48 results on '"Broner S"'
Search Results
2. Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults
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Ciruela, P., Izquierdo, C., Broner, S., Hernández, S., Jané, M., Muñoz-Almagro, C., Esteva, C., de Sevilla, M.F., Henares, D., Pallarés, R., Ardanuy, C., Grau, I., Marco, F., Margall, N., González-Cuevas, A., Díaz, A., Martin, M.T., Llaberia, J., Curriu, M., Gallés, C., Capdevila, E., Gassiot, P., Martínez-Zurita, M., Martí, C., Morta, M., Sauca, G., Gassós, A., Sanfeliu, E., Ballester, F., Pujol, I., Olsina, M., Raga, X., Gómez-Bertomeu, F., Pérez-Moreno, M.O., Vilamala, A., Navarro, M., Ribelles, M., Garcia, M., Padilla, E., Prim, N., Fontanals, D., Sanfeliu, I., Benitez, M.A., Jou, E., Sanjosé, C., Giménez, M., Quesada, M.D., de la Fuente, J.C., Calderon, A., Ayala, P.J., Vega, L., Pérez-Jové, J., Blanco, A., Balado, C., Valle, I., Bastida, M.T., Gonzalez-Moreno, O., Ubanell, A., Fenoll, A., Yuste, J., Ciruela, Pilar, Broner, Sonia, Izquierdo, Conchita, Pallarés, Roman, Muñoz-Almagro, Carmen, Hernández, Sergi, Grau, Imma, Domínguez, Angela, and Jané, Mireia
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- 2019
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3. Varicella-zoster virus immunity among health care workers in Catalonia
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Urbiztondo, L., Bayas, J.M., Broner, S., Costa, J., Esteve, M., Campins, M., Borrás, E., and Domínguez, A.
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- 2014
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4. Cases of acute gastroenteritis due to calicivirus in outbreaks: clinical differences by age and aetiological agent
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Sala, M.R., Broner, S., Moreno, A., Arias, C., Godoy, P., Minguell, S., Martínez, A., Torner, N., Bartolomé, R., de Simón, M., Guix, S., Domínguez, A., and The Working Group for the Study of Outbreaks of Acute Gastroenteritis in Catalonia
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- 2014
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5. Corrigendum to 'Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults' [Int J Infect Dis 86 (2019) 122-130]
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Ciruela Navas P, Broner S, Izquierdo C, Pallarés R, Munoz-Almagro C, Hernández-Bou S, Grau I, Domínguez A, and Jané M
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- 2020
6. Hepatitis A outbreaks: the effect of a mass vaccination programme
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Torner, N., Broner, S., Martinez, A., Godoy, P., Batalla, J., and Dominguez, A.
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- 2011
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7. Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults
- Author
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Ciruela P, Broner S, Izquierdo C, Pallarés R, Munoz-Almagro C, Hernández S, Grau I, Domínguez A, and Jané M
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Case fatality rate ,IPD ,Streptococcus pneumoniae ,Adults ,PCV13 ,Mortality ,Comorbidities - Abstract
OBJECTIVES: The aim of this study was to assess the indirect effect of paediatric 13-valent pneumococcal conjugate vaccine (PCV13) vaccination on people =65 years of age with invasive pneumococcal disease (IPD) in Catalonia and to determine factors predictive of mortality. METHODS: During 2014-2016, 1285 IPD cases were reported to the Public Health Agency of Catalonia. The indirect effect of paediatric PCV13 vaccination was calculated by comparing the incidence rate (IR) in 2016 (PCV13 year) with that in 2009 (pre-PCV13). Predictors of mortality were determined using multivariate logistic regression. RESULTS: Comparing 2016 and 2009, IPD decreased by 19% (IR 40.1 and 32.5 per 100 000 person-years, respectively). PCV13 serotypes decreased by 57% (IR 23.7 and 10.1), while non-PCV13 serotypes increased by 36% (IR 16.4 and 22.4). During 2014-2016, the mortality rate was 17.5%, and mortality was associated with age =85 years (adjusted odds ratio (aOR) 2.91, 95% confidence interval (CI) 1.89, 4.48), meningitis (aOR 2.29, 95% CI 1.25, 4.19), non-focal bacteraemia (aOR 3.73, 95% CI 2.00, 6.94), and =1 high-risk condition (aOR 1.89, 95% CI 1.08, 3.32). PPV23non13 serotypes were associated with lower mortality than PCV13 serotypes (aOR 0.54, 95% CI 0.34, 0.86). CONCLUSIONS: The incidence of IPD in people =65 years of age decreased after the introduction of paediatric PCV13, and this was due to a reduction in PCV13 serotypes, although an increase in non-PCV13 serotypes was observed. Mortality was associated with age, meningitis, non-focal bacteraemia, =1 high-risk condition, and PCV13 serotypes.
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- 2019
8. SRSF10 effects splicing of SMN2 exon 7
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Broner, S., Doktor, T., Hua, Y., Larsen, M., Krainer, A., and Andresen, B.
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- 2018
9. The changing epidemiology of invasive pneumococcal disease after PCV13 vaccination in a country with intermediate vaccination coverage
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Ciruela Navas P, Izquierdo C, Broner S, Munoz-Almagro C, Hernández-Bou S, Ardanuy C, Pallarés R, Domínguez A, Jané M, and Catalan Working Group on Invasive Pneumococcal Disease
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Serotype distribution ,PCV7 ,Vaccine ,IPD ,Impact ,PCV13 ,Streptococcus pneumoniae - Abstract
BACKGROUND: We studied the impact of 13-valent pneumococcal conjugate vaccine (PCV13) on the incidence of invasive pneumococcal disease (IPD) and serotype distribution in a region with intermediate levels of vaccination (around 64% in children aged
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- 2018
10. Invasive pneumococcal disease rates linked to meteorological factors and respiratory virus circulation (Catalonia, 2006-2012)
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Ciruela Navas P, Broner S, Izquierdo C, Hernández S, Munoz-Almagro C, Pallarés R, Jané M, Domínguez A, and Working Group of Invasive Pneumococcal Disease of Catalonia
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- 2016
11. Outbreaks of hepatitis A associated with immigrants travelling to visit friends and relatives
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Godoy, P, Broner, S, Manzanares-Laya, S, Martinez, A, Parron, I, Planas, C, Sala-Farre, MR, Minguell, S, de Olalla, PG, Jane, M, and Dominguez, A
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Epidemiology ,Immigrants ,Vaccination ,Outbreaks ,Hepatitis A ,International travel - Published
- 2016
12. Characteristics of pertussis outbreaks in Catalonia, Spain, 1997 to 2010
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Crespo, I, Broner, S, Soldevila, N, Martinez, A, Godoy, P, Sala-Farre, MR, Company, M, Rius, C, and Dominguez, A
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pertussis ,surveillance ,acellular pertussis vaccine ,whole cell pertussis vaccine ,hospitalization - Abstract
In Catalonia, pertussis outbreaks must be reported to the Department of Health. This study analyzed pertussis outbreaks between 1997 and 2010 in general and according to the characteristics of the index cases. The outbreak rate, hospitalization rate and incidence of associated cases and their 95%CI were calculated. Index cases were classified in two groups according to age (< 15 years and 15 years) and the vaccine type received: whole cell vaccine (DTwP) or acellular vaccine (DTaP). During the study period, 230 outbreaks were reported. The outbreak rate was 2.43 x 10(-6) persons-year, and outbreaks ranged from 2 to 32 cases, with a median duration of 18 days. There were 771 associated cases, with an incidence rate of 0.8 x 10(-5) persons-year. After classifying outbreaks according to the age of the index case, 126 outbreaks (1.3 x 10(-6) persons-year) had an index case aged < 15 y and 87 (0.87 x 10(-6) person-year) had an index case aged 15 y (RR = 1.44, 95%CI 1.10-1.90; P = 0.007). Between 2003 and 2010, after the introduction of the acellular vaccine, the index case was vaccinated with DTwP vaccine in 25 outbreaks (0.43 x 10(-6) persons-year) and with DTaP vaccine in 32 outbreaks (0.55 x 10(-6) person-year) (RR = 0.78, 95%CI 0.46-1.31; P = 0.35). Of cases, 37.2% were correctly vaccinated, suggesting waning immunity of pertussis vaccine protection and endogenous circulation of pertussis. A greater number of outbreaks had an index case aged < 15 y. No changes in the disease incidence, associated cases and hospitalization rate were observed after the introduction of DTaP.
