0000000000933516
AUTHOR
José María Mayoral
showing 19 related works from this author
Smoking may increase the risk of hospitalization due to influenza.
2016
Background: Smoking may facilitate influenza virus infections and their severity. The objective was to investigate the risk of hospitalization due to influenza in Spanish smokers and ex-smokers. Methods: We carried out a multicentre, case-control study in 2011. Cases [patients a parts per thousand yen 18 years hospitalized > 24 h with real time polymerase chain reaction (RT-PCR)-confirmed influenza] were selected from 29 Spanish hospitals. For each case, we selected an outpatient aged a parts per thousand yen 18 years with RT-PCR-confirmed influenza matched by age (+/- 5 years), date of hospitalization of the case (+/- 10 days) and province of residence. We collected epidemiological variabl…
Prognosis of hospitalized patients with 2009 H1N1 influenza in Spain: influence of neuraminidase inhibitors
2012
The H1N1 influenza pandemic strain has been associated with a poor prognosis in hospitalized patients. The present report evaluates the factors influencing prognosis.A total of 813 patients hospitalized with H1N1 influenza in 36 hospitals (nationwide) in Spain were analysed. Detailed histories of variables preceding hospital admission were obtained by interview, validating data on medications and vaccine with their attending physicians. Data on treatment and complications during hospital stay were recorded. As definition of poor outcome, the endpoints of death and admission to intensive care were combined; and as a further outcome, length of stay was used.The mean age was 38.5 years (SD 22.…
Knowledge of and attitudes to influenza in unvaccinated primary care physicians and nurses
2014
Primary healthcare workers, especially nurses, are exposed to the vast majority of patients with influenza and play an important role in vaccinating patients. Healthcare workers' misconceptions about influenza and influenza vaccination have been reported as possible factors associated with lack of vaccination. The objective of this study was to compare the characteristics of unvaccinated physicians and unvaccinated nurses in the 2011-2012 influenza season. We performed an anonymous web survey of Spanish primary healthcare workers in 2012. Information was collected on vaccination and knowledge of and attitudes to the influenza vaccine. Multivariate analysis was performed using unconditional …
Effectiveness of vaccination with 23-valent pneumococcal polysaccharide vaccine in preventing hospitalization with laboratory confirmed influenza dur…
2013
Background: Since influenza predisposes to bacterial pneumonia caused by Streptococcus pneumoniae, studies have suggested that pneumococcal vaccination might reduce its occurrence during pandemics. We assessed the effectiveness of pneumococcal polysaccharide vaccination alone and in combination with influenza vaccination in preventing influenza hospitalization during the 2009–2010 pandemic wave and 2010–2011 influenza epidemic. Methods: We conducted a multicenter case-control study in 36 Spanish hospitals. We selected patients aged ≥ 18 y hospitalized with confirmed influenza and two hospitalized controls per case, matched according to age, date of hospitalization and province of residence.…
Visualizing knowledge and attitude factors related to influenza vaccination of physicians
2014
To characterize groups of primary healthcare physicians according to sociodemographic data, years of professional experience and knowledge of and attitudes to influenza, and to evaluate differences between groups with respect to influenza vaccination in the 2011-2012 season.We carried out an anonymous web survey of Spanish primary healthcare physicians in 2012. Information on vaccination, and knowledge of and attitudes to influenza was collected. Multiple correspondence analysis and cluster analysis were used to define groups of physicians.We included 835 physicians and identified three types. Type B were physicians with low professional experience of influenza. Types A and C were physician…
Different prognosis in hospitalized patients with influenza one season after the pandemic H1N1 influenza of 2009-2010 in Spain
2013
Background The present report compares prognosis in hospitalized cases with the H1N1 pandemic virus in two seasons. Methods Two series of hospitalized patients with laboratory-confirmed H1N1 pandemic influenza have been compared: 813 in the season 2009–2010 and 707 in the season 2010–2011. A detailed history of variables preceding hospital admission and during hospitalization was obtained by interview and clinical charts. A combined endpoint of death admission to intensive care was used as outcome due to the low number of deaths. Logistic regression was applied in the analysis for adverse outcome. Results Patients of the second season had different characteristics than in the first one (old…
Smoking may increase the risk of influenza hospitalization and reduce influenza vaccine effectiveness in the elderly.
