vaccination did not differ among groups: 117.32 (95% confidence interval (CI) 81.52, 168.83) vs. 87.43 (95% CI 72.87, 104.91) for A/(H1N1)pdm, 120.45 (95% CI 82.17, 176.57) vs. 97.86 (95% CI 81.34, 117.44) for A/H3N2 and 143.32 (95% CI 103.46, 198.53) vs. 145.54 (95% CI 122.35, 174.24) for influenza B, respectively. After adjusting for confounding factors, time since transplantation was not associated with response to vaccination. No cases of rejection or severe adverse events were detected in patients vaccinated within the first 6 months after transplantation. In conclusion, influenza vaccination within the first 6 months after transplantation is as safe and immunogenic as vaccination thereafter. Thus, administration of the influenza vaccine can be recommended as soon as 1 month after transplantation.

El tabaco: la epidemia del siglo veinte / No disponible

El tabaquismo es sin duda la gran epidemia del siglo veinte. En principio, el hábito tabáquico no se consideró nocivo y es a partir de la introducción de tabaco en las raciones de los soldados en la Primera Guerra Mundial cuando su consumo experimenta un crecimiento exponencial en toda Europa. Son varias las especialidades que abarcan las enfermedades relacionadas con el abuso del tabaco. En los últimos 50 años se ha acumulado gran número de evidencias de gran consistencia científica que avalan el hecho de que el tabaco está directamente relacionado con el incremento de una amplia variedad de neoplasias. Asimismo existen suficientes pruebas que demuestran que el consumo de tabaco incrementa el riesgo cardiovascular y los procesos respiratorios crónicos. En 1999 se ha estimado que la mortalidad mundial esperada como consecuencia del tabaquismo alcanzará la cifra de 520 millones de adultos durante la primera mitad del siglo veintiuno y que se vería reducida en 180 millones si se lograra la mitad de los adultos fumadores dejaran de fumar durante ese período. En los últimos años se ha demostrado que el consumo ocasional de tabaco conduce a un consumo crónico y que la mayoría de los fumadores crónicos cumplen criterios de “dependencia del tabaco” enfermedad que ha sido enumerada por la OMS. Es importante instaurar algún tipo de tratamiento de deshabituación tabáquica a los pacientes fumadores. Las investigaciones recientes han abarcado tanto estrategias para la prevención del consumo como para el abandono del mismo (AU)

Smoking is certainly the grand epidemic of the 20th century. At the beginning, smoking was not considered as an harmful habit. The introduction of tobacco in the food ration of the first world war solders resulted in its wide consumption all over Europe. Various medical specialties attribute many diseases to tobacco abuse. Over the last 50 years, consistent scientific evidences, of large number, have proved that smoking is directly associated with increased risk of various neoplasm’s. At the same time, sufficient data demonstrates that tobacco consumption increases the risk of cardiovascular and chronic respiratory disease. In 1999, it was estimated that the expected world mortality during the first half of the 21st century because of smoking could reach 520 millions adults and it could be reduced to 180 millions if half of smokers give demonstrated that occasional tobacco consumption leads to chronic consumption and the mayor part of smokers satisfy the recognized and listed by the WHO. It is important to facilitate treatments for smokers to help them to give up smoking. The recent investigations have offered various strategies for prevention of tobacco consumption and its giving up (AU)

[Characteristics of scleritis in patients older than 60 years]. / Características de la escleritis en pacientes mayores de 60 años.

PURPOSE: This study aimed to describe the clinical characteristics of scleritis presented de novo in patients older than 60 years of age. DESIGN: Type of scleritis, ocular manifestations, previous ocular surgery, and disease association were evaluated in patients older than 60 years with scleritis. Comparisons were made between patients with scleritis older and younger than 60 years. RESULTS: Patients with scleritis older than 60 years (61 of 195 patients, 31.3%) had more necrotizing scleritis (47.5%, p=0.0001), decrease in vision (57.4%, p=0.0001), peripheral ulcerative keratitis (29.5%, p=0.0001), previous ocular surgery (39.3%, p=0.0001), and disease association (73.8%, p=0.0001) than did patients with scleritis younger than 60 years. Rheumatoid arthritis (p=0.03) and Wegener granulomatosis (p=0.01) were the most common associated diseases. CONCLUSIONS: The detection of scleritis presented for the first time in the elderly, indicates a poor ocular prognosis because it is often associated with necrotizing scleritis, decrease in vision, and peripheral ulcerative keratitis. It has also an ominous systemic prognosis because it is often associated with potentially lethal systemic diseases.

Características de la escleritis en pacientes mayores de 60 años / Characteristics of scleritis in patients older than 60 years

Objetivo: Este estudio trata de analizar las características clínicas de la escleritis cuyo diagnóstico inicial tiene lugar en pacientes mayores de 60 años.Material y método: El tipo de escleritis, las manifestaciones oculares, las cirugías oculares previas, y las enfermedades asociadas fueron evaluadas en los pacientes con escleritis cuyo diagnóstico inicial tuvo lugar después de los 60 años. Las comparaciones se efectuaron entre los pacientes con escleritis mayores y menores de 60 años. Resultados: Los pacientes mayores de 60 años (61 de los 195 pacientes, 31,3 por ciento) tuvieron más escleritis necrotizante (47,5 por ciento, p=0,0001), disminución de visión (57,4 por ciento, p=0,0001), queratitis ulcerativa periférica (29,5 por ciento, p=0,0001), cirugías oculares previas (39,3 por ciento, p=0,0001), y enfermedades asociadas (73,8 por ciento, p=0,0001) que los pacientes menores de 60 años. La artritis reumatoide (p=0,03) y la granulomatosis de Wegener (p=0,01) fueron las enfermedades asociadas más comunes. Conclusiones: La detección de una escleritis cuyo diagnóstico inicial tiene lugar después de los 60 años tiene un mal pronóstico ocular puesto que a menudo se asocia a escleritis necrotizante, a disminución de agudeza visual, y a queratitis ulcerativa periférica. También tiene un mal pronóstico sistémico porque frecuentemente se asocia a enfermedades sistémicas potencialmente letales (AU)