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RESUMENES
PRIMERA SESION PRESENTACIÓN CARTELES
R-01 EFECTO DEL EJERCICIO EN LA CAPACIDAD FUNCIONAL DEL ADULTO DE EDAD
MAYOR Uso de los Sistemas de Información Geográficos para identificar Fuentes de Contaminación Ambiental Cercanas a Escuelas del Sistema de Educación de Puerto Rico adscritas a los Distritos Ponce I y Ponce II. El propósito de este estudio fue identificar posibles fuentes
de contaminación ambiental cercanas a planteles escolares
utilizando los Sistemas de Información Geográfica
(SIG). Los eventos de olores objetables relacionados con algunas
escuelas dieron base a la presente investigación. Además,
se pretendía conocer si se cumple con la Ley Número
91 del 20 de agosto de 1997, que establece la prohibición
de actividades adversas al desarrollo de la actividad escolar, la
salud y bienestar de los estudiantes dentro de un límite
radial de 200 metros (zona escolar). Se seleccionaron los Distritos
I y II del Municipio de Ponce que comprenden 77 escuelas y una matricula
de 32,124 estudiantes. El análisis espacial de las capas
de información de SIG comprenden estaciones de gasolina,
carreteras estatales, vertederos y zonas industriales. Los resultados
obtenidos fueron los siguientes: 38% (29) de 77 escuelas mostraron
al menos una fuente de contaminación dentro de la zona escolar,
lo cual representa una violación a la Ley Núm. 91.
Entre estas fuentes se identificaron 48% (14) estaciones de gasolina,
55% (16) carreteras estatales y 34% (10) zonas industriales. Esto
representa una población de 13,755 estudiantes, aproximadamente,
expuestos a ruidos y a gases producto de la combustión de
vehículos de motor o de la actividad de zonas industriales.
Las implicaciones de estos hallazgos son los riesgos a la salud
de los niños, particularmente, su sistema respiratorio. La
tecnología digital para este estudio fue provista por la
División de SIG de la Junta de Planificación de Puerto
Rico. La Intervención de Salud Pública de Estudiantes del Programa de Doctorado en Farmacia del Primer Año Profesional en la Península de Cantera, San Juan, Puerto Rico. Título: La Intervención de Salud Pública de
Estudiantes del Programa de Doctorado en Farmacia del Primer Año
Profesional en la Península de Cantera, San Juan, Puerto
Rico. Objetivos: Contribuir al desarrollo de las competencias de los estudiantes del Programa de Doctorado en Farmacia, Cuidado Farmacéutico, Pensamiento Crítico, Solución de Problemas y Toma de Decisiones, Comunicación, Conciencia y Responsabilidad Social e Intervención en Política Pública, mediante su participación en la intervención. Metodología: Resultados:
Partial Ecological Validity for Gazing Preferences toward Artificial Stimuli Found among Free-ranging Rhesus Macaques (Macaca mulatta) Assessing preferences, interests or cognition in both early childhood
and for nonhuman primates, unequipped with language, present a challenge
to scientists. Investigators have largely depended on selective
attention, or more specifically, gazing duration, toward a stimulus
variant as the principle dependent variable to evaluate these parameters.
Until now, the premise that this measure indeed serves as a gauge
to measure underlying preferences of the stimulus, has gone largely
unchallenged. The present study compared data from an experimental
approach and on observational study, both aimed at exploring whether
male and female rhesus macaques (Macaca mulatta) exhibit preferences
for female face and sex skin color. The experimental study evaluated
selective attention toward artificial visual stimuli of animals
of variable color, by measuring predictors that convey underlying
preferences such as gaze duration and frequency, inter-gaze interval
and behavioral responses to stimuli. The second study used data
from free-ranging rhesus macaques on Cayo Santiago, during the mating
season to evaluate relationships between female color and social
behavior exchanged among other females and with males. Observers
for both studies were blind to the results obtained in either study.
We found that sex differences in patterns of gaze duration toward
face and sex skin color sometimes, but did not reliably correspond
to relationships between color and social behavior among free-ranging
primates. Given the partial ecological validity of this measure,
we suggest that gaze duration can sometimes serve as a reliable
measure of underlying attraction, but cannot consistently predict
the behavior an individual will direct toward conspecifics. Segmental Stabilization in Horses. D.C. Dunbar; R.W. Simmons; A. Zarcades. Dept. of Anatomy, UPR Sch. of Medicine, San Juan, PR, and Dept. of Exercise and Nutritional Sciences, San Diego State Univ., San Diego, CA. Kinematic studies of bipedal humans (Pozzo et al., 1990, 1991)
and quadrupedal monkeys (Dunbar, et al., 2004) provide evidence
that the nervous system requires either the head or trunk to be
rotationally stabilized (defined as <20 deg of rotation) in order
to provide a spatial reference frame for monitoring and maintaining
body orientation relative to space. In this study, we address the
question whether segmental stabilization in the horse, a long- and
heavy-necked species, is the same as that observed in short-necked
species, such as humans and monkeys. Kinematic measurements of head,
neck, and trunk displacements in three adult geldings during walks,
trots, and canters (N=8 cycles/gait/horse) revealed that sagittal
(pitch) rotations of all three segments were restricted to less
than 20 deg. Horses were similar to bipedal humans in that both
the head and trunk remained stabilized in all gaits. Horses contrasted
with quadrupedal monkeys, however, in that the trunk was stabilized
during slow gallops (canters). Furthermore, horses contrasted with
humans and monkeys in that head peak frequencies (1-2.5 Hz) always
fell within the range in which inertial properties of the head can
play a major stabilizing role. Regardless of these species differences,
horses nevertheless stabilized the head, neck, and trunk during
locomotion, a finding that is consistent with the hypothesis that
stabilization of a large body segment is required to provide the
brain with a spatial reference frame (Dunbar, et al., 2004; Pozzo
et al., 1990, 1991). Supported by RCMI Award RR-03051 (NIH) and
UPR Medical School. Characterization of protease activity of protein Blo t 1 from the domestic mite Blomia tropicalis Background It is well documented that allergens from Dermatophagoides
pteronyssinus, such Der p 1 (group 1-cysteine protease) and Der
p 3 (serine protease) are responsible for the development of asthma
in sensitized individuals due to its proteolytic functions. Blo
t 1 is a recently isolated and purified allergen from Blomia tropicalis
(Bt), an important triggering factor for asthma and rhinitis in
many tropical and subtropical regions. The lack of documentation
of group 1 allergen from Bt argues against a central role of biochemical
function in allergenicity. Development of Liposome-Mediated Gene Delivery in Rodent Brain The liposomes, which are lipid vesicles derived from a self-forming
enclosed lipid bilayer, have distinct advantages over other existing
gene therapy medium. The objective is to develop a novel liposome-mediated
gene delivery to express the target gene in the mouse brain. Initially,
a report gene expression plasmid, pSV40-Gal, was used to make liposome-DNA
complexes with different liposome formulations. The liposome-DNA
complexes were characterized by particle size, morphology, Zeta
potential were determined using laser diffraction analysis, electrical
scan microscopy and laser Doppler anemometry. In vitro DNase digestion
experiment demonstrated that 60-80% of plasmid DNA could survive
from the Dnase treatment. Secondly, the gene expression level in
the cultured PC-12 cell was evaluated. The cells were transfected
by different liposome:DNA ratios and different incubation times.
