ABSTRACT
Introducción El objetivo de este estudio fue comparar los resultados del tratamiento antibiótico continuado, la autovacuna MV140 y la vacuna bacteriana polivalente MV140 de cepas de colección en la prevención de ITU recurrentes no complicadas. Métodos Se analizaron prospectivamente 377 pacientes desde enero de 2017 hasta agosto de 2019 y se dividieron en 3 grupos según la profilaxis administrada. Grupo A (126): tratamiento antibiótico, Grupo B (126), autovacuna MV140; Grupo C (125), vacuna bacteriana polivalente MV140 a partir cepas seleccionadas. Las variables analizadas fueron: sexo, edad, menopausia, número de episodios de ITU al inicio y a los 3 y 6 meses de finalizar la profilaxis, costes sanitarios a lo largo del seguimiento a los 3 y 6 meses. Resultados A los 3 meses, los episodios de ITU se redujeron a 0-1 en el 65% del grupo A, en el 80,8% del grupo B y en el 81,7% del grupo C. A los 6 meses, se presentaron 0-1 episodios de ITU en el 44,4% del grupo A, en el 61,6% del grupo B y en el 74,6% del grupo C. En cuanto a los costes sanitarios a lo largo del seguimiento, a los 3 meses el grupo A registró 21.171,87 euros, el grupo B 20.763,73 euros y el grupo C 18.866,14 euros. A los 6 meses, los costes sanitarios fueron de 32.980,35 euros en el grupo A, de 28.133,42 euros en el grupo B y de 23.629,19 euros en el grupo C. Conclusiones La autovacuna MV140 y la vacuna bacteriana polivalente MV140 fueron más eficaces reduciendo el número de episodios de ITU a los 3 y 6 meses y con unos costes sanitarios menores durante el seguimiento, en comparación con la profilaxis antibiótica continuada (p < 0,05). La vacuna bacteriana polivalente MV140 de cepas seleccionadas fue más eficaz en la reducción del número de episodios de ITU con unos costes sanitarios menores que la autovacuna (AU)
Introduction The objective of this study was to compare the results on prevention of uncomplicated recurrent UTI between continuous use of antibiotics, MV140 autovaccine and MV140 polybacterial vaccine from collection strain. Methods 377 patients were prospectively analyzed from January 2017 to August 2019 and divided into 3 groups according to the prophylaxis. Group A (126): antibiotics, Group B (126): MV140 autovaccine, Group C (125): MV140 polybacterial vaccine from the collection strain. Variables analyzed were: gender, age, menopause, number of UTI at baseline and 3 and 6 months after the end of prophylaxis, health cost along follow-up at 3 and 6 months. Results At 3 months, group A had 0-1 UTI in 65%, group B had 0-1 UTI in 80.8% and group C in 81.7%. At 6 months, group A had 0-1 UTI in 44.4%, group B had 0-1 UTI in 61.6% and group C in 74.6%. Regarding health cost along follow-up, at 3 months group A had 21,171.87, group B had 20,763.73 and group C 18,866.14. At 6 months, health cost was 32,980.35 in group A, 28,133.42 in group B, and 23,629.19 in group C. Conclusions MV140 autovaccine and MV140 polybacterial vaccine were more efficient with lower number of UTI at 3 and 6 months and lower health cost along follow-up compared to continued prophylaxis with antibiotics (p < .05). Polybacterial MV140 vaccine from collection strain had higher effect to reduce the number of UTI and less health cost than autovaccine (AU)
Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Autovaccines/therapeutic use , Health Care Costs , Urinary Tract Infections/drug therapy , Urinary Tract Infections/prevention & control , Vaccines/therapeutic use , Prospective Studies , Treatment Outcome , Follow-Up Studies , Recurrence , Urinary Tract Infections/economics , Cost-Benefit AnalysisABSTRACT
INTRODUCTION: The objective of this study was to compare the results on prevention of uncomplicated recurrent UTI between continuous use of antibiotics, MV140 autovaccine and MV140 polybacterial vaccine from collection strain. METHODS: 377 patients were prospectively analyzed from January 2017 to August 2019 and divided into 3 groups according to the prophylaxis. Group A (126): antibiotics, Group B (126): MV140 autovaccine, Group C (125): MV140 polybacterial vaccine from the collection strain. Variables analyzed were: gender, age, menopause, number of UTI at baseline and 3 and 6 months after the end of prophylaxis, health cost along follow-up at 3 and 6 months. RESULTS: At 3 months, group A had 0-1 UTI in 65%, group B had 0-1 UTI in 80.8% and group C in 81.7%. At 6 months, group A had 0-1 UTI in 44.4%, group B had 0-1 UTI in 61.6% and group C in 74.6%. Regarding health cost along follow-up, at 3 months group A had euro21,171.87, group B had euro20,763.73 and group C euro18,866.14. At 6 months, health cost was euro32,980.35 in group A, euro28,133.42 in group B, and euro23,629.19 in group C. CONCLUSIONS: MV140 autovaccine and MV140 polybacterial vaccine were more efficient with lower number of UTI at 3 and 6 months and lower health cost along follow-up compared to continued prophylaxis with antibiotics (p < 0.05). Polybacterial MV140 vaccine from collection strain had higher effect to reduce the number of UTI and less health cost than autovaccine.
