Puerto Rico health sciences journal最新文献

Objective: Cardiovascular disease (CVD) is the leading cause of death among women in Puerto Rico (PR). Cardiovascular disease risk factors (CVDRF) during pregnancy, such as obesity, type 2 diabetes (T2D), hypertension, and hypertensive disorders of pregnancy, increase risks for maternal and neonatal health. Limited data exist on CVDRF prevalence among pregnant women in PR.

Methods: This cross-sectional study analyzed medical records of 264 pregnant women aged 21-35 years with no prior pregnancies from an outpatient clinic in San Juan, PR, during 2018-2019. Key CVDRFs included pre-pregnancy obesity, T2D, gestational diabetes, hypertension, and hypertensive disorders of pregnancy. Age groups (21-25, 26-30, 31-35 years) were assessed for CVDRF prevalence. Logistic and multinomial regressions adjusted for sociodemographic variables were used to evaluate associations.

Results: Pre-pregnancy obesity was the most prevalent CVDRF (23.5%). Women aged 31-35 years had significantly higher odds of T2D/ gestational diabetes (OR=4.66; 95% CI=1.18, 18.4) and were more likely to experience two or more CVDRFs (RRR=2.73; 95% CI=1.10, 6.80).

Discussion: Findings align with global data showing increased CVDRF prevalence with age among pregnant women. Comparisons with Latino and non-Latino populations reveal shared risks, such as higher rates of gestational diabetes and obesity in older age groups, emphasizing the universal relevance of addressing maternal CVDRFs. Significance: This study highlights the importance of identifying and managing CVDRF among pregnant women in PR, particularly those aged 31-35 years. The findings provide critical data to inform targeted interventions, optimize prenatal care, and reduce long-term maternal and neonatal complications, contributing to improved health outcomes for Puerto Rican women.

Objective: In Puerto Rico, two in ten adults aged 18 to 64 (18.7%) are diagnosed with a mental illness (MI), such as schizophrenia, bipolar disorder, and major depressive disorder. People with MI diagnosis report higher frequencies of chronic diseases (e.g., diabetes, cancer, heart diseases) and cigarette smoking than the general population. This study explores associations between smoking, sociodemographic characteristics and health history (i.e. chronic diseases and MI diagnosis) among adults with a MI diagnosis in Puerto Rico.

Methods: This cross-sectional study includes data from 285 Puerto Rican adults (> 21 years) with a MI diagnosis receiving psychiatric or psychological treatment in a community healthcare facility between May 2017 to May 2020. Chi-square tests evaluated the associations between smoking and sociodemographic characteristics, chronic diseases and MI diagnosis. Multiple logistic regression explained the relationship between smoking, sociodemographic characteristics, and MI diagnosis.

Results: A total of 25.3% (n=72) of participants reported current smoking. Significant associations were found between smoking with sociodemographic characteristics and MI diagnosis among Puerto Ricans diagnosed with MI. The logistic regression model explained 18.9% of the variance in smoking and classified 76.1% of cases.

Conclusion: Results confirm high prevalence rates of current smoking and the potential impact on health among Puerto Ricans with MI diagnosis. Tailored treatments for smoking cessation for Puerto Ricans living with MI are needed.

Objective: Systemic Sclerosis (SSc) is an autoimmune disease with significant morbidity and mortality secondary to pulmonary manifestations. The six-minute walk test (6MWT) has been used in SSc studies to measure respiratory complications, particularly pulmonary hypertension. In this study, we evaluated whether the six-minute walk distance (6MWD), measured during the 6MWT, is associated with clinical SSc symptoms in Puerto Rican patients in a rheumatology clinic.

Methods: We prospectively collected 6MWT data for 37 consecutive SSc patients at the University of Puerto Rico every three months for one year between 2013 and 2015. A linear mixed regression model was used to investigate the effects of the SSc clinical features and subtypes on average 6MWD over time.

Results: The average baseline distance walked by SSc patients was 365.2 (± 8.1) meters, with no significant differences over time. No statistically significant differences (p>0.05) were found in the sixminute walk distance (6MWD) at different time intervals for SSc subtypes. Two clinical features, palpitations and lung crackles, were associated with a significantly shorter 6MWD(p<0.05).

Conclusion: Our study showed that the 6MWT can be used to evaluate SSc patients. No association was found between 6MWD and most clinical SSc symptoms in our population. Two clinical symptoms, lung crackles and palpitations, were associated with decreased 6MWD.

