RESUMO
The Latinx (Hispanic) social construct obscures differences in the overdose risk levels of groups within this category. When national data are disaggregated, stateside Puerto Rican mortality increases exponentially, so much that this community has the highest rates of overdose deaths across years. Developed by Bronx-based Puerto Ricans, Narcanazo is an empowered upstander campaign that uses local overdose data to mobilize community members as trained naloxone dispensers. This health promotion campaign was grounded in antiracist epidemiological analysis. (Am J Public Health. 2024;114(S6):S463-S466. https://doi.org/10.2105/AJPH.2024.307605) [Formula: see text].
Assuntos
Overdose de Drogas , Promoção da Saúde , Hispânico ou Latino , Naloxona , Humanos , Naloxona/uso terapêutico , Hispânico ou Latino/estatística & dados numéricos , Overdose de Drogas/mortalidade , Overdose de Drogas/prevenção & controle , Overdose de Drogas/epidemiologia , Promoção da Saúde/organização & administração , Antagonistas de Entorpecentes/uso terapêutico , Porto Rico , Cidade de Nova Iorque/epidemiologia , RacismoRESUMO
La inversión uterina es una patología de presentación rara e infrecuente. Se presenta el caso de una paciente con inversión uterina no puerperal con requerimiento de histerectomía abdominal total. Sin antecedentes de importancia asistió al servicio de urgencias por un cuadro clínico de dolor abdominal de 10 días de evolución asociado a sangrado vaginal abundante con inestabilidad hemodinámica y sensación de masa vaginal. Al examen físico se evidenció una masa sobresaliente del canal vaginal de aspecto necrótico, por lo que se sospechó mioma nascens. Durante la estancia hospitalaria presentó inestabilidad hemodinámica, por lo que fue llevada a histerectomía abdominal de urgencia con hallazgo de inversión uterina. La inversión uterina no puerperal es infrecuente. Es importante realizar un buen diagnóstico clínico apoyado de las imágenes si se encuentran disponibles, la intervención quirúrgica es necesaria y proporciona un buen pronóstico. La histerectomía vaginal no es sencilla en estos casos, por lo que se recomienda la histerectomía abdominal total.
Uterine inversion is a rare and infrequent disease. The case of a patient with a non-puerperal uterine inversion that had to be treated with a total abdominal hysterectomy is presented in this study. With no important history of disease, she attended the emergency department presenting abdominal pain in the last 10 days associated with vaginal bleeding and mass sensation. The physical examination revealed a protruding necrotic-like mass through the vagina, hence the suspicion of a myoma nascens. During her hospital ward stay, she presented hemodynamic instability, urgent abdominal hysterectomy had to be done which revealed uterine inversion. Non-puerperal uterine inversion is infrequent. Precise clinical diagnosis is important supported by diagnostic imaging if available. The surgical intervention is necessary, giving a good prognosis. Vaginal hysterectomy is not easy in this type of cases, therefore total abdominal hysterectomy is recommended.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias Uterinas/complicações , Inversão Uterina/cirurgia , Leiomioma/complicações , Hemorragia Uterina/etiologia , Neoplasias Uterinas/cirurgia , Dor Abdominal/etiologia , Inversão Uterina/diagnóstico , Histerectomia/métodos , Leiomioma/cirurgiaRESUMO
Background: The lockdown derived from the declaration of a pandemic due to SARS-CoV-2 in March 2020 by the World Health Organization altered daily activities, including the academic ones, which were adapted to virtuality. In Ecuador, the new modality of study had an increase in the use of electronic devices that triggered new problems. Objective: To stablish the prevalence of depression and anxiety among medical students from the Universidad Central del Ecuador (Central University of Ecuador) in virtual education during the COVID-19 pandemic. Material and methods: Cross-sectional analytic study conducted between June and July of 2021 in students from first to tenth semester during virtual education. All studied subjects were evaluated using an electronic survey, depression and anxiety variables were assessed with the BDI-II and GAD-7 scales, respectively. In addition, sociodemographic data were collected, including the family APGAR. A response rate of 63.3% (1528 students) was obtained. Results: Overall prevalence of depression was 37.8% and the prevalence of anxiety 30.3%. Lower-years students were the most affected by these pathologies. The protective factors found were physical activity and psychological support in religion, whereas the main risk factors found were a dysfunctional family, lack of an exclusive study space and low academic performance. Furthermore, the frequency of depression and anxiety was significantly higher in women. Conclusion: The virtual modality showed a high prevalence of depression and anxiety in medical students.