X-Gal staining technique was used to determine the beta-gal gene
expression level. The results indicated that the gene was expressed
significantly in the cell culture level. At last, the in vivo gene
delivery efficiency was analysed in the mouse brain. The liposome-DNA
complex was infused into mouse brain through the cannulas implanted
by a surgery either intraocerebroventricully or intrahipprocampally.
The mouse brains were sliced and stained by X-gal at several certain
time points after DNA delivering. The results demonstrated that
our target gene was successfully expressed within the mouse brain
and at the specific hippocampus region, and the peak was at 7 days.
It can be concluded that the effectiveness, selectivity and specificity
of gene expression in the brain were achieved by using liposome-mediated
gene delivery system. Gelcarin and Cellulose Gum as a Carrier for Controlled-Release Theophylline Tablets Controlled release dosage forms are now widely used in pharmaceutical
products. The objective of this research was to design a controlled
release system to deliver drug at a rate necessary to achieve and
maintain a constant blood level by incorporating two polymers, Gelcarin
and Cellulose Gum. In this study Gelcarin, Cellulose Gum and a mixture
of these at different levels were evaluated as a carrier for controlled-release
of theophylline tablets. The direct compression method was used
to prepare tablets each containing 250 mg theophylline, lactose
fast flo, 1 % magnesium stearate, and different levels of polymer
(0, 5, 15, 30 and 37 %). Lactose fast flo not incorporated in the
final formulation of tablets with 37 % polymer. The target weight
and hardness was 404 ± 5 mg and 7-9 Kp, respectively. The
tablets were tested for dissolution in distilled water at 50 rpm
using a dissolution apparatus I. Also tablets were evaluated for
physical properties and all formulations were found to be within
the specifications. The dissolution data showed that tablets containing
37 % Gelcarin without lactose gave 60 % drug release at 6 hours
while tablets of the other formulations gave 100 % drug dissolved
at the same time. This data indicated that tablets of 37 % Gelcarin
without lactose were the best formulation for this research. It
can be concluded that matrices of theophylline using Gelcarin and
Cellulose Gum were successfully prepared by direct compression. Chronic Blockade of RAS in Young Cardiomyopathic Hamsters Prevents
the Development of Heart Failure Heart failure (HF) remains a public health burden for industrialized
countries. A hallmark of this condition is overactivation of the
renin-angiotensin-system (RAS). Studies from our laboratory showed
that in 2-month-old Syrian cardiomyopathic hamsters (SCH) vascular
alterations precede cardiac dysfunction. The present study evaluates
the effect of RAS suppression on cardiovascular function early in
the life of SCH. One-month old SCH were treated for a 5-month period
with enalapril (25mg/kg/d) plus losartan (10mg/kg/d). Echocardiographic
studies, which included stroke volume (SV), left ventricular end-diastolic
volume (LVEDV), ejection fraction (EF), cardiac output index (COI),
heart rate (HR), and left ventricular posterior wall thickness (LVPWT),
were performed in 6-month-old SCH. Systolic blood pressure (SBP)
and plasmatic nitric oxide (NO) were also determined. COI improved
after treatment by 26 % (from 66.0 to 83.33 ml/min/100 g BW, P<0.05).
In addition, enalapril plus losartan increased EF from 40% to 77%
(P<0.05), and plasmatic NO (from 18.1 ?M to 68.3 ?M, P<0.05).
LVEDV was significantly decreased by this treatment (from 0.55 ml
to 0.39 ml, P<0.05). These drugs did not affect SV, SBP, HR and
LVPWT. These results suggest that early suppression of RAS with
losartan and enalapril retards the appearance of heart failure in
the SCH model. Supported by Grant 2 SO6 GM08224 MBRS-SCORE and RISE
Program. Increased NOS Activity and Superoxide Production in the Heart are
Involved in the Onset of Dilated Cardiomyopathy in STZ-diabetic
Rat Myocardial infarction is the major complication in diabetes, however,
the mortality due to cardiomyopathies is almost twice more frequent
than in the rest of the population. The etiology of this complication
has not been fully established. This study correlated cardiac function
with oxidative stress in the heart of diabetic (DB) rats 4 weeks
after the induction of diabetes. Diabetes was induced by streptozotocin
(STZ, 65mg/Kg, IP). Echocardiographic studies included stroke volume
(SV), cardiac output (CO), ejection fraction (EF), and left ventricular
end-diastolic and systolic volumes (LVEDV, LVESV). Systolic blood
pressure (SBP), superoxide production (determined by lucigenin),
and NO synthase (NOS) activity in the heart were also determined.
Our results show that SV, CO, and EF were significantly lower in
DB than in control rats (CT). LVESV was 100% higher in DB than in
CT (0.16±0.03 ml/100 g BW vs. 0.08 ± 0.02 ml/100 g
BW, n=7, P<0.05) and SBP was 48% higher in DB than in CT. Cardiac
NOS activity increased from 161± 18 cpm/mg in CT to 286±20
cpm/mg (n=11, P<0.001) in DB rats. Furthermore, superoxide production
in heart tissue was 4 times greater in DB than in CT (P<0.05).
These findings suggest that in DB rats increased NOS activity and
superoxide production in the heart are involved in the development
of dilated cardiomyopathy. Supported by Grant 2 SO6 GM08224 MBRS-SCORE
and RISE Program. Effect of HIV-1 Primary Isolates on Monocyte Proteome and Neurovirulence
from Hispanic women with Cognitive Impairment Background: Human immunodeficiency virus invades the central nervous
system early after viral infection and eventually induces cognitive
and motor abnormalities referred to as HIV-1 associated dementia.
