Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PUERTO RICO”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed2005

Common variable immunodeficiency: experience in Puerto Rico.

Common variable immunodeficiency (CVI) is a primary immunodeficiency characterized by hypogammaglobulinemia and an increased susceptibility to infections. The degree and the type of deficiency of serum immunoglobulins, as well as, the clinical course vary from patient to patient, hence the term "variable". The aim of this report is to describe the clinical characteristics and the response to gammaglobulin therapy of a group of patients with CVI followed at the University Hospital of the Puerto Rico Medical Center. To our knowledge, no data on primary immunodeficiencies in Puerto Rico has been reported in the literature. The study group exhibits specific characteristics as compared to other reported series.

Adolescent↗
PubMed2004

The DSM-IV rates of child and adolescent disorders in Puerto Rico: prevalence, correlates, service use, and the effects of impairment.

BACKGROUND: Few prevalence studies in which DSM-IV criteria were used in children in representative community samples have been reported. We present prevalence data for the child and adolescent population of Puerto Rico and examine the relation of DSM-IV diagnoses to global impairment, demographic correlates, and service use in an island-wide representative sample. METHODS: We sampled 1886 child-caretaker dyads in Puerto Rico by using a multistage sampling design. Children were aged 4 to 17 years. Response rate was 90.1%. Face-to-face interviews of children and their primary caretakers were performed by trained laypersons who administered the Diagnostic Interview Schedule for Children, version IV (DISC-IV) in Spanish. Global impairment was measured by using the Children's Global Assessment Scale scored by the interviewer of the parent. Reports of service use were obtained by using the Service Assessment for Children and Adolescents. RESULTS: Although 19.8% of the sample met DSM-IV criteria without considering impairment, 16.4% of the population had 1 or more of the DSM-IV disorders when a measure of impairment specific to each diagnosis was considered. The overall prevalence was further reduced to 6.9% when a measure of global impairment was added to that definition. The most prevalent disorders were attention-deficit/hyperactivity disorder (8.0%) and oppositional defiant disorder (5.5%). Children in urban settings had higher rates than those in rural regions. Older age was related to higher rates of major depression and social phobia, and younger age was related to higher rates of attention-deficit/hyperactivity disorder. Both overall rates and rates of specific DSM-IV/DISC-IV disorders were related to service use. Children with impairment without diagnosis were more likely to use school services, whereas children with impairment with diagnosis were more likely to use the specialty mental health sector. Of those with both a diagnosis and global impairment, only half received services from any source. CONCLUSIONS: Because we used the DISC-IV to apply DSM-IV criteria, the study yielded prevalence rates that are generally comparable with those found in previous surveys. The inclusion of diagnosis-specific impairment criteria reduced rates slightly. When global impairment criteria were imposed, the rates were reduced by approximately half.

Adolescent↗
PubMed2004

Acute hemorrhagic conjunctivitis outbreak caused by Coxsackievirus A24--Puerto Rico, 2003.

Acute hemorrhagic conjunctivitis (AHC) is an epidemic form of highly contagious conjunctivitis and is characterized by sudden onset of painful, swollen, red eyes, with conjunctival hemorrhaging and excessive tearing. Since 1981, when AHC was first detected in the Western Hemisphere, three major epidemics had occurred until 2003, all affecting the Caribbean. During August-October 2003, a fourth epidemic occurred in Puerto Rico (2000 population: 3.8 million). This report summarizes the outbreak investigation conducted by the Puerto Rico Department of Health (PRDOH), which documented an estimated 490,000 persons with illness, including >51,000 cases reported by physicians; demonstrated laboratory evidence of Coxsackievirus A24 (CA24); and determined that school-aged children (i.e., aged 5-18 years) and those living in crowded urban areas were at highest risk. To control outbreaks of AHC, prevention methods (e.g., frequent hand washing and avoidance of sharing towels and bedding) should be targeted to groups at highest risk, and information should be disseminated after the first report of AHC in the area.

Adolescent↗
PubMed2001

Prevalence of diabetes mellitus among insured of a health insurance company in Puerto Rico: 1997-1998.

