Puerto Rico Health Sciences Journal最新文献

Objective: We aimed to estimate the overall distribution of odontogenic infection by socio-demographic and medical characteristics in patients admitted to the Adult University Hospital (AUH) in Puerto Rico (PR).

Methods: A cross-sectional study was undertaken with the medical charts of 129 patients (≥21 years) with odontogenic infection who had been admitted (2011-2015) to the AUH and treated by the Oral and Maxillofacial Surgery Post - graduate Program of the University of PR. The patients were selected from the hospital's billing database after having been identified using the International Classification of Diseases (9th and 10th revisions). The study variables included age, gender, municipality of residence, medical insurance, infection etiology, surgical and antibiotic treatments, length of stay (LOS), and the presence of diabetes. Descriptive and frequency statistics were calculated for all the variables; chi-squared, Kruskal-Wallis, Kendall tau, and Mann-Whitney tests were performed. A P < .05 was considered statistically significant.

Results: The mean age of the subjects was 40.36 (SD: 14.74) years, and they ranged in age from 21 to 81 years; the majority were enrolled in the public health insurance plan of PR. The leading cause of infection was dental caries. Diabetes was associated with longer LOSs; P < .01.

Conclusion: In our study, the relative frequency of admitted patients with an odontogenic infection, most of them with low income, increased over time with dental caries being the principal cause of infection.

Objective: A minimum of 3-h/day of any intensity physical activity (PA) has been recommended for preschoolers. No previous study has documented accelerometer-based PA and sedentary time (ST) among Hispanic preschoolers in Puerto Rico, a population with high obesity and low PA prevalence. The purpose of this study was to describe and compare total, weekdays (during- and out-of-preschool) and weekend PA and ST, and test associations with body mass index (BMI).

Methods: A group of 3-5-year-old preschoolers (9 boys,13 girls) completed height and weight measurements, and wore an accelerometer during 7-days. Shapiro-Wilk, Mann-Whitney U test and Spearman correlations were used to test for normality, sex differences and associations, respectively.

Results: No sex differences were observed for BMI, weekdays and weekends PA and ST. Light to vigorous intensity PA (LVPA=3.2±0.6 h/day) and moderate to vigorous intensity PA (MVPA=80.4±21.7 min/day) were within guidelines only on weekdays. LVPA occupied 21.3% (15.4±3.7 min/h), MVPA 9.5% (6.6±2.3 min/h), and ST 65.3% (4.8±0.4 h/day) of preschool time. Boys had higher MVPA than girls only during-preschool time. BMI indicative of overweight-obesity was identified in 36.3%, and BMI directly correlated with total ST and inversely correlated with LVPA.

Conclusion: Total and during-preschool LVPA and ST, and their association with BMI highlight the need for interventions to promote PA and reduce ST, particularly during-preschool time.

Objective: The aim of this study was to evaluate the relationship between cyberchondria and obsessive beliefs and determine the potential risk of the former.

Methods: This was a cross-sectional study conducted with 777 individuals. The Cyberchondria Severity Scale and the Obsessive Beliefs Questionnaire were applied to the participants. Univariate and hierarchical multiple linear regression analyses were used to analyze the data.

Results: Of the study group 382 (49.2%) were male, 395 (50.8%), female. Their ages ranged from 18 to 63 years, with an average of 32.6 (± 9.6) years. Multiple linear regression analysis found that the frequency of internet use (several times a day; n = 670), using the internet as a source of health-related information (n = 320), using the internet to research a doctor before making and/or attending an appointment with same (n = 363), halting the use of prescribed medication based on information obtained on the internet (n = 177), and obsessive beliefs were factors linked to cyberchondria. Cyberchondria and obsessive beliefs were positively related and in the final model were found to be the strongest determinants of cyberchondria.

Conclusion: Obsessive beliefs may be a potential risk factor for cyberchondria. Since cyberchondria affects people's health related behaviors, it is important to ensure the safety of health-related information on the internet. The results of this study may guide future ones that thoroughly investigate the factors associated with cyberchondria. More comprehensive studies are needed to reveal the relationship between cyberchondria and obsessive beliefs.

