Passive smoking at home is a risk factor for community-acquired pneumonia in older adults: a population-based case-control study

OBJECTIVE: To assess whether passive smoking exposure at home is a risk factor for community-acquired pneumonia (CAP) in adults. SETTING: A population-based case-control study was designed in a Mediterranean area with 860 000 inhabitants >14 years of age. PARTICIPANTS: 1003 participants who had never smoked were recruited. PRIMARY AND SECONDARY OUTCOME MEASURES: Risk factors for CAP, including home exposure to passive smoking, were registered. All new cases of CAP in a well-defined population were consecutively recruited during a 12-month period. METHODS: A population-based case-control study was designed to assess risk factors for CAP, including home exposure to passive smoking. All new cases of CAP in a well-defined population were consecutively recruited during a 12-month period. The subgroup of never smokers was selected for the present analysis. RESULTS: The study sample included 471 patients with CAP and 532 controls who had never smoked. The annual incidence of CAP was estimated to be 1.14 cases×10(-3) inhabitants in passive smokers and 0.90×10(-3) in non-passive smokers (risk ratio (RR) 1.26; 95% CI 1.02 to 1.55) in the whole sample. In participants ≥65 years of age, this incidence was 2.50×10(-3) in passive smokers and 1.69×10(-3) in non-passive smokers (RR 1.48, 95% CI 1.08 to 2.03). In this last age group, the percentage of passive smokers in cases and controls was 26% and 18.1%, respectively (p=0.039), with a crude OR of 1.59 (95% CI 1.02 to 2.38) and an adjusted (by age and sex) OR of 1.56 (95% CI 1.00 to 2.45). CONCLUSIONS: Passive smoking at home is a risk factor for CAP in older adults (65 years or more)

Relationship between the use of inhaled steroids for chronic respiratory diseases and early outcomes in community-acquired pneumonia.

Background The role of inhaled steroids in patients with chronic respiratory diseases is a matter of debate due to the potential effect on the development and prognosis of community-acquired pneumonia (CAP). We assessed whether treatment with inhaled steroids in patients with chronic bronchitis, COPD or asthma and CAP may affect early outcome of the acute pneumonic episode. Methods Over 1-year period, all population-based cases of CAP in patients with chronic bronchitis, COPD or asthma were registered. Use of inhaled steroids were registered and patients were followed up to 30 days after diagnosis to assess severity of CAP and clinical course (hospital admission, ICU admission and mortality). Results Of 473 patients who fulfilled the selection criteria, inhaled steroids were regularly used by 109 (23%). In the overall sample, inhaled steroids were associated with a higher risk of hospitalization (OR=1.96, p = 0.002) in the bivariate analysis, but this effect disappeared after adjusting by other severity-related factors (adjusted OR=1.08, p=0.787). This effect on hospitalization also disappeared when considering only patients with asthma (OR=1.38, p=0.542), with COPD alone (OR=4.68, p=0.194), but a protective effect was observed in CB patients (OR=0.15, p=0.027). Inhaled steroids showed no association with ICU admission, days to clinical recovery and mortality in the overall sample and in any disease subgroup. Conclusions Treatment with inhaled steroids is not a prognostic factor in COPD and asthmatic patients with CAP, but could prevent hospitalization for CAP in patients with clinical criteria of chronic bronchitis

Changes in Muscle Contractile Properties after Cold- or Warm-Water Immersion Using Tensiomyography: A Cross-Over Randomised Trial

