Examining the association of elevated initial serum lactate with mortality and morbidity in trauma patients: a retrospective study.

Background: Elevated initial serum lactate (iSL) levels are frequently employed to assess trauma severity, but their predictive value for mortality and morbidity remains inconsistent. We evaluated the association of iSL with mortality and morbidity at Puerto Rico Trauma Hospital (PRTH).

Methods: This IRB-approved retrospective study included trauma patients ≥ 18 years with iSL measured within the first 48 h of admission to PRTH (July 2014-June 2019).

Surgical Rib Fixation is Associated With Lower Mortality in Patients With Traumatic Rib Fractures.

Introduction: Nonoperative management (NOM) along with supportive care has been the adopted approach for traumatic rib fractures; however, surgical approaches have emerged recently to treat this common pathology. Despite this, there are no guidelines for surgical rib fixation in patients with traumatic rib fractures.

Methods: An institutional review board-approved retrospective cohort study was performed at the Puerto Rico Trauma Hospital aiming to compare the outcomes and complications between patients with traumatic rib fractures who undergo surgical fixation and their counterparts with NOM.

Trends and outcomes of trauma patients positive to marijuana and cocaine.

Purpose: Substance misuse has long been recognized as a major predisposing risk factor for traumatic injury. However, there still exists no clear scientific consensus regarding the impact of drug use on patient outcomes. Therefore, this study aims to evaluate the demographic profile, hospital-course factors, and outcomes of trauma patients based on their toxicology.

Epidemiology of trauma in patients with mental disorders.

Objectives: We aimed to explore the influence of mental disorders on the risk of developing complications and in-hospital mortality after trauma.

Methods: We conducted an institutional review board-approved cohort study of 23 500 adult patients admitted to the Puerto Rico Trauma Hospital from 2002 to 2019. Participants were divided into 2 groups according to the presence or absence of psychiatric illnesses.

Elderly Admission Trends at the Puerto Rico Trauma Hospital: A Time-Series Analysis.

Introduction: The aging process places the elderly, a worldwide increasing age group, at an increased risk for trauma. This study aims to explore changes over time in admission rates, sociodemographical, clinical, and injury-related data in elderly patients (aged ≥65 y) admitted to the Puerto Rico Trauma Hospital (PRTH) during 2000-2019.

Materials And Methods: A time-series analysis was conducted.

A Retrospective Cohort Study on Health Insurance: Related Disparities in Trauma Patients After Penetrating Injuries: 2000-2014.

Objective: Although the lack of health insurance has been linked to poor health outcomes in several diseases, this relationship is still understudied in trauma. There exist differences between the Puerto Rico health care system and that of the United States. We therefore aimed to assess mortality disparities related to insurance coverage at the Puerto Rico Trauma Hospital (PRTH).

The effect of the lockdown executive order during the COVID-19 pandemic in recent trauma admissions in Puerto Rico.

Background: The COVID-19 pandemic led to world-wide restrictions on social activities to curb the spread of this disease. Very little is known about the impact of these restrictions on trauma centers. Our objective was to determine the effect of the pandemic-associated lockdown on trauma admissions, patient's demographics, mechanisms of injury, injury severity, and outcomes in the Puerto Rico Trauma Hospital.

Recidivism at the puerto rico trauma hospital.

Purpose: Although trauma represents a leading cause of morbidity and mortality worldwide, there is limited and heterogeneous evidence regarding trauma recidivism and its outcomes. This analysis determined the rate and independent risk factors of trauma recidivism and compared the first and second injury episode among recidivists.

Methods: An IRB-approved retrospective cohort study was performed with data from the Puerto Rico Trauma Hospital Registry.

Epidemiology of traumatic falls after Hurricane Maria in Puerto Rico.

Background: Hurricanes are among the most devastating natural disasters, playing a significant role in public health. Currently, the epidemiology of fall-related injuries after the occurrence of a tropical storm is not well described. This study aims to compare the demographical patterns, clinical profile, hospital course, and costs of patients admitted to the Puerto Rico Trauma Hospital before and after Hurricane Maria.

