Puerto Rico Health Sciences Journal最新文献

{"title":"A Rare Case of Congenital Adrenal Hyperplasia with Giant Adrenal Myelolipoma.","authors":"Texell Longoria-Dubocq,&nbsp;Roberto Torres-Aguiar,&nbsp;Karla Ruiz-Vega,&nbsp;Rafael De Ayala-Hillmann,&nbsp;Reynold Lopez-Enriquez","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Adrenal incidentalomas are tumors located in the adrenal glands and found on imaging done for purposes not related to adrenal disease. In other cases adrenal mases can be radiologically found when an adrenal hormone secreting tumor is suspected, such as a pheochromocytoma or Cushing's diseases. Adrenal incidentalomas may be classified as functional or non-functional based on whether they produce hormones, such as aldosterone, cortisol, and androgens, or catecholamines. Studies indicate that around 8% of adrenal incidentalomas are adrenal gland myelolipomas (AGMs). AGMs are non-malignant masses that can cause the compression of vital organs and vessels if said masses become large enough. In patients with congenital adrenal hyperplasia (CAH), adrenocorticotropic hormone (ACTH) levels tend to be elevated due to the lack of adrenal-hormone production. Patients with CAHs are treated with steroids that suppress ACTH levels and prevent adrenal gland hyperplasia. Around 10% of AGMs are found in untreated CAHs. Our patient was a 36-year-old male who was on steroids due to CAH and intermittent abdominal pain; a CT scan revealed a large left adrenal mass that was displacing organs towards the right. Pathological analysis revealed an AGM exceeding 30 x 23.6 x 16.7 cm. This AGM is one of the largest ever to be reported in the literature.</p>","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":"39 2","pages":"226-228"},"PeriodicalIF":0.5,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38158605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benign Multicystic Peritoneal Mesothelioma in a Male Teen: Case Report and Review of the Literature.","authors":"Jorge Luna-Abanto,&nbsp;Grivette Mendoza-Tisoc,&nbsp;Lourdes Huanca-Amesquita,&nbsp;Francisco Berrospi-Espinoza","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The case of a Peruvian 15-year-old male with a left-flank abdominal mass suspected to be a peritoneal pseudomyxoma is presented. The patient underwent a R0 surgery, and the pathology review showed a benign multicystic peritoneal mesothelioma. Characterized by recurrent mesothelial peritoneal cysts originating in the epithelial and mesenchymal elements of mesothelial tissue, this benign tumor is unusual among young males.</p>","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":"39 2","pages":"222-225"},"PeriodicalIF":0.5,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38158604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of the Slipping Slipper Sign to Explore the Connection between the Feet and the Mouth in Patients with Diabetes Mellitus.","authors":"Ramaa Lalita Balkaran,&nbsp;Siara Shivana Teelucksingh,&nbsp;Rahul Siram Naidu,&nbsp;Khama Emily Lutchmansingh,&nbsp;Lerissa Aimee Morris,&nbsp;Vrijesh Tripathi,&nbsp;Surujpal Teelucksingh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Both periodontal disease and peripheral neuropathy are complications associated with poorly controlled diabetes. This study aimed to determine whether periodontal disease was more prevalent and more severe among patients with severe diabetic peripheral neuropathy.</p><p><strong>Methods: </strong>A case-control study was performed; 46 patients with and 48 without the slipping slipper sign (SSS)-a surrogate clinical marker for severe peripheral neuropathy-were recruited from a diabetic outpatient clinic. Demography and data from the Basic Periodontal Examination (BPE) were assessed, in addition to the patients' periodontal health by 2 examiners blinded to patients' SSS status. Multivariate logistic regression was used to evaluate the associations between the risk factors for and the presence of the SSS, adjusting for age, gender, and ethnicity.</p><p><strong>Results: </strong>The mean age of the sample was 55.8 years (±10.69 years). Most of the participants (77.7%) had either never been to a dentist or had last attended a dental clinic more than a year before this examination, and 83% did not have a dentist. Periodontal disease was advanced in 61.7%, and there was no association between the SSS and periodontal disease. Dental-service utilization variables were significantly associated with the SSS. Patients who did not have a regular dentist were more than 7 times more likely to have the SSS than were those who did (OR = 7.70; 95% CI: 1.12 53.21).