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Biomedical subjects

J M Bayas

Publications and source records attributed to J M Bayas.

At least 19 recordsLinked to original sources
PubMed2005

Vaccination coverage in adults undergoing splenectomy: evaluation of hospital vaccination policies.

Vaccination coverage in 595 adult patients undergoing total splenectomy in the Hospital Clinic of Barcelona during 1992-2002 was studied. The rates of cover for pneumococcal, Haemophilus influenzae type b and meningococcal vaccines were 63, 63 and 61% respectively, during 2000-2002; 32, 17 and 22% in 1997-1999; and 24, 9 and 8% in 1992-1996. Multivariate analysis showed a greater risk of no vaccination in splenectomies due to trauma, malignant neoplasms of solid organs and incidental splenectomy compared with both neoplastic and non-neoplastic haematological disease, and those patients undergoing splenectomy before 2001. Coverage (>/=1 vaccine) since 1997 in patients with haematological diseases was 83.5% (71/85), haematological neoplasias 69.2% (18/26), solid organ neoplasms 38.3% (36/94), incidental splenectomy 35.6% (16/45), and traumas 28.4% (21/74). Mandatory hospital admission of patients undergoing splenectomy offers a good opportunity for vaccination of these patients. Specific vaccination policies should be developed to take advantage of this circumstance.

Adult↗
PubMed2003

A nosocomial outbreak of influenza during a period without influenza epidemic activity.

The objective of this study was to describe a nosocomial outbreak of influenza during a period without influenza epidemic activity in the community. Outbreak investigation was carried out in an infectious diseases ward of a tertiary hospital. Presence of two or more of the following symptoms were used to define influenza: cough, sore throat, myalgia and fever. Epidemiological survey, direct immunofluorescence, viral culture, polymerase chain reaction, haemagglutination-inhibition test in throat swabs and serology for respiratory viruses were performed. Twenty-nine of 57 healthcare workers (HCW) (51%) and eight of 23 hospitalised patients (34%) fulfilled the case definition. Sixteen HCW (55%) and three inpatients (37%) had a definitive diagnosis of influenza A virus infection (subtype H1N1). Among the symptomatic HCW, 93% had not been vaccinated against influenza that season. Affected inpatients were isolated and admissions in the ward were cancelled for 2 weeks. Symptomatic HCW were sent home for 1 week. On the seventeenth day of the outbreak the last case was declared. The incidence of cases in this outbreak of influenza, which occurred during a period without influenza epidemic activity in the community, was notably high. Epidemiological data suggest transmission from healthcare workers to inpatients. Most healthcare workers were not vaccinated against influenza. Vaccination programmes should be reinforced among healthcare workers.

Acquired Immunodeficiency Syndrome↗
PubMed2001

[Impact of hospital admissions for pneumonia in a tertiary Spanish hospital].

BACKGROUND: Impact of hospital admissions for pneumonia during 1998 in the Hospital Clínic, Barcelona. PATIENTS AND METHOD: Retrospective information on the hospitalizations for pneumonia was collected. RESULTS: During 1998 a total of 626 adult were admitted with a hospital diagnosis of pneumonia (72% were >/= 65 years). The average length of stay was 10 days. Half of these patients were previously hospitalized during the preceding 5 years. CONCLUSIONS: Hospital admissions due to pneumonia (17 cases per 1.000 hospitalizations) accounted for an estimated cost of 2.3% of the cost of all the hospitalized patients.

Aged↗
PubMed2001

Cost analysis of two strategies for preventing hepatitis A virus infection in Spanish travellers to developing countries.

Our objectives were to assess the prevalence of anti-hepatitis A (HAV) antibodies in Spanish travellers to developing countries and to carry out a cost analysis to allow the comparison of two vaccination strategies. Adult subjects were selected from among travellers to developing countries. Information was obtained on age, sex, destination, previous vaccination against HAV and having received immunoglobulin. Blood specimens were obtained for anti-HAV antibody determination. A total of 485 travellers were studied. The prevalence of anti-HAV antibody was 30.5% (95% CI 26-35). Antibody prevalence was inversely correlated with age: 9.8% in 18-25 years of age, rising to 75.4% in those 41-55 years of age. Cost analysis determined that the critical value of prevalence for vaccination with HAV vaccine was 37.5%. It was concluded that the youngest Spanish travellers lack anti-HAV antibodies. Vaccination without screening in those < or = 35 years of age and screening before vaccination for those > 35 years, are the preferred alternatives.