In the era of HAART, HIV-infected individuals with advanced disease
show a mild form of the disease, termed cognitive impairment. Neuroinvasion
of HIV-1 occurs through the trafficking of infected monocytes and
lymphocytes across the blood-brain barrier and a release of neurotoxins
into the brain. Additionally, there is late emergence of viral variants
that impact disease neuropathogenesis. The hypothesis of this study
is that HIV-1 variants from patients with dementia will influence
macrophage secretory function. Expression and Visualization of Human Insulin Receptor in T-Cells Using Green Fluorescent Protein. Y. GERENA, C. CADILLA, A. SCHWARTZ, and E. FERNANDEZ-REPOLLET. Department of Pharmacology, University of Puerto Rico, School of Medicine, San Juan, Puerto Rico. Special attention has been given to an insulin receptor expressed
on the surface of T cells, which is considered as a universal marker
of activated lymphocytes. Although the presence of the human insulin
receptor (hIR) in T cells has been previously reported, there is
no evidence for its visualization and localization in living cells
using Enhanced Green Fluorescent Protein (EGFP) as a marker for
gene expression. Moreover, the regulation of this fusion protein
expression by its endogenous promoter has not been reported. In
this study, we developed an immortal stable transfected human T
cell line expressing the hIR fused to EGFP under the regulation
of the human insulin receptor promoter (hIRp). This model utilizes
a specific human T cell line (MOLT-4), which is considered an adequate
model for insulin receptor studies. The DNA of the hIR was obtained
by XL-PCR amplification of the entire hIR coding region (4.1kb)
contained in the plasmid pSVHIR. The hIR fragment was ligated upstream
the EGFP coding region of the linearized pEGFP-1 vector (4.1kb).
The DNA of the hIRp was obtained by PCR amplification of the entire
hIRp (1.8kb) contained in the plasmid phINSRP-1. The promoter fragment
was ligated upstream the generated hIR-EGFP construct (8.2kb) and
the resulting final 10kb construct (PIR-EGFP) was purified for transfection
in Molt-4 T cells. Molt-4 T cells (5 x 105 cells) were transfected
using 0.4µg of linear 10kb construct and stable clones were
selected using Geneticin. The intensity and localization of Insulin
Receptor-EGFP expression in Molt-4 T cells was analyzed by laser
scanning confocal microscopy. Confocal studies confirmed that the
human insulin receptor was successfully expressed when attached
to EGFP in stable transfected Molt-4 T cells. The Insulin Receptor-EGFP
protein was visualized in vivo in the membrane and intracellular
vesicles of the Molt-4 T cells. Studies are in progress to evaluate
the effect of glucose and insulin on the expression of the insulin
receptor-EGFP protein. This new insulin receptor-EGFP T cell line
will provide a unique model for studying the role of the insulin
receptor in physiological and pathological conditions. Supported
by NIH Grants No. F31-DK 10188-03 and No. G12-RR-03051 P2Y1, P2Y2 and P2Y12 Receptors Expression in C6 Glial Cell Phenotypes 1Physiology Department, Medical Sciences Campus, UPR; 2Biology
Department, Humacao Campus, UPR;
(Acknowledgements: This work was supported in part by NIH-MBRS-SCORE
grant S06-GM08224 awarded to WIS and NIH-MBRS-RISE GM 61838). Infliximab in Hispanics: Characterization of Response to Infliximab
in an Ethnic Minority with Crohn’s Disease: Jose M. Sanchez,
MD; Juan C. Maldonado; Esther A. Torres, MD; Cynthia Rivera, MPH Methods: Baseline characteristics, infusion related information and clinical response was abstracted from medical records. Clinical response was classified as complete response, partial response, and nonresponse. Results: The study included 15 patients treated for refractory inflammatory disease , 9 for fistulizing disease, and 11 for both. The positive response rate was 83%(29/35) and the non response rate was 17%(6/35 ). Overall the patients with complete, partial, and no response were 13/35(37%), 16/35(46%), and 6/35(17%), respectively. No statistically significant association was found between response and disease location. Significant association was found between response and fistula type (p=0.02). Steroid withdrawal was possible in 21/31 patients (68%). In terms of safety, 9/35 patients (26 %) suffered an adverse reaction, 4 patients required therapy discontinuation. Conclusion: This study suggests that infliximab has similar global
response, allowance of steroid withdrawal and safety in Hispanics
as in other populations. Ethnicity does not seem to influence response
rate to infliximab. DECREASED FUNCTIONALITY OF ALPHA-2 RECEPTORS IN VTA DA CELLS AFTER
COCAINE SENSITIZATION Clonidine Reduces Ih-current in VTA Dopaminergic Neurons. M. Inyushin The ventral tegmental area (VTA) forms part of the circuit that controls voluntary movement, working memory and reward mechanisms that contribute to the development of drug addiction and Parkinson’s disease. A prominent feature of the neurons from this area is that they possess a hyperpolarized-activated cation current (Ih), which controls cell excitability. Alpha-2 adrenoreceptors (A2AR) have been detected in 65% of VTA immunopositive DA cells. However, it is not known whether noradrenergic transmission plays an important role in the modulation of VTA neuronal activity. Therefore, our aim was to investigate if an alpha-2 receptor agonist (i.e. 2-[2,6- dichloranine]-2-imidazoline HCl) ( clonidine) could modulate the Ih current in VTA DA neurons.To study Ih-current in VTA DA cells of rat brain slices we used the patch-clamp method in current-clamp and voltage clamp whole-cell configuration. The recording zone was determined under microscopic control using infrared DIC equipped Olympus BX51W microscope. Only VTA cells with specific characteristics to be classified as dopaminergic neurons were used. The current had a reverse potential calculated as –38.7 ± 3.5 mV, and was completely blocked by Cs2+ and ZD7288 (an specific Ih-blocker). Clonidine administration reduced the spontaneous activity of dopamine cells. It also reduced; dose – dependently (from 10-120 µM), the amplitude of the Ih. In addition, clonidine slowed the activation of the Ih-current, about 2-folds (from 0.08 ± 0.03 to 0.18 ± 0.03 at 40 µM) and similarly the deactivation time constant. Under clonidine, the neurons’ input resistance was increased significantly. The results revealed that clonidine’s effect on Ih-current was at least partially mediated by changes in the channel activation kinetics. At 40 µM the activation curve of Ih-current shifted negatively (from V50 = -88.3 mV to V50 = -100 mV) producing a shift in the Ih-reversal potential (from -45 mV to -38 mV). Further investigations showed that UK14.304 (5-bromo-N-[4,5–dihydro-1H-imidazol
Evaluation of the Interaction between Caveolin-1 and Glial Fibrillary Acidic Protein in C6 Glia. Plasma membrane organelles known as caveolae (CAV) are involved
in signal transduction events and subcellular transport. These roles
of caveolae make it relevant in pathogen, drug entrance to the cell,
and as targets for toxicity. The principal components of caveolae
are the caveolins (cav), of which there are three different isoforms:
cav-1, cav-2, and cav-3. These have been identified in glial cells,
particularly the C6 astroglial cell line. In the evaluation of the
role of Cav/caveolins in glial cells, here we seek to study their
putative interactions with intermediate filaments (IF) proteins.
This evaluation is being done in differentiated C6 astrocytes where
glial fibrillary acidic protein (GFAP) is the major IF protein.
