Assuntos
Varicela , Herpes Zoster , Humanos , Varicela/prevenção & controle , Vacina contra Varicela , Herpesvirus Humano 3 , VacinaçãoRESUMO
There is accumulating evidence showing that influenza infection and cardiorespiratory diseases are closely associated. Influenza has been described as a triggering factor capable of both exacerbate underlying chronic diseases as well as inducing the appearance of new respiratory and cardiovascular events. Consequently, influenza infection and its associated comorbidity have a significant impact on the health system. In this document, we extensively reviewed the current literature to describe the most relevant data on the relationship between influenza infection and cardiorespiratory diseases. Likewise, we analyzed the possible pathophysiological mechanisms explaining the connection between influenza infection and cardiac and respiratory events. Finally, reviewed data has been put into perspective to highlight the importance of influenza vaccination as an effective measure in the prevention of cardiorespiratory diseases, especially in the population with underlying chronic diseases.
Assuntos
Vacinas contra Influenza , Influenza Humana , Comorbidade , Humanos , Influenza Humana/complicações , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , VacinaçãoRESUMO
Pertussis vaccination with 4-5 doses of acellular vaccines is recommended in Spain to all children at 2 months to 6 years of age. The effectiveness of the acellular pertussis vaccination was assessed in this study by comparing the incidence of secondary pertussis in vaccinated (4-5 doses) and unvaccinated or partially vaccinated (0-3 doses) household contacts 1-9 years old of confirmed cases of pertussis in Spain in 2012-13. Eighty-five percent of contacts had been vaccinated with 4-5 doses of acellular pertussis vaccines. During the 2-year study period, 64 cases of secondary pertussis were detected among 405 household contacts 1-9 years old: 47 among vaccinated and 17 among unvaccinated or partially vaccinated contacts. The effectiveness for preventing secondary pertussis, calculated as 1 minus the relative risk (RR) of secondary pertussis in vaccinated vs. unvaccinated/partially vaccinated contacts, was 50 % [95 % confidence interval (CI): 19-69 %, p < 0.01] when household contacts were vaccinated using DTaP, Tdap, hexavalent or heptavalent vaccines, and it was 51.3 % (95 % CI: 21-70 %, p < 0.01) when they were vaccinated using DTaP or TdaP vaccines. The effectiveness adjusted for age, sex, pertussis chemotherapy and type of household contact was 58.6 % (95 % CI: 17-79 %, p < 0.05) when contacts were vaccinated using available acellular vaccines, and it was 59.6 % (95 % CI: 18-80 %, p < 0.01) when they were vaccinated using DTaP vaccines. Acellular pertussis vaccination during childhood was effective for preventing secondary pertussis in household contacts 1-9 years old of pertussis cases in Catalonia and Navarra, Spain.
Assuntos
Transmissão de Doença Infecciosa/prevenção & controle , Saúde da Família , Esquemas de Imunização , Vacina contra Coqueluche/administração & dosagem , Coqueluche/epidemiologia , Coqueluche/prevenção & controle , Criança , Pré-Escolar , Características da Família , Feminino , Humanos , Incidência , Lactente , Masculino , Vacina contra Coqueluche/imunologia , Espanha/epidemiologia , Resultado do Tratamento , Vacinas Acelulares/administração & dosagem , Vacinas Acelulares/imunologiaRESUMO
We aimed to estimate influenza vaccine effectiveness (VE) against laboratory-confirmed influenza during three influenza seasons (2010/11 to 2012/2013) in Spain using surveillance data and to compare the results with data obtained by the cycEVA study, the Spanish component of the Influenza Monitoring Vaccine Effectiveness (I-MOVE) network. We used the test-negative casecontrol design, with data from the Spanish Influenza Sentinel Surveillance System (SISS) or from the cycEVA study. Cases were laboratory-confirmed influenza patients with the predominant influenza virus of each season, and controls were those testing negative for any influenza virus. We calculated the overall and age-specific adjusted VE. Although the number of patients recorded in the SISS was three times higher than that in the cycEVA study, the quality of information for important variables, i.e. vaccination status and laboratory results, was high in both studies. Overall, the SISS and cycEVA influenza VE estimates were largely similar during the study period. For elderly patients (> 59 years), the SISS estimates were slightly lower than those of cycEVA, and estimates for children (014 years) were higher using SISS in two of the three seasons studied. Enhancing the SISS by collecting the date of influenza vaccination and reducing the percentage of patients with incomplete information would optimise the system to provide reliable annual influenza VE estimates to guide influenza vaccination policies.
