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Biomedical subjects

C Alvarez-Dardet

Publications and source records attributed to C Alvarez-Dardet.

81 records · Page 5Linked to original sources
PubMedDate not supplied

[Induced abortions among Spanish women in England and Wales (1974-1988)].

To assess the importance of travelling for abortion in Spanish women from 1974 to 1988, a descriptive epidemiologic study was undertaken, based on information from the United Kingdom Office for Population Censuses and Surveys. Additionally, the effect of the democratic restitution in Spain (1978) and of the passing of the Spanish abortion law in Spain is explored. During the study period, close to 200,000 Spanish women travelled to England and Wales to have an abortion. The annual figures range from 2,978 in 1974 to 22,002 in 1983. In 1988, in spite of the partial decriminalization of abortion in Spain, still 3,188 travelled to the UK for an abortion. In average, 1 out 35 Spanish women in fertile ages travelled to England and Wales for this reason in the study period. The likelihood was higher for the cohort of women born between 1955 and 1959, for which the risk was 4.5%. The proportional distribution by age shows that teenagers increased their relative importance from 9.3% in 1974 to 17% in 1988, suggesting less benefits for this age group than for older women from the democratization of the country and the abortion law.

Abortion, Induced↗
PubMedDate not supplied

Urban clusters of sexually transmitted diseases in the city of Seville, Spain.

To test the hypothesis that there is an increased risk for sexually transmitted diseases in certain geographic areas, 613 patients diagnosed as having sexually transmitted diseases in Seville, Spain, were studied in relation to their address. Increased risks of gonorrhea (relative risk, 3.72), syphilis (relative risk, 3.32), Chlamydia trachomatis infections (relative risk, 3.41), and the three conditions together (relative risk, 3.52) were found in district 1, which represents the core of transmission and the central area of old Seville. These findings represent the first description of spatial clusters for syphilis and Chlamydia trachomatis infections.

Chlamydia Infections↗
PubMedDate not supplied

Oral sex as a risk factor for Chlamydia-negative ureaplasma-negative nongonococcal urethritis.

We present a case-control study that evaluated the association of Chlamydia-negative, Ureaplasma-negative nongonococcal urethritis with oral and/or anal sex. The study population was composed of 120 patients diagnosed as having nongonococcal urethritis in the Diagnostic Center for sexually transmitted diseases (STD) of the Medical School of Seville. Cases were 56 men suffering from nonogonococcal urethritis from whom neither Chlamydia trachomatis nor Ureaplasma urealyticum was isolated; the remaining 64 males with cultures positive for these agents were considered as controls. Insertive genital-oral intercourse significantly increased the risk of Chlamydia-negative, Ureaplasma-negative nongonococcal urethritis (odds ratio, 11.400; 95% confidence interval, 2.357-75.057). This association was still very strong (odds ratio, 8.882) after adjustment for homosexuality. Insertive anal intercourse appears not to increase the risk of Chlamydia-negative, Ureaplasma-negative nongonococcal urethritis. We conclude that insertive oral sex can be an important risk factor in the development of nongonnococcal urethritis in which the microbial agent is still unknown.

Chlamydia trachomatis↗
PubMedDate not supplied

[The pyramid trap].

This paper discusses the impact of globalization on public health practice. Neoliberal supremacy has resulted in both greater interdependence between countries and increasing inequalities. Globalization of health risks and the dependence of local health conditions on external forces precludes the use of local/national solutions for global problems. In this context, the classical organization of public health services in a hierarchical pyramid based on geographically defined areas (from the local to the regional and national levels) no longer makes sense. We thus suggest some characteristics of a different type of organization based on new information technologies: a transnational network, horizontally shaped, more independent from political power, allowing for exchange of information and good practices, promoting dissemination of knowledge and producing "glocal" solutions. Through the creation of work opportunities between health professionals, the model will permit the creation of common strategies and increase the power of their political demands, perhaps allowing for the collective development of a more equitable world.

