Can patients without early, prominent visual deficits still be diagnosed of posterior cortical atrophy?

BACKGROUND: Early and progressive disabling visual impairment is a core feature for the diagnosis of posterior cortical atrophy (PCA). However, some individuals that fulfil criteria over time might initially present with an onset of prominent posterior dysfunction other than visuoperceptual. METHODS: The clinical profile of five patients with a predominantly 'non-visual' posterior presentation (PCA2) was investigated and compared with sixteen individuals with visually predominant PCA (PCA1) and eighteen with typical amnestic Alzheimer disease (tAD). RESULTS: PCA2 patients showed significantly better performance than PCA1 in one visuospatial task and were free of Balint's syndrome and visual agnosia. Compared to tAD, PCA2 showed trends towards significantly lower performance in visuoperceptual tasks, more severe apraxia and more symptoms of Gerstmann's syndrome. CONCLUSIONS: Our sample of PCA2 patients did not present with clinically prominent visual symptoms but did show visual dysfunction on formal neuropsychological assessment (less pronounced than in PCA1 but more than in tAD) in addition to other posterior deficits. Broadening the definition of PCA to encompass individuals presenting with prominent 'non-visual' posterior dysfunction should be potentially considered in clinical and research contexts.

Associative memory deficits in mild cognitive impairment: the role of hippocampal formation.

Neuropathological events featuring early stages of Alzheimer's disease (AD) appear in the entorhinal cortex (EC), subiculum (SB) and cornu ammonis 1 (CA1) of hippocampus, which may account for associative memory deficits in non-demented people with mild cognitive impairment (MCI). To test this hypothesis in vivo, we investigated whether volume changes in these regions are related to failures in associative memory in MCI as compared to cognitively normal (CN) elderly subjects. Volume changes in EC and hippocampal subfields were determined by using deformation-based morphometry techniques applied to probabilistic cytoarchitectonic maps derived from post mortem human brains. CN subjects were distinguished from MCI patients by firstly identifying local volume differences in EC and hippocampus, and then evaluating the way in which these anatomical changes correlated with performance in a non-intentional face-location association task. MCI patients not only performed worse than CN elders in building new associations, but they were further unable to benefit from semantic encoding to improve episodic binding. According to our initial hypothesis, local volume reductions in both EC and hippocampal CA accounted for group differences in associative memory whereas atrophy in CA, but not in EC, accounted for semantic encoding of associations. Two main conclusions can be drawn from the present study: i) access to semantic information during encoding does not reduce the episodic deficit in MCI; and ii) EC and hippocampal CA, two regions early affected by AD neuropathology, are responsible, at least partially, for associative memory deficits observed in MCI patients.

Citas bibliográficas de los artículos del Boletín de Pediatría: ¿por qué no citamos a nuestros colegas? / Bibliographic references of the articles of the Boletín de Pediatría: why don't we cite our colleagues?

Objetivo: Conocer las características más importantes de las citas bibliográficas de los artículos publicados en el Boletín de Pediatría. Material y Métodos: Revisión de las citas bibliográficas de los artículos publicados durante los años 2005 a 2008en el Boletín de Pediatría, excluyendo suplementos. Se estudiaron: número de citas por artículo, número de citas de los5 años previos a la publicación del artículo, número de citas de autores españoles, número de citas electrónicas, número de citas que no fueran de revista científica y número de citas de las distintas revistas pediátricas españolas. Resultados: Se analizaron 171 artículos con un total de3316 citas bibliográficas. La media fue de 19 citas por artículo. El 52% de las citas eran de los 5 años previos al artículo, el 29,7% eran citas de autores españoles, el 5% eran citas electrónicas y el 18,9% eran citas de fuente diferente a revistas científicas. De las 3.316 citas totales, el 9,2% eran citas de revistas españolas de pediatría: 2,3% del Boletín de Pediatría y 5% de Anales de Pediatría. Conclusiones: La bibliografía de los artículos publicados en el Boletín de Pediatría utiliza menos del 30% de citas españolas y sólo un 9% de citas de revistas pediátricas españolas. Las citas de nuestro propio Boletín no llegan al 3% del total (AU)