OBJECTIVE: The purpose of this study was to determine the prevalence of diabetes mellitus in persons covered by a health insurance company. METHODS: The medical claims of persons insured with Triple S Health Insurance Co. of Puerto Rico, whose main diagnosis was diabetes (ICD9-250.0-9), were selected for analysis. Prevalence and medical utilization rates were estimated. General characteristics and services utilization were compared by age and sex using the chi-square distribution. RESULTS: Overall prevalence was 4.73%. Prevalence in the male population (5.07%) was higher than that of females (4.43%) in all age groups, but the difference was not statistically significant (p > 0.05). The proportion of diabetic cases was larger in the > 60 age group. 64% of the cases had 1 or more visits to a physician office, 2% were hospitalized, and almost 3% had emergency room visits. 29% of the cases had insulin prescriptions while 59% had oral prescriptions. The younger age group (< or = 44 years) had a larger utilization rate of emergency room and hospital admissions. Health service utilization varied by age and sex, however, the only significant difference was observed in glucose test services utilization (p < 0.05). CONCLUSIONS: The prevalence of diabetes in this group was lower than the prevalence reported in the Behavioral Risk Factor Surveillance System. This may be partially explained by the fact that the study group did not represent the composition of the Puerto Rican population. Prevalence studies using other groups will be helpful to determine the prevalence of diabetes in Puerto Rico.

Adolescent↗
PubMed1990

Neural tube defects: a study in Puerto Rico.

Recent literature reports an apparent decline in the incidence of neural tube defects throughout the world. A revision of stillbirth certificates and surgical reports of closure procedures for open neural tube defects was done in order to establish the incidence and its trend during a nine year period in Puerto Rico. The current prevalence of the syndrome was estimated using the death certificates in addition to the fore-mentioned surgical reports. Our results indicate that Puerto Rico carries probably the highest incidence of the US territories and that the trend is not declining one.

Cohort Studies↗
PubMed2002

Helminth and arthropod parasites of the brown pelican, Pelecanus occidentalis, in Puerto Rico, with a compilation of all metazoan parasites reported from this host in the Western Hemisphere.

Seven species of helminths and six species of arthropods are reported from 23 of 40 brown pelicans, Pelecanus occidentalis, collected from various localities in Puerto Rico. Helminth parasites include three nematodes (Contracaecum multipapillatum, Contracaecum mexicanum, and Eustrongylides sp.), three trematodes (Galactosomum darbyi, Mesostephanus appendiculatoides, and Ribeiroia ondatrae), and one cestode (Tetrabothrium sulae). Arthropod parasites include Colpocephalum occidentalis, Neottialges apunctatus, Ornithodoros capensis, Phalacrodectus pelecani, Phalacrodectus punctatissimus, and Phalacrodectus sp. The presence of R. ondatrae in the brown pelican is a new species host record, and P. pelecani, P. punctatissimus and N. apunctatus are new subspecies host records. C. multipapillatum, C. mexicanum, G. darbyi and M. appendiculatoides are new locality records for Puerto Rico, and N. apunctatus, P. pelecani, P. punctatissimus and T. sulae are new locality records for the Caribbean. Necrosis produced by C. multipapillatum, C. mexicanum, and R. ondatrae may have contributed to the emaciation and death of the brown pelicans examined in the present study.

Animals↗
PubMed1991

Nd:YAG laser bronchoscopy. The first two successful cases in Puerto Rico.

Two patients underwent bronchoscopic laser photoresection of tumors in the tracheobronchial tree with no mortality or significant morbidity. One patient had an adenoid cystic carcinoma of the trachea and the other a pleomorphic adenoma of left main stem bronchus. These were the first two cases performed in Puerto Rico at San Pablo Medical Center. Both patients are symptomless at this time. We can conclude that laser is a safe and cost effective alternative in experienced hands to other procedures in properly selected patients with tumors of tracheobronchial tree in Puerto Rico.

Adult↗
PubMed1994

Apgar score and infant mortality in Puerto Rico.

This study has as its objectives: 1) to examine the association between Apgar score and a set of demographic and sociodemographic variables so as to assess its usefulness as an indicator of the physical conditions of the newborn; 2) to determine if Apgar score in Puerto Rico is a good predictor of the newborn probability of surviving during his first year of life. For this purpose the 1990 live births and infant deaths data was utilized. The results indicate a direct relation between Apgar score with mother's schooling, father's occupation, and number of prenatal visits. Apgar score shows, also, an U curve type relationship with birthweight and gestational age, while it was found to be higher in private than in public hospitals. One of the most important findings was the strong association between infant mortality and Apgar score, even when the effect of other important independent variables such as birthweight and gestational age were held constant. These results demonstrate that, in spite of its criticisms Apgar score seems to be an excellent indicator of the newborn conditions at birth and a very good predictor of infant mortality in Puerto Rico.

Adolescent↗
PubMed2004

Preventive-care practices among adults with diabetes--Puerto Rico, 2000-2002.

