[Effectiveness of influenza vaccine in preventing severe influenza]. / Efectividad de la vacuna antigripal en la prevención de la gripe grave.

INTRODUCTION: Influenza is one of the diseases with the greatest epidemiological impact and the greatest relevance in the management of health services. The flu vaccine can have great variability each season, so our objective was to know the effectiveness of the flu vaccine for the 2017/2018 season for the prevention of severe cases of flu in a general acute hospital in 385 beds. MATERIAL AND METHOD: Case control study. All hospitalized patients with laboratory confirmed influenza during the 2017/2018 season were included. Those who met the criteria for a severe case of influenza were considered cases. Those that did not meet the severity criteria were considered controls. The factors associated with the development of severe influenza were calculated. RESULTS: The effectiveness adjusted by age group and comorbidity was 60.7% (20.5-80.5). The vaccinated and unvaccinated groups were different in terms of age (P<.0381). The highest proportion of cases were concentrated in those over 65 years of age (45.5%). Vaccination status against severe influenza was found to be an independent protective factor (OR=.746; .694-.831). CONCLUSIONS: The effectiveness of influenza vaccination provided greater protection against infection and reduced the severity of influenza in hospitalized patients. These findings should be considered to improve vaccination strategies and achieve better vaccination coverage in the population at risk.

Patient education during hospital admission due to exacerbation of chronic obstructive pulmonary disease: Effects on quality of life-Controlled and randomized experimental study.

The objective of this study was to assess the effectiveness of an education program and telephone call follow-up at improving the health related quality of life (HRQL) of patients with chronic obstructive pulmonary disease (COPD). METHOD: Experimental, controlled, randomized, single blind study, masked data analysis. Duration of 2 years and 3 months. Patients hospitalised for exacerbation. The effectiveness was evaluated by calculating the absolute and relative change (%) of the St. George questionnaire scores (total and by dimensions) before and after the intervention program. Calculation of the effect of the group variable on the absolute and relative changes of the variables, Multiple Analysis of Variance (MANOVA). RESULTS: Completed study of 116 patients. Greater effects on their HRQL reported at admission (48.3 ± SD 20.0 years). Patients in the intervention group improved significantly in their total SGRQ scores (-6.83) in absolute and relative terms and more significantly in their activity dimension (-16.05). CONCLUSIONS: The education program was effective at improving global HRQL, especially the activity dimension, in exacerbated COPD patients. PRACTICE IMPLICATIONS: This research contributes to clarifying the benefits and contents of education programs for patients with COPD; hospital admission is the suitable moment to contact these patients.

Sistema pedicular de estabilización dinámica. Resultados funcionales y complicaciones del implante en pacientes con enfermedad degenerativa discal lumbar, tras un seguimiento mínimo de 4 años / Pedicular dynamic stabilization system. Functional outcomes and implant-related complications for the treatment of degenerative lumbar disc disease with a minimum follow-up of 4 years

Introducción: El sistema de estabilización Dynesys® es un sistema pedicular de estabilización dinámica sin fusión. El objetivo de nuestro estudio es evaluar los resultados clínicos en pacientes con enfermedad degenerativa discal y/o estenosis, así como medir la prevalencia de aflojamiento de tornillos tras 4 años de seguimiento. Material y métodos: Se trata de un estudio de serie de casos retrospectivo donde fueron incluidos todos los pacientes intervenidos desde enero a diciembre de 2008 con Dynesys®. Se indicó la cirugía si presentaban dolor lumbar de más de 6 meses de evolución y una RM positiva para enfermedad degenerativa discal y/o estenosis. Resultados: Veintidós pacientes (11 mujeres y 11 varones) con una edad media de 44,40 ± 11 años fueron evaluados. Veinte pacientes (91%) recibieron el implante Dynesys® sin ninguna maniobra de descompresión asociada. La evaluación del dolor de espalda y piernas (0-10 mm) registró una disminución media de 2,4 ± 2,06 mm (p = 0,0001). El valor preoperatorio del índice de discapacidad de Oswestry fue de 52,36 ± 16,56% (limitación funcional severa). Tras la cirugía este valor fue de 34,27 ± 17,87% (limitación funcional moderada) con una disminución de 18,09 ± 16,03% (p = 0,001). Cuatro pacientes (18%) mostraron signos de aflojamiento de tornillos. Un paciente (4,5%) presentó rotura de tornillo. Conclusiones: La cirugía con Dynesys® muestra resultados clínicos favorables, sin embargo el rango de mejoría en nuestra serie es menor a los comunicados por otros autores. Estudios comparativos entre Dynesys® y descompresión deberían realizarse para poder aislar el beneficio de la estabilización dinámica del obtenido por la descompresión. Las complicaciones relacionadas con el implante no son infrecuentes (AU)

