Anthropometric measures and breast cancer risk among Hispanic women in Puerto Rico.

INTRODUCTION: Increased risk of postmenopausal breast cancer associated with anthropometric measures including Body Mass Index (BMI), adult weight gain, and waist circumference has been observed in North American and European populations, but little evidence is available for Hispanic women. Breast cancer is the leading type of cancer, and leading cause of cancer-related deaths among Hispanic women in Puerto Rico (PR). However, compared with the United States, breast cancer incidence rates are lower but increasing more rapidly. PURPOSE: To examine associations between anthropometric characteristics and breast cancer risk in Hispanic women in PR. METHODS: Data from a population-based case-control study in the San Juan metropolitan region (cases = 315; controls = 348) were used to examine associations between anthropometric measures and breast cancer risk, also considering menopausal status and hormone therapy (HT). RESULTS: Among premenopausal participants, there was a significant trend for lower odds of breast cancer with higher BMI and borderline significant with higher waist to height ratio (WHtR). For postmenopausal participants, a significant trend for lower odds of breast cancer was observed with higher WHtR, and waist to hip ratio (WHR), borderline significant with higher BMI, and higher odds with height. Among postmenopausal participants using HT, a significant trend for lower odds of breast cancer was observed with higher waist circumference, WHtR, WHR, and body shape index. CONCLUSION: Our study provides evidence of anthropometric differences in relation to breast cancer risk in PR compared to previous studies. Future studies should include analyses of fat and lean mass distribution, and hormone receptor status to further understand anthropometry and breast cancer risk among Hispanic women.

Effect of nepafenac on the foveal profile of glaucomatous patients undergoing phacoemulsification.

PURPOSE: Retrospective, pilot study to determine whether nepafenac treatment pre- and postcataract surgery in glaucoma patients using topical hypotensive agents minimized cystoid macular edema by comparing pre- and postsurgical foveal characteristics, as in some cases these agents cannot be withdrawn and, hypothetically, their inflammatory effect on the fovea could be neutralized by the addition of nepafenac. METHODS: Patients were divided into two subgroups depending on whether or not topical nepafenac was added to the surgical protocol (NEP = nepafenac group and nNEP = non nepafenac group). All had undergone phacoemulsification and data on pre- and postoperative macular status were recorded. RESULTS: In the nNEP group, there was a significant increase in foveal thickness (FT) in the first month postoperative visit with respect to the preoperative status (p = 0.006), and this situation did not change at the third postoperative month (p = 0.9411). In the NEP group, the increase in FT was not significant at the first month after surgery (p = 0.056) nor at the final visit (p = 0.268), in contrast to the nNEP group. CONCLUSION: This study of the possible prophylactic effect of nepafenac on postoperative macular edema supports the results of other studies that confirm subclinical edema post phacoemulsification, and found a significantly lower gradient in the increase in FT in patients treated pre- and postoperatively with nepafenac.

Factores relacionados con el uso del mamograma de cernimiento en mujeres de edad mediana en Puerto Rico / Factors related with the use of screening mammogram in middle age women in Puerto Rico

Mammography for low-income women is an important intervention issue as it is still under utilized in these sectors. Despite evidence in favor of breast cancer screening with mammograms, research indicates that mammogram compliance among low-income females and women over 50 years of age has been slow. This article revolves around the factors that affect compliance with screening mammograms among low-income women ages 40 to 64 in Puerto Rico once they receive a referral from a physician. Although the multivariate analysis demonstrated that only age, work outside of the home and performing breast self-exams significantly increased the probability for middle-aged, low-income women in Puerto Rico to comply with referrals and have mammograms, this research illustrated that certain factors such as knowledge about the disease and screening practices, a satisfactory perception of the patient-physician relationship, and the performance of a clinical breast exam by a physician influence mammogram compliance.

[Level of medical information on diabetes, attitude of patients towards their illness and its association with the level of blood sugar control]. / Nivel de información médica sobre diabetes, actitud de los pacientes hacia la enfermedad y su asociación con el nivel de control glucémico.

OBJECTIVE: To determine the level of information and attitude that it has more than enough their illness has patient with diabetes type 2 (DM2), and their association with level of glycemic control. DESIGN: Cross-sectional. SETTING: Two units of family medicine. PATIENT: 200 subject with DM2. INTERVENTIONS: Two instruments were applied validated to measure, level of knowledge and attitude was measured the average of the last 6 glycemia. MEASUREMENTS AND RESULTS: The qualification average of the instrument of knowledge was 58.6 +/- 17.9 (it scale 0-100). For the instrument of attitude it was of 18.9 +/- 2.1 (it scale 0 at 35). The qualification of knowledge of the controlled group was of 55.48 +/- 16.8, and of the uncontrolled group it was of 59.2 +/- 18.1. The qualification has more than enough attitude of the controlled group it was of 17.8 +/- 2.3, and of the uncontrolled group of 19.1 +/- 2, p = 0.001. The proportionate level of information the family doctor was of 42.9%, of the team of health of 10.2% and of other sources of 6.3%. At the analysis of the degree of attitude and the level of information, there was a better attitude when the information was provided by other sources p < 0.05. In the percentage of information and the level of glycemic control, the control level was better when the information was for the team of health p < 0.01. CONCLUSIONS: The level of medical information on diabetes provided by the family doctor and the team of health is low and it doesn't and only this last are associate to better glycemic control. The attitude is better when one receives information of other sources.

[Validity and reliability of FANTASTIC an instrument for measuring the life style in Mexican patients with arterial hypertension]. / Validez y fiabilidad del instrumento "FANTASTIC" para medir el estilo de vida en pacientes mexicanos con hipertensión arterial.

OBJECTIVE: To evaluate the reliability and validity of the instrument "FANTASTIC", when being applied to a sample of Mexican patients with high blood pressure. DESIGN: Observational, prospective, longitudinal, descriptive. SETTING: Unit of Family Medicine No. 91 Instituto Mexicano del Seguro Social. PATIENTS: 103 patients with hypertension on treatment, adults, non diabetics that knew to read and to write. INTERVENTIONS: Was applied "FANTASTIC" instrument (that consists of 25 closed items on the lifestyle), translated to Spanish in versions of 3 and 5 answers, with an interval test-retest of 14 to 21 days. The average of the systolic arterial tension (SAT), diastolic (DAT) and half arterial tension (HAT) was calculated of the last 3 registrations of the clinical file, mass corporal index (MCI), waist/hip ratio (WHR), and fast glucaemia (FG) was measured. MEASUREMENT AND RESULTS: 66% was women. The correlation test-retest, in the version of five answer options was of 0.81 (p = 0.01) and among both versions of 0.91 (p = 0.01). They were not differences in the total qualification according to the sex. To more age, it was bigger qualification and smaller MCI and FG. Weak correlation was observed (not significant) among more total qualification and smaller DAT. There was negative correlation among more qualification in the nutrition domain and smaller MCI (p = 0.01), among more qualification in the domain of tobacco (smaller consumption) with smaller DAT (p = 0.05) and smaller HAT (p = 0.05). CONCLUSIONS: The consistency of the instrument is very good. Their content doesn't correlate specifically with the control indicators in hypertension.