2017
Background Through its effects on the immune system, smoking may facilitate influenza virus infection, its severity and its most frequent complications. The objective was to investigate the smoking history as a risk factor for influenza hospitalization and influenza vaccine effectiveness in elderly smokers/ex-smokers and non-smokers. Methods We carried out a multicenter case-control study in the 2013-2014 and 2014-2015 influenza seasons. Cases aged ≥65 years and age-, sex-matched controls were selected from 20 Spanish hospitals. We collected epidemiological variables, comorbidities, vaccination history and the smoking history. The risk of hospitalization due to smoking (current smokers and …
Influenza vaccine effectiveness in preventing outpatient, inpatient, and severe cases of laboratory-confirmed influenza.
2013
Background. In most seasons, the influenza vaccine is effective in preventing influenza, but it is not clear whether it is equally effective in preventing mild and severe cases. We designed a case-control study to compare the effectiveness of the influenza vaccine in preventing outpatient, inpatient, and severe or fatal cases of laboratory-confirmed influenza. Methods. Hospitalized patients (n = 691) with laboratory-confirmed influenza in the 2010–2011 season recruited in 29 Spanish hospitals were individually matched by age, admission/visit date, and province with an outpatient with laboratory-confirmed influenza and an outpatient control. Severe cases were considered those patients admitt…
Factors associated with influenza vaccination of hospitalized elderly patients in Spain
2016
Vaccination of the elderly is an important factor in limiting the impact of influenza in the com- munity. The aim of this study was to investigate the factors associated with influenza vacci- nation coverage in hospitalized patients aged 65 years hospitalized due to causes unrelated to influenza in Spain. We carried out a cross-sectional study. Bivariate analysis was performed comparing vaccinated and unvaccinated patients, taking in to account sociodemographic variables and medical risk conditions. Multivariate analysis was per- formed using multilevel regression models. We included 1038 patients: 602 (58%) had received the influenza vaccine in the 2013 - 14 season. Three or more general p…
Comparison of body mass index (BMI) with the CUN-BAE body adiposity estimator in the prediction of hypertension and type 2 diabetes
2016
BACKGROUND: Obesity is a world-wide epidemic whose prevalence is underestimated by BMI measurements, but CUN-BAE (Clínica Universidad de Navarra - Body Adiposity Estimator) estimates the percentage of body fat (BF) while incorporating information on sex and age, thus giving a better match. Our aim is to compare the BMI and CUN-BAE in determining the population attributable fraction (AFp) for obesity as a cause of chronic diseases. METHODS: We calculated the Pearson correlation coefficient between BMI and CUN-BAE, the Kappa index and the internal validity of the BMI. The risks of arterial hypertension (AHT) and diabetes mellitus (DM) and the AFp for obesity were assessed using both the BMI a…
Sociodemographic Factors and Clinical Conditions Associated to Hospitalization in Influenza A (H1N1) 2009 Virus Infected Patients in Spain, 2009–2010
2012
The emergence and pandemic spread of a new strain of influenza A (H1N1) virus in 2009 resulted in a serious alarm in clinical and public health services all over the world. One distinguishing feature of this new influenza pandemic was the different profile of hospitalized patients compared to those from traditional seasonal influenza infections. Our goal was to analyze sociodemographic and clinical factors associated to hospitalization following infection by influenza A(H1N1) virus. We report the results of a Spanish nationwide study with laboratory confirmed infection by the new pandemic virus in a case-control design based on hospitalized patients. The main risk factors for hospitalizatio…
Factors Associated with Influenza Vaccination of Hospitalized Elderly Patients in Spain
2016
Vaccination of the elderly is an important factor in limiting the impact of influenza in the community. The aim of this study was to investigate the factors associated with influenza vaccination coverage in hospitalized patients aged ≥ 65 years hospitalized due to causes unrelated to influenza in Spain. We carried out a cross-sectional study. Bivariate analysis was performed comparing vaccinated and unvaccinated patients, taking in to account sociodemographic variables and medical risk conditions. Multivariate analysis was performed using multilevel regression models. We included 1038 patients: 602 (58%) had received the influenza vaccine in the 2013-14 season. Three or more general practit…
Pandemic influenza A (H1N1) infection in pregnant and nonpregnant women in Spain (2009-2010)
2014
The present study aimed to compare the main features of infection with pandemic influenza A virus in pregnant and nonpregnant women admitted to hospitals in Spain during the first waves of the 2009-2010 influenza pandemic. This was a prospective (November 2009 to June 2010), multicenter observational study. All cases were women of reproductive age who had not been vaccinated against seasonal or pandemic influenza A. Influenza infection was confirmed by reverse transcription-polymerase chain reaction (RT-PCR). The sociodemographic and clinical data of all cases were reviewed. A total of 219 inpatients, including 49 pregnant women and 170 nonpregnant women, were enrolled in the study upon adm…
