The cost effectiveness of influenza vaccination for adults aged 50 to 64 years: a model-based analysis for Spain

An economic evaluation of reducing the age threshold for routine influenza vaccination in Spain from 65 to 50 years was performed. A probabilistic model was used to compare a policy based on a recommendation to vaccinate all adults aged 50-64 with the existing vaccination policy for that age group, during interpandemic periods. Two perspectives were considered: third-party payer (TPP) and societal. Model inputs were obtained primarily from the published literature and validated through expert opinion. From TPP perspective, incremental cost-effectiveness ratios were estimated at euro14,919 per quality-adjusted life-year (QALY) gained and euro9731 per life-year gained. From societal perspective, the corresponding results were euro4149 per QALY and euro2706 per life-year gained. Extending routine influenza vaccination to people over 50 years of age is likely to be cost-effective.     

Smoking during pregnancy according to obstetric complications and parity: results of the EUROPOP study

This study aimed to analyse the relationship between smoking and preterm birth (22-36 weeks) according to the main obstetric complications leading to the preterm birth, both overall and by parity. The EUROPOP study is a case-control study carried out between 1994 and 1997; 3,787 preterm and 5,602 full-term births were included, from maternity units in 10 countries, using the same protocol. Social, demographic and medical information was collected after delivery, from obstetric records and interviews with the mothers. Cases were classified according to the main obstetric complication (hypertension, haemorrhage, preterm premature rupture of membranes (PPROM), idiopathic spontaneous preterm labour, intrauterine growth retardation, all other causes). Multiple logistic regression analysis was used to control for confounders. Twenty four percent of cases and 20% of controls were smokers. Smoking during pregnancy, heavy smoking (>or=10 cigarettes per day) in particular, was a risk factor for preterm birth (aOR = 1.39, 95% CI:1.20-1.60). Smoking increased the risk of preterm delivery due to all obstetric complications other than hypertension. For these complications, the risk of preterm delivery associated with smoking was higher for multiparae (aOR = 1.46, 95% CI:1.24-1.71) than for primiparae (aOR = 1.18, 95% CI:1.00-1.38). In conclusion, smoking during pregnancy increases the risk of preterm birth among women with all obstetric complications except hypertension. This association is stronger in multiparae than in primiparae and the risk is higher for heavy smokers.     

Polychlorinated biphenyl contamination of the spider crab (Maja brachydactyla): influence of physiological and ecological processes

Maja brachydactyla is a decapod crustacean widely distributed along the Northeast Atlantic coasts. The main objective of this work was to establish the influence of ontogenic factors, such as growth, aging, seasonal migrations, and reproduction, on the contamination of this species by polychlorinated biphenyls (PCBs). Two populations were studied: One in the Seine Bay (Eastern English Channel), which is exposed to greatly contaminated discharges from the Seine River, and one in the Iroise Sea (Western Brittany), which is little contaminated by such man-made compounds. At both sampling areas, PCB analysis revealed concentrations in hepatopancreas that were 10- and 50-fold higher than concentrations in gonads and muscle, respectively. Levels of 2,2',4,4',5,5'-hexachlorobiphenyl (CB153) increased with the age of the spider crabs, whereas their seasonal migrations had no direct effect. No significant sex effect was observed with regards to CB153 levels, but adult females exhibited PCB fingerprints different from those of males, probably because of the influence of the reproductive cycle on enzymatic system activity. Finally, spawning gave rise to a higher CB153 decontamination of female body burdens for specimens from the Iroise Sea than for those from the Seine Bay.     

Combination of quinupristin-dalfopristin and gentamicin against methicillin-resistant Staphylococcus aureus: experimental rabbit endocarditis study

The combination of quinupristin-dalfopristin (Q-D) and gentamicin was tested against two strains of gentamicin- and dalfopristin-susceptible methicillin-resistant Staphylococcus aureus (MRSA). One strain was susceptible to macrolides, lincosamides, and streptogramin B type antibiotics (MLS(B)), and the other was constitutively resistant to these antibiotics by virtue of the ermA gene. The checkerboard method and time-kill curves showed that the combination of Q-D and gentamicin was indifferent. A rabbit endocarditis model simulated the pharmacokinetics achieved in humans receiving intravenous injections of Q-D (7.5 mg/kg of body weight three times a day) and gentamicin (3 mg/kg once daily). For the MLS(B)-susceptible strain, a 4-day regimen reduced mean bacterial titers (MBT) in vegetations from 8.5 +/- 0.8 log CFU/g (control group) to 4.1 +/- 2.6 (gentamicin), 3.0 +/- 0.9 (Q-D), and 2.6 +/- 0.5 log CFU/g (Q-D plus gentamicin). For the strain constitutively resistant to MLS(B), a 4-day regimen reduced MBT in vegetations from 8.7 +/- 0.9 log CFU/g (control group) to 5.0 +/- 2.2 (gentamicin), 5.2 +/- 2.2 (Q-D), and 5.1 +/- 2.4 log CFU/g (Q-D plus gentamicin). The differences between control and treatment groups were significant for both strains (P < 0.0001), although there was no significant difference between treatment groups. No resistant variant was isolated from vegetations, and no significant difference in MBT in vegetations of treatment groups after 1-day regimens was observed. This experimental study found no additive benefit in combining Q-D and gentamicin against dalfopristin- and gentamicin-susceptible MRSA.     

Anatomical Congruence of Metabolic and Electromagnetic Activation Signals during a Self-Paced Motor Task: A Combined PET–MEG Study

We have investigated the degree of spatial correlation between the cerebral blood flow variations measured by positron emission tomography (PET) and the electromagnetic sources as measured by magnetoencephalography (MEG) in five subjects while performing a self-paced right index finger tapping task. Data were processed independently for each technique using both single-case and intersubject analysis. PET and MEG were coregistered with anatomical magnetic resonance images for each subject. Both extension and flexion motor-related fields were extracted from the MEG signal. Using the single dipole model we identified the motor evoked field 1 (MEF1) in all subjects and the motor field (MF) in three subjects. Individual and intersubject averaged PET data showed consistent contralateral primary sensorimotor (PSM) hand area and bilateral supplementary motor area activation. MEG individual and intersubject averaged results demonstrated that both MEF1 and MF dipoles were localized within the PSM PET activated area. Individual PSM mass center to dipole distance was 12 and 15.3 mm on average for the MEF1 and the MF component, respectively. For the same components, the intersubject averaged analysis shows distances between the PETZ-score maximum and the dipole locations of 6.3 and 15.0 mm, respectively. These results show that PET and MEG MEF1 activation signals spatially coincide within instrumental, registration, and modeling errors.