Objective: This study aimed to create a model to predict pneumoconiosis risk in coal workers using artificial neural networks (ANNs).

Methods: An ANN-based model was developed using the health records of a population of coal workers (all men). Input neurons comprised current age, year the worker began his employment, occupational category, the number of days spent working underground, the total days spent working, the duration of employment in working underground (i.e., in a so-called group 1 job), and smoking status. Output neurons comprised the states of having pneumoconiosis and being free of pneumoconiosis.

Results: The study found that an ANN model incorporating the variables age, the duration of employment in a group 1 job, the number of days spent working underground, year the worker began his employment, the total days spent working, smoking status, and occupational category can be used to estimate pneumoconiosis risk. The model's success rate was 95.3%; sensitivity was 90.3%, and specificity was 96.5%. The most influential input variable for pneumoconiosis was age, followed by the duration of employment in a group 1 job.

Conclusion: Predicting pneumoconiosis risk in coal workers provides great advantages for strategically monitoring miners and developing preventive health programs. Artificial neural network models should be developed, integrated into occupational medicine practice, and used to evaluate workers' health status.

Malaria is a parasitic disease common in many regions of the world. Cerebral malaria can cause cortical, cerebellar, and pontine infarctions. Although callosal ischemia (CI) due to diabetes mellitus, hypertension, hyperlipidemia and postoperative factors have been described in the literature, isolated CI due to malaria is very rare. We present a patient with isolated corpus callosum ischemia-an unusual complication of cerebral malaria-a case that we believe will contribute to the literature since the woman is 23 years old and has no comorbidities.

Objective: The aim of this study was to evaluate the effect of foot self massage on peripheral neuropathic pain, peripheral skin temperature and patient comfort in individuals with diabetes.

Methods: The sample of the study consisted of 52 individuals with type 2 diabetes (26 self foot massage group and 26 control group) between August 2021 and July 2022. Individuals in the foot self-massage group performed a foot massage for 30 minutes (15 minutes for each foot) three times a week for four weeks after training. Data were collected using an Individual Description Form, a Visual Analog Scale (VAS), the DN4 Pain Questionnaire and the General Comfort Scale-Short Form and peripheral skin temperature was measured. The data were evaluated using the Independent Sample-t test, Paired Sample-t test, Mann-Whitney U test, and Wilcoxon test. Continuity correction and Pearson-χ2 (chi-square) tests were used to compare categorical variables.

Results: In this study, it was found that foot self-massage did not affect the peripheral neuropathic pain level of the patients, but the mean pain (VAS) scores of the patients in the foot massage group significantly decreased compared to the patients in the control groups. In addition, it was found that foot self-massage did not affect patients' peripheral skin temperature and patient comfort.

Conclusion: It is recommended that foot massage, which can be applied by itself without time and place restrictions, be learned by patients and supported by health professionals because it is easy to apply, practical and economical.

Objective: The objectives of this report were to 1) describe the 2015 and 2020 physical activity (PA) Country Cards of Puerto Rico (PR), including data beyond the 2020 Country Card, and 2) propose recommendations for promoting PA research, surveillance, and policy development.

Methods: A comparison of the 2015 and 2020 data from the PR Country Cards provided by the Global Observatory for Physical Activity (GoPA!) was conducted. Country Card data were collected from the World Bank, the United Nations, PubMed, and the Behavioral Risk Factor Surveillance Survey (BRFSS). This ensured that data indicators were standardized for global comparability. Local representatives facilitated data collection through a collaborative review process with GoPA! Country Card data included demographic characteristics, mortality rates, PA prevalence, surveillance data, policy, and research indicators.

Results: In 2015, the BRFSS data indicated a PA prevalence of 34% in PR, decreasing to 20% in 2020. No data on inactivity-related mortality or a national standalone plan focused on PA was available. From 2015 to 2020, research output in PR increased slightly, improving its global ranking from the 61st to the 58th position.

Conclusion: The PR Country Card is a tool to raise awareness and identify surveillance, research, and policy gaps. Recommendations include establishing a dedicated PR health monitoring system, integrating PA into PR national public health plans, and establishing an interinstitutional coalition for PA research (in PR). Multi-sector efforts from policymakers, researchers, and stakeholders are essential for meaningful progress in improving PA levels and public health in PR.

