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Biomedical subjects

J M Bayas

Publications and source records attributed to J M Bayas.

36 records · Page 2Linked to original sources
PubMed1996

[Susceptibility to measles, rubella and parotitis in young adults].

BACKGROUND: The aim of this study was to know the prevalence of antibodies against measles, rubella and parotiditis in young adults. METHODS: The study was carried out in health care students during the academic year of 1992-1993. Demographic and geographic variables were obtained as were vaccination and history of diseases. Antibodies against measles, rubella, and parotiditis were determined by ELISA techniques with commercial reagents. RESULTS: Three hundred and six individuals of 21.3 +/- 2.2 years (range 17-36 years) with 27.5% being males were studied. Past history of measles, rubella and parotiditis was reported in 43.5, 30.7 and 37.3%, respectively, with vaccination being 23.2, 43.8 and 20.6%, respectively. The prevalence of antibodies was 93.1% (measles), 96.4% (rubella) and 92.1% (parotiditis). CONCLUSIONS: The prevalence of infection of measles, rubella and parotiditis in the young population studied is mainly due to infection by wild type virus. The foreseeable growth of susceptibility groups in this population which should be adequately evaluated by extensive seroepidemiologic questionnaires, favors the appearance of epidemic outbreaks. The use of the triple viral vaccine is suggested as an alternative to rubella vaccination in presumable susceptible young women.

Adolescent↗
PubMed1996

Immunogenicity and reactogenicity of a combined hepatitis A and B vaccine in young adults.

The aim of this study was to assess the immunogenicity and reactogenicity of a combined vaccine against hepatitis A virus (HAV) and hepatitis B virus (HBV) in young healthy adults. A total of 150 subjects (20 +/- 1.4 years; 111 females and 39 males) negative for anti-HAV, anti-HBs, anti-HBc and HBsAg markers, were enrolled and randomized to received the study vaccine from one of the three lots under double blind conditions. Three doses of the combined vaccine were administered by intramuscular route (deltoid) following a 0-, 1- and 6 months schedule. Each dose of 1 ml contained at least 720 ELISA Units of HAV antigen (Strain HM175) and 20 micrograms of recombinant HBsAg. Blood samples for anti-HAV (ELISA), anti-HBs (RIA) and transaminases determinations were obtained 1 month after the administration of each dose and before to the administration of the third dose (month 6). Local and general reactions were recorded by the vaccinee on the day of each vaccination and for the three following days on symptom sheets. A total of 147 subjects completed the study. There were not statistically significant differences between groups regarding to immunogenicity. All subjects had seroconverted [geometric mean titres (GMT): 1311 mIU ml-1] for hepatitis A component following the second dose; GMT increased to 8895 mIU ml-1 after the third dose. Seroconversion rates for hepatitis B component were 98% (GMT, 104 mIU ml-1) after the second dose and 100% after the third dose (GMT, 7097 mIU ml-1). There were not statistically significant differences between groups regarding to incidence of local and general symptoms. Soreness at the injection site and headache were the most commonly local and general symptoms reported, following 42% and 11% of the doses, respectively. This vaccine when given to young adults was well tolerated and induced high immunogenic response, similar to that obtained by hepatitis A and hepatitis B vaccines administered separately in previously reported trials.

Adult↗
PubMed1996

Prevention and control of nosocomial infections in Spain: current problems and future trends.

Spain is a state member of the European Union, with more than 180,000 hospital beds and 800 public and private institutions. Only 6.9% of our gross national product is devoted to health expenditures. All citizens receive free health care through the National Health System. This system has given increasing attention to the prevention and control of nosocomial infections since 1986. In this article, results of serial prevalence surveys of antibiotic use and resistance patterns of microorganisms isolated from nosocomial infections are discussed. The needs for future development of infection control and quality assurance training programs in Spain also are discussed. Overall, a clinically and epidemiologically oriented approach to infection control is preferred, with greater emphasis in the role of infection control practitioners and infection control committees.

