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Redondo E, Rivero-Calle I, Mascarós E, Yuste JE, Fernández-Prada M, Ocaña D, Jimeno I, Gil A, Molina J, Díaz-Maroto JL, Linares M, Martinón-Torres F. [Vaccination against community acquired pneumonia in adults. Update 2021 of the position paper by Neumoexpertos en Prevención Group]. Semergen 2021; 47:411-425. [PMID: 34332864 DOI: 10.1016/j.semerg.2021.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 12/13/2022]
Abstract
Community-acquired pneumonia (CAP) continues to be an important cause of morbidity and mortality in adults. The aim of this study is to update the practical prevention guide for CAP through vaccination in Spain developed in 2016 and updated in 2018, based on available vaccines and evidence through bibliographic review and expert opinion. The arrival of COVID-19 as a new cause of CAP and the recent availability of safe and effective vaccines constitutes the most significant change. Vaccines against pneumococcus, influenza, pertussis and COVID-19 can help to reduce the burden of disease from CAP and its associated complications. The available evidence supports the priority indications established in this guide, and it would be advisable to try to achieve a widespread dissemination and implementation of these recommendations in routine clinical practice.
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Affiliation(s)
- E Redondo
- Medicina de Familia, Grupo de Actividades Preventivas y Salud Pública SEMERGEN, Centro de Salud Internacional, Ayuntamiento de Madrid, Madrid, España.
| | - I Rivero-Calle
- Servicio de Pediatría, Sección de Pediatría Clínica, Infectológica y Traslacional, Hospital Clínico Universitario, Santiago de Compostela, A Coruña, España; Genética Vacunas e Infecciones Pediátricas (GENVIP), Instituto de Investigación de Santiago, Santiago de Compostela, A Coruña, España
| | - E Mascarós
- Medicina de Familia, Departamento de Salud Hospital la Fe, Consultorio Auxiliar Arquitecto Tolsá, Valencia, España
| | - J E Yuste
- Centro Nacional de Microbiología, Instituto de Salud Carlos III y CIBER de Enfermedades Respiratorias (CIBERES), Madrid, España
| | - M Fernández-Prada
- Unidad de Vacunas, Servicio Medicina Preventiva y Salud Pública, Hospital Vital Álvarez Buylla, Mieres, Asturias, España
| | - D Ocaña
- Medicina de Familia, Centro de Atención Primaria Algeciras-Norte, Algeciras, Cádiz, España
| | - I Jimeno
- Medicina de Familia, Centro de Salud Isla de Oza, Madrid, España
| | - A Gil
- Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Madrid, España
| | - J Molina
- Medicina de Familia, Centro de Atención Primaria Francia, Fuenlabrada, Madrid, España
| | - J L Díaz-Maroto
- Medicina de Familia, Centro de Atención Primaria de Guadalajara, Guadalajara, España
| | - M Linares
- Medicina de Familia, Microbiología clínica, Miembro del Grupo de Enfermedades Infecciosas de SEMERGEN. Fundación iO, España
| | - F Martinón-Torres
- Servicio de Pediatría, Sección de Pediatría Clínica, Infectológica y Traslacional, Hospital Clínico Universitario, Santiago de Compostela, A Coruña, España; Genética Vacunas e Infecciones Pediátricas (GENVIP), Instituto de Investigación de Santiago, Santiago de Compostela, A Coruña, España
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2
