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1.
Front Nutr ; 11: 1287864, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38425483

RESUMO

Currently, there is a growing interest in the study of fertility because fertility-related problems affect up to 15% of the world's population. The aim of this study was to determine the influence of the Mediterranean diet on seminal quality in men of reproductive age. For this purpose, a systematic review of the literature was carried out following the PRISMA method. Electronic searches were carried out in the international databases PubMed, Scopus, the Cochrane Library, and Web of Science. In total, 10 articles with 2032 men were included. As inclusion criteria, articles published between 2012 and 2022 were selected, including those that included men aged between 18 and 55 years. Nutritional status was assessed through weight, height, and BMI. Dietary habits were evaluated through different indexes and food frequency questionnaires, and finally, semen quality was evaluated by measuring sperm concentration and motility (progressive and non-progressive). In six (60%) of the included articles, a positive relationship between adherence to the Mediterranean diet and semen quality was demonstrated; in two (20%) of the articles, no association was found; and finally, in two (20%) of the included articles, the relationship between dietary patterns typical of DM and semen quality was evaluated. Dietary habits influence semen quality. Adherence to the Mediterranean diet can improve male reproductive health, as it is a diet with antioxidant and anti-inflammatory effects. This is the first systematic review about the influence of the Mediterranean diet on semen quality, and the results are positive. These findings may allow us to provide better advice to our patients and to establish interventions with the aim of improving the results of assisted reproduction techniques.

2.
Mycoses ; 67(3): e13709, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38429225

RESUMO

BACKGROUND: Cryptococcal meningitis (CM), an opportunistic fungal infection affecting immunocompromised hosts, leads to high mortality. The role of previous exposure to glucocorticoids as a risk factor and as an outcome modulator has been observed, but systematic studies are lacking. OBJECTIVE: The primary aim of this study is to evaluate the impact of glucocorticoid use on the clinical outcomes, specifically mortality, of non-HIV and non-transplant (NHNT) patients diagnosed with CM. METHODS: We queried a global research network to identify adult NHNT patients with CM based on ICD codes or recorded specific Cryptococcus CSF lab results with or without glucocorticoid exposure the year before diagnosis. We performed a propensity score-matched analysis to reduce the risk of confounding and analysed outcomes by glucocorticoid exposure. We used a Cox proportional hazards model for survival analysis. RESULTS: We identified 764 patients with a history of glucocorticoid exposure and 1267 patients without who developed CM within 1 year. After propensity score matching of covariates, we obtained 627 patients in each cohort. The mortality risk in 1 year was greater in patients exposed to prior glucocorticoids (OR: 1.3, CI: 1.2-2.0, p = 0.002). We found an excess of 45 deaths among CM patients with previous glucocorticoid use (7.4% increased absolute risk of dying within 1 year of diagnosis) compared to CM controls without glucocorticoid exposure. Hospitalisation, intensive care unit admission, emergency department visits, stroke and cognitive dysfunction also showed significant, unfavourable outcomes in patients with glucocorticoid-exposed CM compared to glucocorticoid-unexposed CM patients. CONCLUSIONS: Previous glucocorticoid administration in NHNT patients seems to associate with 1-year mortality after CM adjusted for possible confounders related to demographics, comorbidities and additional immunosuppressive medications. Serial CrAg screening might be appropriate for higher-risk patients on glucocorticoids after further cost-benefit analyses.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS , Cryptococcus neoformans , Cryptococcus , Infecções por HIV , Meningite Criptocócica , Adulto , Humanos , Meningite Criptocócica/microbiologia , Glucocorticoides/efeitos adversos , Fatores de Risco , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/microbiologia , Antígenos de Fungos
3.
Vaccine ; 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38458873

RESUMO

Healthcare providers (HCP) are seen by the public as the most trustworthy source of information about vaccination. While HCPs could be a valuable partner to increase vaccine confidence in general, it is not clear whether they feel confident themselves to address questions concerning vaccination. In the context of the EU Joint Action on Vaccination (EU-JAV), the Vaccine Training Barometer, an online survey tool, was developed to assess how frequently HCPs receive questions about vaccination, how confident they feel to answer these questions, and to what extent they are willing to follow extra training. After a pilot test in Flanders, Belgium, the Barometer was launched and completed by 833 HCPs in Flanders and 291 HCPs in the Spanish regions of Catalonia, Navarre and Valencian Community from November 2020 until January 2021, during the COVID-19 pandemic, just before and during the start of the first COVID-19 vaccination campaigns. In both countries, HCPs frequently received questions about vaccination (mostly on a daily or weekly basis), and about two thirds of them indicated that the frequency of questions had increased during the three months prior to completing the survey. Most questions were about the side effects and safety of vaccines. In both countries, a considerable proportion of HCPs did not feel confident to answer vaccine-related questions (31.5% felt confident in Flanders, 21.6% in Spain). A large proportion of HCPs received questions in the last three months before the survey that they could not answer (52.4% of respondents in Flemish sample, 41.5% in Spanish sample). Only 11.4% (Flanders) and 11.3% (Spain) of the respondents felt they gained sufficient knowledge through their standard education to be able to answer questions about vaccination. Almost all respondents were willing to follow extra training on vaccination (Flanders: 95.4%, Spain: 96.6%). The Vaccine Training Barometer is thus a useful tool to monitor HCPs' confidence to answer questions about vaccination and to capture their training needs.

