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PubMed2002

The reappearance of dengue-3 and a subsequent dengue-4 and dengue-1 epidemic in Puerto Rico in 1998.

In January 1998, dengue-3 (DEN)-3 (group III genotype) was detected in Puerto Rico after an absence of 20 years. Public health officials intensified education efforts to promote community participation in dengue control. Virologic surveillance revealed an unexpected paradox: DEN-4 and DEN-1 produced a large epidemic overlaying the DEN-3 epidemic. In 1998 there were 17,000 reported cases of dengue (4.8/1,000 persons), and among all virus isolations (n = 960), DEN-4 (419, 43.6%), DEN-1 (337, 35.1%), and DEN-2 (143, 14.9%) were detected much more frequently than DEN-3 (61, 6%). Age group-specific attack rates were highest for persons 10-19 years old, followed by infants less than a year of age. Nineteen fatal cases (median = 37 years old, range = 8 months to 90 years) had a positive laboratory diagnosis of dengue. Among DEN-3 cases no fatalities were documented, 50 were hospitalized, and 10 of 48 (21%) fulfilled the criteria for dengue hemorrhagic fever (four had primary infections and six had secondary infections). During 1999, DEN-3 became the predominant serotype isolated (182 of 310 isolations, 59%). The reappearance of DEN-3 and its subsequent circulation from 1999 to 2001 produced no changes in dengue incidence that could have been detected in the absence of virologic surveillance.

Adolescent↗
PubMed2005

Dissociative experiences in children with abuse histories: a replication in Puerto Rico.

This study examined the use of a Spanish version of the Child Dissociative Checklist (CDC) in Puerto Rico. The CDC was administered to the primary caretakers of three groups of children: 31 with documented abuse histories, 30 with Attention Deficit Hyperactivity Disorder (ADHD), 33 with no abuse or psychiatric record. Results confirmed the reliability and validity of the CDC and revealed that Puerto Rican children with abuse histories showed significantly higher levels of dissociation than the children in the other two groups. Moreover, more than half of the abused children had a score above the usual cut-off point of 12 in the CDC, while only a handful of the ADHD children and none in the control group evidenced such a pattern. The results also showed that there were significant correlations between the CDC and the duration of the abusive experiences. Implications of our findings and subsequent clinical recommendations are offered.

Attention Deficit Disorder with Hyperactivity↗
PubMed1977

Isolation of Histoplasma capsulatum from the air in the Aguas Buenas Caves, Aguas Buenas, Puerto Rico.

White mice were used to isolate H. capsulatum from the air in the Aguas Buenas Caves, Puerto Rico. Based on the infection of mice, the ten test sites yielded positive results for the presence of the fungus. Air currents through this cave are believed to be the most important factor responsible for the even distribution of H. capsulatum. Cultural differences concerning spore concentrations were observed. Age and sex of the exposed mice do not seem to play a role in acquiring histoplasmosis.

Air Microbiology↗
PubMed2005

Antibacterial properties of tropical plants from Puerto Rico.

In an effort to document the antibacterial properties of plants commonly used by the people of Puerto Rico, we studied the effects of 172 plant species, utilizing the disc diffusion method, against Escherichia coli and Staphylococcus aureus. The methanolic extracts of 14 species showed antibacterial activities during this preliminary screen. These positive plant extracts were tested successively over 15 additional species. The results showed that extracts from Citrus aurantifolia (Rutaceae), Citrus aurantium (Rutaceae), Punica granatum (Punicaceae), Phyllanthus acidus (Euphorbiaceae) and Tamarindus indica (Caesalpiniaceae) possess strong in vitro antibacterial activity against the bacteria tested.

Anti-Bacterial Agents↗
PubMed1990

Experience in the management of myelomeningocele in Puerto Rico.

The medical records of 128 children with myelomeningocele who were treated at the Pediatric University Hospital, Puerto Rico Medical Center, from January, 1980, to July, 1985, were reviewed retrospectively. The medical and surgical management during the first hospitalization of these children was studied in detail for predefined parameters. The average age at the time of myelomeningocele repair was 6.6 days. Statistical analysis showed that repair of the myelomeningocele defect before 48 hours of age did not reduce the occurrence of ventriculitis. The incidence of ventriculitis secondary to the management of the myelomeningocele lesion was 12.5%. Complications after repair of the myelomeningocele (including skin flap necrosis, cerebrospinal fluid leaks, and wound infection) were present in 43.8% of the patients who developed ventriculitis and in 19.0% of those who did not. This observation is statistically significant (p = 0.03) and indicates that complications of healing after myelomeningocele repair represent the most significant risk factor for the development of ventriculitis.