Anti-Bacterial Agents↗
PubMed1995

[The efficacy of the prevaccination detection of anti-HAV in hepatitis A vaccination programs].

BACKGROUND: The convenience of carrying out prevaccination detection studies of hepatitis A virus (HAV) markers depends on the relative costs of the detection and vaccination, as well as the prevalence of susceptible subjects in each population group to be vaccinated. The aim of this study was to analyze the efficacy of the systematic prevaccination detection of anti-HAV antibodies in Catalonia, Spain. METHODS: The following formula was applied: Unit cost of detection + (1-X) x Unit cost of vaccination of anti-HAV negative subjects = group vaccination cost, with X being the threshold of prevalence of marker under which detection no longer remains efficient. This prevalence was compared with the findings of a seroepidemiologic survey carried out in international travellers and food handlers. RESULTS: The unit cost of the detection of anti-HAV was calculated as 2,733 pesetas, and the unit cost of the vaccination as 9,963 pesetas obtaining a prevalence anti-HAV threshold of 27%. This prevalence corresponds to travellers under the age of 30 years and food handlers under the age of 25 years. CONCLUSIONS: The systematic detection of anti-HAV is only recommended in population groups in which prevalences higher than 27% may be expected. The vaccination is more efficient without a previous marker study under this threshold. According to this study, direct vaccination of food handlers under the age of 25 years (born after 1969) is recommended as is that of international travellers under the age of 30 years (born after 1964). In those over the age of these collectives, the prevaccination study is more efficient.

Adolescent↗
PubMed1994

[Infection by the human immunodeficiency virus type 1 in the population of prisoners of Catalonia].

BACKGROUND: The prison population represents a high risk group for the human immunodeficiency virus type 1 infection. The present study was carried out to know the prevalence of infection in this collective in three penitentiary centers in Catalonia. METHODS: All the subjects who were in or who were admitted to the three penitentiaries for men from October 1987 to April 1988 were included in the study (n = 1,579). Demographic risk factor and penitentiary variables were obtained. The determination of anti-HIV-1 antibodies was performed by enzymoimmunoanalysis (Dupont HIV ELISA). RESULTS: The global prevalence of HIV-1 infection was of 40.6%. Significant statistical differences were found among intravenous drug users (IVDU) and non IVDU (chi 2 = 376.8, p < 0.0001, OR = 9.6, CI 95% = 7.5 - 12.3) and between habitual and sporadic users (chi 2 = 23.9, p < 0.0001, OR = 3.0, CI 95% = 1.9 x 4.7). CONCLUSIONS: The penitentiary population in Catalonia is a collective with a high prevalence of infection by the human immunodeficiency virus type 1, with intravenous drug use being the fundamental factor associated to this prevalence.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Relationship between severity, costs and claims of hospitalized patients using the Severity of Illness Index.

The results of the prospective application of Horn's 'Severity of Illness Index' in a teaching hospital during 1987, 1989, and 1990 constitute the basis of the present report. The average overall severity of illness scores for the three years were 1.42 in 1987, 1.65 in 1989, and 1.46 in 1990. Most of the processes evaluated in the three periods showed an overall distribution among severity levels 1 and 2, both overall and when the seven dimensions of the severity of illness index were analyzed. A statistically significant correlation between the overall severity of illness and average length of stay was found for patients in 1989 and 1990. The length of stay differed significantly in the different severity levels. When the four levels of the seven dimensions of the severity of illness index for 1987, 1989, and 1990 were compared, it was observed that figures were not uniformly distributed. There was a statistically significant association between severity of illness for hospital service and pharmacy charges per hospital stay for both 1989 and 1990, as well as a statistically significant inverse relationship between severity of illness and the number of claims per hospital service in both periods of time. Case-mix methods that account for the severity of patients constitute a useful indicator of quality for the management of different hospital services and of the hospital as a whole.

Adolescent↗
PubMed1993

[The vaccination of medical and nursing students against hepatitis B].

