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Objective: This study aimed to assess the association of body mass index (BMI) with anal high-risk human papillomavirus (HR-HPV) and biopsy-confirmed histologic anal high-grade squamous intraepithelial lesions (HSIL) among a clinic-based sample of Hispanics in Puerto Rico. Methods: This cross-sectional study evaluated medical records of adults who received services at the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center between October 2014 and December 2022. The study included 543 records with complete clinical information regarding anal HR-HPV and anal HSIL status. Chi-square and logistic regression analyses were performed. Results: Mean age of participants was 44.10 ± 13.24 years, 65.2% were men, 71.7% were HIV-infected, 74.4% had anal HR-HPV infection, and 37.9% had biopsy-confirmed HSIL. Regarding BMI, 2.4% were underweight, 31.9% normal weight, and 39.0 % overweight; while 17.3 % had class I, 5.2% class II, and 4.2% class III obesity. No significant association was observed between BMI and anal HR-HPV infection in adjusted analyses. Lower odds of anal HSIL were observed among overweight individuals (OR: 0.63, 95% CI: 0.41 - 0.99) and those with class II/III obesity (OR: 0.48, 95% CI: 0.22 - 1.01) compared to adults with underweight/normal BMI, after adjusting for potential confounders. No significant association was observed for class I obesity. Conclusion: BMI was not associated with anal HR-HPV infection. Overweight and obese individuals had lower odds of having anal HSIL than adults with underweight/normal BMI. This finding could suggest underdiagnosis of HSIL among overweight/obese individuals, or reduced risk in this group.
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Introduction: Health care providers faced a challenge with the emergence of COVID-19 and its rapid spread. Early studies measuring the psychological impact of COVID-19 on the general population found high levels of anxiety and sleep disorders. The primary goal of this project was to assess the psychological impact of COVID-19 on physicians in Puerto Rico. Materials and methods: A cross-sectional study of physicians in Puerto Rico was conducted anonymously and electronically from February 2021 through April 2021. The electronic survey included socio-demographic data and 4 self-administered assessment tools (Generalized Anxiety Disorder-7, Perceived Stress Scale-10, Pittsburgh Sleep Quality Index and COVID-19 Organizational Support) for anxiety, perceived stress, sleep disturbances, and organizational support during the COVID-19 pandemic. Results: A total of 145 physicians completed the survey, with a female predominance of 53.5% and a majority practicing in the San Juan metropolitan area (50.3%). Mild anxiety symptoms were reported in 26.9% of physicians, and 33.8% had moderate to severe anxiety symptoms. Moderate to high perceived stress was found in 69.9% of participants, and women reported statistically significantly higher levels of anxiety symptoms (8.84 ± 5.99; p = 0.037) and stress (19.0 ± 6.94, p = 0.001). The Pittsburgh Sleep Quality Index reported 67.9% of physicians with global scores associated with poor sleep quality. Assessment of perceived organizational support found a high perception of work support (65.7%) but low perception of personal support (43.4%) and risk support (30.3%). A correlation analysis found a negative correlation for work and personal support, but a positive correlation for risk support, all statistically significant. Conclusion: COVID-19 had a lasting psychological impact in health care providers in Puerto Rico a year after the beginning of the pandemic. Our data supports the importance of organizational support and its correlation with the development of anxiety. It is thus essential to develop strategies to identify individuals at risk of experiencing psychological disturbances and to provide effective support for medical professionals during medical emergencies for their well-being and optimal delivery of patient care.
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Objective: To describe prevalence of chronic diseases and evaluate associations between comorbidities and quality of life in gynecologic cancer patients in Puerto Rico. Methods: A cross-sectional study among 233 women aged ≥21 years with a gynecologic cancer diagnosis. Through telephone interviews, information on comorbidities, quality of life, and other covariates were assessed. Quality of life included six items, assessing physical and mental health. Multivariate logistic regression models were used to estimate magnitude of association between the comorbidities under study (diabetes, cardiovascular and autoimmune diseases) and quality-of-life items, through adjusted prevalence odds ratio (aPOR; 95% confidence interval [CI]). Results: Most women (90.1%) reported one or more comorbidities in addition to their cancer diagnosis; cardiovascular diseases (63.1%) were more common than autoimmune diseases (37.3%) and diabetes (33.9%). Between 30% and 40% of the sample indicated dysfunctions in their general health (39.5%) and frequent physical (33.9%) and mental distress (31.8%). Adjusting for age and gross family income, women with autoimmune diseases presented higher prevalence of frequent limitations for daily activities (aPOR 2.00; 95% CI 1.05-3.81), poor general health (aPOR 3.52; 95% CI 1.90-6.49), frequent mental distress (aPOR 2.19; 95% CI 1.19-4.03), and dissatisfaction with life (aPOR 4.86; 95% CI 1.82-12.95) compared to those who did not report autoimmune diseases. No associations with cardiovascular diseases and diabetes were observed. Conclusions: Quality-of-life dysfunctions were highly prevalent in this population of gynecologic cancer patients. Suffering from autoimmune comorbidities significantly exacerbated those dysfunctions.
