Association of body mass index with anal human papillomavirus infection and histologically confirmed high-grade squamous intraepithelial lesions in people who receive services at the Anal Neoplasia Clinic in Puerto Rico.

Objective: This study aimed to assess the association of body mass index (BMI) with anal high-risk human papillomavirus (HR-HPV) and biopsy-confirmed histologic anal high-grade squamous intraepithelial lesions (HSIL) among a clinic-based sample of Hispanics in Puerto Rico.

Methods: This cross-sectional study evaluated medical records of adults who received services at the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center between October 2014 and December 2022. The study included 543 records with complete clinical information regarding anal HR-HPV and anal HSIL status.

The Use of Therapy Dogs in the Pediatric COVID-19 Vaccination at the University of Puerto Rico Medical Sciences Campus.

Pet ownership and therapy dogs as companion animals and emotional support have potential health benefits. We report the experiences at a COVID-19 vaccination center after authorizing children's vaccines. When the Pfizer-BioNTech vaccine for children aged 5 to 11 years was authorized for emergency use, we adapted the center's space to receive children, adding cartoon posters and balloons and using children's adhesive bandages, among others.

Association of tobacco use and the presence of anal warts in people who attend the anal Neoplasia clinic in Puerto Rico.

Background: Limited research exists regarding the association between smoking and anal warts. In this study, we evaluated this association among a clinic-based Hispanic population in Puerto Rico.

Methods: Cross-sectional study among eligible patients seen at the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center (2016-2023) (n = 920).

Two-Year Incidence and Cumulative Risk and Predictors of Anal High-Grade Squamous Intraepithelial Lesions (Anal Precancer) Among Women With Human Immunodeficiency Virus.

Background: Detection and treatment of anal histologic high-grade squamous intraepithelial lesions (hHSIL) prevents anal cancer. However, anal hHSIL incidence among women with human immunodeficiency virus (HIV, WHIV) remains unknown. Performance of anal high-risk human papillomavirus ([hr]HPV), anal cytology (anal-cyt), and both for hHSIL detection longitudinally over 2 years also remains undetermined.

Evaluating the performance of anal cytology and high-risk HPV genotyping for detecting anal HSIL in a clinic-based sample of people living with and without HIV in Puerto Rico.

Background: Given the disproportionately elevated anal cancer risk in high-risk populations, it is important to assess the performance of commonly used anal cancer screening tools to improve the effectiveness of detection and treatment methods. This study evaluates 1) the concordance between anal cytology and histology results and 2) the performance of cytology and high-risk human papillomavirus (HR-HPV) genotyping as screening tools for detecting histologically confirmed anal high-grade squamous intraepithelial lesions (HSIL).

Methods: Data from the Anal Neoplasia Clinic in Puerto Rico (2014-2021; n = 466) was used.

Association of smoking with anal high-risk HPV infection and histologically confirmed anal high-grade squamous intraepithelial lesions among a clinic-based population in Puerto Rico.

Introduction: Current smoking is a risk factor for anal cancer. Yet, its association with anal human papillomavirus infection (HPV) and anal high-grade squamous intraepithelial lesions (HSIL) remains unclear. We assessed the association of smoking with 1) anal high-risk HPV (HR-HPV) infection and 2) anal HSIL.

Xpert HPV as a Screening Tool for Anal Histologic High-Grade Squamous Intraepithelial Lesions in Women Living With HIV.

Background: Women living with HIV (WLWH) experience high rates of anal cancer. Screening using anal cytology, high-resolution anoscopy (HRA) with biopsies, can histologically diagnose anal cancer precursors called high-grade squamous intraepithelial lesions (HSIL). The low specificity of screening using anal cytology results in HRA referral for many WLWH without HSIL.

Short-term oral albendazole therapy for diffuse unilateral subacute neuroretinitis: A case report.

Purpose: To report on a case of diffuse unilateral subacute neuroretinitis (DUSN) that was successfully treated with a short course of oral albendazole.

Observations: A 51-year-old male presented with severe visual loss secondary to DUSN associated with a positive serology. Because the parasite could not be detected on fundoscopy, first-line treatment with photocoagulation could not be administered.

