Publications by authors named "Juan C Zevallos"

Leptospirosis is a neglected zoonotic disease that is endemic in tropical regions, including Ecuador. It is caused by spirochetes of the genus , which can infect humans through animal reservoirs such as rats and dogs, or through contact with contaminated water or soil. In March 2023, public health authorities declared a concerning outbreak of leptospirosis in Durán Cantón, located in the Coastal region of Ecuador.

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Background: Compared with conventional cigarettes, electronic cigarettes are less harmful in some studies. However, recent research may indicate the opposite. This study aimed to determine whether e-cigarette use is related to myocardial health in adults in the U.

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  • The genus Bartonella consists of Gram-negative bacilli that can infect various mammals, including cats and humans; a recent outbreak of cat scratch disease linked to B. henselae was reported in Guayaquil, Ecuador in 2022.
  • Researchers collected blood samples from 100 domestic and stray cats in the outbreak area to identify the presence of Bartonella spp. through genetic testing.
  • Results showed that 14 cats were carrying Bartonella spp., with 12 infected by B. henselae and 2 by B. clarridgeiae, highlighting the need for a One Health approach to manage and prevent zoonotic diseases in the region.
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In the US, racial disparities in hospital outcomes are well documented. We explored whether race was associated with all-cause in-hospital mortality and intensive care unit (ICU) admission among COVID-19 patients in California. This was a retrospective analysis of California State Inpatient Database during 2020.

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  • Ecuador experienced significant COVID-19 mortality in 2020, despite early implementation of non-pharmaceutical interventions (NPIs), highlighting challenges in high-mobility informal labor settings.
  • A study analyzed respiratory samples from 1950 patients during the pandemic, finding correlations between lower NPI stringency and increased detection of multiple respiratory viruses, including SARS-CoV-2.
  • Phylogenomic analyses showed numerous independent introductions of SARS-CoV-2 in early 2020, with NPIs negatively correlating with the variety of circulating virus strains, emphasizing the importance of effective interventions in controlling outbreaks, particularly in resource-limited contexts.
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Many case reports have indicated that myocarditis could be a prognostic factor for predicting morbidity and mortality among patients with COVID-19. In this study, using a large database we examined the association between myocarditis among COVID-19 hospitalizations and in-hospital mortality and other adverse hospital outcomes. The present study was a retrospective analysis of data collected in the California State Inpatient Database during 2020.

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Cardiovascular diseases and frailty are common conditions of aging populations and often coexist. In this study, we examined the in-hospital management, outcomes, and resource use of frail patients hospitalized for ST-segment elevation myocardial infarction (STEMI). This was a retrospective analysis of the 2005-2014 data from the Nationwide Inpatient Sample.

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Background: While it is widely held that obesity is a risk factor for stroke, its role in mortality after stroke is less understood. We aim to examine effects of Body Mass Index (BMI) on in-hospital mortality after non-subarachnoid, subarachnoid, and ischemic stroke.

Methods: Retrospective cohort study.

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Electronic nicotine delivery systems (ENDS) are growing in use and many of the health implications with these devices remain unknown. This study aims to assess, using a survey representative of the USA general population, if an association exists between a history of ENDS use and a history of stroke.This cross-sectional study was a secondary data analysis using the 2016 behavioral risk factor surveillance system survey.

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Effective and rapid decision making during a pandemic requires data not only about infections, but also about human behavior. Mobile phone surveys (MPS) offer the opportunity to collect real-time data on behavior, exposure, knowledge, and perception, as well as care and treatment to inform decision making. The surveys aimed to collect coronavirus disease 2019 (COVID-19) related information in Ecuador and Sri Lanka using mobile phones.

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Objective: The purpose of this study was to determine if there is an association between marital status (single, married, divorced/separated, and widowed) and inhospital mortality in patients with acute myocardial infarction (AMI) from Puerto Rico in 2007, 2009, and 2011.

Methods: This study was a secondary data analysis of information retrieved from the Puerto Rican Cardiovascular Surveillance System obtained from the University of Puerto Rico for the residents of Puerto Rico during the study years. The sample included individuals aged 18 or older who presented with an incidental AMI.

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Background and Purpose- We aimed to evaluate the current practice patterns, safety and outcomes of patients who receive endovascular therapy (EVT) having mild neurological symptoms. Methods- From Jan 2010 to Jan 2018, 127,794 ischemic stroke patients were enrolled in the Florida-Puerto Rico Stroke Registry. Patients presenting within 24 hours of symptoms who received EVT were classified into mild (National Institutes of Health Stroke Scale [NIHSS] ≤5) or moderate/severe (NIHSS>5) categories.

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Objective: To assess the feasibility of implementing a physician-based, patient-centered counseling intervention model in Ecuador to improve the ability of primary care physicians (PCPs) to reduce cardiovascular disease (CVD) risk factors among patients.

