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This study aimed to investigate predictors of male sexual partner risk among Latinas and Black women in their late thirties. We used multiple regression analysis to examine factors associated with male sexual partner risk among 296 women who participated in two waves of the Harlem Longitudinal Development Study (New York, 2011-2013 and 2014-2016). Women who experienced childhood sexual abuse had higher risk partners than those who did not [b = 0.16, 95% confidence interval (CI) = 0.06, 0.28]. Earlier marijuana use was a risk factor for partner risk in the late thirties (b = 0.12, 95% CI = 0.04, 0.27). Higher levels of ethnic/racial identity commitment mitigated this risk (b = - 0.15, 95% CI = - 0.26, - 0.04). Ethnic/racial identity commitment can be protective against male sexual partner risk among Latina and Black women who use marijuana. Further research should explore the protective role of different dimensions of ethnic/racial identity against sexually transmitted infections, including HIV.
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Infecciones por VIH , Enfermedades de Transmisión Sexual , Negro o Afroamericano , Niño , Femenino , Infecciones por VIH/prevención & control , Hispánicos o Latinos , Humanos , Masculino , Factores Protectores , Factores de Riesgo , Conducta Sexual , Parejas SexualesRESUMEN
Biomedical HIV prevention uptake has not taken hold among Black and Latinx populations who use street-marketed drugs. A pilot intervention providing a PEP informational video and direct pharmacy access to a PEP starter dose was conducted among this population. Four study pharmacies were selected to help facilitate syringe customer recruitment (2012-2016). Baseline, post-video, and 3-month ACASI captured demographic, risk behavior, and psychosocial factors associated with PEP willingness, and willingness to access PEP in a pharmacy. A non-experimental study design revealed baseline PEP willingness to be associated with PEP awareness, health insurance, being female, and having a high-risk partner (n = 454). Three-month PEP willingness was associated with lower HIV stigma (APR = 0.95). Using a pre-post approach, PEP knowledge (p < 0.001) and willingness (p < 0.001) increased overtime; however, only three participants requested PEP during the study. In-depth interviews (n = 15) identified lack of a deeper understanding of PEP, and contextualized perceptions of HIV risk as PEP access barriers. Pharmacy PEP access shows promise but further research on perceived risk and HIV stigma is warranted.
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Fármacos Anti-VIH/administración & dosificación , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Farmacias , Profilaxis Posexposición/provisión & distribución , Adulto , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Ciudad de Nueva York , Prevalencia , Asunción de Riesgos , Estigma SocialRESUMEN
INTRODUCTION: There is limited information on the effectiveness of ceftolozane/tazobactam and ceftazidime/avibactam combinations on clinically relevant strains isolated in Mexico. OBJECTIVE: To determine the antimicrobial profile of both antibiotic combinations in our community. METHOD: The present research study was prospective, descriptive and cross-sectional. Clinically relevant strains isolated from pure-strain cultures were included during the period from August 2018 to January 2019 in Mexicali, Baja California, Mexico. RESULTS: 74 enterobacteriaceae and 19 Pseudomonas aeruginosa strains were analyzed; the percentage of sensitivity of ceftazidime/avibactam was 100 % for enterobacteriaceae and 72.7 % for Pseudomonas aeruginosa; the percentage of sensitivity of ceftolozane/tazobactam for enterobacteriaceae was 90.5 % and 72.7 % for Pseudomonas aeruginosa. CONCLUSIONS: The ceftolozane/tazobactam and ceftazidime/avibactam combinations offer good antimicrobial sensitivity in vitro, both for ESBL-producing enterobacteriaceae and Pseudomonas aeruginosa. More data are required to assess clinical response in patients receiving these antibiotic combinations. INTRODUCCIÓN: Existe poca información acerca de la efectividad de las combinaciones ceftolozano/tazobactam y ceftazidima/avibactam en cepas clínicamente relevantes aisladas en México. OBJETIVO: Determinar el perfil antimicrobiano de ambos antibióticos en nuestra comunidad. MÉTODO: El presente estudio de investigación fue prospectivo, descriptivo y transversal. Se incluyeron cepas clínicamente relevantes aisladas a partir de cultivos de cepa pura durante el periodo de agosto de 2018 a enero de 2019 en Mexicali, Baja California, México. RESULTADOS: Se analizaron 74 cepas de enterobacterias y 19 cepas de Pseudomonas aeruginosa; el porcentaje de sensibilidad de ceftazidima/avibactam fue de 100 % contra enterobacterias y de 72.7 % contra Pseudomonas aeruginosa; el porcentaje de sensibilidad de ceftolozano/tazobactam fue de 90.5 % para enterobacterias y de 72.7 % para Pseudomonas aeruginosa. CONCLUSIONES: Las combinaciones ceftolozano/tazobactam y ceftazidima/avibactam ofrecen buena sensibilidad antimicrobiana in vitro, tanto contra enterobacterias productoras de betalactamasas de espectro extendido como contra Pseudomonas aeruginosa. Se requieren más datos para valorar la respuesta clínica en pacientes que reciben esas combinaciones de antibióticos.