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[ABSTRACT]. Objective. To describe prevalence of chronic diseases and evaluate associations between comorbidities and quality of life in gynecologic cancer patients in Puerto Rico. Methods. A cross-sectional study among 233 women aged ≥21 years with a gynecologic cancer diagnosis. Through telephone interviews, information on comorbidities, quality of life, and other covariates were assessed. Quality of life included six items, assessing physical and mental health. Multivariate logistic regression models were used to estimate magnitude of association between the comorbidities under study (diabetes, cardiovascular and autoimmune diseases) and quality-of-life items, through adjusted prevalence odds ratio (aPOR; 95% confidence interval [CI]). Results. Most women (90.1%) reported one or more comorbidities in addition to their cancer diagnosis; cardiovascular diseases (63.1%) were more common than autoimmune diseases (37.3%) and diabetes (33.9%). Between 30% and 40% of the sample indicated dysfunctions in their general health (39.5%) and frequent physical (33.9%) and mental distress (31.8%). Adjusting for age and gross family income, women with autoimmune diseases presented higher prevalence of frequent limitations for daily activities (aPOR 2.00; 95% CI 1.05–3.81), poor general health (aPOR 3.52; 95% CI 1.90–6.49), frequent mental distress (aPOR 2.19; 95% CI 1.19–4.03), and dissatisfaction with life (aPOR 4.86; 95% CI 1.82–12.95) compared to those who did not report autoimmune diseases. No associations with cardiovascular diseases and diabetes were observed. Conclusions. Quality-of-life dysfunctions were highly prevalent in this population of gynecologic cancer patients. Suffering from autoimmune comorbidities significantly exacerbated those dysfunctions.
[RESUMEN]. Objetivo. Describir la prevalencia de enfermedades crónicas y evaluar la asociación entre varias comorbilidades y la calidad de vida de pacientes con cáncer ginecológico en Puerto Rico. Métodos. Se llevó a cabo un estudio transversal con 233 mujeres de 21 años o más con diagnóstico de cáncer ginecológico. Mediante entrevistas telefónicas se evaluó la información sobre comorbilidades, calidad de vida y otras covariantes; para la calidad de vida, se evaluaron seis elementos relativos a la salud física y mental. Se emplearon modelos de regresión logística con múltiples variables para estimar la magnitud de la asociación entre las comorbilidades objeto de estudio (la diabetes, las enfermedades cardiovasculares y las enfermedades autoinmunitarias) y los elementos relativos a la calidad de vida, mediante una razón de posibilidades de prevalencia ajustada (RPPa; intervalo de confianza [IC] de 95 %). Resultados. La mayoría de las mujeres (90,1 %) notificaron una o más comorbilidades además del diagnóstico de cáncer; las enfermedades cardiovasculares (63,1 %) fueron más comunes que las enfermedades autoinmunitarias (37,3 %) y la diabetes (33,9 %). Entre 30 % y 40 % de la muestra refirió disfunciones generales de salud (39,5 %) y malestar físico (33,9 %) y mental (31,8 %) frecuente. Luego de ajustar por edad e ingresos brutos familiares, las mujeres con enfermedades autoinmunitarias presentaron una mayor prevalencia de limitaciones frecuentes en las actividades cotidianas (RPPa 2,00; IC de 95 % 1,05-3,81), mala salud general (RPPa 3,52; IC de 95 % 1,90-6,49), angustia frecuente (RPPa 2,19; IC de 95 % 1,19-4,03) e insatisfacción vital (RPPa 4,86; IC de 95 % 1,82-12,95), en comparación con las mujeres que no refirieron ninguna enfermedad autoinmunitaria. No se observó ninguna asociación con enfermedades cardiovasculares o la diabetes. Conclusiones. Las disfunciones relativas a la calidad de vida tuvieron una alta prevalencia en esta población de pacientes con cáncer ginecológico. Sufrir comorbilidades autoinmunitarias agravó significativamente estas disfunciones.