Introduction: The Dynesys® system is a non-fusion pedicular dynamic stabilization system. The aim of our study is to evaluate the clinical outcomes in patients with degenerative disc disease and/or stenosis, and to measure the prevalence of screw loosening and breakage after 4 years of follow up. Material and methods: All patients who underwent surgery with Dynesys® system in 2008 were reviewed. The surgery was performed in cases of low back pain of more than 6 months duration and a positive MRI for degenerative disc disease and/or stenosis. Results: A total of 22 patients (11 females, 11 males) with a mean age of 44.40 ± 11 years were included, 20 patients (91%) underwent Dynesys® without any associated decompression maneuver. The evaluation of back and leg pain (0–10 mm) showed a mean decrease of 2.4 ± 2.06 mm (P = .0001). The preoperative value of the Oswestry disability index was 52.36 ± 16.56% (severe functional limitation). After surgery, this value was 34.27 ± 17.87% (moderate functional limitation) (P = .001) with a decrease of 18.09 ± 16.03% (P = .001). A total of 4 (18%) patients showed signs of loosening screws. One patient (4.5%) had a screw breakage. Conclusions: Surgery with Dynesys® shows favorable long term clinical results, however the range of improvement in our series is lower than those reported in other studies. Comparative studies between Dynesys® and decompression need to be performed in order to isolate the benefit of the dynamic stabilization system. Implant-related complications are not uncommon (AU)

[Pedicular dynamic stabilization system. Functional outcomes and implant-related complications for the treatment of degenerative lumbar disc disease with a minimum follow-up of 4 years]. / Sistema pedicular de estabilización dinámica. Resultados funcionales y complicaciones del implante en pacientes con enfermedad degenerativa discal lumbar, tras un seguimiento mínimo de 4 años.

INTRODUCTION: The Dynesys(®) system is a non-fusion pedicular dynamic stabilization system. The aim of our study is to evaluate the clinical outcomes in patients with degenerative disc disease and/or stenosis, and to measure the prevalence of screw loosening and breakage after 4 years of follow up. MATERIAL AND METHODS: All patients who underwent surgery with Dynesys(®) system in 2008 were reviewed. The surgery was performed in cases of low back pain of more than 6 months duration and a positive MRI for degenerative disc disease and/or stenosis. RESULTS: A total of 22 patients (11 females, 11 males) with a mean age of 44.40 ± 11 years were included, 20 patients (91%) underwent Dynesys(®) without any associated decompression maneuver. The evaluation of back and leg pain (0-10mm) showed a mean decrease of 2.4 ± 2.06 mm (P=.0001). The preoperative value of the Oswestry disability index was 52.36 ± 16.56% (severe functional limitation). After surgery, this value was 34.27 ± 17.87% (moderate functional limitation) (P=.001) with a decrease of 18.09 ± 16.03% (P=.001). A total of 4 (18%) patients showed signs of loosening screws. One patient (4.5%) had a screw breakage. CONCLUSIONS: Surgery with Dynesys(®) shows favorable long term clinical results, however the range of improvement in our series is lower than those reported in other studies. Comparative studies between Dynesys(®) and decompression need to be performed in order to isolate the benefit of the dynamic stabilization system. Implant-related complications are not uncommon.