Adult↗
PubMed2001

Immunogenicity and reactogenicity of the adult tetanus-diphtheria vaccine. How many doses are necessary?

The immunogenicity and reactogenicity of the tetanus-diphtheria adult type vaccine was compared in two groups: group I (n = 201, 18-30 years old, presumably vaccinated with the DTP vaccine) and group II (n = 147, > or = 45 years old, without vaccination antecedents). Before vaccination, the seroprotection levels for tetanus were 90.5% (group I) and 30.6% (group II). These rose to 99.5% and 81.7%, respectively, after administration of one vaccine dose. For diphtheria, prevaccination seroprotection levels were 38.3% (group I) and 19.0% (group II). These rose to 85.8% and 65.7%, respectively, after vaccination. The logistic regression analysis showed an association between antibody titre and age. In group II, 3 doses of Td vaccine were needed to reach titres similar to those achieved in group I with a single dose. Stated reactogenicity was greater in: young subjects, women, those with higher titres of tetanus antibodies and those receiving other vaccines simultaneously. These results confirm the need for vaccination schedules adapted to the characteristics of each population age-group.

Adult↗
PubMed2000

[Nosocomial infections due to opportunistic fungi: analysis of a news outbreak in the Spanish press].

BACKGROUND: To study an outbreak of media news related to nosocomial infections due to opportunistic fungi in Spanish hospitals. METHOD CASE DEFINITION: any news related to possible nosocomial infection due to opportunistic fungi in Spanish hospitals, published in national or local daily newspapers, over the pre-epidemic (July-December, 1998) and epidemic periods (January-June, 1999). All news were reviewed and identified using global press reports summaries, prepared by two independent sources, and were analyzed by three different observers. RESULTS: Over the pre-epidemic period there were not any news related to nosocomial infections due to opportunistic fungi. Over the epidemic period, a total of 218 news were identified, 154 (71%) published in national newspapers and 64 (29%) in local ones. We analyzed separately 18 editorials or opinion articles related to this subject. The epidemic curve (distribution of news by week) showed an incidence news peak at week 5 (102 news, 46.7% of all news published). The media mentioned up to 19 different hospitals as institutions with possible cases of nosocomial fungal infections. After week 8, news incidence drop, and remain thereafter at minimum levels. CONCLUSIONS: The example provided by the analysis of this outbreak of media news, related to nosocomial infections by Aspergillus an other opportunistic fungi, is useful to allow us understand how some medical news arise, develop and were transmitted. The public alert situation created in Spain was remarkable, and it is likely that there was a transient loss of confidence in the safety of public health institutions. Today's medicine requires a great and better openness to the media, and a better cooperation between both parts.

Cross Infection↗
PubMed2000

Prevalence of hepatitis B infection in long-stay mentally handicapped adults.

The objective was to determine the prevalence of hepatitis B virus (HBV) infection in long-stay institutionalized mentally handicapped adults and to develop a vaccination programme for them. The study was carried out in 1994. The subjects were 171 mentally handicapped adults aged 37-76 (median age 56) with a median hospital stay of 30 years (range 6-47). Markers for infection were determined using ELISA. Seronegative patients were vaccinated using the standard schedule, and the titre of antiHBs reached was determined later. The prevalence of seropositive subjects was 81.3%. Seropositive subjects had a longer hospital stay (median stay of 32 years, range: 15-47) than seronegative ones (median stay of 15 years, range: 6-33). A total of 43.3% of the vaccinated subjects developed antiHBs antibodies (GMT: 135 IU/l). The high prevalence of HBV exposure is probably a legacy of a past era which is reflected in patients with prolonged institutionalisation in a closed regime. The need for immediate vaccination of mentally handicapped subjects is of the utmost importance, as it has been shown that the response to the vaccine worsens with age.

Adult↗
PubMed2000

Reactogenicity profile of tetanus-diphtheria (adult-type) vaccine: results of a naturalistic study performed at an adult vaccination center.

