RESUMO

OBJECTIVE: The prevalence of human papillomavirus (HPV) in the oral cavity has not been as well studied as genital infection and its prevalence among drug users is uncertain. This study describes the prevalence and correlates of oral HPV infection among a sample of drug users in Puerto Rico (PR). METHODS: Cross-sectional study of 271 drug users aged 18-35 years, not undergoing substance abuse treatment, living in the San Juan metropolitan area. Oral samples were collected through an oral rinse and HPV infection status was detected through PCR and HPV typing. Information on covariates was obtained through face-to-face interviews and serum analyses. RESULTS: A total of 34 participants were positive for any HPV type (12.5%), whereas 13 individuals (4.8%) were positive for one of the 38 type-specific HPV probes evaluated. Among those HPV positive, the most common HPV type detected was non-oncogenic HPV 72 (11.8%, n = 4). Oncogenic HPV types detected were 35 (5.9%) and 56 (2.9%). Factors associated with oral HPV infection included binge drinking (OR = 3.85, 95% CI = 1.40, 10.58), HIV positivity (OR = 4.67, 95% CI = 1.58, 13.74) and ever having engaged in commercial sex (OR = 3.55, 95% CI = 1.46, 8.67); infection did not differ by age or gender. CONCLUSION: Consistent with previous studies in the genital and oral tract, HIV infection, alcohol abuse and commercial sex practices were strongly associated with oral HPV infection. Future studies should assess the implications of oral HPV infection on oral cancer risk in this population.

Assuntos

Alphapapillomavirus/isolamento & purificação , Boca/virologia , Infecções por Papillomavirus/epidemiologia , Estomatite/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Alcoolismo/epidemiologia , Comorbidade , Estudos Transversais , DNA Viral/análise , Feminino , Soropositividade para HIV/epidemiologia , Testes de DNA para Papilomavírus Humano , Humanos , Masculino , Infecções por Papillomavirus/virologia , Prisioneiros , Porto Rico/epidemiologia , Fatores de Risco , Estudos de Amostragem , Trabalho Sexual , Comportamento Sexual , Fatores Socioeconômicos , Estomatite/virologia , Estresse Psicológico/epidemiologia , Adulto Jovem

RESUMO

Penetrating injuries are a major cause of mortality and morbidity. The most common diagnostic tool used in this setting is CT scan. We present a case of a traumatic hepatopleural fistula demonstrated by hepatobiliary scintigraphy. Traumatic abdominal injuries to the liver and diaphragm can result in complications, whose detection by CT scan is not always straightforward. Hepatobiliary scintigraphy is very useful in the search of bilious pleural effusions.

Assuntos

Fístula do Sistema Digestório/diagnóstico por imagem , Hepatopatias/diagnóstico por imagem , Doenças Pleurais/diagnóstico por imagem , Fístula do Sistema Respiratório/diagnóstico por imagem , Fístula do Sistema Digestório/etiologia , Humanos , Hepatopatias/etiologia , Masculino , Doenças Pleurais/etiologia , Cintilografia , Fístula do Sistema Respiratório/etiologia , Ferimentos Penetrantes/complicações

RESUMO

This study was aimed at examining the relationship between suicidal attempts, polydrug use, and depression in adolescents. A sample of 691 adolescents and their parents were interviewed. Subjects who met the criteria for depression and those who used alcohol were significantly more likely to be suicidal attempters (OR = 6.8, p < 0.001; OR = 7.5, p < 0.001). Polydrug users were significantly more likely to attempt suicide (OR = 8.8, p = 0.032). Adolescents with mothers who met the criteria for depression were more likely to report suicide attempts (OR = 2.4, p = 0.069). Health professionals need to screen for polydrug use and depression to prevent future suicidal behaviors.

Assuntos

Alcoolismo/complicações , Depressão/complicações , Transtornos Relacionados ao Uso de Substâncias/complicações , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Consumo de Bebidas Alcoólicas/efeitos adversos , Alcoolismo/epidemiologia , Alcoolismo/psicologia , Criança , Depressão/epidemiologia , Depressão/psicologia , Feminino , Seguimentos , Humanos , Incidência , Entrevistas como Assunto , Masculino , Pais/psicologia , Prevalência , Porto Rico/epidemiologia , Fatores de Risco , Meio Social , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Tentativa de Suicídio/psicologia