Screening strategies for the detection of anal high-grade squamous intraepithelial lesions in women living with HIV.

Objective: HIV-infected women (WLHIV) have more than 10-fold higher risk for squamous cell cancer of the anus. Experts suggest cytology-based strategies developed for cervical cancer screening may prevent anal cancer by detecting anal cytologic or histological high-grade squamous intraepithelial lesion (hHSIL) for treatment. Currently, there is no consensus on anal-hHSIL screening strategies for WLHIV.

Public Health Academic Alliance for COVID-19 Response: The Role of a National Medical Task Force in Puerto Rico.

Alliances between the government and academic communities can be a key component of the public health response to an emergency such as the coronavirus disease 2019 (COVID-19) pandemic. The Governor of Puerto Rico designated the Puerto Rico Medical Task Force (MTF) COVID-19 to provide direct guidance and evaluation of the government response to the epidemic in Puerto Rico. Several work groups were formed within the MTF to create protocols and provide evidence-based recommendations on different public health aspects.

Level of Physical Activity and Knowledge about the Physical Activity Guidelines in a Group of Medical Residents from Puerto Rico.

Objective: Physicians who know about physical activity guidelines (PAG) and those who adhere to the PAG themselves may have a greater tendency to recommend physical activity (PA) to their patients. This study was aimed at evaluating the level of PA in a group of medical residents from Puerto Rico and to assess their knowledge regarding the PAG for adults.

Methods: A total of 104 medical residents from Puerto Rico completed a selfadministered questionnaire designed to obtain standardized estimates of their PA and to determine their level of knowledge regarding the PAG.

Assessment of Anal Cancer Screening Tools in Detecting High-Grade Anal Squamous Intraepithelial Lesions in Women.

Objective: The aim of the study was to evaluate the validity of anal cytology against high-resolution anoscopy in the detection of anal high-grade squamous intraepithelial lesions (HSILs) among women in a clinical setting in Puerto Rico, alone and in combination with high-risk human papillomavirus (HR-HPV) typing.

Materials And Methods: A cross-sectional study was done among 128 eligible women who attended the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Center between 2014 and 2019. Kappa (κ) coefficient, sensitivity, specificity, positive predictive value, and negative predictive value were calculated using high-resolution anoscopy with biopsy as the criterion standard test.

Prevalence of and Risk Factors for Anal High-grade Squamous Intraepithelial Lesions in Women Living with Human Immunodeficiency Virus.

Background: Women living with human immunodeficiency virus (WLHIV) have disproportionately high rates of squamous cell carcinoma of the anus compared with the general population of women. Anal high-grade squamous intraepithelial lesions (HSILs) precede anal cancer, and accurate studies of HSIL prevalence among WLHIV in the United States are lacking.

Methods: The AIDS Malignancy Consortium 084 study was a multicenter national trial to evaluate the prevalence of and risk factors for anal HSIL in a US cohort.

Predicting performance on the United States Medical Licensing Examination Step 1 and Step 2 Clinical Knowledge using results from previous examinations.

Background: Finding early specific indicators of failure in the United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) could be used to develop early interventions that could solve deficiencies and help at-risk students to ultimately attain a passing score. This study was aimed at determining if the National Board of Medical Examiners (NBME) Comprehensive Basic Science Examination (CBSE) could predict a passing score during the USMLE Step 1. We also assessed if the NBME Medicine Clinical Science Subject Examination (CSSE) or the USMLE Step 1 could predict passing scores during the USMLE Step 2 CK.

Human Papillomavirus Correlates With Histologic Anal High-Grade Squamous Intraepithelial Lesions in Hispanics With HIV.

Objective: To estimate the magnitude of association between anal infection with high-risk human papilloma virus (HR-HPV) types and severity of biopsy-confirmed histopathological anal squamous intraepithelial lesions (SILs) among a clinic-based sample of HIV-infected adults in Puerto Rico.