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Antibacterianos/uso terapéutico , Compuestos de Azabiciclo/uso terapéutico , Ceftazidima/uso terapéutico , Cefalosporinas/uso terapéutico , Enterobacteriaceae/efectos de los fármacos , Pseudomonas aeruginosa/efectos de los fármacos , Tazobactam/uso terapéutico , Estudios Transversales , Combinación de Medicamentos , Enterobacteriaceae/aislamiento & purificación , Humanos , México , Pruebas de Sensibilidad Microbiana , Estudios Prospectivos , Pseudomonas aeruginosa/aislamiento & purificaciónRESUMEN
The high-Sensitivity C-Reactive Protein (hs-CRP) is a cardiovascular risk marker. In healthy Mexican children, there islittle evidence that shows any relationship between serum levels of this marker with diet. The objective of this studywas to associate serum levels of hs-CRP with the diet composition in Mexican school children. The cross-sectional study included 300 seemingly healthy children of 10 to 12 years of age, 53.7% were girls and 46.3% boys.hs-CRP quantification was determined by nephelometry. The diet was quantified with a validated food frequency questionnaire. A descriptive statistical analysis, correlation and multivariate regression models were performed by using the SPSS v18 statistical software. The median of the hs-CRP was 0.3 mg / L (range: 0.3 to 6.8 mg / L). A significant direct correlation was found between serum hs-CRP with protein intake (rho=0.126, p=0.029), total fatty acids (rho = 0.128, p = 0.027) and saturated fatty acids (rho = 0.159, p = 0.006). hs-CRP was associated with the intake of protein (ß = 0.203, p = 0.037) by multiple regression analysis, and inversely with whole grains (ß = -0.175, p = 0,002). No significant association was found with the rest of the other variables. The serum concentration of hs-CRP was directly associated with the consumption of protein, total and saturated fatty acids and was indirectly proportional with the consumption of whole grains.
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Proteína C-Reactiva/análisis , Dieta , Alimentos , Niño , Estudios Transversales , Femenino , Humanos , Masculino , México , Estudios ProspectivosRESUMEN
BACKGROUND: Although shared decision making (SDM) is the preferred model of making complex treatment decisions with patients, patients' and doctors' attitudes towards SDM for advance care planning are unknown. OBJECTIVE: We sought to: (i) gain general insights into the current practice of SDM and attitudes about patient involvement, and (ii) gain specific insights into experience with, and attitudes about, SDM for advance care planning. DESIGN: Qualitative analysis of face-to-face semi-structured interviews. SETTING AND PARTICIPANTS: Patients with chronic lung disease and their doctors at a New York City public hospital. RESULTS: Although patients described participation in decision making, many deferred the final decision to their doctors. Doctors indicated a preference for SDM but expressed barriers including perceived lack of patient understanding and lack of patient empowerment. With regard to end-of-life discussions, patients were generally open to having these discussions with their doctors, although their openness sometimes depended on the circumstance (i.e. end-of-life discussions may be more acceptable to patients for whom the chance of dying is high). Doctors reported engaging in end-of-life treatment decisions with their patients, although expressed the need for conversations to take place earlier, in advance of acute illness, and identified a lack of prognostic estimates as one barrier to engaging in this discussion. CONCLUSIONS: Doctors should explore their patients' attitudes regarding end-of-life discussions and preferences for decision-making styles. There is a need for tools such as decision aids which can empower patients to participate in decision making and can support doctors with prognostic estimates pertinent to individual patients.