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Bouza E, Alvar A, Almagro P, Alonso T, Ancochea J, Barbé F, Corbella J, Gracia D, Mascarós E, Melis J, Miravitlles M, Pastor M, Pérez P, Rudilla D, Torres A, Soriano JB, Vallano A, Vargas F, Palomo E. Chronic obstructive pulmonary disease (COPD) in Spain and the different aspects of its social impact: a multidisciplinary opinion document. Rev Esp Quimioter 2020; 33:49-67. [PMID: 31933347 PMCID: PMC6987629 DOI: 10.37201/req/2064.2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/24/2019] [Accepted: 12/02/2019] [Indexed: 12/21/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the most prevalent diseases in the World, and one of the most important causes of mortality and morbidity. In adults 40 years and older, it affects more than 10% of the population and has enormous personal, family and social burden. Tobacco smoking is its main cause, but not the only one, and there is probably a genetic predisposition that increases the risk in some patients. The paradigm of this disease is changing in Spain, with an increase of women that has occurred in recent years. Many of the physio pathological mechanisms of this condition are well known, but the psychological alterations to which it leads, the impact of COPD on relatives and caregivers, the limitation of daily life observed in these patients, and the economic and societal burden that they represent for the health system, are not so well-known. A major problem is the high under-diagnosis, mainly due to difficulties for obtaining, in a systematic way, spirometries in hospitals and health-care centers. For this reason, the Fundación de Ciencias de la Salud and the Spanish National Network Center for Research in Respiratory Diseases (CIBERES) have brought together experts in COPD, patients and their organizations, clinical psychologists, experts in health economics, nurses and journalists to obtain their opinion about COPD in Spain. They also discussed the scientific bibliometrics on COPD that is being carried out from the CIBERES and speculated on the future of this condition. The format of the meeting consisted in the discussion of a series of questions that were addressed by different speakers and discussed until a consensus conclusion was reached.
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Affiliation(s)
- E Bouza
- Emilio Bouza MD, PhD, Instituto de Investigación Sanitaria Gregorio Marañón, C/ Dr. Esquerdo, 46 - 28007 Madrid, Spain.
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- Esteban Palomo, PhD, Director. Fundación de Ciencias de la Salud. C/ Severo Ochoa, 2, - 28760 Tres Cantos. Madrid, Spain. Phone +34 91 3530150
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Valero A, Olaguibel J, Delgado J, Plaza V, Álvarez F, Molina J, Mascarós E, Quirce S. Dilemmas and New Paradigms in Asthma Management. J Investig Allergol Clin Immunol 2019; 29:15-23. [PMID: 30785098 DOI: 10.18176/jiaci.0345] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Asthma is one of the most common inflammatory diseases in the world. The main goal of treatment is to achieve optimal control. Although every patient is different, clinical practice guidelines can help physicians to manage the disease. However, the recommendations made by guidelines are not always identical, and the continuous release of new data on the various management strategies can mislead both patients and physicians. We aim to summarize the main controversies in management and treatment recommendations in asthma guidelines, revise the most recent scientific evidence, and pinpoint possible solutions. We do not issue new recommendations or challenge evidence-based guidelines. We concluded that more tools are necessary to achieve and measure optimal asthma control and to better assess the impact of asthma on patients' lives. Also essential is a more accurate appraisal of the short-term and long-term effectiveness and safety of asthma therapies and the possibilities of successful immunomodulation.
