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Biomedical subjects

M Campins Martí

Publications and source records attributed to M Campins Martí.

18 recordsLinked to original sources

[Influenza vaccination in patients admitted to a tertiary hospital. Factors associated with coverage].

INTRODUCTION: Children aged less than 2 years old and those with chronic diseases have a high risk of complications and hospitalization due to influenza. Despite the broad consensus in the literature on the indication for annual immunization of these patients, less than 30 % of the children with high-risk underlying conditions are immunized each year. The aim of this study is to determine the influenza vaccine coverage in children with high-risk underlying conditions admitted to a university hospital. PATIENTS AND METHODS: We performed a cross-sectional study of patients aged from 6 months to 18 years old with high-risk medical conditions and who had been hospitalized between January and May, 2005 in the Vall d'Hebron University Hospital (Barcelona). Influenza vaccine coverage, factors associated with immunization, and the reasons for nonvaccination were analyzed. RESULTS: Overall vaccine coverage was 23.5 %. The highest vaccination coverage was found in patients with congenital heart disease, chronic respiratory disease, and asthma (43.2 %, 42.9 % and 28.6 %, respectively). The factors most frequently associated with influenza vaccination were the type of underlying disease, having been immunized against influenza in the previous season, having received the pneumococcal vaccine, and age younger than 5 years. The main reason for nonvaccination was the lack of influenza vaccine recommendation by health professionals (95.3 %). CONCLUSIONS: Influenza vaccine coverage in children with high-risk conditions is low. Strategies to increase awareness among health professionals on the importance of recommending influenza immunization are required.

Adolescent↗

European recommendations for the management of healthcare workers occupationally exposed to hepatitis B virus and hepatitis C virus.

Exposure prevention is the primary strategy to reduce the risk of occupational bloodborne pathogen infections in healthcare workers (HCW). HCWs should be made aware of the medicolegal and clinical relevance of reporting an exposure, and have ready access to expert consultants to receive appropriate counselling, treatment and follow-up. Vaccination against hepatitis B virus (HBV), and demonstration of immunisation before employment are strongly recommended. HCWs with postvaccinal anti-HBs levels, 1-2 months after vaccine completion, >or=10 mIU/mL are considered as responders. Responders are protected against HBV infection: booster doses of vaccine or periodic antibody concentration testing are not recommended. Alternative strategies to overcome non-response should be adopted. Isolated anti-HBc positive HCWs should be tested for anti-HBc IgM and HBV-DNA: if negative, anti-HBs response to vaccination can distinguish between infection (anti-HBs >or=50 mUI/ml 30 days after 1st vaccination: anamnestic response) and false positive results(anti-HBs >or=10 mUI/ml 30 days after 3rd vaccination: primary response); true positive subjects have resistance to re-infection. and do not need vaccination The management of an occupational exposure to HBV differs according to the susceptibility of the exposed HCW and the serostatus of the source. When indicated, post-exposure prophylaxis with HBV vaccine, hepatitis B immunoglobulin or both must be started as soon as possible (within 1-7 days). In the absence of prophylaxis against hepatitis C virus (HCV) infection, follow-up management of HCV exposures depends on whether antiviral treatment during the acute phase is chosen. Test the HCW for HCV-Ab at baseline and after 6 months; up to 12 for HIV-HCV co-infected sources. If treatment is recommended, perform ALT (amino alanine transferase) activity at baseline and monthly for 4 months after exposure, and qualitative HCV-RNA when an increase is detected.

Antiviral Agents↗

[Persistence of antibodies three years after vaccination with the 23-valent pneumococcal vaccine].

OBJECTIVE: To study the persistence of antibodies after primary immunization with the 23-valent pneumococcal vaccine in children with nephrotic syndrome. METHODS: Sera from 14 of 26 children with nephrotic syndrome were obtained 3 years after vaccination. We used an ELISA method to measure IgG antibody levels to pneumococcal serotypes 14, 23F, 3 and 6B. Antibody levels before vaccination, 1 month and 3 years after vaccination were compared. RESULTS: Significant increases in specific antibody concentrations were observed 30 days after vaccination for all serotypes except serotype 3. Differences in response according to serotype were found. The highest serological response was observed for serotype 14 (78.5 % of the patients showed a good-to-moderate response). Three years after vaccination antibody levels were significantly decreased (27.3 % of children for serotype 14, 46.2 % for serotype 23F and 50 % for serotype 6B). CONCLUSIONS: The 23-valent pneumococcal vaccine is immunogenic in children aged more than 2 years with nephrotic syndrome. Response varied according to serotype. Persistence of vaccine-induced antibodies is short-term, with low antibody levels 3 years after immunization. The results of this study suggest that these patients require revaccination 3 years after the first dose.

Antibodies, Bacterial↗

[Culture-confirmed whooping cough in a tertiary center over a twelve-year period].

