Boletin de la Asociacion Medica de Puerto Rico最新文献

Boletin de la Asociacion Medica de Puerto Rico Pub Date : 2020-02-02 DOI: 10.32388/70pcf7

F. Tristani

引用次数: 22

Boletin de la Asociacion Medica de Puerto Rico Pub Date : 2018-09-11 DOI: 10.4172/2572-0775-C1-007

G. Rivera, H. Lugo-Vicente

{"title":"Thyroid cancer in children.","authors":"G. Rivera, H. Lugo-Vicente","doi":"10.4172/2572-0775-C1-007","DOIUrl":"https://doi.org/10.4172/2572-0775-C1-007","url":null,"abstract":"Abstract Cancer of the thyroid gland in pediatric patients is rare and if left untreated spreads and become lethal. Thyroid nodules in pediatric patients are four times more likely being malignant than adult nodules. The incidence of thyroid cancer in children increases with age, sex, race and nodule size. Exposures to low level of head and neck irradiation at young age, cancer survivors, family history of thyroid cancer and iodine deficiency are specific risk factors to develop thyroid cancer. Thyroid cancer is subdivided into papillary, follicular and medullary thyroid cancer varying in histological characteristics. Children who present with thyroid nodules should undergo ultrasound and fine needle aspiration biopsy to evaluate malignant potential. If biopsy results are positive for malignancy best option is complete surgical resection of the thyroid gland with central lymph node dissection followed by radioactive iodine treatment. Surgeons need to take certain precaution to avoid postoperative complications like hypoparathyroidism or recurrent laryngeal nerve damage. Follow-up is essential in order to evaluate remission or recurrence. An excellent prognosis in pediatric patients is the result of such an aggressive approach that can be supported by the low complications rate and low recurrence rate following surgery.","PeriodicalId":75610,"journal":{"name":"Boletin de la Asociacion Medica de Puerto Rico","volume":"106 1","pages":"48-54"},"PeriodicalIF":0.0,"publicationDate":"2018-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70317780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Factors Associated to Invasive Fungal Infection in Hispanic Patients with Hematological Malignancies. 西班牙裔血液恶性肿瘤患者侵袭性真菌感染的相关因素。

Boletin de la Asociacion Medica de Puerto Rico Pub Date : 2017-01-01

Rafael de León-Borrás, Esteban DelPilar-Morales, Nicole Rivera-Pérez, Mara Pallens-Feliciano, Maribel Tirado-Gómez, Lorena González-Sepúlveda, Jorge Bertrán-Pasarell

{"title":"Factors Associated to Invasive Fungal Infection in Hispanic Patients with Hematological Malignancies.","authors":"Rafael de León-Borrás, Esteban DelPilar-Morales, Nicole Rivera-Pérez, Mara Pallens-Feliciano, Maribel Tirado-Gómez, Lorena González-Sepúlveda, Jorge Bertrán-Pasarell","doi":"","DOIUrl":"","url":null,"abstract":"Fungal infections represent a serious complication for immunosuppressed patients resulting in an increased morbidity and mortality. A non-concurrent prospective study was performed to evaluate the factors associated to invasive fungal infection (IFI) in patients with hematological malignancies admitted to the University Hospital in San Juan, Puerto Rico from January 1st, 2011 through June 15th, 2014. The medical records of 84 patients were evaluated. Fifty-nine patients with IFI and twenty-five without IFI. The majority were men between 35 to 55 years old. The main hematological diagnosis was acute myelogenous leukemia (AML) followed by acute lymphoblastic leukemia (ALL). Seventy-percent developed IFI. The most common fungi were C. albicans followed by non-albicans species, Fusarium and, Aspergillus species, respectively. About 63% of the patients with AML and 81% without AML had IFI. Those who received steroids were more likely to develop IFI. After adjusting for AML and age, the odds of IFI among patients using steroids were 3.33 higher than those not using steroids. Patients who were exposed to different antifungal medication had 72% lower odds to develop IFI.","PeriodicalId":75610,"journal":{"name":"Boletin de la Asociacion Medica de Puerto Rico","volume":"109 1","pages":"43-48"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980240/pdf/nihms896507.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36188796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Using women and heart disease-specific campaigns to motivate change 利用妇女和心脏病专项运动来推动变革

