Características sociales y clínicas de un grupo de madres infectadas por VIH en Valencia: influencia de la drogadicción parenteral / Social and clinical characteristics of mothers with HIV infection: the influence of intravenous drug addiction

Objetivo: Al principio de conocerse la infección por el virus de la inmunodeficiencia humana (VIH), la causa más importante de su transmisión en las mujeres occidentales fue el consumo de drogas por vía parenteral. El objetivo de nuestro trabajo consistió en describir las principales características sociales y clínicas de un grupo de madres seropositivas, y en analizar su relación potencial con el uso intravenoso de drogas. Métodos: Realizamos un estudio observacional prospectivo con 220 mujeres infectadas por VIH que presentaban la particularidad de haber dado a luz niños con riesgo de infección. Se incluyeron todas las madres reclutadas en la Unidad VIH de un hospital de Valencia que tuviesen definido el diagnóstico de su infección durante el período de estudio comprendido entre el primer caso materno conocido en 1985 y 1993. El análisis de los datos se basó en un análisis univariado. Resultados: La transmisión del virus se produjo por mantener relaciones heterosexuales en un 27,7 por ciento de las mujeres estudiadas, y a través de la drogadicción parenteral en el 69,1 por ciento. Se detectó mayor número de madres que abortaron, con antecedentes penales y abandono domiciliario entre las usuarias de drogas por vía parenteral (UDVP), con odds ratio (OR) de 1,8 (p = 0,087), 8,95 (p = 0,012) y 15 (p = 0,000), al compararlas con las madres no UDVP. Además las UDVP presentaron mayor probabilidad de contraer la infección por hepatitis B o C (OR = 7,06, p = 0,000) y de tener asociados otros hábitos tóxicos como tabaquismo (OR = 6,19, p = 0,000) y alcoholismo (OR = 5,91, p = 0,117).Conclusiones: Muchas de las características analizadas en estas mujeres estaban más relacionadas con el consumo de droga inyectada que con la infección por VIH, tales como la mayor frecuencia de abortos electivos, antecedentes penales, abandono domiciliario, politoxicomanías y antecedentes patológicos como hepatitis B o C (AU)

Efectos del ruido sobre la salud y el proceso educativo de los niños / Noise effects on the health and the educative process in children

Las condiciones acústicas de los centros docentes desempeñan un papel muy importante en el proceso educativo de los niños. En el presente trabajo se definen las magnitudes físicas del sonido, las condiciones acústicas que deben cumplir las aulas, y las fuentes de ruido que afectan a los centros escolares. También se describen los efectos nocivos del ruido sobre la salud, que se relacionan con el deterioro específico del aparato auditivo, con las reacciones mediadas por estímulo del sistema nervioso central y autónomo, con las alteraciones del sueño y descanso, así como la interferencia con la comunicación oral, lo que dificulta el aprendizaje. Es necesaria una acción preventiva que debe formar parte de la Atención Primaria, basada en el reconocimiento médico de la función auditiva. En general, las mejoras en las condiciones acústicas de las aulas son relativamente fáciles de conseguir a través de una selección adecuada de los emplazamientos de los colegios y/o la utilización de técnicas de construcción adecuadas (AU)

[Social and family characteristics in children born to women infected by the human immunodeficiency virus]. / Características sociofamiliares de los niños nacidos de mujeres infectadas por el virus de la inmunodeficiencia humana.

OBJECTIVES: To evaluate the social and family characteristics of children born to women infected by the human immunodeficiency virus (HIV). As secondary objectives, to analyse their schooling and the number of hospital admissions and lengths of stay that these children required. DESIGN: A prospective observation study. SETTING: HIV unit in a children's hospital. INCLUSION CRITERIA: all the children recruited from the HIV unit who had their infection status defined during the study period, understood as between the first known case in 1985 and April 1994. The sample included 177 children (62 HIV-infected and 115 not infected). MEASUREMENTS AND MAIN RESULTS: Through an interview the social, family and school variables were collected. On comparison between infected and non-infected children, there were no important differences as to the lack of protection of the new-born (8.1% vs 13%), scant mother-child relationship (31.2% vs 36.5%) or people responsible for the custody of these children. Less schooling and greater problems of school integration were detected in infected cases, with odds ratios of 2.68 (p = 0.004) and 11.36 (p = 0.004), respectively. Children infected also needed more admissions (4.3 +/- 5.7) than the non-infected (1.7 +/- 0.9) (p = 0.001), and more days of hospital stay (75.1 +/- 110.3 vs 23.3 +/- 19.6) (p = 0.0003). CONCLUSIONS: Infected children and non-infected children had similar social and family characteristics. However, less schooling, problems of school integration, and more and longer hospital admissions were related to HIV infection in children, and not so much to their status as children of seropositive mothers.

