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Posso M.,Hospital Of La Santa Creu I Sant Pau | Urbiztondo Perdices L.,Servicio de Medicina Preventiva | Borras Lopez E.,Servicio Regional de Barcelona | Borras Lopez E.,CIBER ISCIII | And 4 more authors.
Vacunas | Year: 2013

Objective: To assess the safety of simultaneous administration of papillomavirus quadrivalent vaccine (HPV) and hepatitis A and B vaccine (HAB) in scholar children in Catalonia during the scholar period 2008-2009, and to describe the characteristics of the adverse effect following immunization. Methods: A prospective study, using data from 1,220 scholar children ranging from 11 to 12 years old in Catalonia, was conducted. The duration and severity (mild, moderate or serious) of systemic and local adverse effects were collected by a self-administered survey. The analysis was stratified by vaccine group: HPV, HPV + HAB or HAB, and by doses. Results The participation rate was 27.7% (338). Any mild or moderate adverse effects were reported by 89% (301) and 11% (37) of the participants. No serious or permanent effects were reported. Local pain (58.6%) and myalgia (43.8%) were the most frequent adverse effects. Compare with HPV (75.0% and 85.0%), the co-administration of both HPV + HAB (67.6% and 69.4%) do not increase the incidence of systemic or local adverse effects (P >.05). However, there was a lower frequency (33.3% and 34.3%) in the HAB group (P <.05). Adverse effects after vaccination were dose independent (P <.05). Conclusion: The simultaneous administration of both HPV vaccine and HAB vaccine do not show a significant variation in the frequency of adverse effects following immunization compared with HPV vaccine alone. The adverse effects following immunization are mild and moderate, and always transients. © 2013 Elsevier España, S.L. All rights reserved.


Higueras J.,Hospital Clinico Universitario San Carlos | Higueras J.,Complutense University of Madrid | Martin-Ventura J.L.,Autonomous University of Madrid | Martin-Ventura J.L.,Laboratorio Of Patologia Vascular | And 22 more authors.
Clinica e Investigacion en Arteriosclerosis | Year: 2015

Introduction: At present, there is no tool validated by scientific societies for risk stratification of patients with stable coronary artery disease (SCAD). It has been shown that plasma levels of monocyte chemoattractant protein-1 (MCP-1), galectin-3 and pro-B-type natriuretic peptide amino-terminal (NT-proBNP) have prognostic value in this population. Objetive: To analyze the prognostic value of a clinical risk scale published in Long-term Intervention with Pravastatin in Ischemic Disease (LIPID) study and determining its predictive capacity when combined with plasma levels of MCP-1, galectin-3 and NT-proBNP in patients with SCAD. Methods and results: A total of 706 patients with SCAD and a history of acute coronary syndrome (ACS) were analyzed over a follow up period of 2.2 ± 0.99 years. The primary endpoint was the occurrence of an ischemic event (any SCA, stroke or transient ischemic attack), heart failure, or death.A clinical risk scale derived from the LIPID study significantly predicted the development of the primary endpoint, with an area under the ROC curve (Receiver Operating Characteristic) of 0.642 (0.579 to 0.705); P < 0.001. A composite score was developed by adding the scores of the LIPID and scale decile levels of MCP -1, galectin -3 and NT-proBNP. The predictive value improved with an area under the curve of 0.744 (0.684 to 0.805); P< 0.001 (P = 0.022 for comparison). A score greater than 21.5 had a sensitivity of 74% and a specificity of 61% for the development of the primary endpoint (P < 0.001, log -rank test). Conclusion: Plasma levels of MCP-1, galectin -3 and NT-proBNP improve the ability of the LIPID clinical scale to predict the prognosis of patients with SCAD. © 2014 Sociedad Española de Arteriosclerosis.


Montano-Remacha C.,Servicio de Epidemiologia | Marquez-Cruz M.D.,Servicio de Medicina Preventiva | Hidalgo-Guzman P.,Servicio de Nefrologia | Sanchez-Porto A.,Servicio de Microbiologia | Tellez-Perez F.D.P.,Servicio de Enfermedades Infecciosas
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2015

Introduction In January 2014 a possible outbreak of Burkholderia cepacia bacteremia occurred in a hemodialysis center situated in La Linea de la Concepción (Cadiz). An investigation was begun to confirm the outbreak, identify the source, and implement control measures. Methods A descriptive analysis was performed to describe the characteristics of the patients affected with Burkholderia cepacia bacteremia from November 2013 to February 2014. Environmental samples were taken. A molecular typing study was performed using pulsed field gel electrophoresis (SpeI PFGE) and MLST analysis in order to determine the genetic similarity between the isolates. Results The bacterium was isolated from blood cultures of 7 patients during the study period. Three of the samples (2 of which were also cases) were endoluminal fluid from catheter locks, and 4 chlorhexidine bottle samples. The patients were coincident in 2 of the 6 work shifts. The mean age of the cases was 67 years of whom 57% were women. Human samples and an environmental sample was analyzed and found to be genetically identical (ST653 clone). Conclusions The analysis confirmed the outbreak of Burkholderia cepacia, with 7 cases among the patients of the hemodialysis center. The outbreak was due to the same strain, probably a common source and secondary transmission from person to person. © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y MicrobiologíaClínica. All rights reserved.


