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At least 253 records · Page 14Linked to original sources
PubMed2000

Manatee Mortality in Puerto Rico.

/ The most pressing problem in the effective management of the West Indian manatee (Trichechus manatus) in Puerto Rico is mortality due to human activities. We assessed 90 cases of manatee strandings in Puerto Rico based on historical data and a coordinated carcass salvage effort from 1990 through 1995. We determined patterns of mortality, including type of event, condition of carcasses, spatial and temporal distribution, gender, size/age class, and the cause of death. The spatial distribution of stranding events was not uniform, with the north, northeast, and south coasts having the highest numbers. Six clusters representing the highest incidence included the areas of Fajardo and Ceiba, Bahía de Jobos, Toa Baja, Guayanilla, Cabo Rojo, and Rio Grande to Luquillo. The number of reported cases has increased at an average rate of 9.6%/yr since 1990. The seasonality of stranding events showed a bimodal pattern, from February through April and in August and September. Most identified causes of death were due to human interaction, especially captures and watercraft collisions. Natural causes usually involved dependent calves. From 1990 through 1995, most deaths were attributed to watercraft collisions. A reduction in anthropogenic mortality of this endangered species can be accomplished only through education and a proactive management and conservation plan that includes law enforcement, mortality assessment, scientific research, rescue and rehabilitation, and inter- and intraagency cooperation.

Journal Article↗
PubMedDate not supplied

Epidemiological trends of melanoma in Puerto Rico from 1975-1991.

The purpose of this study was to determine the crude and age-adjusted incidence rates of melanoma for residents of Puerto Rico from 1975 to 1991. This is part of an ongoing NASA study aimed at estimating whether melanoma and cataracts have increased in Puerto Rico since 1978 because of potential stratospheric ozone depletion and increased ultraviolet-B (UV-B) radiation. Calculating the percent change from their lowest values in 1978 to 1991, the age-adjusted incidence rate of melanoma increased 528% for males and 200% for females in 13 years.

Age Distribution↗
PubMed2003

Pregnancy in perinatally HIV-infected adolescents and young adults--Puerto Rico, 2002.

Since the introduction of highly active antiretroviral (ARV) therapy in the United States in the mid-1990s, the life expectancy of U.S. children who were infected perinatally with human immunodeficiency virus (HIV) has increased substantially. As a result, the number of perinatally HIV-infected females in the United States who are becoming both sexually active and pregnant is increasing. During August 1998-May 2002, a total of 10 pregnancies were identified among eight perinatally HIV-infected adolescents and young adults in Puerto Rico; in April 2002, the Puerto Rico Department of Health (PRDOH) asked CDC to assist in assessing such pregnancies. This report describes these pregnancies and discusses factors associated with sexual activity and pregnancy. The findings suggest that increasing numbers of pregnancies will occur among perinatally HIV-infected adolescents and young adults and that appropriately tailored reproductive health interventions should be developed.

Adolescent↗
PubMed2000

Prevalence of 21-hydroxylase-deficient nonclassic adrenal hyperplasia and insulin resistance among hirsute women from Puerto Rico.

OBJECTIVE: To determine the prevalence of 21-hydroxylase (21-OH)-deficient nonclassic adrenal hyperplasia (NCAH) and insulin resistance in hirsute women from Puerto Rico. DESIGN: Cross-sectional prospective study. SETTING: Clinical research center. PATIENT(S): 100 consecutive untreated hirsute women. MAIN OUTCOME MEASURE(S): Fasting total T, free T, DHEAS, insulin, and glucose were measured, and a 60-minute acute ACTH-(1-24) stimulation for 17-hydroxyprogesterone (17-HP) was performed. A diagnosis of 21-OH-deficient NCAH was considered when the stimulated 17-HP level was >30.3 nmol/L. The glucose/insulin ratio was calculated as a measure of insulin resistance (normal value, > or =4.5). RESULT(S): Patients had a mean (+/-SD) age of 26.8+/-6.6 years; 82 were oligomenorrheic. Overall, 12%, 8%, and 60% of patients had elevated levels of DHEAS, total T, or free T, respectively. One patient was identified as having 21-OH-deficient NCAH. Eight women, none of whom had NCAH, were found to be hyperglycemic; four of these women had type 2 diabetes mellitus. Excluding hyperglycemic patients, a glucose/insulin ratio of <4.5, consistent with IR, was found in 51.7%. CONCLUSION(S): The prevalence of 21-OH-deficient NCAH among patients from Puerto Rico does not differ significantly from that reported for other non-Jewish, non-Hispanic white populations.

