Four-year antibody persistence and response to a booster dose of a pentavalent MenABCWY vaccine administered to healthy adolescents and young adults.

This open-label, multicenter extension study (NCT02451514) assessed persistence of Neisseria meningitidis serogroups ABCWY antibodies 4 years after primary vaccination. Adolescents and young adults who previously received 2 doses of MenABCWY+OMV (Group III), 1 dose of MenACWY-CRM (Group VI), or newly-recruited vaccine-naïve participants (Group VII) were administered 1 (Group III) or 2 doses (Groups VI and VII) of MenABCWY+OMV, 1 month apart. Immunogenicity was assessed by human serum bactericidal assay (hSBA). Safety and reactogenicity were also evaluated. Percentages of participants with hSBA titers ≥8 (serogroups ACWY), ≥5 (serogroup B) and hSBA geometric mean titers (GMTs) were evaluated in all 129 enrolled participants (Group III: 33; Group VI: 46; Group VII: 50). Anti-ACWY antibody concentrations waned over 4 years post-vaccination, but remained above pre-vaccination concentrations. Similarly, levels of antibodies against serogroup B test strains also waned over 4 years post-vaccination, but remained above pre-vaccination concentrations for some strains. MenABCWY+OMV booster induced a robust anamnestic anti-ACWY response in Group III and VI and a good response against serogroup B test strains (≥82%) in Group III. In serogroup B-naïve participants (Groups VI and VII), anti-B responses to 2 doses of MenABCWY+OMV were less homogenous and lower than in Group III. MenABCWY+OMV was reactogenic, but well-tolerated. No safety concerns were identified. These findings indicate that although antibodies against N. meningitidis serogroups ABCWY waned over 4 years post-vaccination, exposure to a MenABCWY+OMV booster dose elicits an anamnestic response in adolescents previously exposed to the same or another multivalent meningococcal vaccine.

Factores asociados al desarrollo de eventos adversos con transfusión de plasma fresco congelado / Factors associated with the development of adverse events with fresh frozen plasma transfusion

Resumen Lugar: Fundación Cardioinfantil-instituto de Cardiología (FCI), Bogotá, Colombia. Objetivo: determinar los factores asociados con eventos adversos transfusionales (EAT) con plasma fresco congelado (PFC) en la FCI durante los años 2008-2010. Metodología: estudio de casos y controles, en relación 1:3. Pacientes mayores de 18 años transfundidos con PFC en la FCI durante los años 2008-2010. Los casos fueron identificados a partir del registro de EAT de la FCI. Los controles recibieron transfusión de PFC y no presentaron evento adverso. Resultados: el promedio de edad de los casos fue menor que el de los controles (52.4 vs. 60.5 años, p=0.001). los eventos adversos de tipo alérgico fueron los más frecuentes, aumentaron con la utilización de unidades provenientes de otros bancos de sangre (0.7 vs. 0.0 unidades, p=0.003), cuando el donante fue de sexo femenino (2.5 vs. 1.4 donantes de sexo femenino, p=0.11) y con la paridad aumentada de dichas donantes (4.0 vs. 2.6 partos, p=0.04). La sepsis (or: 0.1, iC95%:0.01-0.87, p=0.015) y la diabetes (or: 0.9, iC95%:0.01-0.54, p=0.003) se comportaron como factores protectores para el desarrollo de los eventos adversos de tipo alérgico. Conclusiones: los EAT con PFC están asociados con donantes mujeres, multíparas y unidades provenientes de bancos de sangre no institucionales. su incidencia podría disminuir al no permitir donantes mujeres con más de cuatro embarazos. (Acta Med Colomb 2013; 38: 127-131).

Abstract Place: Fundación Cardio-infantil (FCI), Bogotá, Colombia. Objective: to determine factors associated with transfusion-associated adverse events with fresh frozen plasma (FFP) in the FCI during the years 2008-2010. Methodology: case-control study, in ratio 1:3. Patients over 18 years transfused with FFP in the FCI during the years 2008-2010. Cases were identified from the FCI transfusion -associated adverse events registry. Controls received FFP transfusion and had no adverse events. Results: the average age of cases was lower than that of controls (52.4 vs. 60.5 years, p = 0.001). The adverse events were the most frequent ones, and increased with the use of units from other blood banks (0.7 vs. 0.0 units, p = 0.003), when the donor was female (2.5 vs. 1.4 female donors, p = 0.11) and with the increased parity of such donors (4.0 vs. 2.6 deliveries, p = 0.04). Sepsis (or: 0.1, 95% Ci:0,01-0, 87, p = 0.015) and diabetes (or: 0.9, 95% Ci:0,01-0, 54, p = 0.003) behaved as protective factors for the development of adverse allergic type events. Conclusions: the transfusion-associated adverse events with PFC are associated with female multiparous donors and with blood units provided by non-institutional blood banks. Its incidence could diminish by not allowing female donors with more than four pregnancies. (Acta Med Colomb 2013; 38: 127-131).