Anti-Bacterial Agents↗
PubMedDate not supplied

Poverty, prenatal care, and infant health in Puerto Rico.

Using data from a survey administered to a representative sample of mothers who gave birth in Puerto Rico in 1994-95, we investigate whether prenatal care and infant health outcomes are associated with family poverty and neighborhood poverty. The results show that infant health outcomes are unrelated to both family poverty and neighborhood poverty, despite the association of family poverty with the adequacy of prenatal care and the content of prenatal care. However, the poverty paradigm does receive some support using measures of participation in government programs that serve the low-income population. Women who rely on the government to fund their medical care are more likely than women who rely on private health insurance to have an infant death. They are also less likely to receive the highest levels of prenatal care. Nonetheless, targeted government programs can have an ameliorative impact. The analysis shows that participants in the Women, Infants, and Children (WIC) program are more likely than non-participants to receive superior levels of prenatal care and are less likely to have negative infant health outcomes.

Female↗
PubMedDate not supplied

Abnormal blood glucose and coronary heart disease: the Puerto Rico Heart Health Program.

The presence of abnormal blood glucose (ABG) was determined for participants in the Puerto Rico Heart Health Program, a prospective epidemiological study of cardiovascular disease. Subjects were considered to have ABG at baseline if they were receiving treatment for diabetes (diet, oral hypoglycemics, or insulin), or if the blood glucose level was 140 mg/dl or more. Urban-rural comparisons of the prevalence of ABG were made in this cohort of 2585 rural and 6208 urban men aged 45-64 yr. The prevalence of ABG in the urban population was more than double that in the rural. This population has been followed up for coronary heart disease (CHD) over an 8 1/4-yr period. ABG at baseline is significantly associated with CHD death in urban men. When the relationship is controlled for smoking, systolic blood pressure, cholesterol, and relative weight, the relationship remains significant. The association with total CHD is similar. Either by adjusting for diabetes (i.e., when treated diabetes was excluded from analysis) or by entering both blood glucose and diabetes under treatment into the model, blood glucose was no longer statistically significant. This suggests that ABG, rather than blood glucose alone, is the important variable associated with CHD.

Angina Pectoris↗
PubMed2005

Homelessness and HIV risk behaviors among drug injectors in Puerto Rico.

This report examines associations between homelessness and HIV risk behaviors among injection drug users (IDUs) in Puerto Rico. The study sample consisted of 557 IDUs who were not in treatment, recruited in inner-city neighborhoods of the North Metro Health Care Region. Subjects were categorized into three groups by residential status (last 30 days): housed, transitionally housed (living with friends, family, or others but considering themselves homeless), and on-the-street homeless (living on the street or in a shelter). Multiple logistic regression models were fitted to assess effects of residential status on each HIV risk behavior after adjusting for sociodemographic and drug-use related covariates. Transitionally housed and on-the-street homeless subjects made up 16% of the total sample. On-the-street homeless IDUs were more likely to test positive for HIV than were transitionally housed and housed IDUs. In the adjusted analysis, on-the-street homeless subjects were significantly more likely to share needles, share rinse water, and practice back loading than the other two groups. Sexual risk behaviors (last 30 days) were not significantly associated with residential status after adjustment. Findings from this study present an added challenge to drug treatment and HIV prevention and treatment programs, to provide services that can address the additional needs of drug users suffering the stressors of homelessness.

Adult↗
PubMed2025

RAD-Seq-derived SNPs reveal no local population structure in the commercially important deep-sea queen snapper (Etelis oculatus) in Puerto Rico.

UNLABELLED: The queen snapper (Etelis oculatus Valenciennes in Cuvier & Valenciennes, 1828) is a deep-sea snapper whose commercial importance continues to increase in the US Caribbean. However, little is known about the biology and ecology of this species. In this study, the presence of a fine-scale population structure and genetic diversity of queen snapper from Puerto Rico was assessed through 16,188 SNPs derived from the Restriction site Associated DNA Sequencing (RAD-Seq) technique. Summary statistics estimated low genetic diversity (HO = 0.333-0.264) and did not reveal population differentiation within our samples (F ST = - 0.001-0.025). Principal component analysis and a model-based clustering method did not detect a fine-scale subpopulation structure among sampling sites, however, there was genetic variability within regions and sites. Our results have revealed comparable genetic and dispersal patterns to those observed in other shallow-water snapper species in Puerto Rico waters. It is crucial to further enhance our understanding of the ecological and biological aspect of the queen snapper to effectively manage and conserve this species as fishing pressure has been extended to deep water species in the US Caribbean. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s42995-025-00289-7.