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Affiliation(s)
- A Valero
- Sección de Alergología, Servicio de Neumología y Alergia, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBER de Enfermedades Respiratorias (CIBERES), Spain
| | - J Olaguibel
- Unidad de Asma Grave, Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona and CIBER de Enfermedades Respiratorias (CIBERES)
| | - J Delgado
- Unidad de Gestión Clínica de Alergología, Hospital Virgen Macarena, Sevilla, Spain
| | - V Plaza
- Servei de Pneumologia i Al·lèrgia, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - F Álvarez
- Unidad de Asma, Unidad Médico-Quirúrgica de Enfermedades Respiratorias (UMQER), Hospital Universitario "Virgen del Rocio", Sevilla, Spain
| | - J Molina
- CS Francia, Dirección Asistencial Oeste, Fuenlabrada, Madrid, Spain
| | - E Mascarós
- Centro de Salud Fuente de San Luis, Departamento Hospital Dr Peset, Valencia, Spain
| | - S Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ) and CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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4
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Arias Fernández L, Pardo Seco J, Cebey-López M, Gil Prieto R, Rivero-Calle I, Martinon-Torres F, Gil de Miguel Á, Martinón-Torres F, Vargas D, Mascarós E, Redondo E, Díaz-Maroto JL, Linares-Rufo M, Gil A, Molina J, Ocaña D, Rivero-Calle I. Differences between diabetic and non-diabetic patients with community-acquired pneumonia in primary care in Spain. BMC Infect Dis 2019; 19:973. [PMID: 31730464 PMCID: PMC6858692 DOI: 10.1186/s12879-019-4534-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 10/09/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Diabetes is one of the underlying risk factors for developing community-acquired pneumonia (CAP). The high prevalence of diabetes among population and the rising incidence of this illness, converts it as an important disease to better control and manage, to prevent its secondary consequences as CAP. The objective of this research is to describe the characteristics of the patients with diabetes and the differences with the no diabetes who have had an episode of CAP in the context of the primary care field. METHODS A retrospective, observational study in adult patients (> 18 years-old) who suffer from CAP and attended at primary care in Spain between 2009 and 2013 was developed using the Computerized Database for Pharmacoepidemiological Studies in Primary Care (BIFAP). We carried out a descriptive analysis of the first episodes of CAP, in patients with or without diabetes as comorbidity. Other morbidity (CVA, Anaemia, Arthritis, Asthma, Heart disease, Dementia, Depression, Dysphagia, Multiple sclerosis, Epilepsy, COPD, Liver disease, Arthrosis, Parkinson's disease, Kidney disease, HIV) and life-style factors were also included in the study. RESULTS A total of 51,185 patients were included in the study as they suffer from the first episode of CAP. Of these, 8012 had diabetes as comorbidity. There were differences between sex and age in patients with diabetes. Patients without diabetes were younger, and had less comorbidities including those related to lifestyles such as smoking, alcoholism, social and dental problems than patients with diabetes. CONCLUSIONS Patients who developed an episode of CAP with diabetes have more risk factors which could be reduced with an appropriate intervention, including vaccination to prevent successive CAP episodes and hospitalization. The burden of associated factors in these patients can produce an accumulation of risk. Health care professional should know this for treating and control these patients in order to avoid complications. Diabetes and those other risk factors associated could be reduced with an appropriate intervention, including vaccination to prevent the first and successive CAP episodes and the subsequent hospitalization in severe cases.
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Affiliation(s)
- Loreto Arias Fernández
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
| | - Jacobo Pardo Seco
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Miriam Cebey-López
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ruth Gil Prieto
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - Irene Rivero-Calle
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Federico Martinon-Torres
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ángel Gil de Miguel
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - on behalf of NEUMOEXPERTOS group
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - F. Martinón-Torres
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - D. Vargas
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - E. Mascarós
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - E. Redondo
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - J. L. Díaz-Maroto
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - M. Linares-Rufo
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - A. Gil
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - J. Molina
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - D. Ocaña
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - I. Rivero-Calle
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
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5
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Urrutia I, Delgado J, Domínguez-Ortega J, Mascarós E, Pérez M, Resler G, Plaza V. Clinical Factors Associated With Overuse of Asthma Reliever Medication. J Investig Allergol Clin Immunol 2019; 30:42-48. [PMID: 30741637 DOI: 10.18176/jiaci.0387] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Our aim was to evaluate the relationship between the clinical factors of asthma and the use of reliever medication. METHODS We performed an observational cross-sectional study in Spain. The study population comprised patients aged ≥12 years diagnosed with persistent asthma according to the criteria of the Global Initiative for Asthma and receiving maintenance treatment for at least 12 months. Use of reliever medication was classified as low use of reliever medication (LURM) (≤2 times/wk) and high use of reliever medication (HURM) (≥3 times/wk). A variety of clinical variables and patient-reported outcomes (PROs) were recorded (eg, scores on the Asthma Control Questionnaire-5 [ACQ-5] and Test of Adherence to Inhalers [TAI]). RESULTS A total of 406 patients were recruited. Mean (SD) age was 44.3 (17.9) years, and 64% were women. Reliever medication was used ≤2 times/wk in 76.1%. Bivariate analysis showed that HURM was related to smoking habit, unscheduled emergency department visits, hospital admissions, higher doses of inhaled corticosteroid, and night awakenings in the previous 4 weeks (P<.001). The multivariate analysis showed a higher risk of using reliever medication in smokers and former smokers, when the number of night awakenings increased, in cases of self-perception of partially controlled or uncontrolled asthma, or when asthma is uncontrolled according to the ACQ-5. CONCLUSIONS Our study identifies the potential of poor use of reliever medication in the last week as an alarm signal for disease-related parameters such as exacerbations, poor asthma control, and disease severity.