Muscle contractile properties in clinical practice are often measured using either subjective scales or high-cost, inaccessible equipment. In this randomised cross-over study, we aimed to explore the use of tensiomyography (TMG) to assess changes in muscle contractile properties after cold- and warm-water immersion. The muscle contractile properties of the biceps femoris (BF) were assessed using TMG in 12 healthy active men (mean age 23 +/- 3 years, Body Mass Index 22.9 +/- 1.3 kg/m(2)) before and after a 20-min warm- or cold-water immersion over a period of 40 min. Muscle displacement (Dm) and contraction time (Tc) were registered as the main variables of the study. There was a significant condition by time interaction for Dm (p < 0.01). Post hoc analysis showed that, compared to the baseline, there was an increase in Dm 40 min after warm-water immersion (p < 0.01) and a decrease at 10 min after cold-water immersion (p < 0.01). No significant effect was found for Tc. Our results indicate that muscle contractile properties are affected by water temperature and time after the immersion; therefore, these factors should be taken into account when water-immersion is used as a recovery strategy

Changes in Muscle Contractile Properties after Cold- or Warm-Water Immersion Using Tensiomyography: A Cross-Over Randomised Trial

Muscle contractile properties in clinical practice are often measured using either subjective scales or high-cost, inaccessible equipment. In this randomised cross-over study, we aimed to explore the use of tensiomyography (TMG) to assess changes in muscle contractile properties after cold- and warm-water immersion. The muscle contractile properties of the biceps femoris (BF) were assessed using TMG in 12 healthy active men (mean age 23 &plusmn; 3 years, Body Mass Index 22.9 &plusmn; 1.3 kg/m2) before and after a 20-min warm- or cold-water immersion over a period of 40 min. Muscle displacement (Dm) and contraction time (Tc) were registered as the main variables of the study. There was a significant condition by time interaction for Dm (p &lt; 0.01). Post hoc analysis showed that, compared to the baseline, there was an increase in Dm 40 min after warm-water immersion (p &lt; 0.01) and a decrease at 10 min after cold-water immersion (p &lt; 0.01). No significant effect was found for Tc. Our results indicate that muscle contractile properties are affected by water temperature and time after the immersion; therefore, these factors should be taken into account when water-immersion is used as a recovery strategy

Reduction of pharmaceutical expenditure by a drug appropriateness intervention in polymedicated elderly subjects in Catalonia

To assess the monetary savings resulting from a pharmacist intervention on the appropriateness of prescribed drugs in community-dwelling polymedicated (≥8 drugs) elderly people (≥70 years). (...

Factores individuales y del entorno asociados a la variabilidad geográfica de los trastornos psicológicos entre áreas pequeñas: un análisis multinivel

Fundamento: Para planificar las necesidades de servicios sanitarios es fundamental conocer la distribución de la morbilidad por trastornos psicológicos en el territorio así como los factores que la determinan. El objetivo es identificar los factores que pueden explicar la variabilidad geográfica de estos trastornos en Cataluña. Métodos: Los datos proceden de la Encuesta de Salud de l994 y de la estadística de población de l996 para Cataluña. Se estima la prevalencia de trastornos psicológicos por edad y sexo y por sector sanitario. En un modelo de regresión logística a dos niveles se estudia la asociación entre las variables individuales (primer nivel: Encuesta de Salud n=12.455) y las de la zona de residencia (segundo nivel: el sector sanitario, n= 46) con la prevalencia de trastornos psicológicos. Resultados: Las variables individuales que influyen en las diferencias entre sectores son: la edad (45-64 años OR:0,63 y >64 años: OR:0,22), la situación laboral (no trabaja OR:1,60) y el número de trastornos crónicos (TC) (TC=1 OR: 1,75 TC=2 OR: 2,06 TC=3-5 OR:3,36 y TC>5 OR: 8,9) en hombres. En las mujeres, además de estas variables (edad 25-44 años OR: 0,63 45-64 años OR:0,45 y >64 años OR: 0,32 la situación laboral no trabaja OR:1,30 y el número de trastornos crónicos (TC) TC=1 OR: 1,75 TC=2 OR: 2,44 TC=3-5 OR:4,09 y TC>5 OR: 11,14), influye el tipo de hogar (monoparental OR: 1,42). Las variables a nivel de la zona de residencia son la proporción de inmigración (hombres OR:1,55 y mujeres OR:1,68) y de desempleo (hombres OR:1,07 y mujeres OR:1,06). Conclusiones: Los factores individuales no son suficientes para explicar la variabilidad geográfica de la prevalencia de los trastornos psicológicos, ya que también influyen las características de la zona de residencia