Unveiling the Natural History of Category 4 Tropical Cyclones: The Puerto Rico Trauma Hospital Experience after Hurricane Maria.

Objectives: The hazardous environmental conditions hurricanes create might increase injury incidence almost 7 times. Therefore, a cohort study was performed at the Puerto Rico Trauma Hospital to compare morbidity and mortality patterns of patients after Hurricane Maria with a control period.

Methods: Admissions from September 20, 2017, through January 20, 2018, constituted the post-Maria period (473 patients); the corresponding months of the previous year comprised the pre-Maria period (439 patients).

Traumatic esophageal perforation in Puerto Rico Trauma Hospital: A case-series.

Background: Esophageal injuries are rare, life-threatening, events with an overall reported incidence of less than 3%. In rare cases, trauma due to blunt or penetrating injuries cause esophageal perforations, which account for less than 15% of all esophageal injuries.

Materials And Methods: A case-series study was conducted to describe the outcomes and management of all the traumatic esophageal injuries at the Puerto Rico Trauma Hospital (PRTH) from 2000 through 2017.

Traumatic Vascular Injury and its Management with Temporary Intravascular Shunts: A Puerto Rico Trauma Hospital's Experience.

Objective: Temporary intravascular shunts (TIVSs) are commonly used as a damagecontrol procedure in trauma settings. Currently, there is scarce literature in the civilian field, and what there is is limited to large trauma centers with multiple resources. Therefore, we aimed to describe TIVS usage, and the outcomes of that usage, at Puerto Rico Trauma Hospital.

A Comparative Analysis of the Injury Patterns and In-Hospital Mortality Rates of Belted and Unbelted Motor-Vehicle Occupants - Puerto Rico, January 2000 to December 2014.

Objective: Motor vehicle collisions (MVCs) constitute a leading source of morbidity and mortality worldwide. Seatbelt use has been associated with reduced mortality in MVCs. In Puerto Rico, the impact of seatbelt use on MVC deaths has not been evaluated, although they represent a major public health threat.

Morbidity and mortality of Hispanic trauma patients with diabetes mellitus.

Purpose: DM and trauma are leading causes of death in Hispanic patients, yet the interaction between them remains obscure. We aimed to assess the complications and in-hospital mortality rate of Hispanic diabetic trauma patients.

Methods: A retrospective cohort study was carried out using data from the Puerto Rico Trauma Hospital databank.

Trauma Epidemiology of Women in Puerto Rico, 2002-2011.

Objective: Recent literature has suggested that trauma is heterogenic and that physiological response to it differs between sexes. The study represented in this manuscript aimed to describe gender differences in the mortality rates of trauma patients at the Puerto Rico Trauma Hospital (PRTH).

Materials And Methods: This was a cross-sectional study performed at PRTH.

Trauma epidemiology in Puerto Rico: in-hospital morbidity and mortality from 2002 to 2011.

This study aimed to describe the distribution of injury mechanisms and to assess the impact of those mechanisms on the morbidity and mortality of trauma. All patients admitted to Puerto Rico Trauma Hospital (2002-2011) for road-traffic collisions (RTCs, 5,371), gunshot wounds (GSWs, 2,946), falls (2,319), pedestrian accidents (1,652), and stab wounds (SWs, 1,073) were selected. Gunshot victims were 1.

Patient Outcomes After Early Versus Late Tracheostomy in the Puerto Rico Trauma Hospital.

Objective: This study aimed to evaluate the impact of early tracheostomy (ET, ≤7 days) versus that of late tracheostomy (LT, >7 days) on outcomes such as hospital length of stay (LOS), intensive care unit (ICU) days, mechanical ventilation (MV) days, and mortality ratio.

Methods: A historical cohort study was undertaken using charts of patients admitted to the Puerto Rico Trauma Hospital who required MV and underwent tracheostomies, from 2000 to 2013. A logistic regression was performed to evaluate the association between timing of tracheostomy and complications and mortality.

