Search our Database of Scientific Publications and Authors

I’m looking for a

    3682 results match your criteria Boletin de la Asociacion Medica de Puerto Rico[Journal]

    1 OF 74

    Difficult Diagnosis between B Cell Lymphoma and Classical Hodgkin's Lymphoma.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):98-101
    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. Read More

    Screening for Peripheral Arterial Disease.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):95-7
    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. Read More

    The Prevalence Of Sexually Transmitted Infections On Teen Pregnancies And Their Association To Adverse Pregnancy Outcomes.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):89-94
    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. Read More

    POEMS Syndrome: A Rare Disease With A Challenging Diagnosis.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):85-8
    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. Read More

    Epidemiology of Traumatic Peripheral Nerve Injuries Evaluated by Electrodiagnostic Studies in a Tertiary Care Hospital Clinic.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):79-84
    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. Read More

    Peripheral Arterial Disease: Surgical Treatment.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):75-8
    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. Read More

    Obesity and premature coronary artery disease with myocardial infarction in Puerto Rican young adults.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):70-4
    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. Read More

    Metabolic Changes After Roux-N-Y Bariatric Surgery In Hispanics.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):66-9
    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). Read More

    [Achondroplasia: a pilot study on the psychosocial and medical features of a sample in Puerto Rico].
    Bol Asoc Med P R 2015 Jul-Sep;107(3):58-65
    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). Read More

    Non-Invasive Therapy of Peripheral Arterial Disease.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):52-7
    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. Read More

    Endovascular Intervention in the Treatment of Peripheral Artery Disease.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):47-51
    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. Read More

    Diagnostic Studies for the Evaluation of Peripheral Artery Disease.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):42-5
    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. Read More

    Metastatic Ovarian Tumor Masquerading as Atypical Pneumonia.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):38-41
    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. Read More

    Previous Exposure to Anesthesia and Autism Spectrum Disorder (ASD): A Puerto Rican Population-Based Sibling Cohort Study.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):29-37
    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. Read More

    Usefulness Of Glucocorticoids In The Management Of Foreign Body Aspiration.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):24-7
    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. Read More

    The Racial, Cultural and Social Makeup of Hispanics as a potential Profile Risk for Intensifying the Need for Including this Ethnic Group in Clinical Trials.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):17-23
    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. Read More

    Pleural Effusion In A Patient With Primary Sjögren's Syndrome Successfully Treated With Corticosteroids.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):13-6
    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. Read More

    A Hispanic female patient with heartburn: A rare presentation of Paroxysmal Nocturnal Hemoglobinuria.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):9-12
    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. Read More

    Prevalence of Diabetes Mellitus in Human Immunodeficency Virus positive Patients in Puerto Rico--San Juan City Hospital Experience.
    Bol Asoc Med P R 2015 Jul-Sep;107(3):5-8
    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. Read More

    Lack of training and Comfort level with Provision of Palliative Care in Puerto Rican Emergency Departments.
    Bol Asoc Med P R 2015 Apr-Jun;107(2):92-6
    Objective: Although many institutions in the United States have incorporated palliative care practices in their emergency departments, very little has occurred in Puerto Rico. Information regarding palliative care training of emergency medicine physicians in Puerto Rico is unclear and most physicians have poor or no access to palliative care services for their patients. This study explores the perceptions and barriers encountered by practicing emergency physicians in providing palliative care in Puerto Rican Emergency Departments. Read More

    Do We Need Hormonal Screening In Patients With Subcentimeter Pituitary Microadenomas?
    Bol Asoc Med P R 2015 Apr-Jun;107(2):89-91
    A 54-year-old woman came to our endocrinology clinics presenting with upper and lower extremity paresthesia, salt cravings, episodes of hypotension, fatigue and a long term history of depression. Physical exam was unremarkable. Cervical and brain MRI ordered by her neurologist three years ago revealed sella and pituitary normal in size, stable very small 3 mm pituitary incidentaloma and mild disc bulging. Read More

    Acquired Von Willebrand Syndrome In Aortic Stenosis: Case Report And Review.
    Bol Asoc Med P R 2015 Apr-Jun;107(2):86-8
    We present a case of a 61 year old man who presented with a 3 week history of easy bruising and ecchymoses in both thighs and right arm without significant trauma. Physical exam was remarkable for oozing gums, diminished second heart sound, a systolic ejection murmur at the aortic position with radiation to carotids, and delayed pulses. Laboratories were remarkable for iron deficiency anemia. Read More

    Use of Screening Tests for Colorectal Cancer Among Gynecologists in Puerto Rico.
    Bol Asoc Med P R 2015 Apr-Jun;107(2):82-5
    Objective: To determine the use of screening tests for colorectal cancer (CRC) among Gynecologists in Puerto Rico. This study evaluates the screening practices used by Gynecologists in PR to diagnose CRC and adherence to screening guidelines.

