PubMed Health⌕ Search

Biomedical subjects

I Hernandez-Aguado

Publications and source records attributed to I Hernandez-Aguado.

7 recordsLinked to original sources

Measures to reduce HIV infection have not been successful to reduce the prevalence of HCV in intravenous drug users.

The objective of the study was to determine whether measures taken to prevent human immunodeficiency virus (HIV) infection also lead to a reduction in the prevalence of hepatitis C virus (HCV) infection among intravenous drug users (IDU). Antibodies to HCV, HIV and hepatitis B virus (HBV) were determined in IDU who voluntarily attended AIDS prevention and information centres for the first time between 1990 and 1996. Of the 5473 IDU studied, determination of HCV was done in 3238 cases. The prevalence of antibodies to HCV was 85%. During the first period studied (1990-1992), the prevalence of antibodies to HCV was 84.5%, during the second (1993-1994) 84.1% and during the third (1995-1996) 87%; in the case of HBV the prevalence during the three periods was 74.5, 67.6 and 66.8% respectively, and for HIV it was 41.9, 38.8 and 36.6% respectively (RR: 0.72; 95% confidence interval (CI): 0.65-0.81). Among drug users addicted for less than 2 years, the trend of the prevalence of antibodies to HCV and HBV remained constant, while the prevalence of HIV infection decreased (RR: 0.61; 95% CI: 0.42-0.89). Measures to prevent transmission of HIV in drug users do not lead to a reduction in the prevalence of HCV infection. Further study is necessary to obtain a better understanding of how HCV is transmitted among drug users in order to apply measures which are effective in preventing HCV infection.

Adult↗

Variation in surgical rates: a population study.

OBJECTIVES: The objective of this study was to compare the use of certain surgical services by physicians to three other professional groups (architects, lawyers, and nurses) and to the general population. To meet this objective, variations in six surgical procedures were studied: appendectomy, tonsillectomy, herniorrhaphy, cholecystectomy, cesarean section, and hysterectomy. METHODS: This was a cross-sectional study in the city of Valencia (Spain) from September 1992 to September 1993. The surveys were carried out by mail questionnaire. Two thousand ninety-six subjects were recruited by simple random sampling for each of the groups. The questionnaire contained questions referring to the interviewee and to each family member (spouse or partner and up to a maximum of four children). The proportion of subjects who stated that they had undergone a particular type of surgery was compared among the professional groups. The population denominator was the whole Valencia population. RESULTS: The global response rate was 83.7%. With the exception of herniorrhaphy, the rates of surgical procedures obtained for each procedure for the different groups were not significantly different. The frequency of operations for each group differed according to sex and age. The risk of undergoing tonsillectomy was significantly higher among the general population when there were no medical friends or relatives than when there were. CONCLUSIONS: Barriers against access to surgical care did not seem to have played an important role in the use of surgical services. The frequency of operations for the best informed consumers with the most access to these services, that is, physicians, was very similar to that for other population groups.

Adolescent↗

Associated factors to psychiatric morbidity in postmenopausal phases.

BACKGROUND: The greatest risk of psychiatric morbidity during the climacteric years is linked to a greater exposure to stressful life experiences, women's dissatisfaction with their role in society and to an absence of social backup. The question to be posed now is the extent to which the longitudinal surveys can confirm, refute or complement the results of the cross-sectional analyses. METHODS: A study involving population-based cohorts was carried out on a sample of 120 women who had been previously identified as being premenopausal or menopausal during a cross-sectional examination conducted between 1987 and 1988 within the city of Valencia (Spain). The aims were to analyze the movements of specific psychosocial factors (role satisfaction, level of social support) making a comparison between the premenopausal and postmenopausal phases. RESULTS: An increase in the frequency of psychiatric episodes was detected in the later stages of the climacteric. The absence of global social support, being a possible psychiatric case and experiencing severe life events during the initial phases of the climacteric all emerge as being the most reliable factors for predicting the psychiatric morbidity during the postmenopausal phase. CONCLUSIONS: The results lend weight to the hypothesis of psychiatric morbidity being linked to social changes. A discussion of the clinical implications is presented.

Cohort Studies↗

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↗

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↗

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↗