BACKGROUND: Vaccination against the hepatitis B virus (HBV) of health care staff during their studies would have the advantage of early prevention when the prevalence of infection is presumably low. METHODS: The population to be protected is made up of 1533 medical and nursing students. In those who accepted, anti-HBc was determined and information was obtained concerning circumstances of exposure to HBV. Vaccination was offered to all the cases of negative anti-HBc. Individuals receiving 3 doses of the vaccination (20 micrograms at 0, 1 and 6 months) were seen at 4-7 months of the last dose to determine the anti-HBs titers achieved. RESULTS: One thousand sixty-five students (70%) accepted inclusion into the prevaccination anti-HBc study and 1,029 (3.4%) were anti-HBc negative. Only older age and previous transfusions and jaundice were significantly associated to greater prevalence of infection by HBV. The adherence to 1, 2 or 3 doses of the vaccination was 96%, 94% and 87%, respectively. Following the 3 doses, > or = 10 UI/I of anti-HBs were detected in 97% of the cases studied with geometric measurement of the responders being 1580 U/I. The titer had an inverse relation which was not significant with age. CONCLUSIONS: The high participation in the program of anti-hepatitis B vaccination and the excellent immune response observed leads to the recommendation of systemic vaccination to future health care professionals during their study period. Furthermore, the low prevalence of previous HBV infection advises against previous detection of anti-HBc with immunization of the whole collective being more effective.

Adult↗
PubMed1993

[Risk of nosocomial infection in elderly patients admitted to a university hospital].

BACKGROUND: A high percentage of current hospital visits are made by the elderly. The aim of this work is to quantify the risk of contracting a nosocomial infection among elderly patients admitted to a university hospital. METHODS: From the patients admitted from the emergency unit, outpatients and the waiting list, 6 patients of different age groups were chosen each day by a simple random sampling. The criteria of nosocomial infection were those of the CDC. The analysis of the information was made with the programme EPIINFO version 5. The chi 2 tests and Fisher's exact test were used to compare proportions. RESULTS: The rate of nosocomial infection in the group aged over 64 was 14.8%, showing statistically significant differences with respect to other age groups (p = 0.001). In this group the predominant infection was urinary, with an odds-ratio of 3.69, in comparison with the 25 to 44 age group. A prolonged hospital stay (> 15 days) has proved to be closely related to the risk of nosocomial infection in all age groups (p < 0.0001) in patients over 64. CONCLUSIONS: The greater risk of contracting nosocomial infections in the elderly makes it advisable to develop specific prevention programmes for this group, and the fitness of accommodations the length of stay to the care needs suitable to the hospital level.

Adult↗
PubMed1993

Hepatitis B vaccination in prisons: the Catalonian experience.

A pilot programme of hepatitis B vaccination was set up in three prisons to assess the feasibility and results of this method of reaching a high-risk population. Hepatitis B vaccine was offered to all inmates who lacked serological markers for hepatitis B virus. The antibody response was assessed in those who received two or three doses of vaccine. Candidates for vaccination were 41% of 1755 imprisoned men (20% of intravenous drug users (IVDU) and 63% of non-IVDU), but complete vaccination could be given to only 33% of candidates. A further 29% received two doses. Seroconversion to anti-HBs (titres > 10 IU l-1) occurred in 33% of vaccinees after two doses and in 76% after three doses. The overall rate of susceptible inmates who became protected for hepatitis B was 34%. The seroconversion rate was higher when the interval between the first two doses was shorter than 3 weeks (91%), than in cases with an interval of 3-6 weeks (79%) or longer than 6 weeks (33%). Age greater than 35 years and history of IVDU were associated with a lower response to the vaccine, while anti-HIV seropositivity did not influence the response. In conclusion, vaccination of prisoners susceptible to HBV may achieve protection in at least a third of cases. Shortening intervals between the priming doses of vaccine may improve compliance and increases the response.

Adolescent↗
PubMed1993

[The quality perceived by the consumers of the outpatient consultation services of a university hospital].