A prospective observational naturalistic study was conducted at a vaccination center to assess the reactogenicity of tetanus-diphtheria (adult-type) (Td) vaccine. In 1 year, 3072 adult subjects were invited to participate, of whom 1977 (62% women, mean age [+/- SD]: 39 [+/- 14.5] years [range: 18-85 years]) actively did so. A follow-up diary card was provided to all subjects to record all local and general symptoms experienced during the following 4 days after vaccination. Of the study population (n = 1977), 280 received a second Td dose, and 30 received a third dose: the total number of diary cards collected was 2287. Td was always administered (i.m. route) in the left arm. The study population was grouped by age: 52%, 41%, and 7% were ages 18 to 35, 36 to 65, and > 65 years, respectively, most of them being travelers to developing countries. Close to two-thirds of subjects received up to nine different vaccines (mainly hepatitis B, hepatitis A, and typhoid) in addition to Td. Adverse reactions were classified as mild, moderate, and severe. Overall, 50% of subjects reported some type of adverse reaction. Pain, discomfort with arm movement, swelling, malaise, and fever (axillary temperature > or = 38 degrees C) were recorded in 43%, 14%, 3.8%, 5.1%, and 1.7% of all diary cards, respectively. Local and general reactions were considered as mild by almost two-thirds of vaccinees and lasted < or = 48 hours in about three-fourths of them. The incidence of moderate plus severe local reactions was significantly (p < 0.01) more commonly reported in the 18- to 35-year-old group than in the 36- to 65-year-old group. No statistically significant differences were observed when comparing the incidence of general adverse reactions of those receiving Td alone with those receiving additional vaccines or when comparing the duration and intensity by age groups. Only 5.2% of subjects required analgesic/antipyretic treatment. In conclusion, this study shows that Td vaccine is reasonably well tolerated when given alone or with other vaccines. Similar studies should be conducted with other vaccines routinely recommended to adults to assess how they are administered in usual clinical practice and the reactogenicity profile perceived by the vaccinees.

Adolescent↗
PubMed1999

[Excess length of stay attributable to nosocomial bacteremia: usefulness of the Hospitalization Appropriateness Protocol].

BACKGROUND: To evaluate the usefulness of the Appropriateness Evaluation Protocol (AEP) for assessing the extra length of stay attributable to nosocomial bacteremia. PATIENTS AND METHODS: Retrospective review of the medical records (1989, 1990 and 1991) of all patients, who developed Staphylococcus aureus nosocomial bacteremia. Evaluation of hospital stay was performed using the AEP. Calculation of the kappa index and intraclass correlation coefficient. RESULTS: A total of 158 patients were included S. aureus nosocomial bacteremia is responsible for a mean excess length of stay of 4.3 days per patient. Kappa index for the method used was 76%, and intraclass correlation coefficient was 61%. CONCLUSIONS: The AEP has been shown to be a reliable tool for assessing the extra days of stay attributable to nosocomial bacteremia in the Spanish National Health System. The use of AEP should be extended to assess the extra stay attributable to other types of nosocomial infections.

Adult↗
PubMed1999

Whole cell lysate enzyme immunoassays vs. recombinant glycoprotein G2-based immunoassays for HSV-2 seroprevalence studies.

Seroepidemiology studies of herpes simplex virus type 2 (HSV-2) infections have been difficult to carry out because antibodies to HSV type 1 (HSV-1) show an extensive cross-reactivity with HSV-2 antigens. Many kits available currently are not entirely type specific for serodiagnosis of HSV-2 infections and therefore do not allow reliable discrimination of past exposure to these closely related alphaherpes viruses. Attempts to develop type-specific antigens have focused on the envelope glycoproteins, particularly glycoprotein G (gG). A cross-sectional study was carried out to examine the seroprevalence of antibodies to HSV-2 among healthy university students, using different methods: a whole cell lysate enzyme-linked immunosorbent assay (ELISA), two different ELISAs, and a newly developed immunoblot assay, the last three based on recombinant gG2. HSV-2 prevalence was 24 times higher with the whole cell lysate ELISA (31%; 95% confidence interval [CI]: 27-35%) than the ELISAs and the immunoblot assay based on recombinant gG2 (1.3%; 95% CI: 0.1-2.5%), thus showing the inaccuracy of commercial tests based on whole-antigen preparations for epidemiological studies. Laboratories should be cautious and ensure that commercial tests for HSV typing are based on type-specific glycoproteins.

