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Biomedical subjects

J Chiriboga

Publications and source records attributed to J Chiriboga.

At least 19 recordsLinked to original sources

A process model for assessing adolescent risk for suicide.

As the incidence of adolescent suicide within our society continues to rise, it becomes increasingly important for the mental health professional to be able to accurately assess suicide risk in adolescents who seek help. This process model discusses primary risk factors (previous attempt, affective disorders, and hopelessness), secondary risk factors (substance abuse and personality or behavioral disorders), situational risk factors (family functioning, suicide exposure, social support, life stressors, and homosexuality), and their combined implications and significance in determining an adolescent's level or risk for suicide. Use of both empirical data and clinical intuition are integrated to form a working client model that is continuously reassessed in four stages, guiding the mental health professional through a comprehensive assessment process.

Adolescent↗

Dengue in Puerto Rico, 1977: public health response to characterize and control an epidemic of multiple serotypes.

The largest and most extensive documented dengue epidemic in Puerto Rico struck an estimated 355,000 Puerto Rican residents from July-December 1977. The mixed epidemic of dengue types 2 and 3 coincided with a Caribbean pandemic of dengue type 1, first introduced into the western hemisphere in early 1977 and into Puerto Rico in the fall of that year. Health officials assembled a team to assess the epidemic and mounted a campaign to end it. Attempts to monitor the incidence and spread of dengue were confounded by simultaneous co-circulation of influenza virus, underscoring problems in formulating public health strategies dependent on nonspecific clinical and epidemiologic case criteria, and the need for rapid and reliable diagnostic capabilities. Despite co-circulation of multiple dengue serotypes, a risk factor associated with severe and fatal dengue hemorrhagic fever (DHF) in Southeast Asia, hospital and death certificate surveillance disclosed no cases of DHF in Puerto Rico. The epidemic serves as a reminder that when preventive measures are impossible or infeasible, developed countries with high living standards may be susceptible to large scale epidemics of infectious diseases.

Aedes↗

Lack of greater seroconversion of rhesus monkeys after subcutaneous inoculation of dengue type 2 live-virus vaccine combined with infection-enhancing antibodies.

Four groups of six nonimmune male rhesus monkeys were inoculated subcutaneously with formulations of dengue type 2 vaccine virus DEN-2/S-1. Group A received 1.9 x 10(4) plaque-forming units of vaccine in normal human serum albumin diluent. Group B received the same dose combined with a dengue type 2-immune human serum diluted 1:1,600, beyond its neutralization endpoint of 1:300, but having an immune enhancement titer of 250,000. Groups C and D received 10-fold dilutions of these respective formulations. No migration-inhibitory factor was found when peripheral blood mononuclear leukocytes obtained on day 68 post-immunization from monkeys of all experimental groups were tested. No viremia was detected in any of the monkeys when sera taken on postvaccination days 1 through 12 were inoculated into adult Toxorhynchites amboinensis mosquitoes and LLC-MK2 cells. By day 89, four of the six monkeys had seroconverted by the neutralization test in each of groups A, B, and C, and three of five monkeys in group D (one monkey died from cardiac collapse after anesthesia) had seroconverted. Immune enhancement of dengue virus infection is known to occur in humans and monkeys circulating heterologous flavivirus antibodies. In this study, there was no enhancing effect when antibody was mixed with dengue type 2 vaccine virus and injected subcutaneously.

Animals↗

Epidemic dengue fever in Puerto Rico, 1977: a cost analysis.

During the period July-December 1977, a widespread epidemic of dengue fever occurred in Puerto Rico. The cost of the epidemic was calculated, using upper and lower limit incidence figures, in terms of direct costs (medical care and epidemic control measures) and indirect costs (lost production of ill workers and parents of ill children). Direct costs were estimated to range between $2.4 and $4.7 million. Indirect costs were calculated by using current (1977) employment and wage data and population extrapolations from the 1970 census, and entailed a loss to the Puerto Rico economy of from $3.7 to $10.9 million. The total cost of this epidemic, therefore, was estimated to be in a range of $6.0 to $15.6 million, of which epidemic control measures comprised 7.8--20.2%.

Adolescent↗