The interaction of caveolin-1 and GFAP was evaluated via laser scanning
confocal microscopy, which revealed discrete patches of cav-1/GFAP
co-localization in plasma membrane CAV. Subcellular fractionation
of CAV-rich microdomains using sodium bicarbonate sucrose gradients
shows co-fractionation of caveolin-1 and GFAP. GFAP and IF sequence
analysis lead us to propose a novel caveolin-binding motif in the
rod 1A region of IF proteins. Studies to confirm these preliminary
finding are being undertaken. IF proteins may interact directly
or indirectly with glial cell CAV, playing a potential role in their
physiological functions, such as signal transduction, transcytosis,
potocytosis, and endocytosis. In addition, the interaction between
CAV and GFAP can be related with pathological disorders, such as
Alexander’s disease. Immune response of human Lymphoblastoid and bronchial epithelial cell lines to organic compounds from fine particles (PM2.5) in Puerto Rico. Enrique Fuentes-Mattei (1,3), I. Rodríguez-Fernández (2,3), A. Gioda (3), W. Delgado-Morales (1), and B.D. Jiménez-Vélez (1,3). (1)University of Puerto Rico-Medical Sciences Campus, School of Medicine, Dept. of Biochemistry, (2) UPR- Ponce Campus, Dept. of Biology, (3)Center for Environmental and Toxicological Research Fine atmospheric particles (PM2.5) were sampled in an urban, industrialized
area (Guaynabo) and in a rural reference site (Fajardo) in Puerto
Rico. Sampling of fine air particles was performed for periods of
72 hrs from Nov/2000 to Sept/2001 using RAAS 2.5-400 Andersen Instrument
air sampler. Composite samples were established by pooling them
for each month and performing soxhlet extraction for further analyses.
Organic extracts (Hex and Acetone) from composite samples collected
during a year (2000-2001) were re-dissolved in DMSO and used to
evaluate the effect of organic extracts from stations described
above on the immune-response (17 different human cytokines) of two
human cell types. After exposure to the various extracts, the release
of these cytokines by human lymphoblastoid (CEMss PBMC) and bronchial
epithelial (BEAS-2B) cell lines were assessed using Bio-Plex Cytokine
Array System (BioRad). Results from these experiments revealed two
interesting findings. Both organic extracts from Guaynabo and Fajardo
exert a significant increase on the release of GM-CSF by human lymphoblastoid
cell line. Relative increase in MCP-1 was also observed for these
extracts, which indicates the need for monocytes recruitment. This
research provides the tools for studying the effects of specific
organic components in air particulate matter and elucidating their
role on the development of respiratory diseases such as Asthma in
Puerto Rico. A Study of a Change in the Myosin Heavy Chain Isotype (ß-MHC
to a-MHC ) on the Structure of the Rabbit Cardiac Thick Filament.
Weisberg and Winegrad (1998) reported a difference in diameter
of isolated rat cardiac thick filaments from hearts with beta-myosin
heavy chain (ß-MHC) as compared to those with the alpha-myosin
heavy chain (a-MHC) and showed a bimodal distribution of the filament
diameters for each heavy chain type. We injected rabbits with thyroxine
(0.2 mg/kilogram weight per day) to produce hyperthyroidism and
a change in the myosin heavy chain isotype from the normal ß-MHC
to the a-MHC as confirmed by SDS gels. Preliminary analysis suggests
that both the thyroxine treated (a-MHC) and control filament preparations
(ß-MHC) contain well ordered thick filaments with little apparent
difference in structure. Using the 43 nm helical repeat of the filaments
as a ruler to determine magnification, we measured both the filament
diameter and the average radius of the center of mass of the myosin
crossbridges. The normal isolated rabbit cardiac thick filaments
(ß-MHC) have a mean diameter of 31.05 ± 1.55 nm (n
=100) compared to 30.13 ± 1.45 nm for the thyroxine-treated
heart filaments (a-MHC). The center of mass of the crossbridges
lies at a mean radius of 12.31 ± 1.33 nm (n = 84 transforms)
for the normal ß-MHC containing filaments and at 12.20 ±
1.28 nm (n= 20 transforms) for the filaments containing the a-MHC.
The distributions for the measurements appear unimodal (not bimodal)
for both the normal filaments with the ß-MHC and those with
the a-MHC; consistent with a single population of filaments in each
case. This suggests the possibility that the changes in filament
diameter reported by Weisberg and Winegrad (1998) may be species
specific. This work was supported by a Minorities Basic Research
Support Grant S06 GM08224 from the National Institutes of Health,
and, in part, by funding from a “Research Centers in Minority
Institutions” Award G12RR-03051, from the National Center
for Research Resources, National Institutes of Health. Changes in neuropeptide Y transcript levels in the intergeniculate leaflet of the 13-lined ground squirrel Neuropeptide Y (NPY) is abundantly present in terminals of the
suprachiasmatic nucleus (SCN), site of the mammalian circadian pacemaker.