4.
Am J Trop Med Hyg ; 110(2): 238-245, 2024 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-38109768

RESUMO

Toxoplasma gondii is a prevalent parasitic disease with significant morbidity and mortality in immunocompromised populations. We lack long-term outcomes for latent infections. We aimed to elucidate the relationship between latent T. gondii infection and mortality risk. We queried TriNetX, a international multicenter network, to validate mortality risk differences among patients with positive or negative toxoplasma IgG through propensity score matching (PSM). We excluded patients with toxoplasmosis disease by International Classification of Diseases codes or polymerase chain reaction testing. We found 28,138 patients with available toxoplasma IgG serology. Seropositive patients were older and had a male preponderance. More seropositive patients identified as Hispanic, Latino, or Black persons. Patients who were positive for T. gondii IgG serology were slightly more likely to have underlying heart failure, a transplanted organ or tissue, malignant neoplasms of lymphoid or hematopoietic tissues, and diseases of the nervous system than seronegative controls. After PSM of patients with positive (N = 6,475) and negative (N = 6,475) toxoplasma IgG serologies, toxoplasmosis-positive patients were more likely to have long-term drug use but less likely to suffer from behavioral disorders. The overall PSM 1- and 5-year mortality was higher among patients with a positive toxoplasma IgG serology. The risk of schizophrenia was increased at 5 years. We found a prevalence of toxoplasma IgG positivity of 0.03% during the last 3 years. Latent T. gondii associates with a higher overall mortality risk. The study of social determinants of health and follow-up studies are necessary to corroborate the findings and find possible causal mechanisms.


Assuntos
Transtornos Mentais , Toxoplasma , Toxoplasmose , Humanos , Masculino , Pontuação de Propensão , Toxoplasmose/epidemiologia , Imunoglobulina G , Anticorpos Antiprotozoários , Estudos Soroepidemiológicos , Imunoglobulina M
5.
Rev Esp Salud Publica ; 972023 Dec 18.
Artigo em Espanhol | MEDLINE | ID: mdl-38126466

RESUMO

OBJECTIVE: Neutralizing antibodies against SARS-CoV-2 have shown to be an effective tool for the analysis of the immunity generated against COVID-19. Numerous seroprevalence studies carried out in different groups have made it possible to draw a global map of vaccination coverage through the use of rapid lateral flow immunochromatography serological tests for clinical and epidemiological purposes. The objective of our study was to determine the degree of immunity against SARS-CoV-2 associated with the presence of neutralizing antibodies in administrative staff, teachers and students at the University of Alicante by means of a rapid serological test and to learn about their experience with vaccination against COVID-19. METHODS: A cross-sectional epidemiological study was designed, based on the prevalence of antibodies against the S protein (spike) of SARS-CoV-2. A total of 888 people participated. The study was carried out with a single test (July 6 to July 22, 2021). Using logistic regression, adjusted Odds Ratios were calculated according to sex, age, type of vaccine, number of vaccine doses received, complete vaccination schedule, and having had COVID-19. RESULTS: The vaccines received mostly were Vaxzevria® and Comirnaty®, with 73.3% between both, although 67.2% presented a complete regimen. The results of the OJABIO rapid neutralizing antibody test gave a positive result in 61.4% of the sample. There was a high association between the variables COVID-19 infection, two doses of vaccine, Spikevax® or Comirnaty® vaccine, and eighteen/twenty-nine years old group with a positive result on the OJABIO test. A total of 712 subjects answered the parallel survey (80%) on adverse effects and preferences between the different vaccines against COVID-19. CONCLUSIONS: The vaccination status against COVID-19 in the university community after six months of the start of national immunization strategies reflects low coverage despite the excellent willingness to get vaccinated. Neutralizing antibodies (NAb) rapid tests can be useful to guide immunization strategies and decide when to administer new booster doses.