Adrenal Hyperplasia, Congenital↗
PubMed2005

Diabetes, obesity and non-optimum blood pressure levels in a group of employees of the University of Puerto Rico, Medical Sciences Campus, 2003.

OBJECTIVE: To estimate the proportion of diabetes, obesity and non-optimum blood pressure levels in a group of employees of the University of Puerto Rico Medical Sciences Campus that participated in a diabetes health fair at the "Centro de Diabetes para Puerto Rico". METHODS: A total of 113 participants of the diabetes health fair completed a questionnaire to obtain demographic characteristics and the frequency of self-reported diabetes. The nursing staff examined the participants in order to obtain the following clinical characteristics: body mass index, blood pressure and blood glucose levels. RESULTS: The proportion of self-reported diabetes, obesity (> or = 30 kg/m2) and non-optimum blood pressure levels (systolic > or = 20 mm/Hg or diastolic > or = 80 mm/Hg) were 15.4% (95% CI: 8.5% - 25.7%), 80.0% (95% CI: 70.8%-86.9%) and 70.5% (95% CI: 61.1%-78.6%), respectively. Although it was not statistically significant, diabetes was higher among females (15.4%) compared to males (12.0%). All participants with self-reported diabetes were overweight or obese, and 91.7% showed non-optimum blood pressure levels. A significant positive correlation (p < 0.001) was observed between blood pressure levels and body mass index (r = 0.3). CONCLUSIONS: The percentage of persons with diabetes, obesity, and non-optimum blood pressure levels in this sample of Medical Sciences Campus employees underscores the need for confirming these results in a larger study and developing strategies focused on reducing health risks in this population.

Adult↗
PubMed1997

[Permanent renal disease in Puerto Rico, morbidity and mortality trends 1970-1994].

To describe the characteristics and trends of the incidence and mortality of End-Stage Renal Diseases (ESRD) in Puerto Rico, a descriptive analysis of the data of all patients treated with dialysis between 1970 through 1994 was conducted. A total of 7,256 patients received dialysis treatment for ESRD in Puerto Rico. Of these, 61% were males and 39% were females. Diabetes (41.7%) and glomerulonephritis (18.3) accounted for the largest number of cases followed by circulatory problems (8.3%). Hemodialysis was the predominant treatment modality (76%). The incidence trend was significant for the predictor variable period of time after adjusting by age and gender (Poisson). The mortality trend was significant for the predictor variables, period of time, gender and age (Poisson). A substantial increment in the incidence and mortality of persons receiving dialysis was found, particularly in the diabetics, males and elderly persons. The casual explanations of these findings requires further study.

Adult↗
PubMed2005

Reconstructing the population history of Puerto Rico by means of mtDNA phylogeographic analysis.

The haplogroup identities of 800 mtDNAs randomly and systematically selected to be representative of the population of Puerto Rico were determined by restriction fragment length polymorphism (RFLP), revealing maternal ancestries in this highly mixed population of 61.3% Amerindian, 27.2% sub-Saharan African, and 11.5% West Eurasian. West Eurasian frequencies were low in all 28 municipalities sampled, and displayed no geographic patterns. Thus, a statistically significant negative correlation was observed between the Amerindian and African frequencies of the municipalities. In addition, a statistically highly significant geographic pattern was observed for Amerindian and African mtDNAs. In a scenario in which Amerindian mtDNAs prevailed on either side of longitude 66 degrees 16' West, Amerindian mtDNAs were more frequent west of longitude 66 degrees 16' West than east of it, and the opposite was true for African mtDNAs. Haplogroup A had the highest frequency among Amerindian samples (52.4%), suggesting its predominance among the native Taínos. Principal component analysis showed that the sub-Saharan African fraction had a strong affinity to West Africans. In addition, the magnitudes of the Senegambian and Gulf of Guinea components in Puerto Rico were between those of Cape Verde and São Tomé. Furthermore, the West Eurasian component did not conform to European haplogroup frequencies. HVR-I sequences of haplogroup U samples revealed a strong North African influence among West Eurasian mtDNAs and a new sub-Saharan African clade.

DNA, Mitochondrial↗
PubMed1995

Symptoms of dengue fever in relation to host immunologic response and virus serotype, Puerto Rico, 1990-1991.

