Puerto Rico health sciences journal最新文献

Objective: This study aimed to examine self-medication among university students by estimating its prevalence, identifying associated risk factors, and assessing its impact on health.

Methods: A cross-sectional design was employed with a study population of students aged 21 to 42 years from a university in southern Puerto Rico. A sample size calculation using Epi Info yielded 269 participants, based on an estimated 70.1% prevalence of self-medication, a 95% confidence level, and a 5% error rate. Data collection involved distributing a culturally tailored survey via email, and in-person recruitment. The survey covered demographic information, self-medication frequency, medication types, and related factors.

Results: The analysis of the data revealed a high prevalence of self-medication (95.60%) among surveyed students, predominantly with analgesics (e.g., acetaminophen) and anti-inflammatories. Notably, the use of antibiotics and antidepressants, both requiring prescriptions, was also reported. A significant proportion of the surveyed participants practiced frequent self-medication (34.87%), considering medication dosage (92.58%), potential interactions (70.31%), and adverse effects (70.93%). However, 14.79% were unaware that associated risks might exist.

Conclusion: This study provides insights into the prevalence of self-medication (95.60%) among a population of university students in southern Puerto Rico, as well as the motivations for this behavior and the associated risks. Its findings contribute to understanding self-medication patterns and suggest areas for intervention and education to promote responsible self-care practices.

Objective: This cross-sectional study assessed the type and frequency of injuries associated with traumatic spinal cord injury (TSCI).

Methods: The NTRACS Hospital Trauma Registry database of the Puerto Rico Trauma Hospital was reviewed for the medical records of all admissions with the International Classification of Diseases, 10th Revision, Clinical Modification codes S12-S14, S22-S24, and S32-S34 for the years 2019 through 2022. The injury characteristics recorded included neurological level, mechanism, severity score, hospital length of stay, and associated injuries.

Results: The median number of associated injuries per TSCI patient was 5, and 136 TSCI patients (93.8%) had more than 1 injury. Common injury diagnostic code groups included fractures of the ribs, sternum, and thoracic spine; injuries to intrathoracic organs; fractures of the cervical vertebra and neck; and fractures of the lumbar spine and pelvis. Notably, 88.3% of the TSCI patients had at least 1 injury that could complicate rehabilitation, with one-third having upper extremity fractures and 1 in 5 having a concurrent traumatic brain injury. There was a weak positive correlation between length of stay and the number of associated injuries, as well as with the injury severity score.

Conclusion: These findings indicate that associated injuries are prevalent in TSCI patients, potentially complicating acute care and patient outcomes. A consensus definition of associated injuries in TSCI- particularly those that can complicate rehabilitation-is needed.

Objective: The authors documented, described, and explained the food insecurity experiences of Puerto Rican elders, particularly how they perceive and give meaning to this phenomenon.

Methods: The food insecurity experiences of 50 Puerto Rican elders (≥65 years) were collected using a mixed-methods approach. Qualitative data were collected through in-depth interviews, and quantitative data were obtained from a 22-item questionnaire. The data were integrated with a convergent design.

Results: 92% of the participants were food insecure. Puerto Rican elders' food insecurity experiences have four components (quantity, quality, social, and psychological) and a common pattern of fourteen manifestations.

Conclusion: Food insecurity in Puerto Rican elders has causes that go beyond the economic access to food. Addressing food insecurity should be a priority of integrated national food and nutrition policies to reduce the nutritional health inequities among this population. This study presents the first in-depth examination of food insecurity among Puerto Rican elders residing in Puerto Rico, focusing on their cultural interpretations of the phenomenon.

Report of a conference held in Puerto Rico, this article highlights how interdisciplinary translational science-anchored in education, public trust, and equity-can accelerate innovation in cancer therapy while empowering underserved communities through inclusive training, collaboration, and research participation.

Objective: The objective of this study was to analyze and compare the distribution patterns of fentanyl, morphine, meperidine, and codeine in the continental US compared to Puerto Rico from 2018-2023. Attention was given to meperidine due to its extensive adverse effect profile and irreversible central nervous system toxicity.

Methods: Data was collected from Automation of Reports and Consolidated Orders Systems (ARCOS). The dataset included annual distribution data for meperidine, fentanyl, morphine, and codeine in the US and Puerto Rico. Population data was collected from US Census data and the American Community Survey. Data analyses were conducted using Microsoft Excel Version 2410. For each opioid, the mean distribution and standard deviation (SD) were calculated for the continental US. The mean distribution in Puerto Rico was compared to the US mean distribution with a 95% confidence interval. ANOVA tests were performed to assess differences in distribution of each opioid across years (2018, 2020, and 2022) within the continental US. All descriptive statistics and ANOVA calculations were conducted with statistical significance determined at p < 0.05.

Results: From 2018 to 2023, meperidine distribution declined in both regions but decreased more sharply in the continental US (82.6%) compared to Puerto Rico (43.5%). Distribution levels exceeded six standard deviations above the US mean in 2023. Fentanyl and morphine distributions were consistently lower in Puerto Rico than in the continental US.

Conclusion: There was a disproportionately high distribution of meperidine in Puerto Rico compared to the continental US across the years studied.

