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Biomedical subjects

F Bolumar

Publications and source records attributed to F Bolumar.

At least 19 recordsLinked to original sources
PubMed2005

Influence of age and geographical origin in the prevalence of high risk human papillomavirus in migrant female sex workers in Spain.

OBJECTIVES: To estimate the prevalence and risk factors of high risk human papillomavirus (HPV) infection in migrant female sex workers (FSW) according to age and geographical origin. METHODS: Cross sectional study of migrant FSW attending a sexually transmitted infection (STI) clinic in Madrid during 2002. Information on sociodemographic characteristics, reproductive and sexual health, smoking, time in commercial sex work, history of STIs, HIV, hepatitis B, hepatitis C, syphilis, and genitourinary infections was collected. High risk HPV Infection was determined through the Digene HPV Test, Hybrid Capture II. Data were analysed through multiple logistic regression. RESULTS: 734 women were studied. Overall HPV prevalence was 39%; 61% in eastern Europeans, 42% in Ecuadorians, 39% in Colombians, 29% in sub-Saharan Africans, and 24% in Caribbeans (p = 0.057). HPV prevalence showed a decreasing trend by age; 49% under 20 years, 35% in 21-25 years,14% over 36 years% (p<0.005). In multivariate analyses, area of origin (p = 0.07), hormonal contraception in women not using condoms (OR 19.45 95% CI: 2.45 to 154.27), smoking, age, and an interaction between these last two variables (p = 0.039) had statistically significant associations with HPV prevalence. STI prevalence was 11% and was not related to age or geographical origin. CONCLUSIONS: High risk HPV prevalence in migrant FSW is elevated and related to age, area of origin, and use of oral contraceptives in women not using condoms. These data support the role of acquired immunity in the epidemiology of HPV infection and identifies migrant FSW as a priority group for sexual health promotion.

Adolescent↗
PubMed1998

False-positive tests for syphilis associated with human immunodeficiency virus and hepatitis B virus infection among intravenous drug abusers. Valencian Study Group on HIV Epidemiology.

The role of HIV, hepatitis C virus, and hepatitis B virus infections in the production of biological false-positive reactions for syphilis was evaluated in two large samples of intravenous drug abusers and homosexual men attending AIDS prevention centers in Spain. A significantly increased odds ratio (OR) for false-positive tests for syphilis [OR 2.23, 95% confidence intervals (CI) 1.76-2.83] was observed for HIV-seropositive intravenous drug abusers; biological false-positive reactions were also more frequent (OR 1.73, 95% CI 1.30-2.31) among intravenous drug abusers who were hepatitis B virus seropositive but not among those who were hepatitis C virus seropositive (OR 0.90; 95% CI 0.48-1.69). Among homosexuals, the association between HIV and biological false-positive reactions was restricted to subjects who were also intravenous drug abusers, indicating the crucial role of intravenous drug abuse. Only 20.5% of intravenous drug abusers with a previous biological false-positive reaction yielded a false-positive result in their subsequent visit.

Antibodies, Bacterial↗
PubMed1997

[Smoking reduces the biological capacity of conception. Results from a European multicenter study. The European Study Group on Infertility and Subfecundity].

The aim of the study was to examine the impact on subfecundity of male and female smoking at the start of a couple's waiting time to a planned pregnancy. Two types of designs were applied: a population based sample of women aged 25-44 years of age and a consecutive sample of pregnant women. Both studies were conducted within well-defined geographical regions in a number of European countries and data were collected by personal interviews in the population-based sample and by interview or self-administered questionnaires in the pregnancy study. A total of 10,665 couples participated in the study. Data on possible risk factors for infertility and subfecundity were collected at the start of the pregnancy planning, and fecundity was estimated by using time from the beginning of unprotected intercourse to a pregnancy, which survived at least 20 gestational weeks. Only couples who planned a pregnancy were included in the analyses. The results showed remarkably coherent associations between female smoking and subfecundity in each individual country and in all countries put together. In the population sample the odds ratio for subfecundity in the first pregnancy was 1.7 (95% c.l. 1.3-2.1 at the upper level of tobacco consumption) and during the most recent waiting time to pregnancy the odds ratio was 1.6 (95% c.l. 1.3-2.1). Results based on the pregnancy sample were similar with an odds ratio of 1.7 (95% c.l. 1.3-2.3). No significant association was found between male smoking and the couple's fecundity.

