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Varela Salgado M.,Servicio de Urologia | Paz Esquete J.,Servicio de Medicina Preventiva
Revista Internacional de Andrologia | Year: 2010

Objectives: To explore the concerns, knowledge and attitudes of adolescents in order to advise and support these young people at a difficult stage of their lives. Material and methods: An anonymous survey was carried out in 300 adolescents and young adults aged between 13 and 21 in 2008. The statistical analysis used the Kolmogorov-Smirnov and Shapiro-Wilk tests. Results: Boys obtained information on sexuality from the Internet (30.8%), while women gained information from their families (57.6%). Boys attached much greater importance to sexuality. The first non-coital sexual experience occurred at age 13. The first sexual intercourse was at age 15 for boys and 16 for girls. The first sexual intercourse was motivated by love in girls (40.6%) and by desire in boys (24.1%). Girls were more aware of the risk of pregnancy (82.7%). As for false myths, boys believed that a large penis or breasts led to greater satisfaction. Parents differed in their acceptance of adolescent sexual activity, which was accepted in 27% of adolescent boys and in only 7.8% of girls. The best-known contraceptive method for respondents was the condom but was seldom used (35% of boys, 37% of girls). The best understood sexually transmitted disease was AIDS. Homosexuality was better tolerated by girls, and was rejected by 26.4% of boys. Conclusions: Information among adolescents is inadequate. Consequently, sexual education should be included in schools. © 2010 Sociedad Española de Andrología. Source

Subirats M.,Servicio de Microbiologia | De Juanes J.R.,Servicio de Medicina Preventiva | Pena J.M.,Hospital Universitario La Paz
Revista Clinica Espanola | Year: 2012

Introduction: Few data are available in Spain data on human immunodeficiency virus (HIV) patients coinfected with malaria. This study has aimed to determine the epidemiological and clinical characteristics of imported malaria in patients coinfected with HIV. Patients and methods: A case-series retrospective study was performed using the patient's medical records. The study population consisted on patients diagnosed with malaria attended in our center from january 1, 2002 to december 31, 2007. Results: A total of 484 episodes of malaria, 398 of which were included in this study, were identified. Co-infection with HIV was described in 32 cases. All of them occurred in individuals presumably with some degree of semi-immunity. In the coinfected group, there were 13 cases (40.6%) asymptomatic, whereas this event occurred in 99 cases of patients not coinfected (37.2%) (P=0.707). The greater presence of anemia in co-infected patients (62.5% vs 32.3% in non-coinfected [P=0.001]) stands out. Conclusions: In present study, the clinical presentation forms were similar, regardless of the presence or absence of HIV infection. Although the study population does not reflect all possible scenarios of malaria and HIV coinfection, our results indicate the reality of patients attended in the Autonomous Community of Madrid. © 2011 Elsevier España, S.L. All rights reserved. Source

Gomez-Gonzalez M.C.,Servicio de Medicina Preventiva | Campos R.,Servicio Of Prevencion Riesgos Laborales | Marigliano N.,Servicio de Nefrologia | Lancho J.M.,Servicio de Nefrologia | Teno P.,Servicio de Microbiologia
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2012

Aims: To describe the dynamics of colonization by methicillin resistant Staphylococcus aureus (MRSA) detected in the Haemodialysis Unit (UHD) of the Hospital San Pedro de Alcantara of Caceres due to the detection of catheter-associated infections. Additionally, we attempt to evaluate the effectiveness of preventive strategies introduced. Methods: Nasal swab tests were performed in order to detect MRSA colonization in patients and health professionals from August 2008 to January 2009, according to the Consensus GEIH-SEIMC Y SEMPSPH Consensus. An active surveillance was performed with treatment and control of the carriers until negative results were achieved. A consensus document was drawn up in the UHD with registered preventive measures and work systems were reviewed. Prevalence, cumulative incidence, colonization pressure (carrier ratio per day/total patients or experts per day) were calculated. A chi-square test was performed, as well as a Z test for the comparison ratio. Results: The nasal swabs of 54 acute and chronic patients on haemodialysis showed an initial carrier prevalence of 29.6%; cumulative incidence in patients of 42.6%. Nasal swabs of 48 professionals had a cumulative incidence of 39.5%. There was a parallel decrease in colonization pressure in patients and specialists. After five months A smear was performed 5 months later on 40 patients and 26 specialists, which showed no carriers among the patients, and one among the health professionals. Conclusion: We detected a high number of MRSA carriers among patients and Health professionals from the Haemodialysis Unit. Screening and treatment measures were effective for the decolonization of this population. It is important to adopt long-term strategies for active surveillance for the rapid detection of alert situations. © 2011 Elsevier España, S.L. Todos los derechos reservados. Source