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Affiliation(s)
- I Urrutia
- Respiratory Department, Galdakao Hospital, OSI Barrualde-Galdakao, Biscay, Spain
| | - J Delgado
- Allergy Department, Hospital Virgen Macarena, Sevilla, Spain
| | - J Domínguez-Ortega
- Department of Allergy, Healthcare Research Institute IdiPAZ, CIBER de Enfermedades Respiratorias, CIBERES, Hospital Universitario La Paz, Madrid, Spain
| | - E Mascarós
- Medicina de Familia y Comunitaria, Centro de Salud Fuente de San Luis, Valencia, Spain, Spain
| | - M Pérez
- Medical Department AstraZeneca, Barcelona, Spain
| | - G Resler
- Medical Department AstraZeneca, Barcelona, Spain
| | - V Plaza
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institut d´Investigació Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain
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6
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Redondo E, Rivero-Calle I, Vargas DA, Mascarós E, Díaz-Maroto JL, Linares M, Gil A, Molina J, Jimeno I, Ocaña D, Yuste JE, Martinón-Torres F. [Adult community acquired pneumonia vaccination: 2018 Update of the positioning of the Pneumonia Prevention Expert Group]. Semergen 2018; 44:590-597. [PMID: 30318406 DOI: 10.1016/j.semerg.2018.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 09/28/2018] [Indexed: 02/06/2023]
Abstract
Community-acquired pneumonia (CAP) continues to be an important cause of morbidity and mortality in adults. The aim of this study is to update the 2016 practical prevention guidelines for CAP through vaccination in Spain, based on the available vaccines, as well as the evidence using a literature review and expert opinion. Vaccines against pneumococcus and influenza continue to be the main prevention tools available against CAP, and can contribute to reduce the burden of disease due to CAP and its associated complications. The available evidence supports the priority indications established in these guidelines, and it would be advisable to try to achieve a widespread dissemination and implementation of these recommendations in routine clinical practice.
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Affiliation(s)
- E Redondo
- Grupo de Actividades Preventivas y Salud Pública SEMERGEN. Centro de Salud Internacional Ayuntamiento de Madrid, Madrid, España.
