ABSTRACT
Objetivo: conocer las tasas de vacunación contra el virus del papiloma humano (VPH) y su relación con la estrategia vacunal y la pertenencia a zonas necesitadas de transformación social (ZNTS). Diseño: estudio descriptivo, auditoría de historias clínicas.Emplazamiento:cuatro centros de salud urbanos (2015-2018).Participantes:adolescentes susceptibles de vacunación contra el VPH.Mediciones principales:tasas vacunales de acceso, cobertura y deserción.Resultados:366 adolescentes (12-16 años). Tasas: acceso 85,5%; cobertura 77,6%; deserción 9,3%. A mayor edad, mejores tasas de acceso (odds ratio [OR]: 6,1) y cobertura (OR: 1,4). La vacunación en el centro de salud se relaciona con una mejor tasa de cobertura (OR: 12,7), pero aumenta significativamente la tasa de deserción (OR: 75,6). Vivir en ZNTS disminuye la tasa de deserción (OR: 0,6).Conclusiones:la vacunación en centros de salud mejora la tasa de cobertura, pero con mayor riesgo de no completar la vacunación. La tasa de deserción es menor en ZNTS.(AU)
Objective: To ascertain the vaccination coverage rates against human papillomavirus (HPV) and its relationship with the vaccination strategy and belonging to poverty areas.Design:Descriptive study, audit of medical records.Setting:Four urban Primary Care centres (2015-2018).Participants:Adolescents susceptible to HPV vaccination.Main measurements:Vaccination Access, Coverage and Dropout Rates.Results:366 adolescents (12-16 years). Vaccination Rates: Access 85.5%; Coverage 77,6% and Dropout 9,3%. The oldest adolescents had higher Access (OR 6,1) and Coverage Rates (OR 1,4). Vaccination at the Primary Care centre was associated with a better Coverage Rate (OR 12,7) but the Vaccine Dropout Rate (OR 75,6) significantly increased. Living in a poverty area led to a decrease in Dropout Rate (OR 0,6).Conclusions:Vaccination in Primary Care centres improved the coverage rate but with a higher risk of not completing the vaccination. Adolescents in poverty areas completed vaccination more frequently.(AU)
Subject(s)
Humans , Male , Female , Adolescent , /immunology , Vaccination Coverage , Vaccines , Poverty Areas , Papillomavirus Vaccines , Epidemiology, Descriptive , Cross-Sectional Studies , Spain , Adolescent HealthABSTRACT
Rats that are administered angiotensin II (AngII) for 2 wk develop persistent salt-sensitive hypertension, which can be prevented by the immunosuppressor mycophenolate mofetil (MMF) given during the AngII infusion. This study examined the contribution of glomerular hemodynamics (GFR dynamics) in the post-AngII hypertensive response to a high-salt diet (HSD) and the effect of MMF treatment. During AngII administration, rats developed severe hypertension (systolic BP [SBP], 185 +/- 3.9 mmHg), proteinuria, afferent and efferent vasoconstriction, and glomerular hypertension. Rats that received AngII+MMF showed similar responses to AngII; however, they developed lower proteinuria (P < 0.05). At 2 wk, AngII was withdrawn and SBP returned toward normal. Rats were then placed on an HSD (4% NaCl), resulting in a progressive increase in SBP (155 +/- 8.2 mmHg at week 1 and 163 +/- 4.5 mmHg at week 5). GFR dynamic alterations persisted after AngII was stopped, i.e., afferent and efferent vasoconstriction, decreased glomerular plasma flow and single-nephron GFR, and lower ultrafiltration coefficient. These changes correlated with the thickening of the afferent arteriole and with focal tubulointerstitial injury. In the AngII+MMF group, SBP remained unchanged throughout the HSD period (146 +/- 2.3 mmHg at week 1 and 148 +/- 4.4 mmHg at week 5) in association with less afferent arteriolar thickening and tubulointerstitial injury. Single-nephron GFR, glomerular plasma flow, efferent resistance, and ultrafiltration coefficient returned to normal with a significant reduction in afferent resistance. These results suggest a critical role of cortical vasoconstriction in salt-sensitive hypertension. The MMF-induced prevention of these changes suggests that immune mechanisms are involved in the vasoconstrictive response.