Objective: This study examined how the COVID-19 pandemic contributed to food insecurity in households in Puerto Rico with children with disabilities, compared to households with children without disabilities.

Methods: The present study used a 2-group, cross-sectional design. Participants were interviewed once to describe experiences of food insecurity during the 12 months before the COVID-19 pandemic and again during the pandemic lockdown. In addition, demographic characteristics and mental and physical health were assessed.

Results: Before the COVID-19 pandemic, food insecurity in Puerto Rico was significantly higher in households with children with disabilities (n = 48) than in households with children without disabilities (n = 49) (P < .001). During the COVID-19 pandemic, this difference remained (P = .029). Food insecurity was higher before the pandemic among children in households with children with disabilities (odds ratio [OR]: 3.62; 95% CI:1.19-11.05), and in households overall (OR: 4.72; 95% CI: 1.83 12.14), when assessing adults and children in the same household. This was also true during the pandemic for households overall (OR: 2.54; 95% CI: 1.09-5.96), but to a lesser degree. Food insecurity was not statistically significant in children during the pandemic (OR: 2.56; 95% CI: 0.97-6.74). In both types of households, physical and mental health scores were more than 1 standard deviation below the United States mean.

Conclusion: Both types of households experienced food insecurity during the pandemic. No relationship between food insecurity, disability, and health status was observed in the study sample. All the participants reported low physical and mental health.

This study aimed to evaluate implant outcomes, including success or survival, complications, and marginal bone loss (MBL), in randomized controlled trials (RCTs), comparing short versus long implants with sinus augmentation (SA) after 5 or more years of loading. The objective was to update the qualitative and quantitative evidence on this topic and provide a comprehensive analysis of the previously identified implant outcomes. Electronic searches were conducted in 4 scientific databases from 2016 through 2024. Only RCTs with a minimum follow-up period of 5 years were included (7 studies); these were rated using the revised Cochrane risk-of-bias (RoB 2) tool for main outcomes. The overall risk of bias was "High" in 5 studies, whereas 2 studies were rated as "Some concerns." The risk ratio (RR) and 95% confidence interval (CI) were calculated with Stata software, version 18, for implant success and survival (2.37; 95% CI: 0.83-6.78, P = .11) and for implant complications (0.88; 95% CI: 0.64-1.21, P = .43). The Cohen's d for MBL was -0.41 mm (95% CI: -0.72 to -0.09, P = .01). There was no statistically significant difference in implant success and survival between short and long implants with SA (P = .60). Due to the overall high risk of bias, no definitive conclusions can be drawn regarding the success or survival of short versus long implants. Further RCTs with clear descriptions of implant outcomes, rigorous standardization and calibration protocols, meticulous sample-size calculation, and extended follow-up periods are needed.

Objective: To investigate the relationships between pediatric neuroblastoma outcomes, tumor ploidy, and ethnicity, focusing on disparities in overall survival (OS) while also accounting for race and ethnicity.

Methods: Clinical and tumor ploidy data for 63 Hispanic White, 561 non-Hispanic White, and 86 non-Hispanic Black patients were obtained from cBioPortal for Cancer Genomics (TARGET [Therapeutically Applicable Research to Generate Effective Treatments], 2018). Kaplan Meier survival curves were analyzed using log-rank and Gehan-Breslow Wilcoxon tests. Hazard ratios (HR) with 95% CIs were calculated using the Mantel-Haenszel method. Associations between ethnicity and tumor ploidy were assessed using the chi-square test.

Results: Significant differences in overall survival (OS) were observed between White patients who self-identified as Hispanic and those who identified as non Hispanic, with Hispanic patients exhibiting worse outcomes. (P = .0076, HR = 1.907, 95% CI: 1.187-3.062). Median survival for Hispanic patients was 94 months but was undefined for non-Hispanic patients. Diploid tumors were associated with worse outcomes than hyperdiploid tumors were (P < .0001, HR = 2.291, 95% CI: 1.689-3.109). The chi square test revealed a significant association between ethnicity and tumor ploidy (χ2 = 4.220, P = .0400), with non-Hispanic patients having a higher proportion of hyperdiploid tumors (66.99%) than Hispanic patients (53.97%).

Conclusion: Hispanic White patients with neuroblastoma had lower OS than did non-Hispanic White patients, partly due to the former having a higher proportion of diploid tumors. These findings highlight the importance of considering ethnicity and tumor ploidy in risk stratification and treatment strategies.