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- 2015
13. Changes in the epidemiology of hepatitis A outbreaks 13 years after the introduction of a mass vaccination program
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Martinez, A, Broner, S, Sala, MR, Manzanares-Laya, S, Godoy, P, Planas, C, Minguell, S, Torner, N, Jane, M, and Dominguez, A
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outbreak ,preventable fraction ,incidence rate ,mass immunization program ,Hepatitis A ,hospitalization - Abstract
A hepatitis A+B vaccine vaccination program of 12-year-olds was introduced in Catalonia in 1998. The aim of this study was to investigate the evolution of hepatitis A outbreaks in Catalonia and estimate the preventable fraction of cases associated with outbreaks as a measure of the impact of the vaccination program. Hepatitis A outbreaks reported to the Health Department between 1991 and 2012 were analyzed. The incidence rates of outbreaks, outbreak-associated cases and hospitalizations were calculated. The preventable fraction (PF) and 95% confidence intervals (CI) were estimated for the whole study period (pre-vaccination and post-vaccination) and the post-vaccination period. One-hundred-eight (108) outbreaks (rate of 2.21 per 10(6) persons-year) were reported in the pre-vaccination period and 258 outbreaks (rate of 2.82 per 10(6) persons-year) in the post-vaccination period. The rate of cases associated with outbreaks was 1.52 per 10(5) persons-year in the pre-vaccination period and 1.28 per 10(5) persons-year in the post-vaccination period. Hospitalization rates were 0.08 and 0.75 per 10(6) persons-year, respectively. The number of person-to-person outbreaks whose index case was a school contact decreased in the post-vaccination period (aOR 2.72; 95%CI 1.35-5.48), but outbreaks whose index case was a man who has sex with men (MSM) or an immigrant increased. The PF of all outbreak-associated cases was 6.46% (95%CI 3.11-9.82) and the highest PF was in the 15-24 years age group (42.53%; 95%CI 29.30-55.75). In the 0-4 years age group, the PF was 18.35% (95%CI 9.59-27.11), suggesting a protective herd effect in unvaccinated subjects. Vaccination of immigrants traveling to endemic countries and MSM should be reinforced.
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- 2015
14. Serological survey of hepatitis B immunity in healthcare workers in Catalonia (Spain).
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Domínguez, A., Urbiztondo, L., Bayas, J. M., Borrás, E., Broner, S., Campins, M., Costa, J., and Esteve, M.
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- 2017
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15. Norovirus: A Growing Cause of Gastroenteritis in Catalonia (Spain)?
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Martínez, A., primary, Torner, N., additional, Broner, S., additional, Bartolomé, R., additional, Guix, S., additional, De Simón, M., additional, Godoy, P., additional, Moreno, A., additional, Company, M., additional, Balanyà, P.J., additional, Sala, M.R., additional, Torra, R., additional, Ferrús, G., additional, Parrón, I., additional, Barrabeig, I., additional, and Domínguez, A., additional
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- 2013
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16. Utility of Clinical-Epidemiological Profiles in Outbreaks of Foodborne Disease, Catalonia, 2002 through 2006
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Domínguez, A., primary, Broner, S., additional, Torner, N., additional, Martínez, A., additional, Jansà, J.M., additional, Àlvarez, J., additional, Barrabeig, I., additional, Caylà, J., additional, Godoy, P., additional, Minguell, S., additional, Camps, N., additional, and Sala and, M.R., additional
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- 2010
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17. Differential Features of Foodborne Gastroenteritis Outbreaks of Known and Unknown Etiology
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Domínguez, A., primary, Broner, S., additional, Torner, N., additional, Martínez, A., additional, Jansà, J.M., additional, Àlvarez, J., additional, Barrabeig, I., additional, Caylà, J., additional, Godoy, P., additional, Minguell, S., additional, Camps, N., additional, and Sala, M.R., additional
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- 2009
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18. Reversible anorgasmia with topiramate therapy for migraine
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Newman, L. C., primary, Broner, S. W., additional, and Lay, C. L., additional
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- 2005
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19. Utility of clinical-epidemiological profiles in outbreaks of foodborne disease, Catalonia, 2002 through 2006
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Domínguez A, Broner S, Torner N, Martínez A, Jm, Jansà, Alvarez J, Barrabeig I, Caylà J, Pere Godoy, Minguell S, Camps N, Sala MR, and Working Group for the Study Outbreaks of Acute Gastroenteritis in Catalonia
20. Thunderclap headache as the presenting symptom of myocardial infarction.
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Broner S, Lay C, Newman L, and Swerdlow M
- Abstract
Headache as the presenting symptom of myocardial ischemia has been reported in more than 20 cases. These headaches have been described as of gradual onset, associated with exertion and with EKG changes. We present herein the first case of thunderclap headache occurring at rest as the sole symptom of an acute myocardial infarction. [ABSTRACT FROM AUTHOR]
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- 2007
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21. Epidemiología y perfil de resistencia antibiótica de Neisseria meningitidis: Catalunya, 2016-2019
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Broner, Sònia, Ciruela-Navas, Pilar, Ferré, Lourdes, Piqué, Montserrat, Grup de Treball de Vigilància de les Resistències Antimicrobianes a Catalunya, Mendioroz, Jacobo, Martín García, Ana Alicia, [Broner S, Ciruela P, Ferré L, Martin AA, Mendioroz J, Piqué M] Servei de Prevenció i Control de Malalties Emergents, Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública, Agència de Salut Pública de Catalunya (ASPCAT), Departament de Salut, Generalitat de Catalunya, Barcelona, Spain, and Departament de Salut
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Neissèria de la meningitis ,Meningococcèmia - Epidemiologia ,infecciones bacterianas y micosis::infecciones bacterianas::infecciones bacterianas del sistema nervioso central::meningitis bacterianas::meningitis meningocócica [ENFERMEDADES] ,fenómenos fisiológicos::fenómenos farmacológicos y toxicológicos::fenómenos farmacológicos::resistencia a medicamentos [FENÓMENOS Y PROCESOS] ,Other subheadings::Other subheadings::/epidemiology [Other subheadings] ,Physiological Phenomena::Pharmacological and Toxicological Phenomena::Pharmacological Phenomena::Drug Resistance [PHENOMENA AND PROCESSES] ,Otros calificadores::Otros calificadores::/epidemiología [Otros calificadores] ,Bacterial Infections and Mycoses::Bacterial Infections::Central Nervous System Bacterial Infections::Meningitis, Bacterial::Meningitis, Meningococcal [DISEASES] ,Resistència als medicaments - Abstract
Resistència antibiòtica; Neisseria meningitidis; Salut pública Resistencia antibiótica; Neisseria meningitidis; Salud pública Antibiotic resistance; Neisseria meningitidis; Public health Aquest informe té com a objectiu analitzar les característiques epidemiològiques dels casos confirmats de N. meningitidis i analitzar la sensibilitat antimicrobiana dels casos declarats a l’SNMC durant els anys 2016 – 2019.