Assuntos
Vírus da Influenza A Subtipo H1N1/imunologia , Vacinas contra Influenza/administração & dosagem , Vacinas contra Influenza/imunologia , Influenza Humana/prevenção & controle , Vigilância de Evento Sentinela , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Vírus da Influenza A Subtipo H1N1/classificação , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/epidemiologia , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Espanha/epidemiologia , Vacinação/estatística & dados numéricos , Adulto JovemRESUMO
SUMMARY Two clusters of confirmed cryptosporidiosis infections were detected in Navarra, Spain, in the summer of 2012, in the context of an increased incidence in the region. Molecular subtyping of Cryptosporidium hominis determined that one cluster, occurring in an urban area, was due to the predominant circulating subtype IbA10G2R2 and the other cluster, with cases occurring in a rural area, was due to a rare subtype IaA18R3. No single exposure was associated with infection, although exposure to certain children's pools was reported by a majority of patients interviewed in each cluster. Genotyping tools were useful in the investigation and could aid investigation of cryptosporidiosis outbreaks in Spain in the future.
Assuntos
Criptosporidiose/epidemiologia , Cryptosporidium/genética , Surtos de Doenças , Adolescente , Criança , Pré-Escolar , Criptosporidiose/parasitologia , Cryptosporidium/isolamento & purificação , DNA de Protozoário/análise , Fezes/parasitologia , Feminino , Genótipo , Humanos , Incidência , Lactente , Masculino , População Rural , Análise de Sequência de DNA , Espanha/epidemiologia , População UrbanaRESUMO
Introducción: La habilidad para conducir después de un ictus ha sido reconocida por muchos autores como un indicador de independencia y se asocia de forma significativa con una reintegración social adecuada. Sin embargo, no queda claro quién y cómo debe valorarse la capacidad de conducción de un individuo que ha sufrido un ictus. El proceso neurorrehabilitador es capaz de obtener mejorías en los pacientes que han sufrido un ictus y, por lo tanto, un paciente puede volver a estar capacitado para conducir tras un tratamiento neurorrehabilitador adecuado. El objetivo de este artículo es realizar una revisión de la literatura, con el fin de poner de manifiesto la evidencia actual respecto a los métodos de evaluación de la capacidad para conducir y de aquellas intervenciones llevadas a cabo para recuperar la capacidad de conducir. Desarrollo: Se llevó a cabo una búsqueda de la literatura de diferentes bases de datos entre 1993 y 2011. Se analizaron de forma individual los estudios realizados sobre la base de los métodos de evaluación de la capacidad de conducir y de intervención neurorrehabilitadora. Conclusiones: Se debe valorar de forma apropiada a todos los pacientes con un ictus en los que existen dudas sobre su capacidad de conducir. La forma adecuada de valorar a estos pacientes según la literatura es mediante una valoración multidisciplinar que determine quién está capacitado para someterse a un test en carretera. Los ejercicios de neurorrehabilitación existentes pueden mejorar la capacidad de conducir de los pacientes con ictus
Introduction: The ability to drive after a stroke has been recognised by many authors as a sign of independence and it is closely associated with proper social reintegration. However, it remains unclear how the driving ability of an individual who has suffered a stroke should be evaluated, and by whom. Neurorehabilitation can produce improvements in patients who have suffered a stroke, and patients may therefore be able to resume driving at the end of an appropriate neurorehabilitation programme. The aim of this article is to present a literature review in order to highlight current evidence regarding methods for assessing driving ability and therapeutic methods applied in order to recover a patient's ability to drive. Development: A literature search was performed in different databases for the period between 1993 and 2011. Studies were analysed individually based on methods for assessing driving ability and neurorehabilitation measures. Conclusions: If there are any doubts regarding stroke patients ability to drive, patients should be assessed appropriately. The proper way to assess these patients according to the literature is by employing a multidisciplinary evaluation to determine who is able to take a road test. Neurorehabilitation exercises currently in use may be able to improve driving ability in stroke patients
Assuntos
Humanos , Condução de Veículo , Acidente Vascular Cerebral/reabilitação , Testes de Aptidão , Estatísticas de Sequelas e Incapacidade , Ajustamento Social , Fatores de RiscoRESUMO
Adjusted early estimates of the 2013/14 influenza vaccine effectiveness (VE) in Spain for all age groups was 35% (95% CI: -9 to 62), 33% (95% CI: -33 to 67) and 28% (95% CI: -33 to 61) against any influenza virus type, A(H1N1)pdm09 and A(H3N2) viruses, respectively. For the population targeted for vaccination, the adjusted VE was 44% (95% CI: -11 to 72), 36% (95% CI: -64 to 75) and 42% (95% CI: -29 to 74), respectively. These preliminary results in Spain suggest a suboptimal protective effect of the vaccine against circulating influenza viruses.