Brazil↗
PubMedDate not supplied

[Evolution of epidemiological methods in clinical research in Spain (1975-1994)].

BACKGROUND: Previous studies have shown a sparing utilization of analytical and experimental designs in Spanish clinical research journals. The study aims are to compare among countries, the use of epidemiologic method in articles published in scientific journals, and to determine the extent to which this research has direct funding. METHODS: Cross-sectional study including all original papers published during 1994 in Medicina Clinica [(Med Clin (Barc)], Revista Clinica Española (Rev Clin Esp), The Lancet (Lancet) and New England Journal of Medicine (N Engl J Med). They were classified according to epidemiological design and we verified the financial support mention. RESULTS: 594 papers were included. Epidemiological studies without control group prevailed in Spanish journals. The most common designs were descriptive studies in Med Clin (Barc), with 45.5%, and clinical series in Rev Clin Esp, with 41.7%. The 33.6% of original papers published in Lancet and 28.4% of N England J Med were randomized trials. We found information about financial support in 73.7% of papers published in Lancet, in 77.4% of N Engl J Med, in 23.1% of Med Clin (Barc) papers and not one in the Rev Clin Esp studies. CONCLUSIONS: In Spanish clinical journals the use of epidemiological methods with control group is limited and direct financial support unusual. Wherefore these studies have a limited applicability.

Epidemiologic Methods↗
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[Public policies of research].

With its present configuration, the Spanish public device of research in health sciences has limited possibilities to achieve properly the aims of the Ley General de Sanidad, due to its reduced financial importance as well as its thematic and lack of mechanisms of interterritorial compensation. These limitations are effective according to its small capacity to provide information for the development of a health system, oriented to the overcoming of territorial and social imbalance as well as the promotion of health and prevention of diseases. The capacity of public policies of research in Spain to affect the work of researchers is very small due to the importance of the widespread practice of not using funds which are not specifically dedicated to research of the institutions employing the researchers, among other reasons. Most of the public resources of research are concentrated in Madrid and Barcelona. This situation can seriously jeopardize in a near future the development and quality of the attention given in Regional Health Services transferred to Autonomic Communities without big cities. The funds are mostly used to finance researches of basic sciences, medical specialties and clinic laboratories. Investigation in Public Health is only 0.8% of the research budgets, and the funds dedicated to research in Health Primary Care are also very small. The present predominant thematic and methodological orientation of health research in our country, with medicalized research aims, subindividual observation units, experimental designs, and analysis which are basically quantitative, can endanger the possibilities of Spain to achieve the health aims established by the OMS.

Public Policy↗
PubMedDate not supplied

[Care according to patient gender in emergency services: different or unequal?].

It has been recently published different studies that support the idea that the health services make variability according to the patient's gender. In this sense, the aim of this study is to find out if there are gender differences in diagnostic and therapeutic care in health problems attended in emergency services. With the purpose of assessing this problem in a public hospital in Spain we have make a secondary analysis of the patient's findings got in the Emergency Service of Elche Hospital during four weeks in 1985.3, 709 patients were attended during this period. The results show a greater utilization of this service by men ORmale/female = 1.37 (1.29-1.47). The waiting time was higher for women (35 minutes) than men (29 minutes) (p = 0.0001), and also the time of getting a diagnostic (86 minutes vs 76) (p = 0.003). Diagnostic test were more frequent perform to women than men ORmale/female = 0.75 (0.64-0.85) meanwhile men receive treatment more often, ORmale/female = 1.34 (1.09-1.47). The associations are adjusted for age, diagnostic groups and patient's destination. Taking into account the possibility of more severity diseases among men that could explain the shorter waiting time and the therapeutic effort, the results show the possibility of an inequality attitude in the emergency services that would need further investigations. The more frequent use of diagnostic tests among women and consequently the longer diagnostic time, could be explain by the fact of the higher rates of nonspecific pathology.

Adolescent↗