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ABSTRACT: To evaluate possible persistence of 17D yellow fever vaccine, we tested urine samples from 44 healthy recipients of yellow fever vaccine at varying times up to one year after vaccination. Urine samples from two vaccine recipients had detectable yellow fever virus RNA. The time since vaccination was reported as 21 days for one sample and 198 days for the other sample. These results suggest that yellow fever vaccine virus might persist for at least 6 months after vaccination in some people.
Vaccine 03/2011; 29(18):3374-6. · 3.77 Impact Factor
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Conchita Izquierdo,
Manuel Oviedo,
Laura Ruiz,
Xavier Sintes, Isabel Vera,
Manel Nebot,
Jose-María Bayas,
Jordi Carratalà,
Wenceslao Varona,
Dolores Sousa,
Jose-Miguel Celorrio,
Luis Salleras,
Angela Domínguez
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ABSTRACT: The associations between socioeconomic status and community-acquired pneumonia outcomes in adults have been studied although studies did not always document a relationship.The aim of this multicenter observational study was to determine the association between socioeconomic status and community-acquired pneumonia outcomes in the elderly, in the context of a public health system providing universal free care to the whole population.
A total of 651 patients aged > or =65 years hospitalized due to community-acquired pneumonia through the emergency departments of five Spanish public hospitals were recruited and followed up between May 2005 and January 2007. The primary outcomes studied were: length of stay, intensive care unit admission, overall mortality and readmission. Socioeconomic status was measured using both individual and community data: occupation [categorized in six social groups (I, II, III, IVa, IVb and V)], educational level (< or = primary level or > or = secondary level) and disposable family income of the municipality or district of residence [>12,500 euro (high municipality family income) and < or =12,500 euro (low municipality family income)]. The six social groups were further categorized as upper/middle social class (groups I-IVb) and lower class (group V).Bivariate and multivariate analyses were performed. OR and their 95% confidence intervals were calculated. All statistical tests were two tailed and statistical significance was established as p < 0.05.
17.7% of patients lived in a municipality or district with a high municipality family income and 63.6% were upper/middle social class (I-IVb). Only 15.7% of patients had a secondary education. The adjusted analysis showed no association between pneumonia outcomes and social class, educational level or municipality family income. However, length of stay increased significantly in patients in whom the factors, living alone and being a smoker or ex-smoker coincided (p < 0.001).
We measured socioeconomic status using both individual and community data and found no association between social class, educational level or municipality family income and the variables of pneumonia outcomes. The lack of differences between social classes supports the provision of universal, equitable health care by the public health system.
BMC Public Health 01/2010; 10:421. · 2.00 Impact Factor
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Maria Chaparro,
Paula Vázquez de Parga,
Manuel Van Domselaar,
Raquel García,
Alicia Algaba,
Pilar Martínez, Isabel Vera,
Ignacio Marin-Jimenez,
Angel Ponferrada Diaz,
Manuel Román,
Carlos Taxonera,
Antonio López-San Román
Gastroenterology 01/2010; 138(5). · 11.68 Impact Factor
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ABSTRACT: In recent years, the number of travelers aged >40 years who acquire hepatitis A while traveling has increased. Therefore, there is a need to review hepatitis A vaccination protocols in travelers. The aims of the study were to assess immunity levels to hepatitis A virus (HAV) in international travelers >40 years and to determine the least costly immunization strategy.
A serological examination of HAV antibodies in 427 international travelers aged >40 years traveling endemic zones was carried out. The prevalence of antibodies in each age group was assessed. The costs of two preventive strategies, direct vaccination of all subjects (independent of the immune status) or screening and subsequent vaccination of susceptible subjects were compared. The critical value of prevalence (CVP) (the value at which the costs for the two strategies are equal) was calculated.
Total prevalence of HAV antibodies was 78.9% [95% confidence interval (CI): 74.8-82.5] and was 80.0% (95% CI: 73.8-85.2) in men and 77.9% (95% CI: 71.9-83.2) in women. There was a positive association with age. In the 40 to 49, 50 to 59, 60 to 69, and 70 to 95 years age groups, the prevalence rates were 62.6 (95% CI: 53.8-71.5), 76.8 (95% CI: 70.0-82.7), 91.7 (95% CI: 85.2-95.6), and 97.5% (95% CI: 87.4-99.6), respectively. The CVP was 58.4% using two doses of vaccine.
The CVP was lower than the prevalence rate found in our international travelers. Therefore, we recommend systematic screening for HAV antibodies before selective vaccination of international travelers aged >40 years traveling to hepatitis A endemic zones.