Características sociofamiliares de los niños nacidos de mujeres infectadas por el virus de la inmunodeficiencia humana / Social and family characteristics of children born to women with the HIV

Objetivo. Evaluar las características sociofamiliares de los niños nacidos de mujeres infectadas por el virus de la inmunodeficiencia humana (VIH). Como objetivos secundarios, analizar los aspectos de la escolarización, así como el número de ingresos y tiempo de estancia hospitalaria que han requerido estos niños.Diseño. Estudio observacional prospectivo. Emplazamiento. Unidad VIH. Hospital Infantil. Participantes. Criterios de inclusión: todos los niños reclutados en la Unidad VIH que tuvieran definido el estado de la infección durante el período de estudio, comprendido entre el primer caso conocido en 1985 y abril de 1994. La muestra es de 177 niños (62 VIH-infectados y 115 no infectados). Mediciones y resultados principales. Mediante entrevista, se recogieron las variables sociofamiliares y escolares. Al comparar los niños infectados con los no infectados, no se detectaron diferencias importantes en cuanto a la situación de desamparo en el recién nacido (8,1 frente a 13 por ciento), escasa relación maternofilial (31,2 frente a 36,5 por ciento) o respecto a las personas responsables de la custodia de estos niños. Se detectó menor escolarización y mayores problemas de integración escolar en los casos infectados, con odds ratio de 2,68 (p = 0,004) y 11,36 (p = 0,004), respectivamente. Los niños infectados también necesitaron mayor número de ingresos (4,3 ñ 5,7) que los no infectados (1,7 ñ 0,9) (p = 0,001) y más días de estancia hospitalaria (75,1 ñ 110,3 frente a 23,3 ñ 19,6) (p = 0,0003). Conclusiones. Las características sociofamiliares de los niños infectados fueron similares a las de los niños no infectados. Sin embargo, la menor escolarización, los problemas de integración escolar y el mayor número de ingresos y por más tiempo se relacionaron con la infección VIH en los niños, y no tanto por su condición de hijos de madres seropositivas (AU)

[Social and clinical characteristics of a group of mothers infected with HIV in Valencia: influence of parenteral drug addiction]. / Características sociales y clínicas de un grupo de madres infectadas por VIH en Valencia: influencia de la drogadicción parenteral.

OBJECTIVE: In the first years after the finding of HIV-infection, the main was for its transmission among western women was the intravenous drug addiction. The objective of our work consisted in evaluating the main social and clinical characteristics of a group of seropositive mothers, and in analyzing their potential relationship with intravenous consumption of drugs. METHOD: We performed an observational prospective study in 220 HIV-infected women who had recently given birth to children with high risk for infection. We included every women at an HIV Unit of a hospital in Valencia who had been diagnosed of HIV infection at any moment between the first mother-child transmission reported in 1985 and 1993. The analysis was based on univariate analysis. RESULTS: The virus transmission was produced by heterosexual relations in a 27.7% of the study women and due to the parenteral drug addiction in 69.1%. We detected more women who had an abortion, with criminal antecedents and parental abandonment among those who were intravenous drug users (IVDU), with OR of 1.8 (p = 0.087), 8.95 (p = 0.012) and 15 (p = 0.000), when compared with those mothers non-IVDU. Besides, IVDU presented a higher probability for getting hepatitis B or C infection and for other toxic habits, as smoking (OR = 6.19, p = 0.000) or alcoholism (OR = 5.91, p = 0.017). CONCLUSION: Many of the analysed characteristics in these women were more related with the consumption of injected drug than with the HIV infection, such as the greater frequency of elective abortions, criminal antecedents, parental abandonment, multiple drug abuse and pathological precedents like hepatitis B or C.

[Mortality due to respiratory diseases in Spain (1977-1985)]. / Análisis de la mortalidad por enfermedades respiratorias en Espanña (1977-1985).