PubMed | Servicio de Cardiologia, Complutense University of Madrid, Rey Juan Carlos University, Hospital Universitario Fundacion Alcorcon and 5 more.
Type: Journal Article | Journal: Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis | Year: 2015

At present, there is no tool validated by scientific societies for risk stratification of patients with stable coronary artery disease (SCAD). It has been shown that plasma levels of monocyte chemoattractant protein-1 (MCP-1), galectin-3 and pro-B-type natriuretic peptide amino-terminal (NT-proBNP) have prognostic value in this population.To analyze the prognostic value of a clinical risk scale published in Long-term Intervention with Pravastatin in Ischemic Disease (LIPID) study and determining its predictive capacity when combined with plasma levels of MCP-1, galectin-3 and NT-proBNP in patients with SCAD.A total of 706 patients with SCAD and a history of acute coronary syndrome (ACS) were analyzed over a follow up period of 2.2 0.99 years. The primary endpoint was the occurrence of an ischemic event (any SCA, stroke or transient ischemic attack), heart failure, or death. A clinical risk scale derived from the LIPID study significantly predicted the development of the primary endpoint, with an area under the ROC curve (Receiver Operating Characteristic) of 0.642 (0.579 to 0.705); P<0.001. A composite score was developed by adding the scores of the LIPID and scale decile levels of MCP -1, galectin -3 and NT-proBNP. The predictive value improved with an area under the curve of 0.744 (0.684 to 0.805); P<0.001 (P=0.022 for comparison). A score greater than 21.5 had a sensitivity of 74% and a specificity of 61% for the development of the primary endpoint (P<0.001, log -rank test).Plasma levels of MCP-1, galectin -3 and NT-proBNP improve the ability of the LIPID clinical scale to predict the prognosis of patients with SCAD.


PubMed | Servicio de Enfermedades Infecciosas, Servicio de Medicina Preventiva, Servicio de Microbiologia, Servicio de Epidemiologia and Servicio de Nefrologia
Type: Journal Article | Journal: Enfermedades infecciosas y microbiologia clinica | Year: 2015

In January 2014 a possible outbreak of Burkholderia cepacia bacteremia occurred in a hemodialysis center situated in La Linea de la Concepcin (Cadiz). An investigation was begun to confirm the outbreak, identify the source, and implement control measures.A descriptive analysis was performed to describe the characteristics of the patients affected with Burkholderia cepacia bacteremia from November 2013 to February 2014. Environmental samples were taken. A molecular typing study was performed using pulsed field gel electrophoresis (SpeI PFGE) and MLST analysis in order to determine the genetic similarity between the isolates.The bacterium was isolated from blood cultures of 7 patients during the study period. Three of the samples (2 of which were also cases) were endoluminal fluid from catheter locks, and 4 chlorhexidine bottle samples. The patients were coincident in 2 of the 6 work shifts. The mean age of the cases was 67 years of whom 57% were women. Human samples and an environmental sample was analyzed and found to be genetically identical (ST653 clone).The analysis confirmed the outbreak of Burkholderia cepacia, with 7 cases among the patients of the hemodialysis center. The outbreak was due to the same strain, probably a common source and secondary transmission from person to person.


Valls V.,Servicio de Medicina Preventiva | Garcia P.,Servicio de Medicina Preventiva
Medicina Preventiva | Year: 2010

Catheter-related bacteremia (CRB) are frequent and costly life-threatening but preventable infections. Five measures maximal sterile barrier precautions, hand washing, and cleaning of the skin insertion site with Chlorhexidine as well as the avoidance of femoral vein insertion sites and the removal of unnecessary catheters- significantly reduced the incidence of CRB in critically patients and, integrate the bundle of best practices recommended by the CDC, the IHI and the AHQR as a main component of any prevention approach. More recently, an intervention developed in more than a hundred Michigan (USA) intensive care units achieved rates of 0 CRB per a 1000 catheterization-days. The components of this intervention included translating evidence into practice and improving culture and teamwork. A program, called "On the CUSP: Stop BSI", formulated from the Michigan project, is being implemented in Spain. In our country, the project named "Bacteremia zero" is coordinated by the group ENVINHELICS and is funded by the Ministry of Health and Social Policy. This paper reviews evidences and flaws of the prevention strategies currently proposed.

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