Adolescent↗
PubMed1999

Handwashing with soap or alcoholic solutions? A randomized clinical trial of its effectiveness.

BACKGROUND: The effectiveness of an alcoholic solution compared with the standard hygienic handwashing procedure during regular work in clinical wards and intensive care units of a large public university hospital in Barcelona was assessed. METHODS: A prospective, randomized clinical trial with crossover design, paired data, and blind evaluation was done. Eligible health care workers (HCWs) included permanent and temporary HCWs of wards and intensive care units. From each category, a random sample of persons was selected. HCWs were randomly assigned to regular handwashing (liquid soap and water) or handwashing with the alcoholic solution by using a crossover design. The number of colony-forming units on agar plates from hands printing in 3 different samples was counted. RESULTS: A total of 47 HCWs were included. The average reduction in the number of colony-forming units from samples before handwashing to samples after handwashing was 49.6% for soap and water and 88.2% for the alcoholic solution. When both methods were compared, the average number of colony-forming units recovered after the procedure showed a statistically significant difference in favor of the alcoholic solution (P <.001). The alcoholic solution was well tolerated by HCWs. Overall acceptance rate was classified as "good" by 72% of HCWs after 2 weeks use. Of all HCWs included, 9.3% stated that the use of the alcoholic solution worsened minor pre-existing skin conditions. CONCLUSIONS: Although the regular use of hygienic soap and water handwashing procedures is the gold standard, the use of alcoholic solutions is effective and safe and deserves more attention, especially in situations in which the handwashing compliance rate is hampered by architectural problems (lack of sinks) or nursing work overload.

1-Propanol↗
PubMed1998

[Low level of immune protection against diphtheria in adult population of Catalonia].

BACKGROUND: Seroepidemiologic studies carried out in different European countries have shown the existence of low levels of protection against diphtheria. In this study the prevalence of antidiphtheria antibodies in the adult population of Catalonia, Spain, during 1995 has been studied. PATIENTS AND METHODS: The prevalence of the seroprotection against diphtheria was investigated in a representative sample (n = 1,248) of the adult population of Catalonia aged 15 or older. The antibody levels were determined by means of the in vitro Vero-cell neutralization technique. Two protection levels were considered: 0.01-0.09 U/ml (partial immunity) and > or = 0.1 U/ml (total immunity). RESULTS: The prevalence of absolute seroprotection was 12.4% (CI 95%: 10.5-14.3%) and that of partial and absolute seroprotection was 26.0% (CI 95%: 23.6-28.4%). The prevalence of antibodies is higher in men than in women (29.2% versus 23.1%; p < 0.05), and in urban than in rural environments (27.2% versus 19.9%: p < 0.05). The odds ratios adjusted by multiple logistic regression analysis were 1.43 (1.11-1.85) and 1.56 (1.05-2.29), respectively. CONCLUSION: The prevalence of antidiphtheria antibodies in the adult population of Catalonia, Spain, is low. The results suggest the need to develop antidiphtheria vaccination programmes in the adult population.

Adolescent↗
PubMed1996

[Prevalence of hepatitis B and hepatitis A virus infection among health sciences students in Catalonia, Spain].

BACKGROUND: To know current hepatitis B (HBV) and hepatitis A (HAV) infection status among a group of health sciences students during 1990-1993 period. SUBJECTS AND METHODS SUBJECTS: 1,734 health sciences students during 1990-1991, 1992-1993 and 1993-1994 academic years. MAIN OUTCOME MEASURES: demographic variables, vaccination history against HAV and HBV viruses, anti-HBc and anti-HAV antibody titres (ELISA kits). RESULTS: 1,734 subjects aged 22.5 +/- 2.9 years (75% women) were included. Anti-HBc total cumulated prevalence during the three year period was 2.5% (CI 95%, 1.9%-3.4%). Anti-HAV total cumulated prevalence during the three year period was 13.9% (CI 95%: 11.4%-16.8%). No statistical significant association between antibody prevalence and both age sex was found. CONCLUSIONS: Low prevalence, and thus, high susceptibility to HBV and HAV infection was found. We stress the importance of systematic vaccination among health sciences students not previously engaged in universal vaccination programmes. We also point out the need for further analysis upon the utility of combined HB/HA vaccine as an alternative to antihepatitis B universal vaccination programmes among adolescent cohorts.

Adult↗