Intrathoracic esophageal rupture distal to the carina after blunt chest trauma: Case-report.

Introduction: Esophageal rupture caused by blunt chest trauma is a very rare entity, with an incidence of 0.001%. Eighty two percent of the esophageal perforation secondary to blunt chest trauma occur above the level of the carina, with the lowest reported incidence in the intrathoracic region distal to the carina.

In the (sub)tropics allergic rhinitis and its impact on asthma classification of allergic rhinitis is more useful than perennial-seasonal classification.

Background: Two different allergic rhinitis (AR) symptom phenotype classifications exist. Treatment recommendations are based on intermittent-persistent (INT-PER) cataloging, but clinical trials still use the former seasonal AR-perennial AR (SAR-PAR) classification. This study was designed to describe how INT-PER, mild-moderate/severe and SAR-PAR of patients seen by allergists are distributed over the different climate zones in a (sub)tropical country and how these phenotypes relate to allergen sensitization patterns.

Allergen sensitization linked to climate and age, not to intermittent-persistent rhinitis in a cross-sectional cohort study in the (sub)tropics.

Background: Allergen exposure leads to allergen sensitization in susceptible individuals and this might influence allergic rhinitis (AR) phenotype expression. We investigated whether sensitization patterns vary in a country with subtropical and tropical regions and if sensitization patterns relate to AR phenotypes or age.

Methods: In a national, cross-sectional study AR patients (2-70 y) seen by allergists underwent blinded skin prick testing with a panel of 18 allergens and completed a validated questionnaire on AR phenotypes.

Feasibility of a sedation wake-up trial and spontaneous breathing trial in critically ill trauma patients: a secondary analysis.

Objectives: To determine the feasibility of conducting a sedation wake-up trial (SWT) plus a spontaneous breathing trial (SBT) in critically ill trauma patients based on the ability to implement the combined intervention; to measure and describe patients' physiological responses; and to maintain patient safety.

Methods: A secondary analysis of the intervention group from a trial of 20 mechanically ventilated patients receiving SWT plus SBT in a trauma-intensive care unit.

Results: Patients passed 67% of the 39 SWTs performed; those who failed presented RASS scores of +1 and +2 (70%), tachycardia (15%) or ventilator asynchrony (15%).

[Related systemic reactions to allergen immunotherapy in Monterrey, Mexico].

Background: Patients who receive allergen immunotherapy (IT) have a potential risk of systemic reactions, however such reactions are rare when IT administered properly. The frequency of systemic reactions (SR) due to conventional IT is less than 1%.

Objective: To determine the frequency of secondary SR to allergen IT, and to identify the possible factors involved in developing them.

Efficacy of small doses of ketamine with morphine to decrease procedural pain responses during open wound care.

Objective: The purpose of this study was to evaluate differences in pain intensity, pain quality, physiological measures, and adverse effects when patients received morphine with saline (MS) compared with morphine and a small dose of ketamine (MK) before an open wound care procedure (WCP).

Methods: A randomized, cross-over design was used to determine whether the addition of a small dose of ketamine would potentiate morphine's analgesic effects and decrease WCP pain intensity. Patients were randomized to receive either 0.

Atmospheric pollen count in Monterrey, Mexico.

There are few reports of pollen count and identification in Mexico; therefore, it is important to generate more information on the subject. This study was designed to describe the prevalence of pollen in the city of Monterrey, Mexico, during the year 2004. Atmospheric pollen was collected with a Hirst air sampler, with an airflow of 10 L/minute during 2004.

[Epidemiological characteristics of patients with food allergy assisted at Regional Center of Allergies and Clinical Immunology of Monterrey].

Background: Food allergy is an abnormal immunologic response to food allergens. Prevalence varies between 2% and 8%, although it could vary according to age and ethnicity. Clinical manifestations are diverse among systems.