Factores individuales y del entorno asociados a la variabilidad geográfica de los trastornos psicológicos entre áreas pequeñas: un análisis multinivel

Fundamento: Para planificar las necesidades de servicios sanitarios es fundamental conocer la distribución de la morbilidad por trastornos psicológicos en el territorio así como los factores que la determinan. El objetivo es identificar los factores que pueden explicar la variabilidad geográfica de estos trastornos en Cataluña. Métodos: Los datos proceden de la Encuesta de Salud de l994 y de la estadística de población de l996 para Cataluña. Se estima la prevalencia de trastornos psicológicos por edad y sexo y por sector sanitario. En un modelo de regresión logística a dos niveles se estudia la asociación entre las variables individuales (primer nivel: Encuesta de Salud n=12.455) y las de la zona de residencia (segundo nivel: el sector sanitario, n= 46) con la prevalencia de trastornos psicológicos. Resultados: Las variables individuales que influyen en las diferencias entre sectores son: la edad (45-64 años OR:0,63 y >64 años: OR:0,22), la situación laboral (no trabaja OR:1,60) y el número de trastornos crónicos (TC) (TC=1 OR: 1,75 TC=2 OR: 2,06 TC=3-5 OR:3,36 y TC>5 OR: 8,9) en hombres. En las mujeres, además de estas variables (edad 25-44 años OR: 0,63 45-64 años OR:0,45 y >64 años OR: 0,32 la situación laboral no trabaja OR:1,30 y el número de trastornos crónicos (TC) TC=1 OR: 1,75 TC=2 OR: 2,44 TC=3-5 OR:4,09 y TC>5 OR: 11,14), influye el tipo de hogar (monoparental OR: 1,42). Las variables a nivel de la zona de residencia son la proporción de inmigración (hombres OR:1,55 y mujeres OR:1,68) y de desempleo (hombres OR:1,07 y mujeres OR:1,06). Conclusiones: Los factores individuales no son suficientes para explicar la variabilidad geográfica de la prevalencia de los trastornos psicológicos, ya que también influyen las características de la zona de residencia

Passive smoking at home is a risk factor for community-acquired pneumonia in older adults: a population-based case-control study

OBJECTIVE: To assess whether passive smoking exposure at home is a risk factor for community-acquired pneumonia (CAP) in adults. SETTING: A population-based case-control study was designed in a Mediterranean area with 860 000 inhabitants >14 years of age. PARTICIPANTS: 1003 participants who had never smoked were recruited. PRIMARY AND SECONDARY OUTCOME MEASURES: Risk factors for CAP, including home exposure to passive smoking, were registered. All new cases of CAP in a well-defined population were consecutively recruited during a 12-month period. METHODS: A population-based case-control study was designed to assess risk factors for CAP, including home exposure to passive smoking. All new cases of CAP in a well-defined population were consecutively recruited during a 12-month period. The subgroup of never smokers was selected for the present analysis. RESULTS: The study sample included 471 patients with CAP and 532 controls who had never smoked. The annual incidence of CAP was estimated to be 1.14 cases×10(-3) inhabitants in passive smokers and 0.90×10(-3) in non-passive smokers (risk ratio (RR) 1.26; 95% CI 1.02 to 1.55) in the whole sample. In participants ≥65 years of age, this incidence was 2.50×10(-3) in passive smokers and 1.69×10(-3) in non-passive smokers (RR 1.48, 95% CI 1.08 to 2.03). In this last age group, the percentage of passive smokers in cases and controls was 26% and 18.1%, respectively (p=0.039), with a crude OR of 1.59 (95% CI 1.02 to 2.38) and an adjusted (by age and sex) OR of 1.56 (95% CI 1.00 to 2.45). CONCLUSIONS: Passive smoking at home is a risk factor for CAP in older adults (65 years or more)