NPY terminals in the SCN originate from neurons in the intergeniculate
leaflet (IGL). We have previously reported a daily profile of NPY
immunoreactivity (IR) in the SCN of ground squirrels housed in 12:
12 LD, with significant peaks in NPY levels at the time of lights
on and two hours after lights off, and a significant trough at the
time of lights off. Although our profile of NPY is similar to that
reported in rat SCN it remained unknown whether these changes were
the result of slow peptide turnover in SCN terminals or increases
in peptide synthesis in IGL cells prior to the peaks observed in
the SCN. To address this question, we cloned part of the ground
squirrel NPY gene and then used the polymerase chain reaction assay
to measure NPY mRNA levels in the IGL at specific times prior to
the peaks of NPY-IR that we have observed in SCN terminals. Sequence
data showed that ground squirrel NPY shares a high degree of homology
with NPY of other species. Additionally, there were significant
differences in NPY mRNA levels at the times measured. NPY transcript
levels in the IGL were significantly elevated at zeitgeber time
(ZT) 18 [6 hours (h)] prior to the peak in NPY-IR in the SCN at
ZT0. No significant increases in NPY mRNA were detected prior to
the increase in NPY-IR in the SCN at ZT14. Our results suggest that
NPY levels may be regulated differently during the day and night
or some unknown regulatory events are occurring in the SCN which
cause peptide accumulation at the reported times independent of
peptide synthesis levels. Characterization of p110 sEGFR, a soluble isoform of Epidermal
Growth Factor Receptor. Astrocytosis in Aging Retina: Is Glutamate Toxicity a Cause? E. Kicliter, N. Lugo and M.Cotto. Department of Anatomy and Institute of Neurobiology, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico As rhesus monkeys age outdoors in Puerto Rico they develop a progressive astrocytosis in the ganglion cell and optic nerve fiber layers of the retina. During aging in these animals it appears that the volume occupied by small cells (5-10 μm diameter, presumptive astrocytes) is increased while the volume occupied by larger cells (presumptive neurons) is decreased. In a search for the trigger for this astrocytic reaction we have considered various intraretinal and external factors. Here we consider the possibility that increased levels of extracellular glutamate would lead to increased glutamine synthetase (GS) activity in these astrocytes. We studied a sample of retinal radial sections stained with an antibody to GS. The sample contained sections from monkeys which ranged in age from 1.58 to 28.94 years of age. Eyes were collected post-mortem from animals which died from causes not related to this experiment and were fixed in 10% formalin. While GS activity was observed in the ganglion cell and optic fiber layers, no monotonic relation was observed between either location or amount of the expression versus age. Finally, sections double labeled for GS and glial fibrillary acidic protein, an astrocyte marker, revealed no co-localization. We conclude that GS activity in the ganglion cell and optic fiber layers of these retinas is confined to the end feet of Müller cells and that there is no correlation of amount of GS expression with age. Supported by NIH Grants AG-16057 to EK, MH-48190 to NL and RR-03640 to the Caribbean Primate Research Center R-23 Analysis of cross-reactivity between group 1 allergens from mites House dust mites are an important source of indoor allergens. Mite
allergen exposure can lead to sensitization in genetically predisposed
individuals. The major allergens of mites belong to Dermatophagoides
spp. and in Puerto Rico, as well as many other tropical and subtropical
areas of the world, Blomia tropicalis (Bt). Mite body and feces
extract contain multiples antigens and allergens. In recent years,
various allergens of Bt have been cloned and sequenced. Some of
them shown homology sequence with purified allergens from Dermatophagoides
pteronissynus (Dp). Recently, the allergen group 1 from Bt, Blo
t 1, was cloned and sequenced at our laboratory. The recombinant
protein (rBlo t 1) showed 35% of identity and 50%of similarity with
Der p 1, Der f 1 and Eur m 1 at amino acid level. This would suggest
that cross-reactivity between the allergens of two mite species
could exist. Many asthmatics in tropical and subtropical areas have
a positive skin prick test to both Dermatophagoides spp. and the
mite Bt. Studies carried out with mite extracts showed that the
IgE cross-reactivity between Dp and Bt allergens was generally low
and indicated the unique allergenic specificities of Bt allergens.
In this research we analyzed the cross-reactivity between group
1 allergens from mites using recombinant proteins. ELISA inhibition
assays showed that there is a high level of cross-reactivity between
homologous allergens from Dermatophagoides spp., but the cross-reactivity
between mites from different species was low to moderate. These
results suggest including Bt allergens in the skin prick test for
improve the diagnostic accuracy and precision. Introducing Manual Vacuum Aspiration technique in a teaching hospital Objective: To determine the response of the labor room nursing staff, and that of the OB/GYN residents to the introduction of Manual Vacuum Aspiration (MVA) for medically indicated procedures. Materials and Methods: Survey forms were distributed to 16 labor room nurses and 18 OB/GYN residents 18 months after the introduction of MVA at the University Hospital. The survey included close and open ended questions. Results: The survey was returned by 12 (75%) nurses, 58% who had bachelor's degrees. All judged the procedure to be good for patients with incomplete abortions, and 75% listed elective termination of early gestation as another indication. They cited as benefits less complications, lower blood loss and shorter post-evacuation observation time. From the residents, 14 (78%) returned the questionnaire. All included elective abortion, missed and incomplete abortion, as indications for the use of MVA, and 93%of them projected to use it in their practices. Virtually all wanted to have more training in the use of MVA. Conclusion: There was a positive response from the nursing personnel and the residents to the introduction of MVA at a teaching hospital, particularly the desire of the residents to gain more experience with MVA, and the projection by 93% of them to use this technique in their private offices after completion of Residency. This suggests that the residents will provide services to accommodate patient needs and with a technology that offers minimal complications. Attitude and Misconceptions About Breastfeeding Among Primary Care
Physicians and Residents. Gloria Leavitt MD*, Nerian Ortiz MD, and
Lourdes García* MD. UPR School of Medicine, Department of
Pediatrics, Neonatology Section*, San Juan, Puerto Rico. Pre-pregnancy weight in women who delivered low birth weight infants
Introduction: Obesity is a health concern associated with perinatal
risks. Maternal pre-pregnancy weight has been associated with adverse
pregnancy outcomes. Objective: To describe pre-pregnancy weights
among Puerto Rican women delivering low birth weight (LBW) infants.
Methods: Pre-pregnancy weight and height of mothers of LBW infants
admitted to the University Pediatric Hospital were recorded. Pre-pregnancy
Body Mass Index (BMI) was determined. Women were classified as underweight,
normal, overweight, and obese. Results: 81 women were included.
Mean BMI was 26.8. Distribution by category was underweight 8.6%,
normal 43.2%, overweight 21.0%, and obese 27.2%. Conclusions: Nearly
50% of our group was in the overweight or obese category, with high
BMI values. This suggests a high morbidity in women delivering LBW
infants. Analysis of a larger sample, including babies delivered
at term, will allow us to correlate maternal pre-pregnancy weight
with newborn’s weight and complications. Evidenced Based Management of Neonatal Hemangiolymphangioma: Case Report. Maribel Campos, M. D. FAAP 1, Víctor Ortíz, M. D. FAAP 2, María S. Correa, M. D. 3, Pedro J. Santiago, M. D. FAAP 1, Inés García, M. D. FAAP 1, Lourdes García, M. D. FAAP 1, and Marta Valcárcel, M. D. FAAP 1. 1 Department of Pediatrics, 2 Department of Pediatric Surgery; 3 Department of Pathology, University of Puerto Rico School of Medicine. Hemangiolymphangioma (HL) is a mixed vascular malformation that
can be detected in the prenatal period by sonography. Five cases
of prenatal diagnosis have been reported in the literature. Two
resulted in termination of pregnancy and the others were given aggressive
post-natal management. We present the case of an infant with a left
multicystic intra-abdominal mass diagnosed at 32 weeks gestation
(GA) and born at 34.6 weeks GA. Following radiographic evaluation,
the mass was managed surgically. Histopathologic report revealed
a hemangiolymphangioma. The patient has been managed conservatively.
Follow up studies showed persistence of the mass with lymphatic
and hemangiomatous components. Although treatment with sclerotherapy
and interferon 2 αa has been used in other cases; results
have not been as successful in patients with intra-abdominal HL.