OBJECTIVE: Los anticuerpos neutralizantes frente al SARS-CoV-2 han resultado una herramienta eficaz para el análisis de la inmunidad generada frente a la COVID-19. Numerosos estudios de seroprevalencia realizados en diferentes colectivos han permitido trazar un mapa global sobre la cobertura vacunal mediante el uso de pruebas serológicas rápidas de inmunocromatografía de flujo lateral con fines clínicos y epidemiológicos. El objetivo de nuestro estudio fue determinar el grado de inmunidad frente al SARS-CoV-2 asociado a la presencia de anticuerpos neutralizantes en personal administrativo, docentes y estudiantes de la Universidad de Alicante, mediante un test serológico rápido, así como conocer su experiencia sobre la vacunación frente a la COVID-19. METHODS: Se diseñó un estudio epidemiológico, transversal, basado en la prevalencia de anticuerpos frente a la proteína S (espícula o Spike) del SARS-CoV-2. Participaron un total de 888 personas. El estudio se llevó a cabo con un único test (6 de julio a 22 de julio de 2021). Mediante regresión logística se calcularon Odds Ratios ajustadas según sexo, edad, tipo de vacuna, número de dosis de vacuna recibidas, pauta completa de vacunación y haber padecido la COVID-19. RESULTS: Las vacunas recibidas mayoritariamente fueron Vaxzevria® y Comirnaty®, con un 73,3% entre ambas; el 67,2% presentó pauta completa. Los resultados del test rápido de anticuerpos neutralizantes OJABIO dieron un resultado positivo en el 61,4% de la muestra. La posibilidad de un resultado positivo en el test OJABIO estuvo fuertemente asociada a haber padecido la COVID-19, haber recibido dos dosis, estar vacunado con Spikevax® o Comirnaty® o pertenecer al grupo de dieciocho a veintinueve años. Un total de 712 sujetos respondieron a un cuestionario (80%) paralelo sobre los efectos adversos y las preferencias entre las distintas vacunas contra la COVID-19. CONCLUSIONS: El estado de vacunación frente a la COVID-19 en la comunidad universitaria a los seis meses de la puesta en marcha de las estrategias nacionales de inmunización refleja una baja cobertura asociada, a pesar de la excelente predisposición a vacunarse. Los test rápidos de anticuerpos neutralizantes (AcN) pueden ser de utilidad para orientar las estrategias de inmunización y para decidir el momento de administrar nuevas dosis de refuerzo.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Vacinas contra COVID-19 , Estudos Transversais , Anticorpos Neutralizantes , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/prevenção & controle , Espanha/epidemiologia , Vacina BNT162 , Estudos Soroepidemiológicos , Vacinação , Testes Sorológicos , Anticorpos Antivirais , Teste para COVID-19
6.
Rev. esp. salud pública ; 97: e202312111, Dic. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-229751

RESUMO

Fundamentos: Los anticuerpos neutralizantes frente al SARS-CoV-2 han resultado una herramienta eficaz para el análisis de la inmunidad generada frente a la COVID-19. Numerosos estudios de seroprevalencia realizados en diferentes colectivos han permitido trazar un mapa global sobre la cobertura vacunal mediante el uso de pruebas serológicas rápidas de inmunocromatografía de flujo lateral con fines clínicos y epidemiológicos. El objetivo de nuestro estudio fue determinar el grado de inmunidad frente al SARS-CoV-2 asociado a la presencia de anticuerpos neutralizantes en personal administrativo, docentes y estudiantes de la Universidad de Alicante, mediante un test serológico rápido, así como conocer su experiencia sobre la vacunación frente a la COVID-19. Métodos: Se diseñó un estudio epidemiológico, transversal, basado en la prevalencia de anticuerpos frente a la proteína S (espícula o Spike) del SARS-CoV-2. Participaron un total de 888 personas. El estudio se llevó a cabo con un único test (6 de julio a 22 de julio de 2021). Mediante regresión logística se calcularon Odds Ratios ajustadas según sexo, edad, tipo de vacuna, número de dosis de vacuna recibidas, pauta completa de vacunación y haber padecido la COVID-19. Resultados: Las vacunas recibidas mayoritariamente fueron Vaxzevria® y Comirnaty ® , con un 73,3% entre ambas; el 67,2% presentó pauta completa. Los resultados del test rápido de anticuerpos neutralizantes OJABIO dieron un resultado positivo en el 61,4% de la muestra. La posibilidad de un resultado positivo en el test OJABIO estuvo fuertemente asociada a haber padecido la COVID-19, haber recibido dos dosis, estar vacunado con Spikevax® o Comirnaty® o pertenecer al grupo de dieciocho a veintinueve años. Un total de 712 sujetos respondieron a un cuestionario (80%) paralelo sobre los efectos adversos y las preferencias entre las distintas vacunas contra la COVID-19...(AU)


Background: Neutralizing antibodies against SARS-CoV-2 have shown to be an effective tool for the analysis of the immunity generated against COVID-19. Numerous seroprevalence studies carried out in different groups have made it possible to draw a global map of vaccination coverage through the use of rapid lateral flow immunochromatography serological tests for clinical and epidemiological purposes. The objective of our study was to determine the degree of immunity against SARS-CoV-2 associated with the presence of neutralizing antibodies in administrative staff, teachers and students at the University of Alicante by means of a rapid serological test and to learn about their experience with vaccination against COVID-19. Methods: A cross-sectional epidemiological study was designed, based on the prevalence of antibodies against the S protein (spike) of SARS-CoV-2. A totalof 888 people participated. The study was carried out with a single test (July 6 to July 22, 2021). Using logistic regression, adjusted Odds Ratios were calculated according to sex, age, type of vaccine, number of vaccine doses received, complete vaccination schedule, and having had COVID-19. Results: The vaccines received mostly were Vaxzevria® and Comirnaty® , with 73.3% between both, although 67.2% presented a complete regimen. The results of the OJABIO rapid neutralizing antibody test gave a positive result in 61.4% of the sample. There was a high association between the variables COVID-19 infection, two doses of vaccine, Spikevax® or Comirnaty® vaccine, and eighteen/twenty-nine years old group with a positive result on the OJABIO test. A total of 712 subjects answered the parallel survey (80%) on adverse effects and preferences between the different vaccines against COVID-19...(AU)