With the objective to know the perceived quality of the assistance by the customers of the outpatient facilities in a teaching hospital, the information gathered in 1,970 self-administered, volunteer, anonymous questionnaires was analyzed, being obtained from the 4,756 consultations done in the outpatients department during a one week period. Different aspects of the physician's visit are discussed, together with the attention received from the paramedic personnel and other viewpoints pertaining to the organization and conditions of the waiting area. There is a high level of satisfaction among the users of the outpatients department, more pronounced in the "medical" area, in relation with the physician's consultation as well as with the attention from paramedics or in the adherence to appointments. The results suggest that in those physicians' offices where the relationship of the patient with the unit is less frequent, users show more criticism in comparison with those offices where almost all patients consult because of chronic ailments. We underline the importance of this type of perceived quality studies within the quality control policies, as a complement of the analysis of technical quality.

Adolescent↗
PubMed1992

[Efficiency of prevaccination screening of anti-HBc in the anti-hepatitis B vaccination programs].

BACKGROUND: The convenience of carrying out pre-vaccination screening of VHB markers depends on the relative costs of screening and vaccination and also on the prevalence of susceptible subjects in each group of the population. The aim of the present work was to analyse the efficiency of pre-vaccination screening of antiHBc in Catalonia in 1991. METHODS: The per-unit cost of screening was calculated at 1366 ptas. The formula applied was: cost per-unit of screening + (1-X) x the cost per-unit of vaccination of anti-HBc (-) = cost of vaccinating the group. "X" being the threshold of prevalence of markers below which screening cases to be efficient. This prevalence is compared with those expected in the groups of the population to be vaccinated. RESULTS: By applying the above-mention ned formula and taking into account costs in time and travel of the people to be vaccinated, a prevalence threshold of 23% is obtained. This prevalence is much higher than that found in adolescents and students of medicine and nursing, similar to that found in health professionals and lower than that of other risk groups. CONCLUSIONS: Systematic screening of anti-HBc is only recommended in groups of the population where a prevalence higher than 20-25% can be expected. Below this threshold vaccination without previous study of markers is more efficient. This enormously simplifies the strategies of universal vaccination of children, adolescents or both.

Carrier State↗
PubMed1992

Prevalence of hepatitis B markers in the population of Catalonia (Spain). Rationale for universal vaccination of adolescents.

The prevalence of hepatitis B markers was determined in a representative sample of the general population of Catalonia (Spain). HBsAg was found in 0.5% of children (less than 15 years of age) and in 1.7% of adults (more than 15 years of age), and anti HBs in 1.6% and 18%, respectively. Age-specific prevalence for both markers showed a low risk for hepatitis B before puberty, and a progressive rise since adolescence, suggesting that perinatal transmission and horizontal transmission in children are relatively uncommon in Spain. Prevalence of hepatitis B markers was significantly higher among subjects with low education level, residing in an urban area and born outside Catalonia, but in the stratified analysis, a statistical significant difference was only maintained in the prevalence of HBV markers between those who live in urban and rural areas, and between those who were born outside Catalonia and in Catalonia. These data may be used as a basis for a strategy of hepatitis B prevention in Spain which include universal vaccination of adolescents, passive-active immunization of newborns to HBsAg positive mothers and vaccination of susceptible adults subjects from high-risk groups.

Adolescent↗
PubMed1992

An analysis of the factors affecting the average length of stay in the otolaryngology unit.

Specific factors which have an influence on the average length of stay in the otolaryngology unit of a University Hospital are studied; the patients are covered by some type of insurance and have no out-of-pocket expenses. The effect of the following variables on the average length of stay is evaluated: age, sex and type of pathology. The periods of hospitalisation are significantly longer (Mann-Whitney test) in males (p < 0.0001), in older patients (p < 0.008) and in the case of tumours, which prolong the period of stay especially of males (p < 0.0001). It is suggested that the shorter stay in the case of females may be conditioned by social and family factors.

Age Factors↗
PubMed1990

[Hepatitis B and hepatitis delta in young inmates].