Subject(s)
Autovaccines , Urinary Tract Infections , Vaccines , Female , Humans , Infant , Anti-Bacterial Agents/therapeutic use , Autovaccines/therapeutic use , Urinary Tract Infections/prevention & control , Urinary Tract Infections/drug therapy , Vaccines/therapeutic use , Health Care CostsABSTRACT
Information and communication technologies are transforming the way we understand health, via a hyper-connected world in which patients, professionals and society take on new challenges and roles. This change is creating an ecosystem called connected health, in which telemedicine acquires special importance when distance (not only geographical), is a critical factor. It can respond to financial, social or safety needs or questions of dignity, as is the case with prisoners when they are transferred handcuffed and under custody to hospitals. Bringing health services closer to patients who cannot autonomously travel contributes towards humanising healthcare. Tele-consultations, long-distance encounters between patients and health professionals, reduce the direct and social costs inherent to habitual clinical practice and are very highly valued by patients in prison. Despite its potential benefits in the prison setting, the implementation of telemedicine in Spain continues to be scarce and irregular, which, amongst other things, is due to a lack of awareness of this healthcare practice, the severe shortage of resources currently endemic to the prison health service system and the lack of interoperability solutions for clinical information between the healthcare administration and the prison health services, which unfortunately continue to depend on an organisation outside the healthcare ambit (the Ministry of Home Affairs), despite the legal provisions requiring them to be fully integrated into regional health services. The SARA (Administration Applications and Networks Systems) Network and the Reúnete© Service offer solid, secure, free technology is available to all prisons, to set in motion telemedicine programs at a nationwide level.
Subject(s)
Prisons , Telemedicine , Humans , Spain , Telemedicine/organization & administrationABSTRACT
The Neurexin 3 gene (NRXN3) has been associated with dependence on various addictive substances, as well as with the degree of smoking in schizophrenic patients and impulsivity among tobacco abusers. To further evaluate the role of NRXN3 in nicotine addiction, we analyzed single nucleotide polymorphisms (SNPs) and a copy number variant (CNV) within the NRXN3 genomic region. An initial study was carried out on 157 smokers and 595 controls, all of Spanish Caucasian origin. Nicotine dependence was assessed using the Fagerström index and the number of cigarettes smoked per day. The 45 NRXN3 SNPs genotyped included all the SNPs previously associated with disease, and a previously described deletion within NRXN3. This analysis was replicated in 276 additional independent smokers and 568 controls. Case-control association analyses were performed at the allele, genotype and haplotype levels. Allelic and genotypic association tests showed that three NRXN3 SNPs were associated with a lower risk of being a smoker. The haplotype analysis showed that one block of 16 Kb, consisting of two of the significant SNPs (rs221473 and rs221497), was also associated with lower risk of being a smoker in both the discovery and the replication cohorts, reaching a higher level of significance when the whole sample was considered [odds ratio = 0.57 (0.42-0.77), permuted P = 0.0075]. By contrast, the NRXN3 CNV was not associated with smoking behavior. Taken together, our results confirm a role for NRXN3 in susceptibility to smoking behavior, and strongly implicate this gene in genetic vulnerability to addictive behaviors.