Assuntos
Humanos , Masculino , Feminino , /imunologia , Universidades , Anticorpos Neutralizantes , Espanha/epidemiologia , /epidemiologia , /prevenção & controle , Estudos Transversais , Estudos Epidemiológicos , Testes Sorológicos , Prevalência
7.
Curr Microbiol ; 80(12): 396, 2023 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-37907808

RESUMO

Cryptococcosis is an opportunistic fungal infection of worldwide distribution with significant associated morbidity and mortality. HIV, organ transplantation, malignancy, cirrhosis, sarcoidosis, and immunosuppressive medications are established risk factors for cryptococcosis. Type 2 diabetes mellitus (DM2) has been hypothesized as a risk factor and an outcome modifier for cryptococcosis. We aimed to compare outcomes among HIV-negative, non-transplant (NHNT) patients with and without DM2. We queried a global research network to identify NHNT patients (n = 3280). We performed a propensity score-matched (PSM) analysis comparing clinical outcomes among cryptococcosis patients by DM status. We also characterize adults with cryptococcosis and DM2 as the only risk factor. After PSM, NHNT patients with DM2 were more likely to develop cognitive dysfunction [9% vs. 6%, OR 1.6; 95% CI (1.1-2.3); P = 0.01] but had similar mortality, hospitalization, ICU, and stroke risk after acquiring cryptococcosis when compared to NHNT patients without DM2. Pulmonary cryptococcosis was the most common site of infection. Among 44 cryptococcosis patients with DM2 as the only identifiable risk factor for disease, the annual incidence of cryptococcosis was 0.001%, with a prevalence of 0.002%. DM2 is associated with increased cognitive dysfunction risk in NHNT patients with cryptococcosis. It is rare for DM2 to be the only identified risk factor for developing cryptococcosis. Kidney disease, hyperglycemia, and immune dysfunction can increase the risk of cryptococcosis in patients with DM2.


Assuntos
Criptococose , Diabetes Mellitus Tipo 2 , Infecções por HIV , Adulto , Humanos , Diabetes Mellitus Tipo 2/complicações , Pontuação de Propensão , Fatores de Risco , Criptococose/epidemiologia , Infecções por HIV/complicações
9.
Rev Esp Salud Publica ; 972023 Oct 11.
Artigo em Espanhol | MEDLINE | ID: mdl-37921383

RESUMO

The Madrid Gazette published a Supplement on October 14, 1806, regarding the arrival of the Director of the Royal Expedition Vaccine Philanthropy, Francisco Xavier Balmis, and the reception held by King Carlos IV. Balmis had completed his journey across the Spanish overseas territories, taking the vaccine against smallpox from arm to arm with the help of a human chain of children. During this journey, Balmis also established Vaccination Boards and endeavoured to identify cows with cowpox. The publication endorsed the policies of a declining Bourbon monarchy and marked the peak of Balmis' professional career. Both sides emerged victorious: the Crown showcased itself as the sponsor and organiser of this altruistic journey, in line with prior scientific expeditions; and Balmis secured his place in Public Health history as the director of the first international vaccination campaign. This did not mean the culmination of the expedition, as other members were still administering vaccinations in the Philippines and South America. The main objective of this study was to assess the importance of the newspaper Madrid Gazette, outline the contents of the publication, authenticate the origins of the documentary sources underpinning its composition, and confirm its impact and citations throughout 19th-century Spanish publications. The components of the publication, its origins, as well as Balmis' involvement in its creation, have been substantiated. The Supplement's importance is defined by its utility as a resource for commemorating and appreciating the expedition.


La Gazeta de Madrid publicó un Suplemento el 14 de octubre de 1806 dando noticia de la llegada y recepción al Director de la Real Expedición Filantrópica de la Vacuna, Francisco Xavier Balmis, por parte del Rey Carlos IV. Había finalizado su periplo dando la vuelta al mundo por los territorios españoles de ultramar, llevando la vacuna contra la viruela brazo a brazo con la ayuda de una cadena humana de niños, creando Juntas de Vacunación e intentando encontrar vacas con cowpox. La publicación refrendó las políticas de una monarquía borbónica en decadencia y significó el momento álgido de la carrera profesional de Balmis. Ambas partes ganaban: la Corona publicitándose como financiadora y organizadora del viaje altruista en línea con expediciones científicas anteriores; Balmis pasando a la historia de la Salud Pública como director de la primera campaña internacional de vacunación. No fue el final de la expedición, ya que el resto de los expedicionarios aún seguían vacunando en Filipinas y América del Sur. El objetivo de este estudio fue analizar la importancia de la Gazeta de Madrid como periódico, describir los contenidos de la noticia, verificar el origen de las fuentes documentales que apoyaron su redacción y comprobar el impacto y citas que tuvo a lo largo del siglo XIX en publicaciones en idioma español. Los componentes de la noticia, su proveniencia, así como la participación de Balmis en su redacción han quedado probados. La importancia del Suplemento estribó en su utilidad como recurso para recordar y poner en valor la expedición.


