Intradermal and virosomal influenza vaccines for preventing influenza hospitalization in the elderly during the 2011–2012 influenza season: A comparative effectiveness study using the Valencia health care information system

AbstractBackgroundThe use of intradermal vaccination or virosomal vaccines could increase protection against influenza among the vulnerable population of older adults. Studies assessing the comparative effectiveness of these two influenza vaccine types in this age group are lacking.MethodsWe conducted a retrospective cohort study to estimate the comparative effectiveness of intradermal seasonal trivalent-influenza vaccine (TIV) delivered by a microneedle injection system and a virosomal-TIV intramuscularly delivered for prevention of influenza hospitalization in non-institutionalized adults aged ≥65 years. We obtained administrative data on immunization status and influenza hospitalization for the 2011–2012 influenza season, and used Cox regression models to assess comparative effectiveness. We estimated crude and adjusted (age, sex, comorbidity, pharmaceutical claims, recent pneumococcal vaccination and number of hospitalizations for all causes other than influenza between the previous and current influenza seasons) hazard ratios (HR).ResultsOverall, 164,021 vaccinated subjects were evaluated. There were 127 hospitalizations for influenza among 62,058 subjects, contributing 914,740 person-weeks at risk in the virosomal-TIV group, and 133 hospitalizations for influenza among 101,963 subjects, contributing 1,504,570 person-weeks at risk in the intradermal-TIV group. The crude HR of intradermal-TIV relative to virosomal-TIV was 0.64 (95% confidence interval (CI): 0.50–0.81), and the adjusted Cox estimated HR was 0.67 (95% CI: 0.52–0.85).ConclusionsDuring the 2011–2012 influenza season the risk of hospitalization for influenza was reduced by 33% in non-institutionalized elderly adults who were vaccinated with intradermal-TIV compared with virosomal-TIV

Diffusion in crowded biological environments: applications of Brownian dynamics

Biochemical reactions in living systems occur in complex, heterogeneous media with total concentrations of macromolecules in the range of 50 - 400 mgml. Molecular species occupy a significant fraction of the immersing medium, up to 40% of volume. Such complex and volume-occupied environments are generally termed 'crowded' and/or 'confined'. In crowded conditions non-specific interactions between macromolecules may hinder diffusion - a major process determining metabolism, transport, and signaling. Also, the crowded media can alter, both qualitatively and quantitatively, the reactions in vivo in comparison with their in vitro counterparts. This review focuses on recent developments in particle-based Brownian dynamics algorithms, their applications to model diffusive transport in crowded systems, and their abilities to reproduce and predict the behavior of macromolecules under in vivo conditions

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Uso y abuso de abreviaturas y siglas entre atención primaria, especializada y hospitalaria

La publicación original está disponible en: http://www.sedom.es/3_papeles/index.jsp[ES] [Introducción] Las abreviaciones se utilizan en todos los documentos asistenciales creando serios problemas de comunicación entre los profesionales y con los pacientes. El objetivo de este trabajo es analizar las abreviaciones aparecidas en los documentos de intercambio de información entre los diversos niveles asistenciales: hojas de urgencias del hospital, hojas de alta hospitalaria, hojas de interconsulta de especializada e Informes clínicos de especializada. [Material y métodos] Cinco médicos del Centro de Salud de Xàtiva analizaron, desde el 11 de abril al 11 de mayo de 2005, 87 documentos identificando las abreviaciones que contenían. En cada abreviación se calculó su frecuencia y se buscó su significado, procedencia (atención primaria, especializada u hospitalaria), servicio, así como la existencia de siglas polisémicas. [Resultados] Se recogieron 433 abreviaciones diferentes en las 1.253 registradas, de las que 25 aparecían 10 o más veces. Las más frecuentes fueron “h”, “AP” y “a”. La mayor parte procedían de Urgencias Hospitalarias (72%), Medicina Interna- Ingreso hospitalario (6,2%) y Atención primaria (5,8%). Algunas eran polisémicas, como “h” (que puede significar “hora”, “historia” y “hemograma”) y otras veces se utilizan diferentes formas para abreviar un mismo concepto. [Discusión] Las abreviaciones en los documentos clínicos suelen utilizarse para economizar espacio y tiempo y para evitar el empleo de enfermedades o procesos graves, incurables o vergonzosos. Muchas de ellas no están consensuadas por la comunidad y son inventadas, por lo que resultan difíciles de entender y entorpecen el flujo de comunicación entre los diversos niveles asistenciales y la correcta transmisión del conocimiento.[EN] [Introduction] Abbreviations are used in all the welfare documents creating serious problems of communication among and as well as with patients. The objective of this work is to analyze the abbreviations appeared in the information exchange documents among the diverse welfare levels: emergency room records, hospital discharge summary, consultation reports and clinical reports addressed to specialists. [Method] Five doctors of the primary care health center of Xàtiva (Spain) analyzed, 87 documents from April 11th to May 11 th, 2005, identifying the abbreviations that contained. The frequency of each abbreviation was calculated and what did they stand for, origin (primary care health, specialized care or hospital care), department, as well as the existence of polysemic acronyms. [Results] 433 different abbreviations were collected in the 1.253 registered, 25 of them appearing 10 or more times. The most frequent were “h”, “AP” and “a”. The majority of them came from hospital emergencies (72%), internal medicine hospital admission (6,2%) and primary care health (5,8%). Some them were polysemic, as “h” (that may have different meanings as “hour”, “history” and “hemogram”) and some different forms are used to shorten the same concept. [Discussion] The abbreviations in clinical documents are usually used to save space and time and to avoid naming of illnesses, incurable or shameful processes. Many of them are not agreed by the community and they are made up, that is why they are difficult to understand and they hinder the flow of communication among different welfare levels and the correct transmission of the knowledge.Peer reviewe