Subject(s)
Nerve Tissue Proteins/genetics , Polymorphism, Single Nucleotide/genetics , Smoking/genetics , Tobacco Use Disorder/genetics , Adult , Aged , Case-Control Studies , Cohort Studies , Female , Genetic Predisposition to Disease/epidemiology , Genetic Predisposition to Disease/genetics , Haplotypes , Humans , Male , Middle Aged , Risk Factors , Smoking/epidemiology , Spain/epidemiology , Tobacco Use Disorder/epidemiologyABSTRACT
UNLABELLED: OBJECTIVE. To know the proportion of people with positive result in test. Design. Cross sectional study in 53 health centers. SETTING. Primary care. PARTICIPANTS: Aleatory sample of non-institutionalised, elder than 64 years patients attended in the 53 health centers. VARIABLES: age, sex, civil status, and educational level. The detection of cognitive deterioration (CD) was carried out in primary care units with Folstein's Mini Mental Test (MMT) and the Isaacs Set-Test in case of illiteracy. Cut-off points 24 and 27 respectively. CD predictor variables analysis with logistic regression. MAIN RESULTS: The tests were applied to 4,467 individuals (56.1% females). There were found as possible cases of CD 399 patients (72.2% with MMSE). Positive percentage was 7.78% (95% CI, 5.69%-10.99%) in males and 9.45% (95% CI, 7.31%-12.43%) in female, adjusting with indirect method, according to the 1996 Catalonia list of inhabitants. Significant predictor factors were found with the multivariate analyses: primary educational level in front of illiteracy (OR=1.40, 95% CI, 1.13%-1.74%) and age-groups: 74-79 years, 75-79 years and y >= 80 years in front of <70 years old (OR=1,48, 95% CI, 1.02%-2.14%, OR=2.29; 95% CI, 1.60%-3.28% and OR=5,02; 95% CI, 3.59%-7.03% respectively). CONCLUSIONS: The cognitive deterioration prevalence increases with age and it is less frequent in individuals with higher studies Using MMSE and Set-Test we found several possible cases of cognitive deterioration in our population.
Subject(s)
Cognition Disorders/diagnosis , Cognition Disorders/epidemiology , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Geriatric Assessment , Humans , Male , Neuropsychological Tests , Prevalence , Psychiatric Status Rating ScalesABSTRACT
Objetivo. Estudiar la prevalencia de positivos a un test de detección de deterioro cognitivo (DC) en la población > 64 años de Cataluña y sus factores determinantes. Diseño. Estudio transversal multicéntrico. Ámbito. Cincuenta y tres centros de atención primaria. Sujetos. Muestra aleatoria de 5.300 individuos (100 por centro) de población adscrita, no institucionalizada > 64 años. Mediciones. La detección de DC se realizó en las consultas de atención primaria mediante el test Mini Mental State Examination de Folstein (MMSE), y el Settest de Isaacs en caso de analfabetismo. Puntos de corte, < 24 (MMSE) o < 27 (Settest). Análisis de variables predictoras (edad, sexo, estado civil y nivel de estudios) de posible DC mediante regresión logística. Resultados. Se administró el test a 4.467 individuos (56,1 por ciento, mujeres). Se diagnosticaron como posibles casos de DC 399 pacientes (72,2 por ciento por MMSE). La prevalencia de positivos se estimó en 7,78 por ciento (IC del 95 por ciento, 5,69-10,99 por ciento) en varones y 9,45 por ciento (IC del 95 por ciento, 7,31-12,43 por ciento) en mujeres, ajustando por el método indirecto según el padrón de Cataluña de 1996. En el análisis multivariado resultaron factores predictores los estudios primarios respecto al analfabetismo (OR =1,40; IC del 95 por ciento, 1,13-1,74 por ciento) y los grupos de edad: 74-79 años, 75-79 años y 80 años respecto a los < 70 años (OR = 1,48; IC del 95 por ciento, 1,022,14 por ciento, OR: 2,29; IC del 95 por ciento: 1,60-3,28 por ciento y OR = 5,02; IC del 95 por ciento, 3,59-7,03 por ciento, respectivamente).Conclusiones. La prevalencia de posible deterioro cognitivo aumenta con la edad y es menos frecuente en los individuos con mayor nivel de estudios. Mediante el MMSE y Set-test se detecta un gran número de posibles DC en la población (AU)
Subject(s)
Aged , Aged, 80 and over , Male , Female , Humans , Diagnosis-Related Groups , Time Factors , Prevalence , Geriatric Assessment , Primary Health Care , Psychiatric Status Rating Scales , Cognition Disorders , Cross-Sectional Studies , Ambulatory Care , Hospitalization , Neuropsychological TestsABSTRACT
