ABSTRACT
Introduction: BNT162b2 (BioNTech and Pfizer) is a nucleoside-modified mRNA vaccine that provides protection against SARS-CoV-2 infection and is generally well tolerated. However, data about its efficacy, immunogenicity and safety in people of old age or with underlying chronic conditions are scarce. Purpose: To describe BNT162b2 (BioNTech and Pfizer) COVID-19 vaccine immunogenicity, effectiveness and reactogenicity after complete vaccination (two doses), and immunogenicity and reactogenicity after one booster, in elders residing in nursing homes (NH) and healthy NH workers in real-life conditions. Methods: Observational, ambispective, multicenter study. Older adults and health workers were recruited from three nursing homes of a private hospital corporation located in three Spanish cities. The primary vaccination was carried out between January and March 2021. The follow-up was 13 months. Humoral immunity, adverse events, SARS-CoV-2 infections, hospitalizations and deaths were evaluated. Cellular immunity was assessed in a participant subset. Results: A total of 181 residents (mean age 84.1 years; 89.9% females, Charlson index ≥2: 45%) and 148 members of staff (mean age 45.2 years; 70.2% females) were surveyed (n:329). After primary vaccination of 327 participants, vaccine response in both groups was similar; ≈70% of participants, regardless of the group, had an antibody titer above the cut-off considered currently protective (260BAU/ml). This proportion increased significantly to ≈ 98% after the booster (p<0.0001 in both groups). Immunogenicity was largely determined by a prior history of COVID-19 infection. Twenty residents and 3 workers were tested for cellular immunity. There was evidence of cellular immunity after primary vaccination and after booster. (AU)
Introducción: La vacuna BNT162b2 (BioNTech y Pfizer) es una vacuna de ARNm modificado con nucleósidos que proporcionó protección contra la infección por el SARS-CoV-2 y generalmente fue bien tolerada. Sin embargo, los datos sobre su efectividad y seguridad en personas de edad avanzada o con enfermedades crónicas subyacentes son escasos. Objetivo: Describir la inmunogenicidad, efectividad y seguridad de esta vacuna tras la vacunación completa (dos dosis), y la inmunogenicidad y reactogenicidad tras un refuerzo, en ancianos residentes en hogares geriátricos y trabajadores sanos de estos lugares en condiciones reales. Métodos: Estudio observacional, ambispectivo y multicéntrico. Se reclutaron ancianos y trabajadores sanitarios de tres hogares geriátricos de ancianos de un grupo hospitalario de entidad privada situados en tres ciudades españolas. La vacunación primaria se realizó entre enero y marzo de 2021. El seguimiento fue de 13 meses. Se evaluó la inmunidad humoral, los eventos adversos, las infecciones por SARS-CoV-2, las hospitalizaciones y las muertes. Se evaluó la inmunidad celular en un subconjunto de participantes. Resultados: Se registraron datos de 181 residentes (edad promedio 84,1 años; 89,9% mujeres, índice de Charlson ≥2: 45%) y 148 trabajadores (edad promedio 45,2 años; 70,2% mujeres) (n:329). Tras la primera dosis a 327 de los participantes, la respuesta a la vacuna en ambos grupos fue similar; ≈70% de los participantes, independientemente del grupo, tuvieron un título de anticuerpos por encima del corte considerado actualmente como protector (260 BAU/ml). Esta proporción aumentó significativamente a ≈ 98% después del refuerzo (p<0,0001 en ambos grupos). La inmunogenicidad se determinó en gran medida por los antecedentes de infección por COVID-19. Se analizó la inmunidad celular de 20 residentes y 3 trabajadores. Hubo evidencia de inmunidad celular después de la vacunación primaria y después del refuerzo. (AU)
Subject(s)
Humans , Male , Female , Aged, 80 and over , Pandemics , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/drug therapy , Mass Vaccination/adverse effects , Severe acute respiratory syndrome-related coronavirus , Hospitals, Private , Homes for the Aged , AgingABSTRACT
