Puerto Rico Health Sciences Journal最新文献_第5页

Symptomatic Macromastia and Days Lost from Work. 症状性大乳症和旷工天数。

IF 0.5 4区医学

Puerto Rico Health Sciences Journal Pub Date : 2022-09-01

Norma I Cruz

{"title":"Symptomatic Macromastia and Days Lost from Work.","authors":"Norma I Cruz","doi":"","DOIUrl":"","url":null,"abstract":"Objective: To compare the amount of days lost from work by women with symptomatic macromastia while on conservative management and after they undergo breast reduction surgery.Methods: Working women with symptomatic macromastia were requested to record the number of days lost from work as a result of back or neck pain associated with their large breasts during a 6 months period of conservative management required by their health insurance. The conservative management included physical therapy, weight loss and analgesics. A reduction mammoplasty was approved and performed in all the women following the period of conservative management. After the women returned to work, they were again requested to record the number of lost work days associated with back/neck pain during the next 6 months. Basic demographic information was also obtained.Results: One hundred twenty-three women with symptomatic macromastia participated. The mean age was 31±10, the mean body mass index was 29±4, mean bra size was 38-D, 45% had a college degree or higher, and 90% had full-time employment. The mean number of lost work days was 6±3 with conservative and 1±1 with surgical management in a 6 months period, a difference that was statistically significant (p<0.05). Based on gender-specific median wage rates from the Bureau of Labor Statistics, these lost days represent an economic loss of $1,642 annually per woman in conservative management.Conclusion: Surgical treatment of breast hypertrophy resulted in significantly less days lost from work. There is a higher cost in loss productivity with conservative management.","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":" ","pages":"157-160"},"PeriodicalIF":0.5,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33439225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pain, Anxiety, and the Continuous Use of Opioids and Benzodiazepines in Trauma Intensive Care Unit Survivors: An Exploratory Study. 创伤重症监护室幸存者的疼痛、焦虑和阿片类药物和苯二氮卓类药物的持续使用:一项探索性研究

IF 0.5 4区医学

Puerto Rico Health Sciences Journal Pub Date : 2022-09-01

Carmen Mabel Arroyo-Novoa, Milagros I Figueroa-Ramos, Kathleen A Puntillo

{"title":"Pain, Anxiety, and the Continuous Use of Opioids and Benzodiazepines in Trauma Intensive Care Unit Survivors: An Exploratory Study.","authors":"Carmen Mabel Arroyo-Novoa, Milagros I Figueroa-Ramos, Kathleen A Puntillo","doi":"","DOIUrl":"","url":null,"abstract":"Objective: To evaluate at-home opioid and benzodiazepine use, the degrees of pain and anxiety, and the incidence of probable withdrawal in post-discharge Trauma Intensive Care Unit (TICU) survivors.Methods: This was an exploratory study of post-TICU survivors who had participated in a previous study of opioid and benzodiazepine withdrawal. We surveyed survivors by telephone asking for retrospective information (during their first 4-months postdischarge- Time 1) and current information (around 2-years post-discharge- Time 2).Results: A mostly male (82%), young (median 38 years [IQR, 28-52]) sample of 27 TICU survivors reported using opioids (56%) at Time 1 for a median of 30 (IQR,14-90) days. Twelve percent of 26 survivors were still using opioids at Time 2. Sixty percent of the survivors had pain during Time 1, a median pain score of 6 (IQR, 5-8) on a 0-10 numeric rating scale (NRS).; 57% had pain at Time 2, median NRS score=6 (IQR, 4-7). Sixty-five percent of survivors had anxiety during Time 1, NRS median=7 (IQR, 5-9); 50% had anxiety at Time 2, NRS median= 6 (IQR, 3-7). At Time 1, 26% used prescribed benzodiazepines, and 12% used benzodiazepines at Time 2. Five and one of the 27 patients reported symptoms of opioid or benzodiazepine withdrawal, respectively, upon discontinuation or weaning.Conclusion: Many TICU survivors had discontinued opioid/benzodiazepine prescriptions by 4-months post discharge while half reporting pain/anxiety for up to 2-years. Investigating the effects of acute-to-chronic pain in ICU survivors and gaining a better understanding of the mechanisms of prolonged opioid use are warranted.","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":" ","pages":"111-116"},"PeriodicalIF":0.5,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9469201/pdf/nihms-1833929.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33439519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bilateral Submandibular Gland Aplasia: A Case Report and Review of the Literature. 双侧颌下腺发育不全1例报告及文献复习。