Methods: This cross-sectional study analyzed data from medical records of adult patients who visited a specialized anal neoplasia clinic from June 2015 to December 2017 (n = 239); sociodemographics, behavioral risk factors, medical history, clinical data, and pathology reports were collected. The magnitude of association between anal HR-HPV and severity of anal SIL, adjusted for potential confounders, was assessed using a multinomial logistic model.

Ceftazidime/Avibactam for Refractory Bacteremia, Vertebral Diskitis/Osteomyelitis with Pre-Vertebral Abscess and Bilateral Psoas Pyomyositis Secondary to Klebsiella Pneumoniae Carbapenemase-Producing Bacteria (KPC).

A 36-year-old man was admitted to the intensive care unit due to diabetic ketoacidosis and pneumonia requiring mechanical ventilation. Three weeks after admission, he developed a refractory bacteremia with Klebsiella pneumoniae carbapenemase-producing bacteria (KPC). He remained febrile and with bacteremia for six weeks despite therapy with polymyxin B, carbapenems, and amikacin.

Survival from anal cancer among Hispanics-Puerto Rico, 2000-2007.

Purpose: The incidence of anal cancer is increasing, particularly among HIV and men who have sex with men (MSM) groups. The vast majority of cases are associated with human papillomavirus (HPV), the most common sexually transmitted infection. Epidemiological studies have also documented low survival, which might be linked to lack of appropriate screening, access, and utilization of pertinent health care services.

Recognizing and treating anal cancer: training medical students and physicians in Puerto Rico.

Objective: This training activity aimed at increasing the knowledge of anal cancer screening, diagnostic and treatment options in medical students and physicians, to determine the interest of these individuals in receiving training in the diagnosis and treatment of anal cancer, and to explore any previous training and/or experience with both anal cancer and clinical trials that these individuals might have.

Methods: An educational activity (1.5 contact hours) was attended by a group of medical students, residents and several faculty members, all from the Medical Sciences Campus of the University of Puerto Rico (n = 50).

Clinical experience with posaconazole in patients with invasive mucormycosis: a case series.

Posaconazole (POS) is approved for prophylaxis of Aspergillus and Candida infections in immunocompromised patients and for the treatment of oropharyngeal candidiasis. Data is limited as step-down therapy after treatment with amphotericin B (AMB). Four cases with refractory mucormycosis who had a favorable response after a change in antifungal therapy to POS are presented.

Cytomegalovirus polyradiculomyelopathy in AIDS: a case report and review of the literature.

Cytomegalovirus (CMV) neurologic disease is a serious complication of the acquired immunodeficiency virus (AIDS). We report the case of a 40 year-old woman with AIDS who presented paralysis of lower extremities, areflexia, sensory loss, and urinary retention. CMV polymerase chain reaction (PCR) of cerebrospinal fluid (CSF) allowed confirmation of CMV polyradiculomyelopathy (PRAM).

Ileal perforation and reactive hemophagocytic syndrome in a patient with disseminated histoplasmosis: the role of the real-time polymerase chain reaction in the diagnosis and successful treatment with amphotericin B lipid complex.

The following case illustrates an ileal perforation and reactive hemophagocytic syndrome (RHS) resulting from disseminated histoplasmosis in a patient with Human Immunodeficiency Virus (HIV) from Puerto Rico. Although the diagnosis was established by histopathologic findings and a positive bone marrow culture, Histoplasma capsulatum-specific real-time Polymerase Chain Reaction (PCR) allowed to confirm the diagnosis from formalin-fixed, paraffin-embedded tissue. Interestingly, the Histoplasma antigens in both serum and urine samples were falsely negative.

Applicability of the Spanish Translation of the Zung Self-Rating Depression Scale in a general Puerto Rican population.

Voluntary screening has shown to be an effective way to identify depressive symptoms and to provide adequate treatment. If a screening tool was to be used in a general Puerto Rican population, it should be validated in Spanish and be consistent with the particular response style of this group. The main objective of this research study is to assess if the Spanish translation of the Zung SDS is adequate to screen for depression in Puerto Ricans, and if the translation considers the sociocultural peculiarities of this group.