Diagnóstico de necesidades de salud de la población de adultos viejos de un sector de la comunidad de Puerto Rico / Diagnosis of health needs of the elderly population of a community of Puerto Nuevo

The purpose of this study was to identify the health needs of the non-institutionalized population, 65 years and over, residing in a sector of the community of Puerto Nuevo. This was the first urbanization established in Puerto Rico in the early 50's. The ®snowball® technique was use to identify all the residents 65 year and over of the mentioned sector. Eighty five elderly persons were interviewed to gather data of the following variables: demographics, health conditions, preventive measures, activities of daily living (ADLs, IADLs), health services utilization, psychosocial aspects and use of programs and services available for the elderly population. Statistical analysis included descriptive measures and chi-square. Results revealed a population with a higher education and economic level than the average for this age group in Puerto Rico. People over 75 years over reported more functional limitations than the 65-74 years interviewees did. In comparison with men, women were less educated and presented a higher percent of widows, persons living alone and functional limitations. In almost all the interviewees, help was available in case of need. The majority expressed satisfaction with their family and social lives. Very few utilized programs and services available for elderly persons. It is concluded that in order to improve their quality of life, this population needs to be managed in an holistic mode to address their biopsychosocial needs and to be educated in health promotion issues to prevent further functional limitations. They also need education about the available services for elderly persons.

Descripción del estado de salud y la capacidad funcional de la población de 65 años o más residente en la Región Universitaria de Salud de Puerto Rico / Description of health status and functional capacity of the 65-years-old and older population residing in the University Region of Health of Puerto Rico

This study intended to describe the health and functional status of the population 65 years and over resident in the Puerto Rico University Health Region (municipalities of Canóvanas, Loiza, Carolina and Trujillo Alto, Puerto Rico). Four ninety one hundred elderly subjects selected from a random sample of households, were interviewed. A questionnaire was designed to gather data of the following variables: health conditions, functional capacity, health services utilization, social support and preventive measures. Descriptive measures and chi-square were utilized for the statistical analysis. Findings revealed a population composed mostly of women with a higher prevalence of health conditions than their male counterparts. More than half of the sample report visual problems, arthritis or hypertension. Almost a quarter had diabetes mellitus. The prevalence of these conditions was higher in the age group over 75, with the exception of diabetes. Thirty percent of the sample was classified as functionally dependent, condition that increased with the subject's age. Findings evidence the need of an early assessment in this population in order to intervene with potentially modifiable factors to prevent future disability and improve quality of life of the aged.

Condiciones de salud y limitaciones funcionales en la poplación de edad avanzada de la Región Universitaria de la Salud de Puerto Rico: aspectos metodológicos y estimación de prevalencias / Health status and functional limitations in the elderly population of the University Region of Health of Puerto Rico: methodologic aspects and prevalence estimates

In order to plan the health services for the elderly population, it is necessary to quantify their health status and their functional capacity. In Puerto Rico, few epidemiological studies have been conducted regarding functional capacity and chronic diseases in the elderly population. One of the difficulties to undertake these studies is the high cost and risks to move this population for clinical exams, in addition to the methodology limitation of self-report in the elderly population. This study shows the use of logistic regression to estimate the prevalence of chronic diseases and functional capacity, when the observed data are not consisted with the planed sampling scheme. Four hundred and eighty-seven elderly persons (65 yr. and over) were interviewed in the municipalities of Canóvanas, Carolina, Loíza and Trujillo Alto in Puerto Rico, using a cross-sectional design. More than half of the elderly had visual problems (IC 95 percent: 54.8 percent, 63.8 percent), arthritis (IC 95 percent: 52.7 percent, 61.5 percent) and hypertension (IC 95 percent: 47.3 percent, 56.3 percent). In the case of hypertension, significant differences (p < 0.05) by sex were observed, where women reported a higher prevalence than men. One of the higher prevalence in the functional capacity status was with urine accidents. More than one-third of the population is estimated to have this problem (IC 95 percent: 34.7 percent, 43.4 percent). One-fourth of the population had limitations with going out for shopping (IC 95 percent: 23.9 percent, 31.9 percent) and using public and private transportation (IC 95 percent: 19.5 percent, 26.9 percent). We conclude that the applied methodology was consistent with the estimation presented in the literature and statistics from the Puerto Rico Health Department. However, it is necessary to continue assessing the design and analytical methodology, in order to undertake consistent and periodic evaluations of the elderly population.

Endocarditis bacteriana / Bacterial endocarditis

Se presenta un caso de endocarditis bacteriana subaguda de valvula aortica, complicada con insuficiencia cardiaca congestiva, en una paciente de 50 anos de edad, con antecedente de fiebre reumatica diagnosticada a los 18 anos y sin tratamiento. El agente causal de su enfermedad fue el estreptococo viridans comprobado por hemocultivos seriados. Fallecio a las 24 horas de su ingreso