| | - I Rivero-Calle
- Sección de Pediatría Clínica, Infectológica y Traslacional, Servicio de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España; Genética, Vacunas e Infecciones Pediátricas (GENVIP), Instituto de Investigación de Santiago, Santiago de Compostela, La Coruña, España
| | - D A Vargas
- Unidad de Hospitalización Versátil, Hospital de Alta Resolución El Toyo. Agencia Pública Sanitaria, Hospital de Poniente, Almería, España
| | - E Mascarós
- Departamento de Salud Dr. Peset, Centro de Atención Primaria Fuente de San Luís, Valencia, España
| | - J L Díaz-Maroto
- Centro de Atención Primaria de Guadalajara, Guadalajara, España
| | - M Linares
- Grupo de Enfermedades Infecciosas de SEMERGEN, Fundación io, Madrid, España
| | - A Gil
- Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Madrid, España
| | - J Molina
- Centro de Atención Primaria Francia, Fuenlabrada, Madrid, España
| | - I Jimeno
- Centro de salud Isla de Oza, Madrid, España
| | - D Ocaña
- Centro de Atención Primaria Algeciras-Norte, Algeciras, Cádiz, España
| | - J E Yuste
- Centro Nacional de Microbiología, Instituto de Salud Carlos III y CIBER de Enfermedades Respiratorias (CIBERES), Madrid, España
| | - F Martinón-Torres
- Sección de Pediatría Clínica, Infectológica y Traslacional, Servicio de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España; Genética, Vacunas e Infecciones Pediátricas (GENVIP), Instituto de Investigación de Santiago, Santiago de Compostela, La Coruña, España
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7
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Quirce S, Delgado J, Entrenas LM, Grande M, Llorente C, López Viña A, Martínez Moragón E, Mascarós E, Molina J, Olaguibel JM, Pérez de Llano LA, Perpiñá Tordera M, Quintano JA, Rodríguez M, Román-Rodriguez M, Sastre J, Trigueros JA, Valero AL, Zoni AC, Plaza V. Quality Indicators of Asthma Care Derived From the Spanish Guidelines for Asthma Management (GEMA 4.0): A Multidisciplinary Team Report. J Investig Allergol Clin Immunol 2017; 27:69-73. [PMID: 28211351 DOI: 10.18176/jiaci.0121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S Quirce
- Servicio de Alergología, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - J Delgado
- Unidad de Gestión Clínica de Alergología, Hospital Virgen Macarena, Sevilla, Spain
| | - L M Entrenas
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - M Grande
- Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, SERMAS, Madrid, Spain
| | - C Llorente
- Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, SERMAS, Madrid, Spain
| | - A López Viña
- Servicio de Neumología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - E Martínez Moragón
- Servicio de Neumología, Hospital Universitario Dr. Peset, Valencia, Spain
| | - E Mascarós
- Medicina de Atención Primaria, Centro de Salud Fuente de San Luis, Valencia, Spain; Departamento de Salud, Hospital Dr. Peset, Valencia, Spain
| | - J Molina
- Medicina de Atención Primaria, EAP Francia, Fuenlabrada, Madrid, Spain
| | - J M Olaguibel
- Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - L A Pérez de Llano
- Servicio de Neumología, Hospital Universitario Lucus Agusti, Lugo, Spain
| | - M Perpiñá Tordera
- Servicio de Neumología, Hospital Universitario Politécnico La Fe, Valencia, Spain
| | - J A Quintano
- Medicina de Atención Primaria, Lucena, Córdoba, Spain
| | - M Rodríguez
- Servicio de Alergología, Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - M Román-Rodriguez
- Medicina de Atención Primaria, Centro de Salud Son Pisá, Instituto de Investigación de Palma de Mallorca (IdisPa), Palma de Mallorca, Spain
| | - J Sastre
- Servicio de Alergología, Fundación Jiménez Díaz, CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Universidad Autónoma de Madrid, Madrid, Spain
| | - J A Trigueros
- Medicina de Atención Primaria, Centro de Salud Menasalbas, Toledo, Spain
| | - A L Valero
- Servicio de Neumología, Intitut Clinic Respiratori, Hospital Clinic, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Spain
| | - A C Zoni
- Área de Epidemiología, Subdirección de Promoción y Prevención de la Salud, Consejería de Salud de la Comunidad de Madrid, Madrid, Spain
| | - V Plaza
- Departmento of Medicina Respiratoria, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Departmento de Medicina, Barcelona, Spain
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8
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González-Romo F, Picazo JJ, García Rojas A, Labrador Horrillo M, Barrios V, Magro MC, Gil Gregorio P, de la Cámara R, Rodríguez A, Barberán J, Botía Martínez F, Linares Rufo M, Jimeno Sanz I, Portolés JM, Sanz Herrero F, Espinosa Arranz J, García-Sánchez V, Galindo Izquierdo M, Mascarós E. [Consensus document on pneumococcal vaccination in adults at risk by age and underlying clinical conditions. 2017 Update]. Rev Esp Quimioter 2017; 30:142-168. [PMID: 28198169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Invasive pneumococcal disease (IPD) and pneumococcal pneumonia (PP) represent an important health problem among aging adults and those with certain underlying pathologies and some diseases, especially immunosuppressed and some immunocompetent subjects, who are more susceptible to infections and present greater severity and worse evolution. Among the strategies to prevent IPD and PP, vaccination has its place, although vaccination coverage in this group is lower than desirable. Nowadays, there are 2 vaccines available for adults. Polysacharide vaccine (PPV23), used in patients aged 2 and older since decades ago, includes a greater number of serotypes (23), but it does not generate immune memory, antibody levels decrease with time, causes an immune tolerance phenomenon, and have no effect on nasopharyngeal colonization. PCV13 can be used from children 6 weeks of age to elderly and generates an immune response more powerful than PPV23 against most of the 13 serotypes included in it. In the year 2013 the 16 most directly related to groups of risk of presenting IPD publised a series of vaccine recommendations based on scientific evidence regarding anti-pneumococcal vaccination in adults with underlying pathologies and special conditions. A commitment was made about updating it if new scientific evidence became available. We present an exhaustive revised document focusing mainly in recommendation by age in which some more Scientific Societies have been involved.