Assuntos
Vacina Antivariólica , Varíola , Vacinas , Criança , Humanos , Animais , Bovinos , Vacina Antivariólica/história , Espanha , Vacinação/história , Varíola/história , Varíola/prevenção & controle
10.
Rev Esp Salud Publica ; 972023 Aug 29.
Artigo em Espanhol | MEDLINE | ID: mdl-37970887

RESUMO

OBJECTIVE: Heart failure (HF) is a complex clinical syndrome that impairs the ability to achieve proper filling or ejection, in which patients have typical symptoms and signs. It is a major Public Health problem with a high incidence and prevalence associated with high morbidity and mortality. The management of the patient with HF is complex, requiring in its treatment the work of specialized multidisciplinary teams in which the management of cardiac-healthy habits and self-care will play a leading role. Knowing the health literacy (HL) level of patients is a fundamental piece that will help us to provide a holistic attention, based on individual needs, promoting in this way the empowerment of the patient. Our aim will be to evaluate the effectiveness of an HL intervention for improving quality of life and decreasing morbidity/mortality. METHODS: A two-arm randomized controlled clinical trial will be conducted, with concealment of randomization. Patients with diagnosis of HF attended in cardiology and internal medicine consultations of 5 hospitals in Spain will be included.


OBJETIVO: La insuficiencia cardiaca (IC) es un síndrome clínico complejo con una sintomatología bien definida que constituye un problema de Salud Pública por su impacto en la morbi-mortalidad. El manejo del paciente con IC requiere el trabajo de equipos especializados multidisciplinares que enfaticen en los hábitos cardiovasculares y el autocuidado. Conocer el grado alfabetización en salud (AeS) de estos pacientes es una buena herramienta para prestarles una atención holística, basada en necesidades individuales, así como para fomentar su empoderamiento. Se ha diseñado un protocolo con el objetivo de evaluar la eficacia de una intervención en AeS en la mejora de su calidad de vida, así como en la disminución de la morbi/mortalidad. METODOS: Se llevará a cabo un estudio clínico controlado aleatorio a dos brazos multicéntrico, con ocultación del reparto aleatorio. Se incluirán pacientes con diagnóstico de IC atendidos en consultas de cardiología y medicina interna de cinco hospitales de España.


Assuntos
Insuficiência Cardíaca , Qualidade de Vida , Humanos , Espanha , Síndrome , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/terapia , Morbidade , Estudos Retrospectivos
11.
Vaccines (Basel) ; 11(10)2023 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-37896950

RESUMO

The COVID-19 vaccination of prisoners and prison staff represents a public health intervention to reduce the impact of the pandemic in conglomerate settings. In Spanish prisons, the road map of the Ministry of Health was followed to protect the population at risk. We conducted a cross-sectional study to assess the acceptance of COVID-19 vaccination by prisoners and prison staff in a prison in Alicante, Spain. We analyzed data obtained through a standardized, self-administered, and anonymous questionnaire; 1016 prisoners and 288 prison staff responded to the survey. The majority of inmates and staff reported no history of symptomatic COVID-19, 90.15% and 91.66%, respectively. Respondents reported that 88.72% agreed to be vaccinated and 89.64% would recommend the vaccine to others. Approximately 89% believe that the benefit of getting vaccinated against COVID-19 is greater than the risk, and 70.55% reported that vaccination should be mandatory for inmates and staff to participate in some activities. The acceptance of COVID-19 vaccination among prisoners and prison staff is high in a Provincial Prison in Spain. Elevated acceptance of COVID-19 vaccination in prisons is a major factor in public health intervention and vaccine equity.

12.
Gac Sanit ; 37: 102329, 2023.
Artigo em Espanhol | MEDLINE | ID: mdl-37820503

RESUMO

OBJECTIVE: To develop and validate a survey aimed at epidemiologists to measure factors associated with vaccine reluctance. METHOD: Vaccination hesitancy refers to delayed acceptance or refusal of vaccination despite the availability of vaccination services. WHO included vaccination hesitancy among the 10 global health threats in 2019. Within this conceptual framework proposed by WHO, a committee of six experts from the Spanish Society of Epidemiology (SEE) designed a self-administered questionnaire to study factors associated with vaccination hesitancy in epidemiologists. This questionnaire was approved by the SEE Board, and was sent online to all members in 2019. Based on the responses obtained, the following characteristics were validated: face validity, internal validity, construct validity, criterion validity, reliability, as well as the characteristic curves of each item and the information function per item and overall. RESULTS: The final questionnaire showed two well-defined components, perception of vaccines and confidence in the transparency of vaccine data with high degrees of fit in all aspects of validation. Both components have shown that the higher the reluctance to vaccinate the better the questionnaire reports on these aspects. CONCLUSIONS: The study has allowed the development of a validated instrument in Spanish to measure the factors associated with vaccine reluctance among epidemiologists.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , Vacinas , Humanos , Reprodutibilidade dos Testes , Vacinação , Inquéritos e Questionários
13.
Rev. esp. salud pública ; 97: e202310083, Oct. 2023. ilus
Artigo em Espanhol | IBECS | ID: ibc-228323

