Long-term complete remission of metastatic adrenocortical carcinoma.

Objectives: To report a rare case of a metastatic adrenocortical carcinoma (ACC) that achieve a complete and a long-term remission.

Case Presentation: AAC is a rare and aggressive tumor, with a high risk of recurrence and that present metastases in 21% of cases at diagnosis. Treatment of advanced ACC is challenging, mitotane is the only available adrenolytic treatment, with modest and unpredictable responses.

Chikungunya Virus: History, Geographic Distribution, Clinical Picture, and Treatment.

Chikungunya fever (CHIKF) is a re-emerging mosquito-borne disease caused by a virus endemic to Africa and Asia. Due to the ease with which its vectors propagate, the virus has spread to India and Europe, and more recently it arrived to the Caribbean, eventually extending into North, Central, and South America. According to the World Health Organization (WHO), the most common clinical manifestations are abrupt fever, polyarthralgia, headache, maculopapular rash, myalgia, and nausea/vomiting.

Primary Squamous Cell Carcinoma of the Stomach.

Squamous cell carcinoma (SCC) of the stomach is a rare entity. There are several theories regarding the development of this tumor, but its pathogenesis remains obscure. Fewer than 100 cases of primary SCC of the stomach have been published in the literature.

Sex Disparities in Ischemic Stroke Care: FL-PR CReSD Study (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities).

Background And Purpose: Sex-specific disparities in stroke care including thrombolytic therapy and early hospital admission are reported. In a large registry of Florida and Puerto Rico hospitals participating in the Get With The Guidelines-Stroke program, we sought to determine sex-specific differences in ischemic stroke performance metrics and overall thrombolytic treatment.

Methods: Around 51 317 (49% women) patients were included from 73 sites from 2010 to 2014.

Gastric necrosis: A late complication of nissen fundoplication.

Gastric necrosis is a rare condition because of the rich blood supply and the extensive submucosal vascular network of the stomach. "Gas-bloat" syndrome is a well known Nissen fundoplication postoperative complication. It may cause severe gastric dilatation, but very rarely an ischemic compromise of the organ.

Gender disparities in Puerto Ricans hospitalized with an initial acute myocardial infarction: A population-based perspective.

Objective: The published literature suggests differences in presenting symptoms for acute myocardial infarction (AMI), management, and outcomes according to gender and age. However, limited information exists on this topic among Hispanics.

Methods: In Puerto Rican patients hospitalized with an initial AMI, we examined differences in presenting symptoms, effective cardiac therapies, and in-hospital mortality as a function of gender and age groups.

[The University of Puerto Rico Emergency Medicine Program: 15th anniversary, its history and contribution to health care in Puerto Rico].

Emergency medicine is a newly created specialty in Puerto Rico. The first training program began in 1977. Unfortunately this program was decertified by ACGME in 30 July 30 1993.

University of Puerto Rico Emergency Medicine Program: impact throughout the country.

Objectives: Determine distribution, job description, and board certification status of the University of Puerto Rico Emergency Medicine Program (UPREMP) graduates.

Methods: A telephone survey was performed of all UPREMP graduates from 1995 to 2007, asking for the following information: practitioner or non practitioner, working place, job description (e.g.

The use of therapeutic hypothermia after cardiopulmonary arrest.

Actually recommended by the International Liaison Committee on Resuscitation (ILCOR), therapeutic hypothermia has been the only modality shown to improve neurological outcomes after cardiac arrest. This article provides the background for such recommendations as well as: pathophysiology, review of brain injury during cardiac arrest, discussion of beneficial effects of therapeutic hypothermia, different mechanisms used to induce it and the latest clinical trials results.

Descriptive study of cerebrovascular accidents among Hispanic population.

Background And Purpose: Data characterizing stroke patients among Hispanic population are scant. The aim of this study was to describe this population and to assess baseline knowledge of stroke type, risk factors, and family history, among others.

Methods: A retrospective chart review of 253 stroke patients admitted to the University of Puerto Rico Hospital during the fiscal year July 2002 to June 2003 was done.

Bariatric surgery patients: reasons to visit emergency department after surgery.

Study Objective: Morbid obesity prevalence is reaching epidemic proportions in Western society. Long-term weight loss can be achieved by bariatric surgery. This surgery also has a positive impact in the reduction of obesity related co-morbid conditions.