Puerto Rico health sciences journal最新文献

Objective: In this study, the localization of tumor necrosis factor alpha (TNF-α) and interleukin (IL) -6 in the umbilical cord tissue of pregnant women with preeclampsia who smoke and in those who do not smoke was investigated using immunohistochemical methods.

Methods: The sample groups consisted of a control group, cigarette smokers, preeclampsia, and cigarette smokers with preeclampsia. Histological and immunohistochemical methods were applied to the tissue samples.

Results: It was determined that there were varying degrees of edemato s change in the layers of arteries and veins in the preeclampsia and the cigarette smokers with preeclampsia groups, with a statistically significant level of difference in thickness compared to the other groups. In addition, different levels of TNF α and IL-6 immunoreactivity were detected in the umbilical cord tissue across all the groups. In the preeclampsia group, TNF-α immunoreactivity was found to increase in the arterial muscle layer. Moreover, IL-6 immunoreactivity was found to decrease in the arterial endothelium and muscle layers in the cigarette smokers, preeclampsia, and cigarette smokers with preeclampsia groups and increase in the venous endothelium and muscle layers. In addition, immunoreactivity increased in the amniotic epithelium in the cigarette smokers with preeclampsia group.

Discussion: In conclusion, the differences in cytokine levels between the cigarette smokers, preeclampsia, and cigarette smokers with preeclampsia groups were thought to be caused by responses of the maternal immune system and histopathological changes in the umbilical cord tissue.

This is the case of a 22-year-old female who arrived at our institution after experiencing refractory insomnia, disorganized behavior, inappropriate laughter, and anorexia. Upon admission, a physical examination revealed mutism, irritability, and visual hallucinations. Infectious, metabolic, and other, alternative, causes for the presenting symptoms were excluded. Brain magnetic resonance imaging and chest and abdominopelvic computed tomography scan results showed no evidence of pathology. Due to there being a high clinical suspicion of paraneoplastic encephalitis, treatment was initiated with intravenous (IV) high-dose steroids and IV immunoglobulins. An endovaginal ultrasound was performed, which revealed a small atypical intraovarian dermoid cyst. The patient's laboratory tests were positive for anti-N-methyl-D-aspartate antibodies within her cerebrospinal fluid. A laparoscopic right partial salpingectomy and an oophorectomy were performed on day 25, after the symptoms developed further. Histopathology confirmed the presence of a mature teratoma within the right ovary. After surgery, she returned to her baseline mental status, with no further complications.

Objective: Röntgen's discovery made international news in January 1896, but the appearance of x-rays in Puerto Rico has been dated to 1911. This investigation was undertaken to identify the time, place, participants, and equipment of the first public demonstration of x-rays in Puerto Rico, document other users before 1911, and frame the events and persons in their social, professional, and international contexts.

Methods: Information was retrieved from digitized Puerto Rico newspapers available online and secondary printed and digital sources.

Discussion: The first demonstration of x rays in Puerto Rico was organized by physician José Esteban Saldaña in June 1897 and included Francisco Pelati (who documented the event), an electrician; José C. Barbosa, Francisco and Pedro Del Valle, and Juan and Ricardo Hernández, physicians; and José A. Canals, an engineer. Other users prior to 1911 are documented.

Conclusions: Internationally, the first reaction to the discovery of x-rays was a mixture of wonder, experimentation, fascination with a scientific novelty carrying other-worldly resonance, and recognition of potential dangers. Puerto Rico was not an exception. The news arrived in seven weeks, although the equipment (apparently from New York) arrived a year and a half later (June 1897). The readily apparent common denominator for this group of first users is political affiliation, but they were connected by a variety of experiences, despite differences in race, class, and religious ideas. As in other places, x-ray use increased slowly and was available in several cities in Puerto Rico by 1911.

Objective: The epidemiology of meningiomas for patients with Hispanic ethnicity is mainly unknown beyond a few studies. Evidence supporting the ethnic influence over meningioma World Health Organization (WHO) grade is limited. This study aimed to investigate a Hispanic population in Puerto Rico with intracranial meningiomas regarding the WHO grade.