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Planificación Anticipada de Atención , Actitud del Personal de Salud , Actitud Frente a la Salud , Toma de Decisiones , Participación del Paciente/psicología , Relaciones Médico-Paciente , Enfermedad Crónica , Comunicación , Técnicas de Apoyo para la Decisión , Femenino , Humanos , Enfermedades Pulmonares , Prioridad del Paciente , Investigación CualitativaRESUMEN
BACKGROUND: The absence of IUD visible threads in the cervix is a complication of the intrauterine device. The IUD withdrawal in these cases was performed with Novak cannula or curettage instrumented under anesthesia and surgery. Its extraction with Mathew clip is an alternative. OBJECTIVE: To demostrate the effectiveness of the Mathew's clip as an alternatively for removal of intrauterine devices not visible threads. MATERIAL AND METHODS: A cross-sectional, retrospective, descriptive study was conducted in from February 2012 to July 2014 at the Family Planning Service of Gynecology and Obstetrics of the General Hospital of Mexico "Dr. Eduardo Liceaga ". RESULTS: 106 patients (54%) had no visible threads; in 84 patients (81.5 %) it was removed with Novak, cannula; in 19 patients (18.4%) in which it was not possible, the removal was done with a Mathew's clip. DISCUSSION: Mathew' clip is an alternative in cases where it was not possible to remove the IUD with Novak cannula, 19 IUDs no visible threads were removed. CONCLUSIONS. Mathew clip for removal of intrauterine devices with no visible threads means less risk to the patient and a decrease in institutional costs.
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Remoción de Dispositivos/instrumentación , Dispositivos Intrauterinos , Adolescente , Adulto , Estudios Transversales , Diseño de Equipo , Servicios de Planificación Familiar , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenRESUMEN
We sought to characterize HIV antiretroviral therapy (ART) adherence and psychosocial correlates of adherence in a sample of gay, bisexual, and other non-gay or -bisexual identified men who have sex with men aged 50 and over. As part of a cross-sectional study we recruited a community-based sample of 199 men and assessed adherence to current ART medications along four domains: (1) missing doses in the past 4 days, (2) taking doses on the specified schedule in the past 4 days, (3) following instructions about how to take the medications (e.g., to take medications with food), and (4) missing doses in the last weekend. A total adherence score was also computed. Bivariable analyses indicated negative associations between depression, sexual compulsivity, and HIV-related stigma with each of the individual adherence variables and the composite adherence score, while an older age was found to be protective. In multivariable analyses, controlling for age and educational attainment, a higher likelihood of missing doses and failing to follow instructions were related to higher levels of HIV-related stigma, while dosing off-schedule and missing doses on weekends was associated with higher levels of sexual compulsivity. These results indicate that psychosocial burdens undermine the adherence behaviors of older HIV-positive sexual minority men. Programming and services to address this compromising health behavior must embrace a holistic approach to health as informed by syndemics theory, while attending to the developmental and age-specific needs of older men.
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Antirretrovirales/uso terapéutico , Bisexualidad/psicología , Costo de Enfermedad , Infecciones por VIH/tratamiento farmacológico , Homosexualidad Masculina/psicología , Cumplimiento de la Medicación/psicología , Factores de Edad , Anciano , Envejecimiento , Estudios Transversales , Depresión/diagnóstico , Depresión/psicología , Infecciones por VIH/psicología , Humanos , Masculino , Persona de Mediana Edad , Prejuicio , Escalas de Valoración Psiquiátrica , Asunción de Riesgos , Conducta Sexual/psicología , Factores Socioeconómicos , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicologíaRESUMEN
The risk of pregnancy in breastfeeding should be a concern of women. Family planning programs in the post natal period contraceptive choices offer high efficiency. Breastfeeding is a natural contraception method (LAM) as a contraceptive shield has 98% efficiency. Women should consider using an alternate contraceptive method when feeding requirements for this method to be effective are not met. Some of contraceptive alternatives in lactation include hormonal methods. According to the Medical Eligibility Criteria for Contraceptive Use WHO combined hormonal methods are contraindicated during breastfeeding, hormonal progestogen only methodo are considered only in Group 3 and Group 1 immediate postpartum after 6 weeks postpartum. There are modifications to these criteria by the CDC and the UK for the use of these hormones in early in lactation.