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- 2023
22. Invasive pneumococcal disease rates linked to meteorological factors and respiratory virus circulation (Catalonia, 2006–2012)
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[Ciruela P, Broner S, Izquierdo C, Hernández S. Jané M] Agència de Salut Pública de Catalunya, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain. [Muñoz-Almagro C] Hospital Universitari Sant Joan de Deu, Parc Sanitari Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain. [Pallarès R] Hospital Universitari Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain. Universitat de Barcelona, Barcelona, Spain. [Domínguez A] Universitat de Barcelona, Barcelona, Spain. CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain and Departament de Salut
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Environmental Health::Science::Meteorology::Meteorological Concepts [PUBLIC HEALTH] ,Catalonia ,Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Streptococcal Infections::Pneumococcal Infections [DISEASES] ,Pneumococs ,Other subheadings::Other subheadings::/epidemiology [Other subheadings] ,Otros calificadores::Otros calificadores::/epidemiología [Otros calificadores] ,Enfermedades Respiratorias::Infecciones del Sistema Respiratorio [ENFERMEDADES] ,Virosis ,Cataluña ,Factors climàtics ,Malalties - Epidemiologia - Catalunya ,Infecciones Bacterianas y Micosis::Infecciones Bacterianas::Infecciones por Bacterias Grampositivas::Infecciones Estreptocócicas::Infecciones Neumocócicas [ENFERMEDADES] ,salud ambiental::ciencia::meteorología::conceptos meteorológicos [SALUD PÚBLICA] ,Respiratory Tract Diseases::Respiratory Tract Infections [DISEASES] - Published
- 2021
23. Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults
- Author
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[Ciruela P, Jané M] Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain. CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. [Broner S, Izquierdo C, Hernández S] Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain. [Pallarés R, Grau I] Hospital Universitari Bellvitge, Universitat de Barcelona (UB), L’Hospitalet, Spain. CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain. [Muñoz-Almagro C] CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. Hospital Universitari Sant Joan de Déu, Esplugues, Spain. Department of Medicine, Universitat Internacional de Catalunya (UIC), Sant Cugat del Vallès, Spain. [Domínguez A] CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. Departament de Medicina, Universitat de Barcelona (UB), Barcelona, Spain and Departament de Salut
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Bacteria::Firmicutes::Lactobacillales::Streptococcaceae::Streptococcus::Streptococcus pneumoniae [ORGANISMS] ,Bacterias::Firmicutes::Lactobacillales::Streptococcaceae::Streptococcus::Streptococcus pneumoniae [ORGANISMOS] ,Mezclas Complejas::Productos Biológicos::Vacunas::Vacunas Bacterianas::Vacunas Estreptocócicas::Vacunas Neumococicas [COMPUESTOS QUÍMICOS Y DROGAS] ,Pneumococs ,Persons::Age Groups::Adult::Aged [NAMED GROUPS] ,Complex Mixtures::Biological Products::Vaccines::Bacterial Vaccines::Streptococcal Vaccines::Pneumococcal Vaccines [CHEMICALS AND DRUGS] ,Persones grans ,Vacuna antipneumocòccica ,Personas::Grupos de Edad::Adulto::Anciano [DENOMINACIONES DE GRUPOS] - Published
- 2021
24. Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults
- Author
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Pilar Ciruela, Sonia Broner, Conchita Izquierdo, Roman Pallarés, Carmen Muñoz-Almagro, Sergi Hernández, Imma Grau, Angela Domínguez, Mireia Jané, P. Ciruela, C. Izquierdo, S. Broner, S. Hernández, M. Jané, C. Muñoz-Almagro, C. Esteva, M.F. de Sevilla, D. Henares, R. Pallarés, C. Ardanuy, I. Grau, F. Marco, N. Margall, A. González-Cuevas, A. Díaz, M.T. Martin, J. Llaberia, M. Curriu, C. Gallés, E. Capdevila, P. Gassiot, M. Martínez-Zurita, C. Martí, M. Morta, G. Sauca, A. Gassós, E. Sanfeliu, F. Ballester, I. Pujol, M. Olsina, X. Raga, F. Gómez-Bertomeu, M.O. Pérez-Moreno, A. Vilamala, M. Navarro, M. Ribelles, M. Garcia, E. Padilla, N. Prim, D. Fontanals, I. Sanfeliu, M.A. Benitez, E. Jou, C. Sanjosé, M. Giménez, M.D. Quesada, J.C. de la Fuente, A. Calderon, P.J. Ayala, L. Vega, J. Pérez-Jové, A. Blanco, C. Balado, I. Valle, M.T. Bastida, O. Gonzalez-Moreno, A. Ubanell, A. Fenoll, J. Yuste, European Centre for Disease Prevention and Control (ECDC), Centro de Investigación Biomedica en Red - CIBER, [Ciruela P, Jané M] Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain. CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. [Broner S, Izquierdo C, Hernández S] Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain. [Pallarés R, Grau I] Hospital Universitari Bellvitge, Universitat de Barcelona (UB), L’Hospitalet, Spain. CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain. [Muñoz-Almagro C] CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. Hospital Universitari Sant Joan de Déu, Esplugues, Spain. Department of Medicine, Universitat Internacional de Catalunya (UIC), Sant Cugat del Vallès, Spain. [Domínguez A] CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. Departament de Medicina, Universitat de Barcelona (UB), Barcelona, Spain, and Departament de Salut
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0301 basic medicine ,Male ,Bacteria::Firmicutes::Lactobacillales::Streptococcaceae::Streptococcus::Streptococcus pneumoniae [ORGANISMOS] ,PCV13 ,Infeccions per pneumococs ,Pneumococcal conjugate vaccine ,Persones grans ,Comorbidities ,Pneumococcal Vaccines ,0302 clinical medicine ,Mezclas Complejas::Productos Biológicos::Vacunas::Vacunas Bacterianas::Vacunas Estreptocócicas::Vacunas Neumococicas [COMPUESTOS QUÍMICOS Y DROGAS] ,Case fatality rate ,030212 general & internal medicine ,Vacunació ,Bacterias::Firmicutes::Lactobacillales::Streptococcaceae::Streptococcus::Streptococcus pneumoniae [ORGANISMOS] ,Aged, 80 and over ,Pneumococs ,Mortality rate ,Incidence (epidemiology) ,Incidence ,Vaccination ,Complex Mixtures::Biological Products::Vaccines::Bacterial Vaccines::Streptococcal Vaccines::Pneumococcal Vaccines [CHEMICALS AND DRUGS] ,General Medicine ,Bacteria::Firmicutes::Lactobacillales::Streptococcaceae::Streptococcus::Streptococcus pneumoniae [ORGANISMS] ,Infectious Diseases ,Streptococcus pneumoniae ,Persons::Age Groups::Adult::Aged [NAMED GROUPS] ,Child, Preschool ,Female ,Meningitis ,medicine.drug ,Microbiology (medical) ,medicine.medical_specialty ,030106 microbiology ,Serogroup ,Pneumococcal Infections ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,Internal medicine ,medicine ,Mortalitat ,Adults ,Humans ,lcsh:RC109-216 ,Mortality ,personas::Grupos de Edad::adulto::anciano [DENOMINACIONES DE GRUPOS] ,Aged ,mezclas complejas::productos biológicos::vacunas::vacunas bacterianas::vacunas antiestreptocócicas::vacunas antineumocócicas [COMPUESTOS QUÍMICOS Y DROGAS] ,Vaccines, Conjugate ,business.industry ,Cerebrospinal meningitis ,Meningitis cerebrospinal epidèmica ,Infant ,Odds ratio ,medicine.disease ,Confidence interval ,Vacuna antipneumocòccica ,IPD ,business - Abstract
OBJECTIVES: The aim of this study was to assess the indirect effect of paediatric 13-valent pneumococcal conjugate vaccine (PCV13) vaccination on people ≥65 years of age with invasive pneumococcal disease (IPD) in Catalonia and to determine factors predictive of mortality. METHODS: During 2014-2016, 1285 IPD cases were reported to the Public Health Agency of Catalonia. The indirect effect of paediatric PCV13 vaccination was calculated by comparing the incidence rate (IR) in 2016 (PCV13 year) with that in 2009 (pre-PCV13). Predictors of mortality were determined using multivariate logistic regression. RESULTS: Comparing 2016 and 2009, IPD decreased by 19% (IR 40.1 and 32.5 per 100 000 person-years, respectively). PCV13 serotypes decreased by 57% (IR 23.7 and 10.1), while non-PCV13 serotypes increased by 36% (IR 16.4 and 22.4). During 2014-2016, the mortality rate was 17.5%, and mortality was associated with age ≥85 years (adjusted odds ratio (aOR) 2.91, 95% confidence interval (CI) 1.89, 4.48), meningitis (aOR 2.29, 95% CI 1.25, 4.19), non-focal bacteraemia (aOR 3.73, 95% CI 2.00, 6.94), and ≥1 high-risk condition (aOR 1.89, 95% CI 1.08, 3.32). PPV23non13 serotypes were associated with lower mortality than PCV13 serotypes (aOR 0.54, 95% CI 0.34, 0.86). CONCLUSIONS: The incidence of IPD in people ≥65 years of age decreased after the introduction of paediatric PCV13, and this was due to a reduction in PCV13 serotypes, although an increase in non-PCV13 serotypes was observed. Mortality was associated with age, meningitis, non-focal bacteraemia, ≥1 high-risk condition, and PCV13 serotypes. This study was partially supported by SpIDnet (Assessing the impact of vaccination with conjugate vaccines on the epidemiology of invasive pneumococcal disease in Europe), a network funded by the European Centre for Disease Prevention and Control ( ECDC/2015/031 ); the Catalan Agency for the Management of Grants for University Research ( AGAUR Grant number 2017/SGR 1342 and 2017/SGR 0742 ); the Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública ( CIBERESP CB06/02/0076 and CB15/00067 ); and the Centro de Investigación Biomédica en Red de Enfermedades Respiratorias ( CIBERES CB06/06/0037 ). Sí
- Published
- 2019
25. Invasive pneumococcal disease rates linked to meteorological factors and respiratory virus circulation (Catalonia, 2006–2012)
- Author
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Ciruela-Navas, Pilar, Broner, Sònia, Izquierdo-Gómez, Concepción, Hernández-Baeza, Sergi, Muñoz-Almagro, Carmen, Pallarés, Roman, Jané-Checa, Mireia, Domínguez-García, Àngela, Grup de Treball de Malalties Pneumocòccies Invasives de Catalunya, [Ciruela P, Broner S, Izquierdo C, Hernández S. Jané M] Agència de Salut Pública de Catalunya, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain. [Muñoz-Almagro C] Hospital Universitari Sant Joan de Deu, Parc Sanitari Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain. [Pallarès R] Hospital Universitari Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain. Universitat de Barcelona, Barcelona, Spain. [Domínguez A] Universitat de Barcelona, Barcelona, Spain. CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain, Departament de Salut, and Universitat de Barcelona