IF 0.5 4区医学

Puerto Rico Health Sciences Journal Pub Date : 2022-09-01

Muammer Akyol, Mehtap Cicekci, Sertac Duzer

引用次数: 0

Effectiveness of Multiple Consecutive Fecal Immunohistochemical Testing for Colorectal Cancer Screening. 多次连续粪便免疫组化检测在大肠癌筛查中的有效性。

IF 0.5 4区医学

Puerto Rico Health Sciences Journal Pub Date : 2022-09-01

Loscar Santiago, Doris H Toro

{"title":"Effectiveness of Multiple Consecutive Fecal Immunohistochemical Testing for Colorectal Cancer Screening.","authors":"Loscar Santiago, Doris H Toro","doi":"","DOIUrl":"","url":null,"abstract":"Objective: The fecal immunohistochemical test (FIT) is a simple colorectal-cancer screening test. There are no recent studies evaluating the benefits of doing more than one a year. Our study aimed to evaluate the effectiveness of performing the test for 3 consecutive days in terms of detecting cancer and advanced adenomas.Methods: This was a single-center retrospective review of records of patients who had daily tests for 3 consecutive days and had at least one positive during the period from 2009-2011.Results: A total of 456 records were reviewed, 410 met the inclusion criteria. Most of the participants were men (95.9%), with the mean age of all the participants being 64.3 (±7.8) years. Regarding the FIT results, 18.8% had positive results on all 3 tests, 20.2% had 2 positive tests, and 61.0% had 1 positive FIT. There were 16 (3.9%) patients in the studied sample that had colon cancer. Their lesions were located predominantly in the distal colon (ratio of distal to proximal: 2:1). The patients with 3 positive FITs had a higher prevalence of advanced adenomas (33.3% vs. 13.4%, respectively; P < .05).Discussion: Our study showed a low concordance between daily consecutive tests results. those patients with more than 1 positive FIT had a higher prevalence of advanced adenoma or adenocarcinoma than patients who had only one. Fewer than 4% of the patients in our study had colon cancer. Prospective studies would be needed to determine the effectiveness of more than 1 annual FIT in colon cancer prevention.","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":"41 3","pages":"117-122"},"PeriodicalIF":0.5,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116953/pdf/nihms-1887057.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9327958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating the Levels of Awareness of and Attitudes on Advance Directives Among Primary Care Physicians in Puerto Rico. 评估波多黎各初级保健医生对预先指示的认识水平和态度。

IF 0.5 4区医学

Puerto Rico Health Sciences Journal Pub Date : 2022-09-01

Danilea M Carmona-Matos, Verónica H Layrisse-Landaeta, Keishla González-Sánchez, Dalilah Reyes-De Jesús, Frank De La Cruz, Krizia Ovando, Yadier Brito-Cuas, Jean Paul Iñesta-Rivera, Shirley Valentín-Berríos, Martha E García-Osorio

{"title":"Evaluating the Levels of Awareness of and Attitudes on Advance Directives Among Primary Care Physicians in Puerto Rico.","authors":"Danilea M Carmona-Matos, Verónica H Layrisse-Landaeta, Keishla González-Sánchez, Dalilah Reyes-De Jesús, Frank De La Cruz, Krizia Ovando, Yadier Brito-Cuas, Jean Paul Iñesta-Rivera, Shirley Valentín-Berríos, Martha E García-Osorio","doi":"","DOIUrl":"","url":null,"abstract":"Objective: Advance directives (ADs) are legal documents designed to guarantee a patient's preference of care for the future. Primary care physicians (PCPs) have long been identified as key to promoting AD completion among patients. Furthermore, PCPs' levels of awareness of and attitudes toward ADs have been related to positive completion rates in patients. In this project, we sought to identify the levels of awareness and attitudes towards ADs in Puerto Rican PCPs.Methods: Self-administered questionnaires were distributed at primary care medical conferences in Puerto Rico (PR) to explore the levels of awareness and attitudes of PCPs on ADs.Results: A total of 332 surveys were collected. Overall, PCPs in PR had high selfrated knowledge of ADs, with the highest being reported among internal medicine physicians (8.63 ± 1.51). However, this self-rating was in stark contrast with the lower than 60% level of awareness of and commitment to reading the applicable laws on ADs in PR across all specialties. Puerto Rican PCPs showed strongly positive attitudes towards ADs and recognized them as useful tools for patients, healthcare workers, and families, enabling them to make healthcare decisions. Internal medicine practitioners showed the strongest positive attitudes of all PCPs. Despite the perceived usefulness of ADs, Puerto Rican PCPs had a low predisposition to complete their own ADs in the short term.Conclusion: Our results suggest that improvements in the education of health professionals with regard to ADs are needed to increase in physicians both their knowledge of the legal standards governing ADs and their commitment to ensuring that patients complete such directives.","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":" ","pages":"135-141"},"PeriodicalIF":0.5,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33439221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Impact of a Sustained Virologic Response to Hepatitis C Virus Treatment on Liver Stiffness in the Puerto Rico Veterans Attending Liver Clinics in the Veterans Affairs Caribbean Healthcare System. 在波多黎各退伍军人事务部加勒比医疗保健系统肝脏诊所接受丙型肝炎病毒治疗的退伍军人持续病毒学反应对肝脏僵硬的影响。