Caribbean Fisheries↗
PubMed1988

Maternal smoking and low birthweight in the reproductive history of women in Puerto Rico, 1982.

In 1982, a representative sample of 3,175 women ages 15 to 49 years living in Puerto Rico were interviewed and complete reproductive histories obtained. Births to mothers who started smoking regularly at some time before delivery and who were still smoking at the time of the interview (the exposure definition) were compared with unexposed births. Our analysis of 4,444 single, live births delivered in public and private hospitals from 1946 through 1982 demonstrates that births to smoking women aged 20 and older delivering in public hospitals were 2.5 times more likely to weigh less than 2,500 grams (95% confidence interval (CI) = 1.9, 2.3), and on the average weighed 207 grams less (95% CI = 130, 284) than births to a comparable group of nonsmoking mothers. However, we found no other difference in birthweight between newborns of smoking and nonsmoking women when comparing their births within the same hospital category and age group. The data in this study suggest that the effect of smoking on birthweight among births to Puerto Rican women may be modified by maternal age and by whether the infant was born in a private or public hospital.

Adolescent↗
PubMed1996

Forecasting the AIDS epidemic in Puerto Rico.

The purpose of this study is to model and predict the diffusion of the AIDS epidemic in Puerto Rico. Specifically we aim at identifying primary influences in the geographical distribution of the population affected with AIDS to produce a reasonable projection of the time and space paths that will be followed by the epidemic. The study is based on AIDS incidence data from 1982 through 1992. The epidemic is analyzed statistically through multivariate regression and the potential model to produce a probability surface in which risk behavior and intra-municipality mobility are significant risk factors. The growth forecast is produced using the logistic function fitted to the past growth using an iterative non-linear optimization method. A simulation technique is then employed to forecast the spatial development of the epidemic from 1993 through 1997. The results indicate a clear hierarchical tendency at the beginning of the epidemic, later a wave-like diffusion pattern is also observed. While the absolute number of new cases is expected to remain higher in the more urbanized areas, the relative growth of AIDS cases is likely to become much higher in the rural municipalities. The forecasting procedure employed here is applicable to populations with diverse epidemiological profiles.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Leptospirosis among patients presenting with dengue-like illness in Puerto Rico.

Leptospirosis is difficult to distinguish from dengue fever without laboratory confirmation. Sporadic cases/clusters of leptospirosis occur in Puerto Rico, but surveillance is passive and laboratory confirmation is rare. We tested for leptospirosis using an IgM ELISA on sera testing negative for dengue virus IgM antibody and conducted a case-control study assessing risk factors for leptospirosis, comparing clinical/laboratory findings between leptospirosis (case-patients) and dengue patients (controls). Among 730 dengue-negative sera, 36 (5%) were positive for leptospirosis. We performed post mortem testing for leptospirosis on 12 available specimens from suspected dengue-related fatalities; 10 (83%) tested positive. Among these 10 fatal cases, pulmonary hemorrhage and renal failure were the most common causes of death. We enrolled 42 case-patients and 84 controls. Jaundice, elevated BUN, hyperbilirubinemia, anemia, and leukocytosis were associated with leptospirosis (p < .01 for all). Male sex, walking in puddles, rural habitation, and owning horses were independently associated with leptospirosis. Epidemiological, clinical, and laboratory criteria may help distinguish leptospirosis from dengue and identify patients who would benefit from early antibiotic treatment.

Adolescent↗
PubMed1993

Hookworm disease: Puerto Rico's secret killer.

Drs. Bailey Ashford and Pedro Gutiérrez, with the economic aid of the United States and Puerto Rican governments, were able to implement a program to reduce the incidence of hookworm infestations in Puerto Rico during the turn of the century. The program was conducted in three phases. The first phase consisted of evaluating the prevalence of infestations among the population. The second phase was concerned with treating patients and reducing further infestations. The last phase of the program was the implementation of prevention programs whose goals were to educate the population on the mechanisms of contaminations and to help implement improvements in the waste disposal systems so as to reduce the exposure to contaminated soil. The programs greatly improved the level of health of many Puerto Ricans. The incidence of hookworm infestations was reduced from 90% to 15% among members of the population. The program obtained world-wide recognition and serves as a model for similar programs.

Ancylostomatoidea↗
PubMed2002

Molluscicidal activity of plants from Puerto Rico.