A descriptive and comparative epidemiological is made of mortality due to respiratory disease by provinces in Spain. The study period covers 1977 to 1985, this being the last year reported by the Natural Movement of the Spanish Population (Movimiento Natural de la Población Española). In particular, 5 causes of death were analyzed in accordance to the International Classification of Disease (IX Revision): respiratory tuberculosis, influenza, chronic pulmonary disease, pneumonia and other pathologies of the respiratory apparatus. The results reveal an annual increase in these diseases. Standardized mortality ratio in turn reflects the provinces with increased mortality, the distribution of which varies for each pathology studied as a result of the different factors involved. Variation is also seen in terms of sex. Thus, influenza predominates among women, whereas males are more frequent as regards the remaining pathologies. Mortality due to pneumonia is similar in both sexes, this being the disease exhibiting the greatest increase during the study period. The results obtained may be of use in protocolizing resources for better control and prevention of respiratory disease in this country.

[Mortality from acute respiratory infections and influenza (1976-1980)]. / Mortalidad por infecciones respiratorias agudas e influenza (1976-1980).

Acute respiratory infections (ARI) and influenza (flu) are extremely common illnesses, which make up the main causes of medical consultation and absence from work. OBJECTIVE. To discover the level of mortality because of ARI and flu in the Health Areas within the Community of Valencia; to analyse their possible relationship with socio-economic factors and also to identify higher-risk groups according to age and sex. DESIGN. Retrospective study. SITE. The Community of Valencia. PATIENTS OR OTHER PARTICIPANTS. Mortality data across the Community were obtained from the mortality statistics published by the Generalitat (Government) of Valencia during the five-year period of 1976 to 1980. MAIN MEASUREMENTS AND RESULTS. The results establish that Health Areas 4, 6, 7, 9-12 and 18 present less mortality because of ARI and flu. These are the better areas, socio-economically speaking, although the data are without statistical significance. A spectacular increase in mortality in the age-group of those over 70 was observed, with no great differences found between the sexes. CONCLUSIONS. Given that the main interventions to prevent these diseases are based on vaccination, it would be useful to carry out vaccination programmes with greater thoroughness in those areas identified as of high risk.

[An epidemiological study of the evolution of pneumonia in the Valencia community (1976-1980)]. / Estudio epidemiológico de la evolución de la neumonía en la comunidad Valenciana (1976-1980).

Pneumonia is an inflammatory process of lung parenchyma, being one of the ten first causes of death in developed countries. The data for the performance of this study have been obtained from Monografías Sanitarias: mortality statistics published by the Generalitat Valenciana for the five-year period 1976-1980. The distribution of pneumonia was analyzed according to age and sex by means of specific rates and mortality reasons. Furthermore, calculations of standardized rates and standardized mortality rates were carried out using the direct method. The results establish that in Health areas 2, 8, 9-12, 15, 16, 21 and 22 there is an increased mortality due to pneumonia. Similarly, it is note worthy the predominance of pneumonia in older groups, while no significant differences exists between sexes.

[Respiratory tuberculosis mortality in the health region of the Valencia community (1976-1980]. / Evolución de la mortalidad por tuberculosis respiratoria en las áreas de salud de la Comunidad Valenciana (1976-1980).

Respiratory tuberculosis continues to be a health and social problem in Spain. The data for carrying out this study was obtained from the Monographic Health Studies: death rate statistics, published by the Regional Government of Valencia for the 1976-1980 five-year period. In this study, the standardized death rates and the standardized causes thereof, with regard to respiratory tuberculosis have been calculated using direct method. In addition, the distribution of tuberculosis has been broken down according to age and sex using specific rates and statistical tests to compare proportions. The results obtained make it possible to compare the different Health Care Areas with regard to the Region of Valencia, it being established that Areas 2, 5, 9-12 and 21 are those revealing an overly high death rate due to respiratory tuberculosis. Likewise, the predominance of this cause of death among men and among the groups most up in age must be stressed, due to the importance of this disease in the working environment and diverse socioeconomic factors.

[An analysis of the mortality from extrapulmonary tuberculosis in the catchment areas of the community of Valencia (1976-1980)]. / Análisis de la mortalidad por tuberculosis extrapulmonar en las áreas de salud de la Comunidad Valenciana (1976-1980).

Tuberculosis is a chronic infectious disease produced by Mycobacterium tuberculosis or Koch's bacillus, which mainly affects the airways and, less frequently, other organs in the body. Tuberculosis is still a health and social problem in Spain. The data of this study were obtained from "Monografías Sanitarias", "Análisis de Mortalidad", published by "Generalitat Valenciana", the standard mortality rate was calculated by direct methods. Mortality is not the best sanitary parameter to study the real situation of this disease, because the present methods of treatment are effective and death caused by tuberculosis is very rare. Despite the aforementioned fact, when comparing the mortality data of different health areas during a period between 1976 and 1980, we confirm that this disease persists as a cause of death in our community.