    Methods: A self-administered anonymous questionnaire was mailed to 440 practicing gynecologists through the College of Physicians and Surgeons of PR. Read More

    Does Injection Site Matter? A Randomized Controlled Trial to Evaluate Different Entry Site Efficacy of Knee Intra-articular Injections.
    Bol Asoc Med P R 2015 Apr-Jun;107(2):78-81
    Background: Complaints of knee pain secondary to early osteoarthritis may account for up to 30% of visits to primary care physicians. Due to the proposed inflammatory changes in early osteoarthritis, intra-articular injections of corticosteroids (IACS) have been considered as an option for disease progression modification, pain control, and improvement of function. However, some studies have suggested poor accuracy rates of IA injections depending on the entry site chosen. Read More

    Functional Brain Imaging in Cornelia de Lange Syndrome: Case Report and Literature review.
    Bol Asoc Med P R 2015 Apr-Jun;107(2):73-7
    Functional brain imaging with brain single photon emission computer tomography (Brain SPECT) has been used for many years in the evaluation of multiple neuro-degenerative and neuro-developmental disorders. Brain SPECT is a nuclear medicine tomographic study performed with a lipophilic radiopharmaceutical labeled with 99mTc-pertechnetate. It is a cerebral perfusion agent that depicts the global and regional perfusion patterns in the cortical gray matter and subcortical structures. Read More

    23 y/o female with dysphagia--Evaluation, intervention and resolution of symptoms in the Psychiatry consultation setting.
    Bol Asoc Med P R 2015 Apr-Jun;107(2):71-2
    Dysphagia is a symptom shared by many medical and psychiatric conditions. A thorough Psychiatric evaluation could rule in a functional or psychological etiology. If a Psychological etiology is identified, a psychodynamic formulation could help the consultation psychiatrist clarify the origin of the symptom and provide a better explanation to the patient and medical team, resulting in improved care by prevention of unnecessary medical interventions, improvement of symptoms and individualization of the treatment. Read More

    Brugada Syndrome in Puerto Rico: a Case Series.
    Bol Asoc Med P R 2015 Apr-Jun;107(2):67-70
    Brugada syndrome (BrS) is characterized by ST-segment changes in the right precordial ECG leads and a high incidence of sudden death in patients with structurally normal hearts. Life-threatening ventricular arrhythmias are the hallmark of Brugada syndrome. The incidence and prevalence of BrS in Puerto Rico, to our knowledge, has never been studied and there is only one case report of BrS in Puerto Rico in the literature [1]. Read More

    [Metabolic correction: a biochemical option against diseases].
    Bol Asoc Med P R 2015 Apr-Jun;107(2):60-6
    Human development and its physiology depends on a number of complex biochemical body processes, many of which are interactive and codependent. The speed and the degree in which many physiological reactions are completed depend on enzyme activity, which in turn depends on the bioavailability of co-factors and micronutrients such as vitamins and minerals. To achieve a healthy physiological state, organism need that biochemical reactions occur in a controlled and specific way at a particular speed and level or grade fully completed. Read More

    Metabolic Correction as a tool to improve diabetes type 2 management.
    Bol Asoc Med P R 2015 Apr-Jun;107(2):54-9
    Diabetes Mellitus type 2 (DM2) is a metabolic disease that develops by a decrease in sensitivity of insulin receptors as an effect of the disruption certain metabolic functions in the processing of glucose. DM2 patients have, uncontrolled glucose levels, and commonly have problems with obesity and cardiovascular disease. Patients are treated with standard diet, insulin, diabetic oral agents and antihypertensive drugs, but this approach does not completely stops tissue deterioration since it does not address the metabolic root of the disease. Read More

    Dengue Fever: A Rare Cause Of Immune Thrombocytopenia.
    Bol Asoc Med P R 2015 Apr-Jun;107(2):51-3
    Immune thrombocytopenia (ITP) is a rare autoimmune disorder characterized by low platelet count and skin-mucosal bleeding. In adults it is usually idiopathic and may have a chronic onset, while in children it is usually acute following a viral illness. Dengue has been rarely reported as a cause of ITP. Read More