Overall, 173 tropical plants from 72 different families, collected from the north-western and western regions of Puerto Rico, were screened for their molluscicidal properties against Biomphalaria glabrata, the intermediate host of Schistosoma mansoni. Six plant extracts were effective at 50 ppm. The two most effective extracts were those from the leaves of Didymopanax morototoni (Araliaceae) and Mammea americana (Guttiferae), which, at 50 ppm, killed all snails after 24 h of exposure and a day for recovery. Under the same conditions, extracts of Furcraea tuberosa, Argemone mexicana and Paullinia pinnata killed 50% of the snails and that of Solanum americanum killed 33%. The most effective extracts (or their active components or compounds based on them) may have potential as molluscides for the relatively cheap control of human schistosomiasis.

Animals↗
PubMed1991

[Use of health services in Puerto Rico by persons with mental disorders].

As part of a major study on the prevalence of mental disorders in Puerto Rico, this paper describes the mental health care utilization patterns of persons with a DIS/DSM-III disorder within the last year. The main findings of this analysis show that (a) There is a high rate of health service utilization, (b) The public sector is the main provider of services, (c) People with a DIS disorder tend to resort to the non-psychiatric physician, (d) People with alcohol abuse and/or dependence tend to use the services of general practitioners while schizophrenics, somatizers, and people with cognitive impairment tend to apply for the services of mental health specialists. Seeking help from other sources such as clergymen or spiritualists does not substitute the use of health services.

Adolescent↗
PubMedDate not supplied

A new poroid species of Resupinatus from Puerto Rico, with a reassessment of the cyphelloid genus Stigmatolemma.

A fungus with gelatinous poroid fruiting bodies was found in Puerto Rico and determined by macro- and micromorphology to be most similar to members of the lamellate agaric genus Resupinatus. This species is described as a new species, Resupinatus porosus. Phylogenetic analyses of ribosomal DNA sequences support the inclusion of this fungus in the clade containing Resupinatus, and indicate that this monophyletic group also includes members of Asterotus and the cyphelloid genus Stigmatolemma. Resupinatus porosus is another example of tropical poroid representatives of lamellate agaric genera. Resupinatus is emended to include species with poroid (R. porosus) or merulioid (R. merulioides) hymenophore as well as those with laterally stipitate (Asterotus) or cyphelloid (Stigmatolemma) fruiting bodies. Seven new combinations in Resupinatus are proposed to accommodate well-known species of Stigmatolemma.

Agaricales↗
PubMed1991

[Utilization of health services in Puerto Rico of persons with mental disorders].

As part of a major study on the prevalence of mental disorders in Puerto Rico, this paper describes the mental health care utilization patterns of persons with a Diagnostic Interview Schedule (DIS) disorder within the last year. The main findings of this analysis show that a) there is a high rate of health service utilization, b) the public sector is the main provider of services c) persons with a DIS disorder use more the non psychiatric physician d) those with alcohol abuse and/or dependence tend to use more the services of general practitioners while schizophrenics, somatizers and those with cognitive impairment use more the services of mental health specialists. The use of other resources such as clergy or spiritualists do not substitute the use of health services.

Adolescent↗
PubMed2000

Haloterrigena thermotolerans sp. nov., a halophilic archaeon from Puerto Rico.

An extremely halophilic Archaeon belonging to the order Halobacteriales was isolated from the solar salterns of Cabo Rojo, Puerto Rico. The organism, designated strain PR5T, is rod-shaped, non-motile and requires at least 12% (w/v) NaCl to grow. The strain is highly thermotolerant: its temperature optimum is 50 degrees C and growth is possible up to 60 degrees C. Polar lipid analysis revealed the presence of the bis-sulfated glycolipid S2-DGD-1 as sole glycolipid and the absence of the glycerol diether analogue of phosphatidylglycerosulfate. Both C20,C20 and C20,C25 core lipids are present. The G+C content of the DNA is 63.3 mol%. According to 16S rDNA sequence data, strain PR5T is closely related to the representatives of the genera Haloterrigena and Natrinema, but on the basis of its phenotypic properties, 16S rDNA sequence and DNA-DNA hybridization studies, strain PR5T cannot be assigned to any of the recognized species within these genera. On the basis of its polar lipid composition, the isolate has been assigned to the genus Haloterrigena. The creation of a new species, Haloterrigena thermotolerans, is therefore proposed to accommodate this isolate. The type strain is strain PR5T (= DSM 11552T = ATCC 700275T).

Base Composition↗