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Purpose of review: Latinx sexual minority adolescents (LSMA) are at an intersection of ethnic and sexual minority (SM) status and may experience heighten risk of substance use and related problems. These youth may also hold unique protective factors that help mitigate the effects of minority stress and curb substance use. Little is known, however, about the intersectional minority stressors (i.e., due to ethnicity and SM status) and protective factors related to substance use among this population. Recent Findings: According to the minority stress model, there are unique minority stressors and resiliency factors that can help explain differences in behavioral health rates between white SM and SM of color. Research supports the notion that minority stressors (e.g., stigma/risk, homophobic bullying, and family rejection of SM status) confer risk for substance use among LSMA. In terms of resilience, less is known, but there may be some protective factors that have not been measured that could explain lower rates in some substances (i.e., club drugs and methamphetamine). Summary: Little is known about how the intersections of ethnicity and SM status are associated with substance use in adolescence. Future research should assess the temporal relationship of multilevel (i.e., intrapersonal, relational, and system), intersectional (i.e., ethnicity and SM status) minority stressors and protective factors unique to LSMA on substance use. We propose that the findings from these future studies will help to create socioculturally appropriate behavioral health treatments that consider the intersectional risks and strengths within the LSMA population.
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Introduction: Alphaviruses may cause arthritis, but there is a lack of studies assessing it in flaviviruses such as dengue. Through the 28 Joint Disease Activity Score (DAS-28), incorporating swollen joint counts, and through the Arthritis Index from Western Ontario and McMaster Universities (WOMAC), we assessed pain, stiffness, and dimensions of arthritic function in post-DENV patients. Methods: Prospective study of a cohort of participants who were diagnosed with dengue in centres in Honduras from December 2019 to February 2020, with a follow-up period of 4 months to evaluate post-dengue rheumatological disease through the WOMAC and DAS-28 questionnaires. Results: After a four-month follow-up phase with 281 participants, the final cohort comprised 58.8% women and 41.20% men. After the follow-up, 63.02% persisted with the clinical findings. According to WOMAC, joint involvement was higher in women with (58.76%) (p < 0.0001) these symptoms or functional limitations when performing daily activities were limited to pain when walking (34.81% vs. 5.51%), climbing or descending stairs (36.46% vs. 8.66%), and at night at bedtime (28.73% vs. 7.08%). With the DAS-28, we found at least one alteration with inflammation or pain in 14.91% of the participants, primarily women (p < 0.01). Discussion: Joint involvement was high during the dengue epidemic in 2019. We observed a significant proportion of women with inflammation and joint pain, showing that dengue may lead to the development of chronic rheumatological findings, although lower than in CHIKV, still affecting everyday life and, consequently, their quality of life. Additional long-term evaluation studies after dengue are required.
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Antecedentes: Estudios recientes refieren que los pacientes con dolor crónico sufren cambios en el procesamiento de la información que les llega desde la periferia con el solo hecho de cambiar el orden en que los estímulos les son ejercidos, por ejemplo, cuando se les cruzan las manos. En los pacientes con dolor crónico se ha demostrado la presencia de alteraciones en sus marcos de referencia somatotópicos, y es por esto que la estrategia de cruzar las extremidades por la línea media, podría generar cambios en la percepción dolorosa. Objetivo: Evaluar si un programa de fisioterapia analgésica aplicada con cruce de manos es más eficaz que uno sin el cruce para disminuir el dolor. Material y método: 16 pacientes con dolor crónico de codo, muñeca o mano ingresaron al estudio. Fueron aleatorizados en un grupo experimental, que recibió la aplicación de electroanalgesia nerviosa transcutánea (TENS) con cruce de manos y ojos cerrados, además de un grupo control, que recibió solo electroanalgesia. A cada grupo se les evaluó su dolor pre y postintervención, con el cuestionario del dolor de McGill y la escala visual análoga (EVA). Resultados: Ambos grupos, el control y experimental, presentaron una disminución en el dolor postintervención; el grupo control disminuyó una media de 3,5 cm y el grupo experimental con una media de 3,75 cm. Todas las sesiones del grupo experimental fueron estadísticamente significativas (p < 0,05), mientras que el grupo control presentó una sesión no estadísticamente significativa (p = 0,051). El análisis de varianza (ANOVA) entre ambos grupos, sin embargo, no dio estadísticamente significativo (p = 0,863). Conclusiones: Los resultados no evidencian convincentemente que el cruce de manos potencia los efectos de la terapia analgésica en relación con la intensidad dolorosa. Más estudios serían necesarios para incluir esta técnica como una estrategia de apoyo en pacientes con dolor crónico, y poder manejar así las alteraciones sensoperceptivas y los cambios en el procesamiento de la información que les llega de la periferia
Background: Recent studies report that patients with chronic pain, they undergo changes in the processing of information that reaches them from the periphery with the mere fact of changing the order in which the stimuli are exercised, for example, when their hands are crossed. In patients with chronic pain, the presence of alterations in their somatotropic frames of reference has been demonstrated, and this is why the strategy of crossing the extremities through the midline could generate changes in the perception of pain. Objective: To evaluate if an analgesic physiotherapy program with hand crossing technique is more effective than a program without crossing hands, in order to reduce pain. Material and method: Sixteen patients with chronic pain in elbow, wrist or hand, were randomized in two groups. One received transcutaneous electrical nerve stimulation (TENS) with hand crossing and closed eyes, and the other (control group) received only the application of TENS. Each group was evaluated before and after the intervention with the McGill pain questionnaire and the visual analog scale (VAS). Results: A decrease in post-intervention pain was observed in both groups; where the control group decreased an average of 3.5 cm and the experimental group 3.75 cm. All sessions of the experimental group were statistically significant (P = <0.05), while one session in the control group was not statistically significant (P = 0.051). However, the Analysis of variance (ANOVA) between both groups, did not give statistically signifi cant (p = 0.863). Conclusions: The results do not show that the crossing of hands potentiates the effects of analgesic therapy on pain intensity. More information is the effects to include this technique as a support strategy in patients with chronic pain, and to manage sensory alterations and changes in the processing of information that reaches the periphery