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Biomedical subjects

E Fernández García

Publications and source records attributed to E Fernández García.

16 recordsLinked to original sources
PubMed1995

[Opinion of asymptomatic HIV-positive patients about their primary care physicians].

OBJECTIVE: To find the opinion of asymptomatic HIV+patients about their Primary Care doctors. DESIGN: A descriptive, crossover study with an 11-item questionnaire, filled in by the patient him/herself anonymously and analysing: communication of being seropositive, frequency of attendance, confidence in the doctor and their competence in dealing with the patient. SETTING: AIDS Information and Prevention Centre, Alicante. PATIENTS: Consecutive sampling of the first 100 HIV+patients who attended voluntarily during the first 5 months of 1993 (from January 3 to May 18 inclusive). MEASUREMENTS: 60.2% (C.I. 95%, 69.9%--50.5%) said they communicated their being seropositive to the doctor. Intravenous drug users communicated this fact more (72.9%), against 41% of the rest of the groups (p = 0.0016). 25% had little or no confidence in their doctor and 44% considered him/her incompetent or barely competent, with these two variables being related (r = 0.42; p = 0.0001). Communicating their condition to the doctor is only related to more frequent attendance at the clinic (p = 0.0001). The reasons for not doing so are due mainly to lack of confidence (30.8%) and "didn't think of it" (46.2%). The doctor's competence obtained the lowest points average, 2.6, with its Confidence limits sharing no value with frequency of attendance or confidence. CONCLUSIONS: An important percentage of patients do not communicate their condition, due basically to problems of confidentiality and rejection. There are doubts among HIV+patients interviewed about their doctor's competence, at the same time as they have little confidence in him/her.

Adult↗
PubMed1993

[Prevalence of human immunodeficiency virus infection among parenteral drug users in the community of Valencia 1987-1991)].

BACKGROUND: To contribute to the knowledge of the frequency and distribution of infection by the HIV-1 in intravenous drug consumers (IVDC) the prevalence of infection in those in whom the voluntary serologic testing was practised and tendency over 5 years were studied. METHODS: The study included 2794 IVDC from centers of primary health care (70%) or those who attended directly (30%), from 1987 to 1991, to three Centers of Information and Prevention of AIDS located in the cities of Valencia, Alicante and Castellón in which the voluntary and free practice of the test of antibodies versus HIV-1 was performed. The serologic test (enzymoimmunoassay) was carried out in 2694 individuals whose positive results were confirmed by Western-blot. Risk factors of the infection in addition to sociodemographic data were collected by questionnaire. RESULTS: The estimated global prevalence was of 49.9% with confidence intervals of 95% (CI 95%) of 48.1% to 51.7%. Differences were observed according to the city with the highest being Valencia (55.3%, CI 95%: 52.8%; 57.8%) in comparison with Alicante (43.7%. CI 95%: 40.5%; 46.9%) and Castellón (41.3%, CI 95%: 35.6%, 47%). A decrease in prevalence was detected during the period studied (chi 2 of tendency = 6.37; p = 0.011), with this decrease only being produced in Alicante and Castellón. No differences were found with regard to sex in contrast to those found according to age, from 35.3% in those under 20 years of age to 59.5% in those over 29 years (chi 2 of tendency = 80.62; p < 0.0001). Only in the youngest age groups was a decreased tendency in prevalence found. The IVDC attended reported interchanging of needles at the time of consultation in 16.9% (CI 95%: 15.5%; 18.3%) with a descending temporal tendency from 27.7% in 1987 to 2.8% in 1991 (chi 2 of tendency = 14.18; p = 0.0001). Only 18.7% (CI 95%: 17.2%; 20.2%) of the IVDC used condoms in more than 66% of their sexual encounters of vaginal coitus. No differences were found with respect to sex or year of consultation. CONCLUSIONS: The prevalence of infection by the HIV-1 in intravenous drug consumers requesting the serologic test is decreasing in the Community of Valencia. This reduction in frequency should be confirmed by estimated rate of incidence of seroconversion. The frequency of the use of condoms in intravenous drug consumers is low conditioning a high risk of extension of the epidemics by sexual transmission.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Determinants of the prevalence of hepatitis B viral infection in parenteral drug abusers].

In order to study the frequency of hepatitis B viral infection and its determinants, we studied 2337 intravenous drug users who visited three AIDS information and prevention centers between 1987 and 1991. The presence of three markers for HBV (AntiHBc, AntiHBs, and AgHBs) and of HIV-1 antibodies was analyzed. A structured questionnaire was used to gather data on sociodemographic information and risk factors for infection. The prevalence of HBV infection (at least one positive marker) was 78% (95% CI: 76%-80%). After adjustment via logistic regression, duration of drug addiction (OR-5.04), the number of sexual partners (OR = 1.70), and the presence of antibodies for HIV-1 (OR = 2.44) were associated with increased HBV infection were higher level of education (OR = 0.67) and residence in a smaller city (OR = 0.66). The marginalization of the practice of drug use makes prevention activities very difficult, and by the time they use health services, the majority of users have already been in contact with HBV. Other infectious agents which share parenteral transmission can reach a similar prevalence if preventive efforts are not intensified.

Adult↗
PubMed1993

[Study of the gene of Duchenne muscular dystrophy using PCR analysis].

We have performed the polymerase chain reaction (PCR) to study 26 patients affected with Duchenne muscular dystrophy as a direct diagnostic method of screening for gene deletions. We have amplified simultaneously 9 sequences which belong to 9 exons located along the two "hot spots" of the gene. We have detected deletions in many of the exons in 11 of the 26 patients (42.3% of the cases).