Objective: To know the most important characteristics of the Boletín de Pediatría bibliographic references. Material and methods: Review of 2005 to 2008 Boletín de Pediatría bibliographic references, without supplements. We studied: total reference number by article, less than 5years references, Spanish author references, electronic references, “no scientific journal” references, and references of the different paediatric Spanish journals. Results: We analysed 171 articles with 3316 total bibliographic references. The reference number mean by article was 19. The 5 year previous reference percentage was52%, the Spanish reference was 29.7% , the electronic reference was 5% and the “no scientific journal” was 18,9%.From 3,316 total references, 9.2% was from paediatric Spanish journals: 2.3% from Boletin de Pediatría and 5% from Anales de Pediatría. Conclusions: The bibliographic references from Boletín de Pediatría manage less than 30% of Spanish references and only 9% from Spanish paediatric journals. The references from our own Boletin de Pediatría are less than 3% (AU)

[Maternal non-diagnosed celiac disease and risk of low birth weight]. / Enfermedad celiaca materna no diagnosticada y riesgo de tener hijos con bajo peso al nacimiento.

AIMS: In order to know the prevalence of celiac disease in mothers with newborns weighing less or more than 2,500 g at birth we carried out a case-control study. PATIENTS: mothers of newborns in Cabueñes Hospital. Case group: Mothers with babies weighing less than 2,500 g at birth. CONTROLS: Mothers with babies weighing more than 2,500 g at birth. One control for each case. METHODS: epidemiological and clinical interviews, and celiac disease serology. RESULTS: We studied 1103 women: 577 cases and 526 controls. We diagnosed 4 celiac disease cases, 2 in the case group and 2 in the control group. These 4 mothers had 3 term newborns (1 case in each 235 mothers; prevalence 0.42%) and 1 preterm newborn (1 case in each 389 mothers; prevalence 0.26%). Two cases had babies with adequate birth weight for their gestational age (1 case in each 419 mothers; prevalence 0.24%) and two cases had babies with low birth weight for their gestational age (1 in each 132 mothers; prevalence 0.75%). The odds ratio for low birth weight was 0.91 (95% CI: 0.12-6.49), the odds ratio for preterm birth was 0.61 (95% CI: 0.06-5.89), ad the odds ratio for low birth weight for gestational age was 3.19 (95% CI: 0.44-22.79). CONCLUSIONS: The prevalence of celiac disease in fertile women in our geographic area was 0.36% (1 case in each 275 mothers), and no differences were found between study groups.

Enfermedad celiaca materna no diagnosticada y riesgo de tener hijos con bajo peso al nacimiento / No disponible

Objetivo: conocer la prevalencia de enfermedad celiaca enmadres de neonatos mayores y menores de 2.500 gramos depeso al nacimiento.Pacientes: sujetos: casos: madres de neonatos menores de2.500 g al nacimiento. Controles: madres de neonatos mayoresde 2.500 g al nacimiento. Un control por cada caso. Instrumentalización:encuesta clínico-epidemiológica y serología celiaca.Métodos: estudio caso-control. Ámbito: mujeres del Área SanitariaV (Gijón) del Principado de Asturias que den a luz en elHospital de Cabueñes.Resultados: se analizaron 1.103 mujeres: 577 madres de niñosmenores de 2.500 g y 526 madres de niños mayores de 2.500 g.Se diagnosticaron 4 casos de celiaquía, 2 en cada grupo. De las 4madres, 3 dieron a luz a niños a término (1 caso cada 235 madres,prevalencia 0,42%) y 1 dio a luz a un niño prematuro (1 caso cada389 madres, prevalencia 0,26%). Dos madres dieron a luz a niñosde peso adecuado para su edad gestacional (1/419 madres, prevalencia0,24%) y 2 madres dieron a luz niños de bajo peso para suedad gestacional (1/132 madres, prevalencia 0,75%). La odds ratiopara peso menor de 2.500 g al nacimiento fue 0,91 (IC 95% 0,12-6,49), para prematuridad 0,61 (IC 95% 0,06-5,89) y para bajo pesopara su edad gestacional 3,19 (0,44-22,79).Conclusiones: la prevalencia de enfermedad celiaca en mujeresfértiles de Gijón es de un caso cada 275 madres (prevalencia0,36%), sin que hayamos encontrado diferencias entre los dosgrupos estudiados