RESUMO

Gazeta de Madrid publicó un Suplemento el 14 de octubre de 1806 dando noticia de la llegada y recepción al Director de la Real Expedición Filantrópica de la Vacuna, Francisco Xavier Balmis, por parte del Rey Carlos IV. Había finalizado su periplo dando la vuelta al mundo por los territorios españoles de ultramar, llevando la vacuna contra la viruela brazo a brazo con la ayuda de una cadena humana de niños, creando Juntas de Vacunación e intentando encontrar vacas concowpox. La publicación refrendó las políticas de una monarquía borbónica en decadencia y significó el momento álgido de la carrera profesional de Balmis. Ambas partes ganaban: la Corona publicitándose como financiadora y organizadora del viaje altruista en línea con expediciones científicas anteriores; Balmis pasando a la historia de la Salud Pública como director de la primera campaña internacional de vacunación. No fue el final de la expedición, ya que el resto de los expedicionarios aún seguían vacunando en Filipinas y América del Sur. El objetivo de este estudio fue analizar la importancia de la Gazeta de Madrid como periódico, describir los contenidos de la noticia, verificar el origen de las fuentes documentales que apoyaron su redacción y comprobar el impacto y citas que tuvo a lo largo del siglo XIX en publicaciones en idioma español. Los componentes de la noticia, su proveniencia, así como la participación de Balmis en su redacción han quedado probados. La importancia del Suplemento estribó en su utilidad como recurso para recordar y poner en valor la expedición.(AU)


The Madrid Gazette published a Supplement on October 14, 1806, regarding the arrival of the Director of the Royal Expedition Vaccine Philanthropy, Francisco Xavier Balmis, and the reception held by King Carlos IV. Balmis had completed his journey across the Spanish overseas territories, taking the vaccine against smallpox from arm to arm with the help of a human chain of children. During this journey, Balmis also established Vaccination Boards and endeavoured to identify cows with cowpox. The publication endorsed the policies of a declining Bourbon monarchy and marked the peak of Balmis’ professional career. Both sides emerged victorious: the Crown showcased itself as the sponsor and organiser of this altruistic journey, in line with prior scientific expeditions; and Balmis secured his place in Public Health history as the director of the first international vaccination campaign. This did not mean the culmination of the expedition, as other members were still administering vaccinations in the Philippines and South America. The main objective of this study was to assess the importance of the newspaper Madrid Gazette, outline the contents of the publication, authenticate the origins of the documentary sources underpinning its composition, and confirm its impact and citations throughout 19 th -century Spanish publications. The components of the publication, its origins, as well as Balmis’ involvement in its creation, have been substantiated. The Supplement’s importance is defined by its utility as a resource for commemorating and appreciating the expedition.(AU)


Assuntos
Humanos , Masculino , Feminino , Vacinas/história , Vacinação/história , Vacina Antivariólica/história , Varíola/imunologia , Espanha , História do Século XIX , Varíola/história , Varíola/prevenção & controle
14.
Ther Adv Infect Dis ; 10: 20499361231196683, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37663111

RESUMO

Background: Monkeypox (Mpox) is a reemerging, neglected viral disease. By May 2023, worldwide Mpox cases surpassed 87,000. Predictive factors for hospitalization with Mpox are lacking. Objective: We aim to compare clinical characteristics and outcomes in hospitalized and nonhospitalized patients with Mpox infection. Design: A multicenter retrospective case-control cohort of patients with Mpox infection. Methods: We performed a propensity score match analysis from a global health network (TrinetX). We compare clinical characteristics and outcomes between hospitalized and nonhospitalized patients with Mpox. Results: Of 1477 patients, 6% were hospitalized, 52% required an ED visit, and 29% received treatment at urgent care. After propensity score matching, 80 patients remained in each group. Hospitalizations were more common among Black persons (51% versus 33%, p = 0.01), people with HIV (50% versus 20%, p < 0.0001), and those with proctitis (44% versus 12.5%, p < 0.001). Conclusion: Independent predictive factors of hospitalization in our cohort for Mpox included people who are Black with a diagnosis of HIV, severe proctitis, pain requiring opioids, and elevated lactate dehydrogenase. Greater recognition of factors associated with increased risk of Mpox severity and hospitalization is paramount.

15.
Am J Trop Med Hyg ; 109(5): 1006-1011, 2023 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-37696508

RESUMO

Chagas disease affects approximately 300,000 patients in the United States. We evaluated a multicenter U.S.-based network to obtain clinical characteristics and outcomes of chronic Chagas disease by disease forms. This was a U.S.-based, multicenter, population-based, retrospective cohort study. We queried TriNetX, a global research network, to identify patients with dual-positive IgG serology for Trypanosoma cruzi. We captured outcomes of interest for up to 5 years. We found 429 patients with evidence of dual-positive T. cruzi IgG out of 19,831 patients with an available test result from 31 U.S. medical centers. The positive proportion for those tested was 2.2%, up to 4.6% among Hispanics. We found a prevalence of a positive Chagas serology of 0.02% among Hispanics. Cardiomyopathy risk reached an annual rate of 1.3% during the initial 5 years of follow-up among patients with the indeterminate form. We found no new events for pulmonary embolism, sudden death, or left ventricular aneurysms at 5 years. Annual risks for arrhythmias and stroke for chronic Chagas cardiomyopathy (CCC) were 1.6% and 0.8%, respectively. The yearly mortality and hospitalization rates for CCC were 2.7% and 17.1%, respectively. Only 13 patients had a documented antitrypanosomal therapy course within 6 months after diagnosis. Of those receiving treatment, 10 patients received benznidazole and three nifurtimox. Chagas disease screening in patients from endemic areas living in the United States remains crucial. Chronic Chagas cardiomyopathy carries a considerable disease burden, translating into increased morbidity and mortality and an enlarging medical health service utilization.