IF 0.5 4区医学

Puerto Rico Health Sciences Journal Pub Date : 2022-09-01

Andres Rabell-Bernal, Ricardo López-Valle, Angel Morales-Santiago, Doris H Toro

{"title":"The Impact of a Sustained Virologic Response to Hepatitis C Virus Treatment on Liver Stiffness in the Puerto Rico Veterans Attending Liver Clinics in the Veterans Affairs Caribbean Healthcare System.","authors":"Andres Rabell-Bernal, Ricardo López-Valle, Angel Morales-Santiago, Doris H Toro","doi":"","DOIUrl":"","url":null,"abstract":"Objective: To evaluate the impact of sustained virologic response (SVR) on liver stiffness, as measured by transient elastography (TE), in Hispanic patients treated with direct-acting antivirals (DAAs) in the outpatient clinics in the Veterans Affairs Caribbean Healthcare System.Methods: We included hepatitis C virus (HCV) patients treated with DAA regimens from 11/2017 through 06/2019. Patient demographics and variables such as body mass index, HCV genotype, and treatment regimen were collected. The patients had a TE measurement before treatment initiation, and a repeat study 6 to 9 months after the achievement of SVR. A comparison between pre and post-treatment TE scores was performed via a paired t test.Results: Forty-three subjects met all the inclusion criteria and completed a posttreatment TE. Most of the subjects were infected with genotypes 1a or 1b. Six to 9 months post SVR, we measured liver stiffness and found a statistically significant reduction in TE score (P value = .0003). The pretreatment median TE score was 10.2 kPa. On a repeat TE study at 6 to 9 months post-treatment, our subjects had a median score of 7.2 kPa.Conclusion: The eradication of HCV infection with DAAs is associated with improved TE scores. Fibrosis-stage reduction was more frequent in those who had stage 4 fibrosis prior to treatment. These results suggest that achieving SVR may spare patients from future clinical decompensation and complications. Adequate screening of this potentially deadly chronic infection can lead to early therapy with DAAs and the significant regression of fibrosis in this kind of patient.","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":" ","pages":"123-127"},"PeriodicalIF":0.5,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33439520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Knowledge and Attitudes about Transgender Healthcare: Exploring the Perspectives of Hispanic Medical Students. 跨性别医疗保健的知识和态度:西班牙裔医学生的观点探讨。

IF 0.5 4区医学

Puerto Rico Health Sciences Journal Pub Date : 2022-09-01

Sofía M Muns, Kevin J Ortiz-Ramos, Enid J García-Rivera, Loida González, Josefina Romaguera