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Environmental Health::Science::Meteorology::Meteorological Concepts [PUBLIC HEALTH] ,Catalonia ,Epidemiology ,viruses ,Other subheadings::Other subheadings::/epidemiology [Other subheadings] ,infecciones bacterianas y micosis::infecciones bacterianas::infecciones por bacterias grampositivas::infecciones estreptocócicas::infecciones neumocócicas [ENFERMEDADES] ,Enfermedades Respiratorias::Infecciones del Sistema Respiratorio [ENFERMEDADES] ,Infeccions per pneumococs ,Efecte del clima sobre l'home ,Malalties víriques ,Pneumococcal Infections ,Cataluña ,salud ambiental::ciencia::meteorología::conceptos meteorológicos [SALUD PÚBLICA] ,Epidemiologia ,enfermedades respiratorias::infecciones del tracto respiratorio [ENFERMEDADES] ,Effect of climate on human beings ,Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Streptococcal Infections::Pneumococcal Infections [DISEASES] ,Pneumococs ,Otros calificadores::Otros calificadores::/epidemiología [Otros calificadores] ,Catalunya ,bacterial infections and mycoses ,Virosis ,Factors climàtics ,Malalties - Epidemiologia - Catalunya ,Virus diseases ,Respiratory Tract Diseases::Respiratory Tract Infections [DISEASES] - Abstract
Streptococcus pneumoniae; Respiratory viruses; Influenza; Meteorological variables Streptococcus pneumoniae; Virus respiratoris; Grip; Variables meteorològiques Streptococcus pneumoniae; Virus respiratorios; Gripe; Variables meteorológicas Background To study the impact of meteorological data and respiratory viral infections on invasive pneumococcal disease (IPD) rates. Methods We analysed all notifications of IPD and respiratory viral infections to the Microbiological Reporting System of Catalonia (2006–2012). Correlations between rates of IPD and viral infections (influenza virus, respiratory syncytial virus [RSV] and adenovirus), and meteorological variables (temperature, humidity, hours of sunshine, wind speed and number of days with rainfall) were assessed using Spearman’s correlation coefficient and negative binomial regression models. Results We found significant correlations between monthly rates of IPD and monthly rates of all respiratory viruses and meteorological factors. However, after multiple regression analysis, associations remained between IPD rates and influenza rates and reductions in temperature in the total population, and between IPD rates and adenovirus rates in children aged
26. Epidemiology and antimicrobial resistance profile of Neisseria gonorrhoeae in Catalonia, Spain, 2016-2019.
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Herrero M, Broner S, Cruells A, Esteve S, Ferré L, Mendioroz J, Jané M, and Ciruela P
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- Humans, Azithromycin pharmacology, Ceftriaxone pharmacology, Ciprofloxacin pharmacology, Drug Resistance, Bacterial, Microbial Sensitivity Tests, Neisseria gonorrhoeae, Retrospective Studies, Spain epidemiology, Anti-Bacterial Agents pharmacology, Gonorrhea drug therapy, Gonorrhea epidemiology, Gonorrhea microbiology
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Antimicrobial resistance data for Neisseria gonorrhoeae is globally sparse and resistant strains are emerging in Catalonia. We aim to describe epidemiological and antimicrobial resistance in all patients infected with N. gonorrhoeae during the period from 2016 to 2019, using available antimicrobial susceptibility data. We retrospectively analysed confirmed N. gonorrhoeae cases notified to Catalonia's microbiological reporting system. Antibiotic susceptibility testing (azithromycin, cefixime, ceftriaxone, ciprofloxacin, penicillin, spectinomycin, and tetracycline) was assessed using clinical breakpoints published by the European Committee on Antimicrobial Susceptibility Testing. Incidence rates were calculated and proportions were compared using the χ
2 test or Fisher's exact test, and analysed using the Statistical Package for Social Sciences (SPSS 18.0). A total of 14,251 confirmed cases of N. gonorrhoeae were notified. Incidence increased from 30.7 cases/100,000 person-years (p < 0.001) in 2016 to 64.7 in 2019. Culture was available in 6,292 isolates (44.2%), of which 5,377 (85.5%) were resistant to at least one of the antibiotics tested. Azithromycin resistance rose from 6.1% in 2016 to 16% in 2019 (p < 0.001). Only 1.0% (45 cases) were resistant to ceftriaxone. Multidrug-resistant N. gonorrhoeae increased from 0.25% in 2016 to 0.42% in 2019 (p = 0.521). One case presented extensively drug-resistant N. gonorrhoeae. In Catalonia, 10% of the N. gonorrhoeae isolates were resistant to azithromycin in the 2016-2019 period. According to World Health Organization guidelines, resistance above 5% indicates an alert to review treatment guidelines. Antimicrobial susceptibility testing in clinical practice followed by surveillance and interventions are essential to monitor trends and prevent the spread of antimicrobial resistance., (© 2023. The Author(s).)- Published
- 2023
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27. The development of a diversity, equity, and inclusion committee in a neurology department and residency program.
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Harpe JM, Safdieh JE, Broner S, Strong G, and Robbins MS
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- Education, Medical, Graduate, Humans, Internship and Residency, Neurology education
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Background: Diversity, Equity, and Inclusion (DEI) initiatives have been described in different academic and graduate medical education settings, but not specifically in neurology., Objective: To describe the development of a DEI committee within a neurology department and training program., Methods: The need to prioritize DEI as a critical focus within our neurology department led to the appointment of an initial task force who identified strategic priorities and stakeholders to establish a committee. DEI committee members included faculty, trainees, and staff, and this phase of the initiative took place from May 2019 through January 2021., Results: The DEI committee was established and has met monthly for over one year. Initial meetings formulated goals of the initiative. Specific objectives were developed in the domains of recruitment, education, engagement, training, conflict resolution, and recognition. Early outcomes included augmented resident recruitment efforts of UiM students, curriculum changes including frequent representation of DEI topics in Grand Rounds, and measures to reduce unconscious bias., Conclusions: The creation of a DEI Committee within a specialty department such as neurology is feasible and can result in immediate and long-term actions related to recruitment and education in particular. Our blueprint that heavily involves graduate medical education stakeholders may be generalizable to other specialty departments in academic medicine., (Copyright © 2021 Elsevier B.V. All rights reserved.)
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- 2021
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28. Factors Associated With, and Mitigation Strategies for, Health Care Disparities Faced by Patients With Headache Disorders.
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Kiarashi J, VanderPluym J, Szperka CL, Turner S, Minen MT, Broner S, Ross AC, Wagstaff AE, Anto M, Marzouk M, Monteith TS, Rosen N, Manrriquez SL, Seng E, Finkel A, and Charleston L 4th
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- Humans, Headache Disorders therapy, Healthcare Disparities statistics & numerical data
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Objective: To review contemporary issues of health care disparities in headache medicine with regard to race/ethnicity, socioeconomic status (SES), and geography and propose solutions for addressing these disparities., Methods: An Internet and PubMed search was performed and literature was reviewed for key concepts underpinning disparities in headache medicine. Content was refined to areas most salient to our goal of informing the provision of equitable care in headache treatment through discussions with a group of 16 experts from a range of headache subspecialties., Results: Taken together, a multitude of factors, including racism, SES, insurance status, and geographical disparities, contribute to the inequities that exist within the health care system when treating headache disorders. Interventions such as improving public education, advocacy, optimizing telemedicine, engaging in community outreach to educate primary care providers, training providers in cultural sensitivity and competence and implicit bias, addressing health literacy, and developing recruitment strategies to increase representation of underserved groups within headache research are proposed as solutions to ameliorate disparities., Conclusion: Neurologists have a responsibility to provide and deliver equitable care to all. It is important that disparities in the management of headache disorders are identified and addressed., (© 2021 American Academy of Neurology.)
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- 2021
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29. Structured headache services as the solution to the ill-health burden of headache: 1. Rationale and description
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Steiner TJ, Jensen R, Katsarava Z, Stovner LJ, Uluduz D, Adarmouch L, Al Jumah M, Al Khathaami AM, Ashina M, Braschinsky M, Broner S, Eliasson JH, Gil-Gouveia R, Gómez-Galván JB, Gudmundsson LS, Herekar AA, Kawatu N, Kissani N, Kulkarni GB, Lebedeva ER, Leonardi M, Linde M, Luvsannorov O, Maiga Y, Milanov I, Mitsikostas DD, Musayev T, Olesen J, Osipova V, Paemeleire K, Peres MFP, Quispe G, Rao GN, Risal A, de la Torre ER, Saylor D, Togha M, Yu SY, Zebenigus M, Zewde YZ, Zidverc-Trajković J, and Tinelli M
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- Delivery of Health Care, Humans, Primary Health Care, Headache therapy, Headache Disorders
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In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the "patient journey") with perplexing obstacles.High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary.The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded.It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses., (© 2021. The Author(s).)
