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Biomedical subjects

A Plasencia

Publications and source records attributed to A Plasencia.

At least 19 recordsLinked to original sources

Seroprevalence of measles, rubella, and mumps antibodies in Catalonia, Spain: results of a cross-sectional study.

Determination of antibody levels against vaccine-preventable diseases is of great value to assess immunization programmes. The objective of this study was to determine the prevalence of measles, rubella, and mumps antibodies in representative samples of the child and adult population of Catalonia and compare the findings to those obtained in 1996. A representative sample of the child and adult (>or=15 years) population of Catalonia was studied. Enzyme-linked immunosorbent assay techniques were used to determine the presence of antibodies. Equivocal results for antibodies against measles and rubella were tested using an immunofluorescence technique. To compare proportions, the chi-square test and the Fisher's exact test were used. Statistical significance was set at 0.05. Adjusted odds ratios were calculated using multiple logistic regression analysis. Samples from 2,619 people were analyzed. The global prevalence of antibodies was 98.3% for measles, 91.1% for mumps, and 98.1% for rubella. The prevalence of rubella antibodies was higher in women than in men (98.8 vs. 97.2%, respectively). Compared with the results obtained in the 1996 seroprevalence study, only the prevalence of rubella antibodies showed a statistically significant increase in men (97.2 vs. 94.6%; p=0.002) and, in particular, in women (98.8 vs. 95.3%; p<0.001). The low prevalence of susceptible subjects has already led to the elimination of indigenous measles in Catalonia and should allow the elimination of indigenous rubella by 2005. The level of antibodies necessary to interrupt the transmission of mumps has still not been reached in all age groups.

Adolescent↗

Epidemic soybean asthma and public health: new control systems and initial evaluation in Barcelona, 1996-98.

OBJECTIVE: To evaluate the new measures adopted to control the risks from soybean unloading operations in the Port of Barcelona, after an episode of epidemic asthma in June 1996. METHODS: After an initial cautionary suspension of all soybean unloading operations, they were subsequently resumed under restrictive criteria for time, flux, simultaneity, and meteorological conditions. Emission filtration systems based on either micro pore size filters or polytetrafluoroethylene membranes on tetratex filters showed promising results. RESULTS: Allergen emission underwent a very important decrease to levels 95% to 98% lower. Emissions from the two plants with unloading operations are in the same order of magnitude as the processing plant that does not unload soybean. Allergen concentration levels presented fluctuations initially, but the new filters decreased mean values; despite increased unloading, allergen levels did not increase-mean allergen levels on unloading days (67 U/m(3)) and on days without unloading operations (63 U/m(3)) are similar. A panel of patients detected a cluster of increased symptoms during unloading operations on a day with suboptimal meteorological conditions and comparatively low allergen levels (225-415 U/m(3)). Since the June 1996 episode, no further asthma outbreak has been detected. CONCLUSIONS: The evaluation shows the effectiveness of the new filters in the control of soybean dust emission. With a systematic control programme, industrial soybean operations may function near urban centres without public health risks. These data may be useful in the development of future standards for allergenic agents.

Allergens↗

Apheis: public health impact of PM10 in 19 European cities.

STUDY OBJECTIVE: Apheis is a public health surveillance system that aims to provide European, national, regional, and local decision makers, environmental health professionals, and the general public with up to date and easy to use information on air pollution and public health. This study presents the health impact assessment done in 19 cities of Western and Eastern European countries. DESIGN: Apheis developed guidelines for gathering and analysing data on air pollution and the impact on public health. Apheis has analysed the acute and chronic effects of fine particles on premature mortality using the estimates developed by Aphea2 study and two American cohort studies. This health impact assessment was performed for different scenarios on the health benefits of reducing levels of particles less than 10 microm in size (PM(10)). MAIN RESULTS: PM(10) concentrations were measured in 19 cities (range: 14-73 microg/m(3)). The population covered in this health impact assessment includes nearly 32 million inhabitants. The age standardised mortality rates (per 100 000 people) range from 456 in Toulouse to 1127 in Bucharest. Reducing long term exposure to PM(10) concentrations by 5 microg/m(3) would have "prevented" between 3300 and 7700 early deaths annually, 500 to 1000 of which are associated with short term exposure. CONCLUSIONS: Apheis shows that current levels of air pollution in urban Europe have a non-negligible impact on public health, and that preventive measures could reduce this impact, even in cities with low levels of air pollution.

