La cooperación internacional para el desarrollo en la prensa de Castilla y León

Producción CientíficaEste artículo presenta los hallazgos de un análisis de contenido cuantitativo sobre la presencia de la cooperación internacional para el desarrollo en doce periódicos que se distribuyen diariamente en Castilla y León. Entre enero y agosto de 2010 se publicaron 910 piezas periodísticas tratando esta cuestión, un volumen escaso en líneas generales y con una presencia irregular en todas las cabeceras. Estos contenidos, además, carecen de profundidad analítica, no incorporan el enfoque crítico necesario para comprender las complejas relaciones sobre las que se construye la cooperación entre países y, finalmente, priorizan los intereses locales sobre los aspectos de alcance global

Impact of rotavirus vaccination on seizure hospitalizations in children: A systematic review

Background: Previous studies found conflicting results about the effect of rotavirus (RV) vaccination on seizure hospitalizations in children younger than 5 years old. Objectives: To evaluate the evidence of the impact of RV vaccination on the prevention of seizure hospitalizations in children. Methods: A systematic review was conducted in the electronic database MEDLINE of all observational studies in children younger than 5 years old published since 2006. Two reviewers performed title/abstract, full-text review, and data extraction. Results: Thirteen studies met eligibility criteria. Nine studies reported a significant reduction in seizure hospitalizations upon RV vaccine introduction, three studies reported an absence of significant impact, and one study reported a significant rise in seizure hospitalization after the introduction of RV vaccines. Limitations: The great variability between study designs, case definitions and potential biases prevent quantifying the impact of RV vaccination against seizure hospitalizations. Conclusions: RV vaccination might prevent seizure hospitalizations in children; however, robust, and well-designed studies are needed to better determine the strength of this associationMedicin

Hospitalizations related to respiratory viral infections during the 2017/18 season in the Valencia Region of Spain

Objectives To describe the impact and severity of hospitalizations related to respiratory viral infections using data from weeks 2017-37 to 2018-19 in the Valencia Region of Spain. Methods All consenting admitted patients were included in the study if they were non-institutionalized, residents in any of the participating hospitals' catchment areas, not discharged from a previous hospital admission within 30 days, had an influenza-like illness (ILI, only for patients ≥5 years old) and were hospitalized within 7 days of the onset of symptoms. Demographic and clinical information was collected by interviewing and/or from clinical records. Swabs were tested by real-time reverse transcription polymerase chain reaction (RT-PCR) for influenza, respiratory syncytial virus (RSV), metapneumovirus, parainfluenza, rhinovirus/enterovirus, adenovirus, coronavirus and bocavirus. Hospitalization incidence rates were calculated by virus and age. Severity was explored through Intensive Care Unit (ICU) admission, death in hospital, mechanical ventilation, extracorporeal membrane oxygenation and the length of hospitalization. Results The hospitalization incidence rates related to respiratory viral infections were 1062.89, 31.38, 36.12 and 434.64 per 100,000 in patients <5, 5 to <18, 18 to <65 and ≥65 years old (y.o.), respectively. The incidence rates were especially high in children <1 y.o. and in adults ≥85 y.o.: 3311.94 and 1044.77 per 100,000, respectively. The highest rates were detected for influenza, rhinovirus/enterovirus and RSV: 63.11, 40.20 and 25.81 per 100,000, respectively. Among infected patients, 2% were admitted to the ICU, 4% needed mechanical ventilation and 4% died in hospital. No differences in severity were detected among viruses. The median length of hospitalization among infected patients was 5 days (Interquartile Range, IQR: 3-8 days). Conclusions Respiratory viral infections affected mainly young children and elderly people. Influenza, rhinovirus/enterovirus and RSV were the most commonly detected infections. No differences in severity were detected between the assessed viruses.Medicin

Impact of postherpetic neuralgia: A six year population-based analysis on people aged 50 years or older

Objectives: To estimate the incidence and burden of postherpetic neuralgia (PHN) and to investigate risk factors for PHN in the Valencia Region of Spain. Methods: Data were extracted from population and healthcare databases from the Valencia Region (2009–2014). Herpes zoster (HZ) and PHN were defined using ICD-9 codes and drug prescriptions in people aged ≥50 years. The risk of HZ patients for developing PHN and potential risk factors (diabetes mellitus, COPD and heart failure) were investigated. A survival analysis was developed to estimate the cumulative hazard of developing HZ and PHN between ages 50–90 years. Results: From a total of 2,289,485 subjects, 87,086 cases of HZ were registered, 13,658 (15.7%) of whom developed PHN. PHN risk was higher in women and increased sharply with age and comorbidities as diabetes mellitus, COPD and heart failure. The cumulative risk of developing HZ between ages 50–90 years was 31.7% (95% CI: 31.3-32.1) and 6.9 (95% CI: 6.7–7.1) for PHN. Conclusions: PHN risk was higher in women and increased with age and comorbidities. At least 32% and 7% of people will develop HZ and PHN, respectively, between ages 50–90 years. These results should be considered for vaccine policy implementation.The authors thank Topi Turunen for manuscript review. This study was funded by Sanofi Pasteur MSD (SPMSD).Medicin