Methods: This study retrospectively reviewed 173 Hispanic patients who underwent pathology-proven intracranial meningioma resection by a single surgeon at a tertiary care facility during 25 years. Descriptive statistics were used to investigate clinical and histopathological differences among the patients.

Results: The cohort had 71.1% female patients, with a female-to-male ratio of 2.6:1. The median age of the patients was 53 years, ranging between 19 and 87 years. Analysis showed that 159 patients had a WHO grade 1 meningioma (91.9%), 13 patients had a WHO grade 2 meningioma (7.5%), and one patient had a WHO grade 3 meningioma (0.6%). Recurrence occurred in ten patients (5.8%).

Conclusion: This study reveals a higher percentage of Hispanic patients with WHO grade 1 meningiomas in Puerto Rico than for Hispanic patients living in the United States.

Objective: Currently, in Puerto Rico (PR) there is no study for HPV vaccination rates after implementing mandatory HPV vaccination school entry policy in 2018. This study aims to (a) explore HPV vaccination status in adults (≥18 years) residing in PR., particularly those who fall within the age range approved for vaccination; (b) describe participants' gender and sexual identities and behavior risk factors; and (c) determine how the willingness to vaccinate against HPV is influenced by sociodemographic factors such as age, gender, education level, and health insurance.

Methods: We conducted a cross-sectional study to understand HPV vaccination status, sexual health and behavior risk factors, and sociodemographic factors in adults residing in PR. Surveys were distributed using various strategies over six months to collect data. Informed consent was obtained, and participants were assured anonymity and data utilization. We performed descriptive and logistic regression analyses using STATA.

Results: From a sample of 314 individuals, 47% were vaccinated, and 82% were familiar with the HPV vaccine. Among the unvaccinated, 49% were open to vaccination. Age and gender significantly predicted vaccination status, with older individuals 65% less likely and females 60% more likely to be vaccinated than males and other genders.

Conclusion: This study identifies age, gender identity, education, and health insurance as pivotal determinants of HPV vaccination status in PR. It also found interest in vaccine information among non-vaccinated people, revealing significant coverage disparities crucial for enhancing vaccination rates and sexual health education.

Objective: The objective of this study was to determine the incidence and evolution of patients with acute fatty liver of pregnancy (AFLP) over a period of 18 years in the city of Toluca, Mexico.

Methods: This was a descriptive and retrospective study of eighteen years. All women with AFLP confirmed by biopsy were included and the incidence, laboratory test values and complications were registered.

Results: AFLP incidence was of 1 case for every 8,451 deliveries. The main complications were bleeding, infections and neurological compromise. The mortality was of 33.33%.

Conclusion: It can be concluded that AFLP has a slightly lower incidence in Mexico than that reported in other countries but with a higher survival. This condition deserves a multidisciplinary team to improve the survival rate.

Objective: We aimed to describe the head circumference (HC) growth trends for non-microcephalic infants exposed to the Zika virus (ZIKV) in utero.

Methods: This was a medical record review of non-microcephalic neonates exposed to ZIKV whose mothers received prenatal care at the fetal evaluation unit (2015-2017). The mean HC values of babies from prenatal age to 1 year old were compared with the standardized values on HC growth charts.

Results: Sixty-three mother-infant pairs were included, and 56 infants (boys, 30%; girls, 70%) were evaluated. The mothers tested positive for ZIKV; their babies had a mean gestational age of 38 weeks (32-42) and a mean birth weight of 3,150 grams (1,190-4,220). The mean HC growth of the fetuses (19-34 weeks gestational age) placed them in the 25th percentile, increasing to the 50th percentile (according to the World Health Organization [WHO]). Compared with other growth charts (INTERGROWTH- 21st [International Fetal and Newborn Growth Consortium for the 21st Century] and Puerto Rico reference values), the mean HC grew in the 50th percentile at 18 to 30 weeks of gestational age, indicating normal growth in children from Zika-positive women. According to the WHO chart, the postnatal HCs of both the girls and boys reached the 75th and 50th percentiles, respectively.

