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Boletín de la Asociación Médica de Puerto Rico

Yaixa Rentas Torres, Joshua L Rodríguez-López, Maria Valentin, Hector Silva
Although primary mediastinal large B-cell lymphoma and classic Hodgkin lymphoma of nodular sclerosis type are distinct disease, they share several clinical characteristics and biologic features. However, there are mediastinal lymphomas that not fit in either category. These types of lymphomas are recognized as mediastinal gray zone lymphomas. Gray zone lymphomas are lymphatic tumors that cannot be assigned to a defined lymphoma entity due to morphological, clinical, or genetic reasons. In this report, we present a case of a 22 year-old-Hispanic-female diagnosed with B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Hodgkin lymphoma...
July 2015: Boletín de la Asociación Médica de Puerto Rico
Edinson Camargo-Arias, Jaime Aponte-Rodriguez, Hector Banchs-Pieretti, Pablo I Altieri-Nieto
Lower extremity peripheral artery disease is a manifestation of systemic atherosclerotic disease, which affects over 8 million Americans and conveys a significant health burden globally. Although PAD can be asymptomatic and subclinical, it is associated with a reduction in functional capacity and quality of life when symptomatic, and, in its most severe form, is a major cause of limb amputation. Peripheral arterial disease (PAD) commonly results from progressive narrowing of arteries in the lower extremities...
July 2015: Boletín de la Asociación Médica de Puerto Rico
Zaskia M Rodriguez Gonzalez, Karla Leavitt, Jose Martin, Erika Benabe, Josefina Romaguera, Ivette Negrón
INTRODUCTION: Based on our population data, the teen pregnancy rate and the prevalence of sexually transmitted infections (STIs) reported during pregnancy are worrisome. STIs appear to pose a threat to pregnancy outcomes including preterm birth (PTB), neonatal low birth weight (NLBW) and premature rupture of membranes (PROM). The objective of this study is to determine the prevalence of STIs in pregnant teens and the association of this variable to adverse pregnancy outcomes. METHODS: We performed a cross sectional study to assess the prevalence of STIs among pregnant teens during a 4-year period at our institution...
July 2015: Boletín de la Asociación Médica de Puerto Rico
Glorilee Delgado Flores, América Robles Cartagena, Ivonne Robles Cartagena, Armando Muñiz, Fernando Cabanillas, Rafael Vicens
A complex conglomerate of symptoms, signs, and abnormalities are present with POEMS syndrome, making the diagnosis, management and follow-up a challenge. Recognizing the disease early on may be difficult. Many patients are initially misdiagnosed as having others disorders, for example: multiple myeloma. There is no standard treatment for patients diagnosed with POEMS syndrome.
July 2015: Boletín de la Asociación Médica de Puerto Rico
Ruben Y Torres, Gerardo E Miranda
OBJECTIVES: Describe the etiology and frequency of traumatic peripheral nerve injuries (TPNI) in the electrodiagnostic laboratory of a tertiary care hospital. METHODS: The charts of patients who underwent an electrodiagnostic study for a TPNI were revised. The main outcome measure was the frequency of each injury by anatomic location, involved nerve, mechanism, and severity. RESULTS: 146 charts were included for a total of 163 injured nerves; 109 (74...
July 2015: Boletín de la Asociación Médica de Puerto Rico
Gil de Lamadrid José Hernández, Héctor Delgado Osorio
Peripheral arterial disease is a frequent under-diagnosed and poorly recognized clinical entity that can affect a great number of patients. Recognition of risk factors is crucial and a through evaluation of symptoms and use of diagnostic tools to better decide when an intervention is warranted. Lower extremity bypass surgery is one alternative method for treatment of PAD. It is indicated for type D and C lesions with low cardiac risk according to the TASC classification system. Preoperative assessment is imperative for every vascular procedure since it has been associated with major postoperative cardiovascular events; myocardial infarction being the most common...
July 2015: Boletín de la Asociación Médica de Puerto Rico
José M Marcial, Pablo I Altieri
A cross-sectional study examined adults aged 21 to 35 years who underwent left cardiac catheterization in the Cardiovascular Center for Puerto Rico and the Caribbean during 2008-2012 due to myocardial infarction. Demographic characteristics, clinical risk factors, and the extent of CAD were documented. Chi-square statistic or Fisher's exact test was used to compare the distribution of demographic, clinical, and lifestyle characteristics across CAD extent. Polytomous logistic regression models were fitted to estimate the prevalence odds ratios (POR) with 95% confidence intervals (Cl) for non-obstructive and obstructive coronary disease (OCD) compared with normal coronary anatomy...