Aims: in order to know the prevalence of celiac disease inmothers with newborns weighing less or more than 2,500 g atbirth we carried out a case-control study.Patients: mothers of newborns in Cabueñes Hospital. Casegroup: Mothers with babies weighing less than 2,500 g at birth.Controls: Mothers with babies weighing more than 2,500 g atbirth. One control for each case.Methods: epidemiological and clinical interviews, and celiacdisease serology.Results: we studied 1103 women: 577 cases and 526 controls.We diagnosed 4 celiac disease cases, 2 in the case groupand 2 in the control group. These 4 mothers had 3 term newborns(1 case in each 235 mothers; prevalence 0.42%) and 1preterm newborn (1 case in each 389 mothers; prevalence0.26%). Two cases had babies with adequate birth weight for theirgestational age (1 case in each 419 mothers; prevalence 0.24%)and two cases had babies with low birth weight for their gestationalage (1 in each 132 mothers; prevalence 0.75%). The odds ratiofor low birth weight was 0.91 (95% CI: 0.12-6.49), the odds ratiofor preterm birth was 0.61 (95% CI: 0.06-5.89), ad the odds ratiofor low birth weight for gestational age was 3.19 (95% CI: 0.44-22.79).Conclusions: the prevalence of celiac disease in fertilewomen in our geographic area was 0.36% (1 case in each 275mothers), and no differences were found between study groups

Diagnóstico ecográfico de embarazo ectópico y cornual tras una transferencia de dos embriones / Ultrasound diagnosis of ectopic and cornual pregnancy after transfer of two embryos

Presentamos un caso en el que tras una transferenciaembrionaria ecoguiada ninguno de los embriones llegó aimplantarse adecuadamente.La dificultad del diagnóstico ecográfico fue importante,ya que si bien la sospecha de embarazo ectópico fue muyprecoz, el embarazo cornual se identificó muy tardíamente

We present a case in which after an echo-guidedembryo transfer, none of the embryos were implantedsuccessfully.The difficulty of diagnostic ultrasound was importantbecause although the suspected ectopic pregnancy wasvery early, cornual pregnancy was identified very later

Eritrocitosis paraneoplásica / Paraneoplasic erythrocytosis

No disponible

Búsqueda activa de casos entre familiares de primer grado de niños celíacos / Case finding study among first degree relatives of coeliac children

Objetivo. Conocer la prevalencia de la enfermedad celíaca entre familiares de primer grado de niños afectos de celiaquía. Estudiar el comportamiento del HLA DQ2 entre los niños y sus familiares. Material y Métodos. Estudio descriptivo transversal de serología de celíaca y de HLA DQ2 entre los familiares de primer grado de niños diagnosticados de enfermedad celíaca en nuestro Área Sanitaria entre 1992 y 2003.Resultados. Se diagnosticaron 54 casos nuevos de enfermedad celíaca en el periodo de estudio (17 varones y 37 mujeres), con una mediana de edad en la biopsia yeyunal de 24 meses. De ellos, el 89 por ciento presentaban clínica digestiva, el 46 por ciento hipocrecimiento/fallo de medro y el 2 por ciento eran asintomáticos. Todos presentaron serología y biopsia yeyunal típica de enfermedad celíaca. El 85 por ciento eran HLA DQ2 positivos. Se pudieron estudiar 44 familias de las 54 iniciales. Se realizó la serología de celíaca en 115 familiares, detectándose cuatro nuevos casos (dos hermanos, una hermana y una madre) (3,5 por ciento de los familiares estudiados). El HLA DQ2 se estudió en 110 familiares, siendo positivo en el 64 por ciento de los mismos (74 por ciento de los padres, 59 por ciento de las madres y 60 por ciento de los hermanos). Los cuatro nuevos casos eran HLA DQ2 positivos. Conclusión. El 3,5 por ciento de los familiares de primer grado de nuestros niños celíacos presentaban marcadores serológicos de celíaca. El HLA DQ2 fue positivo en el 85 por ciento de los niños celíacos y en el 64 por ciento de los familiares estudiados. Los cuatro nuevos casos detectados eran HLA DQ2 positivos (AU)

[Prevalence of immunity to hepatitis viruses in pregnant women from the health area of Gijón (Spain)]. / Prevalencia de inmunidad frente a los virus de la hepatitis en gestantes del Area Sanitaria de Gijón.