Methods: This was a randomized clinical trial conducted in primary care clinics in Quito in 2014 - 2016. Participants included 15 PCPs and their adult patients at high risk of developing type-2 diabetes.

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Background and Purpose- Ischemic stroke (IS) secondary to atrial fibrillation (AF) is largely preventable with the use of anticoagulation. We sought to identify race-ethnicity and sex disparities with the use of direct oral anticoagulants (DOACs), aspirin, and warfarin in IS patients with AF and to identify temporal trends in the utilization of these medications. Methods- The FLiPER-AF Stroke Study (Florida Puerto Rico Atrial Fibrillation) included 24 040 IS cases enrolled in the Florida-Puerto Rico Collaboration to Reduce Stroke Registry from 2010 to 2016.

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Older Hispanics are an understudied minority group in the US, and further understanding of the association between frailty, gait and balance impairments in disadvantaged older Hispanics is needed. The objectives of this study were to compare the balance and gait of older Hispanics by their frailty status. Sixty-three older Hispanics (21 men, 42 women, mean age 75 ± 7 years) attending senior centers in disadvantaged neighborhoods were grouped by their frailty status and completed balance and walking tests at a preferred speed and during street crossing simulations.

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Colorectal cancer (CRC) is the third most common cause of mortality in the United States (US). Differences in CRC mortality according to race have been extensively studied; however, much more understanding with regard to tumor characteristics' effect on mortality is needed. The objective was to investigate the association between race and mortality among CRC patients in the US during 2007⁻2014.

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Background And Purpose: Atrial Fibrillation (AF) is the most common cardiac cause of ischemic stroke. However, the relation between AF and stroke care outcomes in diverse populations is understudied. We aimed to evaluate sex and race-ethnic disparities associated with AF in hospital stroke outcomes utilizing data from the FLorida PuErto Rico Atrial Fibrillation (FLiPER-AF) Stroke Study.

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Intraoperative iatrogenic type A aortic dissection is a rare but known complication of cardiac surgery, with an incidence of 0.06% to 0.23%.

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Background: Glioblastoma is the most common primary brain cancer in adults with an incidence of 3.4 per 100,000, making up about 15% of all brain tumors. Inconsistent results have been published in regard differences in survival between white and black glioblastoma patients.

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  • Stroke is the second leading cause of death globally, with about 795,000 strokes occurring annually in the US, and its prevalence varies by race/ethnicity.
  • The study aimed to analyze the relationship between race/ethnicity and stroke prevalence among US adults in 2015, using a large sample of over 432,000 people.
  • Results showed that Hispanics (4.2%) and non-Hispanic Blacks (4.1%) had a higher stroke prevalence compared to non-Hispanic Whites (3.2%), with Hispanics being 57% more likely and Blacks 30% more likely to experience a stroke after controlling for confounding factors.
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Background And Purpose: Mild stroke is the most common cause for thrombolysis exclusion in patients acutely presenting to the hospital. Thrombolysis administration in this subgroup is highly variable among different clinicians and institutions. We aim to study the predictors of thrombolysis in patients with mild ischemic stroke in the FL-PR CReSD registry (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities).

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Short-term blood pressure variability is associated with pre-diabetes/diabetes cross-sectionally, but there are no longitudinal studies evaluating this association. The objective of this study is to evaluate the association between within-visit systolic and diastolic blood pressure variability and development of pre-diabetes/diabetes longitudinally. The study was conducted among eligible participants from the San Juan Overweight Adults Longitudinal Study (SOALS), who completed the 3-year follow-up exam.

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Patients with mental illness carry risk factors that predispose them to excess cardiovascular mortality from an acute myocardial infarction (AMI) compared to the general population. The aim of this study was to determine if patients with AMI and charted mental illness (CMI) received less reperfusion therapy following an AMI, compared to AMI patients without CMI in a recent sample population from Florida.A secondary analysis of data was conducted using the Florida Agency for Health Care Administration (FL-AHCA) hospital discharge registry.

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Background And Purpose: In the United States, about half of acute ischemic stroke patients treated with tPA (tissue-type plasminogen activator) receive treatment within 60 minutes of hospital arrival. We aimed to determine the proportion of patients receiving tPA within 60 minutes (door-to-needle time [DTNT] ≤60) and 45 minutes (DTNT ≤45) of hospital arrival by race/ethnicity and sex and to identify temporal trends in DTNT ≤60 and DTNT ≤45.

Methods: Among 65 654 acute ischemic stroke admissions in the National Institute of Neurological Disorders and Stroke-funded FL-PR CReSD study (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities) from 2010 to 2015, we included 6181 intravenous tPA-treated cases (9.

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Stroke remains one of the leading causes of death in the United States. Current evidence identified electrocardiographic abnormalities and cardiac arrhythmias in 50% of patients with an acute stroke. The purpose of this study was to assess whether the presence of ventricular arrhythmia (VA) in adult patients hospitalized in Florida with acute stroke increased the risk of in-hospital mortality.

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