Assuntos
Cardiomiopatia Chagásica , Doença de Chagas , Nitroimidazóis , Trypanosoma cruzi , Humanos , Estados Unidos/epidemiologia , Estudos Retrospectivos , Doença de Chagas/diagnóstico , Doença de Chagas/tratamento farmacológico , Doença de Chagas/epidemiologia , Nitroimidazóis/uso terapêutico , Imunoglobulina G/uso terapêutico
17.
Rev. esp. salud pública ; 97: e202308068, Agos. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-224700

RESUMO

Fuandamentos: La insuficiencia cardiaca (IC) es un síndrome clínico complejo con una sintomatología bien definida que constituye un problema de Salud Pública por su impacto en la morbi-mortalidad. El manejo del paciente con IC requiere el trabajo de equiposespecializados multidisciplinares que enfaticen en los hábitos cardiovasculares y el autocuidado. Conocer el grado alfabetización ensalud (AeS) de estos pacientes es una buena herramienta para prestarles una atención holística, basada en necesidades individuales,así como para fomentar su empoderamiento. Se ha diseñado un protocolo con el objetivo de evaluar la eficacia de una intervenciónen AeS en la mejora de su calidad de vida, así como en la disminución de la morbi/mortalidad. Métodos: Se llevará a cabo un estudio clínico controlado aleatorio a dos brazos multicéntrico, con ocultación del reparto aleatorio.Se incluirán pacientes con diagnóstico de IC atendidos en consultas de cardiología y medicina interna de cinco hospitales de España.(AU)


Background: Heart failure (HF) is a complex clinical syndrome that impairs the ability to achieve proper filling or ejection, inwhich patients have typical symptoms and signs. It is a major Public Health problem with a high incidence and prevalence associatedwith high morbidity and mortality. The management of the patient with HF is complex, requiring in its treatment the work of specialized multidisciplinary teams in which the management of cardiac-healthy habits and self-care will play a leading role. Knowingthe health literacy (HL) level of patients is a fundamental piece that will help us to provide a holistic attention, based on individualneeds, promoting in this way the empowerment of the patient. Our aim will be to evaluate the effectiveness of an HL intervention forimproving quality of life and decreasing morbidity/mortality.Methods: A two-arm randomized controlled clinical trial will be conducted, with concealment of randomization. Patients with diagnosis of HF attended in cardiology and internal medicine consultations of 5 hospitals in Spain will be included.(AU)


Assuntos
Humanos , Masculino , Feminino , Insuficiência Cardíaca/prevenção & controle , Letramento em Saúde , Qualidade de Vida , Indicadores de Morbimortalidade , Insuficiência Cardíaca/etiologia
18.
Aging Clin Exp Res ; 35(5): 917-923, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37027085

RESUMO

BACKGROUND: Older adults and immunocompromised individulas are often excluded from vaccine trials. AIM: We hypothesised that during the coronavirus disease 2019 (COVID-19) pandemic, the proportion of trials excluding these patients decreased. METHODS: Using the US Food and Drug Administration and and European Medicines Agency search engines, we identified all vaccines approved against pneumococcal disease, influenza (quadrivalent vaccines), and COVID-19 from 2011 to 2021. Study protocols were screened for direct and indirect age exclusion criteria and exclusion of immunocompromised individuals. In addition, we reviewed the studies with no explicit exclusion criteria and investigated the actual inclusion of those individuals. RESULTS: We identified 2024 trial records; 1702 were excluded (e.g., use of other vaccine or risk group); and 322 studies were eligible for our review. Among the pneumococcal and influenza vaccine trials (n = 193), 81 (42%) had an explicit direct age exclusion, and 150 (78%) had an indirect age-related exclusion. In total, 163 trials (84%) trials were likely to exclude older adults. Among the COVID-19 vaccine trials (n = 129), 33 (26%) had direct age exclusion and 82 (64%) had indirect age exclusion; in total, 85 (66%) trials were likely to exclude older adults. Therefore was a 18% decrease in the proportion of trials with age-related exclusion between 2011 and 2021 (only influenza and pneumococcal vaccine trials) and 2020-2021 (only COVID-19 vaccine trials) (p = 0.014). In a sub-analysis assessing observational and randomised trials, the decrease was 25% and 9%, respectively. Immunocompromised individuals were included in 87 (45%) of the pneumococcal and influenza vaccine trials compared with 54 (42%) of the COVID-19 vaccine trials (p = 0.058). CONCLUSIONS: During the COVID-19 pandemic, we found a decrease in the exclusion of older adults from vaccine trials but no significant change in the inclusion of immunocompromised individulas.