{"title":"Knowledge and Attitudes about Transgender Healthcare: Exploring the Perspectives of Hispanic Medical Students.","authors":"Sofía M Muns, Kevin J Ortiz-Ramos, Enid J García-Rivera, Loida González, Josefina Romaguera","doi":"","DOIUrl":"","url":null,"abstract":"Objective: The aim of this study was to explore the knowledge and attitudes about transgender care in Hispanic medical students at the University of Puerto Rico School of Medicine (UPR SOM).Methods: Medical students at the UPR SOM were invited to participate in a questionnaire to assess their attitudes and knowledge about the healthcare of transgender patients. The data were analyzed as percentages and averages using Stata version 14.Results: A total of 141 medical students completed the survey. The majority of the students (52.5%) reported that they needed to learn more about transgender health issues. Most of the students (60.3%) were not familiar with the hormonal regimens used for gender reassignment and transition and were not knowledgeable about the requirements an individual must fulfil prior to undergoing gender-reassignment surgery. The Likert scale scores for how comfortable students felt about working with transgender patients and becoming known among peers as a doctor that cares for transgender patients were 4.0 (95% CI: 4.0-4.2) and 4.7 (95% CI: 4.6-4.8), respectively. Almost all the medical students (97.9%) thought that transgender patients deserved the same quality of care from medical institutions as heterosexual patients receive. Most of the medical students (87.3%) believed physicians are responsible for the treatment of transgender patients.Conclusion: Our study revealed that even though UPR SOM medical students tend to be willing to treat transgender patients, there are limitations to their knowledge and training regarding this specific healthcare topic. Strategies to improve medical student knowledge about and training on these topics must be considered.","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":" ","pages":"128-134"},"PeriodicalIF":0.5,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33439521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Enucleations, Eviscerations, and Exenterations at a Supratertiary-care Hospital in Puerto Rico: A Retrospective Study. 波多黎各一家高级护理医院的剜出、剜出和剜出:一项回顾性研究。

IF 0.5 4区医学

Puerto Rico Health Sciences Journal Pub Date : 2022-09-01

Nicole P Rebollo, Hiram J Jiménez, Ambar Ramírez, Jan C Ortiz, Julio A Rodríguez

{"title":"Enucleations, Eviscerations, and Exenterations at a Supratertiary-care Hospital in Puerto Rico: A Retrospective Study.","authors":"Nicole P Rebollo, Hiram J Jiménez, Ambar Ramírez, Jan C Ortiz, Julio A Rodríguez","doi":"","DOIUrl":"","url":null,"abstract":"Objective: To provide a descriptive analysis of the indications and the intraoperative and postoperative complications of eye enucleations and eviscerations, and orbital exenterations performed at the only academic institution in Puerto Rico providing supratertiary care.Methods: A retrospective medical record review of patients who underwent enucleations, eviscerations, and exenterations from January 2015 through June 2020 was conducted. The data were analyzed to generate a descriptive profile of the demographic characteristics of the patients, their clinical indications and surgical complications, and a histopathological diagnosis per type of eye-removal procedure.Results: A total of 118 eyes were removed via enucleation, evisceration, or exenteration over the 66-month study period. The average patient age was 64 (±17.5) years and 63.8% of the patients were male. The most frequently performed eye-removal procedure was enucleation (73.7%), followed by evisceration (18.6%) and exenteration (7.6%). The main clinical indications for enucleations and eviscerations were infectious processes, namely panophthalmitis, endophthalmitis, and/or perforated corneal ulcers, that failed medical management. In our sample, squamous cell carcinoma was the most common diagnosis (both clinically and histopathologically) leading to exenteration. Postoperative complications in our patient cohort were minimal.Conclusion: At our institution, enucleations predominate over eviscerations. Retrospective reviews published in recent years indicate that the rate of eviscerations at our institution is comparatively low. The results of this study, the first of its kind at our institution, may encourage a re-evaluation of the indications for evisceration versus enucleation in our patient population.","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":" ","pages":"142-148"},"PeriodicalIF":0.5,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33439222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Determining the Incidence of Retinoblastoma and Survival Rate of Retinoblastoma Patients in Puerto Rico using the Cancer Registry of Puerto Rico (1985-2012). 利用波多黎各癌症登记处(1985-2012)确定波多黎各视网膜母细胞瘤患者的发病率和存活率。

IF 0.5 4区医学

Puerto Rico Health Sciences Journal Pub Date : 2022-09-01

Jose Alberto Quintero-Estades, Natalio J Izquierdo

引用次数: 0

A Rare Case of Non-IUD-Related Chronic Endometritis caused by Actinomyces Bacteria in a Postmenopausal Woman: A Case Report. 绝经后妇女放线菌引起的非宫内节育器相关性慢性子宫内膜炎1例。

IF 0.5 4区医学

Puerto Rico Health Sciences Journal Pub Date : 2022-09-01

Stephanie M González-García, Manuel J Pastrana-Arroyo, Eduardo Medina-Parrilla, Anarda González, José Martín

引用次数: 0