Distinguishing patients with laboratory-confirmed chikungunya from dengue and other acute febrile illnesses, Puerto Rico, 2012-2015.

Chikungunya, a mosquito-borne viral, acute febrile illness (AFI) is associated with polyarthralgia and polyarthritis. Differentiation from other AFI is difficult due to the non-specific presentation and limited availability of diagnostics. This 3-year study identified independent clinical predictors by day post-illness onset (DPO) at presentation and age-group that distinguish chikungunya cases from two groups: other AFI and dengue.

Risk factors for hospitalization of patients with chikungunya virus infection at sentinel hospitals in Puerto Rico.

Background: Hospitalization of patients during outbreaks of chikungunya virus has been reported to be uncommon (0.5-8.7%), but more frequent among infants and the elderly.

Symptomatic Zika Virus Infection in Infants, Children, and Adolescents Living in Puerto Rico.

Importance: Little information is available regarding Zika virus (ZIKV) infection in children.

Objective: To describe patients younger than 18 years who were infected with ZIKV and were enrolled in the Sentinel Enhanced Dengue and Acute Febrile Illness Surveillance System (SEDSS).

Design, Setting, And Participants: Children infected with ZIKV with 7 or fewer days of fever or emancipated minors aged 14 to 17 years with a generalized maculopapular rash, arthritis or arthralgia, or nonpurulent conjunctivitis were eligible for enrollment on or before December 31, 2016, in Puerto Rico.

Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012-2015.

Identifying etiologies of acute febrile illnesses (AFI) is challenging due to non-specific presentation and limited availability of diagnostics. Prospective AFI studies provide a methodology to describe the syndrome by age and etiology, findings that can be used to develop case definitions and multiplexed diagnostics to optimize management. We conducted a 3-year prospective AFI study in Puerto Rico.

Persistence of Zika Virus in Body Fluids - Final Report.

Background: To estimate the frequency and duration of detectable Zika virus (ZIKV) RNA in human body fluids, we prospectively assessed a cohort of newly infected participants in Puerto Rico.

Methods: We evaluated samples obtained from 150 participants (including 55 men) in whom ZIKV RNA was detected on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay in urine or blood in an enhanced arboviral clinical surveillance site. We collected serum, urine, saliva, semen, and vaginal secretions weekly for the first month and then at 2, 4, and 6 months.

Solid pseudopapillary pancreatic tumor as a portal hypertension causal: the first reported case in Puerto Rico.

We describe the first reported case in Puerto Rico of Solid Pseudopapillary Tumor (SPT) of the pancreas causing portal hypertension. Clinical presentation and characteristic imaging findings are helpful to differentiate SPT from pancreatic carcinoma. Diagnosis can be confirmed by histopathological and immunohistochemical approach through biopsy.

Thoracic endometriosis: first reported case in Puerto Rico and review of literature.

Endometriosis is defined as the presence of endometrial tissue in extra uterine sites. It affects 5-15% of females during their reproductive years. Thoracic endometriosis syndrome is characterized by the presence of functional endometrial tissue within the pleura, the lung parenchyma or the airway.

Acute febrile illness surveillance in a tertiary hospital emergency department: comparison of influenza and dengue virus infections.

In 2009, an increased proportion of suspected dengue cases reported to the surveillance system in Puerto Rico were laboratory negative. As a result, enhanced acute febrile illness (AFI) surveillance was initiated in a tertiary care hospital. Patients with fever of unknown origin for 2-7 days duration were tested for Leptospira, enteroviruses, influenza, and dengue virus.

Is the Puerto Rican racer, Alsophis portoricensis, really harmless? A case report series.

Puerto Rico (PR) is home to 10 indigenous species of snake. Alsophis portorricensis has traditionally been considered harmless. In 1961, Hageman classified A portorricensis as somewhere between "venomous" and "nonvenomous.

Essential concepts of wound management.

The practice of wound care has greatly improved and evolved over the years. The emergency provider (EP) can choose from a wide variety of sutures, adhesives, strips, and surgical staples, and uses proven wound closure techniques to address this common Emergency Department (ED) patient complaint. All EPs should be comfortable and proficient in the management and care of wounds in the ED.

Spinal cord toxoplasmosis as an unusual presentation of AIDS: case report and review of the literature.

Approximately 10% of patients with AIDS present with some neurological deficit as their initial complaint, and up to 80% will have CNS involvement during the course of their disease. Toxoplasmosis is the most common cause of cerebral mass lesions in patients with AIDS, but appears to be an uncommon cause of spinal cord disease. The incidence of myelopathy may be as high as 20%, with 50% of the cases reported post-mortem.

Workforce projections for emergency medicine in Puerto Rico: a five-year follow-up of an evident demand.

In this study, two mathematical equations were used to calculate and establish the actual Emergency Medicine workforce needed in Puerto Rico (PR) and project the time frame to meet the actual demand. 1) Supply equals the number of existing Emergency Physicians (EPs) plus residency-trained graduates in EM per year minus the annual attrition rate (3%); and 2) Demand equals six (6) full time equivalent positions per Emergency Department (ED) times the total number of EDs in PR. Under both scenarios tested, the significant EP shortage in PR will continue until 2044.

Most common injuries associated to scooters seen in the emergency department.

The foot propelled scooter is a popular toy preferred by girls and boys, but at the same time, these put the children at risk of some kind of injury. The literature had reported that the fractures at the upper extremities are the most frequent injury observed related to the use of a scooter. The purpose of our study was to describe the injuries related to the scooters use in a sample of injuries handled at the UPR Hospital at Carolina, Puerto Rico.