Boletin de la Asociacion Medica de Puerto Rico Pub Date : 2016-09-20 DOI: 10.4172/2155-9880.C1.047

M. McGowan, E. Maciejewski

引用次数: 4

[Status epilepticus]. (癫痫持续状态)。

Boletin de la Asociacion Medica de Puerto Rico Pub Date : 2016-04-30 DOI: 10.1542/9781610020190-part02-status

E. M. Font

引用次数: 0

Cerebrospinal Fluids Leaks of the Cranial Vault Management with Compression Cap: Case Series. 颅顶压帽治疗脑脊液泄漏:病例系列。

Boletin de la Asociacion Medica de Puerto Rico Pub Date : 2016-01-01

Luis Orlando Rojas, Daniel Contento Meléndez, Miguel Ángel Maldonado Morán, Juan Esteban Muñoz, Claudia Marcela Restrepo

引用次数: 0

Intradialytic Hypertension / Hypotension and Mortality in San Juan, Puerto Rico. 波多黎各圣胡安的分析性高血压/低血压和死亡率。

Boletin de la Asociacion Medica de Puerto Rico Pub Date : 2016-01-01

Hector J Diaz, James Bryan, Juan C Arraut, Jose Betancourt, Carlos M Morales, Jose L Cangiano

{"title":"Intradialytic Hypertension / Hypotension and Mortality in San Juan, Puerto Rico.","authors":"Hector J Diaz, James Bryan, Juan C Arraut, Jose Betancourt, Carlos M Morales, Jose L Cangiano","doi":"","DOIUrl":"","url":null,"abstract":"End Stage Renal Disease patients undergo profound hemodynamic changes\u0000during hemodialysis treatments which are now recognized as a marker for\u0000increased risk of morbidity and mortality. Development of intradialytic\u0000hypotension or hypertension are a common clinical problem in this population\u0000with an incidence of up to 20%. We performed a retrospective review of\u000049 Hispanic patients receiving ambulatory hemodialysis during a period of\u00006 months to ascertain the development of aforementioned intradialytic events.\u0000Clinical data examined the association of these events to mortality and their\u0000relationship to antihypertensive medications and cardiomegaly. The prevalence\u0000of intradialytic hypotension was 38.78%, hypertension 16.33% individually\u0000and both taking place 16.33%. Taken together, the prevalence of these\u0000intradialytic events was 71.43% in our Hispanic population. A significant \u0000association was found between mortality and Beta blockers (BB)(P=0.044),\u0000Calcium channel blockers (CCB) (P=0.023), cardiomegaly (P=0.044),\u0000and intradialytic events (P=0.035). Odds ratio of multiple variables dis-\u0000closed that dependent variable death decreased in probability with the use\u0000of BB by an estimate of 73% and with the use of CCB by 74.8%. On the other\u0000hand, odds of developing the dependent variable death increased by 74.5% if the\u0000patients developed intradialytic events. Similarly, the odds of developing \u0000cardiomegaly in the living group increased by 70%. A logistic regression of multiple\u0000variables found that the probability of developing the dependent condition of\u0000death increases by almost 2.896 times if intradialytic events are present and\u0000that there is a 58.9% inferred causality. It is concluded that intradialytic hyper-\u0000tension and hypotension are major risk factors for mortality in dialysis patients.\u0000The use of BB and CCB may be protetive to avoid the risk of mortality in\u0000these patients.","PeriodicalId":75610,"journal":{"name":"Boletin de la Asociacion Medica de Puerto Rico","volume":"108 1","pages":"77-80"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35211926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An Isolated Gluteus Minimus Tendon Tear with Stress Fracture of the Iliac Wing in a Marathon Runner:A case report. 马拉松运动员一例孤立性臀小肌肌腱撕裂伴髂翼应力性骨折。

