ABSTRACT
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Humans , Anti-Bacterial Agents/therapeutic use , Respiratory Tract Infections/drug therapy , Drug Utilization/statistics & numerical dataABSTRACT
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Humans , Severe Acute Respiratory Syndrome/diagnosis , Severe Acute Respiratory Syndrome/prevention & control , Bioterrorism/prevention & control , Primary Health CareABSTRACT
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Humans , Aged , Female , Pulmonary Disease, Chronic Obstructive , Consensus , Antimetabolites, Antineoplastic , Practice Guidelines as Topic , Anti-Bacterial Agents , Treatment Outcome , Bronchoalveolar Lavage , Paclitaxel , Glucocorticoids , Deoxycytidine , Cryptogenic Organizing Pneumonia , Antineoplastic Agents, Phytogenic , Antineoplastic Agents , Antineoplastic Agents, Phytogenic , Lung NeoplasmsABSTRACT
OBJECTIVE: To assess the effectiveness of systematic pneumococcus vaccination (PV) in the over-65s by comparing rates of incidence and severity of the cases of pneumonia caught in the community (PCC), in two cohorts-those vaccinated (VC) and those not (NVC). DESIGN: Multi-centre study of cohorts. SETTING: Primary Health Care. PARTICIPANTS: All those over 65 registered at 8 urban Health Districts and distributed into a VC (with PV) and an NVC. INTERVENTIONS: Active monitoring will be conducted for 3 years, with detection of all the PCC occurring during this period. Data sources will be the specific register of the PV programme and exhaustive review of primary Care and referral hospital clinical records (records of pneumonia cases admitted and records of pneumonia cases detected in Casualty). MAIN MEASUREMENT: Variables considered will be: age, sex, and presence or otherwise of risk factors linked to greater susceptibility to catching pneumonia (diabetes mellitus, low immunity levels, cardiopathy, COPD, tobacco dependency, alcoholism, splenectomy). To measure the effect, we will calculate the annual and overall accumulated (over 3 years) rates of incidence of pneumonia, as well as the relative and attributable risks. As measurements of its severity, we will analyse the mortality index and the "fine" ordinal scale of severity. DISCUSSION: The study will give a reply in terms of effectiveness and efficiency of the vaccine and will contribute to a definitive decision on the controversial question of the systematic indication of this vaccine for the over-65 population.
Subject(s)
Community-Acquired Infections/prevention & control , Pneumococcal Vaccines/administration & dosage , Pneumonia, Pneumococcal/prevention & control , Streptococcus pneumoniae/immunology , Vaccination/methods , Aged , Aged, 80 and over , Female , Humans , Male , Pneumococcal Vaccines/adverse effects , Risk Factors , Treatment Outcome , Vaccination/standardsABSTRACT
Objetivo. Evaluar la efectividad de la vacunación antineumocócica sistemática entre las personas mayores de 65 años mediante la comparación de las tasas de incidencia y gravedad de las neumonías adquiridas en la comunidad aparecidas en dos cohortes (vacunados y no vacunados).Diseño. Estudio de cohortes de carácter multicéntrico. Emplazamiento. Atencion primaria de salud. Participantes. Todas las personas mayores de 65 años adscritas a 8 áreas básicas de salud urbanas y distribuidas en vacunados con vacuna antineumocócica y no vacunados. Intervenciones. Se realizará seguimiento activo durante 3 años, identificándose todas las neumonías adquiridas en la comunidad acaecidas durante el trienio de seguimiento. Como fuente de datos utilizaremos el registro específico del programa de vacunación antineumocócica y la revisión exhaustiva de las historias clínicas de atención primaria y del hospital de referencia (registro de neumonías ingresadas y de neumonías detectadas en el servicio de urgencias).Mediciones principales. Las variables contempladas serán: edad, sexo, presencia de factores de riesgo asociados a una mayor susceptibilidad para adquirir infección neumocócica (diabetes mellitus, inmunodepresión, cardiopatía, enfermedad pulmonar obstructiva crónica, tabaquismo, enolismo y esplenectomía). Para la medida del efecto calcularemos la tasa de incidencia anual y global acumulada (trienal) de neumonías, así como el riesgo relativo y el riesgo atribuible. Como medidas de gravedad analizaremos el índice de letalidad, así como una escala ordinal de gravedad (escala de Fine).Discusión. El estudio dará una respuesta en términos de efectividad y eficiencia de la vacuna y contribuirá a una toma definitiva de decisiones respecto al controvertido tema de la indicación sistemática de esta vacuna en la población mayor de 65 años (AU)
Subject(s)
Aged, 80 and over , Male , Humans , Female , Aged , Pneumococcal Vaccines , Treatment Outcome , Streptococcus pneumoniae , Vaccination , Risk Factors , Pneumonia, Pneumococcal , Community-Acquired InfectionsABSTRACT
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Humans , Adult , Female , Aged , Male , Middle Aged , Life Style , Primary Health Care , Antihypertensive Agents , Cardiovascular Diseases , Cohort Studies , Age Factors , Hypercholesterolemia , Tobacco Use Disorder , Primary Prevention , Sex Factors , Hypolipidemic Agents , Risk Factors , HypertensionABSTRACT
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Humans , Risk Factors , Spain , Hypolipidemic Agents , Coronary Disease , HyperlipidemiasABSTRACT
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Humans , Patient Compliance , Azithromycin , Respiratory Tract Infections , Anti-Bacterial Agents , Practice Patterns, Physicians'Subject(s)
Cardiovascular Diseases/prevention & control , Adult , Age Factors , Aged , Antihypertensive Agents/therapeutic use , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/mortality , Cohort Studies , Female , Humans , Hypercholesterolemia/complications , Hypertension/complications , Hypertension/drug therapy , Hypolipidemic Agents/therapeutic use , Life Style , Male , Middle Aged , Primary Health Care , Primary Prevention , Risk Factors , Sex Factors , Smoking/adverse effects , Smoking PreventionSubject(s)
Anti-Bacterial Agents/therapeutic use , Data Collection/methods , Lung Diseases, Obstructive/complications , Physicians, Family/psychology , Practice Patterns, Physicians'/statistics & numerical data , Research Design , Respiratory Tract Infections/drug therapy , Drug Utilization , Humans , Macrolides , Multicenter Studies as Topic , Random Allocation , Respiratory Tract Infections/epidemiology , Retrospective Studies , Spain/epidemiology , Surveys and QuestionnairesABSTRACT
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