Adult↗
PubMed1997

Repeating episodes of low fecundability. A multicentre European study. The European Study Group on Infertility and Subfecundity.

Many reproductive failures tend to repeat themselves within the same couple. Whether fecundability (the probability of conceiving in a given number of menstrual cycles) follows the same pattern is studied using data from the European Studies on Infertility and Subfecundity (ESIS): 6630 women were interviewed on 'time to pregnancy' (TTP) and other aspects of their pregnancy history. Surveys were conducted between 1991 and 1994 in seven regions from five European countries. Furthermore, the pattern of fecundability in this population was compared with results from computer simulations based upon a population with fixed fecundability parameters. Results from ESIS speak in favour of the stability of fecundability in the relatively short reproductive life of a couple. However, a substantial proportion of couples with up to two events of subfecundability (TTP >9.5 months) became pregnant shortly after trying again. This finding calls for reservation in starting expensive and/ or unpleasant diagnostic procedures at an early stage when a couple tries to become pregnant again.

Adult↗
PubMed1997

Does moderate alcohol intake reduce fecundability? A European multicenter study on infertility and subfecundity. European Study Group on Infertility and Subfecundity.

BACKGROUND AND AIM: There are plausible reasons to suggest that heavy alcohol consumption reduces male as well as female fecundability, but only a few epidemiological studies have addressed this issue, and results concerning the effect of a moderate intake are equivocal. The present studies were designed to examine the association between male and female alcohol intake at the start of the waiting time to a planned pregnancy. METHODS: Two types of studies were used-a population-based study of randomly selected women between 25 and 44 years in the different European countries from census registers and electoral rolls, and a pregnancy-based study of consecutive pregnant women (at least 20 weeks pregnant) recruited during prenatal care encounters. More than 4000 couples were included in each study, and 10 different regions in Europe took part in the data collection. Data were collected through personal interviews in all population-based samples and in all but four regions of the pregnancy study. RESULTS: The results showed no strong nor coherent association between alcohol intake and subfecundity. CONCLUSIONS: Should any causal effect be present it is restricted to females with a high intake of alcohol within the range of normal consumption reported in European countries.

Adult↗
PubMed1996

Smoking reduces fecundity: a European multicenter study on infertility and subfecundity. The European Study Group on Infertility and Subfecundity.

Several studies published within the past 10 years indicate that smoking reduces fecundity, but not all studies have found this effect, and smoking cessation is not used routinely in infertility treatment in Europe. The present study was designed to examine male and female smoking at the start of a couple's waiting time to a planned pregnancy. Two types of samples were used: population-based samples of women aged 25-44 years who were randomly selected in different countries from census registers and electoral rolls, in which the unit of analysis was the couple; and pregnancy-based samples of pregnant women (at least 20 weeks' pregnant) who were consecutively recruited during prenatal care visits, in which the unit of analysis was a pregnancy. More than 4,000 couples were included in each sample, and 10 different regions in Europe took part in data collection. The data were collected between August 1991 and February 1993 by personal interview in all population-based samples and in all but three regions of the pregnancy sample, where self-administered questionnaires were used. The results based on the population sample showed a remarkably coherent association between female smoking and subfecundity in each individual country and in all countries together, both with the first pregnancy (odds ratio (OR) = 1.7, 95% confidence interval (CI) 1.3-2.1, at the upper level of exposure) and during the most recent waiting time to pregnancy (OR = 1.6, 95% CI 1.3-2.1). Results based on the pregnancy sample were similar (OR = 1.7, 95% CI 1.3-2.3). No significant association was found with male smoking (in the population sample, OR = 0.9, 95% CI 0.7-1.1 (first pregnancy) and OR = 1.0, 95% CI 0.9-1.3 (most recent waiting time); in the pregnancy sample, OR = 0.9, 95% CI 0.7-1.1). The fecundity distribution among smokers appeared to be shifted toward longer waiting times without a change in the shape of the distribution. Women who have difficulty conceiving should try to stop smoking or to reduce their smoking to less than 10 cigarettes per day.

Adult↗
PubMed1996

Prevalence of antibiotics to hepatitis C in a population of intravenous drug users in Valencia, Spain, 1990-1992.

