P R Health Sci J
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Genital human papillomavirus (HPV) infection is one of the most commonly diagnosed sexually transmitted infections world-wide. Over the last two decades, research has established a strong causal link between specific types of HPV infection and cancer, particularly cervical, anal, vulvar/vaginal, penile, and oropharyngeal cancer. Limited epidemiological studies of anogenital HPV infection have been conducted in Hispanic populations (including Puerto Rico), and population-based incidence and prevalence estimates of HPV infection among Hispanics are limited. ⋯ This review article summarizes existing research on HPV infection and HPV-related morbidities in men, with a particular emphasis on Hispanic men in the United States and Puerto Rico. Three major areas are discussed: (1) genital warts, (2) HPV and related cancers and (3) biobehavioral and psychosocial factors related to HPV infection and vaccination. Specific recommendations for advancing HPV research and knowledge among Hispanic populations also are suggested.
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The analysis of cancer scientific production in Puerto Rico is largely unexplored. The objective of this study was to characterize trends in cancer-related research publications by authors affiliated to Puerto Rican institutions in recent decades. ⋯ Cancer-scientific production in Puerto Rico underwent constant growth during the last three decades. A complete understanding of citing, publishing, and collaboration patterns in Puerto Rico is critical to researchers, policy makers, and health-care professionals in order to make informed decisions about cancer research priorities.
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Neuropathic pain is initiated or caused by a primary lesion or dysfunction in the central and/or peripheral nervous systems, including infection, trauma, metabolic abnormalities, and nerve compression, and is typically accompanied by hyperalgesia and allodynia. Neuropathic pain can be mild to excruciating, debilitating, difficult to manage, cause depression, decrease the quality of life, require extremity amputations, and has a variety of clinical symptoms. It effects up to 5% of the population, 70% of patients with advanced cancer and inflammatory pathologies, and 95% of patients with spinal cord injuries. ⋯ Alternative treatments to pharmacology include peripheral or neuraxial nerve blockade, and implanted cortical or spinal cord stimulators. However, the great need remains for development of new and more effective approaches to reducing neuropathic pain. This review examines various approaches currently used for treatment of neuropathic pain and potential new and more effective approaches.
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Lumbar discectomy is the most common surgical procedure performed in the United States for patients having back and leg symptoms. The vast majority of the procedures are elective and are performed under general anesthesia. ⋯ The use of Dexmedetomidine was discussed with the patient, explaining the advantage of motor and sensory testing during the surgery and immediate patient feedback. Awake laminotomy and discectomy could be performed as an ambulatory procedure, since the use of Dexmedetomidine as the main anesthetic represents a safe and convenient alternative to general anesthesia in this patient with lumbar disc herniation.
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Randomized Controlled Trial
Timing of ondansetron administration to prevent postoperative nausea and vomiting.
The original guidelines for using ondansetron recommending its administration prior to induction of anesthesia have been questioned. ⋯ This clinical study indicates that when performing prolonged surgical procedures, late administration of ondansetron (within 30 minutes prior to completing the surgery) is significantly more effective in the prevention of late PONV than when administered prior to the induction of anesthesia.