The authors investigated the role of secondary immunologic response, virus serotype, age, and sex on the clinical manifestations of dengue fever in Puerto Rico. From surveillance data for 1990 and 1991, this study identified 3,926 laboratory-positive cases, including 889 for whom dengue immunologic status and symptoms could be ascertained. Of those, 622 cases were virologically confirmed, and 267 cases were serologically confirmed. More than 50% of all positive patients reported fever, chills, headache, eye pain, body pains, joint pains, nausea, vomiting, or skin rash. The frequency of reporting signs, symptoms, and hospitalization was significantly higher among persons with secondary infections diagnosed by serological methods. Only rash was more common among those with primary infections. Symptom reporting increased with age; body pains, joint pains, and rash were significantly more frequently reported by female patients. No significant difference in symptom frequency was found among the virologically confirmed cases, comparing primary and secondary cases or infections due to different serotypes. The data for serologically confirmed cases suggest that in Puerto Rico the manifestations of dengue fever are, as with dengue hemorrhagic fever in Asia, more prominent among those who are experiencing secondary infections, and this effect may be more marked in the younger age groups.

Adolescent↗
PubMed1998

Using disability-adjusted life years to assess the economic impact of dengue in Puerto Rico: 1984-1994.

This study presents the disability-adjusted life years (DALYs), a non-monetary economic measure of impact, lost to dengue in Puerto Rico for the period 1984-1994. Data on the number of reported cases, cases with hemorrhagic manifestations, hospitalizations, and deaths were obtained from a surveillance system maintained at the Dengue Branch, Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention (San Juan, PR). The reported cases were divided into two age groups (0-15 years old and >15 years old), and then multiplied by predetermined factors (10 for 0-15 years; 27 for >15 years) to allow for age-related under-reporting of cases. Severity of dengue was modeled by classifying cases into three groups: dengue fever, dengue with severe manifestations, and hospitalized cases. Each group was assigned a different number of days lost because of dengue-related disability. Dengue caused an average of 658 DALYs per year per million population (SE = 114, range = 145-1,519). A multivariate sensitivity analysis, which simultaneously altered the values of six input variables, produced a mean of 580 DALYs/year/million population, with a maximum average of 1,021 DALYs/year/million population, and a maximum, single-year estimate for 1994 of 2,153 DALYs/million population. The most important input was the number of days lost to classic dengue. The DALYs/year/million population lost to dengue in Puerto Rico are much greater than previous estimates concerning the impact of dengue hemorrhagic fever alone. The loss to dengue is similar to the losses per million population in the Latin American and Caribbean region attributed to any of the following diseases or disease clusters; the childhood cluster (polio, measles, pertussis, diphtheria, tetanus), meningitis, hepatitis, or malaria. The loss is also of the same order of magnitude as any one of the following: tuberculosis, sexually transmitted diseases (excluding human immunodeficiency virus), tropical cluster (e.g., Chagas' disease, leishmaniasis), or intestinal helminths. The results objectively suggest that when governments and international funding agencies allocate resources for research and control, dengue should be given a priority equal to many other infectious diseases that are generally considered more important.

Adolescent↗
PubMedDate not supplied

Acute dissection of the thoracic aorta: experience at the Puerto Rico Medical Center (1991 through 1995)

BACKGROUND: Acute dissection of the thoracic aorta has a very poor prognosis unless promptly diagnosed and treated. The clinical presentation, diagnosis and management of 16 patients was reviewed. METHODS: We identified 12 patients from the Puerto Rico Medical Center and 4 patients from the "Centro Cardiovascular de Puerto Rico y del Caribe" whose diagnosis was made from January 1991 to December 1995. Medical records and autopsy reports were reviewed. RESULTS: Of the 16 patients, 10 [62%] were males, 10 [62%] were 60 years old or older [range 25 to 85 years], and 15 [93%] had a past history of hypertension although only 6 [38%] were found with an initial blood pressure of 140/90 or higher. Chest pain was the initial symptom in 13 [81%]. Of these 46% [6/13] described it as oppressive, with radiation to back or neck in 38% [5/13]. In none a neurological abnormality was the initial presentation. No physical sign was present in more than 40% of patients. One patient had a diastolic murmur suggestive of aortic regurgitation but none had a pericardial rub or a neurologic deficit. The electrocardiogram showed left ventricular hypertrophy in 35% but none had changes compatible with an acute Q wave infarction. The chest radiography was compatible with dissection in all in whom it was done [8/8]. Computerized tomography of the chest was diagnostic in 6 of 8 patients [sensitivity 75%]. Aortography had a sensitivity of 80% [4/5]. Trans-thoracic echocardiogram was diagnostic in 3 of 4 patients [75% sensitivity]. Transesophageal echocardiogram had a 100% sensitivity [2/2]. In 8 patients [50%] the correct diagnosis was made by postmortem examination, all of whom died within 24 hours of Emergency Room's evaluation. Of those properly diagnosed 5 died without being surgically intervened. Only one survived surgery [1/3] Overall mortality was 93%. The most common pathological finding was Type A dissection in 14 [88%]. Cardiac tamponade was found in 9 [56%]. Hemothorax was found in 6 [38%]. Aortic valve insufficiency was reported in 20% and coronary artery involvement in 28%. CONCLUSIONS: The dismal prognosis traditionally associated with acute dissection of the thoracic aorta remains unchanged. Prompt diagnosis based on high clinical suspicion. followed by expeditious medical and surgical treatment are fundamental to change the natural course of this condition.