Despite a complicated neonatal course, the patient is currently
thriving. Based on the patient’s current clinical status and
literature reports regarding neonatal hemangiolymphangioma, it has
been decided to continue conservative management. This case confirms
that conservative therapy can be successful and patients can thrive
even in the presence of a large invasive intra-abdominal mass. Prevalence of overweight and obesity in a group of children living
in San Juan. Myrta Otero MD1 and Lourdes García MD2. San
Juan City Hospital, Department of Pediatrics1 and UPR School of
Medicine, Department of Pediatrics, Neonatology Section2, San Juan,
Puerto Rico. PROGENITOR STEM CELL MOBILIZATION (PSCM) EXPERIENCE AT THE UNIVERSITY HOSPITAL, BONE MARROW TRANSPLANT PROGRAM, SAN JUAN PUERTO RICO Changes in the different aspects of PSCM has emerged in the last decade. The mobilization and the collection process involve the use of chemotherapeutic agents growth factors and apheresis as a source of stem cells for the transplant. Purpose Patients and Methods Results Conclusion Fetal Growth Normograms in Very Low Birth Weight Infants of Hispanic
Origin Neonatal services in Puerto Rico have used the Lubchenko Intrauterine
Growth Curves (IUGC) to classify infants even though there are genetic
and environmental differences between the two populations. This
descriptive study wants to establish fetal growth normograms of
birth weight by gestational age for Hispanic infants born in Puerto
Rico and compare its variations with published normograms in the
United States and Spain. Methods: Data of all newborns born after
25-40 weeks of gestation admitted to the Neonatal Intensive Care
Unit of the University Pediatric Hospital in Puerto Rico from January
1999 to December 2004 were analyzed. The Institutional Review Board
and the Institutional Privacy Board approved the study protocol.
Results: 1463 infants were included. Mean birth weight for Puerto
Rican infants was consistently lower than those established by the
Lubchenko IUGC, while mean birth weight for infants born in Spain
proved to be lower than those stated above. Desarrollo, Implantación y Evaluación de un Curso
Basado en Competencias del Currículo Doctoral de la Escuela
de Farmacia para la Práctica en Farmacia de Comunidad Como parte del nuevo programa doctoral se desarrolló, implantó
y evaluó un curso que integra competencias que se desarrollan
en una farmacia de la comunidad. Cada estudiante fue asignado a
una farmacia de comunidad y realizó actividades educativas
dirigidas al desarrollo de las distintas competencias considerando
las necesidades identificadas en la farmacia. Estas estaban dirigidas
a pacientes, personal farmacéuticos o a los procesos administrativos.
Resultados: Se desarrolló e implantó este curso que
integra las competencias profesionales necesarias para ejercer en
una farmacia de la comunidad; los estudiantes indicaron haber desarrollado
las competencias profesionales en un escenario real: Cuidado Farmacéutico
(91.7%), Pensamiento Crítico (91.7%), Solución de
Problemas y Toma de Decisiones (100%), Comunicación (100%),
Ética (91.7%), Conciencia y Responsabilidad Social (91.6%),
Interacción y Relación Social (100%), Administración
(93.3%), Autoaprendizaje y Desarrollo Profesional (100%) e Intervención
en la Política Pública (50%). Educaron sobre diferentes
temas: medicamentos para catarro, diabetes, osteoporosis, menopausia,
anticonceptivos y productos herbarios; los preceptores, establecieron
una relación nutricia y bi-direccional de aprendizaje con
el estudiante. Las experiencias iniciales de desarrollo y de implantación
de este curso fueron beneficiosas para estudiantes, preceptores,
profesores y pacientes y el currículo de la Escuela de Farmacia.
Además contribuyeron al desarrollo humano y al desarrollo
de competencias en los estudiantes. Teaching Breastfeeding to Pediatric Residents: Results of a Pilot
Educational Intervention. Nerian Ortiz MD, and Lourdes García*
MD. UPR School of Medicine, Department of Pediatrics, Neonatology
Section*, San Juan, Puerto Rico. Programa para el Apoderamiento en las Deficiencias en el Desarrollo
en Vieques y Culebra El Programa de Apoderamiento en las Deficiencias en el Desarrollo
en Vieques y Culebra iniciado en el año 2004 es una iniciativa
de acción comunitaria para la población con deficiencias
en el desarrollo en ambos municipios. Este programa se desarrolla
como un proyecto de tres años propuesto por el Instituto
de Deficiencias en el Desarrollo, Centro Universitario para la Excelencia
de la Escuela Graduada de Salud Pública del Recinto de Ciencias
Médicas y subvencionado por el Consejo Estatal Sobre las
Deficiencias en el Desarrollo. La meta del proyecto es el de promover
actividades y servicios que contribuyan a mejorar la calidad en
la prestación de servicios a la población con deficiencias
en el desarrollo (DD) y a sus familias. Entre los objetivos de la
propuesta se perfilan el aumentar los conocimientos y las destrezas
en el campo de las deficiencias en el desarrollo y poder desarrollar
una coalición comunitaria e interagencial que mejore los
servicios que se prestan a dicha población. Como parte de
la labor de capacitación del programa, se ofrecen adiestramientos
y asistencia técnica en temas relacionados a las deficiencias
en el desarrollo, la coordinación de servicios, política
pública y legislación, entre otros, que contribuyan
al conocimiento y al desarrollo de destrezas en el campo de las
deficiencias en el desarrollo en consumidores, familias profesionales,
para profesionales y líderes de la comunidad en los municipios
de Vieques y Culebra. Esta gestión de formación y
de cohesión de recursos en el área de las deficiencias
en el desarrollo constituye una iniciativa fundamental al atender
las necesidades de la población con deficiencias en el desarrollo
y de sus familias que incidan en un cambio social comunitario. Programa para el Apoderamiento en las Deficiencias en el Desarrollo
en Vieques y Culebra El Programa de Apoderamiento en las Deficiencias en el Desarrollo
en Vieques y Culebra iniciado en el año 2004 es una iniciativa
de acción comunitaria para la población con deficiencias
en el desarrollo en ambos municipios. Este programa se desarrolla
como un proyecto de tres años propuesto por el Instituto
de Deficiencias en el Desarrollo, Centro Universitario para la Excelencia
de la Escuela Graduada de Salud Pública del Recinto de Ciencias
Médicas y subvencionado por el Consejo Estatal Sobre las
Deficiencias en el Desarrollo. La meta del proyecto es el de promover
actividades y servicios que contribuyan a mejorar la calidad en
la prestación de servicios a la población con deficiencias
en el desarrollo (DD) y a sus familias. Entre los objetivos de la
propuesta se perfilan el aumentar los conocimientos y las destrezas
en el campo de las deficiencias en el desarrollo y poder desarrollar
una coalición comunitaria e interagencial que mejore los
servicios que se prestan a dicha población. Como parte de
la labor de capacitación del programa, se ofrecen adiestramientos
y asistencia técnica en temas relacionados a las deficiencias
en el desarrollo, la coordinación de servicios, política