Conclusion: Postnatal HC growth was normal. Results from this study suggest that infants exposed to ZIKV in utero can be normocephalic at birth. Therefore, the neurodevelopmental outcomes of such infants should be followed throughout childhood and adolescence, regardless of their HCs at birth.

Objective: The abrupt decline in the Total Fertility Rate (TFR) of Puerto Rico to 0.9 children per woman, well below the replacement level of 2.1 children per woman, makes the prospect of a sustained population decline a real possibility. Population projections produced by the United States Census Bureau and the United Nations Population Division show that the island population may decline from 3.8 millions in 2000 to slightly above 2 million by 2050, a dramatic population decline of 47% in 50 years. Both population projections assume that all countries with a TFR below replacement level could eventually increase toward or oscillate to 2.1 children per woman and have Puerto Rico's TFR approaching 1.5 by 2050. This assumption has been widely criticized as unrealistic and not supported by evidence. The main objective of our research is to provide an alternative fertility projection for Puerto Rico by 2050 that has more realistic assumptions.

Methods: Our methodology is based on the Bayesian Hierarchical Probabilistic Theory used by the United Nations to incorporate a way to measure the uncertainty and to estimate the projection parameters. We modified the assumptions used by the United Nations by considering 17 countries with TFR similar to Puerto Rico.

Results: By 2050, Puerto Rico may have a TFR of 1.1 bounded by a 95% credibility interval (0.56,1.77).

Conclusion: Under this scenario Puerto Rico can expect to have a larger population decline than that projected by the Census Bureau and the United Nations.

Objective: Monkeypox is a viral zoonotic disease endemic to West and Central Africa; it has been reported in more countries during the last decade than in the previous 40 years. In 2022 a multinational outbreak occurred. This change in the epidemiology of the virus may represent an evolutionary adaptation. The purpose of this study is to analyze the molecular aspects of Monkeypox virus (MPXV) disease that may explain the latter's change in epidemiology during the 2022 outbreak.

Methods: From July 2022 through December 2022, the period of the outbreak, a narrative review was conducted on the available literature, with a total of 271 articles published in the MEDLINE/PubMed and LILACS databases being examined. The chosen articles were organized using the search and reference manager Mendeley Desktop 1.19.4. Duplicates and articles that did not meet the study's objective were eliminated, resulting in the selection of 49 articles for the present review.

Discussion: MPXV resurgence poses challenges due to waning immunity and changing epidemiological patterns. Recent outbreaks show different transmission routes, affecting new demographics. Genomic evolution, vaccination history, and potential new animal reservoirs complicate containment efforts. Continued surveillance and vaccination are crucial for control.

Conclusions: It seems possible that MPXV has (re-)emerged to occupy the ecological niche left by the smallpox virus. Mutations of the apolipoprotein B mRNA editing enzyme, catalytic subunit 3G motif, in MPXV clade IIb since 2017 may explain the epidemiological change that has occurred in recent years. This pattern could be due to sustained transmission in a new host or a new route of infection.

Objective: Primary ciliary dyskinesia (PCD) is a respiratory disorder that impairs mucociliary clearance, leading to decreased lung function. Conventional chest physiotherapy (CCP) is the traditional airway clearance technique (ACT) and is considered a standard treatment for PCD patients. This systematic review investigated whether device supported ACTs are better alternatives for improving lung function and/or quality of life in PCD, compared with CCP.

Methods: The OVID Medline, PubMed, CINAHL, and Cochrane databases were searched. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed, and the Grading of Recommendations, Assessment, Development, and Evaluation approach was used to aggregate the data. This systematic review has been registered on the International Prospective Register of Systematic Reviews website.

Results: Of the 389 citations that resulted from our literature search, 2 randomized crossover trials that included a total of 54 patients were analyzed. The certainty of the aggregated study evidence was very low. No difference was identified between device-supported ACTs and CCP in terms of forced vital capacity and forced expiratory volume in 1 second in PCD patients aged 6 to 20 years.

Conclusion: Device-supported ACTs could be considered alternative treatment options to replace CCP. High quality research is required to confirm this result.