July 2015: Boletín de la Asociación Médica de Puerto Rico
José Hernández-Gil de Lamadrid, Juan J Nieves-Rivera, Laura Mora, Lisa Corretjer, Pablo I Altieri, Albert Suárez, Héctor L Banchs, Jesús Muñiz, Marie Ivelisse Soto, Nelson Escobales, María Crespo
The objective was to describe the metabolic outcomes 12 months after bariatric surgery (Roux-N-Y) in morbidly obese Hispanic patients, and evaluate the correlation between weight loss and the observed changes. Medical records from a hundred-and-two Hispanic obese patients who underwent bariatric surgery were identified at the University of Puerto Rico (UPR) Hospital. The following variables were obtained before and 12 months after surgery: Body Mass Index (BMI), body weight, total cholesterol (TC), triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL), and fasting blood sugar (FBS)...
July 2015: Boletín de la Asociación Médica de Puerto Rico
José Rodriguez-Gomez, Ariadna Aldarondo, Frances Vidot, Ana Quiñones, Maily Rivera, Eledy Cintrón, Natalie Gonzilez, Rodolfo F Trujillo, Nanet M Lopez-Cordova, Natalia Colón
This study explores the psychological wellbeing of twenty-two (n = 22) adults with achondroplasia. The sample was composed of seven (n = 7) males and fifteen (n = 15) females between the ages of 21 and 75 (mean age = 39.6). Each individual completed four self-administered questionnaires: the Beck Depression Inventory (BDI-l), the Beck Anxiety Inventory (BAI), the Beck Hopelessness Scale (BHS), and Derogatis Symptom Check-list-90-Revisited (SCL-90-R). They also filled out a socio-demographic questionnaire. We found that 31...
July 2015: Boletín de la Asociación Médica de Puerto Rico
José M Marcial, Reynerio Pérez, Pedro Vargas, Hilton Franqui-Rivera
Peripheral arterial disease (PAD) is a significant cause of morbidity and mortality worldwide. Lifestyle changes, like the cessation of the use of tobacco as well as a modification of dietary and exercise habits, can be the most cost-effective interventions in patients with PAD. Smocking cessation is the most important intervention, since it increases survival in these patients. Antiplatelet therapy is an essential component in the treatment of peripheral arterial disease (PAD) of the lower extremities. In addition to delaying arterial obstructive progression, these agents are most usefull in reducing adverse cardiovascular events such as non-fatal myocardial infarction (MI), stroke and vascular death...
July 2015: Boletín de la Asociación Médica de Puerto Rico
Marian Couto, Alejandro Figueróa, Antonio Sotolongo, Reynerio Pérez, José Martinez Ojeda
Endovascular therapy has emerged as an essential part of the management we can offer patients suffering from peripheral arterial disease. The AHA/ACCF guidelines deemed ballon angioplasty as a reasonable alternative for patients with limb threatening lower extremity ischemia who are not candidates for an autologus venous graft. Endovascular treatment is most useful for the treatment of critical limb ischemia and should ensure adequate proximal flow before engaging in interventions of distal disease.To increase procedure success rate, a thorough diagnostic evaluation is fundamental...
July 2015: Boletín de la Asociación Médica de Puerto Rico
Hector Banchs Viña, Hector Claudio, Marcel Mesa, Angel López-Candales
Atherosclerosis is a systemic disease that may affect multiple vascular territories including the coronary, cerebral and peripheral circulation. Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis and has an important impact on quality of life as well as morbidity in affected individuals. The diagnosis of PAD can be challenging and the clinician must know the different methods available and the limitations of each of them. In this article we review noninvasive methods used in the diagnosis of PAD in detail as well as the indications for conventional invasive angiography...
July 2015: Boletín de la Asociación Médica de Puerto Rico
Ivonne Robles Cartagena, América Robles Cartagena, Glorilee Delgado Flores, Pedro Monroig Quiles, Fernando Cabanillas, Luis Báez, Luis Acabá, Luis Santos Reyes, Rafael Vicens
Krukenberg tumor is a malignancy in the ovary from a primary lesion in the gastrointestinal tract and a metastatic signet ring cell adenocarcinoma to the ovary. Stomach is the most common primary site, but other organs can serve as a primary site. The lymphatic system is the most likely route for metastasis. CA 125 levels can be used for screening for early detection of ovarian metastasis as well as for monitoring the course of disease. The prognosis of Krukenberg tumor is poor and no curative treatment is currently available...