Objective: Review the profile of patients with spinal trauma after diving accidents referred to the Puerto Rico Medical Center. This study intended to develop more awareness of the risks of spinal cord injury after diving.

Methods: The patient's records for diving accident cases referred to our center during January 2014 until December 2020 were assessed retrospectively. The cases were evaluated according to sex, age, vertebral level, and neurological deficit. The Puerto Rico Medical Center is the only level 1 trauma center in Puerto Rico; therefore, this study likely included all the cases of diving injury on the island.

Results: Sixty five patients with a median age of 29 years were identified consisting primarily of males (94%). The regions affected included the cervical (96%), thoracic (2%), and lumbar (2%) spine. Twenty-seven patients (42%) developed a spinal cord injury secondary to a diving accident. Involvement of the C4, C5, or C6 vertebral level, was significant for the development of a spinal cord injury. Diving accidents occurring at beaches were the most common cause.

Conclusion: In Puerto Rico, there is a yearly incidence of 9.3 diving accidents causing spinal trauma; these accidents most frequently affect the C6 vertebra. These diving accidents mainly occur in young individuals, predominantly at beaches. Most of our patients were neurologically intact after their diving accident, although 42% sustained a spinal cord injury. This study provided a better understanding of this traumatic event and determined its most affected levels, accident sites, and population involved.

Objective: The countries of the Community of Latin American and Caribbean States (CELAC, by its initials in Spanish) have been some of the most affected by COVID-19. This paper analyzes whether, in the 33 CELAC countries, population density, together with other economic variables, such as gross domestic product (GDP) at purchasing power parity (PPP) values or the Human Development Index (HDI), were significantly associated with the coronavirus mortality rate.

Methods: A correlation analysis and an ordinary least squares regression model were used to analyze the effects of different variables on the COVID-19 mortality rate.

Results: The results showed that countries with higher numbers of inhabitants per square kilometer had lower death rates. Gross domestic product was not associated with the number of deaths, while the HDI had a positive impact on that number.

Conclusion: Countries with high population density are not more vulnerable to COVID-19, as population density allows for economic development and better-designed institutions.

Objective: Accurate and inaccurate vaccination information is readily accessible. Unfortunately, the information found by parents may be wrong. Due to the limited studies on this issue in Puerto Rico, we aim to correlate Puerto Rican parents' sociodemographic characteristics to their vaccine hesitancy level.

Methods: We quantified vaccine hesitancy in Puerto Rican parents and legal guardians who were at least 18 years old using the Parent Attitudes about Childhood Vaccines survey, their attitudes towards a possible SARS-CoV-2 vaccine, and the correlation between vaccine hesitancy and socio-demographic factors. The subjects were recruited through social networks and by distributing the online survey among pediatricians in Puerto Rico.

Results: We identified a vaccine hesitancy prevalence of 38.3%, higher than has been found by other similar studies. The results also demonstrated a significant association between vaccine hesitancy, income, and the type of legal guardian. Participants with a household income less than $75,000 and a legal guardian were more likely to be vaccine-hesitant. Most participants surveyed (80.8%) would not immediately vaccinate their children against SARS-CoV-2, independent of vaccine-hesitancy status, citing general worries of vaccine safety and side effects.

Conclusion: Our results demonstrate the need for better vaccine-education campaigns in Puerto Rico and the challenges that SARS- CoV-2 vaccine fears pose to the proper control of the COVID-19 pandemic. It should be noted that at the time of the survey described herein, a COVID-19 vaccine had yet been developed.

Objective: Anxiety disorders are prevalent among children and adolescents. Identifying anxiety symptoms in primary care, school, and community settings has implications for service planning, resource allocation, and prevention and treatment programming. The Generalized Anxiety Disorder 7-item (GAD-7) scale is a commonly used instrument for evaluating anxiety symptoms. Still, it has yet to be validated in vulnerable groups, such as Spanish-speaking adolescents who are at risk due to socioeconomic disadvantages.