pública y legislación, entre otros, que contribuyan
al conocimiento y al desarrollo de destrezas en el campo de las
deficiencias en el desarrollo en consumidores, familias profesionales,
para profesionales y líderes de la comunidad en los municipios
de Vieques y Culebra. Esta gestión de formación y
de cohesión de recursos en el área de las deficiencias
en el desarrollo constituye una iniciativa fundamental al atender
las necesidades de la población con deficiencias en el desarrollo
y de sus familias que incidan en un cambio social comunitario. Medios y Medicamentos: La Voz de los Envejecientes El objetivo general de esta investigación fue determinar
los canales de comunicación que son mayormente utilizados
por las personas de 65 años o más para informarse
sobre las medicinas sin receta (O.T.C) o que no necesitan intervención
del médico para adquirirlas. Tambien se exploraron los canales
de comunicaciín que se consultan en relación a estas
medicinas. La metodología consistió en la administración
de un cuestionario mediante entrevista a 150 personas de 65 años
o más que estaban relacionadas con los estudiantes de primer
año de doctorado en Farmacia en el período de Agosto
de 2001 a Agosto de 2004. El cuestionario consistía de 23
preguntas que midieron 38 variables. Las variables principales midieron
conocimiento general de medicamentos O.T.C de amplia difusión
en categorías como: vitaminas, analgésicos, laxantes,
anti-catarrales y antiácidos. Los resultados que se han obtenido
de forma preliminar mediante el uso del programa S.P.S.S apuntan
a una relación entre el número de horas que dedica
la persona de 65 años o más a exponerse a la televisión
y su conocimiento general de las medicinas O.T.C. El marco teórico
seleccionado para esta investigación establece que el conocimiento
de estas medicinas puede relacionarse con las siguientes variables:
ingreso, edad,sexo, tipo de vivienda, dolencias menores, tamaño
de grupo familiar, canales de información ya sea de comunicación
de masas como de canales interpersonales, tiempo de exposición
a la televisión y preferencias de programación. Desarrollo e Implantación de un Currículo de Comunicación
en Salud en el Programa Doctoral de la Escuela de Farmacia del R.C.M A Novel Evidence-Based Medicine Curriculum for Pediatric Residents Evidence-based medicine (EBM) is an essential component of residency
programs. A survey conducted among our residents demonstrated that
only 22% feel competent reading peer-reviewed hypothesis-driven
articles (PRHDA), and 65% read 1 or less PRHDA/month. Research methodology
is usually considered a dull topic. To stimulate reading of PRHDA
and improve our residents’ skills on critical appraisal of
the literature we developed an EBM curriculum that integrates a
social activity with discussion of PRHDA. The objectives of the
curriculum are: to divulge scientific information, promote reading,
self-directed learning, research, and enhance critical appraisal
and interpersonal communication skills. The first step of the curriculum
consists of 2 workshops (2 hours each) on EBM and literature search
at the computer center of our library. The second step is a 1-hour
lecture on the elements of clinical research. In this session the
residents are provided with a step-by-step guide on how to assess
PRHDA. The third step is a monthly journal club-format discussion.
The activity takes place on evening hours, at a faculty member’s
home. Attendance is compulsory to residents. The faculty is invited.
The attending host is responsible for organizing a 1-hour social
gathering preceding the discussion. All participants receive the
article in advance. The residents on the ambulatory rotation supervised
by a faculty member, present the article. The presentation format
consists of: a brief background on the topic (PGY-1), discussion
on the methodology and results (PGY-2), and critical review of the
article, with emphasis on the strengths and flaws (PGY-3). The supervising
attending selects the article and serves as facilitator during the
presentation. The presenting residents are evaluated using a standard
checklist. A standardized test on EBM skills will be used as an
outcome measure. Residents and faculty have responded positively,
demonstrated by increasing attendance, better participation in daily
didactic activities and improveme Elderly Population in Puerto Rico: Sociodemographic Characteristics among the Poor and Non-poor. Vivianna M. De Jesús Monge. University of Puerto Rico. Very few studies had taken into account the poverty among the Puerto
Rico’s 65 years old and over persons. Due to that the elders
conform a subpopulation with different needs to the rest of the
general population, the poverty affects them not necessarily in
the same magnitude as other age groups. Within the analysis, is
important to know the elders’ sociodemographic characteristics
that live below the poverty level because possibly those are the
same characteristics that place them at risk of living in poor conditions,
like having a lower education and not being in the labor force.
The research main objective is to know the sociodemographic characteristics
of the 65 and over population in Puerto Rico in 2000, below and
above the poverty level, as classified by the US Census Bureau.
The analysis realized was descriptive. It was found that poverty
in 65 and over population increased, as the age increased. Besides,
other results are a greater poverty level amongst the feminine population,
householders or householders’ spouses, married or widowed
elders, ones with lower education, not in the labor force, and who
received Social Security income. The sociodemographic characteristics
are related to diverse life events, such as the retirement from
the labor force. Events like that can increase the risk of the elder
of being poor. These sociodemographic characteristics along with
having 65 or more years old could increase the vulnerability of
this important subpopulation to live in poor conditions that could
affect the elder’s health. The Association of Mercury Exposure from Dental Amalgam and Neurological
Disorders: Parkinson's and Alzheimer's Diseases. G.A. Gata; A. Elías-Boneta;
L. López; C.J. Buxó. Research Center, School of Dentistry,
MSC,UPR. PREVALENCE OF TLR-4 POLYMORPHISMS IN A PUERTO RICAN INFLAMMATORY
BOWEL DISEASE POPULATION. Federico Gregory, MD (Associate), Roberto
Mera, MD (Associate), Carlos E. Jiménez, MD (Associate),
Esther A. Torres, MD, FACP Huiying Yang, MD, PhD, Yoana Picornell,
Debra Dutridge Introduction: Toll-like receptors (TLR) in humans mediate cytokine
production for effective innate immunity, particularly in response
to bacterial endotoxins. Different polymorphisms identified in TLR
type 4 (TLR-4) have been previously studied in different medical
conditions. Inflammatory intestinal response in Inflammatory Bowel
Disease (IBD) may result from exaggerated host responses to intestinal
flora. Particular interest has evolved over the role of such TLR-4
polymorphisms in IBD patients. Conflicting results have been reported
regarding the role of TLR-4 polymorphisms in IBD. Prevalence of
IBD is rising in Puerto Rico, a genetically admixed population.
