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Casado I.,Institute Salud Publica Of Navarra | Dominguez A.,CIBER ISCIII | Dominguez A.,University of Barcelona | Toledo D.,University of Barcelona | And 12 more authors.
Expert Review of Vaccines | Year: 2016

Objectives: This study aimed to assess whether influenza vaccination reduces the risk of severe and fatal outcomes in influenza inpatients aged ≥65 years.Methods: During the 2013-2014 influenza season persons aged ≥65 years hospitalized with laboratory-confirmed influenza were selected in 19 Spanish hospitals. A severe influenza case was defined as admission to the intensive care unit, death in hospital or within 30 days after admission. Logistic regression was used to compare the influenza vaccination status between severe and non-severe influenza inpatients.Results: Of 433 influenza confirmed patients, 81 (19%) were severe cases. Vaccination reduced the risk of severe illness (odds ratio: 0.57; 95%CI: 0.33-0.98). The cumulative number of influenza vaccine doses received since the 2010-2011 season was associated with a lower risk of severe influenza (odds ratio: 0.78; 95% CI 0.66-0.91).Conclusion: Adherence to seasonal influenza vaccination in the elderly may reduce the risk of severe influenza outcomes. © 2016 Taylor & Francis. Source


Pitarch G.,Dermatologia | Perez-Ferriols A.,Consorci Hospital General Universitari Of Valencia | Millan F.,Dermatologia
Actas Dermo-Sifiliograficas | Year: 2012

The appearance of multiple satellite lesions is a rare complication of the treatment of a primary pyogenic granuloma lesion. We report 5 cases of recurrent pyogenic granuloma in patients aged between 4 and 31 years. The lesions resolved spontaneously after 1 to 9 months. Although the diagnosis and treatment of recurrent pyogenic granuloma can be problematic, this condition is benign and frequently self-limiting. © 2011 Elsevier España, S.L. and AEDV. All rights reserved. Source


Sanz Herrero F.,Consorci Hospital General Universitari Of Valencia | Malanda N.M.,Servicio de Neumologia | Veiga B.M.,Hospital Universitario La Paz | Sanjuan Lopez M.P.,Complexo Hospitalario Universitario
Archivos de Bronconeumologia | Year: 2010

Community-acquired pneumonia is a major cause of morbidity and mortality. Severity assessment is a fundamental tool in the management of pneumonia that allows patients to be stratified according to risk of death and the most appropriate treatment intensity to be provided. The most widely used scales are the PSI/Fine and CURB-65 scales, which have been widely validated and are easy to calculate in clinical practice. Biomarkers can additionally be used to increase accuracy in predicting complications and mortality. Etiologic diagnosis of pneumonia continues to pose a challenge to clinicians. With the experience acquired in the 2009 AH1/N1 influenza pandemic, virological diagnosis of pneumonia by rapid polymerase chain reaction techniques has recently begun to be used. Experience has also been gained in antiviral treatment and complications, especially bacterial superinfection as the main unfavorable event in viral pneumonias. Just as the use of antibiotics to treat infections radically changed their prognosis and treatment, reports in the literature have progressively began to appear of the immunomodulatory effect of drugs that were not initially designed for the treatment of pneumonia, leading to hope for the potential modification of outcome in these patients. © 2010 Sociedad Española de Neumología y Cirugía Torácica. Source


Hsu C.-H.,University of Texas Health Science Center at San Antonio | Reyes L.F.,University of Texas Health Science Center at San Antonio | Reyes L.F.,University of La Sabana | Orihuela C.J.,University of Texas Health Science Center at San Antonio | And 18 more authors.
Biomarkers | Year: 2015

Context: Chromogranin A (CgA) is a novel biomarker with potential to assess mortality risk of patients with severe sepsis.Objective: Assess association of CgA levels and mortality risk of severely septic patients.Methods: Serum CgA levels were measured in 50 hospitalized, severely septic patients with organ failure <48 h.Results: Higher CgA levels trended toward higher ICU and hospital mortality. Patients without cardiovascular disease who died in the ICU had higher median (IQR) CgA levels 602.3 (343.3, 1134.3) ng/ml versus 205.5 (130.7, 325.9) ng/ml, p = 0.01.Conclusions: High CgA levels predict ICU mortality in severely septic patients without prior cardiovascular disease. © 2015 Informa UK Ltd. All rights reserved. Source


Sanz-Herrero F.,Consorci Hospital General Universitari Of Valencia | Gimeno-Cardona C.,Consorci Hospital General Universitari Of Valencia | Gimeno-Cardona C.,University of Valencia | Tormo-Palop N.,Consorci Hospital General Universitari Of Valencia | And 4 more authors.
Vaccine | Year: 2016

Introduction: Pneumococcal 13-valent vaccine (PCV-13) has a potential role in preventing bacteraemic pneumococcal pneumonia and its complications, but little is known about its ability to specifically prevent respiratory complications. Our aim were to analyse the pneumococcal serotypes associated with the development of respiratory complications and the potential role of PCV-13 in preventing respiratory complications in bacteraemic pneumococcal pneumonia. Material and methods: We analysed demographic characteristics, comorbidities, antibiotic resistances and the outcomes of a cohort of 65 vaccine-naïve bacteraemic pneumococcal pneumonias, stratified by the pneumococcal serotypes included in PCV13 vs. those not included. Complications were clustered as follows: respiratory complications (hypoxemic respiratory failure; mechanical ventilation), systemic complications (septic shock; multiorgan failure), suppurative complications (empyema; pleural effusion; lung abscess). Results: From a population of 65 CAP-SP, 47.7% of the isolates belonged to PCV-13 serotypes group. No differences in comorbidities or clinical manifestations were found between groups. With regard to biochemical parameters, we found more profound hypoxemia levels in PCV-13 serotypes group comparing to non-vaccine group [PaO2/FiO2 209 (63) vs. 268 (57); p =0.007]. Global complications were identified in 69.2% (45 patients), and the most frequent were respiratory complications, found in 47.7%. Respiratory complications were detected more frequently in PCV-13 groups compared to non-vaccine groups (61.3% vs. 35.3%; p =0.036). Overall 30-day mortality was 30.8%. Mortality was similar between both groups (25.8% vs. 35.3%; p =0.408). Conclusions: Pneumococcal 13-valent conjugate vaccine includes the serotypes which cause more respiratory complications in our series; these serotypes were not associated with higher mortality in our series. PCV-13 may have a potential role in preventing respiratory complications due to bacteraemic pneumonoccal pneumonia. © 2016 Elsevier Ltd. Source

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