The effectiveness of influenza vaccination in the elderly in Spain in two influenza seasons: a multicenter case-control study
2017
Influenza vaccination may limit the impact of influenza in the community. The aim of this study was to assess the effectiveness of influenza vaccination in preventing hospitalisation in individuals aged ≥ 65 years in Spain. A multicentre case-control study was conducted in 20 Spanish hospitals during 2013/14 and 2014/15. Patients aged ≥ 65 years who were hospitalised with laboratory-confirmed influenza were matched with controls according to sex, age and date of hospitalisation. Adjusted vaccine effectiveness (VE) was calculated by multivariate conditional logistic regression. A total of 728 cases and 1,826 matched controls were included in the study. Overall VE was 36% (95% confidence inte…
Knowledge of and attitudes to influenza in unvaccinated primary care physicians and nurses
2014
Primary healthcare workers, especially nurses, are exposed to the vast majority of patients with influenza and play an important role in vaccinating patients. Healthcare workers' misconceptions about influenza and influenza vaccination have been reported as possible factors associated with lack of vaccination. The objective of this study was to compare the characteristics of unvaccinated physicians and unvaccinated nurses in the 2011-2012 influenza season. We performed an anonymous web survey of Spanish primary healthcare workers in 2012. Information was collected on vaccination and knowledge of and attitudes to the influenza vaccine. Multivariate analysis was performed using unconditional …
Influenza vaccination of primary healthcare physicians may be associated with vaccination in their patients: a vaccination coverage study
2015
Background: To assess the contribution of physician-related factors, especially their influenza vaccine status, in the vaccination coverage of their patients. Methods: A study of vaccination coverage was carried out in Spain in 2011–12. The dependent variable (vaccination coverage in patients aged ≥65 years) was obtained from regional records. Information was gathered on the vaccination of physicians through an anonymous web survey. We compared the vaccination coverage of patients with the vaccination of their physicians using the Student t test. Associations were determined using a multilevel regression model. Results: The coverage in patients aged ≥ 65 years was 56.3% and was higher (57.3…
Managing an online survey about influenza vaccination in primary healthcare workers
2015
Online surveys are increasingly used due to their speed and efficiency. The aim of this study was to analyze factors that may have contributed to the quality and speed of response of an online survey on influenza vaccination in primary healthcare workers. A multicenter study including family physicians, nurses and pediatricians from primary healthcare teams from seven Spanish Autonomous Communities was designed. The centers were selected by simple random sampling. The survey remained active and accessible for 56 days and four reminders were sent. The odds ratios (OR) and their 95% confidence intervals (CI) were calculated to assess the association of sociodemographic variables and respondin…
Economic evaluation of health services costs during pandemic influenza A (H1N1) pdm09 infection in pregnant and non-pregnant women in Spain (2009)
2016
Background: The healthcare and socio-economic burden resulting from influenza A (H1N1) pdm09 in Spain was considerable. Our aim was to estimate and compare the management (resource utilization) and economic healthcare impact in an at-risk group of unvaccinated pregnant women with an unvaccinated group of non-pregnant woman of childbearing age (15-44 yr old). Methods: We addressed this question with a longitudinal, observational, multicentre study. Inputs were the require-ments in managing both groups of women. Outcome measures were healthcare costs. Direct healthcare (including medical utilisation, prescriptions of antivirals, medication, diagnostic tests, and hospitalisation) costs and ind…
The effectiveness of influenza vaccination in preventing hospitalisations of elderly individuals in two influenza seasons: a multicentre case-control…
2017
Influenza vaccination may limit the impact of influenza in the community. The aim of this study was to assess the effectiveness of influenza vaccination in preventing hospitalisation in individuals aged ≥ 65 years in Spain. A multicentre case–control study was conducted in 20 Spanish hospitals during 2013/14 and 2014/15. Patients aged ≥ 65 years who were hospitalised with laboratory-confirmed influenza were matched with controls according to sex, age and date of hospitalisation. Adjusted vaccine effectiveness (VE) was calculated by multivariate conditional logistic regression. A total of 728 cases and 1,826 matched controls were included in the study. Overall VE was 36% (95% confidence inte…