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Intervalo entre Nacimientos , Lactancia Materna , Anticoncepción/métodos , Femenino , HumanosRESUMEN
The risk of pregnancy in breastfeeding should be a concern of women. Family planning programs in the postnatal period contraceptive choices offer high efficiency. Breastfeeding is a natural contraception method (LAM) as a contraceptive shield has 98 % efficiency. Women should consider using an alternate contraceptive method when feeding requirements for this method to be effective are not met. Some of contraceptive alternatives in lactation include hormonal methods. According to the Medical Eligibility Criteria for Contraceptive Use WHO combined hormonal methods are contraindicated during breast feeding, hormonal progestogen only method are considered only in Group 3 and Group 1 immediate postpartum after 6 weeks postpartum. There are modifications to these criteria by the CDC and the UK for the use of these hormones in early in lactation.
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Lactancia Materna , Anticoncepción/métodos , Lactancia/fisiología , Contraindicaciones , Servicios de Planificación Familiar , Femenino , Humanos , Periodo Posparto , Embarazo , Factores de Tiempo , Organización Mundial de la SaludRESUMEN
OBJECTIVES: We examined associations of individual, psychosocial, and social factors with unprotected anal intercourse (UAI) among young men who have sex with men in New York City. METHODS: Using baseline assessment data from 592 young men who have sex with men participating in an ongoing prospective cohort study, we conducted multivariable logistic regression analyses to examine the associations between covariates and likelihood of recently engaging in UAI with same-sex partners. RESULTS: Nineteen percent reported recent UAI with a same-sex partner. In multivariable models, being in a current relationship with another man (adjusted odds ratio [AOR] = 4.87), an arrest history (AOR = 2.01), greater residential instability (AOR = 1.75), and unstable housing or homelessness (AOR = 3.10) was associated with recent UAI. Although high levels of gay community affinity and low internalized homophobia were associated with engaging in UAI in bivariate analyses, these associations did not persist in multivariable analyses. CONCLUSIONS: Associations of psychosocial and socially produced conditions with UAI among a new generation of young men who have sex with men warrant that HIV prevention programs and policies address structural factors that predispose sexual risk behaviors.
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Homosexualidad Masculina/psicología , Clase Social , Sexo Inseguro/psicología , Adolescente , Factores de Edad , Distribución de Chi-Cuadrado , Seronegatividad para VIH , Jóvenes sin Hogar , Homofobia/psicología , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Funciones de Verosimilitud , Masculino , Análisis Multivariante , Ciudad de Nueva York , Prisioneros/psicología , Prisioneros/estadística & datos numéricos , Análisis de Regresión , Características de la Residencia , Parejas Sexuales , Sexo Inseguro/estadística & datos numéricos , Adulto JovenRESUMEN
The prevalence of HIV among adults 50 and older in the USA is increasing as a result of improvements in treatment and detection of HIV infection. Substance use by this population has implications for physical and mental health outcomes. We examined patterns of demographics, mental health, and recent substance use in a diverse sample of heterosexual, bisexual, and gay adults 50 and older living with HIV/AIDS (PLWHA) in New York City. The most commonly used substances were cigarettes or alcohol; however, the majority of the sample did not report recent use of marijuana, poppers, or hard drugs (crystal methamphetamine, cocaine, crack, heroin, ecstasy, GHB, ketamine, and LSD or PCP). Statistically significant associations between substance use and psychological states (well-being and loneliness) were generally weak, and depression scores were not significantly related to use; instead, drug use was associated with gender/sexual orientation. The study observations support addressing substance use specific to subpopulations within PLWHA.
