[Injecting drug users from Eastern Europe in Barcelona, Spain]. / Ciudadanos del este de Europa consumidores de drogas en Barcelona.

From May 1999 to May 2001, we made contact with injecting drug users from Eastern Europe in the healthcare and prevention service of the Red Cross (servicio de atención y prevención sociosanitaria [SAPS]) in Barcelona (Spain). The users attended free therapeutic centers, but paid approximately 500 e for the trip. The users were aged between 18 and 30 years old and maintained family contact. The knew the risk of disease transmission, but often exchanged needles. The prevalence of hepatitis C (92%) and B (62%) was high but less than that of HIV (19%). If they did not stop taking drugs their return would be a failure and they would have difficulties in following methadone and antiretroviral treatments in their countries of origin. The healthcare provided in these centers should respond to user' needs: cultural mediation should be sought, as well as information from users' countries of origin. Centers receiving users from other countries should be supervised and alternatives should be designed for users who abandon treatment. International cooperation and programs to reduce the risk of drug consumption should be developed. Treatment should be prevented from becoming a business.

Ciudadanos del este de Europa consumidores de drogas en Barcelona / Injecting drug users from Eastern Europe in Barcelona, Spain

Desde mayo de 1999 hasta mayo de 2001, hemos contactado en el SAPS (Servicio de Atención Social y Sanitaria) de Barcelona con usuarios de drogas de países del este de Europa. Acuden a centros terapéuticos gratuitos, aunque pagan por la organización del viaje unos 500 euros. Son jóvenes entre 18 y 30 años y mantienen el contacto con sus familiares. Conocen los riesgos de transmisión de enfermedades, pero suelen reutilizar las jeringas. Es alta la prevalencia de hepatitis C (92 por ciento) y B (62 por ciento) y menor la de infección por el VIH (19 por ciento).Si no abandonan las drogas, el retorno es un fracaso y tienen dificultades para proseguir los tratamientos con metadona o antirretrovirales. La respuesta asistencial ha de adecuarse a sus necesidades. Se debe procurar la mediación cultural y la información en los lugares de origen, supervisar los centros terapéuticos y diseñar alternativas a los abandonos. Hay que desarrollar la colaboración internacional, estimular programas de disminución de riesgos derivados del consumo y evitar que del tratamiento se haga un comercio (AU)

From May 1999 to May 2001, we made contact with injecting drug users from Eastern Europe in the healthcare and prevention service of the Red Cross (servicio de atención y prevención sociosanitaria [SAPS]) in Barcelona (Spain). The users attended free therapeutic centers, but paid approximately 500 € for the trip. The users were aged between 18 and 30 years old and maintained family contact. The knew the risk of disease transmission, but often exchanged needles. The prevalence of hepatitis C (92%) and B (62%) was high but less than that of HIV (19%). If they did not stop taking drugs their return would be a failure and they would have difficulties in following methadone and antiretroviral treatments in their countries of origin. The healthcare provided in these centers should respond to user' needs: cultural mediation should be sought, as well as information from users' countries of origin. Centers receiving users from other countries should be supervised and alternatives should be designed for users who abandon treatment. International cooperation and programs to reduce the risk of drug consumption should be developed. Treatment should be prevented from becoming a business (AU)

Clinical features and functional outcome of intracerebral hemorrhage in patients aged 85 and older.

OBJECTIVES: The importance of studies of older stroke victims is growing because of the changes in the age structure of Western populations. We determined demographic characteristics, clinical features, neuroimaging data, and outcome of acute spontaneous intracerebral hemorrhage occurring in people aged 85 and older. DESIGN: Prospective collection of data from a hospital-based registry. SETTING: Sagrat Cor Hospital of Barcelona (an acute care, 350-bed teaching hospital serving a population of approximately 250,000). PARTICIPANTS: Between January 1986 and December 1995, data were collected on 2,000 stroke patients admitted consecutively to the department of neurology (25 beds and an acute stroke unit). MEASUREMENTS: For the purpose of this study, all cases of intracerebral hemorrhage were selected (n = 229). Demographic data, clinical features, neuroimaging findings, and outcome variables (in-hospital mortality and medical complications developed during hospitalization)in patients aged 85 and older (n = 28) were compared with patients who were younger than age 85 (n = 201). Distinctive clinical features of intracerebral hemorrhage in very old people were assessed by multivariate analysis. RESULTS: Intracerebral hemorrhage was diagnosed in 11% of subjects aged 85 and older included in the stroke registry and accounted for 12% of all cases of intracerebral hemorrhage. Very old people with intracerebral hemorrhage showed a significantly higher frequency of female gender (75% vs 32%, P < .005), altered consciousness (64% vs 43%, P < .05), multiple topographic involvement (29% vs 13%, P < .03), undetermined etiology of bleeding (50% vs 27%, P < .02), moderate or severe neurological deficit at hospital discharge (89% vs 58%, P < .005), and in-hospital mortality (50% vs 27%, P < .01) than younger people. After multivariate analysis, female sex (odds ratio (OR) = 3.2,95% confidence interval (CI) - 1.27-7.99) and moderate or severe neurological deficit at hospital discharge (OR =4.75, 95% Cl = 1.36-16.55) were independent clinical factors associated with intracerebral hemorrhage in very old people. CONCLUSIONS: Patients aged 85 and older with intra-cerebral hemorrhage showed some peculiar clinical features and poorer outcome, including higher in-hospital mortality and moderate or severe neurological deficit at hospital discharge, than younger patients with intracerebral hemorrhage.