Introducción: el confinamiento derivado de la declaración de pandemia por SARS-CoV-2 en marzo de 2020 por la Organización Mundial de la Salud alteró las actividades diarias, incluidas las académicas, que se adaptaron a la virtualidad. En Ecuador, la nueva modalidad de estudio tuvo un aumento del uso de dispositivos electrónicos que desencadenó nuevos problemas. Objetivo: determinar la prevalencia de depresión y ansiedad en estudiantes de medicina de la Universidad Central del Ecuador en el ciclo de educación virtual durante la pandemia por COVID-19. Material y métodos: estudio analítico transversal realizado entre junio y julio de 2021 en estudiantes de medicina de primero a décimo semestre durante la educación virtual. Por medio de una encuesta electrónica enviada a todos los sujetos de estudio, se evaluaron las variables depresión y ansiedad mediante las escalas BDI-II y GAD-7 respectivamente. Además, se recopilaron datos sociodemográficos, incluido el APGAR familiar. Se obtuvo una tasa de respuesta del 63.3% (1528 estudiantes). Resultados: la prevalencia de depresión fue de 37.8% y la de ansiedad 30.3%. Los estudiantes de años inferiores fueron los más afectados. Los factores protectores fueron la actividad física y el apoyo psicológico en la religión, mientras que los factores de riesgo fueron tener una familia disfuncional, la ausencia de un espacio exclusivo de estudio y un bajo rendimiento académico. Asimismo, la frecuencia de depresión y ansiedad fue significativamente superior en mujeres. Conclusión: durante la modalidad virtual se observó una alta prevalencia de sintomatología de depresión y ansiedad en estudiantes de medicina.
Assuntos
COVID-19 , Estudantes de Medicina , Feminino , Humanos , Pandemias , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , COVID-19/epidemiologia , SARS-CoV-2 , Controle de Doenças Transmissíveis , Ansiedade/epidemiologia , Ansiedade/etiologia , Estresse Psicológico , UniversidadesRESUMO
In the United States (US), individuals of Puerto Rican heritage die of drug overdoses at higher rates than other Hispanic groups or non-Hispanic Whites; yet, little is known about the extent to which drug overdose mortality affects island-born, versus US-born, Puerto Ricans. The distinction between Puerto Rican-born and US-born provides a starting point for culturally tailored services and interventions, as place of birth often informs language preferences and cultural identifications. Therefore, this study analyzed 2013-2019 death certificate data from the National Center for Health Statistics for 415,111 US deaths attributed to drug overdose. Drug overdose deaths were compared for island-born Puerto Ricans (N=3516), US-born Puerto Ricans (N=4949), and individuals not of Puerto Rican heritage (N=406,646). Drug overdose mortality rates, including age-specific and directly age-standardized rates, were calculated for each subgroup using population estimates from the US Census Bureau's American Community Survey. Results indicated that age-adjusted drug overdose mortality rates over the period of 2013-2019 were significantly higher for island-born than US-born Puerto Rican men (46.8 versus 34.6, per 100,000), with rates in both groups significantly higher than for men not of Puerto Rican heritage (24.0 per 100,000). For women, in contrast, drug overdose mortality rates were lower for island-born than US-born Puerto Ricans (8.6 versus 11.1, per 100,000). Within stateside Puerto Rican communities, island-born men experience a disproportionate burden of drug overdose mortality, necessitating targeted, culturally appropriate interventions built around the specific norms, circumstances, and lived experiences shared by Puerto Rican migrants who use drugs.
Assuntos
Overdose de Drogas , Migrantes , Feminino , Hispânico ou Latino , Humanos , Masculino , Porto Rico , Estados Unidos/epidemiologia , População BrancaRESUMO
Background: University students are usually a risk group in terms of their sexual life, either because of social habits or because of the behavioral predisposers to which they are exposed. This article analyse the relationship between these factors. Objective: To establish the frequency and relationship between behavioral and social predisposers with active sexual life (ASL) in university students. Material and methods: Cross-sectional study, carried out in 360 medical students. The data of sexual life and the behavioral and social factors associated with it were analyzed through prevalences with their confidence intervals, as well as the calculation of the Odds Ratio (OR). Results: The results showed that 58.9% (95%CI: 53.7%-63.9%) of the students have ever had sexual intercourse. The only behavioral predisposing associated with ASL was the absence of religious practices (OR: 2.6; 95%CI: 1.6-4.1; p < 0.001), while all the habits and social behaviors analyzed were significantly associated with ASL, the most common being attendance at parties (77.8%) and the consumption of alcoholic beverages (67.2%). Conclusions: Our results show that young people present a wide range of behavioral and social characteristics that influence their sexual life, therefore, implementing strategies aimed at protecting sexual and reproductive health is also necessary in this age group.
Introducción: los estudiantes universitarios suelen ser un grupo de riesgo en cuanto a su vida sexual, ya sea por los hábitos sociales o por los predisponentes conductuales a los que se encuentran expuestos. Este artículo analiza la relación entre estos factores. Objetivo: establecer la frecuencia y relación entre predisponentes conductuales y sociales con la vida sexual activa (VSA) en estudiantes universitarios. Material y métodos: estudio transversal, realizado en 360 estudiantes de Medicina. Los datos de la vida sexual y los factores conductuales y sociales asociados a ella, se analizaron a través de prevalencias con sus intervalos de confianza, así como con el cálculo del Odds Ratio (OR). Resultados: los resultados mostraron que el 58.9% (IC95%: 53.7%-63.9%) de los estudiantes han tenido alguna vez relaciones sexuales. El único predisponente conductual que se asoció con la VSA fue la ausencia de prácticas religiosas (OR: 2.6; IC95%: 1.6-4.1; p < 0.001), mientras que todos los hábitos y conductas sociales analizados, se asociaron significativamente con la VSA, siendo los más comúnes la asistencia a fiestas (77.8%) y el consumo de bebidas alcohólicas (67.2%). Conclusiones: nuestros resultados muestran que los jóvenes presentan una amplia gama de características conductuales y sociales que influyen en su vida sexual, por lo que, el implementar estrategias orientadas a proteger la salud sexual y reproductiva también es necesario en este grupo etario.
