Breast and Colorectal Cancer Screening Utilization after Hurricane María and the COVID-19 Pandemic in Puerto Rico.

Puerto Rico (PR) has faced environmental and public health challenges that could have significantly affected cancer screening access. Using administrative claims data from PR's Medicaid population, this study assessed trends in colorectal and breast cancer screening from 2016 to 2021, the impact of disasters in screening, and the absolute deficit in screening due to the pandemic. The monthly rates of claims were analyzed using Poisson regression.

Diabetes is associated with chronic liver disease and liver cancer in the adult population of Puerto Rico.

Objective: Diabetes mellitus (DM) has been proposed as a risk factor for both chronic liver disease (CLD) and for hepatocellular carcinoma (HCC); however, studies among Hispanics are limited. Puerto Rico (PR) has a high prevalence of DM (13%), supporting the need for a better understanding of the public health implications associated with DM in this population. We assessed the association of DM with CLD and with HCC in a population of Puerto Rican adults with health insurance.

Prevalence of autism spectrum disorders in relatives of patients with selective immunoglobulin A deficiency.

Background: An association of selective IgA (immunoglobulin A) deficiency in individuals with autism has been previously described. The objective of this study was to examine the incidence of autism spectrum disorders (ASD) in children and siblings of selective IgA deficient patients.

Objective: to assess the likelihood of parents with the most common type of primary immunodeficiency (selective IgA deficiency) having children with ASD and to investigate the occurrence of ASD in siblings of the immunodeficient patients.

Patient profiles and their relationship with the CES-D scale at the Diabetes Center for Puerto Rico.

Purpose: The prevalence of diabetes mellitus in Puerto Ricans has been identified and reported as being disproportionately higher as compared to other metabolic pathologies. Recently, diabetes has been identified as the third cause of mortality in Puerto Rico (Puerto Rico Health Department, Vital Statistics Annual Report, 1999-2001). The Research Center, Education and Medical Services for Diabetes in Puerto Rico (also known as the "Centro de Diabetes para Puerto Rico" [CDPR]) is a public corporation in the island created by the government to reduce diabetes prevalence, mortality and morbidity.

Anaphylaxis: an analysis of cases evaluated at the Puerto Rico Medical Center over a ten-year period.

Objective: To examine the clinical characteristics of patients with anaphylactic reactions evaluated at the Puerto Rico Medical Center over a ten year period.

Background: Anaphylaxis, an immunologic reaction classically initiated by the combination of an antigen and a mast cell fixed antibody (usually IgE), still carries a fatality rate of 500 to 1000 cases per year in the United States. It constitutes a medical emergency that needs to be identified promptly in order to install appropriate treatment.

Rheumatologic manifestations in patients with selected primary immunodeficiencies evaluated at the University Hospital.

Objective: To characterize an IgA deficient and common variable immunodeficiency (CVI) group of patients in terms of the presence of rheumatologic manifestations.

Background: Although the molecular basis of some of the primary immunodeficiencies has been elucidated, it has not been possible to explain why in most cases these conditions are often associated with autoimmune manifestations, besides infections. The concomitant inability to fight infections adequately (immunodeficiency) and an inordinate reaction of the immune system to self components (autoimmunity) has been a perplexing situation.

IgA deficiency: clinical correlates with IgG subclass and mannan-binding lectin deficiencies.

Objective: To characterize an IgA deficient population in terms of the incidence of IgG subclass and mannose-binding lectin (MBL) deficiencies and the type and severity of infections and other associated disorders.

Background: Selective IgA deficiency is probably the commonest of the primary immunodeficiency disorders and although it may lead to an increased risk for respiratory and gastrointestinal infections and associated to various autoimmune diseases, it may also be asymptomatic. Several studies have suggested the need of a concomitant defect in order for manifestation of its symptoms.

Common variable immunodeficiency: experience in Puerto Rico.

Common variable immunodeficiency (CVI) is a primary immunodeficiency characterized by hypogammaglobulinemia and an increased susceptibility to infections. The degree and the type of deficiency of serum immunoglobulins, as well as, the clinical course vary from patient to patient, hence the term "variable". The aim of this report is to describe the clinical characteristics and the response to gammaglobulin therapy of a group of patients with CVI followed at the University Hospital of the Puerto Rico Medical Center.

Comparison of oral nicotinamide adenine dinucleotide (NADH) versus conventional therapy for chronic fatigue syndrome.

Objective: To compare effectiveness of oral therapy with reduced nicotinamide adenine dinucleotide (NADH) to conventional modalities of treatment in patients with chronic fatigue syndrome (CFS).

Background: CFS is a potentially disabling condition of unknown etiology. Although its clinical presentation is associated to a myriad of symptoms, fatigue is a universal and essential finding for its diagnosis.