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According to these studies:


* The pneumococcal conjugate vaccine has significantly reduced pneumococcal pneumonia admissions.


* The vaccine also reduces the incidence of invasive pneumococcal disease in young children with sickle cell disease.



Pneumonia, particularly that resulting from Streptococcus pneumoniae, is a prime cause of illness and death in the United States. A recent study published in the Lancet shows that in children younger than two years immunization with 7-valent pneumococcal conjugate vaccine (PCV7), which became available in 2000, significantly reduces rates of hospitalization for pneumococcal pneumonia and pneumonia from all other causes.


Researchers used data from the Agency for Healthcare Research and Quality's Nationwide Inpatient Sample to compare estimated admission rates for pneumonia after the introduction of PCV7 (2001 to 2004) and before (1997 to 1999). Admission rates for dehydration were assessed for comparison.


There were 10,787,865 "all-cause" pneumonia admissions during the study period. At the end of 2004, these admissions had declined by 39% in children younger than two years of age, which correlates to approximately 41,000 fewer pneumonia admissions in 2004. Among those children, 2% of the pneumonia admissions were coded as "pneumococcal pneumonia." In this subpopulation, there were 17 fewer admissions per 100,000 children in 2004, a 65% decline.


In another study, Natasha B. Halasa, MD, MPH, and colleagues reported similarly impressive findings on the effects of pneumococcal conjugate vaccine on patients with chronic illness, specifically sickle cell disease. The incidence of invasive pneumococcal disease in this population was determined from data on Tennessee's Medicaid recipients from 1995 through 2004. Invasive pneumococcal disease developed in 37 of the 2,026 patients with sickle cell disease; 21 of them were younger than age five. In the postvaccine periods, the rates of invasive pneumococcal disease dramatically decreased-by 90.8% in children younger than age two and by 93.4% in children younger than age five.


"Currently," says Carlos Grijalva, coauthor of the Lancet study, "vaccination with pneumococcal conjugate vaccine is recommended for healthy children younger than two years of age, and for older children ages 24 to 59 months with sickle cell disease, HIV infection, immunodeficiency, or chronic illnesses." -JC


Grijalva CG, et al. Lancet 2007;369(9568):1179-86; Halasa NB, et al. Clin Infect Dis 2007;44(11):1428-33.



According to this study:


* The majority of patients stated that the injury had "altered their sexual sense of self."


* Research should focus on improving the quality of patients' lives, not just on increasing mobility.



"Most researchers are focused on the holy grail of neuroscience-regeneration," Jaimie Borisoff, PhD, one of this study's coauthors, recently told AJN. But as a first step in improving the quality of the lives of people with spinal cord injury, Borisoff and his colleagues wanted to focus on studying the importance of sexual function in this population.


The researchers developed an online survey to be answered by both men and women, related to demographics, bladder and bowel continence, characteristics of the injury, and sexual activity, among other topics.


Two hundred eighty-six adult participants (70% male) with permanent spinal cord injury completed the questionnaire.


Most (87.4%) participants had been in a sexual relationship after experiencing their injury, and the likelihood of having had a sexual relationship increased with the length of time that had elapsed since the injury. When asked whether the spinal cord injury had altered their sexual sense of self and whether improving sexual function was important to improving the quality of their lives, 83.2% and 82.9% of participants, respectively, answered affirmatively.


The authors also found that while bladder and bowel incontinence issues didn't dissuade the majority of participants from taking part in sexual activity, it did significantly deter those who were concerned about incontinence.


Participants reported seeking sexual interaction primarily to fulfill intimacy and sexual needs, not for fertility. In this regard, Borisoff said, "Future research should address sexual pleasure and orgasm potential."-SDSJ


Anderson KD, et al. Spinal Cord 2007;45(5):328-37.