Journal of Travel Medicine 08/2009; 16(5):344-8. · 1.75 Impact Factor
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Javier P Gisbert,
Fernando Bermejo,
Jose-Lázaro Pérez-Calle,
Carlos Taxonera, Isabel Vera,
Adrian G McNicholl,
Alicia Algaba,
Pilar López,
Natalia López-Palacios,
Marta Calvo,
Yago González-Lama,
Jose-Antonio Carneros,
Marta Velasco,
José Maté
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ABSTRACT: The purpose of the study was to determine the role of fecal calprotectin and lactoferrin in the prediction of inflammatory bowel disease relapses, both in patients with ulcerative colitis (UC) and Crohn's disease (CD), in a large, long-term, follow-up study.
The prospective multicenter study included CD and UC patients who had been in clinical remission for 6 months. At baseline, patients provided a single stool sample for calprotectin and lactoferrin determination. Follow-up was 12 months in patients showing no relapse and until activity flare in relapsing patients.
In all, 163 patients (89 CD, 74 UC) were included. Twenty-six patients (16%) relapsed during follow-up. Calprotectin concentrations in patients who suffered a relapse were higher than in nonrelapsing patients (239 +/- 150 versus 136 +/- 158 microg/g; P < 0.001). Relapse risk was higher in patients having high (>150 microg/g) calprotectin concentrations (30% versus 7.8%; P < 0.001) or positive lactoferrin (25% versus 10%; P < 0.05). Fecal calprotectin (>150 microg/g) sensitivity and specificity to predict relapse were 69% and 69%, respectively. Corresponding values for lactoferrin were 62% and 65%, respectively. The area under the receiver operating characteristic curve to predict relapse using calprotectin determination was 0.73 (0.69 for UC and 0.77 for CD). Better results were obtained when only colonic CD disease or only relapses during the first 3 months were considered (100% sensitivity). High fecal calprotectin levels or lactoferrin positivity was associated with clinical relapse in Kaplan-Meier survival analysis, and both fecal tests were associated with relapse in the multivariate analysis.
Fecal calprotectin and lactoferrin determination may be useful in predicting impending clinical relapse-especially during the following 3 months-in both CD and UC patients.
Inflammatory Bowel Diseases 03/2009; 15(8):1190-8. · 4.86 Impact Factor
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Yago González-Lama,
Antonio López-San Román,
Ignacio Marín-Jiménez,
Begoña Casis, Isabel Vera,
Fernando Bermejo,
José Lázaro Pérez-Calle,
Carlos Taxonera,
Francisca Martínez-Silva,
Luis Menchén, [......],
José Antonio Carneros,
Pilar López,
Juan Luis Mendoza,
José María Milicua,
Alaín Huerta,
Fernando Sánchez,
Luis Abreu,
Natalia López-Palacios,
José Maté,
Javier P Gisbert
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ABSTRACT: Efficacy of infliximab in Crohn's disease (CD) showed by randomized controlled trials must be confirmed in clinical practice. We aimed to evaluate efficacy and safety of infliximab in CD patients of the Madrid area, looking for clinical predictors of response.
Multicenter retrospective survey of all CD patients treated with infliximab in 8 University hospitals of the Madrid area (Spain) with a minimum follow up of 14 wks.
169 patients included (48%males, mean age 39 +/- 12 yrs). 64% of them had perianal disease. 82% were under immunosuppressants. 1,355 infliximab infusions administered (mean 8, range 1-30). 90% response rate and 48% remission rate were obtained with induction therapy. 73% followed maintenance treatment, and 78% of them maintained or improved the response after a mean follow up of 28 months (range 3.5-86). 24 patients lost response during the follow up, after a mean of 41 wks (range 6-248). Only the prescription of maintenance therapy was predictive factor for favourable response (p < 0.01). 17 infusion reactions were reported (10% of the patients, 1.2% of the infusions; only one case was severe) and were the cause of treatment withdrawal in 7 patients. Co-treatment with immunosuppressive drugs and maintenance infliximab therapy were protective factors for infusion reactions (p < 0.05). Other adverse events occurred in 26% of the patients, and were cause of treatment withdrawal in 7 patients.
Infliximab is effective and safe for CD management but concomitant immunosuppressive drugs and maintenance treatment should be prescribed to obtain the best outcome. That confirms in a real life clinical setting the favourable results obtained in randomized clinical trials.
Gastroenterología y Hepatología 09/2008; 31(7):421-6. · 0.73 Impact Factor
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Conchita Izquierdo,
Manuel Oviedo,
Laura Ruiz,
Xavier Sintes, Isabel Vera,
Manel Nebot,
José Maria Bayas,
Jordi Carratala,
Wenceslao Varona,
Dolores Sousa,
José Miguel Celorrio,
Lluís Salleras i Sanmartí,
Àngela Domínguez García,
Working Group for the Study of the Prevention of CAP in the Elderly
