Effects of Lactobacillus coryniformis K8 CECT5711 on the immune response to influenza vaccination and the assessment of common respiratory symptoms in elderly subjects: a randomized controlled trial.

PURPOSE: Elderly people are particularly vulnerable to seasonal influenza. Therefore, vaccination is strongly recommended. However, the vaccine efficacy is lower in the elderly, owing to immunosenescence. The objective of the present study was to evaluate the ability of the probiotic strain Lactobacillus coryniformis K8 CECT5711 to enhance the immune response to the influenza vaccine in the elderly and to assess the effects on symptoms related to respiratory infections. METHODS: A randomized, double-blind, placebo-controlled trial was conducted between November 2015 and April 2016. A total of 98 nursing home residents, more than 65 years of age were randomly assigned to receive L. coryniformis K8 CECT5711 (3 × 109 CFU/day) or a placebo for 2 weeks before influenza vaccination. The primary outcome was the percentage of seroconversion. The secondary outcomes were the incidence of influenza-like illness (ILI) and respiratory symptoms associated with respiratory infections during the 5-month follow-up period. The serum cytokine and immunoglobulin levels were also evaluated. RESULTS: The percentage of responders to vaccination was higher in the probiotic group than in the control group (p = 0.036). L. coryniformis ingestion was associated with a significantly lower incidence of respiratory symptoms commonly associated with respiratory infections (p = 0.007) and lower consumption of analgesics (p = 0.008). CONCLUSION: The administration of L. coryniformis K8 CECT5711 to an elderly population increased the immune response against the influenza vaccine and decreased symptoms associated with respiratory infections. Probiotic administration may be a natural and safe strategy to improve the efficacy of vaccines and to protect against common respiratory infections in susceptible populations.

[Not Available]. / Mortalidad oculta en el ámbito extrahospitalario.

OBJECTIVE: To determine the occult mortality in the extra-hospital setting. PATIENTS AND METHOD: Retrospective study included patients who required health care using the Andalusian Emergency Services from January 2002 to June 2002 and who remained at home or were transferred to an Emergency department of a hospital in a normal ambulance as they were not considered to be in need of emergency assistance. RESULTS: Of the 562 patients who met the inclusion criteria of this study, 17 patients died after this care, which was an occult mortality of 3%, 8 of whom had remained at home. CONCLUSIONS: The occult mortality in this study is not insignificant; it affects all ages and is mainly due to respiratory disorders.

[Prognostic factors for mortality in out-of-hospital cardiorespiratory arrest]. / Factores pronósticos de mortalidad en la parada cardiorrespiratoria extrahospitalaria.

BACKGROUND AND OBJECTIVE: Our purpose was to determine the prognostic factors of mortality among patients with cardiorespiratory arrest (CRA) assisted by 061 emergency teams in Andalusia. PATIENTS AND METHOD: Retrospective observational study from January 1998 to December 1999 of 1950 cases of out-of-hospital CRA (OH-CRA) assisted by Andalusian 061 emergency teams (ETs). Independent (predictor) variables considered in the study were those defined in the Utstein style, after categorization. The dependent (outcome) variable was out-of-hospital mortality. A multivariate model was constructed using logistic regression to define the factors that, when considered together, predict mortality. The model was calibrated using the Hosmer-Lemeshow test. For the discrimination of the model, we calculated the area under the ROC curve. RESULTS: The incidence of OH-CRA was 27/100,000. Among our population of 1950 patients, 24.95% (483) were admitted alive to hospital and 75.05% (1444) died in the out-of hospital setting; 1393 patients were male and 552 were female. The mean age was 61.3 28.4 years. The model revealed the following mortality prognostic factors: personnel performing cadiopulmonary resuscitation before ET arrival (healthcare/non-healthcare), presence of defibrillation, number of defibrillations, CRA site, general function categories before CRA, and cardiac massage within the first minute by ET. CONCLUSIONS: In order to reduce the CRA-induced mortality in our setting, defibrillation and cardiac massage by ETs must be done without delay. It is fundamental to achieve greater health awareness and education among both the general population and the healthcare workers involved in the survival chain.

Use of emergency transport by patients with cardiopathies: a focus group study.

BACKGROUND: The importance of emergency systems accessible by telephone for the early attention of patients with ischemic cardiopathy is well known. In Andalusia, this service is provided by calling 061. However, studies show an insufficient use of the existing emergency system in this type of patient. OBJECTIVE: To identify explanations related to the decision regarding the method of transport to health-care systems, by private means of transport or 061 services, for people with ischemic cardiopathy from the onset of symptoms until their arrival at the Emergency Department. METHODS: Eleven focal groups were held with subjects diagnosed with ischemic cardiopathy. The discussions were related to the method of transport (using 061 or their own means of transport to a major hospital or to a nearby health facility for onward transfer), depending on the existence of previous experience and distance to the hospital. RESULTS: The method of transport is related to the degree of ignorance about what is happening, perceptions regarding the fastest way to reach the hospital, people available around the patient when the event takes place, vehicle availability and possible stressful situations. CONCLUSIONS: This study provides information about the reasons for using or not using the emergency transport systems for these patients and understanding how decisions were made. The study's importance lies in the possibility of improving individuals' access to health care systems through education-based actions and a strategic information and training plan that targets patients, families and health professionals.