INTRODUCTION: The objective of the study is to determine the prevalence of hepatitis B or C chronic infection, and hepatitis A or E immunity among pregnant women from Gijón, as well as their clinical and epidemiological antecedents. PATIENTS AND METHOD: HBsAg and anti-HCV were determined in 2287 pregnant women consecutively attended in the Cabueñes Hospital, Gijón. Ninety nine of them, non-European or Gipsy, were also tested for anti-HAV IgG and anti-HEV IgG as were a sample of 325 and 365 respectively of the remaining 2188. Several clinical and epidemiological parameters were checked in all of them. RESULTS: Hepatitis B virus: 10.8% (246/2287) were previously vaccinated. Among the 2043 non vaccinated, 0.8% (17 cases) were HBsAg+. None of them had HBV replication and in 59% (10/17) the HBV infection was unknown. Hepatitis C virus: 1.44% (33/2287) women were anti-VHC+, 1.26% (29/2287) anti-VHC and PCR+. In 28% of them (8/29) no parenteral risk factor was identified. Again, the infection was unknown in 58% (17/29) previously unknown. Hepatitis A virus: excluding non-European and Gipsy women, with a rate of immunity against HAV in younger than 29 years-old of 57% (12/21) and 89% (16/18), respectively, the anti-HAV IgG was positive in 17% (22/128) of the women younger than 29 years-old, 28% (60/214) between 29 and 36 years-old, and in 56% (13/23) of those older than 36 years-old. Hepatitis E virus: anti-HEC IgG was found in 2% (2/99) non European or Gipsy pregnant women and in 0.6% of the rest (2/325). CONCLUSIONS: a). Vaccination rate against hepatitis B virus is still low among pregnant women in Gijón; b). most of HBsAg+ or anti-VHC+ ignore it and many of them have not an evident risk factor; c). susceptibility to hepatitis A infection is high, with progress towards adult age, and d). remember the possibility of infection by hepatitis E virus.

[Epidemiology of chronic inflammatory bowel disease in Gijón, Asturias]. / Epidemiología de la enfermedad inflamatoria intestinal crónica en Gijón. Asturias.

AIMS: To determine several aspects of the epidemiology of chronic inflammatory bowel disease (IBD), including distribution of the various forms of IBD, sex, age at diagnosis considering lag-time to diagnosis, criteria used in the diagnosis, the relationship between educational level and activity, familial aggregation, phenotype (site and clinical type), number of admissions and mean hospital stay/year, surgical requirements and mortality. PATIENTS AND METHODS: We carried out a retrospective (1954-1993) and prospective (1994-97) descriptive epidemiologic population study, in the fifth health district of Gijón in Asturias (Spain), with 225,798 inhabitants. A total of 595 patients diagnosed with chronic IBD according to the diagnostic criteria described by Lennard-Jones and Truelove for Crohn's disease (CD) and ulcerative colitis (UC) and according to Ashley B. Price's criteria for indeterminate colitis (IC) were studied. In all patients a complete clinical follow-up was performed. RESULTS: During the study period, we diagnosed 595 patients with IBD [305 patients with UC (51.3%), 272 (45.7%) patients with CD and 18 (3%) with IC]. Sex distribution was 287 females (48.2%) and 308 males (51.8%), with a male/female ratio of 1.07. Mean age at presentation was 38.79 +/- 17.44 years (UC: 43.37 +/- 17.55; CD: 33.98 +/- 16.16; IC: 33.73 +/- 13.48), p = 0.000. Age at onset prior to diagnosis was as follows: UC: 42.03; CD: 30.47; IC: 30.99 (p = 0.000). Diagnostic criteria used in UC was symptomatic in 99.01% (p = ns), endoscopic in 95.04% (p = 0.000), and pathologic in 87.21% (p = 0.000); in CD diagnostic criteria used was radiologic in 85.29% (p = 0.000). A total of 29.1% of patients with UC and 66.7% of those with CD had higher education (p = 0.0005). Family history was found in 9.8%. Anatomical site was as follows: in UC: rectum 21%, 28.2% rectum and sigmoid, 22.3% left colitis, 4.2% distal to hepatic flexure and 24% pancolitis; in CD: 32.72% terminal ileum, 19.11% colon, 37.13% ileo-colon, 11.02% extensive intestinal and 3.67% gastro-duodenal. A total of 8.37% of patients with UC and 14.51% of those with CD had been hospitalized during the previous 4 years; mean hospital stay was 1.63 days in UC and 2.27 days in CD. The mean surgical requirements were 0.54 +/- 1.08 (31.59%); UC: 0.11 +/- 0.36 (10.2%); CD: 1.04 +/- 1.38 (56.25%), p = 0.000. The mortality rate was 48.73 deaths/1,000 inhabitants (UC: T = 65.57; CD: T = 33.08; IC:T= 0) p = ns. The standardized mortality ratio was 4.83 (UC: 6.51; CD: 3.28). CONCLUSIONS: We highlight the uniformity of the distribution of IBD in relation to types of disease and sex. Patients with CD had a higher level of education. Genetic components play an important role in these diseases and familial aggregation was high, especially in CD. Complicated situations are infrequent in this group of patients. Morbidity was higher in patients with CD as reflected by surgical requirements and hospital stay. Mortality was lower in CD than in UC.