Blotting, Southern↗
PubMed1992

[Infection caused by the human immunodeficiency virus type 1 in prostitutes and risk factors].

BACKGROUND: Women dedicated to prostitution constitute a group at risk of acquiring the human immunodeficiency virus-1 (HIV-1). This study was designed with the aim of knowing the frequency of this infection in prostitutes and the factors associated to the same. METHODS: A descriptive transversal study with analytic components including 444 women who voluntarily attended an AIDS prevention center from 1986-1991 was carried out. The HIV-1 antibody test was performed in 440 of the subjects. All the subjects were interrogated on sociodemographic variables and risk of infection. RESULTS: Of the 440 women studied, 24 had HIV-1 antibodies with a global prevalence (1986-1991) of 5.5% with confidence intervals of 3.4, and 7.6% at 95% (CI 95%). During the study period the prevalence remained stable: 6.8% (1986-87), 5.5% (1988), 4.3% (1989) and 4.3% (1990-91). No positive association was found between HIV-1 infection and education, time in prostitution and the use of condoms. HIV-1 infection was strongly associated to the use of drugs, adjusted odds ratio by logistic regression OR = 26.9 (CI 95%: 8.9; 9/1). Positive associations were also observed with greater number of sexual partners and syphilis but these did not reach statistical significance. The percentage of prostitutes who used condoms with more than 33% of their clients increased from 44.5% in 1986-87 to 85.9% in 1990-91. CONCLUSIONS: In this study no considerable changes were found with respect to the prevalence of infection by the human immunodeficiency virus-1 in prostitutes in Spain. Similarly, this collective has increased its use of preventive measures although they remain insufficient, indicating that more energetic preventive strategies are necessary. These measures should be particularly active with the group of young prostitutes.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Modification of the calculation of risk factors in women, possible carriers of Duchenne muscular dystrophy, based on CPK levels].

We have analyzed the CPK levels in 44 carriers of DMD women, previously diagnosed by using molecular techniques (from a risk population of 133 women), and compare them with the CPK levels of 138 women of a control population. The results obtained show that values higher than the normal level (> 250 mU/ml) are compatible compatible in 99% of the cases with the carrier status (21 women of the carrier population and 1 women of the control population showed values higher than 250 mU/ml). On the other hand, normal values do not distinguish between the healthy and carrier populations (22 women of the carrier population showed normal CPK levels). These results can be very useful in genetic counselling, especially in centers where it is not possible to apply recombinant-DNA techniques.

Creatine Kinase↗
PubMed1990

[Evaluation of the variability of rapid diagnosis of infection by Chlamydia trachomatis using direct immunofluorescence].

The interobserver and intraobserver agreement between two microscopists was independently assessed in a blind fashion to evaluate the reproducibility of the results of the quick diagnosis of Chlamydia trachomatis infection with direct immunofluorescence. The study was carried out in two phases, and 604 samples of cervical and urethral exudate from patients seen at a center for the prevention and therapy of sexually transmitted diseases were evaluated. The two observers had a kappa index of agreement between them of 0.41, with 95% confidence intervals (95% Cl) of 0.31-0.51, while their agreement within themselves was 0.78 (95% Cl: 0.65-0.91) for the first observer and 0.61 (95% Cl: 0.47-0.75) for the second one. After discussion of the data and analysis of the reasons of disagreement, the evaluation was repeated. In this second phase, both interobserver and intraobserver agreement were substantially improved. The kappa index was 0.71 (95% Cl: 0.61-0.80) for the former, whereas regarding the latter the first observer had a kappa index of 1 (95% Cl: 0.86-1.13) and the second observer an index of 0.82 (95% Cl: 0.61-0.80). It was concluded that the test may have problems in its practical performance if the microscopists are not previously trained with systematic programs for the evaluation of results.

Cervix Uteri↗
PubMed1989

[Use of the recombinant DNA technic in studying cystic fibrosis in 14 Spanish families: detection of carriers and healthy subjects].

Fourteen Spanish families, containing at least one affected child with cystic fibrosis, were typed for restriction fragment length polymorphisms (RFLPs) by proper pJ3.11, pmet H and pmet D. Nine (64.3%) were fully informative for prenatal diagnosis and carrier detection; four (28.5%) were partially informative and prenatal exclusion of an affected fetus could be carried out in half of pregnancies. One (7.1%) was uninformative for these probes. Allelic frequencies obtained have also been analized, being pJ3.11 probe the most informative in our families.

Alleles↗
PubMedDate not supplied

[Changes in condom use among a cohort of prostitutes].

OBJECTIVE: To describe changes in condom use among prostitutes enrolled in a prospective cohort study in Alicante (Spain), and to identify those factors associated with changes in this behaviour. METHODS: Data from this study come from a prospective cohort study of women working at prostitution enrolled in a center for AIDS preventive at Alicante from 1986 to 1996. The proportion of condom use by prostitutes with their clients was recorded during the first visit and the last one, and changes in condom use were estimated as the difference between them. Two logistic regression analyses were done to identify those factors associated with positive or negative changes in condom use. RESULTS: A statistically significant increase in the prevalence of condom use was observed between the first, 69,2%, and the last visit, 83,9% (p < 0,001). Prostitutes working private increased the condom use more than five time than those working in clubs or at the street. The higher the follow-up time the higher the prevalence of condom user, OR > 6 years = 7,6 (95% CI: 2,2-26,0). No variable was associated with a negative change in condom use. CONCLUSION: This study shows an overall increase of condom use in a cohort of prostitutes after 10 years of follow-up. Relapse in risk behavior has been infrequent. In the future, preventive strategies to increase the use of condoms among prostitutes should be adapted to the new forms of sexual commerce.

Adult↗