Air Pollutants↗

An outbreak of Legionnaires' disease in an inner city district: importance of the first 24 hours in the investigation.

OBJECTIVE: To present the main results of the investigation of an outbreak of Legionnaire's disease that occurred in an inner city district of Barcelona between 15 October and 15 November 2000. METHODS: Epidemiological surveys of patients and environmental investigations were initiated on the day the first five cases were notified. Water samples and smears from cooling tower trays were taken for microbiological analysis. Maps of the distribution of cases and possible contamination foci were elaborated. Incidences were calculated for each census tract. RESULTS: A total of 54 patients related to the outbreak were identified, with a case fatality rate of 5.5%. Incidence rate in the area closest to the cooling tower (6.40/1000) was significantly higher than that of the rest of the neighbourhood (2.23/1.000, RR 2.87, 95%CI 1.37-6.12, P = 0.0035). Cultures positive for Legionella pneumophila serogroup 1, subtypes Pontiac, Philadelphia or Allentown, were obtained from eight patients. On the 39th day of the investigation it was found that the strain isolated in one of the cooling towers coincided with the serogroup, subtype and molecular profiles identified in clinical samples. CONCLUSIONS: Rapid coordination of clinicians, microbiologists, epidemiologists and environmentalists permitted the source of infection and the affected cases to be correlated within a few days.

Adult↗

Transient nonketotic hyperglycinaemia: ultrasound, CT and MRI: case report.

We report a case of transient nonketotic hyperglycinaemia in which radiography correlated closely with clinical and biochemical findings. Only 5 patients have been previously described with this transient from of nonketotic hyperglycinaemia. Among the radiographic findings, thinning of the corpus callosum is the most characteristic.

Brain↗

Arteriovenous malformation animal model for radiosurgery: the rete mirabile.

PURPOSE: To study the effects of single-dose radiation on the porcine rete mirabile, a tangle of microvessels that mimics human arteriovenous malformations of the brain. METHODS: Eight retia mirabilia received a single dose of radiation under stereotactic location with digital angiography and CT. The following doses were applied: 20, 30, 40, 50, 60, 70, 80, and 90 Gy. The animals were followed up for a period of 7 months. Findings at neurologic examination, serial angiography, and histopathologic examination were analyzed. RESULTS: Progressive occlusion as observed by angiography corresponded to the histopathologic finding of intimal hyperplasia; that is, marked thickening of the vessel wall, progressing to occlusion of the vascular lumen, and associated thrombosis. A direct dose response was noted for these changes. Neurologic findings were related to the dose distribution and to histologic findings in structures adjacent to the rete mirabile. CONCLUSION: The rete mirabile is an excellent model by which to study the radiologic and histologic effects of single-dose radiation to the microvasculature of the central nervous system.

Angiography, Digital Subtraction↗

PCR-based study of the presence of Y-chromosome sequences in patients with Ullrich-Turner syndrome.

The presence of Y chromosome sequences in Ullrich-Turner syndrome (UTS) patients has been suggested in previous work. Karyotype analysis estimated at about 60% of patients with a 45, X constitution and molecular analysis (Southern blot analysis with several Y chromosome probes and PCR of specific sequences) identified the presence of Y chromosome material in about 40% of 45, X patients. We have developed a very sensitive, PCR-based method to detect Y specific sequences in DNA from UTS patients. This protocol permits the detection of a single cell carrying a Y sequence among 10(5) Y-negative cells. We studied 18 UTS patients with 4 Y-specific sequences. In 11 patients we detected a positive amplification for at least one Y sequence. The existence of a simple and sensitive method for the detection of Y sequences has important implications for UTS patients, in view of the risk for some of the females carrying Y-chromosome material of developing gonadoblastoma and virilization. Additionally, some of the UTS associated phenotypes, such as renal anomalies, could be correlated with the presence of Y chromosome specific sequences.