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Affiliation(s)
- F González-Romo
- Fernando González Romo, Servicio de Microbiología Clínica. Hospital Clínico San Carlos, Madrid, Spain.
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9
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Rivero-Calle I, Pardo-Seco J, Aldaz P, Vargas DA, Mascarós E, Redondo E, Díaz-Maroto JL, Linares-Rufo M, Fierro-Alacio MJ, Gil A, Molina J, Ocaña D, Martinón-Torres F. Incidence and risk factor prevalence of community-acquired pneumonia in adults in primary care in Spain (NEUMO-ES-RISK project). BMC Infect Dis 2016; 16:645. [PMID: 27821085 PMCID: PMC5100110 DOI: 10.1186/s12879-016-1974-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 10/26/2016] [Indexed: 12/20/2022] Open
Abstract
Background Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in adults even in developed countries. Several lifestyle factors and comorbidities have been linked to an increased risk, although their prevalence has not been well documented in the primary care setting. The aim of this study is to assess the incidence, risk factor and comorbid conditions distribution of CAP in adults in primary care in Spain. Methods Retrospective observational study in adults (>18 years-old) with CAP diagnosed and attended at primary care in Spain between 2009 and 2013, using the Computerized Database for Pharmacoepidemiological Studies in Primary Care (BIFAP). Results Twenty-eight thousand four hundred thirteen patient records were retrieved and analyzed. Mean age (standard deviation): 60.5 (20.3) years, 51.7 % males. Global incidence of CAP in adults was estimated at 4.63 per 1000 persons/year. CAP incidence increased progressively with age, ranging from a 1.98 at 18–20 years of age to 23.74 in patients over 90 years of age. According to sex, global CAP incidence was slightly higher in males (5.04) than females (4.26); CAP incidence from 18 to 65 year-olds up was comparable between males (range: 2.18–5.75) and females (range: 1.47–5.21), whereas from 65 years of age, CAP incidence was noticeable higher in males (range: 7.06–36.93) than in females (range: 5.43–19.62). Average prevalence of risk factors was 71.3 %, which increased with age, doubling the risk in males by the age of 75 (females 20 % vs males 40 %). From 55 years of age, at least one risk factor was identified in 85.7 % of cases: one risk factor (23.8 %), two risk factors (23.4 %), three or more risk factors (38.5 %). Major risk factors were: metabolic disease (27.4 %), cardiovascular disease (17.8 %) and diabetes (15.5 %). Conclusions The annual incidence of CAP in primary care adults in Spain is high, comparable between males and females up to 65 years of age, but clearly increasing in males from that age. CAP risk increases with age and doubles in males older than 75 years. The majority of CAP cases in patients over 55 years of age is associated to at least one risk factor. The main risk factors associated were metabolic disease, cardiovascular disease, and diabetes. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1974-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- I Rivero-Calle
- Translational Pediatrics and Infectious Diseases Section, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Travesía da Choupana, s/n, 15706, Santiago de Compostela, Spain.,Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - J Pardo-Seco
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - P Aldaz
- Member of the Infectious Diseases Prevention Group PAPPS-SEMFYC, Primary Health Care Center San Juan, Pamplona, Spain
| | - D A Vargas