[Incidence and prevalence of inflammatory bowel disease in Gijon, Asturias, Spain]. / Incidencia y prevalencia de la enfermedad inflamatoria intestinal en Gijón (Asturias).

AIM: To determine the incidence and prevalence of inflammatory bowel disease in our area and to compare our results with those of other series from Spain and other parts of the world. PATIENTS AND METHODS: Descriptive epidemiologic population study, retrospective (1954-1993) and prospective (1994-1997) in health district V of Gijón in Asturias (Spain) with 225,798 inhabitants. Diagnostic criteria used were those described by Lennard-Jones and Truelove for Crohn's disease and ulcerative colitis and those described by Ashley B. Price for indeterminate colitis. Annual incidence was expressed per 100,000 inhabitants. Prevalence was calculated excluding cured patients: proctocolectomized in ulcerative colitis (10 cases) and deaths (29 cases). RESULTS: During the period studied, 595 patients were diagnosed with bowel disease (305 patients with ulcerative colitis, 272 with Crohn's disease and 18 with indeterminate colitis). Mean annual incidence (1954-1997) was 6.128 (95% CI: 2.90-9.36). In the 4-year prospective study the incidence was 15.49 (95% CI: 11.19-21.79), 9.36 for ulcerative colitis, 6.08 for Crohn's disease and 0.77 for indeterminate colitis (UC/CD: 1.58). Prevalence was 246.23 (95% CI: 225.6-226.70, 212.79 for ulcerative colitis, 116.47 for Crohn's disease and 7.97 for indeterminate colitis. CONCLUSIONS: Incidence and prevalence obtained in our environment were higher than those described in other areas of Spain and were similar to those found in areas of Europe and other parts of the world with a higher incidence. Incidence and prevalence have increased since 1980, probably due to the widespread use of endoscopy as a diagnostic technique. Rates were higher in the prospective study than in the retrospective one.

[Effect of Ispaghula husks on postprandial glycemia in healthy female volunteers]. / Influencia de las cutículas de semillas de Plantago ovata (Ispaghula husk) en la glucemia posprandial en voluntarias sanas.

OBJECTIVES: To evaluate the influence of Ispaghula husk in the postprandial glucose concentrations in serum in healthy volunteers. MATERIAL AND METHODS: This study is divided in two assays and 7 healthy women with ages ranging from 35 to 45 years participated in both assays. Assay 1. Administration of 50 g of glucose dissolved in 125 ml of water (followed by other 150 ml of water). Assay 2. It was carried out one week later in the same women and conditions as assay 1 but adding 10.5 g of Ispaghula husk to the dissolution. In both assays, blood samples were obtained at 0, 10, 20, 30, 45, 60, 75, 90 and 120 minutes after administration and glucose concentration was determined in serum. RESULTS: The value of the area under the mean glucose concentration-time curve obtained in assay 2 (in the presence of fiber) was a 13.6% lower than that obtained in assay 1 (significant difference, p < or = 0.05). Individual concentration-time curves obtained in assay 1 can be considered as normal in 4 of the 7 volunteers. Abnormalities observed in the other 3 curves were due to: her history of prediabetic in one of them (glucose concentration values over 180 mg/100 ml); diabetic patients in her family in other of them (2 values over 180 mg/100 ml) and hypoglycaemia in two of the volunteers. When we administered glucose with fiber in assay 2, in all cases, the maximum concentration reached was lower, the variations in glycaemia values were also lower along the different sampling times (peaks disappear or are less marked) and no hypoglycaemia appeared.