The prevalence of infection by hepatitis B (HBV) and delta (HDV) viruses and presumably related variables were evaluated in a prison for young male convicts, aged 16-21 years (n = 686), 55.1% of convicts were positive for one or more VHB markers, and 7.1% were positive for HBsAg; 89.7% of these were negative for IgM anti-HBc (chronic carriers), while 36.6% were positive for HBeAg. Anti-delta antibodies were detected in 37.5% of chronic carriers. The seropositivity of HVB markers was much higher in parenteral drug abusers (PDA) as compared with non PDA (76.3% vs 26.7%, p less than 0.0000001, OR = 8.82). Among PDA, it was higher in regular users than in occasional ones (83.3% vs 62.9%, p = 0.0001, OR = 2.95) and in those who had acquired the habit at an early age (p = 0.035). The stratified analysis also showed an association of VHB infection with other variables, basically ethical and prison-related. The possibility to develop active immunization programs is evaluated.

Adolescent↗
PubMed1990

Seroepidemiology of HIV-1 infection in a Catalonian penitentiary.

A seroepidemiological study of HIV-1 infection was carried out among all the subjects who were imprisoned in a correctional centre in Catalonia (Spain) between October 1987 and April 1988. Six hundred and thirty-one inmates (male, mean age 19.1 +/- 1.7 years) were surveyed. The overall prevalence of HIV-1 infection was 33.6%. Statistically significant differences were observed between intravenous drug users (IVDUs) and non-IVDUs (P less than 0.0000001) and between regular and irregular IVDUs (P less than 0.000001). The age at which the person started using drugs and the length of time spent in prison were also significantly associated with the prevalence of infection. No other variables, except the higher prevalence among the gipsy ethnic group, showed any statistically significant association with HIV-1 infection.

Adolescent↗
PubMedDate not supplied

[Epidemiologic surveillance system for reportable diseases at the hospital].

The aim of this work is to present a detection system of reportable diseases among patients attending a teaching hospital. Since January 1988, based on daily data obtained from the Admissions Department of Hospital Clínic of Barcelona (HCP) (emergency department visits and hospital admissions and discharges), the Preventive Medicine Unit identifies every day those diseases considered as reportable by the Department of Health of Catalonia, Spain. Reported cases from HCP during the 1988-1991 period were compared to cases reported from HCP in 1987, as well to the corresponding cases in the remaining hospitals of Barcelona. Between 1987 and 1988 there was a 245% increase in the reporting of Individualized Reportable Diseases and of 4345% for Numeric Reportable Diseases. The increased notification has also been shown for the most frequent Individualized Reportable Diseases: 364% for hepatitis, 195% for meningococcal infection and 233% for pulmonary tuberculosis. This system is an approach to the introduction, development and perfection of the detection process, in order to improve reporting levels in the hospital, contributing to strengthen the epidemiologic surveillance system in the community.

Disease Notification↗
PubMedDate not supplied

[Epidemic outbreak of hepatitis A related to a day care center].

The aim of this study was to describe an outbreak of hepatitis A in a family group which extended to a day care center and to the families of the children attending the same and to determine the risk of acquiring the disease based on exposure to one or several sources of infection. The temporary distribution of the cases and the rate of hepatitis A in the population at risk were analyzed. The risk of acquiring hepatitis by exposure to one or more sources of infection was studied by logistic regression, calculating the odds ratio and the confidence interval of 95%. Initiation of the outbreak was in May 1996, in a 25-year-old male and finalized in November, having affected 63 people. The rate of global attack was of 12% and the risk of infection 18-fold greater (CI 95% = 5.4-61.8) in those exposed to more than one source of infection than in those exposed to only one source and 3.5-fold greater (CI 95% = 1.2-9.9) in the group from 15 to 29 years of age than in those under 14. The massive administration of immunoglobulin was useful to control the hepatitis in the day care center and in the school. The size of this epidemic of hepatitis A was due to its occurrence in a population little exposed to the virus. The greatest involvement was observed in young adults, with person to person transmission and the greater risk of acquiring hepatitis A on exposure to several sources of infection characterizing the outbreak. The possible usefulness of designing prevention strategies with the vaccine should be considered.

Adolescent↗