Methods: This study aimed to examine the psychometric properties of the Spanish version of the GAD-7 for adolescents in a sample of middle and high school students in Puerto Rico. Secondary data from 566 students in fifth to twelfth grade in Puerto Rico were collected as part of a school-based services program.

Results: A confirmatory factor analysis evidenced the 1-factor structure of the GAD-7, while a test of invariance supported the equality of the factor loadings across gender and school level. The scores of the GAD-7 showed positive and significant correlations with the 8-item Patient Health Questionnaire depression scale-providing evidence of convergent validity-and the reliability estimates of the GAD-7 were adequate.

Conclusion: Thus, the GAD-7 has optimal psychometric properties in terms of construct and convergent validity and internal consistency. It is a useful instrument for assessing anxiety in Spanish speaking youth in Puerto Rico.

Objective: This study evaluated physicians' knowledge of cancer screening guidelines and human papillomavirus (HPV) recommendations.

Methods: The Puerto Rico Community Cancer Control Outreach Program in collaboration with the Comprehensive Cancer Control Program and the Breast and Cervical Cancer Early Detection Program developed an educational activity for physicians who attended a professional annual meeting. This activity consisted of 2 sessions: one about cancer screening guidelines and the other about HPV and HPV vaccination. A survey measuring the attendees' knowledge of the session topics was administered before and after each session. Changes in knowledge were assesed using McNemar's test with a significance level of 0.05.

Results: A total of 43 physicians responded to the survey about cancer screening, and 67 responded to the survey about HPV. A significant increase in the mean score of the pre-test (3.3 ± 1.42) and post-test (6.7 ± 1.38) of the cancer screening guidelines was observed as well as in that of the pre-test (7.82 ± 1.44) and post-test (9.66 ± 0.53) of HPV. The results showed that there were improvements regarding the most recent cervical cancer screening and colonoscopy guidelines as well as in the knowledge of HPV serotypes.

Conclusion: This mid-day educational activity significantly improved knowledge among primary care physicians. Given its feasibility, future efforts should discuss the most recent cancer guidelines and emerging socio behavioral factors that impact vaccination.

Objective: The main objective was to present the experience of the Institute of Forensic Sciences of Puerto Rico in facing the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19. It has been found that some COVID-19 positive cases may continue to show post-mortem positive results for up to 49 days.

Methods: The in vitro technique of ID NOW COVID-19 was used in the analysis to evaluate the presence of SARS-Cov-2 in postmortem forensic cases. This isothermal method allows to amplify and identify the presence of the RNA-dependent RNA polymerase viral segment. Information on demographics, comorbidities, and the manner and cause of death was collected.

Results: A total of 612 subjects were sampled, of which 41 (6.7%) tested positive for COVID-19;14 (34.1%) of those subjects remained positive for more than 7 days Postmortem. Of the 41 positive cases, only 3 (7.3%) had been diagnosed with COVID-19 before their demise. The most common comorbidities were hypertension (36%), obesity (29%), and mental health conditions (50%).

Conclusion: Results from postmortem COVID-19 testing revealed that some cadavers remain COVID-19 positive for a longer period than expected. Despite this, based on the information collected from the cases that were tested more than once, there is no direct correlation between the cause of death and persistent COVID-19 positivity. We recommend that additional investigations be carried out, in which investigations viral load and the maximum time of the infectious phase are specifically evaluated.

Primary testicular rhabdomyosarcoma is a rare pediatric genitourinary tumor with few cases reported in the literature. The clinical presentation is identical to that of other common testicular neoplasms. Diagnosis entails careful microscopic examination and immunohistochemical analysis to rule out other primary testicular malignancies. Treatment consists of radical orchiectomy and adjuvant chemotherapy with possible retroperitoneal lymph node dissection. This multimodal approach is required to improve survival outcomes and reduce disease recurrence. We present the case of a primary testicular embryonal rhabdomyosarcoma in a 19-year-old male who presented with a rapidly, enlarging, painless testicular mass. He was treated with radical orchiectomy and adjuvant chemotherapy. Once found with metastatic disease, he then received salvage chemotherapy and radiotherapy without success.