Effectiveness of pandemic and seasonal influenza vaccines in preventing pandemic influenza-associated hospitalization

Vaccines are leading pharmacological measures for limiting the impact of pandemic influenza in the community. The objective of this study was to investigate the effectiveness of influenza (pandemic and seasonal) vaccines in preventing pandemic influenza-associated hospitalization. We conducted a multicenter matched case-control study in 36 Spanish hospitals. Patients hospitalized with confirmed pandemic influenza between November 2009 and February 2010 and two hospitalized controls per case, matched according to age, date of hospitalization and province of residence, were selected. Multivariate analysis was performed using conditional logistic regression. Subjects were considered vaccinated if they had received the vaccine >14 days (seasonal influenza vaccine) or >7 days (pandemic influenza vaccine) before the onset of symptoms (cases) or the onset of symptoms of the matched case (controls). For the pandemic influenza vaccine, vaccination effectiveness (VE) was estimated taking into account only patients recruited from November 23, 2009, seven days after the beginning of the pandemic influenza vaccination campaign. 638 cases and 1250 controls were included. The adjusted VE of the pandemic vaccine in the ≥18 years age group was 74.2% (95% CI, 29-90) and that of the influenza seasonal vaccine 15.0% (-34 to 43). The recommendation of influenza vaccination should be reinforced as a regular measure to reduce influenza-associated hospitalization during pandemics and seasonal epidemics.     

Quality of Life of Workers with an Intellectual Disability in Supported Employment

Aim This study investigate what characteristics of supported employment increase quality of life and whether quality of life is higher in supported employment workers or the sheltered ones in Spain. Typicalness, the degree to which the characteristics of a job are the same as those of co‐workers without a disability in the same company, was considered as one of the supported employment characteristics in the analysis. Method Two groups were put together to obtain the data using two questionnaires that were administered by trained professionals. Correlational analysis of the data and manova were also employed. Results No differences were found between the two groups regarding quality of life but results indicate that in supported employment, high levels of typicalness are associated with a higher quality of life and that the handling of certain characteristics of support and the job, for example the hours of direct external support, are related to the enhancement of quality of life of the workers. Conclusions Workers in supported employment show the same quality of life as those in sheltered employment centers. In Spain, the greater the typicalness of the employment, the higher the quality of life. The implications of this for the amount of direct external support for workers with disability is that such support should be used only when absolutely necessary – the minimum support necessary to encourage development.     

Applicability of the Spanish version of the Supports Intensity Scale (SIS), in the Mexican population with severe mental illness

This study presents the results obtained from the evaluation, by specialist judges, of the Supports Intensity Scale (SIS), Spanish version, to determine its suitability for the Mexican population with severe mental illness (SMI). The instrument, originally designed for people with intellectual disabilities, is consistent with the multidimensional concept of quality of life and the social model of disability. The semantic equivalence of the items adjusted by specialist judges, the reliability of the subscales, using Cronbach's alpha, and the concurrent validity between the SIS and the Global Functioning Assessment (GAF) were analyzed. The mean similarity to the original was 9.91 from a total of 10 (sd=0.14). The reliability coefficients were above 0.95 and the correlations between the SIS and the GAF were medium to high and significant. In conclusion, in the Mexican context, the SIS scale can be used to understand the needs and expectations of people with mental illness.     

Risk factors of influenza (H1N1) 2009 hospitalization and effectiveness of pharmaceutical and nonpharmaceutical interventions in its prevention: a case-control study

Potentially useful pharmaceutical measures to limit the impact of pandemic influenza in the community include antiviral drugs (neuraminidase inhibitors) and the influenza and pneumococcal vaccines, as influenza predisposes to bacterial pneumonia caused by Streptococcus pneumoniae. Non-pharmaceutical measures include hand washing and respiratory hygiene. Due to the lack of knowledge of the effectiveness of these measures in a pandemic situation, in September 2009, CIBER de Epidemiología y Salud Pública presented a multicenter case-control study, with controls matched for age, hospital and date of hospitalization, to investigate these aspects in 37 hospitals in 7 Spanish autonomous communities, in response to the call for research projects by the Ministry of Science and Innovation Research Program on Influenza A (H1N1) in Spain. For each confirmed hospitalized case of pandemic influenza, 1 confirmed outpatient case and 3 controls (2 hospitalized and 1 outpatient) were selected. Demographic variables, underlying medical conditions, use of antiviral agents, vaccines received and hygiene habits were collected for all cases and controls. In hospitalized cases, information on antiviral therapy and disease progression was collected. A total of 3750 patients were recruited by October 2010. Data cleansing and the recovery of variables is now underway. The involvement of the Public Health Directorate has been instrumental in adapting the project to the evolution of the pandemic.     

Temporary arterial clipping in surgery for cerebral aneurysms in acute subarachnoidal hemorrhage

Temporary clipping was used during operations in 69 patients. Of them, 51 patients underwent temporary arterial clipping, forced temporary arterial clipping was used in 18 patients. A total of 104 patients were operated on with preventive temporary clipping. Aneurysmal rupture occurred in 18 (17.3%) patients of them. The bioelectrical activity of the brain was intraoperatively monitored by using EEG and ECG in 12 patients of whom 11 felt rather well on discharge. The temporarily arterial clipping technique using EEG and ECG makes it possible to monitor the allowable time of temporary arterial clipping, which is in turn associated with a less risk for postoperative ischemic complications.     

Falsas creencias sobre las vacunas

Vaccines are an essential tool for the prevention of infectious diseases. However, false ideas and rumours with no scientific foundation about their possible negative effects may dissuade people from being vaccinated, with the consequent risks for the health of the population. The objective of this article is to evaluate the origin and the arguments of some of the most frequent mistaken ideas and rumours about the possible adverse effects of vaccines. Some clearly established adverse effects are presented, as well as false beliefs about various vaccines and potential harm to health. Vaccines, like any drug, can cause adverse effects, but the possible adverse effects of vaccination programs are clearly lower than their individual (vaccinated) and collective benefits (those vaccinated and those who cannot be vaccinated for medical reasons). The possible adverse effects attributable to vaccines should be detected by powerful and well-structured pharmacovigilance systems.