Illescas T.,Servicio de Ginecologia y Obstetricia | Fernandez C.,Servicio de Medicina Preventiva | De La Puente M.,Servicio de Ginecologia y Obstetricia | Coronado P.,Servicio de Ginecologia y Obstetricia | Montalvo J.,Servicio de Ginecologia y Obstetricia
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2013

Objectives: Combined screening for chromosome abnormalities in the first trimester of pregnancy is based on maternal age, nuchal translucency (NT) and biochemical markers (PAPP-A and free β-hCG). We sought to assess the value of the variables used in the combined screening strategy taking into account maternal gravidity and foetal gender. Study design: Between July 1999 and December 2009, a total of 21,193 singleton pregnancies were screened for aneuploidy in the first trimester, in the Hospital Clínico San Carlos (Madrid, Spain). In the original database foetal gender data were available in 4370 euploid cases, and there were 2343 women with at least two consecutive pregnancies. We conducted a retrospective assessment of ultrasound and biochemical markers taking into account foetal gender and maternal gravidity, and evaluated the effect on the performance of screening, in terms of detection rates and false positive rates. Information on pregnancy outcome was obtained from the hospital's intranet medical records or by contacting the patient by telephone postpartum. Karyotype was ascertained by amniocentesis or chorionic villus sampling, and euploid status was assumed in newborns with normal phenotype. Student's t-tests (paired or unpaired as appropriate) were applied to the data, and the Bland-Altmann method was applied in evaluating individual differences in markers between successive gestations. Results: PAPP-A decreased significantly between the first and the second pregnancy (p < 0.01). PAPP-A and free β-hCG values were significantly higher (p = 0.04 and p < 0.01 respectively) and NT was lower (p = 0.02) in pregnancies with a female foetus. Conclusions: Correlations between the biochemical variables in relation to gravidity and foetal gender can introduce a bias in the calculated risk of chromosome abnormalities. Differences in NT measurements with respect to foetal gender do not seem to be of clinical importance. NT is independent of gravidity so routine use of NT compensates for the influence of these maternal-foetal variables on the values of biochemical parameters. Hence, the bias in overall combined screening is small. © 2012 Elsevier Ireland Ltd. Source

Subirats M.,Servicio de Microbiologia | De Juanes J.R.,Servicio de Medicina Preventiva | Pena J.M.,Hospital Universitario La Paz
Revista Clinica Espanola | Year: 2012

Introduction: Up to now, the epidemiological and clinical features of imported malaria in Spain have been described in small series from general hospitals. Almost all diagnosis had been made based on symptomatic patients. The aim of this study has been to determine the epidemiological, clinical and laboratorial characteristics of imported malaria in a Reference Unit for Tropical Diseases. Patients and methods: We performed a cross-sectional, observational and retrospective study. The series consisted of patients diagnosed of malaria who had been attended at the Hospital Carlos III from January 1, 2002 to December 31, 2007. Results: We identified 484 episodes of malaria, of which 398 cases were included in the analysis. Almost 50% of the patients were natives of endemic areas, while the rest were native-travelers or travelers. Most cases (88-98% according to the group) had not taken malaria chemoprophylaxis correctly when indicated. At the time of diagnosis, 30.4% of patients were asymptomatic and 28.1% of asymptomatic patients had anemia, 19.8% thrombocytopenia, 14% leukopenia, 5% hypocholesterolemia, 5% renal failure and 4.1% hypoglycemia. Low parasitemia was present in 97.5% of asymptomatic individuals compared to 80.5% of the symptomatic patients (P<0.001). Discussion: Absence of chemoprophylaxis (or poor compliance) is the main reason for malaria in individuals traveling to endemic areas. Malaria must be ruled out in individuals coming from tropical countries with compatible symptoms, and it also should be suspected in certain groups of asymptomatic individuals with abnormal laboratorial parameters. © 2011 Elsevier España, S.L. All rights reserved. Source

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