- Versatile Hospitalization Unit, Hospital de Alta Resolución El Toyo, Agencia Pública Sanitaria, Hospital de Poniente, Almería, Spain
| | - E Mascarós
- Health Department, Hospital Dr Peset, Primary Care Center Fuente de San Luís, Valencia, Spain
| | - E Redondo
- Preventive and Public Health Activities Group SEMERGEN, International Heath Center, Madrid, Spain
| | - J L Díaz-Maroto
- Primary Care Health Center Guadalajara, Infectious Diseases Group SEMERGEN, Guadalajara, Spain
| | - M Linares-Rufo
- Primary Care and Clinical Microbiology, Infectious Diseases Group SEMERGEN, Fundación io, Spain
| | | | - A Gil
- Preventive Medicine and Public Health, Rey Juan Carlos University, Madrid, Spain
| | - J Molina
- Primary Care Respiratory Group, Health Care Center Francia, Fuenlabrada, Madrid, Spain
| | - D Ocaña
- Primary Care Respiratory Group, Health Care Center Algeciras, Algeciras, Spain
| | - Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases Section, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Travesía da Choupana, s/n, 15706, Santiago de Compostela, Spain. .,Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain.
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Redondo E, Rivero I, Vargas D, Mascarós E, Díaz-Maroto J, Linares M, Valdepérez J, Gil A, Molina J, Jimeno I, Ocaña D, Martinón-Torres F. Vacunación frente a la neumonía adquirida en la comunidad del adulto. Posicionamiento del Grupo de Neumoexpertos en Prevención. Semergen 2016; 42:464-475. [DOI: 10.1016/j.semerg.2016.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 07/14/2016] [Indexed: 10/21/2022]
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Molina J, Trigueros J, Quintano J, Mascarós E, Xaubet A, Ancochea J. Fibrosis pulmonar idiopática: un reto para la atención primaria. Semergen 2014; 40:134-42. [DOI: 10.1016/j.semerg.2014.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 02/09/2014] [Indexed: 11/25/2022]
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Lozano Giménez C, Gómez-Taylor JC, Otero MC, Fernández-Gilino C, Mascarós E. [Sepsis in neonate, A 291 cases study (author's transl)]. An Esp Pediatr 1979; 12:95-104. [PMID: 426397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A four-year experience with sepsis in the neonate is described. Clinical picture, laboratory data and mortality of 291 newborn, aged 0-28 days, are analyzed. The rise in the incidence of septicemia in the group of newborn with clinical onset within the first 24 hours of life and the preterm 5. degrees to 9. degrees day of life, was commented. The need to develop a more effective profilaxis toward the reduction of morbidity and mortality is emphasized.
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Taylor CG, Mascarós E, Román J, Paz M, Santos M, Muñoz A, Gobernado M. Enteropathogenic E. coli gastroenterocolitis in neonates treated with fosfomycin. Chemotherapy 1977; 23 Suppl 1:310-4. [PMID: 318975 DOI: 10.1159/000222068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The effect of calcium salt of fosfomycin in the treatment of 43 neonates suffering from acute gastroenterocolitis produced by enteropathogenic E. coli is evaluated. The minimal inhibitory concentration of these E. coli was, generally, lower than 128 mug/ml. Dosages of 150-200 mg/kg body weight/day were administered orally every 8 h. This treatment lasted for 4 days only. Clinical evolution was favorable in 38 (88%) babies and bacteriological evolution in 30 (70%). In eight cases a different flora to the initial was selected during the treatment with fosfomycin. None of the cases treated showed any toxic alteration attributed to the antibiotic.
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