[RESUMO]. Objetivo. Descrever a prevalência de doenças crônicas e avaliar as associações entre comorbidades e qualidade de vida em pacientes com câncer ginecológico em Porto Rico. Métodos. Estudo transversal de 233 mulheres com idade ≥21 anos, com diagnóstico de câncer ginecológico. Mediante entrevistas telefônicas, foram avaliadas informações sobre comorbidades, qualidade de vida e outras covariáveis. A avaliação da qualidade de vida incluiu seis itens, abrangendo saúde física e mental. Foram utilizados modelos de regressão logística multivariada para estimar a magnitude da associação entre as comorbidades avaliadas (diabetes, doenças cardiovasculares e autoimunes) e os itens de qualidade de vida, por meio da razão de chances de prevalência ajustada (aPOR) com intervalo de confiança de 95% (IC 95%). Resultados. A maioria das mulheres (90,1%) relatou uma ou mais comorbidades além de seu diagnóstico de câncer; as doenças cardiovasculares (63,1%) foram mais comuns que as doenças autoimunes (37,3%) e diabetes (33,9%). Entre 30% e 40% das entrevistadas relataram problemas de saúde geral (39,5%) e frequentes problemas físicos (33,9%) e mentais (31,8%). Após ajuste para idade e renda familiar bruta, as mulheres com doenças autoimunes apresentaram maior prevalência de limitação frequente das atividades da vida diária (aPOR 2,00; IC 95% 1,05-3,81), saúde geral precária (aPOR 3,52; IC 95% 1,90-6,49), angústia mental frequente (aPOR 2,19; IC 95% 1,19-4,03) e insatisfação com a vida (aPOR 4,86; IC 95% 1,82-12,95), em comparação àquelas que não relataram doenças autoimunes. Não foram observadas associações com doenças cardiovasculares ou diabetes. Conclusões. Foi constatada uma prevalência elevada de disfunções de qualidade de vida nesta população de pacientes com câncer ginecológico. Sofrer de comorbidades autoimunes exacerbou significativamente essas disfunções.
Assuntos
Qualidade de Vida , Neoplasias dos Genitais Femininos , Doenças Cardiovasculares , Diabetes Mellitus , Doenças Autoimunes , Porto Rico , Qualidade de Vida , Neoplasias dos Genitais Femininos , Doenças Cardiovasculares , Doenças Autoimunes , Qualidade de Vida , Neoplasias dos Genitais Femininos , Doenças Cardiovasculares , Doenças Autoimunes , Porto RicoRESUMO
ABSTRACT Objective. To describe prevalence of chronic diseases and evaluate associations between comorbidities and quality of life in gynecologic cancer patients in Puerto Rico. Methods. A cross-sectional study among 233 women aged ≥21 years with a gynecologic cancer diagnosis. Through telephone interviews, information on comorbidities, quality of life, and other covariates were assessed. Quality of life included six items, assessing physical and mental health. Multivariate logistic regression models were used to estimate magnitude of association between the comorbidities under study (diabetes, cardiovascular and autoimmune diseases) and quality-of-life items, through adjusted prevalence odds ratio (aPOR; 95% confidence interval [CI]). Results. Most women (90.1%) reported one or more comorbidities in addition to their cancer diagnosis; cardiovascular diseases (63.1%) were more common than autoimmune diseases (37.3%) and diabetes (33.9%). Between 30% and 40% of the sample indicated dysfunctions in their general health (39.5%) and frequent physical (33.9%) and mental distress (31.8%). Adjusting for age and gross family income, women with autoimmune diseases presented higher prevalence of frequent limitations for daily activities (aPOR 2.00; 95% CI 1.05-3.81), poor general health (aPOR 3.52; 95% CI 1.90-6.49), frequent mental distress (aPOR 2.19; 95% CI 1.19-4.03), and dissatisfaction with life (aPOR 4.86; 95% CI 1.82-12.95) compared to those who did not report autoimmune diseases. No associations with cardiovascular diseases and diabetes were observed. Conclusions. Quality-of-life dysfunctions were highly prevalent in this population of gynecologic cancer patients. Suffering from autoimmune comorbidities significantly exacerbated those dysfunctions.