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Demografía , Infecciones por VIH/complicaciones , Trastornos Relacionados con Sustancias/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ciudad de Nueva YorkRESUMEN
OBJECTIVE: Primary cardiac tumors are rare neoplasms in humans, of which the most common is the atrial Myxoma. The objective of this study was to find the incidence of these tumors at the Heart Center of Puerto Rico and the Caribbean. METHODS: This study was approved by the Institutional Review Board of the Medical Sciences Campus University of Puerto Rico to review the records at the Heart Center of patients with heart tumors in the last 14 years. RESULTS: The sample consists of 55 patients (78.9% were females and 24.1% were male) with a median age of 52 years. Sixty-five percent of patients lived in rural areas. Clinical presentations included shortness of breath (43.1%), chest pain (37.9%), asymptomatic (25%), palpitations (20.7%), neurologic symptoms (10.3%) and dizziness (6.9%). Electrocardiographic findings included normal sinus rhythm (53.4%), non-specific ST-T changes (32.8%), sinus tachycardia (20.7%), left atrial enlargement (10.3%) and atrial fibrillation (8.6%). A subgroup presenting with atrial fibrillation prior to diagnosis had left atrial myxoma. The tumors found, in descending order of frequency are: left atrial myxoma, right atrial myxoma, papillary fibroelastoma, hamartoma, lipoma and rhabdomyoma. We found a correlation between large left atrial myxoma and atrial fibrillation. CONCLUSION: The most frequent heart tumor was atrial myxoma. The larger myxomas were associated with atrial fibrillation.
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Fibrilación Atrial/etiología , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Neoplasias Cardíacas/diagnóstico , Humanos , Incidencia , Lactante , Masculino , Persona de Mediana Edad , Puerto Rico , Adulto JovenRESUMEN
Amyloidosis is a multisystemic disease caused by extracellular deposition of pathologic beta fibrillar proteins in multiple organs. Deposited fibrils can be either innunoglobulin light chanis or amyloid-A protein. The incidence of anyloidosis derived from anyloid-A protein, usually associated to an underlying disease, has been dimisishing over the decades in the United States producing clinical evidence of cardiac involvement in less than 5% of all cases. The extent of cardiac involvement is the determining prognostic factor. Early diagnosis and therapy aimed at the underlying disease may halt progression of cardiac dysfuction and improve prognosis. We report a case of a 63-year-old man who was diagnosed with cardiac amyloidosis secondary to multiple myeloma.
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Amiloidosis/etiología , Cardiopatías/etiología , Mieloma Múltiple/complicaciones , Amiloidosis/diagnóstico , Cardiopatías/diagnóstico , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: The authors quantified the impact of the use of telehealth services on patient-level clinical outcomes among children with complex behavioral and emotional needs in Idaho during the COVID-19 pandemic by comparing data collected in 2020 with data for the same months in 2019. METHODS: Longitudinal statewide data of Child and Adolescent Needs and Strengths (CANS) assessments were extracted from Idaho's mental and behavioral health system. Prepandemic assessments were matched to midpandemic assessments. A linear mixed-effect model was used to explore four child-level outcomes: psychosocial strengths-building rate, rate of need resolution within a life-functioning domain, rate of need resolution within a behavior-emotional domain, and rate of need resolution within a high-risk behaviors domain. RESULTS: The number of new patients admitted to Idaho's state-funded mental and behavioral health program decreased almost twofold from April-December 2019 to April-December 2020 (N=4,458 vs. 2,794). For most children with complex needs, the use of telehealth was as effective in terms of strengths building and needs resolution as in-person services; for children whose caregivers had issues with access to transportation, availability of telehealth services improved outcomes for the children. CONCLUSIONS: The COVID-19 pandemic in 2020 was associated with a dramatic drop in the number of children served by Idaho's mental health program. Telehealth may effectively bridge mental health service delivery while patients and providers work toward the resolution of transportation issues or may serve as a more acceptable permanent format of service delivery for some populations.
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COVID-19 , Servicios de Salud Mental , Telemedicina , Adolescente , Humanos , Pandemias , Evaluación de NecesidadesRESUMEN
PURPOSE OF REVIEW: This review reports on the myriad barriers and facilitators related to COVID-19 vaccine hesitancy and factors contribution to uptake among people living with HIV (PLWH) globally published over the past year (2021-2022). RECENT FINDINGS: Across the literature, participants indicated concerns about the safety, efficacy and overall rapid development of the COVID-19 vaccine as a reason for delaying or not being vaccinated. Medical mistrust and perceptions about the risk of COVID-19 immune response and severity also played a role in COVID-19 vaccine hesitancy among PLWH. Almost every study examined different sociodemographic characteristics associated with COVID-19 vaccination acceptance and uptake, and although strong themes emerged around race/ethnicity, sex and educational attainment, the results were mixed across other characteristics, including age. Some studies also examined medical factors specifically related to PLWH including CD4 + cell count and adherence to antiretroviral therapy. SUMMARY: The findings highlight individual, structural and social differences in COVID-19 vaccine acceptance and uptake among PLWH, which are varied throughout the world. We call on researchers and interventionists to not just consider the role of medical mistrust and disinformation, but also how emotional, financial and political vulnerability plays into making decisions around COVID-19 vaccine uptake and overall healthcare.