Mortality and causes of death in patients with chronic inflammatory bowel disease in Gijón, Asturias (Spain).

OBJECTIVE: to review mortality, survival, influence of age at diagnosis and at death, cause of death, and relation with the extent of chronic inflammatory bowel disease, in a city in northern Spain. METHOD: descriptive retrospective epidemiological study of 516 patients diagnosed in Gijón (Asturias) between 1954 and 1997. RESULTS: of the 26 patients who died (5.03%), 18 had ulcerative colitis, 8 had Crohn's disease, and none had indeterminate colitis. Mortality was higher than in the general population, with a standard mortality ratio (SMR) of 5 (95% confidence interval 1.6-11.6). We found no differences in sex ratio (p = 0.63). Mean duration of the disease was 10 +/- 8 years in surviving patients, and 6 +/- 6 years in patients who died (p = 0.02). Duration was longer in Crohn's disease than in ulcerative colitis (p = 0.014). Mean age at diagnosis for chronic inflammatory bowel disease was 37.5 +/- 17 years in patients who survived, and 58 +/- 18 years in patients who died (p = 0.0005). Mean age at death was 64 +/- 20 years. In Crohn's disease, the most frequent cause of death was the primary disease (50%), followed by tumors of different origin (37.5%). In ulcerative colitis the primary disease was also the most frequent cause of death (38.%), followed by thromboembolic disease (22.2%) and tumors (22.2%). CONCLUSIONS: mortality among patients with chronic inflammatory bowel disease is higher than in the general population in our setting, decreases as duration of the disease increases, and is higher in patients diagnosed at older ages. Fewer than half the deaths were due to the primary disease; many patients with Crohn's disease died from tumors or thromboembolic disease.

[Acute ++indomethacin-induced hepatitis in a female patient with asymptomatic primary biliary cirrhosis]. / Hepatitis aguda por indometacina en una enferma con cirrosis biliar primaria asintomática.

We present an infrequent case of acute hepatitis by indomethacin, in a patient with a primary biliary cirrhosis, previously not diagnosed and asymptomatic, in who during in the follow-up, with a persistent analytical pattern of disociated cholestasis, a liver biopsy was indicated, with the final diagnosis of chronic non-suppurative destructive cholangitis.

[Functional capacity of patients over 65 according to the Katz index. Reliability of the method]. / Capacidad funcional de pacientes mayores de 65 años, según el índice de Katz. Fiabilidad del método.

OBJECTIVE: To find functional capacity of elderly patients by using the Katz Index, which measures the "Basic Activities of Daily Life". To examine how reliable the Katz Index is in the Primary Care field. DESIGN: Descriptive crossover study. Assessment of the measuring instrument's internal consistency and reliability, using a test-retest method. SITE. Otero Health Area, in Oviedo. PATIENTS OR OTHERS PARTICIPANTS: This was a random sample, ordered by age and gender, of people over 65 who used the Otero Health centre. MAIN MEASUREMENTS AND RESULTS: The elderly population made up 12.86% of our base Health Area. The Katz Index showed that 81.6% of the elderly in the sample were independent in all their functions. A significant age difference was found. Internal consistency was measured by Cronbach's Alpha and was 0.8612 for nurses and 0.8362 for doctors. The correlation coefficient within Sperman's estimated observer was r = 0.936074. Kappa was 0.8436 (p < 0.0000) for the different observers, i.e. nurses or doctors. CONCLUSIONS: Most of the elderly patients in our base Health area possess full functional capacity, at the level of the routine activities of their daily life. The Katz Index is a reliable method of evaluating elderly peoples' functional capacity, at the Primary Care level. It can be used by any professional in the health team.

Intrafamilial spread of hepatitis C virus.

We studied the prevalence of antibodies against hepatitis C virus (anti-HCV) among 530 household contacts of 225 anti-HCV-positive subjects (index cases). Twenty-six (4.9%) relatives had anti-HCV, a proportion higher than that found among blood donors (175 of 22,435; 0.78%) (p less than 0.001). We did not find any differences regarding the type of relation with the index case (sexual or nonsexual). The prevalence of anti-HCV increased with the age of the relatives, with the contact time with the index case, and with the time of exposure to HCV. On the other hand, the anti-HCV was associated mainly with the existence of cirrhosis or hepatocellular carcinoma in the patient. We concluded that intrafamilial transmission may be an important mechanism in the spread of HCV.