Adolescent↗

Predictive factors of enrollment and adherence in a breast cancer screening program in Barcelona (Spain).

This paper study the predictive factors associated to enrollment and adherence in a breast cancer screening program in Barcelona, Spain; the Program is targeted to women 50-70 years of age who are members of a Health Maintenance Organization. Data were collected by personal interview for the attending women and by telephone in the non-attending group. The questionnaire was focused on knowledge, attitudes and practices related to female cancer prevention and breast cancer risk factors. Data analysis consisted of bivariate and multivariate analysis. Enrolling in a breast cancer screening program was strongly associated with practices related to cancer prevention in the bivariate analysis. Having had a previous mammography was the only behavioral factor that showed an independent relationship with enrollment (OR = 6.45, 95% CI = 3.35-12.42) in the multivariate analysis together with being younger than 55 and having family history of cancer. Adherence was associated with having the best opinion of the program, knowing the preventive role of mammography and performing regular breast self-examination in the bivariate analysis; of these, knowing the preventive role of mammography (OR = 2.66, 95% CI = 1.14-6.18) and performing regular breast self-examination (OR = 1.99, 95% CI = 1.23-3.23) were independently associated in the multivariated analysis. Being a relative of a municipal worker and younger than 55 were also significantly associated with adherence. Getting women to participate in a breast cancer screening program is difficult--mailed invitation letters are not sufficient.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Repeaters count: a sentinel method for asthma outbreaks. Barcelona Soybean-Asthma Group.

BACKGROUND: Asthma outbreaks have not been detected in Barcelona, Spain since the epidemic of 1981-7. On 29 October 1994 several subjects attended a Barcelona hospital because of acute attacks of asthma and were identified as former soybean epidemic asthma patients (repeaters), raising the possibility of an asthma soybean-related episode. The usefulness of counting repeaters to evaluate small increases of acute asthma in a non-epidemic period is illustrated. METHODS: A retrospective identification of asthma admissions was performed, pollution filters collected before and after the index day were analysed for contents of low molecular weight soybean allergen, and soybean unloading activities were investigated. RESULTS: There was no epidemic increase of asthma patients during this day in the whole of Barcelona, but an unusually high number were repeaters (seven observed v 0.483 expected). A relationship with increased levels of low molecular weight soybean allergen (U/m3) was detected in the available pollution filters collected the day before and after the index day. Two ships were unloading soybean in the city harbour on the index day. CONCLUSION: Soybean unloading at the harbour of Barcelona released soybean dust and produced a small cluster of emergency room visits for asthma in patients formerly affected by soybean asthma epidemics. It is suggested that counting repeaters could provide the basis for a systematic epidemiological surveillance of sensitised populations.

Acute Disease↗

[Cystic fibrosis in Asturias: an elevated frequency of the delta F508 mutation].

BACKGROUND: Cystic fibrosis (CF) is the most common autosomic-recessive inherited disorder. More than 300 different mutations in the CF gene (CFTR) have been described, being delta F508 and G542X the most common in the Spanish population. The frequencies of these mutations vary between the different European populations. METHODS: We have studied the delta F508 and G542X mutations in 20 CF-patients from Asturias. These mutations were analysed through the polymerase chain reaction (PCR). RESULTS: The frequency of the delta F508 mutation in Asturias was 77.5%, higher than those found in most of the other Spanish populations. The frequency found in Asturias is close to the frequency described for the Basque Country population. Patients homozygous for the delta F508 mutation showed clinical symptoms similar to those described in studies on other populations. CONCLUSIONS: The high frequency of two mutations in the CFTR gene in Asturias makes possible the direct diagnostic in most families. The delta F508 mutation is associated to severe clinical manifestations, like early pancreatic insufficiency and Pseudomonas infection.