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- 2021
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30. Corrigendum to "Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults" [Int J Infect Dis 86 (2019) 122-130].
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Ciruela P, Broner S, Izquierdo C, Pallarés R, Muñoz-Almagro C, Hernández S, Grau I, Domínguez A, and Jané M
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- 2020
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31. The changing epidemiology of invasive pneumococcal disease after PCV13 vaccination in a country with intermediate vaccination coverage.
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Ciruela P, Izquierdo C, Broner S, Muñoz-Almagro C, Hernández S, Ardanuy C, Pallarés R, Domínguez A, and Jané M
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- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Incidence, Infant, Infant, Newborn, Male, Middle Aged, Pneumococcal Infections microbiology, Serogroup, Spain epidemiology, Young Adult, Pneumococcal Infections epidemiology, Pneumococcal Infections prevention & control, Pneumococcal Vaccines administration & dosage, Pneumococcal Vaccines immunology, Streptococcus pneumoniae classification, Streptococcus pneumoniae isolation & purification, Vaccination Coverage
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Background: We studied the impact of 13-valent pneumococcal conjugate vaccine (PCV13) on the incidence of invasive pneumococcal disease (IPD) and serotype distribution in a region with intermediate levels of vaccination (around 64% in children aged <2 years)., Methods: Surveillance data on IPD cases reported by microbiologists participating in the Microbiological Reporting System of Catalonia during 2006-2014 were analysed. We compared estimated incidence rate (IR) ratios for serotypes included in PCV7, PCV10non7, PCV13non10 and non-PCV13 between the PCV7 (2006-2009) and PCV13 periods (2010-2014). IR were corrected for missing serotypes according to year and age groups: <2 years, 2-4 years, 5-64 years and ≥65 years., Results: A total of 9338 IPD cases were reported. Overall IPD incidence declined by 26.2% (from 16.4 to 12.1) in the PCV13 period. The largest decrease was observed in children aged 2-4 years (44.5%, from 37.4 to 20.8). Pneumonia fell in all age groups with the largest reduction in children aged 2-4 years (49.3%) and <2 years (42%). PCV13 serotypes decreased significantly in all age groups, from 52% (31.6 to 15.1) in children aged 2-4 years to 35% (22.8 to 14.8) in adults aged ≥65 years. Non-PCV13 serotypes rose by 13% (14.8 to 16.8) in people aged ≥65 years., Conclusions: In a region with intermediate vaccination coverage, the introduction of PCV13 has reduced the overall incidence of IPD, mainly due to the decrease in PCV13 serotypes in all age groups, suggesting herd immunity. Non-PCV13 serotypes have increased in adults aged ≥65 years, suggesting serotype replacement. Higher PCV13 vaccination coverage in children will further reduce IPD incidence in all age groups., (Copyright © 2018 Elsevier Ltd. All rights reserved.)
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- 2018
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32. Invasive pneumococcal disease rates linked to meteorological factors and respiratory virus circulation (Catalonia, 2006-2012).
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Ciruela P, Broner S, Izquierdo C, Hernández S, Muñoz-Almagro C, Pallarés R, Jané M, and Domínguez A
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- Child, Child Health Services, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Meteorological Concepts, Models, Statistical, Pneumococcal Infections complications, Regression Analysis, Spain epidemiology, Pneumococcal Infections epidemiology, Respiratory Syncytial Virus Infections complications, Respiratory Tract Infections virology
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Background: To study the impact of meteorological data and respiratory viral infections on invasive pneumococcal disease (IPD) rates., Methods: We analysed all notifications of IPD and respiratory viral infections to the Microbiological Reporting System of Catalonia (2006-2012). Correlations between rates of IPD and viral infections (influenza virus, respiratory syncytial virus [RSV] and adenovirus), and meteorological variables (temperature, humidity, hours of sunshine, wind speed and number of days with rainfall) were assessed using Spearman's correlation coefficient and negative binomial regression models., Results: We found significant correlations between monthly rates of IPD and monthly rates of all respiratory viruses and meteorological factors. However, after multiple regression analysis, associations remained between IPD rates and influenza rates and reductions in temperature in the total population, and between IPD rates and adenovirus rates in children aged <5 years. When models were repeated for the total population using data from the preceding month, IPD rates increased when RSV was circulating and when the temperature was lower. In children aged <5 years, RSV circulation was associated with increased IPD rates., Conclusions: IPD rates were linked to increased activity of some respiratory viruses and reductions in temperature. Preventive measures, including influenza vaccination, may help reduce IPD.
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- 2016
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33. Epidemiology of Acute Gastroenteritis Outbreaks Caused by Human Calicivirus (Norovirus and Sapovirus) in Catalonia: A Two Year Prospective Study, 2010-2011.
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Torner N, Martinez A, Broner S, Moreno A, Camps N, and Domínguez A
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- Adolescent, Adult, Aged, Aged, 80 and over, Caliciviridae Infections virology, Child, Child, Preschool, Disease Outbreaks, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Norovirus genetics, Nursing Homes, Prospective Studies, Sapovirus genetics, Young Adult, Caliciviridae Infections epidemiology, Gastroenteritis epidemiology, Gastroenteritis virology, Norovirus pathogenicity, Sapovirus pathogenicity
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Background: The epidemiology of cases of acute gastroenteritis (AGE) of viral etiology is a relevant public health issue. Due to underreporting, the study of outbreaks is an accepted approach to investigate their epidemiology. The objective of this study was to investigate the epidemiological characteristics of AGE outbreaks due to norovirus (NoV) and sapovirus (SV) in Catalonia., Material and Methods: Prospective study of AGE outbreaks of possible viral etiology notified during two years in Catalonia. NoV and SV were detected by real time reverse transcription polymerase (RT-PCR)., Results: A total of 101 outbreaks were registered affecting a total of 2756 persons and 12 hospitalizations (hospitalization rate: 0.8x1,000,000 persons-year); 49.5% of outbreaks were foodborne, 45.5% person to person and 5% waterborne. The distribution of outbreaks according to the setting showed a predominance of catering services (39.6%), nursing homes and long term care facilities (26.8%) and schools (11.9%). The median number of cases per outbreak was 17 (range 2-191). The total Incidence rate (IR) was 18.3 per 100,000 persons-years (95%CI: 17.6-19.0). The highest IR was in persons aged ≥65 years (43.6x100,000 (95% CI: 41.0-46.2)) (p<0.001). A total of 1065 samples were analyzed with a positivity rate of 60.8%. 98% of positive samples were NoV (GII 56.3%; GI 4.2%; GII+GI 4.2%; non- typable 33.0%). SV was identified in two person-to-person transmission outbreaks in children., Conclusions: These results confirm the relevance of viral AGE outbreaks, both foodborne and person-to-person, especially in institutionalized persons. SV should be taken into account when investigating viral AGE outbreaks.
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- 2016
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34. Outbreaks of hepatitis A associated with immigrants travelling to visit friends and relatives.
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Godoy P, Broner S, Manzanares-Laya S, Martínez A, Parrón I, Planas C, Sala-Farré MR, Minguell S, de Olalla PG, Jané M, and Dominguez A
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- Female, Humans, Male, Hepatitis A epidemiology, Hepatitis A Vaccines therapeutic use, Hepatitis B epidemiology, Hepatitis B Vaccines therapeutic use, Immunization standards, Travel
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- 2016
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35. Economic costs of outbreaks of acute viral gastroenteritis due to norovirus in Catalonia (Spain), 2010-2011.