BACKGROUND: One of the greatest challenges for health care institutions is to know the hospital product (HP), defined as patients, diagnoses and resources used in health care. Proper measurement of HP allows an effective resource management. The Diagnosis Related Groups (DRG) system facilitates the measurement of HP, classifying patients according to their characteristics, complexity, and resource consumption. AIM: To describe the implementation of DRGs in a high complexity health care institution in Colombia and to describe the incidence of coding errors. MATERIAL AND METHODS: A random sample of 98 episodes was selected out of 3802 episodes registered from June to September 2019. We described the cumulative incidence of errors in the assignment of main diagnoses, procedures and the variable "Present on admission" (POA). RESULTS: An incorrect assignment of the main diagnosis was found in 18/98 episodes (18%, 95% confidence intervals (CI)11-27). Seventeen of 98(17%-95% CI10.4-26) and 8/98(8%-95% CI 3.6-15) had incorrect assignment of POA ("NO" or "YES" respectively). Eighteen episodes had at least one procedure incorrectly assigned (19% - 95%CI (11.4 - 28.5)). CONCLUSIONS: The use of DRGs improves hospital efficiency. Its implementation is possible in health care institutions in Colombia. However, the commitment of the institution's clinical and administrative staff is essential.
Subject(s)
Diagnosis-Related Groups , Hospitalization , Colombia , Hospitals , HumansABSTRACT
BACKGROUND: One of the greatest challenges for health care institutions is to know the hospital product (HP), defined as patients, diagnoses and resources used in health care. Proper measurement of HP allows an effective resource management. The Diagnosis Related Groups (DRG) system facilitates the measurement of HP, classifying patients according to their characteristics, complexity, and resource consumption. AIM: To describe the implementation of DRGs in a high complexity health care institution in Colombia and to describe the incidence of coding errors. Material and Methods: A random sample of 98 episodes was selected out of 3802 episodes registered from June to September 2019. We described the cumulative incidence of errors in the assignment of main diagnoses, procedures and the variable "Present on admission" (POA). RESULTS: An incorrect assignment of the main diagnosis was found in 18/98 episodes (18%, 95% confidence intervals (CI)11-27). Seventeen of 98(17%-95% CI10.4-26) and 8/98(8%-95% CI 3.6-15) had incorrect assignment of POA ("NO" or "YES" respectively). Eighteen episodes had at least one procedure incorrectly assigned (19% − 95%CI (11.4 − 28.5)). Conclusions: The use of DRGs improves hospital efficiency. Its implementation is possible in health care institutions in Colombia. However, the commitment of the institution's clinical and administrative staff is essential.
Subject(s)
Humans , Diagnosis-Related Groups , Hospitalization , Colombia , HospitalsABSTRACT
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Subject(s)
Humans , Brachytherapy/methods , Uveal Neoplasms/radiotherapy , Melanoma/radiotherapyABSTRACT
Se realizó un estudio clínico abierto para valorar la eficacia y tolerancia del ketotifeno en 26 pacientes ambulatorios, derechohabientes del hospital de zona de Petróleos Mexicanos en Poza Rica, jóvenes y adultos de ambos sexos, diagnosticados de rinopatía alérgica. A todos los pacientes incluidos en el estudio se les administró el fármaco en forma de comprimidos de 1 mg cada 12 horas diarias e ininterrumpidamente durante 3 meses. Se valoró la sintomatología clínica: rinorrea, prurito, obstrucción nasal, estornudos y tos, así como parámetros complementarios, eosinofilia nasal y sanguínea y el aspecto de la mucosa nasal. Todos los parámetros valorados disminuyeron en intensidad significativamente (p<0.001), desde el primer mes de tratamiento hasta el final del mismo, manteniéndose la significancia estadística en relación a la intensidad inicial. El Ketotifeno fue bien tolerado, observándose en 6 casos efectos secundarios leves y transitorios: somnolencia, cefalea y sequedad de boca, permitiendo el cumplimiento de la terapéutica hasta el final