Boletin de la Asociacion Medica de Puerto Rico Pub Date : 2016-01-01

Emanuel Rivera Rosado, Borja Santaella Sante, Priscila M Corderob, Juan J Rivera, Francisco Otero Lopez

引用次数: 0

Implementation of a pre-operative decolonization protocol of Methicillin Resistance Staphylococcusaureus in elective orthopedic surgery at Manatí Medical Center: Pilot Study. Manatí医疗中心择期骨科手术中耐甲氧西林金黄色葡萄球菌术前去菌落方案的实施:试点研究

Boletin de la Asociacion Medica de Puerto Rico Pub Date : 2016-01-01

Jessica C Marrero Rolón, Greisha Adorno Robles, Nicolás D Duchemin, Jaime Fumero, Aracelis Nieves Rodriguez, Vielka M Cintrón Rivera, Martha L Villarreal Morales, Marielys Otero

{"title":"Implementation of a pre-operative decolonization protocol of Methicillin Resistance Staphylococcus\u0000aureus in elective orthopedic surgery at Manatí Medical Center: Pilot Study.","authors":"Jessica C Marrero Rolón, Greisha Adorno Robles, Nicolás D Duchemin, Jaime Fumero, Aracelis Nieves Rodriguez, Vielka M Cintrón Rivera, Martha L Villarreal Morales, Marielys Otero","doi":"","DOIUrl":"","url":null,"abstract":"Methicillin-resistant Staphylococcus aureus (MRSA) is a strain of S. aureus that\u0000shows resistance to multiple antibiotics. Up to 30% of S. aureus strains isolated\u0000from nosocomial infections are MRSA, and it has become a growing problem\u0000for public health. The cost of MRSA infection is also having a huge impact\u0000financially and results in considerable resource utilization. Puerto Rico’s\u0000Legislature passed Law # 298 on October 19, 2012 for the control and prevention\u0000of MRSA infections in medical installations in Puerto Rico. In order to comply\u0000with the law we conducted a pilot study to identify possible setbacks of the\u0000implementation of the MRSA decolonization protocol as standard of care therapy in\u0000our institution while contributing to the process of quality improvement and\u0000patient safety. Nasal swabs were taken at the Pre-admission Department and\u0000processed through a PCR-based MRSA detection assay. A protocol of decolonization\u0000in patients with positive results was implemented. The study showed\u0000that patients without apparent risk factors could be colonized either with\u0000MRSA or Methicillin-sensitive S. aureus (MSSA). The time between pre-\u0000admission and surgery was less than the indicated for a proper decolonization\u0000procedure. Therefore, 50% of the scheduled surgeries could have been\u0000postponed in case of positive MRSA or MSSA. In our experience patient’s education\u0000was crucial to guarantee compliance and adherence to treatment. In\u0000order to decrease risk of wound infection we recommend that both, screening\u0000process and decolonization if required, be performed before the preadmission\u0000appointment for elective surgery. This study provided a framework for MRSA\u0000pre-admission screening and decolonization in our Institution.","PeriodicalId":75610,"journal":{"name":"Boletin de la Asociacion Medica de Puerto Rico","volume":"108 1","pages":"71-77"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35211925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical profile, bacterial isolates, and antibiotic resistance of corneal ulcers in Puerto Rico. 波多黎各角膜溃疡的临床概况、细菌分离和抗生素耐药性。

Boletin de la Asociacion Medica de Puerto Rico Pub Date : 2016-01-01

Pedro J Dávila, Maria Pilar-Fernandez, Jan P Ulloa-Padilla, Victor M Villegas, Vanessa Lopez, Lilia Rivera, Carmen A Santos, Luis A Santiago-Cabán

引用次数: 0