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Navas E, Torner N, Broner S, Godoy P, Martínez A, Bartolomé R, and Domínguez A
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- Acute Disease, Adult, Caliciviridae Infections epidemiology, Caliciviridae Infections virology, Child, Community Health Centers, Female, Gastroenteritis epidemiology, Gastroenteritis virology, Health Care Costs, Hospitals, Humans, Male, Nursing Homes, Spain epidemiology, Caliciviridae Infections economics, Costs and Cost Analysis, Disease Outbreaks economics, Gastroenteritis economics, Health Facilities, Norovirus, Residence Characteristics
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Background: To determine the direct and indirect costs of outbreaks of acute viral gastroenteritis (AVG) due to norovirus in closed institutions (hospitals, social health centers or nursing homes) and the community in Catalonia in 2010-11., Methods: Information on outbreaks were gathered from the reports made by epidemiological surveillance units. Direct costs (medical visits, hospital stays, drug treatment, sample processing, transport, diagnostic tests, monitoring and control of the outbreaks investigated) and indirect costs (lost productivity due to work absenteeism, caregivers time and working hours lost due to medical visits) were calculated., Results: Twenty-seven outbreaks affecting 816 people in closed institutions and 74 outbreaks affecting 1,940 people in the community were detected. The direct and indirect costs of outbreaks were € 131,997.36 (€ 4,888.79 per outbreak) in closed institutions and € 260,557.16 (€ 3,521.04 per outbreak) in community outbreaks. The cost per case was € 161.76 in outbreaks in closed institutions and € 134.31 in community outbreaks. The main costs were surveillance unit monitoring (€ 116,652.93), laboratory diagnoses (€ 119,950.95), transport of samples (€ 69,970.90), medical visits (€ 25,250.50) and hospitalization (€ 13,400.00)., Conclusions: The cost of outbreaks of acute viral gastroenteritis due to norovirus obtained in this study was influenced by the number of people affected and the severity of the outbreak, which determined hospitalizations and work absenteeism. Urgent reporting of outbreaks would allow the implementation of control measures that could reduce the numbers affected and the duration of the illness and thus the costs derived from them.
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- 2015
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36. Seroprevalence study of B. pertussis infection in health care workers in Catalonia, Spain.
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Urbiztondo L, Broner S, Costa J, Rocamora L, Bayas JM, Campins M, Esteve M, Borras E, Domínguez A, and For The Study Of The Immune Status In Health Care TW
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- Adult, Aged, Female, Humans, Immunoglobulin G blood, Male, Middle Aged, Seroepidemiologic Studies, Spain epidemiology, Young Adult, Antibodies, Bacterial blood, Health Personnel, Whooping Cough immunology, Whooping Cough prevention & control
- Abstract
Pertussis is a re-emerging infection in countries with high infant immunization coverage. Healthcare workers (HCW) are exposed and can transmit the infection to especially-vulnerable patients. Therefore, pertussis vaccination of HCW is recommended. Between June 2008 and December 2010, 460 HCW from hospital and primary healthcare centers were recruited to determine susceptibility to pertussis. IgG antibodies against pertussis (anti-pertussis ab) were measured, using a routine technique that detects antibodies against pertussis including pertussis toxin (PT) and filamentous hemagglutinin (FHA). Positive results were confirmed with a more-specific technique that only assesses anti-PT IgG antibodies. The median age was 42 years (range, 21-65), 77.3% were female. 172 were nurses, 133 physicians, 60 other clinical workers and 95 non-clinical workers. None had received pertussis vaccination since childhood. The overall prevalence of anti-pertussis antibodies was 51.7%, (95% CI 47.1-56.4). Anti-PT antibodies were determined in the 220 HCW with positive anti-pertussis antibodies: 4 (1.8%) were negative and 33 (15%) had a high titer (≥ 45 IU/mL). No significant differences between the prevalence of anti-pertussis antibodies or anti-TP antibodies were found according to age, type of occupation or type of center. Our study confirms the need for vaccination of HCW because at least half are susceptible to pertussis. High anti-PT titers found in 15% of seropositive HCW showed that they had had recent contact with B. pertussis.
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- 2015
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37. Changes in the epidemiology of hepatitis A outbreaks 13 years after the introduction of a mass vaccination program.
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Martínez A, Broner S, Sala MR, Manzanares-Laya S, Godoy P, Planas C, Minguell S, Torner N, Jané M, Domínguez A, For The Study Of The Immune Status In Health Care TW, and Hepatitis A In Catalonia FT
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- Adolescent, Adult, Age Factors, Child, Child, Preschool, Female, Hepatitis B Vaccines administration & dosage, Hospitalization statistics & numerical data, Humans, Incidence, Infant, Male, Middle Aged, Risk Factors, Sexual Behavior, Spain epidemiology, Young Adult, Disease Outbreaks, Hepatitis A epidemiology, Hepatitis A prevention & control, Hepatitis A Vaccines administration & dosage, Mass Vaccination methods
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A hepatitis A+B vaccine vaccination program of 12-year-olds was introduced in Catalonia in 1998. The aim of this study was to investigate the evolution of hepatitis A outbreaks in Catalonia and estimate the preventable fraction of cases associated with outbreaks as a measure of the impact of the vaccination program. Hepatitis A outbreaks reported to the Health Department between 1991 and 2012 were analyzed. The incidence rates of outbreaks, outbreak-associated cases and hospitalizations were calculated. The preventable fraction (PF) and 95% confidence intervals (CI) were estimated for the whole study period (pre-vaccination and post-vaccination) and the post-vaccination period. One-hundred-eight (108) outbreaks (rate of 2.21 per 10(6) persons-year) were reported in the pre-vaccination period and 258 outbreaks (rate of 2.82 per 10(6) persons-year) in the post-vaccination period. The rate of cases associated with outbreaks was 1.52 per 10(5) persons-year in the pre-vaccination period and 1.28 per 10(5) persons-year in the post-vaccination period. Hospitalization rates were 0.08 and 0.75 per 10(6) persons-year, respectively. The number of person-to-person outbreaks whose index case was a school contact decreased in the post-vaccination period (aOR 2.72; 95%CI 1.35-5.48), but outbreaks whose index case was a man who has sex with men (MSM) or an immigrant increased. The PF of all outbreak-associated cases was 6.46% (95%CI 3.11-9.82) and the highest PF was in the 15-24 years age group (42.53%; 95%CI 29.30-55.75). In the 0-4 years age group, the PF was 18.35% (95%CI 9.59-27.11), suggesting a protective herd effect in unvaccinated subjects. Vaccination of immigrants traveling to endemic countries and MSM should be reinforced.
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- 2015
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38. Characteristics of pertussis outbreaks in Catalonia, Spain, 1997 to 2010.
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Crespo I, Broner S, Soldevila N, Martínez A, Godoy P, Sala-Farré MR, Company M, Rius C, Domínguez A, and Group Of Catalonia TP
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- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Hospitalization statistics & numerical data, Humans, Incidence, Infant, Male, Middle Aged, Pertussis Vaccine administration & dosage, Spain epidemiology, Vaccination methods, Young Adult, Disease Outbreaks, Whooping Cough epidemiology
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In Catalonia, pertussis outbreaks must be reported to the Department of Health. This study analyzed pertussis outbreaks between 1997 and 2010 in general and according to the characteristics of the index cases. The outbreak rate, hospitalization rate and incidence of associated cases and their 95%CI were calculated. Index cases were classified in two groups according to age (<15 years and ≥15 years) and the vaccine type received: whole cell vaccine (DTwP) or acellular vaccine (DTaP). During the study period, 230 outbreaks were reported. The outbreak rate was 2.43 × 10(-6) persons-year, and outbreaks ranged from 2 to 32 cases, with a median duration of 18 days. There were 771 associated cases, with an incidence rate of 0.8 × 10(-5) persons-year. After classifying outbreaks according to the age of the index case, 126 outbreaks (1.3 × 10(-6) persons-year) had an index case aged <15 y and 87 (0.87 × 10(-6) person-year) had an index case aged ≥15 y (RR = 1.44, 95%CI 1.10-1.90; P = 0.007). Between 2003 and 2010, after the introduction of the acellular vaccine, the index case was vaccinated with DTwP vaccine in 25 outbreaks (0.43 × 10(-6) persons-year) and with DTaP vaccine in 32 outbreaks (0.55 × 10(-6) person-year) (RR = 0.78, 95%CI 0.46-1.31; P = 0.35). Of cases, 37.2% were correctly vaccinated, suggesting waning immunity of pertussis vaccine protection and endogenous circulation of pertussis. A greater number of outbreaks had an index case aged <15 y. No changes in the disease incidence, associated cases and hospitalization rate were observed after the introduction of DTaP.
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- 2015
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39. Are healthcare workers immune to rubella?