OBJECTIVE: To study the characteristics of patients diagnosed with whooping cough at a tertiary center in Barcelona, Spain. MATERIAL AND METHODS: We performed a retrospective study of patients aged less than 18 years treated for pertussis-like cough or clinically-suspected whooping cough over a 12-year period (1989-2000). Only patients with isolated Bordetella spp. were included. The variables of age, sex, vaccination status, hospitalization, clinical manifestations, severity, and lethality were analyzed. RESULTS: One hundred sixty-one patients with positive Bordetella spp. culture were identified. Of these, complete information was available in 149 (79 boys and 70 girls) with a median age of 3 months (range: 13 days-17 years); 77.2 % were aged 6 months or less. All the isolated strains corresponded to B. pertussis except three that corresponded to B. parapertussis. Three epidemic cycles (in 1989, 1992 and 2000) were observed during the study period. A total of 72.5 % of cases occurred between May and September. Bordetella spp. was associated with other bacteria in 28.2 % of the patients, viruses in 13.4 % and a bacterium and a virus in 4.7 %. One hundred twenty-one patients required hospitalization, of which 14.9 % were admitted to the intensive care unit. Age was the only factor associated with risk for hospitalization, which was more frequent in younger infants (p < 0.0001). Paroxysmal cough with cyanosis was present in 53.4 % of the patients, leucocytosis with lymphocytosis occurred in 67.5 % and apneas were present in 21.5 %. Chest X-ray revealed atelectasis in 34.1 %. The mean length of hospital stay was 11 days (range: 1-70 days). Three boys aged less than 3 months with malignant pertussis syndrome died (lethality: 2 %). More than half the patients (59.7 %) were not vaccinated (55.4 % for being under the age of 3 months) and only 16 % had received three or more vaccination doses. CONCLUSIONS: Whooping cough continues to be a severe disease in infants, with a high admission rate during the first 6 months of life. New preventive strategies are required to protect infants who have not yet developed full immunity to this infection.

Adolescent↗

[Vaccinations and solid-organ transplantation: review and recommendations].

Pediatric solid-organ transplant recipients are at high risk for various infectious diseases. Many children are not fully vaccinated before transplantation. To reduce the risk of morbidity and mortality from vaccine-preventable disease, physicians treating pediatric solid-organ transplant recipients should monitor the immunization status of these patients. Consensus on the most appropriate immunization schedule for solid-organ transplant recipients is lacking. Therefore, we provide a review of the currently available data on immunization safety and efficacy and describe strategies to avoid vaccine-preventable diseases in pediatric solid-organ transplant recipients.

Child↗

[Immunogenicity of the 23-valent pneumococcal vaccine in children with chronic renal disease].

OBJECTIVE: To study the immunogenicity of the 23-valent pneumoccal vaccine in children with chronic renal disease and in those with nephrotic syndrome, and to compare it with the response in healthy children. METHODS: The vaccine was administered to 150 children aged 2-18 years: 113 with renal diseases (26 with nephrotic syndrome, 23 with severe grades of vesicoureteral reflux, 16 with chronic renal insufficiency, 6 renal transplant recipients, 6 requiring dialysis and 36 with other renal diseases) (group 1) and 37 healthy (group 2). Specific IgG antibodies concentrations were measured by ELISA before and 30 days after vaccination. The results obtained in both groups were compared. We compared too the response observed between the subgroup of children with renal diseases in which pneumococcal vaccine is indicated (nephrotic syndrome, chronic renal insufficiency, renal transplant and those requiring dialysis (group 3) and healthy children. RESULTS: 87.3% of children showed a 2-fold increase in antibody concentrations after vaccination. No significant differences were observed between the three groups. We considered that the vaccine was immunogenic in 78.4% of healthy children, in 77.9% of group 1 children and in 72.5% of those in the group 3 (p = 0,533). A lower response was observed in children with a kidney transplant and in those requiring dialysis. CONCLUSIONS: These results suggest that 23-valent pneumococcal vaccine is immunogenic in children with chronic renal diseases or nephrotic syndrome and may protect these patients from invasive pneumococcal disease. The importance of improved vaccine coverage is emphasized.

Bacterial Vaccines↗

[The use and attitudes of adolescents toward addictive substances: a prevalence study].

OBJECTIVE: The purpose of this study was to know the use of addictive substances by adolescents of the city of Barcelona (Catalonia, Spain). PATIENTS AND METHODS: Data were obtained from an anonymous and self-administered questionnaire about tobacco use, alcohol use and non-institutionalized drug abuse. participants were students in 3 degrees BUP (16-17 years old) of twelve institutes that are representative of the different districts of the city. The survey was made during the 1991-1992 school year. RESULTS: Among the 426 individuals included, 32.2% reported use of tobacco, 59.2% alcohol, and 16.4% marijuana. Tobacco use was higher among females (p = 0.05), and that of alcohol (p < 0.0001) and other drugs (p = 0.02) higher among males. The parents' smoking behavior was significantly associated with the use of non-institutionalized drugs (p = 0.01). There was a positive and significant association among the use of all three kinds of addictive substances (p < 0.0001). CONCLUSIONS: The prevalence of tobacco, alcohol and non-institutionalized drug use by students in this age range is high. Compared with previous studies in this population we can appreciate a decreasing trend of use.

Adolescent↗