BACKGROUND: Hepatitis C has been related to other viral diseases such as the human immunodeficiency virus infection (HIV) or hepatitis B (HBV). The objective of this study was to estimate the prevalence and determinants of antibodies to hepatitis C virus (HCV) in intravenous drug users (IVDU) in Valencia (Spain) and to compare the seroprevalence between the HCV, HIV and HBV in this high risk group. METHODS: A cross-sectional study was conducted in a sample of 1056 current IVDU from the Valencia area who attended the city's AIDS Information Centre between January 1990 and December 1992. Information on sociodemographic, sexual behaviour, and drug use variables was collected by means of a structured questionnaire. Antibodies to HCV, HIV and HBV were assayed by ELISA test. RESULTS: The seroprevalence of HCV for the whole period was 85.5% (95% confidence interval [CI]: 83.2-87.5%), ranging from 76.5% in 1990 (95% CI: 71.9-81.1%) to 87.8% in 1992 (95% CI: 82.5-93.1%). Year of testing and prevalence of HBV markers showed an independent association with HCV seroprevalence. When only IVDU aged < 25 years were analysed, sharing of needles also appeared as an independent dominant. Of those IVDU with less than one year of addiction, 69% were HCV seropositive compared with 41% for HBV and 14% for HIV. CONCLUSIONS: Intravenous drug users in Valencia showed one of the highest reported hepatitis C seroprevalences (85.5%). A more efficient parenteral transmission of hepatitis C virus than HBV or HIV is suggested.

Adult↗
PubMed1995

Assessment of exposure to environmental tobacco smoke in nonsmoking pregnant women in different environments of daily living.

The relation between duration of recent exposure to environmental tobacco smoke and salivary cotinine concentration was assessed in a cross-sectional study conducted during the third trimester of pregnancy of 710 nonsmoking women attending a prenatal clinic in La Fe Hospital, Valencia, Spain, between September 1, 1989, and September 30, 1991. A structured interview questionnaire was used to obtain information on duration of exposure to environmental tobacco smoke in the last 3 days to four sources: 1) partner's smoking at home, 2) others' smoking at home, 3) others' smoking at work, and 4) others' smoking in vehicles and in indoor public places. Cotinine levels were determined in saliva samples obtained during interviews. The duration of exposure to any source was positively related to cotinine levels independent of exposure to the other sources (p < 0.05). Self-reporting of the duration of recent exposure was a proxy measure of the integrated dose as assessed by saliva cotinine concentrations. The results underline the need to consider sources of exposure other than partner's tobacco smoke and to assess them individually rather than as an unweighted summative measure.

Activities of Daily Living↗
PubMed1995

Exposure to environmental tobacco smoke in nonsmoking pregnant women in relation to birth weight.

The objective of this study was to determine whether birth weight is related to maternal exposure to environmental tobacco smoke. A cohort study was conducted in a sample of 710 nonsmoking women attending a prenatal education program in the third trimester of pregnancy in La Fe Hospital, Valencia, Spain. The duration of exposure to environmental tobacco smoke in the home, at work, and in vehicles and public places was collected by structured questionnaire. Cotinine levels were determined in saliva samples. Multiple regression was used to control for infant's sex and gestational age and for maternal age, height, prepregnancy weight, parity, education, social class, and episodic illnesses during pregnancy. The mean birth weight of infants of women with cotinine levels > 1.7 ng/ml was 87.3 g lower than that of infants of women with cotinine levels in the range 0-0.5 ng/ml (p = 0.048). Birth weight was negatively associated with average weekly duration of exposure in public places (p < 0.05), whereas mothers exposed to the partner's smoke for up to 14 hours/week had infants 177.2 g heavier than those of unexposed mothers. Although the evidence is weak for an effect of exposure to environmental tobacco smoke on the fetus of nonsmoking pregnant women, it may be sufficient to recommend restriction of smoking in enclosed work-and public places to reduce any risk of growth retardation.

Adult↗
PubMed1995

Epidemiology of hepatitis A in Valencia, Spain: public health implications.

