Abstract：
OBJECTIVE:To evaluate the utility of the substituted judgement standard in terminally ill patients by determining agreement between patients, family proxies and physicians. BACKGROUND:Several studies have addressed the utility of substituted judgement, showing conflicting data whether surrogates are accurate predicting patient's wishes. METHODS:Patients with acquired immunodeficiency syndrome, congestive heart failure, chronic liver disease admitted to the San Juan Veterans Affairs Medical Center in Puerto Rico from November 1997 to February 1998 were evaluated. A questionnaire presented three hypothetical situations on withholding and withdrawal of life-support and CPR. The percent agreement was used as a measure of concordance between choices made by physician, surrogate and patients. RESULTS:Twenty patients met inclusion criteria (5 chronic liver disease, 9 heart failure, 6 AIDS). Relatives had a higher percent of agreement as compared to physicians in all vignettes. Even though, none did better than chance in predicting patient's wishes (k < 0.4). There was a tendency for relatives not to provide a wanted life-support measure, and for physicians to provide an unwanted life-support measure. CONCLUSION:The poor agreement between patients and surrogates suggests that substituted judgement is not an accurate tool to make end-of-life decisions. These findings, although similar to previous published studies, are unique because the direction of discrepant responses is opposite to the findings of studies published elsewhere. These results could reflect religious, cultural and socioeconomic differences.
journal_name
P R Health Sci Jjournal_title
Puerto Rico health sciences journalauthors
Príncipe-Rodríguez K,Rodríguez-Cintrón W,Torres-Palacios A,Casal-Hidalgo Jsubject
Has Abstractpub_date
1999-12-01 00:00:00pages
405-9issue
4eissn
0738-0658issn
2373-6011journal_volume
18pub_type
杂志文章abstract：OBJECTIVE:A preliminary investigation to test the efficacy of intravenous propranolol in reducing the cesarean section rate in nulliparas in active labor and evaluate its effect on neonatal and maternal outcomes. METHODS:Fifty seven nulliparous patients admitted in active labor were randomly divided into two groups: a...
journal_title：Puerto Rico health sciences journal
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1999-03-01 00:00:00
abstract：:Four hundred and sixty six non-institutionalized seniors, 65 years of age and over comprise the sample. The questions pertaining to the specific topic are made up of 17 items: 9 related to background information and 8 relating to nutritional practices. It is part of a larger study of the socio-demographic characterist...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：1989-12-01 00:00:00
abstract：OBJECTIVE:A cross-sectional study was conducted (2012-2013) to evaluate the prevalence of 1) malocclusion and 2) occlusal characteristics in 13- to 18-yearold adolescents in San Juan, Puerto Rico (PR) from selected high schools in the municipality of San Juan. METHODS:The study sample consisted of 155 adolescents. The...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2017-06-01 00:00:00
abstract：:The physical parameters of nuclear size and granularity, and the biological parameters of nuclear protein and DNA content were simultaneously measured by the flow cytometric analysis of mitogen-activated Rhesus monkey lymphocytes. These experiments were performed with the purpose of establishing baseline values for mi...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：1991-08-01 00:00:00
abstract：:The objective of this study was to identify the knowledge about sexuality (including STD/HIV/AIDS), the sexual practices more frequents and sexuality education sources in a group of students with visual impairments. A self administered questionnaire was utilized in 50 students with visual impairment. Descriptive stati...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2001-09-01 00:00:00
abstract：OBJECTIVE:Peripartum cardiomyopathy is a rare type of heart failure to which only pregnant women are susceptible. In Puerto Rico there is a paucity of information regarding this condition. In this report we describe our experience with peripartum cardiomyopathy. METHODS:This was a descriptive retrospective study. We c...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2016-12-01 00:00:00
abstract：:Formal training in public health in Puerto Rico began in 1940 when a degree-granting Division of Public Health was established within the existing School of Tropical Medicine. The division was sponsored by five institutions--the Puerto Rico Department of Health, the U.S. Public Health Service, the Children's Bureau, t...