Bronchiolitis, Regardless of Its Etiology and Severity, Is Associated With Increased Risk of Asthma: A Population-Based Study

An association exists between severe respiratory syncytial virus (RSV)–bronchiolitis and a subsequent increased risk of recurrent wheezing (RW) and asthma. However, a causal relationship remains unproven. Using a retrospective population-based cohort study (339 814 children), bronchiolitis during the first 2 years of life (regardless of etiology and severity) was associated with at least a 3-fold increased risk of RW/asthma at 2–4 years and an increased prevalence of asthma at ≥5 years of age. The risk was similar in children with mild bronchiolitis as in those with hospitalized RSV-bronchiolitis and was higher in children with hospitalized non-RSV-bronchiolitis. The rate of RW/asthma was higher when bronchiolitis occurred after the first 6 months of life. Our results seem to support the hypothesis of a shared predisposition to bronchiolitis (irrespective of etiology) and RW/ asthma. However, 60% of hospitalized bronchiolitis cases in our setting are due to RSV, which should be paramount in decision-making on imminent RSV prevention strategiesMedicin

Herpes zoster risk and burden of disease in immunocompromised populations: a population-based study using health system integrated databases, 2009–2014

Background: Estimate the incidence of herpes zoster (HZ), its complications and healthcare utilization rates in adults (≥ 18-years-old) with a wide range of immunocompromised (IC) conditions compared to IC-free cohort. Method: A population-based retrospective study using the Valencia healthcare Integrated Databases (VID) (2009– 2014). HZ and IC were defined using ICD-9 codes in primary care (PC) and hospitalization registers. Incidence rates (IR), risk of HZ, HZ-recurrence, HZ-complications and healthcare utilization rates were estimated in the IC-cohort compared to IC-free. Results: The study population consisted of 4,382,590 subjects, of which 578,873 were IC (13%). IR (in 1000 persons-year) of HZ overall, in IC and in IC-free cohort was 5.02, 9.15 and 4.65, respectively. IR of HZ increased with age in both cohorts and it was higher for all IC conditions studied, reaching up to twelvefold in subjects with stem cell transplantation. IC subjects had 51% higher risk of developing HZ, 25% higher HZrecurrence and the risk of HZ-complications was 2.37 times higher than in IC-free. HZ-related healthcare utilization was higher in the IC-cohort than in IC-free (number of hospitalizations 2.93 times greater, hospital stays 12% longer, 66% more HZ-specialist visits, 2% more PC visits, sick leaves 18% longer and 20% higher antiviral dispensation). Conclusions: Patients suffering from all the IC conditions studied are at higher risk of developing HZ, HZrecurrence and post-herpetic complications, which implies a substantial morbidity and a high consumption of resources. These results should be considered for vaccine policy implementation.Funding for this study was provided by GlaxoSmithKline Biologicals SA (GSK study identifier 207685). GlaxoSmithKline Biologicals SA was provided the opportunity to review a preliminary version of this manuscript for factual accuracy but the authors are solely responsible for final content and interpretation. The Company (GSK) had no role in the analysis or discussion of the results.Medicin

Epidemiology of schizophrenia and its management over 8-years period using real-world data in Spain

Background: Real-World Data (RWD) studies provide important insights in disease epidemiology, in real clinical populations, with long follow-up periods. The aim of the present study was to describe the epidemiology of schizophrenia spectrum disorders (SD) during an 8-year period in Spain. Methods: A retrospective cohort of subjects aged 15 to 64 years was followed-up using electronic healthcare databases of the Valencia region (2008–2015). SD cases included outpatient and inpatient settings (ICD 9 codes 295.XX). Prevalence of SD was assessed. Incidence rate (IR) in the subpopulation aged between 15 and 34 years was also provided. Healthcare utilization (HCU) rates, including outpatient, specialists, hospitalizations and antipsychotic dispensations were estimated. Results: The cohort included 3,976,071 subjects; 24,749 of them had a prevalent diagnosis of SD. The overall prevalence for SD was 6.2 per 1000 persons. SD were 76% more prevalent in men than women. IR in the subpopulation aged between 15 and 34 years was 50.25 per 100,000 persons years and was more than 2 times higher for men than for women. 83.4% of the overall outpatient visits from the cohort of patients were related to SD. The 21,095 overall hospitalizations with the SD code resulted in 286,139 days of hospitalization, with a median of 4 days (IQR: 1.6–9.2) per person-year. 93.2% of subjects diagnosed with SD were ever treated with some antipsychotic drug during the study period, and 70% of the patients were ever treated with antipsychotic polypharmacy. Conclusions: This large population-based study using RWD provides novel and recent information SD in a southern European country. The prevalence and IR of SD showed is greater than previously published and higher in men than in women. The fact of having used a large arsenal of electronic data (including outpatient and inpatient) for 8 years may have influenced. SD represents high burden and healthcare utilization. Contrary to guidelines recommendations the majority of patients were ever treated with antipsychotic polypharmacy.This study was supported by Janssen pharmaceutical. The company had no role in the analysis or discussion of the resultMedicin