Between July 1988 and July 1989, sera from 1223 persons resident in the Valencia area of Spain were tested for antibodies against the hepatitis A virus. Sixty-five per cent of serum samples were positive for anti-HAV (95% confidence interval = 62.4-67.6). The prevalence of anti-HAV increased significantly with age (odds ratio > 50 years = 69.8; 95% confidence interval = 26.5-183.4) and previous history of hepatitis A (odds ratio = 2.1; 95% confidence interval = 1.4-3.2). Prevalence decreased with higher educational level (odds ratio, university studies = 0.2; 95% confidence interval = 0.1-0.5). Overall, there has been a reduction of anti-HAV prevalence reflecting the decreasing exposure of the Spanish population to hepatitis A virus in recent years, particularly in the younger generations. The age of infection has increased, increasing the probability of future epidemics in groups previously protected by immunity acquired in early childhood. This new epidemiological pattern has strong public health implications, and universal childhood vaccination together with measures directed to improve sanitation may be the best public health strategy to protect the population.

Adolescent↗
PubMed1994

[The effect of moderate intake of alcohol during pregnancy on the weight of the newborn].

BACKGROUND: There is currently no doubt concerning the detrimental effects of the intake of high doses of alcohol during pregnancy. Nonetheless, there has been some controversy regarding the effects of intake of low or moderate quantities of alcohol. The aim of the present study, carried out within the framework of a more extensive European study (EUROMAC), was to specifically analyze the relation between moderate intake of alcohol in pregnant women and the weight of the newborns. METHODS: A prospective cohort study including 1,005 women who attended prenatal consultation in the Hospital La Fe of Valencia between 12 and 18 weeks of pregnancy during 1989 was performed. All the subjects were asked on alcohol intake during the week prior to the interview with data on other sociodemographic and biologic variables being collected. Variance analysis was carried out to evaluate the association of the weight of the newborn with alcohol intake as well as with each of the control variables. Multiple lineal regression analysis was performed by the minimum squares method to evaluate possible effects of confusion and interaction. RESULTS: Following adjustment for parity, weight of the mother prior to pregnancy, sex of the newborn, age at pregnancy and tobacco consumption, only a slight reduction in the weight of the newborns was observed in the category of intake greater than 90 g/week, however this difference was not statistically significant. CONCLUSIONS: The low or moderate intake of alcohol during the first months of pregnancy has no detectable effect on fetal growth.

Adult↗
PubMed1994

Sharing of injection equipment among 3755 intravenous drug users in Valencia, Spain, 1987-1992.

BACKGROUND: In order to identify, in a sample of heroin intravenous drug users (IVDU), those factors associated with the predominant risk behaviour related to the transmission of HIV-1 infection--sharing of injection equipment--a cross-sectional survey was carried out in Valencia, Spain from 1987 to 1992. METHODS: Informed consent and pertinent data were obtained from 3755 heroin IVDU recruited at two public AIDS Information Centres in two cities in the region of Valencia. Data were gathered on sociodemographic variables, and sexual and drug use behaviour by interview. The subjects were subsequently tested for HIV-1 antibody. A univariate analysis was carried out to identify variables that were significantly associated with sharing injection equipment. A logistic regression model was used to control for possible confounders. RESULTS: The IVDU who were teenagers, prostitutes (OR = 1.95), who had antibodies to HIV-1 (OR = 1.30) or who had an IVDU steady partner were at significantly higher risk for sharing of injection equipment. Higher levels of education, condom use (OR = 0.65) and living in the smaller city (OR = 0.75) were inversely related to sharing injection equipment. CONCLUSIONS: Our results suggest that different subgroups of IVDU have different characteristics that place them at different risk for HIV-1 infection. These characteristics should guide the design and intensity of specific preventive interventions. Teenagers and IVDU with low educational levels should be targetted for special attention by health authorities.

Adolescent↗
PubMed1994

Smoking and drinking habits before and during pregnancy in Spanish women.