journal_title：Puerto Rico health sciences journal
pub_type： 历史文章,杂志文章
doi：
更新日期：1991-12-01 00:00:00
abstract：OBJECTIVE:This study was conducted to determine the experience of tooth loss, as well as its associated variables, in a sample of adult Mexicans, aged 60 years and older. MATERIALS AND METHODS:This cross-sectional study was part of a larger project to measure diverse oral health indicators in a convenience sample: it ...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2016-06-01 00:00:00
abstract：BACKGROUND:Suicidal behavior among adolescents is not a well-explored public health problem. Health policy decision-making on suicidal behavior needs reliable information on the prevalence of suicidal ideation (SI) and its associated risk factors to produce health promotion and prevention programs. METHODS:The Global ...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2008-12-01 00:00:00
abstract：OBJECTIVE:To describe the respiratory pathogens found in the bronchoalveolar lavage of a Puerto Rican population infected with the human immunodeficiency virus (HIV). BACKGROUND:Empirical treatment is an accepted strategy for management of HIV-related pneumonia, but it is usually recommended for countries that have kn...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2005-09-01 00:00:00
abstract：OBJECTIVE:Describe the pre-, intra-, and postoperative experience of colpocleisis in a group of patients at the University Hospital of the Puerto Rico Medical Center. METHODS:A chart review was done on a subgroup of patients, 70 years or older, on which colpocleisis was performed between January 2001 and December 2007...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2010-12-01 00:00:00
abstract：OBJECTIVE:To compare the effectiveness of intravenous immunoglobulin (IVIG) alone, high dose methylprednisolone (HDMP) alone and the combination of IVIG and HDMP in the treatment of childhood immune thrombocytopenic purpura (ITP). BACKGROUND:Acute ITP in children is a self-limited disease with a benign course and low ...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2000-03-01 00:00:00
abstract：OBJECTIVE:Breast asymmetries have a high prevalence among women requesting breast augmentation. However, the prevalence of breast asymmetries in women undergoing other types of breast surgeries is not known. METHODS:The breast measurements of consecutively women evaluated for plastic surgery of the breast, but without...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2018-12-01 00:00:00
abstract：:Breastfeeding mothers need orientation and help in order to succeed with breastfeeding. Lack of support from health professionals and societal barriers result in a median duration of breastfeeding in Puerto Rico of only 3 weeks. A telephone warm line at our breastfeeding clinic tries to provide some much-needed suppor...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2001-12-01 00:00:00
abstract：:We have studied the spontaneous interaction with small, inedible objects by group-living Saimiri. Twenty-one animals living in a large outdoor enclosure were presented with a set of 10 novel objects of diverse materials, colors, sizes, and shapes. We have used a sampling technique to record the number of monkeys inter...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：1985-12-01 00:00:00
abstract：BACKGROUND:The recent FDA approval of non-prescription sales of Plan B, an emergency contraceptive method to those 18 years old and over, gives a prominent role to pharmacists in providing timely access to emergency contraception (EC). While this decision affects Puerto Rico, no studies on non-prescription EC in Puerto...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2007-09-01 00:00:00
abstract：:Small island exigencies and a legacy of colonial jurisprudence set the stage for this three-year study in 2001-2003 of abortion practice on several islands of the northeast Caribbean: St. Martin, St. Maarten, Anguilla, Antigua and St Kitts. Based on in-depth interviews with 26 physicians, 16 of whom were performing ab...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2008-03-01 00:00:00
abstract：:We tested a dietary supplement formulated with a synergistic combination of vitamins, minerals, herbals in a group of 15 patients with uncontrolled diabetes type II. The supplement was given for 30 days. Fasting blood glucose was measured prior to the supplementation and at the end of the 30 days treatment period. Blo...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2004-06-01 00:00:00
abstract：:Deficient mydriasis of diverse etiology renders extracapsular cataract extraction and posterior chamber intraocular lens implantation technically difficult. Several techniques are available to improve surgical results when this problem is present. We have used multiple sphincterotomies in 6 patients with narrow pupils...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：1993-06-01 00:00:00
abstract：BACKGROUND:Pre- and postoperative evaluation of the pediatric patient with a cerebrovascular malformation can be cumbersome. This may be due to several factors, including age and ability to verbalize. Functional evaluation scales have been devised, yet application to a retrospective study, where information can be limi...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2008-03-01 00:00:00
abstract：:Thymidine kinase is a key enzyme responsible for the activation of several anticancer and antiviral drugs. As the first enzyme in the salvage pathway of thymidine, it is regulated by the feedback inhibition exerted by the end-product of the pathway, namely thymidine 5'-triphosphate. 5'-Aminothymidine is a non-toxic an...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章,评审
doi：
更新日期：1994-03-01 00:00:00
abstract：:This brief celebration of the work of Francisco Guerra (1916-2011) highlights his role as mentor for an international community, his study of local events in the context of global developments, and his contributions to the understanding of the medical history of Puerto Rico. A selective review of Francisco Guerra's me...