Assuntos
Vírus da Influenza A Subtipo H1N1/imunologia , Vírus da Influenza A Subtipo H3N2/imunologia , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Avaliação de Resultados em Cuidados de Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Vírus da Influenza A Subtipo H1N1/genética , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vírus da Influenza A Subtipo H3N2/genética , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Influenza Humana/epidemiologia , Influenza Humana/virologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Espanha/epidemiologia , Vacinação , Adulto JovemRESUMO
A Spanish household was identified through a Public Health follow up on a Shiga toxin-producing Escherichia coli (STEC)-positive 14-month-old girl reporting bloody diarrhoea, with the four household members experiencing either symptomatic or asymptomatic STEC and/or atypical enteropathogenic E. coli (aEPEC) shedding. In total, two different O76:H19 STEC strains and six aEPEC strains belonging to multiple serotypes were isolated and characterized in the household during a 5-month period. Prolonged asymptomatic shedding of O76:H19 STEC and O51:H49 aEPEC was detected in two family members. Although there was no conclusive evidence, consumption of vegetables fertilized with sheep manure was the suspected source of infection. This study highlights the risk of cross-infections posed by prolonged asymptomatic carriage and close household contact between family members, and illustrates the importance of molecular epidemiology in understanding disease clusters.
Assuntos
Coinfecção/microbiologia , Escherichia coli Enteropatogênica/isolamento & purificação , Infecções por Escherichia coli/microbiologia , Escherichia coli Shiga Toxigênica/isolamento & purificação , Adulto , Pré-Escolar , Escherichia coli Enteropatogênica/classificação , Escherichia coli Enteropatogênica/genética , Proteínas de Escherichia coli/genética , Família , Fezes/microbiologia , Feminino , Humanos , Lactente , Masculino , Escherichia coli Shiga Toxigênica/classificação , Escherichia coli Shiga Toxigênica/genética , Virulência/genéticaRESUMO
INTRODUCTION: The ability to drive after a stroke has been recognised by many authors as a sign of independence and it is closely associated with proper social reintegration. However, it remains unclear how the driving ability of an individual who has suffered a stroke should be evaluated, and by whom. Neurorehabilitation can produce improvements in patients who have suffered a stroke, and patients may therefore be able to resume driving at the end of an appropriate neurorehabilitation programme. The aim of this article is to present a literature review in order to highlight current evidence regarding methods for assessing driving ability and therapeutic methods applied in order to recover a patient's ability to drive. DEVELOPMENT: A literature search was performed in different databases for the period between 1993 and 2011. Studies were analysed individually based on methods for assessing driving ability and neurorehabilitation measures. CONCLUSIONS: If there are any doubts regarding stroke patients' ability to drive, patients should be assessed appropriately. The proper way to assess these patients according to the literature is by employing a multidisciplinary evaluation to determine who is able to take a road test. Neurorehabilitation exercises currently in use may be able to improve driving ability in stroke patients.
Assuntos
Condução de Veículo , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/terapia , Humanos , Testes NeuropsicológicosAssuntos
Vacina contra Varicela/administração & dosagem , Varicela/epidemiologia , Programas de Imunização , Vacinação/estatística & dados numéricos , Vacinas Atenuadas/administração & dosagem , Adolescente , Adulto , Idoso , Varicela/prevenção & controle , Vacina contra Varicela/imunologia , Criança , Pré-Escolar , Estudos de Coortes , Relação Dose-Resposta a Droga , Hospitalização/estatística & dados numéricos , Humanos , Imunização Secundária/métodos , Incidência , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Vigilância da População , Espanha/epidemiologia , Fatores de Tempo , Resultado do Tratamento , Vacinação/tendências , Vacinas Atenuadas/imunologia , Adulto JovemRESUMO
We present estimates of influenza vaccine effectiveness (VE) in Navarre, Spain, in the early 2012/13 season, which was dominated by influenza B. In a population-based cohort using electronic records from physicians, the adjusted VE in preventing influenzalike illness was 32% (95% confidence interval (CI): 15 to 46). In a nested test-negative case-control analysis the adjusted VE in preventing laboratory-confirmed influenza was 86% (95% CI: 45 to 96). These results suggest a high protective effect of the vaccine.