Supplementary Material. Quality of Life Impact of an Adjuvanted Recombinant Zoster Vaccine in Adults Aged 50 Years and Older

Supplementary Material Quality of Life Impact of an Adjuvanted Recombinant Zoster Vaccine in Adults Aged 50 Years and OlderMedicin

Human papillomavirus vaccines effectiveness to prevent genital warts: A population-based study using health system integrated databases, 2009-2017.

Objectives: To assess the effectiveness of the HPV vaccines in preventing genital warts (GW) in women aged 14–23 years and to estimate the incidence of GW in the whole population aged from 14 to 65. Design: Population-based retrospective cohort study using real-world data from the Valencia health system Integrated Databases (VID). Study population: All subjects aged 14–65 years residing in the Valencia Region during 2009–2017 (n = 4,492,724), including a cohort of 563,240 females aged 14–23 years followed-up for the vaccine effectiveness (VE) estimations. Main outcome measures: Incident cases of GW defined as the first activation of GW-related codes (ICD-9- CM 078.11 or ICD-10-CM A63.0) in hospital, primary and specialized care during the study period. Adjusted VE was estimated as (1-Relative Risk (RR)) 100 by a negative binomial Bayesian model. Results: There were 23,049 cases of GW in the overall population and 2,565 in the females’ cohort 14– 23 years old. The incidence rate (IR) (in 100,000 persons-year) was 69.1 (95% CI 68.21–69.99) in the population overall, being higher in men (72.73; 95% CI 71.45–74.04). The IR of GW was 104.08 (95% CI 100.79–108.94) in the cohort of young women. The RR of GW increased with age from 14 to 21 years, reaching a plateau from 21 to 23. The VE of a complete schedule was 74% (95% CrI 68–79) for quadrivalent HPV vaccine (HPV4v). No effectiveness was seen with a full vaccination course with the bivalent HPV vaccine (HPV2v) in girls up to 21 years old. GW IR tends to be higher in unvaccinated cohorts covered by HPV4v vaccine than in unvaccinated cohorts not covered by HPV4v vaccine. Conclusions: A complete HPV4v vaccination schedule was 74% effective in reducing GW in our population. Our results also suggest an indirect protection to unvaccinated and HPV2v vaccinated girlsThis study has been funded by MSD. MSD had no role in the design, collection, analysis, interpretation of the data and writing of the article, and had no access to the data. MSD did not intervene in the decision to submit the manuscript for publication.Medicin

Knowledge and attitudes of Spanish adolescent girls towards human papillomavirus infection: where to intervene to improve vaccination coverage

Background: HPV vaccine coverage is far from ideal in Valencia, Spain, and this could be partially related to the low knowledge about the disease and the vaccine, therefore we assessed these, as well as the attitude towards vaccination in adolescent girls, and tried to identify independently associated factors that could potentially be modified by an intervention in order to increase vaccine coverage. Methods: A cross sectional study was conducted in a random selection of schools of the Spanish region of Valencia. We asked mothers of 1278 girls, who should have been vaccinated in the 2011 campaign, for informed consent. Those that accepted their daughters’ participation, a questionnaire regarding the Knowledge of HPV infection and vaccine was passed to the girls in the school. Results: 833 mothers (65.1%) accepted participation. All their daughters’ responded the questionnaire. Of those, 89.9% had heard about HPV and they associated it to cervical cancer. Only 14% related it to other problems like genital warts. The knowledge score of the girls who had heard about HPV was 6.1/10. Knowledge was unrelated to the number of contacts with the health system (Pediatrician or nurse), and positively correlated with the discussions with classmates about the vaccine. Adolescents Spanish in origin or with an older sister vaccinated, had higher punctuation. 67% of the girls thought that the vaccine prevented cancer, and 22.6% felt that although prevented cancer the vaccine had important safety problems. 6.4% of the girls rejected the vaccine for safety problems or for not considering themselves at risk of infection. 71.5% of the girls had received at least one vaccine dose. Vaccinated girls scored higher knowledge (p = 0.05). Conclusion: Knowledge about HPV infection and vaccine was fair in adolescents of Valencia, and is independent to the number of contacts with the health system, it is however correlated to the conversations about the vaccine with their peers and the vaccination status. An action to improve HPV knowledge through health providers might increase vaccine coverage in the adolescents.This study was sponsored by Sanofi Pasteur – MSD