    Case Report: Prothesis-patient mismatch after aortic valve replacement.
    Bol Asoc Med P R 2015 Apr-Jun;107(2):40-3
    Valve replacement is the standard surgical treatment of diseased valves that cannot be repaired. The main goal of replacement is to exchange the diseased valve with one that has the engineering and hemodynamics as close as possible to the disease free native valve. However due to mechanical and fluid dynamic constraints all prosthetic heart valves (PHVs) are smaller than normal and thus are inherently stenotic. Read More

    Manatí Medical Center Sepsis Management Epidemiological Study.
    Bol Asoc Med P R 2015 Apr-Jun;107(2):34-9
    Sepsis is the combination of infection and physiological changes known as the systemic inflammatory response syndrome. There have been improvements in mortality rates and outcomes of septic patients based on "Surviving Sepsis Campaign" guidelines. Current management of sepsis at our Institution follows no specific mandatory protocols. Read More

    Isolated Xanthoma Of The Sphenoid Sinus: A Rare Presentation.
    • Authors:
    Bol Asoc Med P R 2015 Apr-Jun;107(2):32-3
    Objective: To present the first case in the English literature of a sphenoid xanthoma.

    Methods: Case Report

    Discussion: A 36 year-old Hispanic female with past medical history of Hashimoto's hypothyroidism and family history of hyperlipidemia that presented with a 1-year history of sporadic left sided epistaxis. A paranasal sinus Computed Tomography (CT) was performed revealing a soft tissue lesion infiltrating the left sphenoid sinus. Read More

    Endoscopic Resection of a Posterior Nasal Septum Pleomorphic Adenoma.
    Bol Asoc Med P R 2015 Apr-Jun;107(2):29-31
    A 60 year-old female presented to our clinic with a two-year history of progressive nasal obstruction and one isolated episode of epistaxis that did not respond to medical treatment. Endoscopic evaluation revealed roundish, dumbbell-shape, smooth-surfaced, submucosal mass with prominent vessels of approximately 2 cm in the posterior nasal septum,. A paranasal CT scan revealed a well-circumscribed oval shape mass (1. Read More

    Endoscopic- Assisted Trephination approach for repair of Frontal Sinus posterior wall fracture in a Child.
    Bol Asoc Med P R 2015 Apr-Jun;107(2):27-8
    A 9 year-old male sustained multiple maxillofacial fractures after falling from a two-store building. Frontal sinuses suffered a bilateral non-displaced linear fractures extending into the anterior and posterior walls. Magnetic resonance imaging (MRI) at this time showed a small encephalocele extending into the right frontal sinus. Read More

    Rapidly Progressive Seeding of a Community Acquired Pathogen in an Immune-competent Host--End Organ Damage from Head to Bone.
    Bol Asoc Med P R 2015 Apr-Jun;107(2):20-3
    This report describes a 64-years-old male patient that presented to our hospital with a chief complaint of acute worsening of his usual chronic lower back pain, progressive weakness in lower extremities and subjective fevers at home. Spine CT failed to demonstrate any infectious foci but showed partially visualized lung cavitary lesion and renal pole abnormalities. Blood cultures grew methicillin-sensitive Staphylococcus Aureus (MSSA). Read More

    Should we revisit anticoagulation guidelines during thyroid storm?
    Bol Asoc Med P R 2015 Jan-Mar;107(1):62-6
    Thyroid storm is a rare but potentially catastrophic disease expression of thyrotoxicosis with well-recognized cardiovascular manifestations such as heart failure and atrial fibrillation. Even through some studies have found an increased risk of cardiac thrombus formation and subsequent thromboembolism in these patients, the use of anticoagulation to prevent thromboembolic sequelae of thyrotoxic atrial fibrillation remains unclear. We present a patient presenting with new onset dilated cardiomyopathy and resistant atrial fibrillation with thyroid storm that had a large left atrial appendage clot. Read More

    Handlebar hernia: case report and literature review.
    Bol Asoc Med P R 2015 Jan-Mar;107(1):58-61
    Handlebar hernia is a rare traumatic abdominal wall hernia occurring after blunt trauma. We report a case of an adolescent patient with a traumatic rectus muscle abdominal wall hernia produced by injury with the bicycle handlebar. The skin abrasion caused by the trauma and a swelling reproduced after a Valsalva maneuver suggested the diagnosis. Read More