Assuntos
Vírus da Influenza A Subtipo H1N1/imunologia , Vírus da Influenza A Subtipo H3N2/imunologia , Vírus da Influenza A Subtipo H3N8/imunologia , Vírus da Influenza B/imunologia , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Hospitalização , Humanos , Incidência , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Vírus da Influenza A Subtipo H3N8/isolamento & purificação , Vírus da Influenza B/isolamento & purificação , Vacinas contra Influenza/imunologia , Influenza Humana/epidemiologia , Influenza Humana/virologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Estudos Prospectivos , Estações do Ano , Espanha/epidemiologia , Resultado do Tratamento , Vacinação/estatística & dados numéricos , Adulto JovemRESUMO
This study evaluates the influenza vaccine effectiveness (VE) in preventing laboratory-confirmed cases in Navarre, Spain, in the 2011/12 season in which the peak was delayed until week 7 of 2012. We conducted a test-negative casecontrol study. Patients with influenza-like illness in hospitals and primary healthcare were swabbed for testing by reverse transcription-polymerase chain reaction. Influenza vaccination status and other covariates were obtained from healthcare databases. The vaccination status of confirmed cases and negative controls was compared after adjusting for potential confounders. VE was calculated as (1-odds ratio)x100. The 411 confirmed cases (93% influenza A(H3)) were compared with 346 controls. Most characterised viruses did not match the vaccine strains. The adjusted estimate of VE was 31% (95% confidence interval (CI): -21 to 60) for all patients, 44% (95% CI: -11 to 72) for those younger than 65 years and 19% (95% CI: -146 to 73) for those 65 or older. The VE was 61% (95% CI: 5 to 84) in the first 100 days after vaccination, 42% (95% CI: -39 to 75) between 100 and 119 days, and zero thereafter. This decline mainly affected people aged 65 or over. These results suggest a low preventive effect of the 2011/12 seasonal influenza vaccine, and a decline in VE with time since vaccination.
Assuntos
Vírus da Influenza A/genética , Vacinas contra Influenza/imunologia , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Criança , Pré-Escolar , Intervalos de Confiança , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Vírus da Influenza A/imunologia , Vírus da Influenza A/isolamento & purificação , Vacinas contra Influenza/administração & dosagem , Influenza Humana/diagnóstico , Influenza Humana/virologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Estações do Ano , Vigilância de Evento Sentinela , Espanha/epidemiologia , Fatores de Tempo , Resultado do Tratamento , Vacinação/estatística & dados numéricos , Adulto JovemRESUMO
We present early estimates of influenza vaccine effectiveness (VE) in the population targeted for vaccination, during 25 December 2011 to 19 February 2012. The adjusted VE was 55% (95% CI: 3 to 79) against any type of influenza virus and 54% (95% CI: 1 to 79) against influenza A(H3N2) virus. This suggests a moderate protective effect of the vaccine in the targeted population in a late influenza epidemic with limited match between vaccine and circulating strains.