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Borràs E, Campins M, Esteve M, Urbiztondo L, Broner S, Bayas JM, Costa J, and Domínguez A
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- Adult, Blood immunology, Female, Humans, Immunoassay, Immunoglobulin G blood, Male, Middle Aged, Seroepidemiologic Studies, Surveys and Questionnaires, Antibodies, Viral blood, Health Personnel, Rubella immunology
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Healthcare workers (HCW) have high exposure to infectious diseases, some of which, such as rubella, are vaccine-preventable. The aim of this study was to determine the immunity of HCW against rubella. We performed a seroprevalence study using a self-administered survey and obtained blood samples to determine rubella Immunoglobulin G (IgG) antibody levels in HCW during preventive examinations by five Primary Care Basic Prevention Units and six tertiary hospitals in Catalonia. Informed consent was obtained. IgG was determined using an antibody capture microparticle direct chemiluminometric technique. The odss ratio (OR) and 95% confidence intervals (CI) were calculated. Logistic regression was made to calculate adjusted OR. Of 642 HCW who participated (29.9% physician, 38.8% nurses, 13.3% other health workers and 18% non-health workers), 46.6% were primary care workers and 53.4% hospital workers. Of total, 97.2% had rubella antibodies. HCW aged 30-44 years had a higher prevalence of antibodies (98.4%) compared with HCW aged<30 years (adjusted OR 3.92; 95% CI 1.04-14.85). The prevalence was higher in nurses than in other HCW (adjusted OR: 5.57, 95% CI 1.21-25.59). Antibody prevalence did not differ between females and males (97.4% vs. 97.1%, P 0.89), type of center (97.7% vs. 96.8%, P 0.51) or according to history of vaccination (97.3% vs. 96.8%, P 0.82). Seroprevalence of rubella antibodies is high in HCW, but workers aged<30 years have a higher susceptibility (5.5%). Vaccination should be reinforced in HCW in this age group, due to the risk of nosocomial transmission and congenital rubella.
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- 2014
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40. Prevalence of measles antibodies among health care workers in Catalonia (Spain) in the elimination era.
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Urbiztondo L, Borràs E, Costa J, Broner S, Campins M, Bayas JM, Esteve M, and Domínguez A
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- Adult, Aged, Analysis of Variance, Female, Humans, Male, Measles prevention & control, Middle Aged, Models, Statistical, Odds Ratio, Prevalence, Seroepidemiologic Studies, Spain epidemiology, Vaccination statistics & numerical data, Antibodies, Viral blood, Health Personnel statistics & numerical data, Measles epidemiology, Measles immunology, Measles Vaccine administration & dosage
- Abstract
Background: Interruption of measles transmission was achieved in Catalonia (Spain) in 2000. Six years later, a measles outbreak occurred between August 2006 and June 2007 with 381 cases, 11 of whom were health care workers (HCW).The objective was to estimate susceptibility to measles in HCW and related demographic and occupational characteristics., Methods: A measles seroprevalence study was carried out in 639 HCW from six public tertiary hospitals and five primary healthcare areas. Antibodies were tested using the Vircell Measles ELISA IgG Kit. Data were analyzed according to age, sex, type of HCW, type of centre and vaccination history.The odds ratios (OR) and their 95% CI were calculated to determine the variables associated with antibody prevalence. OR were adjusted using logistic regression.Positive predictive values (PPV) and the 95% confidence intervals (CI) of having two documented doses of a measles containing vaccine (MCV) for the presence of measles antibodies and of reporting a history of measles infection were calculated., Results: The prevalence of measles antibodies in HCW was 98% (95% CI 96.6-98.9), and was lower in HCW born in 1981 or later, after the introduction of systematic paediatric vaccination (94.4%; 95% CI 86.4-98.5) and higher in HCW born between 1965 and 1980 (99.0%; 95% CI 97.0-99.8). Significant differences were found for HCW born in 1965-1980 with respect to those born in 1981 and after (adjusted OR of 5.67; 95% CI: 1.24-25.91).A total of 187 HCW reported being vaccinated: the proportion of vaccinated HCW decreased with age. Of HCW who reported being vaccinated, vaccination was confirmed by the vaccination card in 49%. Vaccination with 2 doses was documented in only 50 HCW, of whom 48 had measles antibodies. 311 HCW reported a history of measles.The PPV of having received two documented doses of MCV was 96% (95% CI 86.3-99.5) and the PPV of reporting a history of measles was 98.7% (95% CI 96.7-99.6)., Conclusions: Screening to detect HCW who lack presumptive evidence of immunity and vaccination with two doses of vaccine should be reinforced, especially in young workers, to minimize the risk of contracting measles and infecting the susceptible patients they care for.
- Published
- 2013
- Full Text
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41. Serological survey of mumps immunity among health care workers in the Catalonia region of Spain.
- Author
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Campins M, Urbiztondo L, Costa J, Broner S, Esteve M, Bayas JM, Borras E, and Dominguez A
- Subjects
- Adult, Female, Humans, Male, Middle Aged, Seroepidemiologic Studies, Spain epidemiology, Young Adult, Antibodies, Viral blood, Cross Infection epidemiology, Cross Infection prevention & control, Health Personnel, Mumps epidemiology, Mumps prevention & control
- Abstract
Susceptible health care workers are at risk of acquiring and transmitting mumps to or from patients. A survey was carried out in 639 health care workers from tertiary public hospitals and primary care centers in the Catalonia region of Spain during 2009 to determine the prevalence of immunity to mumps among this group. The prevalence of immune health care workers was 87.5% (95% confidence interval, 84.7-89.9). Vaccination with 2 doses of vaccine should be reinforced in health care workers to minimize the risk of mumps transmission in health care settings., (Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)
- Published
- 2013
- Full Text
- View/download PDF
42. Epidemiology of vaccine-preventable invasive diseases in Catalonia in the era of conjugate vaccines.
- Author
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Ciruela P, Martínez A, Izquierdo C, Hernández S, Broner S, Muñoz-Almagro C, and Domínguez À
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Haemophilus Infections prevention & control, Haemophilus Vaccines administration & dosage, Humans, Incidence, Infant, Infant, Newborn, Male, Meningococcal Infections prevention & control, Meningococcal Vaccines administration & dosage, Middle Aged, Pneumococcal Infections prevention & control, Pneumococcal Vaccines administration & dosage, Spain epidemiology, Vaccines, Conjugate administration & dosage, Vaccines, Conjugate immunology, Young Adult, Haemophilus Infections epidemiology, Haemophilus Vaccines immunology, Meningococcal Infections epidemiology, Meningococcal Vaccines immunology, Pneumococcal Infections epidemiology, Pneumococcal Vaccines immunology, Vaccination statistics & numerical data
- Abstract
We investigated the incidence and distribution of cases of invasive pneumococcal disease (IPD), invasive meningococcal disease (IMD) and invasive Hemophilus influenzae disease (IHiD) notified by hospital laboratories to the Microbiological Reporting System of Catalonia between 2005 and 2009. Incidence rates were compared using the rate ratio (RR) and 95% CI were calculated. A value of p < 0.05 was considered statistically significant. Of the 6,661 cases, 6,012 were IPD, 436 IMD and 213 IHiD. The global annual incidence per 10 ( 5) inhabitants was 16.62 (95% CI 16.20-17.04) for IPD, 1.21 (95% CI 1.09-1.32) for IMD and 0.59 (95% CI 0.51-0.67) for IHiD. IPD increased in 2009 compared with 2005 (RR:1.55, 95%CI: 1.43-1.70) and IMD and IHiD remained stable. Pneumonia was the most-frequent clinical manifestation of IPD (75.6%) and IHiD (44.1%) and meningoencephalitis with or without sepsis for IMD (70.6%). The male:female ratio was 1.37 for IPD, 1.0 for IMD and 1.15 for IHiD. The age groups with the highest incidence were the ≤ 2 y and 2-4 y groups for IPD (66.40 and 50.66/100,000 persons-year) and IMD (14.88 and 7.26/100,000 persons-year) and the ≤ 2 y and ≥ 65 y groups for IHiD (1.88 and 1.89/100,000 persons-year). The most-frequent serotypes were serotype 1 (19.0%) in IPD and untypeable serotypes (60.8%) in IHiD. Serogroup B (78.3%) was the most frequent in IMD. S. pneumoniae is the most-frequent agent causing invasive disease in Catalonia. The main clinical manifestations were pneumonia in IPD and IHiD and meningitis in IMD. The main causative agent of meningitis was N. meningitidis in people aged < 20 y and S. pneumoniae in people aged ≥ 20 y. Vaccination with conjugate vaccines may reduce the risk of infectious disease in our setting.
- Published
- 2013
- Full Text
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43. Prevalence of susceptibility to tetanus and diphtheria in health care workers in Catalonia.
- Author
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Esteve M, Domínguez A, Urbiztondo L, Borrás E, Costa J, Broner S, Campins M, and Bayas JM
- Subjects
- Adult, Age Factors, Aged, Antibodies, Bacterial blood, Female, Humans, Male, Middle Aged, Seroepidemiologic Studies, Spain, Young Adult, Diphtheria immunology, Disease Susceptibility epidemiology, Health Personnel, Tetanus immunology
- Abstract
A seroprevalence study of tetanus and diphtheria was carried out in a sample of 537 health care workers in Catalonia. The prevalence of protective antibodies against tetanus was 93.9% (95% confidence interval: 91.5-95.7). The prevalence of protective antibodies against diphtheria was 46.4% (95% confidence interval: 42.1-50.7). Tetanus protection should be improved in health care workers born before 1975. The immune status against diphtheria was poor, with less than half of people born before 1975 correctly immunized., (Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)
- Published
- 2012
- Full Text
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44. Quality in the provision of headache care. 2: defining quality and its indicators.