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COVID-19 , Infecciones por VIH , Humanos , Vacunas contra la COVID-19 , COVID-19/prevención & control , Infecciones por VIH/tratamiento farmacológico , Confianza , Recuento de Linfocito CD4RESUMEN
Background: Sexually transmitted infections (STIs) are a major health issue, exacerbated by limited financial and infrastructural resources in developing countries. Methods: Prevalence of STIs was assessed in two urban centers of the Dominican Republic (DR) among populations at high risk for STIs: pregnant youth, men who have sex with men (MSM), trans women (TG), batey residents, female sex workers, and people living with human immunodeficiency virus (HIV). We conducted a cross-sectional survey and biological specimen collection to screen for Chlamydia trachomatis, Neisseria gonorrhea, Mycoplasma genitalium, Trichomonas vaginalis (trichomoniasis), Treponema pallidum (syphilis), HIV, hepatitis B and C, and human papillomavirus (HPV) among at-risk populations between 2015 and 2018. Ureaplasma urealyticum testing was also conducted even though it is not considered a STI. A non-probability community sample was recruited. Descriptive statistics examined the prevalence of STIs by population. Results: A total of 1991 subjects participated in the study. The median age was 26 years (range: 18-65). Most participants were female (65.3%), heterosexual (76.7%), and were not partnered (55.7%). Most of the participants reported unprotected vaginal sex in the last 6 months (54%); among MSM and TG almost half of the participants reported unprotected anal sex in the last 6 months and 17.6% reported drug use in the last 6 months. Almost half of the participants (49%) tested positive for one or more STIs. The most prevalent STI was Chlamydia trachomatis (12.8%), and human papillomavirus (11.9%). Among transgender women, 65.3% tested positive for an STI, 64.8% of female sex workers tested positive for an STI, and 53.8% of pregnant adolescents tested positive for an STI. Conclusion: There is a high prevalence of STIs among key and under resourced populations in the DR. Our findings highlight the need to conduct further research to optimize prevention and care strategies for structurally vulnerable and under resourced populations in the DR.
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Primary adenocarcinoma of the appendix is a rare neoplasm, and a large number are found incidentally during abdominal imaging and operations with other indications. This report examines a case of primary appendiceal adenocarcinoma discovered incidentally following a seemingly routine laparoscopic appendectomy in a 69-year-old male. The patient presented with atypical signs of acute appendicitis, including a history of waxing and waning right lower quadrant pain without anorexia, fever, or chills over five days. After undergoing laparoscopic appendectomy, histopathologic analysis of the appendix specimen revealed invasive adenocarcinoma. This case emphasizes the importance of maintaining a high index of suspicion for appendicitis versus appendiceal neoplasm in older adults presenting with atypical signs and symptoms.
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OBJECTIVE: The objective of the study was to present the experience of the family planning service Hospital General de México, in locating and removing no palpable subdermal single-rod contraceptive implants. MATERIALS AND METHODS: A descriptive, prospective, and cross-sectional study was performed from January 2011 to April 2018. RESULTS: Hundred and sixty-four patients in whom the implant was not palpable were reviewed, the time between insertion and removal averaged 3.3 years (maximum 10 years and minimum 3 months). Three implants were inserted in the right arm, the rest on the left one. Forty-seven implants were found in fatty tissue (29%), 18 in fascia (11%), 94 in muscle (57%), 2 in the armpit (1.2%), and 3 were not found (1.8%). CONCLUSIONS: The no palpable implant is caused by an incorrect insertion technique. Migration should not be assumed as a cause of difficult location. Amount of non-palpable implants is not possible to determine due to a lack of records, but approximately 3% are considered non-palpable. Ultrasound has proven to be the study of choice to locate an incorrect inserted implant. In this case, the total number of implants was located, except in two patients.