STUDY OBJECTIVE: To investigate possible changes in smoking and drinking habits during pregnancy and to elucidate the sociodemographic factors associated with these changes in Spanish women. DESIGN: A cross-sectional survey. PARTICIPANTS AND SETTING: A total of 1004 pregnant women of between 12 and 18 weeks of gestation who were attending the antenatal clinic of the main regional hospital of Valencia (Spain) during 1989 were studied. All participants completed the study and only one eligible woman refused to participate when approached. MEASUREMENTS AND MAIN RESULTS: Information was obtained by structured questionnaire (Euromac questionnaire), which included items on age, educational level, marital status, occupation, parity, previous and present smoking habits, and previous and present alcohol consumption. Women were asked about the consumption of cigarettes and alcohol for a typical week before they knew they were pregnant, and details of current consumption were obtained for the week before the interview. The number of drinks taken per week was later converted to the amount of absolute alcohol (in g). Sixty per cent of the women smoked and 72% drank alcohol before pregnancy. Forty eight per cent of smokers stopped smoking and 37% of drinkers stopped drinking alcohol during pregnancy. No sociodemographic factor showed an independent association with either smoking or drinking cessation. Only the number of cigarettes and the amount of alcohol consumed before pregnancy were identified as significant independent predictors for stopping. CONCLUSIONS: Pregnant Spanish women seemed to stop smoking at about three times the rate found in Spanish women in the reproductive years. The sociodemographic variables usually associated with stopping smoking could not account for the high rate of quitting in these Spanish women, a rate higher than that in women from other developed countries. The high prevalence of smoking before pregnancy might explain not only the high rate of stopping smoking but also the absence of a well defined profile of "quitters". In our study, high levels of alcohol consumption were limited to a small group of pregnant women, and preventive efforts should be focused on this group.

Adolescent↗
PubMed1994

Reliability of the diagnosis of rheumatic conditions at the primary health care level.

OBJECTIVE: To assess the reliability of the diagnosis given to rheumatic disease patients at the primary care level, the clinical records of 612 patients at the outpatient clinic of rheumatology of the main General Hospital in Alicante (Spain) were studied. METHODS: The accuracy indices (sensitivity, specificity), the predictive values of tentative diagnosis made by the referring physicians and the degree of agreement (Kappa statistics) with the final diagnoses made by rheumatologists at the outpatient clinic of rheumatology were calculated. RESULTS: There were differences in diagnosis agreement depending on the age of the referring doctor, with a greater degree of concordance among younger ones. More than 50% of the referral diagnoses were modified at the rheumatology outpatient clinic. In the most frequent diagnoses (inflammatory rheumatic diseases, osteoarthritis, soft tissue rheumatism) the level of concordance and the predictive values were low. CONCLUSION: Our results highlight the need for upgrading courses in rheumatology for primary care physicians who have not been exposed to systematic training in rheumatology during their undergraduate studies. The epidemiological studies on rheumatic diseases based on primary care data should be interpreted with caution.

Adult↗
PubMed1993

Determinants of HIV-1 infection in intravenous drug users in Valencia, Spain, 1987-1991.

From 1987 through 1991, 2687 intravenous drug users recruited at three AIDS information centres in the Region of Valencia (Spain) were interviewed about drug use and sexual behaviour and subsequently tested for HIV-1 antibody. The overall seroprevalence was high, 50% (95% confidence interval [CI]: 41.8-51.9%). There were no differences by gender, but HIV-1 infection was related to older age and city of residence. After adjustment by means of logistic regression age (odds ratio [OR] = 1.80), sharing of injection equipment (OR = 2.16), duration of addiction (OR = 6.59) and prostitution (OR = 1.77) were significantly associated with HIV-1 prevalence. High educational level was inversely related to HIV-1 status (OR = 0.43) and a decreasing trend of prevalence with time was observed.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Shiftwork: its impact on the length and quality of sleep among nurses of the Valencian region in Spain.

Previous research has shown the repercussions of shiftwork for workers' sleep. The objective of the present work is to evaluate the impact of shiftwork on the length and quality of sleep among nurses and on the intake of psychotropic drugs. A cross-sectional epidemiological study was carried out in 606 female nurses and 367 male nurses selected at random from the public hospitals in the Valencian region. Information was collected by means of a questionnaire. Univariate and multivariate statistical analysis techniques were used. For both female and male nurses, shiftwork led to a reduction in the length of sleep (by 2 h in those permanently on night shifts and by 30 min in those on a rotating night shift system) and an alteration in the quality of sleep (difficulty in sleeping, intermittent sleep, early waking, etc. occurred 10% more frequently), but it did not lead to an increase in the consumption of psychotropic drugs.

Cross-Sectional Studies↗