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Peters M, Jenkinson C, Perera S, Loder E, Jensen R, Katsarava Z, Gil Gouveia R, Broner S, and Steiner T
- Subjects
- Disease Management, Headache diagnosis, Headache economics, Humans, United Kingdom, Delivery of Health Care economics, Evidence-Based Medicine, Headache therapy, Quality Indicators, Health Care economics
- Abstract
The objective of this study was to define "quality" of headache care, and develop indicators that are applicable in different settings and cultures and to all types of headache. No definition of quality of headache care has been formulated. Two sets of quality indicators, proposed in the US and UK, are limited to their localities and/or specific to migraine and their development received no input from people with headache. We first undertook a literature review. Then we conducted a series of focus-group consultations with key stakeholders (doctors, nurses and patients) in headache care. From the findings we proposed a large number of putative quality indicators, and refined these and reduced their number in consultations with larger international groups of stakeholder representatives. We formulated a definition of quality from the quality indicators. Five main themes were identified: (1) headache services; (2) health professionals; (3) patients; (4) financial resources; (5) political agenda and legislation. An initial list of 160 putative quality indicators in 14 domains was reduced to 30 indicators in 9 domains. These gave rise to the following multidimensional definition of quality of headache care: "Good-quality headache care achieves accurate diagnosis and individualized management, has appropriate referral pathways, educates patients about their headaches and their management, is convenient and comfortable, satisfies patients, is efficient and equitable, assesses outcomes and is safe." Quality in headache care is multidimensional and resides in nine essential domains that are of equal importance. The indicators are currently being tested for feasibility of use in clinical settings.
- Published
- 2012
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45. Factors associated to duration of hepatitis a outbreaks: implications for control.
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Torner N, Broner S, Martinez A, Tortajada C, Garcia de Olalla P, Barrabeig I, Sala M, Camps N, Minguell S, Alvarez J, Ferrús G, Torra R, Godoy P, and Dominguez A
- Subjects
- Child, DNA, Viral genetics, Female, Hepatitis A epidemiology, Hepatitis A Antibodies blood, Hepatitis A Vaccines therapeutic use, Hepatitis A virus genetics, Hepatitis A virus isolation & purification, Humans, Male, Population Surveillance, Risk Factors, Schools, Spain epidemiology, Time Factors, Communicable Disease Control organization & administration, Disease Outbreaks prevention & control, Hepatitis A diagnosis, Hepatitis A transmission, Hepatitis A virus pathogenicity
- Abstract
Even though hepatitis A mass vaccination effectiveness is high, outbreaks continue to occur. The aim of this study was to investigate the association between duration and characteristics of hepatitis A outbreaks. Hepatitis A (HA) outbreaks reported between 1991 and 2007 were studied. An outbreak was defined as ≥2 epidemiologically-linked cases with ≥1 case laboratory-confirmed by detection of HA immunoglobulin M (IgM) antibodies. Relationships between explanatory variables and outbreak duration were assessed by logistic regression. During the study period, 268 outbreaks (rate 2.45 per million persons-year) and 1396 cases (rate 1.28 per 10(5) persons-year) were reported. Factors associated with shorter duration were time to intervention (OR = 0.96; 95% CI: 0.94-0.98) and school setting (OR = 0.39; 95% CI: 0.16-0.92). In person-to-person transmission outbreaks only time to intervention was associated with shorter outbreak duration (OR = 0.96; 95% CI: 0.95-0.98). The only variables associated with shorter outbreak duration were early administration of IG or vaccine and a school setting. Timely reporting HA outbreaks was associated with outbreak duration. Making confirmed HA infections statutory reportable for clinical laboratories could diminish outbreak duration.
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- 2012
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46. Hepatitis A outbreaks in the vaccination era in Catalonia, Spain.
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Martínez A, Broner S, Torner N, Godoy P, Batalla J, Alvarez J, Barrabeig I, Camps N, Carmona G, Minguell S, Sala R, Caylà J, and Domínguez A
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Hepatitis B Vaccines administration & dosage, Hepatitis B Vaccines immunology, Hospitalization statistics & numerical data, Humans, Incidence, Infant, Infant, Newborn, Male, Middle Aged, Spain epidemiology, Young Adult, Disease Outbreaks, Hepatitis A epidemiology, Hepatitis A prevention & control, Hepatitis A Vaccines administration & dosage, Hepatitis A Vaccines immunology, Vaccination statistics & numerical data
- Abstract
Hepatitis A outbreaks have a major impact on public health services and involve case investigation and intervention measures to susceptible contacts. At the end of 1998 a universal vaccination program with a combined hepatitis A+B vaccine was started in Catalonia (Spain) in 12-years-old preadolescents. The objective of this study was to compare the characteristics of hepatitis A outbreaks in the periods before and after the introduction of the preadolescent vaccination program and to estimate the preventable fraction of cases associated to outbreaks. The incidence rates of outbreaks, cases and hospitalization associated with each outbreak were calculated. Two periods were considered: before (1991-1998) and after (2000-2007) the introduction of mass vaccination. The preventable fraction and 95% confidence intervals (CI) of cases associated with outbreaks was calculated. The rate of associated cases with outbreaks was higher in the period before the vaccination program than in the post vaccination period (1.53 per 100,000 person-year vs 1.12 ; p< 0.001), but the rate of hospitalization was greater in the period after the introduction of vaccination program than in the period previous to vaccination (0.70 per million persons-year vs 0.08; p< 0.001). The preventable fraction of cases associated to outbreaks was 19.6%(95%CI 6.7-32.5) in the 0-4 years group and 16.7% (95% CI 6.0-27.5) in the 5-14 years group, but the highest figure (38.6%; 95%CI 21.3-55.9) was observed in the 15-24 years age group. The estimated proportion of cases associated with outbreaks that would theoretically have been prevented with the vaccination program suggests that substantial benefits have been obtained in Catalonia in people aged less than 25 years.
- Published
- 2011
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47. Reversible anorgasmia with topiramate therapy for headache: a report of 7 patients.
- Author
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Sun C, Lay C, Broner S, Silberstein S, Tepper S, and Newman L
- Subjects
- Adult, Anesthetics, Local administration & dosage, Bupivacaine administration & dosage, Emergency Service, Hospital, Female, Humans, Injections, Spinal, Male, Retrospective Studies, Anesthetics, Local therapeutic use, Bupivacaine therapeutic use, Emergency Medical Services, Headache drug therapy
- Abstract
Objective: To describe 7 patients who developed new onset anorgasmia while using topiramate therapy for migraine prophylaxis., Background: Topiramate is an effective drug for the prevention of migraine headaches. Though it is generally well tolerated, it may be associated with a dose-related anorgasmia., Methods: Case reports., Results: Seven patients (5 women, 2 men), between the ages of 40 and 62, developed anorgasmia while using topiramate for headache prevention. Four women and 2 men had migraine without aura, and 1 woman had migraine with aura. None had a prior history of anorgasmia or sexual dysfunction. Doses associated with this side effect ranged from 45 to 200 mg daily. All subjects had symptom resolution. Six patients had resolution within 7 days of discontinuing or decreasing the medication; the exact time frame of resolution for the seventh patient is unknown., Conclusion: In our series, anorgasmia was a reversible, dose-related adverse effect of topiramate. Physicians need to be aware of the potential for topiramate to cause sexual side effects, and should inquire about these symptoms in patients for whom this agent has been prescribed.
- Published
- 2006
- Full Text
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48. The use of acetone to dissolve a Styrofoam impaction of the ear.
- Author
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White SJ and Broner S
- Subjects
- Child, Female, Humans, Polystyrenes, Acetone therapeutic use, Ear Canal, Foreign Bodies therapy
- Abstract
Foreign bodies in the ear occasionally thwart conventional means of removal. Styrofoam can be particularly problematic because it can be compressed and become tightly impacted in an ear canal. Furthermore, Styrofoam is friable and tends to fragment with usual removal methods. We report the case of a 6-year-old girl who was referred from another tertiary care hospital after failed efforts to remove a painfully impacted piece of Styrofoam from her left ear canal. Instillation of the organic solvent acetone into the ear canal was well tolerated and caused rapid and near-complete dissolution of the Styrofoam impaction. This is the first reported case of organic solvent dissolution of an otic foreign body. Ototoxic considerations are discussed as is a method for safe acetone instillation that minimizes the amount of acetone introduced into the ear canal.
- Published
- 1994
- Full Text
- View/download PDF
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