</p><p><strong>Conclusion: </strong>In diabetic patients, oral health-related risk factors, such as not having a dentist, wearing a denture or dentures, and visiting a dentist once a year or more, may be associated with systemic complications, including peripheral neuropathy. Early collaboration between dentists and doctors on the care of patients with diabetes is recommended.</p>","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":"39 2","pages":"216-221"},"PeriodicalIF":0.5,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38158603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scientific Representations at the UPR School of Tropical Medicine. IV: Special Technical Studies.","authors":"Raúl Mayo-Santana","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The essay examines the scientific representations that unfolded and evolved at the University of Puerto Rico School of Tropical Medicine (STM) under the auspices of Columbia University (1926-1949). This article on the STM's scientific endeavors is the fourth in a historical serial collection about the images and evolution of sciences at the institution and it portrays the diagrammatic representations of special technical research aspects and studies (i.e., personnel, epidemiology, methodology, animal studies, biology, field studies, treatment and immunology, and chemotherapy agents). The essay focuses on the emerged scientific representations and on the nature and evolution of sciences at the School, and has been divided into four sections: a) images of science, b) evolution during the first two eras, c) the third and last era unfolding, and d) special technical studies. In this paper the scientific representations have been brought about mainly through the analyses of research publications in external and local venues. The analysis of the STM's scientific evolution has been organized in three distinct historical stages: 1926-31, 1932-40, and 1941-49. These representations open an exploration pathway for a better understanding of the intricate interrelationships between the techné and the episteme horizons of tropical medical science in Puerto Rico.</p>","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":"39 2","pages":"178-183"},"PeriodicalIF":0.5,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38158214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic Aneurysm as a Cause of Dysphonia in a Patient Who Smokes.","authors":"Miguel Bayones,&nbsp;Jose Ruiz-Rodríguez,&nbsp;Carlos Sierra","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Vocal cord paralysis secondary to a cardiovascular disease is known as Cardiovocal or Ortner's syndrome. The most common cause of Ortner's syndrome is atrial dilation due to mitral valvulopathy. Other causes include aneurysms of the thoracic aorta, patent ductus arteriosus, aneurysm of the ductus arteriosus, defects of the interatrial or interventricular septum, among others. Hoarseness might be the only symptom that leads a given individual to consult with a physician. Here we present the case of a 77-year-old male patient with history of diabetes mellitus type 1 and hypertension, whose illness started about a year ago when he presented progressive dysphonia associated with dry cough after food intake without another concomitant symptom. CT studies reported the presence of an aortic aneurism compressing the left recurrent nerve. Patient refused surgical treatment. As of this writing, he remains symptomatic.</p>","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":"39 2","pages":"229-231"},"PeriodicalIF":0.5,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38158606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Hurricane Maria on the Surgical Workload of the UPR-affiliated Hospitals.","authors":"Norma I Cruz,&nbsp;Elvis Santiago,&nbsp;Karla Rodríguez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The Caribbean islands are regularly affected by hurricanes in a seasonal manner, but major (category 4 and 5) hurricanes are infrequent, and what happens in their aftermath is important for future planning.</p><p><strong>Methods: </strong>We reviewed the surgical cases entered into the University of Puerto Rico (UPR) General Surgery Department database from January 1, 2016, through December 31, 2017. This database collects patient and procedural information from the surgical services of the UPR-affiliated hospitals. To analyze the impact that Hurricane Maria had on the surgical population, we compared cases per month using September 2017 (the month that Maria struck Puerto Rico) as the reference month. A chi-square goodness-of-fit test was used to evaluate differences between months.