OBJECTIVES: To compare the concordance between two cognitive impairment (CI) screening tests: the 30-point Folstein's Mini Mental State Examination (MMSE) and their validated and slightly modified spanish translation, the 35-point Lobo's Mini-Examen Cognoscitivo (MEC). DESIGN: Analytical cross-sectional multicenter study. SETTING: Primary care. PATIENTS: Randomized sample of subjects aged 65 years or more attended in 54 primary care centers in Catalonia. Inclusion of 3,167 subjects. Institutionalized patients were excluded. MEASUREMENTS: After a training period, primary care doctors and nurses administered MMSE and MEC simultaneously to their own patients. Standardization of variables. RESULTS: Age 74 (6.1) years-old, 1,611 (50.9%) women, 954 (30.1%) illiterate or without primary education. Prevalence of CI according to MMSE was 16.52% (n = 449) and according to MEC 5,49% (n = 165) (P<.001). Although intraclass correlation coefficient was 0,864 (95% CI, 0.855-0.873), the kappa index at score 24 for both tests was 0.468, but it increased up to 0.788 taking 20 and 23 scores for MMSE and MEC, respectively. At multivariate analysis, low educational level, and age more than 80 years-old predict a bad concordance among both tests. CONCLUSIONS: In spite of good correlation between MMSE and MEC, both detect different CI prevalences with the cut-off point at 23/24. Their agreement is only moderated in practice, because we interpret tests in a dichotomic way (CI versus no-CI). In our experience, we cannot use them indistinctly with the cut-off point at 23/24, especially in subjects with low educational level or aged 80 or more years.
Subject(s)
Cognition Disorders/diagnosis , Geriatric Assessment , Mental Status Schedule , Primary Health Care , Age Factors , Aged , Aged, 80 and over , Cross-Sectional Studies , Data Interpretation, Statistical , Education , Female , Humans , Male , Random AllocationABSTRACT
OBJECTIVE: To report a case of infected urachal cyst, with special reference to the difficulty in making the diagnosis due to the low incidence of this condition. METHODS/RESULTS: The embryologic origin of the urachus, its anomalies, clinical features, diagnosis and treatment are discussed. CONCLUSION: A high index of suspicion is necessary to diagnose this condition with unspecific clinical features. Ultrasound and CT are useful in making the diagnosis. Radical surgery continues to be the first therapeutic procedure.
Subject(s)
Infections/diagnosis , Urachal Cyst/diagnosis , Adult , Humans , Infections/complications , Male , Urachal Cyst/complicationsABSTRACT
The clinical responses of 58 men who were given Viagra between April and December 1998 in a psychiatric outpatient setting were tracked through 2 follow-up visits. Four categories of success and 3 categories of failure are defined to describe the outcomes. Although 43% had ideal outcomes--cure or uncomplicated drug-dependent successes--50% again were able to have intercourse and 63% experienced improved erections. Seventeen percent of the original sample did not benefit from the drug; 21% were lost to follow-up. This intent-to-treat study adds more evidence of Viagra's effectiveness and further clarifies the need to focus on psychodynamic considerations when trying to assist the majority of patients who did not have ideal outcomes.
Subject(s)
Erectile Dysfunction/drug therapy , Phosphodiesterase Inhibitors/therapeutic use , Piperazines/therapeutic use , Adult , Aged , Dose-Response Relationship, Drug , Erectile Dysfunction/psychology , Follow-Up Studies , Humans , Male , Middle Aged , Phosphodiesterase Inhibitors/adverse effects , Piperazines/adverse effects , Purines , Sildenafil Citrate , Sulfones , Treatment FailureABSTRACT
In order to know the prevalence and risk factors for coinfections by human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) among injecting drug users (IDUs), a cross-sectional study was carried out in two prisons of the province of Cantabria, northern Spain. Three hundred and sixty-two IDU inmates were recruited. All inmates were interviewed and their blood tested for HIV, HBV and HCV. Crude and multiple risk factor adjusted for (by polychotomous logistic regression) odds ratios were calculated. Prevalence of HBV-HCV coinfection (42.5%) was higher than HIV-HBV-HCV coinfection (37.3%), whereas monoinfections were very uncommon (overall: 13%). Long-term injectors and reincarceration were the foremost risk factors for both coinfections, showing a trend between the degree of association and the number of viruses infecting a patient. No significant relationship between coinfection status and sexual practices was observed. The results related to coinfections are consistent with previous studies of prevalence and risk factors for HIV, HBV and HCV, in indicating that the high rates of coinfections among IDU inmates emphasise the need to harm-reduction policy across prisons in Spain.