    Small cell carcinoma of the uterine cervix: a case report and literature review.
    Bol Asoc Med P R 2015 Jan-Mar;107(1):55-7
    Small cell carcinoma of the uterine cervix is a rare and aggressive extra-pulmonary variant of small cell tumors. This carcinoma of the cervix comprises less than 5% of all cervical carcinomas and is know to be highly undifferentiated. It is associated with a poor prognosis and characterized by premature distant nodal involvement. Read More

    Atraumatic bilateral femoral neck fractures in a premenopausal female with hypovitaminosis D.
    Bol Asoc Med P R 2015 Jan-Mar;107(1):51-4
    Bilateral femur neck fractures in young adult patients are very rare in atraumatic circumstances. We report a young premenopausal female with osteomalacia secondary to vitamin D deficiency and spontaneous bilateral femur neck fractures. Patients had no reported risk factors for osteomalacia but hypovitaminosis D was noted on laboratory evaluation. Read More

    Uncommon cause of life-threatening retroperitoneal hemorrhage in a healthy young Hispanic patient: splenic artery aneurysm rupture.
    Bol Asoc Med P R 2015 Jan-Mar;107(1):45-8
    Splenic artery aneurysms (SAA) are a rare life threatening clinical diagnosis. We present a case of a young Hispanic woman with an aneurysm of the middle branch of the splenic artery and active leakage. The defect was embolized with complete resolution of the retroperitoneal bleeding. Read More

    Worsening gradient of aortic stenosis with treatment of pulmonary arterial hypertension in scleroderma.
    Bol Asoc Med P R 2015 Jan-Mar;107(1):41-4
    Systemic sclerosis (SSc) can cause interstitial lung and pulmonary vascular disease that can induce pulmonary arterial hypertension (PAH). It is well known that severe PAH may reduce left ventricluar preload and decrease diastolic filling with the potential of reducing forward flow. We present a case in which a patient with SSc and symptomatic PAH required direct pulmonary vasodilator therapy for treatment of elevated pulmonary pressures. Read More

    Celiac trunk and branches dissection due to energy drink consumption and heavy resistance exercise: case report and review of literature.
    Bol Asoc Med P R 2015 Jan-Mar;107(1):38-40
    Higher doses and consumption of energy drinks leads to cardiovascular effects and potential consequences. Principal components found in energy drinks such as caffeine, guarana and taurine has been related to dilatation, aneurysm formation, dissection and ruptures. There is no evidence showing an integration of these components and its effects in endothelium and aortic walls due to higher levels of pressure during exercises. Read More

    Clinical and radiological indicators of severity in patients with acute pancreatitis.
    Bol Asoc Med P R 2015 Jan-Mar;107(1):33-7
    Unlabelled: The purpose of this study was to estimate the degree of association between clinical (Ranson criteria) and radiological variables (Abdominal CT scan) with degree of severity in patients with a diagnosis of acute pancreatitis.

    Method: All patients discharged with the diagnosis of acute pancreatitis from January 1, 2010 through December 31, 2012 in a community hospital were selected (N=174). The following variables were studied: sex; age; weight; height; admission and discharge dates; presence of several chronic conditions; laboratory results included in Ranson criteria; abdominal CT category; outcome, including fatality surgery, and other complications. Read More

    Quality of life-in patients with differentiated thyroid cancer at the general endocrinology clinics of the University Hospital of Puerto Rico.
    Bol Asoc Med P R 2015 Jan-Mar;107(1):25-31
    Unlabelled: Differentiated thyroid cancer (DTC) can compromise the quality of life of patients. Our purpose is to investigate if the quality of life, in a cohort of patients in Puerto Rico, is affected by the diagnosis and/or treatment modalities received for DTC.

    Methods: This is a cross-sectional study of 75 subjects with DTC. Read More

    Intravenous ascorbic acid and hydrogen peroxide in the management of patients with chikungunya.
    Bol Asoc Med P R 2015 Jan-Mar;107(1):20-4
    Chikungunya is a viral illness characterized by severe joint pains, which may persist for months to years. There is no effective treatment for this disease. We treated 56 patients with moderate to severe persistent pains with a single infusion of ascorbic acid ranging from 25-50 grams and hydrogen peroxide (3 cc of a 3% solution) from July to October 2014. Read More

    1 OF 74