journal_title：Puerto Rico health sciences journal
pub_type： 传,历史文章,杂志文章
doi：
更新日期：2012-06-01 00:00:00
abstract：OBJECTIVE:Burnout exerts a significant negative influence on job performance, especially in such difficult jobs as those to be found in the health care industry. This research aimed to evaluate the association between 3 dimensions of burnout and demographic factors among the medical staff working in all of the hospital...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2015-12-01 00:00:00
abstract：OBJECTIVE:This study intends to determine the prevalence of multidrug resistant (MDR) infections by A. baumannii, K. pneumoniae and P. aeruginosa in a tertiary care teaching hospital intensive care unit (ICU) in San Juan, PR, estimate the mortality rate and compare the morbidity and mortality differences among those tr...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2019-03-01 00:00:00
abstract：:Insulin-dependent diabetes mellitus (IDDM) is a chronic health condition that affects 18 of every 100,000 Puerto Rican youth. Few research studies have been performed on the problems that youth with diabetes encounter and how they are related to adherence to treatment and adequate metabolic control. Adequate metabolic...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2006-12-01 00:00:00
abstract：:Exposure to lead in children living on a former landfill in Vega Baja-Puerto Rico, a United States Environmental Protection Agency (USEPA) designated Superfund Site, is a major health concern. Direct contact with lead-contaminated soil is considered a major exposure source. However, there is a lack of information rega...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2003-06-01 00:00:00
abstract：OBJECTIVE:This study aimed to assess the demographic, behavioral, and clinical factors associated with HIV and syphilis infection among a sample of men attending a sexually transmitted infection clinic during 2009 to 2010 in San Juan, Puerto Rico (PR). METHODS:A sample of 350 clinical records from men visiting the cli...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2013-03-01 00:00:00
abstract：:The main professional organizations of obstetrical and pediatric care providers in the United States and Puerto Rico have issued official position papers in favor of breastfeeding. Routine labor and delivery practices, however, constitute frequent barriers for the initiation, type and duration of breastfeeding. Many o...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：2000-12-01 00:00:00
abstract：:Although regeneration in the peripheral nervous system (PNS) after injury is robust, regeneration in the central nervous system (CNS) is abortive. The results from differences in the balance of regeneration inhibiting and promoting factors, which in the CNS is skewed toward inhibition while in the PNS it is skewed tow...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章,评审
doi：
更新日期：2000-09-01 00:00:00
abstract：:Patterns of stress-responsiveness were studied in 19 adolescent male rhesus monkeys (Macaca mulatta) who are part of the free-ranging colony on Cayo Santiago, PR. Morphometric and blood samples were obtained as each male was captured and after holding overnight. Subject heart rate was recorded on Day 2, using surface ...
journal_title：Puerto Rico health sciences journal
pub_type： 杂志文章
doi：
更新日期：1989-04-01 00:00:00