Subject(s)
HIV Infections/epidemiology , Hepatitis B/epidemiology , Hepatitis C/epidemiology , Prisoners , Substance Abuse, Intravenous , Adult , Comorbidity , Cross-Sectional Studies , Female , Humans , Male , Odds Ratio , Risk Factors , Spain/epidemiologyABSTRACT
cDNA and genomic clones encoding Brassica napus non-specific lipid transfer proteins (LTP) were isolated and sequenced. The encoded amino acid sequences were very similar to those reported previously for LTPs from B. napus and other species. Sequence information indicates that B. napus contains an LTP gene family. The 5'-flanking region of one gene, designated BnLTP, was fused to GUS and the fusion introduced into Arabidopsis. LTP transcripts and BnLTP-Gus expression were present predominantly in the epidermis of leaf and stem, consistent with the hypothesised function of LTPs in the deposition of cuticular or epicuticular waxes. However, GUS activity was detected in other tissues, including lateral root initials, anthers, stigmas and vascular tissues, which may suggest additional functions. LTP transcript levels in B. napus and Arabidopsis and BnLTP-GUS expression in transgenic Arabidopsis were stimulated by blue and red light but not UV-B. BnLTP promoter activity was also stimulated upon viral infection, at a time when the virus had spread systemically. No increase in expression was observed in response to cold or wounding.
Subject(s)
Arabidopsis/genetics , Brassica/genetics , Carrier Proteins/genetics , Light , Promoter Regions, Genetic/genetics , Amino Acid Sequence , Antigens, Plant , Arabidopsis/virology , Brassica/chemistry , Carrier Proteins/metabolism , Caulimovirus/growth & development , Cold Temperature , DNA, Complementary/chemistry , DNA, Complementary/genetics , DNA, Plant/chemistry , DNA, Plant/genetics , Gene Expression Regulation, Plant/radiation effects , Glucuronidase/analysis , Glucuronidase/genetics , Histocytochemistry , In Situ Hybridization , Molecular Sequence Data , Plant Proteins , Plants, Genetically Modified , RNA, Plant/genetics , RNA, Plant/metabolism , Recombinant Fusion Proteins/genetics , Sequence Alignment , Sequence Analysis, DNA , Sequence Homology, Amino Acid , Tissue DistributionABSTRACT
A cross-sectional study was conducted in prisons of Cantabria (northern Spain) from June 1992 to December 1994. Inmates were asked to participate in a survey on prevalence and risk factors for monoinfections and coinfections with HIV, HBV and HCV. Crude and multiple odds ratios of risk factors were calculated (by polychotomous logistic regression). Prevalence of coinfections was higher than that of monoinfections. IDU risk factors were the main independent variables associated with monoinfections and coinfections with these agents. The strength of association increased with the degree of coinfection for IDU risk factors and penal status, e.g. duration of injecting drug use for more than 5 years yielded an adjusted OR ranging from 1.3 (95% CI: 0.4-5.1) for HBV monoinfection to 180 (95% CI: 61.0-540.0) for HIV-HBV-HCV coinfection. In comparison, sexual behaviours were less important than IDU risk factors.
Subject(s)
HIV Infections/epidemiology , Hepatitis B/epidemiology , Hepatitis C/epidemiology , Prisoners/statistics & numerical data , Adult , Cross-Sectional Studies , HIV Infections/blood , HIV Infections/complications , Hepatitis B/blood , Hepatitis B/complications , Hepatitis C/blood , Hepatitis C/complications , Humans , Male , Prevalence , Risk Factors , Spain/epidemiology , Substance Abuse, Intravenous/complications , Substance Abuse, Intravenous/epidemiology , Surveys and QuestionnairesABSTRACT
OBJECTIVES: To report an additional case of renal hydatid cyst in a patient who had been clinically asymptomatic despite the significant renal derangement observed at diagnosis. METHODS/RESULTS: Patient clinical history is presented and the diagnostic methods are described. CONCLUSIONS: US, urography and CT permit an accurate diagnosis in most of the cases. MRI has diagnostic limitations in this condition. To date, surgery continues to be the treatment of choice.