Assuntos
Vírus da Influenza A Subtipo H3N2/imunologia , Vacinas contra Influenza/administração & dosagem , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Vírus da Influenza A Subtipo H3N2/genética , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Influenza Humana/virologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Vigilância de Evento Sentinela , Espanha/epidemiologia , Vacinação , Adulto JovemRESUMO
BACKGROUND: In 2007 universal vaccination against chicken pox was introduced in the vaccine calendar of Navarre. The aim of this study is to evaluate the impact of this measure on the incidence of chicken pox in both the vaccinated cohorts (direct effect) and in the unvaccinated cohorts (indirect effect). MATERIAL AND METHODS: Chicken pox is a disease of individualized compulsory notification. We analyzed the annual incidence by age groups between 2006 and 2010. Hospital admittances with chicken pox or complicated chicken pox as the principal diagnosis were taken from the minimum basic data set on hospital discharges for the years 2006 to 2009. RESULTS: The incidence of chicken pox has fallen by 93.0%, from 8.04 cases per 1,000 inhabitants in 2006 to 0.56 per 1,000 inhabitants in 2010 (p<0,0001). In children from 1 to 6 years (vaccinated cohorts), the incidence of chicken pox has fallen by 96.3%. In the cohorts vaccinated at 10 and 14 years, a fall of 93.6% can also be observed in children from 10 to 14 years, and of 85.0% in those of 15 to 19 years. In the unvaccinated age groups we can observe falls of 88.2% in children under one year, of 73.3% in those of 7 to 9 years, and of 84.6% in people over 20 years. In 2006 there were 25 hospital admissions due to chicken pox in Navarre and in 2009 this figure fell to 7. The rate of admissions fell by 71%. CONCLUSION: The introduction of universal chicken pox vaccination in Navarre has resulted in a rapid and very steep reduction of the incidence of chicken pox in both vaccinated and unvaccinated people.
Assuntos
Varicela/epidemiologia , Varicela/prevenção & controle , Vacinação , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologia , Adulto JovemRESUMO
Fundamento. En 2007 se introdujo la vacunación universalfrente a la varicela en el calendario vacunal deNavarra. Este estudio tiene por objeto evaluar el impactode dicha medida en la incidencia de varicela tanto enlas cohortes vacunadas (efecto directo), como en las novacunadas (efecto indirecto).Material y métodos. La varicela es una enfermedad dedeclaración obligatoria individualizada. Analizamos laincidencia anual por grupos de edad entre 2006 y 2010.Del conjunto mínimo básico de datos al alta hospitalariase tomaron los ingresos con diagnóstico principal de varicelao de varicela complicada de los años 2006 a 2009.Resultados. La incidencia de varicela ha disminuido un93,0%, desde 8,04 casos por 1.000 habitantes en 2006 a0,56 por 1000 habitantes en 2010 (p<0,0001). En niñosde 1 a 6 años (cohortes vacunadas), la incidencia de lavaricela ha disminuido un 96,3%. En las cohortes vacunadasa los 10 y 14 años, también se observa un descensodel 93,6% en niños de 10 a 14 años, y de un 85,0% enlos de 15 a 19 años. En los grupos de edad no vacunadosobservamos descensos del 88,2% en los niños menoresde un año, del 73,3% en los de 7 a 9 años, y del 84,6% enpersonas mayores de 20 años.En 2006 se produjeron 25 ingresos hospitalarios por varicelaen Navarra y en 2009 esta cifra descendió a 7. Latasa de ingresos descendió un 73%.Conclusión. La introducción de la vacunación universalde la varicela en Navarra ha llevado a una disminuciónrápida y muy pronunciada de la incidencia de la varicela,tanto en vacunados como en no vacunados(AU)
Background. In 2007 universal varicella vaccinationwas introduced in the childhood immunization scheduleof of Navarre. The aim of this study is to evaluate theimpact of this measure on the incidence of varicella inboth vaccinated cohorts (direct effect) and in the unvaccinated(indirect effect).Material and methods. Varicella is a notifiable disease.We analyzed the annual incidence by age groups between2006 and 2010. Hospital admissions with varicellaor complicated varicella as the principal diagnosis wereobtained from the minimum basic data set on hospitaldischarges for the years 2006 to 2009.Results. The incidence of varicella has decreased by93.0%, from 8.04 cases per 1,000 inhabitants in 2006 to0.56 per 1,000 inhabitants in 2010 (p<0,0001). In childrenfrom 1 to 6 years (vaccinated cohorts), the incidenceof varicella has fallen by 96.3%. In the cohortsvaccinated at 10 and 14 years, a decrease of 93.6% canalso be observed in children from 10 to 14 years, and of85.0% in those of 15 to 19 years. In the unvaccinated agegroups we can observe falls of 88.2% in children underone year, of 73.3% in those of 7 to 9 years, and of 84.6%in people over 20 years.In 2006 there were 25 hospital admissions due to varicellain Navarre and in 2009 this figure decreased to 7. Therate of admissions fell by 73%.Conclusion. The introduction of universal varicellavaccination in Navarre has resulted in a rapid and verysteep reduction of the incidence of varicella in bothvaccinated and unvaccinated people(AU)
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Varicela/diagnóstico , Varicela/história , Varicela/patologia , Vacinação/ética , Programas de Imunização/ética , Programas de Imunização/provisão & distribuição , Varicela/epidemiologia , Varicela/etiologia , Varicela/enfermagem , Varicela/prevenção & controle , Programas de Imunização , Programas de Imunização/métodos , Programas de Imunização/estatística & dados numéricos , Programas de Imunização/tendênciasRESUMO
We defined a cohort of people with major chronic conditions (152,585 subjects) in Navarre, Spain, using electronic records from physicians, to obtain 2010/11 mid-season estimates of influenza vaccine effectiveness. The adjusted estimates of the effectiveness of the 2010/11 trivalent influenza vaccine were 31% (95% confidence interval (CI): 2040%) in preventing medically attended influenza-like illness, and 58% (95% CI: 1180%) in preventing laboratory-confirmed influenza. Having received the monovalent influenza A(H1N1)2009 vaccine in the 2009/10 season had an independent preventive effect against medically attended influenza-like illness (17%, 95% CI: 130%), and having received both vaccines had 68% (95% CI: 2387%) effectiveness in preventing laboratory-confirmed influenza.