This case report highlights the potential of continuous ST segment monitoring (C-STM) in the emergency department (ED) for identifying transient ischemic changes in patients with acute coronary syndrome (ACS). We present a case of a 62-year-old male with type 2 diabetes and hypertension who presented with chest pain, that resolved prior to arrival. Despite an initially non-diagnostic ECG, C-STM detected transient hyperacute T waves and mild ST elevations, prompting further investigation, and ultimately leading to successful percutaneous coronary intervention (PCI) for a critical left anterior descending (LAD) coronary artery lesion. Our case emphasizes the importance of high clinical suspicion, continuous monitoring, and timely intervention in patients with ACS, even when initial presentations are atypical. It also raises the question of which ACS patients benefit from C-STM.

Objective: This cross-sectional study aimed to estimate the prevalence of impacted maxillary canines in patients seeking treatment from 2016 2020 at the University of Puerto Rico School of Dental Medicine Orthodontic Graduate Program and compare it to the prevalence of published reports. Additionally, we sought to describe the clinical pattern of impaction using initial photographs and panoramic radiographs.

Materials and methods: Data were extracted from the dental records aged 14 years and older who had sought orthodontic treatment in 2016 2020. A calibrated examiner conducted all the dental measurements using 2D images from the initial records. Descriptive statistics included means (standard deviations), medians (interquartile range), and frequencies. A one-sample binomial test was used to compare the prevalence found to those of published reports. A chi-square, Fisher's exact, and the Mann-Whitney tests were used to compare patients with and without impaction. We used logistic regression to evaluate the associations between tooth-level risk factors and impaction, accounting for clustering and adjusting for age and sex.

Results: The study included 217 patients (mean age: 21.38 ± 9.16 years; 58.5% were female). The prevalence of maxillary canine impaction was 7.83%. The odds of impaction were higher if the deciduous canine was present (OR = 67.59; 95% CI: 18.61-245.40) or if the canine overlapped the lateral incisor root (OR = 155.92; 95% CI: 36.32-669.29).

Conclusion: The overall prevalence of maxillary canine impaction was high, although parallel to that reported in a Mexican population; site-level risk factors (deciduous canine presence, overlap) were identified.

Peripartum cardiomyopathy (PPCM) is a rare and potentially life-threatening cause of systolic heart failure that usually arises in the late stages of pregnancy or the early postpartum period. Its clinical presentation can range from moderate symptoms to severe forms of heart failure, such as cardiogenic shock. However, there is scarce data on severe forms of PPCM leading to multiple organ dysfunction and its management. We report a case of a 30-year-old G2P2 previously healthy Puerto Rican woman postpartum day #56 who presented to our Institution with respiratory symptoms. Further evaluation confirmed cardiogenic shock with ischemic hepatitis and acute kidney injury. Echocardiography revealed a dilated left ventricle with an ejection fraction of less than 20%, which suggested PPCM. This case highlights severe manifestations of PPCM, its challenges in management, and the importance of considering it in the differential diagnosis of respiratory symptoms during the peripartum period.

Objective: To determine the association between health literacy, adherence to treatment with quality of life in patients with chronic obstructive pulmonary disease (COPD).

Methods: This cross-sectional study conducted among adults with COPD between February and March 2023. Sociodemographic characteristics, EuroQol Five-Dimension questionnaire (EQ-5D-5L), Health Literacy Scale, Morisky Medication Adherence Scale (MMAS-8), and COPD assessment test (CAT) were assessed.

Results: A total of 425 patients with COPD were included. Better treatment adherence was positively correlated with better quality of life (p<0.001). There was a negative correlation between the quality of life and age (p<0.001; r=-0.174), COPD duration (p<0.001; r=-0.261), pack-years smoking history (p=0.002; r=- 0.162), and CAT score (p<0.001; r=-0.765). There was a positive correlation between quality of life and body mass index (p=0.049; r=0.096), and health literacy scores (p<0.001; r=0.473). Increased health literacy scores were also significantly related to better quality of life (p=0.004).

Conclusion: Treatment adherence and health literacy significantly influenced HRQoL, highlighting the need for interventions focused on enhancing health literacy and adherence in COPD management.

Objective: This study compared the healthcare utilization of and costs for adults (18-64 years) with diabetes mellitus (DM) by plan type in Puerto Rico in 2013. This study is important because understanding disparities in healthcare access and expenditures can inform public health policy decisions aimed at improving diabetes care in Puerto Rico.

Methods: Puerto Rico public and private medical insurance paid claims and enrollment data from 2013 were used to calculate the diabetes prevalence and medical care expenditures associated with this disease for total enrollers and by type of health insurance. This cross-sectional analytic study analyzed healthcare claims from 96% of the insured population in Puerto Rico, providing a comprehensive assessment of diabetes-related healthcare costs.

Results: The total expenditure for patients with DM for 2013 was $388,536,735, with 58.0% attributed to the private sector. In the public sector, the largest expenditure was for hospital services (53.8%), while in the private sector, the highest spending occurred in outpatient services (54.6%). After adjusting for sex, age, Charlson comorbidity index, and percent of copayment, public insurance beneficiaries were more likely to use hospital services (PR=3.23, 95% CI: 3.13-3.33, p<0.001) and emergency services (PR=1.61, 95% CI: 1.56-1.64, p<0.001), while private insurance beneficiaries used more ambulatory services (PR=0.91, 95% CI: 0.89-0.93, p<0.001).

Conclusion: The findings of this study suggest disparities in access to primary health services for people with DM between public and private insureds, and that there is no continuity of care, leading to high costs for such services.