July 2015: Boletín de la Asociación Médica de Puerto Rico
O Creagh, H Torres, K Rivera, M Morales-Franqui, G Altieri-Acevedo, D Warner
BACKGROUND: Autism Spectrum Disorder (ASD) is characterized by impaired social interaction and communication, and by restricted and repetitive behavior, that begins usually before a child is three years old.1 Researchers have shown that prevalence rates in the U.S. may be as high as 1 in 68.52 A number of studies have examined the effects of early exposure to anesthesia on brain development and subsequent impairment in neurocognitive function; yet, little is known about the possible effects of anesthetic agents on social-behavioral functioning...
July 2015: Boletín de la Asociación Médica de Puerto Rico
Bryan L Pagán Rivera, Francisco Jaume Anselmi, Maria Del Mar Torres, Amaury Segarra, Jose Ramirez Rivera
Foreign body aspiration can be a life-threatening emergency. An aspirated solid or semi-solid object may lodge in the larynx, trachea or other breathing airways. If the object is large enough to cause nearly complete obstruction of the airway, asphyxia may rapidly cause death. We report a 19-year old man admitted with right lower lobe pneumonia who spontaneously expelled a foreign body, one day after admission and glucocorticoids administration. Glucocorticoids should be considered in foreign body aspiration management because improvement of the inflammatory reaction may facilitate expontaneous expulsion or foreign body extraction...
July 2015: Boletín de la Asociación Médica de Puerto Rico
Angel López-Candales, Jaime Aponte Rodríguez, David Harris
Hypertension not only is the most frequently listed cause of death worldwide; but also a well-recognized major risk factor for cardiovascular disease and stroke. Based on the latest published statistics published by the American Heart Association, hypertension is very prevalent and found in one of every 3 US adults. Furthermore, data from NHANES 2007 to 2010 claims that almost 6% of US adults have undiagnosed hypertension. Despite this staggering statistic, previous US guidelines for the prevention, detection, and treatment of hypertension (The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 7 [JNC 7]), released in 2003, stated that; "unfortunately, sufficient numbers of Mexican Americans and other Hispanic Americans...
July 2015: Boletín de la Asociación Médica de Puerto Rico
Franchesca del Pilar Cruz-Pérez, Armando Doval-Cortés, Francisco Jaume-Anselmi, José Ramírez-Rivera
Sjögren's syndrome is a systemic autoimmune disorder characterized by salivary insufficiency and lymphocytic infiltration of the exocrine glands. Bronchiolitis and bronchiectasis are common airway manifestations but interstitial pneumonitis, and lymphocytic interstitial pneumonitis may also occur. It rarely presents with pleuritis. We report a woman with primary Sjögren's syndrome who developed pleuritis with moderately large effusions and antibody levels for SS-A and SS-B in the serum without evidence of infection, malignancy or other collagen diseases...
July 2015: Boletín de la Asociación Médica de Puerto Rico
Luis A Figueroa-Jiménez, Amy Lee González-Márquez, Ricardo Alicea-Guevara, Mónica Santiago-Casiano, Maryknoll de la Paz-López, Luis Negrón-Garcia, Luis Báez-Diaz, William Cáceres-Pérkins
Paroxysmal nocturnal hemoglobinuria (PNH) is a non-malignant, acquired clonal hematopoietic stem cell disease that can present with bone marrow failure, hemolytic anemia, smooth muscle dystonias, and thrombosis. We present a case of a 32 year-old-female, G2P2A0 with no past medical history of any systemic illnesses who refers approximately 2 months of progressively worsening constant heartburn with associated abdominal discomfort. CBC showed leukopenia (WBC 2.9 x 103 /µL) with neutropenia (segmented neutrophils 48%), macrocytic anemia (Hgb 6...
July 2015: Boletín de la Asociación Médica de Puerto Rico
Luis R Hernández-Vázquez, José H Martinez, Carmen Rivera-Anaya, José Laboy, Samayra Miranda, Paola Mancilla, Sharon Vélez
INTRODUCTION: The total number of patients with Human Immunodeficiency Virus (HIV) is 33 million, with 2.7 million new infections in 2007(1). Puerto Rico has an increasing prevalence trend of Diabetes Mellitus of 12.8% in 2010(3). As treatment of HIV continues to develop, and access to therapy improves, the incidence of HIV associated diabetes is bound to grow. We investigate the prevalence of Diabetes Mellitus and its associated risk factors in a determinate HIV positive population. MATERIALS AND METHODS: A retrospective study, reviewing the medical records of 146 HIV positive patients...
July 2015: Boletín de la Asociación Médica de Puerto Rico
Yara Bonet-Pagan, Rafael Gonzalez-Alonso, Pedro Castaing-Lespier
No abstract text is available yet for this article.
April 2015: Boletín de la Asociación Médica de Puerto Rico
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