Assuntos
Doença Crônica , Surtos de Doenças/prevenção & controle , Vírus da Influenza A Subtipo H1N1/imunologia , Vacinas contra Influenza/imunologia , Influenza Humana/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Intervalos de Confiança , Feminino , Humanos , Incidência , Lactente , Vacinas contra Influenza/uso terapêutico , Influenza Humana/epidemiologia , Influenza Humana/imunologia , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Vigilância da População , Atenção Primária à Saúde , Estudos Prospectivos , Estações do Ano , Espanha/epidemiologia , Resultado do Tratamento , Adulto JovemRESUMO
Fundamento. Describir la actividad gripal durante la pandemia de 2009-2010 en Navarra y compararla con la de temporadas anteriores. Métodos. Se han analizado los casos de gripe notificados en atención primaria y todas las confirmaciones virológicas realizadas en pacientes de atención primaria y en hospitales de Navarra entre las semanas 21 de 2009 y 20 de 2010. Resultados. El virus de la gripe A (H1N1) 2009 se detectó en Navarra entre las semana 23 de 2009 a la 2 de 2010, periodo en el que se registraron 39 casos con diagnóstico médico de síndrome gripal por 1.000 habitantes. El umbral epidémico se superó en dos periodos, con un pico en julio y otro mayor en noviembre. La mayor incidencia se alcanzó en niños de 5 a 14 años (121 por mil), seguidos por el grupo de menores de 5 años. Se produjeron 224 hospitalizaciones (36 por 100.000 habitantes) con confirmación de gripe A H1N1 2009, 8% de ellos requirieron ingreso en unidades de cuidados intensivos y hubo cuatro defunciones (0,6 por 100.000 habitantes). La tasa de hospitalizaciones fue mayor en niños menores de 5 años (163 por 100.000 habitantes), mientras que la probabilidad de derivación a cuidados intensivos aumentó con la edad. Conclusión. A pesar de no haber dispuesto de una vacuna específica hasta que la temporada estaba muy avanzada, el virus de gripe A (H1N1) 2009 produjo una onda gripal en rangos similares a los de otras temporadas y su repercusión en hospitalizaciones y casos graves fue moderada (AU)
Background. To describe influenza activity during the2009-2010 pandemic in Navarre and compare it to previous seasons. Methods. An analysis was made of all influenza-like illness cases reported in primary care and all the virological confirmations made in patients in primary care and in hospitals of Navarre between week 21 of 2009 and week 20 of 2010. Results. Influenza 2009 H1N1 virus was detected in Navarre between week 23 of 2009 and week 2 of 2010, a period when 39 medically diagnosed cases of influenza-like illness per 1,000 inhabitants were registered. The epidemicthres hold was surpassed in two periods, with a peak in July and a greater one in November. The greatest incidence was reached in children aged between 5 and 14 years (121 per thousand), followed by the group of under fives.There were 224 hospitalisations (36 per 100,000 inhabitants)with confirmation of influenza 2009 H1N1 virus, 8% of whom required admission to intensive care units and there were four deaths (0.6 per 100,000 inhabitants). The rate of hospitalisation was greater amongst children under five (163 per 100,000 inhabitants), while the probability of referral to intensive care increased with age. Conclusion. In spite of not having a specific vaccine available until the season was very well advanced, influenza 2009 H1N1 virus produced a wave of cases with similar incidence to those of other seasons and its repercussion in hospitalizations and serious cases was moderate (AU)
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Vírus da Influenza A Subtipo H1N1/imunologia , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Surtos de Doenças/estatística & dados numéricos , Monitoramento Epidemiológico , Atenção Primária à Saúde/métodos , Influenza Humana/epidemiologia , Influenza Humana/complicações , Atenção Primária à Saúde/tendências , Saúde Pública/estatística & dados numéricos , Saúde Pública/tendências , Influenza Humana/imunologia , Influenza Humana/virologiaRESUMO