RESUMEN Objetivo. Describir la prevalencia de enfermedades crónicas y evaluar la asociación entre varias comorbilidades y la calidad de vida de pacientes con cáncer ginecológico en Puerto Rico. Métodos. Se llevó a cabo un estudio transversal con 233 mujeres de 21 años o más con diagnóstico de cáncer ginecológico. Mediante entrevistas telefónicas se evaluó la información sobre comorbilidades, calidad de vida y otras covariantes; para la calidad de vida, se evaluaron seis elementos relativos a la salud física y mental. Se emplearon modelos de regresión logística con múltiples variables para estimar la magnitud de la asociación entre las comorbilidades objeto de estudio (la diabetes, las enfermedades cardiovasculares y las enfermedades autoinmunitarias) y los elementos relativos a la calidad de vida, mediante una razón de posibilidades de prevalencia ajustada (RPPa; intervalo de confianza [IC] de 95 %). Resultados. La mayoría de las mujeres (90,1 %) notificaron una o más comorbilidades además del diagnóstico de cáncer; las enfermedades cardiovasculares (63,1 %) fueron más comunes que las enfermedades autoinmunitarias (37,3 %) y la diabetes (33,9 %). Entre 30 % y 40 % de la muestra refirió disfunciones generales de salud (39,5 %) y malestar físico (33,9 %) y mental (31,8 %) frecuente. Luego de ajustar por edad e ingresos brutos familiares, las mujeres con enfermedades autoinmunitarias presentaron una mayor prevalencia de limitaciones frecuentes en las actividades cotidianas (RPPa 2,00; IC de 95 % 1,05-3,81), mala salud general (RPPa 3,52; IC de 95 % 1,90-6,49), angustia frecuente (RPPa 2,19; IC de 95 % 1,19-4,03) e insatisfacción vital (RPPa 4,86; IC de 95 % 1,82-12,95), en comparación con las mujeres que no refirieron ninguna enfermedad autoinmunitaria. No se observó ninguna asociación con enfermedades cardiovasculares o la diabetes. Conclusiones. Las disfunciones relativas a la calidad de vida tuvieron una alta prevalencia en esta población de pacientes con cáncer ginecológico. Sufrir comorbilidades autoinmunitarias agravó significativamente estas disfunciones.
RESUMO Objetivo. Descrever a prevalência de doenças crônicas e avaliar as associações entre comorbidades e qualidade de vida em pacientes com câncer ginecológico em Porto Rico. Métodos. Estudo transversal de 233 mulheres com idade ≥21 anos, com diagnóstico de câncer ginecológico. Mediante entrevistas telefônicas, foram avaliadas informações sobre comorbidades, qualidade de vida e outras covariáveis. A avaliação da qualidade de vida incluiu seis itens, abrangendo saúde física e mental. Foram utilizados modelos de regressão logística multivariada para estimar a magnitude da associação entre as comorbidades avaliadas (diabetes, doenças cardiovasculares e autoimunes) e os itens de qualidade de vida, por meio da razão de chances de prevalência ajustada (aPOR) com intervalo de confiança de 95% (IC 95%). Resultados. A maioria das mulheres (90,1%) relatou uma ou mais comorbidades além de seu diagnóstico de câncer; as doenças cardiovasculares (63,1%) foram mais comuns que as doenças autoimunes (37,3%) e diabetes (33,9%). Entre 30% e 40% das entrevistadas relataram problemas de saúde geral (39,5%) e frequentes problemas físicos (33,9%) e mentais (31,8%). Após ajuste para idade e renda familiar bruta, as mulheres com doenças autoimunes apresentaram maior prevalência de limitação frequente das atividades da vida diária (aPOR 2,00; IC 95% 1,05-3,81), saúde geral precária (aPOR 3,52; IC 95% 1,90-6,49), angústia mental frequente (aPOR 2,19; IC 95% 1,19-4,03) e insatisfação com a vida (aPOR 4,86; IC 95% 1,82-12,95), em comparação àquelas que não relataram doenças autoimunes. Não foram observadas associações com doenças cardiovasculares ou diabetes. Conclusões. Foi constatada uma prevalência elevada de disfunções de qualidade de vida nesta população de pacientes com câncer ginecológico. Sofrer de comorbidades autoimunes exacerbou significativamente essas disfunções.