Preventive-care practices among persons with diabetes can prevent or delay complications such as eye disease, kidney disease, or nerve damage that is a precursor to disabling foot disease. However, the level of diabetes-related preventive care is inadequate in the United States, and little has been reported about preventive care in Puerto Rico, where an estimated 10% of adults have diagnosed diabetes. CDC analyzed data from 2000, 2001, and 2002 Behavioral Risk Factor Surveillance System (BRFSS) surveys to assess the percentage of adults with diabetes in Puerto Rico who engaged in five selected preventive-care practices. This report summarizes the results of that analysis, which indicated that, with the exception of hemoglobin A1c testing, the percentages of adults engaging in preventive-care practices were lower than the target percentages set by U.S. national health objectives for 2010.

Adult↗
PubMed2006

Indirect upstream effects of dams: consequences of migratory consumer extirpation in Puerto Rico.

Large dams degrade the integrity of a wide variety of ecosystems, yet direct downstream effects of dams have received the most attention from ecosystem managers and researchers. We investigated indirect upstream effects of dams resulting from decimation of migratory freshwater shrimp and fish populations in Puerto Rico, USA, in both high- and low-gradient streams. In high-gradient streams above large dams, native shrimps and fishes were extremely rare, whereas similar sites without large dams had high abundances of native consumers. Losses of native fauna above dams dramatically altered their basal food resources and assemblages of invertebrate competitors and prey. Compared to pools in high-gradient streams with no large dams, pool epilithon above dams had nine times more algal biomass, 20 times more fine benthic organic matter (FBOM), 65 times more fine benthic inorganic matter (FBIM), 28 times more carbon, 19 times more nitrogen, and four times more non-decapod invertebrate biomass. High-gradient riffles upstream from large dams had five times more FBIM than did undammed riffles but showed no difference in algal abundance, FBOM, or non-decapod invertebrate biomass. For epilithon of low-gradient streams, differences in basal resources between pools above large dams vs. without large dams were considerably smaller in magnitude than those observed for pools in high-gradient sites. These results match previous stream experiments in which the strength of native shrimp and fish effects increased with stream gradient. Our results demonstrate that dams can indirectly affect upstream free-flowing reaches by eliminating strong top-down effects of consumers. Migratory omnivorous shrimps and fishes occur throughout the tropics, and the consequences of their declines upstream from many tropical dams are likely to be similar to those in Puerto Rico. Thus, ecological effects of migratory fauna loss upstream from dams encompass a wider variety of species interactions and biomes than the bottom-up effects (i.e., elimination of salmonid nutrient subsidies) recognized for northern temperate systems.

Animals↗
PubMed1989

Catholicism and fertility in Puerto Rico.

This paper examines the association between fertility and religious affiliation among Puerto Ricans. Bongaarts' proximate determinants framework is used to compare religious categories on behaviors that directly affect fertility. We found no difference in recent fertility between Catholics and non-Catholics in Puerto Rico (total fertility rate = 2.5). We also found Catholics and non-Catholics to be similar on age at first marriage (23.3 and 23.4 years, respectively), contraceptive use (71 percent and 69 percent of married women currently contracepting), and breast-feeding practices (mean duration of breast-feeding of 4.4 and 4.3 months). Differences were observed between less committed and more committed Catholics in total fertility rate, age at first marriage, and contraceptive use, but these differences were not large and were in the opposite direction from the expected. Our findings support the theory of convergence of Catholic and non-Catholic fertility for the US. Our discrepancy with findings from the National Survey of Family Growth is evidence of the cultural diversity in the US Hispanic population and indicates the importance of disaggregating by ethnicity or national origin when studying this population.

Adolescent↗
PubMed1993

Drug abuse and illicit drug use in Puerto Rico.

OBJECTIVES: Based on an epidemiologic field survey of community households in Puerto Rico, this study estimates the frequency of illicit drug use and clinically defined drug abuse and/or dependence syndromes. Results are compared with those from surveys on the United States mainland. Suspected risk factors are studied as well, with a special focus on childhood misbehavior. METHODS: Trained lay interviewers administered a Spanish Diagnostic Interview Schedule to 912 respondents aged 17 to 68 years who were selected by multistage probability sampling of island households. RESULTS: An estimated 8.2% of the population had a history of illicit drug use and 1.2% qualified for a standardized lifetime diagnosis of drug abuse, dependence, or both. An estimated 18.4% of the male drug users and 7.7% of the female drug users met criteria for drug abuse and/or dependence. A history of drug use was related to the diagnoses of alcohol abuse and/or dependence and antisocial personality, but few persons who had used illicit drugs at least once in their lifetime reported a history of receiving treatment for alcohol, drug, or mental health problems. CONCLUSIONS: The data were consistent with a suspected association between level of childhood misbehavior and occurrence of illicit drug use, even after statistical control for potentially confounding variables.

