Background: The rate of suicide attempts among people with substance abuse disorders in the U.S. is six times higher than in the general population. The prevalence of suicidal ideations and attempts continues to increase in Puerto Rico, with a signi cant incidence in substance-abusing populations.Methods: This retrospective cohort study evaluate the suicide pro le of 4,347 opioid-dependent participants in ASSMCA's methadone center in San Juan, PR, from 2015 to 2018 using questions related to suicidal ideation and attempts included in the admission questionnaire.Results: Participants reporting suicide ideation increase from 8.5% in 2015 to 17.0% in 2018. In 2015 only 7.0% claimed to have had a history of a suicide attempt, increasing to 12.4% in 2018.Discussion: Our data support the need for screening for suicide risk among substance-abusing populations to identify targeted interventions. The identi cation of high-risk populations for suicide can help during rehabilitation and nding the adequate resources needed.
One of the most common treatments available for cancer patients is surgical removal of the malignant tumor; its long-term implications, however, are still little-known. The purpose of this review is to look at the perioperative effects and determine if there is any correlation between surgery, anesthetics and analgesics, and cancer progression, in the form of cancerous tumor growth and progression and patient survival, within the Puerto Rican population. A retrospective literature review was conducted. Current data suggest that surgery is associated with an increase in cancer proliferation and metastasis, for various reasons such as angiogenesis enhancement and bloodstream migration. Also, it was found that some anesthetics and analgesics have been associated with cancer progression, based on the peri- and postoperative immune status of the patient. Thiopental, ketamine, isoflurane, halothane and some opioids were positively correlated with cancer progression given their role in immunosuppression; while propofol, lidocaine, ropivacaine and bupivacaine were negatively correlated with tumor progression given their immune enhancement. Others, like sevoflurane, nitrous oxide, and etomidate showed inconclusive correspondence. Therefore, it was concluded that immune system boosting anesthetics and analgesics can reduce cancer progression in a patient that has undergone surgical resection. For further research and since the available data are not extensive, other variables such as age, sex, stressors and comorbidities could be considered to better understand the mechanism in which the chemicals hereby studied can cause cancer progression.
Background: The rate of suicide attempts among people with substance abuse disorders in the U.S. is six times higher than in the general population. The prevalence of suicidal ideations and attempts continues to increase in Puerto Rico, with a significant incidence in substance-abusing populations. Methods: This retrospective cohort study evaluate the suicide profile of 4,347 opioid-dependent participants in ASSMCA's methadone center in San Juan, PR, from 2015 to 2018 using questions related to suicidal ideation and attempts included in the admission questionnaire. Results: Participants reporting suicide ideation increase from 8.5% in 2015 to 17.0% in 2018. In 2015 only 7.0% claimed to have had a history of a suicide attempt, increasing to 12.4% in 2018. Discussion: Our data support the need for screening for suicide risk among substance-abusing populations to identify targeted interventions. The identification of high-risk populations for suicide can help during rehabilitation and finding the adequate resources needed.
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