Acute Disease↗
PubMedDate not supplied

Carotid endarterectomy in Puerto Rico.

The experience of the authors performing carotid endarterectomy in Puerto Rico is reported. The study was stimulated by the recently published results of the Carotid Endarterectomy Cooperative Trial groups in North America and Europe. This series consists of 61 carotid endarterectomies performed on 53 patients. The majority of the patients suffered from hypertension, diabetes mellitus, smoking, and ischemic heart disease. Most of the patients presented with Transient Ischemic Attacks (64%) or Reversible Ischemic Neurologic Deficits (19%). One patient died of a presumptive myocardial infarction and one patient had a post-operative worsening of his neurologic condition. The permanent morbidity and mortality rate was 3.2%.

Aged↗
PubMed2005

HIV transmission behaviors in jail/prison among puerto rican drug injectors in New York and Puerto Rico.

This study examined HIV risk behavior in jail/prison among Puerto Rican drug injectors in New York (NY, n = 300) and Puerto Rico (PR, n = 200), and its relationship with later drug and sex risk behaviors. During 3 years prior to interview, 66% of NY and 43% of PR samples were incarcerated at least once. While incarcerated, 5% of NY and 53% of PR injected drugs. Few reported engaging in sex inside jail/prison (5% in both sites). Of those who engaged in risk behaviors in jail/prison, almost all reported having unprotected sex and sharing injection equipment. The impact of jail/prison risk behaviors on risk behaviors after release differed between the two sites: they were more related to subsequent sex risk behaviors in NY, and subsequent injection risk behaviors in PR. The findings indicate a need for effective drug treatment programs inside jail/prisons to reduce HIV-related risk behaviors among drug injectors during incarceration and after release.

Adolescent↗
PubMed1989

[The aging person in Gurabo: a bio-psychosocial profile of the aging person in a community in Puerto Rico].

The Department of Family Medicine of the University of Puerto Rico Medicine School performed a census of the inhabitants 60 years and older in the community of Gurabo. A total of 1,890 elderly were interviewed 51% were female and 49% male. Sixty percent were married and twenty-five percent were widowed. Eighty two percent still lived within a family setting and only seventeen percent lived alone 86% owned their own home despite ninety percent reporting incomes below $400.00 per month. Ninety five percent have access to medical services but 63% receive services in multiples sites. Eighteen percent were functionally impaired, fourteen percent intellectually impaired and five percent had impairment in both areas. Preliminary data show that the latter group had an annual mortality rate of 15% compared to only 3.6% and 1.3% respectively in the other two group. We concluded that: 1) functional and mental impairment are indicators of increased mortality. 2) although access to health care is not a problem this health care is episodic and interrupted being provided in multiple different sites.

Aged↗
PubMed1998

Factors associated with changes in sex behaviour among drug users in Puerto Rico.

Despite available strategies to prevent sex risk behaviours in Puerto Rico, heterosexual transmission of HIV continues to increase. Since 1990, heterosexual contact has been the fastest growing infection risk category among the island's general population, and the primary transmission route for women and children. To understand change in sex risk behaviours and factors related to change, 911 drug injectors and 359 crack smokers were recruited from the San Juan metropolitan area following a stratified cluster design. This study comprised a total of 1,004 (79.1%) drug users who were assessed at follow-up. Abstinence from sex behaviour increased from 54.6% to 61.1% (p < 0.01), use of condoms during vaginal sex also increased from 26.4% to 36.9% (p < 0.01). In multivariate analysis, significant predictors of abstinence were gender, injection drug use, HIV seropositivity and not having a steady partner. Predictors of using condoms during vaginal sex were HIV seropositivity, STD diagnosis and participation in an HIV preventive programme. These findings indicate that additional HIV preventive efforts are needed to reduce sex risk behaviours among drug users who have a steady sex partner, as well as among drug users who are HIV-negative.

