Do Centenarians Die Healthier than Younger Elders? A Comparative Epidemiological Study in Spain.

This study aims to describe the clinical course, drug use, and health services use characteristics during the last year of life of elders who die being centenarians and to identify key aspects differentiating them from elders who die at an earlier age, with a particular focus on sex differences. We conducted an observational, population-based study in the EpiChron Cohort (Aragón, Spain). The population was stratified by sex and into three age sub-populations (80-89, 90-99, and ≥100 years), and their characteristics were described and compared. Multimorbidity was the rule in our elders, affecting up to 3 in 4 centenarians and 9 in 10 octogenarians and nonagenarians. Polypharmacy was also observed in half of the centenarian population and in most of the younger elders. Risk factors for cardiovascular disease (i.e., hypertension, dyslipidaemia, diabetes), cerebrovascular disease and dementia were amongst the most common chronic conditions in all age groups, whereas the gastroprotective drugs and antithrombotic agents were the most dispensed drugs. Centenarians presented in general lower morbidity and treatment burden and lower use of both primary and hospital healthcare services than octogenarians and nonagenarians, suggesting a better health status. Sex-differences in their clinical characteristics were more striking in octogenarians and tended to decrease with age.

Is vaccinating monkeys against yellow fever the ultimate solution for the Brazilian recurrent epizootics?

Vaccinating monkeys against yellow fever (YF) has been a common practice in the beginning of the 17D vaccine development. Although it may seem strange at first sight, vaccinating monkeys as a public health strategy is, we think, feasible and theoretically could eliminate the infection among non-human primates, interrupting the virus circulation (or significantly reducing it) and therefore reducing the risk of spilling over to the human population. We propose a series of studies that could demonstrate (or not) the efficacy and feasibility of vaccinating non-human primates YF reservoirs living in green areas of urban centres to cut off or curb the virus circulation that recurrently spill over to the human population. Therefore, vaccinating monkeys in relatively small green areas of the urban centres is perhaps the ultimate solution for the Brazilian recurrent YF epizootics.

Initial experience with a new biodegradable airway stent in children: Is this the stent we were waiting for?

OBJECTIVE: To report our experience with a new type of biodegradable airway stent in the setting of severe tracheobronchial obstruction in children. DESIGN AND METHODOLOGY: We conducted a retrospective and prospective (since June 2014) study of pediatric patients with severe airway obstruction treated with biodegradable stents in our institution between 2012 and 2015. The following data were collected: demographics, indication for stenting, bronchoscopic findings, insertion technique complications, clinical outcome, stent related complications, re-stenting, and time of follow-up. RESULTS: Thirteen custom-made polydioxanone stents were placed in four infants (mean age, 4 months) with severe tracheobronchial obstruction: tracheomalacia (two patients), bronchomalacia (1), and diffuse tracheal stenosis (1). All the stents were bronchoscopically inserted uneventfully. Immediate and maintained clinical improvement was observed in every case. No major stent related complications have occurred and only mild or moderate granulation tissue was observed during surveillance bronchoscopy. Two patients required repeated stenting as expected. All the patients are alive and in a good respiratory condition with a follow-up ranging from 5 to 40 months. CONCLUSIONS: Biodegradable airway stents seem to be safe, effective, and cause fewer complications than other types of stents. They can be an alternative to the classic metallic or plastic stents for severe tracheal stenosis or malacia in small children. More experience is needed in order to establish the definite clinical criteria for their use in pediatric patients. Pediatr Pulmonol. 2016;51:607-612. © 2015 Wiley Periodicals, Inc.

Inicio y continuidad de la lactancia materna en relación con la asistencia a un programa educativo para madres jóvenes / Beginning and continuity of breastfeeding according to the attendance to a specific intervention for a young mothers

OBJETIVO: Determinar si las gestantes de hasta 22 años de edad que participaron en el programa Mares Joves (Madres Jóvenes [MJ]) y que recibieron una intervención específica para el fomento de la lactancia materna aumentaron la duración de la lactancia materna y la asistencia al programa de educación prenatal (EPN) y posnatal (EPP) con respecto a las que no participaron, así como la relación entre la duración de la LM, la asistencia a EPN y EPP y otras variables socioeconómicas, demográficas, obstétricas y familiares. METODOLOGÍA: Estudio cuasi experimental, con grupo de intervención y grupo control, comparando la duración de la lactancia materna (LM) en función de la participación en el programa de MJ (grupo de intervención) o no (grupo control). Otras variables de estudio: edad, nivel socioeconómico, hijos previos, presencia de pareja afectiva en el momento del parto, apoyo familiar y asistencia a EPN y EPP. Análisis estadístico: descriptivo, mediante porcentajes, medias y desviación estándar. Prueba de la t de Student o ANOVA y el test de la ji al cuadrado (Chi²) como estadística bivariada. Paquete estadístico SPSS, versión 16.0. RESULTADOS: Mujeres participantes: 242 (grupo de intervención: 131; grupo control: 111). Las participantes en el programa MJ lactaron más tiempo que las del grupo control y asistieron con más frecuencia a los grupos específicos de madres jóvenes de preparación para el parto. La asistencia a EPN y EPP se asoció a un incremento significativo de la duración de la LM. Las mujeres de América del Sur son las que más tiempo lactaron, y las españolas las que menos. No se encontraron diferencias significativas en función de la edad, el nivel socioeconómico, los hijos previos, la presencia o no de pareja afectiva o el apoyo familiar. CONCLUSIONES: La participación en el programa MJ y la asistencia a los grupos de EPN y EPP específicos para madres jóvenes se asociaron a un incremento de la duración de la LM

AIM: To determine whether pregnant women up to 22 years who participated in the program Young Mothers (YM), receiving a specific intervention for the promotion of breastfeeding (BR), increased the duration of BR and the attendance at prenatal education program (EPN) and postnatal (EPP) in comparison with the non-attendants, and the relationship between duration of BR and assistance to EPN and EPP, and socio-economic, demographic, obstetric and family variables. METHODOLOGY: A quasi-experimental study, non-randomized, control group, comparing the length of BR depending on the participation or not in the YM program. Other study variables: age, socioeconomic status, previous children, the presence of affective partner at the time of birth, family support, and assistance to EPN and EPP. Statistical analysis: descriptive, using percentages, means and standard deviation. T Student's test or ANOVA and the Chi² and bivariate statistics. SPSS version 16.0. RESULTS: 242 female participants (131 intervention group, control group 111). The program participants YM breastfed longer than the control group and attended more frequently to specific groups of young mothers in preparation for the birth. The EPN and EPP support was associated with a significant increase in the duration of breastfeeding. Latin American women are the longest breastfed and Spanish the least. No significant differences in terms of age, socio- economic status, previous children, couple or family support affective found. CONCLUSIONS: Participation in the YM program and assistance to specific EPN and EPP groups for young mothers, was associated with an increased duration of BR