Adolescent↗
PubMedDate not supplied

Skin pigmentation, self-perceived color, and arterial blood pressure in Puerto Rico.

Darker skin color has been associated with higher average blood pressure in several African-derived populations in the Americas. This pattern has been interpreted as evidence of genetic, physiologic, or sociocultural mechanisms, but existing evidence does not provide an adequate means of evaluating these alternatives. This paper introduces a measurement strategy to isolate the cultural and biological dimensions of skin color, and it develops a specific hypothesis regarding the cultural significance of skin color in Puerto Rico and its relationship to arterial blood pressure. Data come from a face-to-face survey in southeastern Puerto Rico (N = 100). There is no association between blood pressure and skin pigmentation, as measured by reflectance spectrophotometry. However, the discrepancy between self-perceived color and skin pigmentation, a measure we call "color incongruity," is associated with systolic blood pressure (SBP) through an interaction with socioeconomic status (SES) (P = 0.009). For low-SES respondents, darker self-ratings of color relative to skin pigmentation are associated with higher mean SBP. For high-SES respondents, however, darker self-ratings of color relative to pigmentation are associated with lower mean SBP. We interpret this pattern as evidence that the relationship between skin color and blood pressure is mediated by sociocultural processes, and we highlight the need for testable hypotheses and appropriate measurement operations in research on racial inequalities in health.

Adult↗
PubMed2006

A longitudinal study of syringe acquisition by Puerto Rican injection drug users in New York and Puerto Rico: implications for syringe exchange and distribution programs.

Increasing access to sterile syringes and new drug preparation materials is an effective means of reducing HIV transmission among injection drug users (IDUs), and a fundamental component of harm reduction ideology. The purpose of this study is to examine changes during a three-year period in syringe acquisition by street-recruited Puerto Rican IDUs characterized by frequent drug injection and high HIV seroprevalence. At baseline (1998-1999) and 36-month follow-up, 103 IDUs recruited in East Harlem, New York (NY), and 135 from Bayamón, Puerto Rico (PR) were surveyed about syringe sources and HIV risk behaviors in the prior 30 days. A majority of participants in both sites were male (NY 78.6%, PR 84.4%), were born in Puerto Rico (NY 59.2%, PR 87.4%), and had not completed high school (NY 56.3%, PR 51.9%). Compared to PR IDUs at follow-up, NY IDUs injected less (3.4 vs. 7.0 times/day, p < .001), and re-used syringes less (3.1 vs. 8.0 times, p < .001). Between baseline and follow-up, in NY the proportion of syringes from syringe exchange programs (SEPs) increased from 54.2% to 72.9% (p = .001); syringes from pharmacies did not increase significantly (0.2% to 2.5%, p = .095). In PR, the proportions of syringes from major sources did not change significantly: private sellers (50.9% to 50.9%, p = .996); pharmacies (18.6% to 19.0%, p = .867); SEP (12.8% to 14.4%, p = .585). The study indicates that NY SEPs became more dominant, while NY pharmacies remained a minor source even though a law enacted in 2001 legalized syringe purchases without prescription. Private sellers in PR remained the dominant and most expensive source. The only source of free syringes, the SEP, permitted more syringes to be exchanged but the increase was not statistically significant. Implications for syringe exchange and distribution programs are discussed.

Adult↗
PubMed1994

Behavioural risk factors and HIV infection of injection drug users at detoxification clinics in Puerto Rico.

BACKGROUND: The ethnic and geographical variations of AIDS prevalence among injection drug users (IDU) have highlighted the need to understand the role of the relevant risk factors in specific subpopulations of IDU. In this study we examine the factors related to seropositivity among IDU entering drug detoxification facilities in metropolitan San Juan, Puerto Rico. METHODS: From October 1990 until August 1991, 390 IDU were interviewed. Four groups of risk factors were examined: sexual practices, drug injection behaviours, risk behaviours while in US Mainland cities, and while incarcerated. A stepwise logistic regression model was used to simultaneously assess the independent effects of the behavioural risk factors on HIV seropositivity. RESULTS: Of the 342 IDU who were tested for HIV antibodies, 29.5% were seropositive. The behaviours found to be associated with seropositivity were: having sex with an IDU in the last 6 months; having injected drugs for over 5 years; and injecting with used needles while incarcerated. DISCUSSION: Public health programmes will need to establish more effective collaborative links with correctional institutions in order to reduce the spread of HIV among IDU in Puerto Rico.

Adult↗
PubMed2002

Prospective study using standardized methodology for antimicrobial susceptibility of gram-positive cocci isolated from the Puerto Rico Medical Center.