Adult↗
PubMedDate not supplied

Drug-scene roles and HIV risk among Puerto Rican injection drug users in East Harlem, New York and Bayamón, Puerto Rico.

This article describes and compares distributions of drug-scene roles, frequency of engaging in role behaviors, and relationships of role-holding to high-risk behaviors and sexual partnerships among Puerto Rican injection drug users in New York and Puerto Rico. For this study 561 street-recruited injection drug users in East Harlem, New York, and 312 in Bayamón, Puerto Rico were asked the number of days (in the last 30) in which they earned money or drugs in each of seven drug-scene roles; and about behaviors and egocentric risk partner characteristics in the last 30 days. East Harlem subjects were more likely to get resources by selling drugs and syringes, and buying drugs for someone else; Bayamón subjects were more likely to be "hit doctors," buy needles for others, operate a shooting gallery, or escort others to shooting galleries. All roles were part-time except shooting gallery management in East Harlem. About 27% of respondents at each site engaged in two or more roles. Many roles were associated with increased odds of injecting more than twice a day, receptive syringe sharing, distributive syringe sharing, receptive paraphernalia sharing, and having a drug-injecting sex partner. Drug-scene role structures vary between cities. Most roles are part-time pursuits. Role-holders have higher-risk behaviors and sexual partnerships than other drug injectors. Although further research is needed, drug-scene role-holders should be targeted for interventions to affect their own risk and their communications with others.

Adult↗
PubMed2004

Basic epidemiology of inflammatory bowel disease in Puerto Rico.

BACKGROUND: Previous epidemiological studies have suggested that the incidence of inflammatory bowel disease (IBD) is lower in Latin American populations. The aim of this study was to estimate the incidence of IBD in Puerto Rico, a predominantly Hispanic population. METHODS: A nonconcurrent prospective study was conducted in collaboration with private gastroenterologists in southwest Puerto Rico. Basic medical history and demographics were extracted from the medical records of patients for which a new diagnosis of IBD (Crohn's disease, CD; ulcerative colitis, UC; or nonspecified IBD) was made during each of the years 1996-2000. RESULTS: A total of 202 eligible cases of IBD were identified (95 male, 107 female). Forty-eight patients were diagnosed with CD, 102 with UC, and 52 with nonspecified IBD. The total incidence of IBD increased significantly between 1996 and 2000 (3.07/100,000 to 7.74/100,000; p < 0.001), being significantly higher for CD (four-fold increase, p < 0.01) and nonspecified IBD (fourfold increase, p < 0.005), but not UC (1.7-fold increase). The prevalence of CD was higher in males with an earlier age of onset (p < 0.05). CONCLUSIONS: This study demonstrates that the incidence of IBD within the Puerto Rican population is increasing and may be higher than previously reported for other Latin American populations.

Adolescent↗
PubMed1981

Serotypes of previously unclassified isolates of Erysipelothrix rhusiopathiae from swine in the United States and Puerto Rico.

Serotypes of 46 previously unclassified isolates of Erysipelothrix rhusiopathiae from porcine tissues in the United States and serotypes of 31 isolates of the organism from porcine tissues received from Puerto Rico were determined. The 46 isolates from the United States were classified in serotype 21. Four isolates (from Georgia, Minnesota, Ohio, and Oklahoma) were tested and found to be pathogenic for swine. Serotypes 1 (subtypes 1a and 1b), 2, 5, 6, and 21 were found in porcine tissues from Puerto Rico. The relative frequency of the various serotypes was similar to that previously reported in the United States.

Animals↗
PubMed1990

Recreational sun exposure in Puerto Rico: trends and cancer risk awareness.

Persons who sunbathe or engage in other activities at the beach are exposed to large amounts of UV radiation. Four hundred seven adults who visited the beaches of Puerto Rico were surveyed to determine their knowledge about the risks of sun exposure and to evaluate sunscreen use. The group consisted of 195 year-round Puerto Rican residents and 212 tourists. Ninety-five percent believed that the sun can cause skin cancer, although only half of the subset who lived all year in Puerto Rico believed that they personally received enough exposure to be at risk. The majority of the group (83%) understood the meaning of the sun protection factor numbers, although 35% used either nothing or a nonscreening oil. Half of Puerto Rican residents rarely or never used sunscreen protection while sunbathing. When sunscreen was used, the most important factor sought was given as sun protection factor (64%), followed by a perceived ability to aid in tanning (26%).

Adult↗