OBJETIVO: Presentar la experiencia del servicio de planificación familiar del Hospital General de México Dr. Eduardo Liceaga en la localización y la extracción de implantes anticonceptivos subdérmicos no palpables. MATERIALS Y MÉTODOS: Estudio clínico descriptivo, prospectivo y transversal, realizado desde enero de 2011 hasta abril de 2018 en el servicio de planificación familiar del Hospital General de México Dr. Eduardo Liceaga. RESULTADOS: Se incluyeron 164 pacientes con implantes no palpables, de los cuales 161 se localizaron por ultrasonido. El promedio entre la inserción y el retiro fue de 3.3 años. Tres implantes fueron insertados en el brazo derecho y el resto en el izquierdo; tres no se encontraron. CONCLUSIÓN: Por su fácil acceso y simplicidad, el ultrasonido es el método de elección para localizar implantes profundos no palpables.
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Brazo , Dispositivos Anticonceptivos Femeninos , Remoción de Dispositivos/métodos , Adulto , Brazo/diagnóstico por imagen , Anticonceptivos Femeninos , Dispositivos Anticonceptivos Femeninos/estadística & datos numéricos , Estudios Transversales , Desogestrel , Servicios de Planificación Familiar , Femenino , Humanos , Palpación/métodos , Estudios Prospectivos , Radiografía , Factores de Tiempo , UltrasonografíaAsunto(s)
Sobredosis de Droga , Naloxona , Humanos , Naloxona/uso terapéutico , Antagonistas de Narcóticos/uso terapéutico , Accesibilidad a los Servicios de Salud , Sobredosis de Droga/prevención & control , Sobredosis de Droga/tratamiento farmacológico , Área sin Atención Médica , Analgésicos Opioides/uso terapéuticoRESUMEN
Resumen OBJETIVO: Describir el nivel de conocimiento de los signos y síntomas de alarma obstétrica en mujeres embarazadas. MATERIALES Y MÉTODOS: Estudio de serie de casos prolectivo y descriptivo efectuado en la Unidad de Medicina Familiar 16, Instituto Mexicano del Seguro Social, Mexicali, Baja California, entre los meses de enero a junio de 2022. Variables de estudio: edad, sexo, escolaridad y nivel de conocimiento de signos y síntomas de alarma a través de una encuesta elaborada conforme a los criterios de la guía de práctica clínica. Se utilizó estadística descriptiva con el programa SPSSv24. RESULTADOS: Se estudiaron 150 pacientes embarazadas. El bajo nivel de conocimiento de los signos y síntomas de alarma se observó en 15 casos, el nivel medio en 47 casos y el nivel alto en 88 casos (58.7%). En cuanto a las características de la población, los límites de edad fueron 20 y 34 años, la escolaridad secundaria ocupó el 47.3% seguido de la preparatoria con el 35.3% y en cuanto a la ocupación el 80.7% refirió ser empleada. El 34% cursaba el primer trimestre del embarazo y el 48.7% el segundo trimestre. CONCLUSIONES: El nivel de conocimiento de las pacientes embarazadas atendidas en la unidad es alto y medio porque pueden reconocer los signos y síntomas de alarma durante el embarazo, sobre todo quienes cursan el segundo embarazo, en coincidencia con estudios nacionales e internacionales. El grupo predominante fue el de 20 a 34 años, con escolaridad media y superior.
Abstract OBJECTIVE: To describe the level of knowledge of obstetric alarm signs and symptoms in pregnant women. MATERIALS AND METHODS: Selective and descriptive case series study carried out in the Family Medicine Unit 16, Mexican Institute of Social Security, Mexicali, Baja California, between January and June 2022. Study variables: age, sex, education and level of knowledge of warning signs and symptoms through a survey prepared according to the criteria of the Clinical Practice Guide. Descriptive statistics were performed using SPSSv24. RESULTS: 150 pregnant patients were screened. A low level of knowledge of warning signs and symptoms was observed in 15 cases, a medium level in 47 cases and a high level in 88 cases (58.7%). Regarding the characteristics of the population, the age range was 20-34 years, 47.3% had secondary education, followed by high school with 35.3%, and 80.7% reported being employed. Thirty-four per cent were in the first trimester of pregnancy and 48.7 per cent in the second trimester. CONCLUSIONS: The level of knowledge of pregnant patients attending the unit is high and medium in terms of being able to recognize the warning signs and symptoms of pregnancy, particularly in the second trimester, in line with national and international studies. The predominant age group was 20-34 years, with secondary and higher education.