BACKGROUND: To describe flu activity during the 2009-2010 pandemic in Navarre and compare it to previous seasons. METHODS: An analysis was made of all flu cases reported in primary care and all the virological confirmations made in patients in primary care and in hospitals of Navarre between week 21 of 2009 and week 20 of 2010. RESULTS: Influenza A (H1N1) Virus 2009 was detected in Navarre between week 23 of 2009 and week 2 of 2010, a period when 39 medically diagnosed cases of flu syndrome per 1,000 inhabitants were registered. The epidemic threshold was surpassed in two periods, with a peak in July and a greater one in November. The greatest incidence was reached in children aged between 5 and 14 years (121 per thousand), followed by the group of under fives. There were 224 hospitalisations (36 per 100,000 inhabitants) with confirmation of Influenza A (H1N1) Virus 2009, 8% of whom required admission to intensive care units and there were four deaths (0.6 per 100,000 inhabitants). The rate of hospitalisation was greater amongst children under five (163 per 100,000 inhabitants), while the probability of referral to intensive care increased with age. CONCLUSION: In spite of not having a specific vaccine available until the season was very well advanced, Influenza A (H1N1)Virus 2009 produced a flu wave with similar levels to those of other seasons and its repercussion in hospitalisations and serious cases was moderate.
Assuntos
Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Pandemias , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologia , Adulto JovemRESUMO
The aim of this study was to analyse the effectiveness of teicoplanin versus vancomycin lock therapy in the treatment of coagulase-negative staphylococci (CoNS) venous access port-related bloodstream infection (BSI). The study included 44 consecutive patients during a 36-month prospective case-series study. The primary endpoint was failure to cure. Treatment was successful in 39 patients. At the end of the study, the cumulative port survival rate was 100% in the teicoplanin lock group compared with 77% in the vancomycin lock group (P=0.06). In the Cox regression analysis, fever beyond 48 h of treatment was a significant predictor of treatment failure (P=0.02). Use of vancomycin or teicoplanin locks had an effectiveness of 88.6% in the treatment of CoNS port-related BSI. Teicoplanin locks reduced the failure rate from 18.5% to 0% compared with vancomycin locks. The presence of fever after beginning antimicrobial lock therapy was associated with treatment failure.
Assuntos
Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Infecções Relacionadas a Cateter/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus/efeitos dos fármacos , Teicoplanina/uso terapêutico , Vancomicina/uso terapêutico , Adulto , Idoso , Antibacterianos/administração & dosagem , Biofilmes/efeitos dos fármacos , Coagulase/biossíntese , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Análise de Sobrevida , Teicoplanina/administração & dosagem , Resultado do Tratamento , Vancomicina/administração & dosagemRESUMO
A cluster of five cases of tuberculosis (TB) in persons aged 19-23 years who were not close contacts was detected in a small village in Spain in 2006. All culture isolates had the same chromosomal-DNA restriction pattern. Contact investigations of family members, friends, workmates and schoolmates were complemented with tuberculin screening offered to the resident population born between 1976 and 1995. Expanded contact tracing detected two new cases of TB, 27 tuberculin conversions and an excess of latent tuberculosis infections (LTI) in persons born between 1978 and 1990. The contacts of two cases had a significantly elevated prevalence of LTI. Two secondary cases of TB, 33.3% of those diagnosed with LTI and 47.8% of the converters were unaware of any contact with the TB cases, but had frequented some of the same bars. This study suggests that a considerable percentage of the episodes of TB transmission in young people may escape detection in conventional contact studies.