¿Existe asociación entre los comportamientos de riesgo en salud sexual y reproductiva y el ser estudiante de medicina? estudio de corte transversal: Bogotá (Colombia) / Is there an association between sexual and reproductive health risk behaviour and being a medicine student? A cross-sectional study, Bogotá, Colombia

Objetivo: explorar si hay una asociación entre el mayor conocimiento en áreas del cuidado de la salud, que presumiblemente tienen los estudiantes de medicina, y el desarrollo de actitudes y comportamientos saludables en la salud sexual y reproductiva. Metodología: se realizó un estudio de corte transversal analítico en una muestra por conveniencia de 829 estudiantes de pregrado en las facultades de medicina y derecho de una universidad privada en Bogotá (Colombia). Se diseñó una encuesta basada en el Youth Risk Behavioral Survey (YRBS) para evaluar de manera anónima la percepción de conocimientos y comportamientos en salud sexual y reproductiva. Se compararon los dos grupos por medio del OR (Odds Ratio) y su respectivo IC del 95%. Resultados: se encuestaron 225 estudiantes (27,1%) de la facultad de derecho y 604 (72,9%) de la facultad de medicina. Los estudiantes de derecho presentaron mayor riesgo de haber iniciado relaciones sexuales de manera más frecuente (OR=2,21, IC95% 1,5-3,24) y un mayor riesgo de tener relaciones sexuales concomitantes al consumo de alcohol y drogas (OR=1,92 IC95% 1,19-3,11). No se encontraron diferencias en cuanto al uso del condón, prácticas anticonceptivas, presencia de infecciones de transmisión sexual (ITS), antecedentes de embarazo, ni en prácticas de autocuidado relacionadas con la salud sexual y reproductiva. Conclusiones: no se encuentra un menor riesgo en todos los criterios de salud sexual y reproductiva en los estudiantes de medicina.

Objective: exploring whether there is an association between having greater knowledge in areas regarding health care which, presumably, medical students have, and developing healthy attitudes and behaviour regarding sexual and reproductive health. Methodology: an analytical cross-sectional study was performed using a convenience sample of 829 undergraduate students studying in the schools of medicine and law at a private university in Bogotá, Colombia. A survey was designed which was based on the Youth Risk Behavioral Survey (YRBS) to anonymously evaluate students’ perception of knowledge and behavior regarding sexual and reproductive health. Both groups were compared by OR and their respective 95% CI. Results: 225 (27.1%) students were surveyed from the law school and 604 (72.9%) from the school of medicine. The law students presented a greater risk of having initiated sexual relationships (OR=2,21; 1.5 3.24 95% CI); having had a higher number of sexual partners (2.33 vs 2.76 p<0.0001) and were at greater risk of engaging in sexual relationships accompanied of drug and alcohol consumption (OR=1.92; 1.19 3.11 95% CI). No statistically significant differences were found regarding condom use, contraceptive practices, presentation of STD, having a background of pregnancy or self-care practices related to sexual and reproductive health. Conclusions: medical students were not found to be at less risk regarding all criteria related to sexual and reproductive health.

Antiepileptic drugs in treatment of pain caused by diabetic neuropathy.

Pain is frequent in diabetic neuropathy and is very hard to manage. Antiepileptic drugs have been used in treating pain for several decades. Their effectiveness has been described in different types of neuropathic pain, but when used as analgesics in painful diabetic neuropathy it still remains controversial. To clarify this effectiveness, a meta-analysis was performed to determine which antiepileptic drug had the best analgesic potential for managing pain in patients suffering from painful diabetic neuropathy. The search covered the Cochrane, MEDLINE, EMBASE, and LILACS databases, between January 1966 and September 2005. The following information was obtained from each article: criteria for diagnosing diabetic neuropathy, patients' age average, antiepileptic drug received and dose, sample size, duration of the disease and treatment follow-up, outcome measurement, evaluation of pain, and rescue medication. A combined 2.33 relative risk (95% confidence interval [CI] 1.88-2.88) was obtained; this result indicated that the antiepileptic drugs studied were effective for controlling pain in diabetic neuropathy. The corresponding necessary number to treat (NNT) values were established for evaluating which antiepileptic drug was most effective as an analgesic, according to our interests; pregabalin was shown to be the antiepileptic drug having the lowest NNT (NNT=3.24 and 95% CI 2.12-6.81) for achieving greater than 50% analgesia in patients suffering from painful diabetic neuropathy. Antiepileptic drugs are frequently used in the specific case of diabetic neuropathy; the combined result of this meta-analysis has demonstrated their analgesic benefit.

Conocimientos, actitudes y prácticas en salud sexual y reproductiva en una población universitaria / Knowledge, attitudes and practice in sexual and reproductive health in university population

Introducción: El estudio evalúa las características de salud sexual y reproductiva de una población estudiantil universitaria para fomentar hábitos de salud. Metodología: Se establecieron factores de riesgo y protección de una población estudiantil universitaria a través de un instrumento relacionado con percepción de conocimientos, verificación de conocimientos y comportamientos. Resultados: Se incluyeron 1106 estudiantes de las Facultades de Medicina, Rehabilitación y Jurisprudencia. La percepción de los conocimientos fueron consideradas como buenas pero los conocimientos concretos fueron escasos.66,7 por ciento manifestó haber tenido relaciones sexuales que iniciaron entre los 17-18 años; 48 por ciento de los encuestados usó preservativo ;hubo consumo de sustancias en 13 por ciento y 1 por ciento había tenido enfermedades de transmisión sexual. Conclusiones: El perfil del comportamiento sexual es amplio y ambiguo por lo que se debe fomentar factores protectores e intervenir en los comportamientos de riesgo a través de diferentes estrategias de educación y prevención que orienten hacia una sexualidad responsable y satisfactoria.

Cómo encontrar la evidencia a través de bases de datos electrónicas de la literatura médica / How to find evidence through electronic medical literature databases

El presente trabajo consiste en una guía básica y concreta, basada en las referencias y la opinión del autor, que tiene como objetivo orientar al lector en la búsqueda de artículos científicos mediante el planteamiento de una estrategia previa y el uso de las bases electrónicas de la literatura.