Adolescent↗

[Clinico-epidemiologic study of human listeriosis in Barcelona (1990-1991)].

BACKGROUND: The aim of this study was to determine the incidence of human listeriosis in Barcelona in addition to its clinical form of presentation, seasonability, risk groups and evolution. METHODS: A prospective study of the cases of listeriosis registered in the city of Barcelona, Spain (population of 1,643,542 inhabitants) over the period from January 1, 1990 to December 31, 1991 was carried out. RESULTS: Fifty-five cases were reviewed with a global rate of incidence of listeriosis of 9.4 per one million inhabitants per year with predominance being observed in the summer months (39% in 1990, 42% in 1991). Ninety-one percent of the cases were observed in non pregnant adults, with 86% of the patients being immunosuppressed. Nosocomial listeriosis, diagnosed in 23 patients (42%), was predominant in the group with immunosuppressive treatment (p = 0.0005). The main site of isolation was blood in 45 cases (82%), in the form of primary listeriosis (p < 0.0005). Global mortality was 49%, being greater in the group of patients with nosocomial infection (p = 0.01) and with primary bacteremia (p < 0.001). No patients without known risk factors or pertaining to the perinatal group have died. CONCLUSIONS: The use of an active system of registration of listeriosis facilitates better knowledge of its incidence, distribution and infection pattern thus allowing the early detection of epidemic outbreaks with the aim of controlling such an infection, given the social implications and morbidity of this disease.

Adolescent↗

Incidence of listeriosis in Barcelona, Spain, in 1990. The Collaborative Study Group of Listeriosis of Barcelona.

A population-based register of cases of listeriosis admitted to acute-care hospitals has been established in Barcelona, Spain, in order to estimate the basal incidence of sporadic cases and to facilitate epidemiological surveillance of potential epidemics. Eleven acute-care hospitals reported all cases of listeriosis to a central unit following a standardized protocol. During 1990, 31 patients with listeriosis were identified, 18 of whom were residents of the city, resulting in an annual incidence of 10.95 cases per million inhabitants. Twelve of the 31 cases occurred in the period from July to September 1990, ten of them being community-acquired. The incidence of listeriosis was higher in elderly (> or = 65 years) and immunosuppressed persons. Forty-two percent of the cases were considered to be nosocomial infections. The overall mortality rate was 51.6%. The incidence of listeriosis in the present study is one of the highest reported in the literature. A high sensitivity of the reporting system with good case identification techniques, or demographic and environmental characteristics related to Listeria monocytogenes infection in our area, might be possible reasons for this geographic variation.

Adolescent↗

[Reproducibility of the use of classifications of causes of death in the context of inquiries in perinatal mortality].

The objective of this study was to verify the reliability of the classifications of perinatal mortality causes. An independent observer coded the cases of perinatal death (n = 152) collected in the Encuesta Confidencial de Mortalidad Perinatal de Barcelona (ECMP, Confidential Perinatal Mortality Inquiry of Barcelona), by using both the Aberdeen classification system (regarding obstetric factors) and the Wigglesworth classification system (according to the initial pathological cause), with the same information used previously by the ECMP Commission. For the Aberdeen classification, the observed concordance index (Po) was 86% and the Kappa coefficient (K) 0.77 (95% CI: 0.68-0.86). For the Wigglesworth classification, the figures were 89% and 0.82 (95% CI: 0.74-0.90), respectively. The disagreement was mainly due to differences in the interpretation of the sequence of death, minimal information available in order to classify the cause of death, and misunderstanding of the existing information. To a lesser extent, the disagreement was caused by a failure to comply with the rules laid down for classifications. The assessment of the causes of death was not significantly influenced by birth weight, gestational age, time of death or the presence of necropsy. These results support the use of classifications of perinatal mortality causes in the context of confidential inquiries.

Autopsy↗