RESUMO

OBJECTIVE: This research aims to understand the circumstances associated with school dropout in a cohort of Puerto Rican adolescents. METHODS: The study collected data from adolescents and their parents. Information related to school dropout among adolescents was obtained from the second year follow-up data from the longitudinal study funded by NIDA "Risky Families Embedded in Risky Environments" (Grant No. R01 DA 15301). Data was collected employing a self-administered and a face-to-face interview protocol. Prediction of school dropout was assessed throughout adolescent characteristics, family background, school experiences and behaviors. RESULTS: During the second follow-up, two years after the baseline assessment, approximately 6.2% of the adolescents reported dropping out from school. Logistic regression analysis indicates that older adolescents (OR = 6.6, 1.37-31.67), whose mother used drugs during pregnancy (OR = 4.9, 1.31-17.91), who reported high rates of absenteeism (OR = 4.8, 1.63-14.13), high school grade retention (OR = 3.7, 1.14-12.05), and attended school where teachers were attacked or wounded by students (O R =7.0, 1.44-34.17) were more likely to dropout of school. DISCUSSION: : These findings emphasize the need to further understand the effects of different elements of adolescents' environment such as family and school. It has been posited that dropping out of school is a process whose characteristics can be detected long before it occurs. The fact that students who dropout are more likely to report skip classes and grade retention can be relevant elements in prevention and early intervention for teachers and other school personnel.

Assuntos

Evasão Escolar/estatística & dados numéricos , Adolescente , Feminino , Previsões , Humanos , Masculino , Porto Rico

RESUMO

Injection drug users (IDUs) contaminate preparation materials with blood-borne pathogens by using syringes as measuring and dispensing devices. In collaboration with IDUs, we developed a preventive intervention consisting of four new preparation practices aimed at avoiding the use of syringes in the preparation, and reducing the contamination of the materials. This report describes the results of a pilot trial introducing the new practices to ascertain their adoption potential and their potential efficacy in reducing contamination. Participants comprised 37 active IDUs among whom the new practices were promoted during 16 weeks. In addition to self-reported behaviors, the study collected cookers and plastic caps from shooting galleries and tested them for the presence of blood residues. Adoption rates were: (1) cleaning of skin area with hand sanitizer--65.6%; (2) directly pouring water with a dropper into the cooker--56.3%; (3) drawing drug solution with a preparation syringe and syringe filter--34.4%; and, (4) backload rinsing syringes--53.1%. Rates of blood residues detected in cookers and plastic caps were 41.7% prior to the trial, 28.6% at week 8, 24.6% at week 14, and 12.0% at week 18. We believe the results of the pilot trial are compelling and suggest that this intervention merits further formal testing.

Assuntos

Composição de Medicamentos/métodos , Usuários de Drogas/educação , Reutilização de Equipamento , Conhecimentos, Atitudes e Prática em Saúde , Abuso de Substâncias por Via Intravenosa , Adulto , Pesquisa Participativa Baseada na Comunidade , Difusão de Inovações , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Porto Rico , Abuso de Substâncias por Via Intravenosa/epidemiologia , Abuso de Substâncias por Via Intravenosa/prevenção & controle , Seringas , Adulto Jovem

RESUMO

Injection drug users (IDUs) in San Juan, Puerto Rico are characterized by high rates of daily injecting, injection of shared drugs, re-use of injection syringes, and use of shooting galleries. They lack adequate access to new injection syringes and drug preparation equipment, and experience elevated rates of HIV and HCV infection. Between April and August, 2006, researchers and active IDUs collaborated in the development of an experimental HIV/HCV intervention aimed at identifying drug preparation items and practices that will enable IDUs to make drug solutions without potentially contaminated injection syringes contacting materials used to prepare drugs. The collaboration involved discussing and testing a variety of drug preparation items and practices in office and community settings. The process was repeated until concerns that had been raised were resolved, and a tentative set of intervention items and practices to be evaluated in a community field trial was identified. Throughout, a strong emphasis was placed on the capacity of an item or practice to address common problems confronted by IDUs (blunted needles, clogged syringes, injected particles) in addition to the core aim of reducing contamination of preparation materials by blood in injection syringes. This report describes the final selection of items and practices: 1) A small water bottle that permits IDUs to add approximately .05 cc water drops directly to drug powder in cookers; 2) A preparation syringe (a type of ancillary equipment not used for injecting) that permits IDUs to pull up a measurable amount of water to add to drug powder, an alternative to producing water drops; 3) A filtering device, the Sterifilt filter, attached to a preparation syringe, which eliminates the need for cotton or cigarette filters; 4) Use of a preparation syringe to distribute drug solution by backloading to injection syringe(s); 5) A small water bottle enabling IDUs to clean injection syringes by backload rinsing. The overarching aim of this experimental HIV/HCV intervention was to promote the safe re-use of drug preparation and injection items, and to impact the large number of IDUs in San Juan who maintain personal injection syringes, but currently use communal ancillary equipment in shooting galleries and inject drug solutions prepared with other IDUs' injection syringes.