</p><p><strong>Results: </strong>Information was available for 9,059 cases during the study period. The mean age of the group was 49±14 years, the gender distribution being 56% women, 44% men. The study found a statistically significant difference (p<0.001) in the number of surgical cases per month, with fewer patients in September 2017 (n = 210) compared to other months, representing a 57% decline in the number of cases. These patients tended to be sicker, with an increase in the number who had an American Society of Anesthesiologists physical status classification of 3 or greater. Within 3 months after the natural disaster, the volume of patients started to return to normal.</p><p><strong>Conclusion: </strong>We found that this major hurricane resulted in a decreased surgical workload, mostly because elective surgery cases were fewer, but that the patients that came for surgical care tended to be sicker and had, for the most part, poorly controlled systemic diseases. The volume of surgical cases did not reach normal levels until 3 months after the natural disaster.</p>","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":"39 2","pages":"195-199"},"PeriodicalIF":0.5,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38158219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Dental Caries in 12-Year-Olds in San Pedro de Macorís, DR.","authors":"Jomar Diaz-Nicolas,&nbsp;Maria Guadalupe Silva-Vetri,&nbsp;Sona Rivas-Tumanyan,&nbsp;Milagros J Toro,&nbsp;Augusto R Elías-Boneta","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Dental caries is one of the most prevalent chronic diseases in children. Currently, no data are available on dental caries prevalence in the Dominican Republic. The purpose of this study was to estimate the prevalence of dental caries in schoolattending 12-year-olds in San Pedro de Macorís, Dominican Republic.</p><p><strong>Methods: </strong>A cross-sectional epidemiological study using a probabilistic sample, stratified by type of school (public/private) and gender, was conducted. Two calibrated examiners conducted the evaluations of oral soft/hard tissues. Caries experience was summarized in terms of prevalence; the number of decayed, missing, and filled teeth (DMFT) and surfaces (DMFS); and the significant caries (SiC) index, in all the participants, and by gender and school type. Logistic and Poisson regression models were used to compare caries experience by sex and school type.</p><p><strong>Results: </strong>Four hundred and two 12-year-olds enrolled in 14 public and 11 private schools were evaluated. The overall dental caries prevalence was 73%. The mean DMFS was 3.87, the mean DMFT was 2.64, and the SiC index was 5.07. Girls had significantly higher mean DMFS, DMFT, and SiC indices than did boys. Public school attendees had significantly higher DMFS, DMFT, and SiC indices than did those children attending private schools. The decayed (D) component accounted for 71% of the DMFT value.</p><p><strong>Conclusion: </strong>The WHO's goal of all 12-year-olds having a DMFT less than or equal to 3 was met by all the participants in our study. Girls and public-school attendees carry the burden of the disease. The high D component of the index suggests that there are unmet dental-caries needs. This information will assist in the design and implementation of future primary and secondary prevention programs.</p>","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":"39 2","pages":"210-215"},"PeriodicalIF":0.5,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38158602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative Cultures for Cerebrospinal Fluid Samples taken from the Myelomeningocele Sac on the Day of Repair.","authors":"Miguel Mayol,&nbsp;Eva F Pamias,&nbsp;Joel Pellot,&nbsp;Juan Vigo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Our goal was to evaluate the intraoperative laboratory analysis of cerebrospinal fluid (CSF) aspirated from the myelomeningocele (MMC) sac prior to the repair to determine if there was bacterial growth in the culture.</p><p><strong>Methods: </strong>This was a retrospective analysis of the CSF cultures of 45 MMC patients operated on during the years of 2002 to 2013 at the University Pediatric Hospital. Before repairing the defect, the sac area was cleaned and three milliliters of CSF were drawn and sent for analysis for red blood cells, white blood cells, glucose level, protein level, chloride level, gram stain and culture. The CSF sample results were analyzed for irregularities in the values before proceeding with placement of a ventricular shunt.</p><p><strong>Results: </strong>All the CSF samples that were studied had at least 1 abnormal value in their results, even though none grew any pathogens in the cultures analyzed.</p><p><strong>Conclusion: </strong>Upon CSF analysis, we found increased levels of CSF protein and other abnormal values in this population; however, none of the cultures grew any pathogens. This finding is an important tool in the evaluation of the possible etiologies of and therapeutic approaches for future shunt problems in this group of patients.