The prevalence and association of TLR-4 has not been reported in
Hispanic IBD populations Use of cellular phone while driving vehicles in metropolitan area of San Juan, Puerto Rico, 2004 J Rullán, L Chiroque, O Cruz, G Davila, A Soto, W Torres, M Márquez Background: The US National Highway Traffic Safety Administration considers cellular phone use while driving to be a distracter and a potential factor in traffic collisions. Puerto Rico has attempted to pass restrictive legislation on the use of cellular phone while driving. The main objective of this study was to estimate the prevalence rate of cellular phone use while driving motor vehicles in the metropolitan area of San Juan, Puerto Rico. Methods: This was an observational study to determine the prevalence of cellular phone use while driving motor vehicles. The study was conducted at seven intersections, during rush hours, 7:00-9:00am and 4:00-6:00pm, observing one intersection per day from May 4-8, 2004. Intersections were selected based on Puerto Rico Department of Transportation Reports. Only vehicles traveling in the two lanes closest to the curb were included. Two observers were assigned to each intersection; one counted the number of vehicles and the other was responsible for counting the number of drivers using the cellular phone. Epi-Info 6 was used for statistical analysis. Results: Data indicate that out of 26,036 drivers observed a total of 2,009 (7.72%; 95% CI, 7.39-8.04) were using a cellular phone at the time of observation. Rate of use during the afternoon was significantly higher than in the morning (9.09 vs. 6.16; p value < 0.01). There was no significant difference between the use of cellular phone during the weekday compared with the weekend (12.06 vs. 11.12; p value < 0.4). Conclusions: Findings suggest that the rate of cellular phone use
among drivers in the metropolitan area of San Juan, Puerto Rico
(7.72%) is much higher than those reported by cities such as Melbourne,
Australia (1.85%) and Lleida, Spain (3.3%). These findings underscore
the need for restrictive legislation to decrease the use of cellular
phone while driving. “Fatal Drowning in Water Settings-Puerto Rico, 2001-2003” Background: Drowning is a major cause of deaths worldwide with 449,000 fatalities reported in 2000. In Puerto Rico (PR), approximately 50 drowning victims occur every year in recreational water settings, with an annual mortality rate of 1.4/100,000 population, versus 1.18 /100,000 in the United States (USA). Adult males have a higher risk of drowning compared to females; other factors associated with drowning include alcohol consumption, swimming alone, and not wearing personal floatation devices. Method: This study attempts to define a profile of fatal drowning which occurred in PR during 2001-2003. All accidental deaths due to drowning must be investigated and processed by the Medical Examiner’s Office (ME). A total of 182 autopsy records from the ME were reviewed. These cases represent all deaths due to respiratory failure as a result of immersion in liquid for 2001-2003. Descriptive statistics were used to formulate an epidemiologic profile using Epi Info 6. Results: Of the 182 cases reviewed the median age was 37.0 years (range 1-88 years); 88% were males; 43% had alcohol in blood and of this group 55% had alcohol levels of 0.08% or higher. Most deaths (59%) occurred at sea settings, followed by rivers (20%), and residential pools (9%). Non-residents accounted for 10% of fatalities. Data indicate that, for the three years of study, deaths occurred most often during the months of June and July; 5.5% of the deaths were suicides and 14% of cases showed presence of illicit drugs, e.g., cocaine, opiates. After controlling for suicides and deaths occurring in non- recreational water settings, the drowning rate was 4.0/100,000 population for 2001-2003 Conclusions: This is the first national epidemiologic profile of drowning deaths in PR. Findings suggest the urgent need to strengthen drowning prevention education including information on avoidance of alcohol consumption while in water environments. PR is a tropical island, thus the risk of drowning is present throughout the year. Keywords: fatal drowning, water-related injuries, injury prevention,
drowning risk factors, Puerto Rico Prevalence of suicidal behaviour among public school adolescent
students, 2002-04. Suicide is a leading cause of death among adolescents in many countries.
Suicidal behavior includes suicidal ideation (thinking about it),
attempted suicide, and completed suicide. The magnitude of this
public health problem is difficult to establish due to the lack
of statistics and research, particularly among Puerto Ricans. The
death statistics are only a fraction of the bigger problem, since
it is difficult to measure attempted suicides and suicidal ideation.
This presentation is a secondary analysis of the "Consulta
Juvenil VI" survey, an island-wide bi-annual cross-sectional
survey. The sample (n=55,227) was selected using a multi-stage stratified
cluster sampling design, and is representative of all students 7th-12th
grade in public schools in Puerto Rico. The objective of this study
is to determine the prevalence of suicide ideation and suicide attempt
among students. Approximately 15.7% of the students reported suicide
ideation, and 12.8% reported at least one suicide attempt. Prevalences
were higher in eastern, south eastern, and northern (metro area)
municipalities. Suicidal risk was significantly higher among high
school students (compared to middle school) and among females. Prevalence
of ideation was almost twice as high among high school students
(20.0% vs 12.1%), and among females (21.3% vs. 9.5%). Prevalence
of attempts was higher among high school students (15.6% vs. 10.6%),
and over twice as high among females (17.4% vs. 7.6%). Also, a high
proportion of the students who reported suicide ideation (75.5%)
also reported suicide attempts. Effective strategies for the prevention
of suicidal behavior among adolescents should target these high
risk groups in the geographic areas identified. Supported by the
Mental Health Services and Drug Addiction Administration (ASSMCA)
and the Puerto Rico Office of Drug Control. Assessment of Skeletal Changes Following Maxillary Expansion: A Meta-analysis Maxillary expansion has been used as a means to correcting transverse
discrepancies of the maxillary arch via orthopedic, orthodontic
or surgically assisted techniques. Literature studies have suggested
that maxillary expansion therapy produces skeletal and soft tissue
changes. The purpose of this study was to develop a meta-analysis
for investigating the skeletal effects caused by maxillary expansion
techniques with hyrax-type appliances. A survey of scientific literature
through the MEDLINE search using the subject headings "maxillary
expansion" and "skeletal changes" was performed.
Abstracts and summaries were reviewed to select the most relevant
papers. To minimize any any chances of omitting relevant literature,
screening procedures were performed twice. rom the total number
of papers, the ones that were most relevant were chosen according
to the inclusion and exclusion criteria. The parameters that comply
with the inclusion criteria were nasal and maxillary width. Homogeneity
test and publication bias were analyzed for the population of studies.
Classification of quality of studies was done. Regression and Correlation
tests were performed at the probability level of p=0.05. The results
showed a total amount of 23 papers that were reviewed. Twelve studies
were classified as high quality. The eleven low quality studies
were not included in the meta-analysis. Heterogeneity of the samples
studies was proved (p=0.02). Publication bias was assessed by the
funnel technique. Nasal and maxillary width were reported consistently
for six extra high quality studies giving a positive correlation
for reported skeletal changes and sample size of the study. Comparison
of summary estimates for the different types of studies did not
show statistically significant differences. Longitudinal and cohort
studies provided the strongest scientific evidence for effectiveness
of maxillary expansion therapy with hyrax appliances. In conclusion,
research studies on maxillary expansion therapy should standardize
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