RESUMO

This study investigates the role of neighborhoods in adolescent violence in poor neighborhoods in San Juan, Puerto Rico. The study is part of a larger longitudinal project examining risk and resilience in adolescents' ages 12 to 15 years old and their caregivers. Using a cross-sectional design, a self-completion questionnaire, and an interviewer questionnaire, the authors assessed violent behaviors among participants across demographics, characteristics, and neighborhood social disorganization using the concepts of physical disorders and social disorder. Adolescent violence was positively associated with social disorder. The finding that adults in these neighborhoods walk around with visible firearms and engage in fighting, may have led adolescents to perceive that violence is an accepted behavior. Furthermore, socially disorganized neighborhoods might be less likely to organize on their own behalf because the occurrence of negative experience limits the amount of social support and resources that are available in the neighborhood.

Assuntos

Comportamento do Adolescente , Delinquência Juvenil/estatística & dados numéricos , Relações Pais-Filho , Características de Residência/estatística & dados numéricos , Meio Social , População Urbana/estatística & dados numéricos , Adolescente , Comportamento do Adolescente/psicologia , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Porto Rico/epidemiologia , Assunção de Riscos , Fatores Socioeconômicos

RESUMO

OBJECTIVE: We analyzed early sexual activity among Hispanic 14 to 15-year-old adolescents residing in a poor neighborhood in Puerto Rico. METHODS: Information from a sample of 325 adolescents was collected from a randomized sample of community households. Logistic regression analysis was used to identify the variables that help explained adolescents' sexual behavior. RESULTS: Adolescents whose parents reported poor communication and poor parent control were more likely to engage in early sexual activity that those peers that did not report this type of family relationship. Adolescents who reported poor parent bonding and lack of discipline were more likely to engage in early sexual relationships. CONCLUSIONS: Intervention and prevention programs need to be aware and address the role of the Hispanic culture in gender differences in early sexual activity in adolescence. If sexual norms related to gender role are changing in Puerto Rico, is a question that needs to be answered in future research.

Assuntos

Coito , Hispânico ou Latino , Adolescente , Fatores Etários , Feminino , Humanos , Masculino , Relações Pais-Filho , Porto Rico

RESUMO

Throughout the world, injection drug users (IDUs) are the group at highest risk for hepatitis C virus (HCV) infection. IDUs residing in the island of Puerto Rico and Puerto Rican IDUs residing in the U.S. mainland have been shown to be at very high risk of infection with HIV. However, the extent to which HCV infection has spread among IDUs in Puerto Rico is not yet known. The aims of this study were to estimate seroprevalence of HCV and to identify the correlates associated with HCV transmission. The sample was drawn through street outreach strategies and was comprised of 400 injection drug users not in treatment, living in the San Juan metropolitan area. HCV and HIV infection were detected by enzyme-linked immunosorbent assay and the results were confirmed by Western blot. Information on sociodemographics, drug use patterns, and risk behaviors was obtained through structured interviews. Bivariate analyses and multivariate logistic regression were used to assess covariates of infection with HCV. The prevalence of HCV infection was 89%. After controlling for sociodemographic characteristics, HCV infection was positively associated with increasing years of injection, injecting in a shooting gallery, tattooing in prison, and self-reported STD infection. Notably, IDUs who had initiated drug injection within the year prior to the study interview had an HCV infection rate of 57%. This study indicates that more aggressive educational programs are urgently needed to reduce the spread of HCV infection among IDUs in Puerto Rico.

Assuntos

Hepatite C/epidemiologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adulto , Western Blotting , Ensaio de Imunoadsorção Enzimática , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Hepatite C/transmissão , Humanos , Masculino , Porto Rico/epidemiologia , Assunção de Riscos , Estudos Soroepidemiológicos , Fatores Socioeconômicos

RESUMO

El sangrado gastrointestinal de un divertículo de Meckel es una entidad clínica muy difícil de diagnosticar con técnicas endoscópicas o radiografías rutinarias, necesitándose a veces la angiografía. El escintigrama con pertecnetato de tecnecio 99m resulta una alternativa viable para el diagnóstico de esta condición

Assuntos

Humanos , Hemorragia Gastrointestinal , Divertículo Ileal/diagnóstico , Tecnécio , Divertículo Ileal , Bexiga Urinária