Assuntos
COVID-19 , Vacinas contra Influenza , Influenza Humana , Humanos , Idoso , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Vacinas contra Influenza/uso terapêutico , Vacinas contra COVID-19/uso terapêutico , Pandemias/prevenção & controle , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas Pneumocócicas/uso terapêutico
19.
Ther Adv Infect Dis ; 10: 20499361231159481, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36938147

RESUMO

Background: HIV-negative patients have substantial mortality from Pneumocystis jirovecii pneumonia (PJP). We lack predictors of HIV-negative PJP-associated mortality. Objective: We aim to characterize the role of prior corticosteroid exposure in PJP-related mortality. Methods: We queried a global research network to identify adult HIV-negative patients with PJP with or without corticosteroid exposure in the preceding year before diagnosis (n = 8,021). We performed a propensity score-matched analysis to adjust baseline patient characteristics and analyzed outcomes. We follow-up the results with a multicenter ten years retrospective case-control cohort of HIV-negative patients tested for PJP by PCP Direct Fluorescent Antigen. We used a Cox proportional hazards model for survival analysis. Results: 1822 HIV-negative propensity-scored matched patients with prior corticosteroid exposure had significantly increased 10 weeks (16% versus 9%, p < 0.0001) and one-year mortality after PJP diagnosis (23% versus 14%, p < 0.0001). (1→3)-ß-D-glucan (197.6 ± 155.8 versus 63 ± 0 pg/ml, p = 0.014), ferritin levels (1227 ± 2486 versus 768 ± 1060 mcg/l, p = 0.047), lymphopenia (1.5 ± 1.5 versus 2.0 ± 1.6 103 cells/µl, p < 0.0001) and hypoxia (SatO2: 86.7% versus 91.6%, p < 0.0001) were higher or worse in those with prior steroid use. Patients who died were more likely to have previously received dexamethasone (35% versus 16%, p < 0.001) or prednisone (49% versus 29%, p < 0.001). Adjusted Cox proportional-hazard model validation showed an independently increased mortality at 10 weeks (HR: 3.7, CI: 1.5-9.2, p = 0.004) and 1 year (HR: 4.5, CI: 2.0-10.4, p < 0.0001) among HIV-negative patients with previous corticosteroid exposure. Conclusion: Preceding corticosteroids in HIV-negative patients with PJP are associated with higher mortality. A higher fungal burden may influence corticosteroid-mediated mortality. Assessment of PJP prophylaxis must become a standard clinical best practice when instituting corticosteroid therapy courses.

20.
Gac. sanit. (Barc., Ed. impr.) ; 37: 102329, 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-226781

RESUMO

Objetivo: Confeccionar y validar una encuesta dirigida a profesionales de epidemiología para medir factores asociados a la reticencia vacunal. Método: La reticencia a la vacunación se refiere al retraso en la aceptación o el rechazo de la vacunación a pesar de la disponibilidad de ella. La OMS la incluyó entre las diez amenazas a la salud global en 2019.En este marco conceptual propuesto por la OMS, un comité de seis expertos de la Sociedad Española de Epidemiología (SEE) diseñó un cuestionario autoadministrado para estudiar los factores asociados a la reticencia a la vacunación en epidemiólogos/as. Este cuestionario fue aprobado por la Junta de la SEE y se envió on line a todos/as los/las socios/as en 2019. A partir de las respuestas obtenidas se validaron las siguientes características: validez aparente, interna, de constructo y de criterio, fiabilidad, curvas características de cada ítem y función de información por ítem y conjunta. Resultados: El cuestionario mostró dos componentes bien definidos: la percepción sobre las vacunas y la confianza en la transparencia de los datos sobre vacunas con altos grados de ajuste en todos los aspectos de la validación. Ambos componentes han demostrado que cuanto mayor es la reticencia a la vacunación, mejor informa el cuestionario sobre estos aspectos. Conclusiones: El estudio ha permitido elaborar un instrumento validado en español para medir los factores asociados a la reticencia vacunal entre los/las epidemiólogos/as.(AU)


Objective: To develop and validate a survey aimed at epidemiologists to measure factors associated withvaccine reluctance.Method: Vaccination hesitancy refers to delayed acceptance or refusal of vaccination despite the availa-bility of vaccination services. WHO included vaccination hesitancy among the 10 global health threats in2019. Within this conceptual framework proposed by WHO, a committee of six experts from the Spanish Society of Epidemiology (SEE) designed a self-administered questionnaire to study factors associatedwith vaccination hesitancy in epidemiologists. This questionnaire was approved by the SEE Board, andwas sent online to all members in 2019. Based on the responses obtained, the following characteristicswere validated: face validity, internal validity, construct validity, criterion validity, reliability, as well asthe characteristic curves of each item and the information function per item and overall. Results: The final questionnaire showed two well-defined components, perception of vaccines and con-fidence in the transparency of vaccine data with high degrees of fit in all aspects of validation. Bothcomponents have shown that the higher the reluctance to vaccinate the better the questionnaire reportson these aspects. Conclusions: The study has allowed the development of a validated instrument in Spanish to measurethe factors associated with vaccine reluctance among epidemiologists.(AU)


Assuntos
Humanos , Masculino , Feminino , Vacinação , Recusa de Vacinação , Vacinas , Espanha/epidemiologia , Inquéritos e Questionários
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