Assuntos
Comportamento Sexual , Universidades , Adolescente , Estudos Transversais , Hábitos , Humanos , Estudantes , Inquéritos e QuestionáriosRESUMO
Introducción: los estudiantes universitarios suelen ser un grupo de riesgo en cuanto a su vida sexual, ya sea por los hábitos sociales o por los predisponentes conductuales a los que se encuentran expuestos. Este artículo analiza la relación entre estos factores. Objetivo: establecer la frecuencia y relación entre predisponentes conductuales y sociales con la vida sexual activa (VSA) en estudiantes universitarios. Material y métodos: estudio transversal, realizado en 360 estudiantes de Medicina. Los datos de la vida sexual y los factores conductuales y sociales asociados a ella, se analizaron a través de prevalencias con sus intervalos de confianza, así como con el cálculo del Odds Ratio (OR). Resultados: los resultados mostraron que el 58.9% (IC95%: 53.7%-63.9%) de los estudiantes han tenido alguna vez relaciones sexuales. El único predisponente conductual que se asoció con la VSA fue la ausencia de prácticas religiosas (OR: 2.6; IC95%: 1.6-4.1; p < 0.001), mientras que todos los hábitos y conductas sociales analizados, se asociaron significativamente con la VSA, siendo los más comúnes la asistencia a fiestas (77.8%) y el consumo de bebidas alcohólicas (67.2%). Conclusiones: nuestros resultados muestran que los jóvenes presentan una amplia gama de características conductuales y sociales que influyen en su vida sexual, por lo que, el implementar estrategias orientadas a proteger la salud sexual y reproductiva también es necesario en este grupo etario.
Background: University students are usually a risk group in terms of their sexual life, either because of social habits or because of the behavioral predisposers to which they are exposed. This article analyse the relationship between these factors. Objective: To establish the frequency and relationship between behavioral and social predisposers with active sexual life (ASL) in university students. Material and methods: Cross-sectional study, carried out in 360 medical students. The data of sexual life and the behavioral and social factors associated with it were analyzed through prevalences with their confidence intervals, as well as the calculation of the Odds Ratio (OR). Results: The results showed that 58.9% (95%CI: 53.7%-63.9%) of the students have ever had sexual intercourse. The only behavioral predisposing associated with ASL was the absence of religious practices (OR: 2.6; 95%CI: 1.6-4.1; p < 0.001), while all the habits and social behaviors analyzed were significantly associated with ASL, the most common being attendance at parties (77.8%) and the consumption of alcoholic beverages (67.2%). Conclusions: Our results show that young people present a wide range of behavioral and social characteristics that influence their sexual life, therefore, implementing strategies aimed at protecting sexual and reproductive health is also necessary in this age group.
Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Comportamento Sexual , Comportamento Social , Estudantes de Medicina , Estudos Transversais , Fatores Sociais , Consumo de Bebidas Alcoólicas , Estratégias de Saúde , Fatores SociológicosRESUMO
BACKGROUND: This study compared drug overdose mortality rates in Puerto Rican-heritage and Non-Hispanic (NH) White individuals in the United States (US), examining time trends and recent variation by age, sex, state of residence, and drugs involved in overdose. METHODS: Death certificate data from the National Center for Health Statistics, as well as American Community Survey population estimates, were used to calculate age-specific and age-adjusted drug overdose mortality rates for Puerto Rican-heritage and NH White residents of the 50 United States or District of Columbia (DC). Rates for 2018 were compared between Puerto Rican-heritage and NH White individuals, overall and by sex, age, state, and specific drug involved in overdose. Joinpoint Regression was used to examine trends in drug overdose mortality rates from 2009 to 2018. RESULTS: From 2009 to 2018, the age-adjusted drug overdose mortality rate in stateside Puerto Ricans doubled among women (from 6.0 to 12.5 per 100,000) and nearly tripled among men (from 15.3 to 45.2 per 100,000). In 2018, the age-adjusted drug overdose mortality rate was significantly higher in Puerto Rican-heritage than NH White individuals (28.7 vs. 26.2 per 100,000, respectively). The 2018 drug overdose mortality rate was highest among Puerto Rican-heritage men ages 45-54 (104.1 per 100,000). CONCLUSION: Findings emphasize the necessity of policies, programs, and interventions to mitigate risk of fatal overdose in stateside Puerto Rican communities.