The Gram-positive cocci (GPC), Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecalis and Enterococcus faecium, have become important causes of community and nosocomial-acquired infections. The prevalence of multiple resistant isolates to standard antimicrobial drugs has significantly increased over the past decades. Few prospective studies have been performed in Puerto Rico (PR) concerning the GPC antimicrobial susceptibilities pattern. The purpose of this study was to evaluate the in vitro susceptibility of GPC clinical isolates from PR to selected standard antibiotics and to the new antimicrobial agents, linezolid (LZ), quinupristin/dalfopristin (Q/D) and gemifloxacin (GM). The in vitro susceptibility utilizing disk diffusion and Etest methods to selected antibiotics was determined for a total of 429 isolates obtained during a period of 5 months from the Puerto Rico Medical Center Bacteriology Laboratory. The distribution of GPC collected was as follows: 213 S. aureus isolates, 162 E. faecalis, 16 E. faecium and 38 S. pneumoniae. The results of the susceptibility test demonstrated: 1) that in S. aureus, 100% of the isolates were susceptible to vancomycin (VAN), LZ and Q/D; 93% to GM; and 61% to methicillin/oxacillin; 2) in S. pneumoniae, 100% were susceptible to LN and GM; 87% to Q/D; and 53% to penicillin; 3) in E. faecalis, 99% were susceptible to ampicillin; 93% to LZ; 79% to GM; 78.6% to VAN; and 0% to Q/D. Sixty eight and 66% of the E. faecalis isolates were susceptible to gentamicin and streptomycin respectively; and 4) in E. faecium, 100% were susceptible to LZ; 94% to Q/D; 69% to GM; 37.5% to VAN and 20% to ampicillin. In E. faecium isolates, 50% and 31% were susceptible to gentamicin and streptomycin, respectively. Of the vancomycin resistant enterococci, 88.9% and 21% of E. faecium and faecalis showed VanA phenotypic resistance, respectively. These results show that there is a significant degree of antimicrobial resistance in GPC, including 38% methicillin resistance in S. aureus, a near 50% penicillin resistant S. pneumoniae, and a significant resistance of enterococcal species to VAN. The new agents, LZ, Q/D and GM, proved to be effective against both, S. aureus and S. pneumoniae. For E. faecium, both, LZ and Q/D were active, while for E. faecalis, only LZ showed consistent activity.

Gram-Positive Cocci↗
PubMed2004

HIV incidence among high-risk Puerto Rican drug users: a comparison of East Harlem, New York, and Bayamón, Puerto Rico.

Significant differences in HIV-related risk behaviors have been found between Puerto Rican drug users in New York City (NY) and Puerto Rico (PR). An examination of HIV incidence rates and characteristics of seroconverters in each location was undertaken. Baseline and follow-up interviewing and HIV testing were conducted in 1998 to 2002 with seronegative Puerto Rican injection drug users (IDUs) and crack smokers from East Harlem, NY (n = 455) and Bayamón, PR (n = 268). There were a total of 32 seroconverters, 9 in NY and 23 in PR, for seroconversion rates of 0.88/100 person-years at risk (pyr; 95% CI, 0.31-1.45) in NY and 3.37/100 pyr (95% CI, 2.02-4.72) in PR (P < 0.001). In PR, variables significantly related to seroconversion were younger age and using shooting galleries. Being in methadone treatment was protective against seroconversion. In NY, crack use was significantly related to seroconversion. The higher seroconversion rate found in PR indicates a need to enhance HIV prevention efforts, including increasing methadone treatment and access to sterile syringes. The need to address sexual risk behaviors in both locations was also indicated. Resources focusing on reducing HIV transmission in the Caribbean should include efforts to target the drug use-HIV epidemic in PR.

Adult↗
PubMed2003

[Factors related with the use of screening mammogram in middle age women in Puerto Rico].

Mammography for low-income women is an important intervention issue as it is still under utilized in these sectors. Despite evidence in favor of breast cancer screening with mammograms, research indicates that mammogram compliance among low-income females and women over 50 years of age has been slow. This article revolves around the factors that affect compliance with screening mammograms among low-income women ages 40 to 64 in Puerto Rico once they receive a referral from a physician. Although the multivariate analysis demonstrated that only age, work outside of the home and performing breast self-exams significantly increased the probability for middle-aged, low-income women in Puerto Rico to comply with referrals and have mammograms, this research illustrated that certain factors such as knowledge about the disease and screening practices, a satisfactory perception of the patient-physician relationship, and the performance of a clinical breast exam by a physician influence mammogram compliance.

Adult↗