</p>","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":"39 2","pages":"200-202"},"PeriodicalIF":0.5,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38158220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with the use of Dental Health Services by Mexican Schoolchildren to receive Professionally Applied Topical Fluoride.","authors":"Eduardo Cerón-Zamora,&nbsp;José De Jesús Navarrete-Hernández,&nbsp;Edith Lara-Carrillo,&nbsp;Norma Leticia Robles-Bermeo,&nbsp;Salvador Eduardo Lucas-Rincón,&nbsp;César Tadeo Hernández-Martínez,&nbsp;Lydia López-Pontigo,&nbsp;Juan José Villalobos-Rodelo,&nbsp;Carlo Eduardo Medina-Solís","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To identify the prevalence of and factors associated with the use of dental health services to receive professionally applied topical fluoride (DHSU-PATF) in the 12 months prior to the study among Mexican schoolchildren aged 6 to 12 years.</p><p><strong>Methods: </strong>A cross-sectional study was performed in 1,404 schoolchildren selected randomly from 15 public schools in the city of Pachuca, Mexico. Questionnaires were distributed to determine the demographic, socioeconomic, and behavioral variables. The dependent variable was the DHSU-PATF in the year before the study, which was dichotomized as 0 (no DHSU-PATF) or 1 (yes, DHSU-PATF). We calculated odds ratios (OR) and 95% confidence intervals. The analysis was performed in Stata 11.0.</p><p><strong>Results: </strong>The prevalence of DHSU-PATF was 5.1%, but lower among younger children (OR = 0.86) and greater among children with health insurance (private insurance, OR = 3.64; insurance provided by the government owned oil company, the Army, or the Navy, OR = 5.03). The level of knowledge about oral health among guardians/ parents was also a factor (medium, OR = 2.37; high, OR = 4.05). Additionally, among the children whose parents/guardians perceived them (the children) as having good or very good oral health, the OR was 3.33; among children whose parents brushed their teeth with greater relative frequency, the OR was 8.74. Finally, DHSU-PATF was greater among children with relatively higher socioeconomic status (2nd quartile, OR = 3.29; 3rd quartile, OR = 5.99; 4th quartile, OR = 4.64).</p><p><strong>Conclusion: </strong>The receipt of PATF was low in this sample of Mexican schoolchildren and is associated with socioeconomic and behavioral factors. This gives us a guideline to create or improve topical fluoride application strategies in the public and private Mexican health systems.</p>","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":"39 2","pages":"203-209"},"PeriodicalIF":0.5,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38158221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Descriptive Study on the Population of Patients with Inflammatory Bowel Disease at the Veterans Affairs Caribbean Healthcare System in San Juan.","authors":"Doris H Toro,&nbsp;Walisbeth Class-Vázquez,&nbsp;Pedro A Rosa-Cortés,&nbsp;Frances Rodríguez-Berrios","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Inflammatory bowel disease (IBD) comprises a group of related conditions characterized by idiopathic inflammation of the gastrointestinal (GI) tract. Several studies have described the epidemiology of IBD in Puerto Rico (PR) but none have included the US military and Veteran population. The goal of this study was to describe the prevalence of IBD in this population as well as to describe patients' characteristics.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 163 patients using data gathered from electronic medical records of Veterans who received care at the VA Caribbean Healthcare System (VACHS) and the diagnosis of IBD between October 1, 2010 and September 30, 2015. The prevalence out of 100,000 in our study was calculated for each Fiscal Year.</p><p><strong>Results: </strong>Overall, the prevalence of IBD markedly increased among VA patients. Among 163 patients who met inclusion criteria, 7 (4.3%) patients had a diagnosis of undetermined IBD, 45 (27.6%) had Crohn's disease (CD) and 111 (68.0%) had ulcerative colitis (UC). This information was used to compare the epidemiologic data of IBD in the population receiving care at the VACHS with the epidemiologic data of IBD in the general population in PR.</p><p><strong>Conclusion: </strong>This is the first study to describe the prevalence of IBD and to describe additional characteristics of patients with IBD receiving care at the VACHS.</p>","PeriodicalId":54529,"journal":{"name":"Puerto Rico Health Sciences Journal","volume":"39 1","pages":"51-54"},"PeriodicalIF":0.5,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37913379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}