Pneumococcal pneumonia is a serious cause of morbidity and mortality in the elderly, but investigation of the etiological agent of community-acquired pneumonia (CAP) is not possible in most hospitalized patients. The aim of this study was to estimate the effect of pneumococcal polysaccharide vaccination (PPSV23) in preventing CAP hospitalization and reducing the risk of intensive care unit admission (ICU) and fatal outcomes in hospitalized people aged ≥65 years. We made a multicenter case-control study in 20 Spanish hospitals during 2013–2014 and 2014–2015. We selected patients aged ≥65 years hospitalized with a diagnosis of pneumonia and controls matched by sex, age and date of hospitalization. Multivariate analysis was performed using conditional logistic regression to estimate vaccine effectiveness and unconditional logistic regression to evaluate the reduction in the risk of severe and fatal outcomes. 1895 cases and 1895 controls were included; 13.7% of cases and 14.4% of controls had received PPSV23 in the last five years. The effectiveness of PPSV23 in preventing CAP hospitalization was 15.2% (95% CI -3.1–30.3). The benefit of PPSV23 in avoiding ICU admission or death was 28.1% (95% CI -14.3–56.9) in all patients, 30.9% (95% CI -32.2–67.4) in immunocompetent patients and 26.9% (95% CI -38.6–64.8) in immunocompromised patients. In conclusion, PPSV23 showed a modest trend to avoidance of hospitalizations due to CAP and to the prevention of death or ICU admission in elderly patients hospitalized with a diagnosis of CAP.

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Resumen: Este artículo se centra en analizar las necesidades de formación que poseen los jóvenes entre 15 y 26 años, que asisten al programa de Formación Profesional Básica, para continuar estudios y/o acceder a un empleo. El estudio realizado es exploratorio, descriptivo e inferencial desarrollado en la Comunidad de Madrid. Se ha elaborado un cuestionario ad hoc, validado por jueces expertos. Se analizaron los datos mediante métodos cuantitativos: descriptivos, inferenciales y multivariados. Los hallazgos han posibilitado el conocimiento de propuestas educativas para lograr una formación eficaz que permita a los jóvenes en riesgo social su integración en la sociedad mediante el apoyo de los implicados. Promover un enfoque formativo integral mediante una relación fuerte entre las instituciones formativas y lugares de trabajo, serían modos de avanzar en la igualdad de oportunidades en todos los estratos poblacionales de la sociedad y sobre todo en aquellos jóvenes más vulnerables.Abstract: This article is focused on analyzing training needs about youth among 15 and 26 years old, who attend the Basic Professional Training program, to continue studies and/or to access to a job post. The made study is exploratory, descriptive and inferential type carried out in the Community of Madrid. A survey has been elaborated (ah doc), which was validate for expert judges. Quantitative methods were used to analysis data: descriptive, inferential and multivariate. The discoveries have let the direct knowledge of the real situations and contexts of the youth in social difficulty, like so the educational proposals which are carried out with the finality to get an efficient training which let youth in social risk to reach an integration in the society through the support of the involved. Promoting an integral and training approach close through a strong relationship among training institutions and labor places, they would be ways to go forward in the equal opportunities in all population strata and especially in youth more vulnerable.

Background:Efficacy and safety profile of new JAK inhibitors have been properly defined by several clinical trials, being tested in many patients with Arthritis Reumatoid. However, real-life conditions studies play an important role in order to know JAK inhibitors behaviour in safety.Objectives:To describe adverse events of JAK inhibitors in patients with Arthritis Rheumatoid and asses the survival in relation to adverse events.Methods:Observational, descriptive, retrospective design performed in patients with Arthritis Reumatoid in follow-up by the Rheumatology department of the Hospital de Valme until January 2019. Demographic and clinical data related to safety has been collectedResults:58 patients were included with a mean age of 57,77 ± 10,78 years. Mean time from diagnosis was 8,7 ± 6,54 years, female predominance (75%). Mean ASDAS at the beginningof JAK inhibitor treatment was 4,76 ± 0,93. Regarding the determination of FR and CCCP 69% and was positive in both cases. Baricitinib was the treatment chosen in 13 patients (22.4%), and Tofacitinib in 45 patients (77.6%). Regarding associated treatments: 84.5% was under low-dose steroids theraphy; 77.6% was under combined therapy with at least 1 DMARD; 15.5% with two of them. Metotrexato was used in 53,4% of patients, leflunomide in 19%, hydroxycloroquine in 13.8%, sulfasalazyne in 12.1%. 72,4% have been before under at least one biologic treatment (frequently antiTNF), 41,1% one of them, 15.5% two of them, 12.1% three and 1.7% four before starting Jak inhibitor therapy. Adverse events has been observed in 17 patients (13 from de Tofacitinib group -28.8%-, and 4 in the Baricitinib group -30.76%). The most common advers events were: herpes zoster infections (4 patients in Tofacitinib group), respiratory infections (3), urinary infections (2), cutaneous (3), caphalea (1), legs oedema (2), toxic hepatitis in 1 patient of Baricitinib group; pulmonary thromboembolism was observed in 1 patient of Tofacitinib group, and atrial fibrillation in other patients of that group. Treatment was interrupted in 24 of 58 patients (mean time 8.92 ± 5.14 months), 16 from Tofacitinib group (35.5% of patients with Tofacitinib) and 8 from Baricitinib group (61.15% of patients with Tofacitinib). In Tofacitinib group, 10 patients stopped therapy for inefficacy reasons and 6 for advers effects related. In Baricitinib group, 5 due to inefficacy, 2 to adverse effects and 1 to clinical remission.Conclusion:Main adverse effect were mild-moderate infections (involving in-hospital treatment only in one Barictinib group patient). One pulmonary thromboembolism has been detected in a hypertensive 70 years old patient, supporting the recent recommendation of avoiding these drugs in patients over 65 or with cardiovascular risk factors. It is remarkable low survival results due to inefficacy, that could be related to clinical profile of refractory patients in our study, and/or to the small sample that we describe.Disclosure of Interests:None declared