Publications by authors named "Robert Hunter-Mellado"
Dendritic cells (DC) are important antigen-presenting cells that have abilities to induce and maintain T-cell immunity, or attenuate it during hyperimmunization. Additional activation of DCs may be useful for vaccination purposes. Imiquimod is known to be a specific agonist of the Toll-like receptors (TLR7), which are located mainly on DCs.
View Article and Find Full Text PDFSoy and Frequent Dairy Consumption with Subsequent Equol Production Reveals Decreased Gut Health in a Cohort of Healthy Puerto Rican Women.
Int J Environ Res Public Health
August 2021
The U.S. Hispanic female population has one of the highest breast cancer (BC) incidence and mortality rates, while BC is the leading cause of cancer death in Puerto Rican women.
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- Recent research reveals that platelets and megakaryocytes (MKs) play crucial roles in inflammation and infection, particularly concerning viral threats like dengue and influenza.
- The study found that the antiviral immune gene IFITM3 is significantly upregulated in platelets during these infections; higher levels of IFITM3 are linked to less severe illness and lower mortality among patients.
- Additionally, MKs were shown to have antiviral capabilities, as they can produce interferons that protect other MKs and stem cells from DENV infection, highlighting the immune functions of these blood cells.
Objective: This study aims to examine factors associated with the use of adjuvant chemotherapy and the use of oxaliplatin after curative resection in stage III colon cancer patients and assesses the effect of their use in three-year survival.
Methods: This retrospective cohort study was conducted using Puerto Rico Central Cancer Registry-Health Insurance Linkage Database. The study cohort consisted of stage III colon cancer patients with a curative surgery in the period 2008-2012.
Article Synopsis
- This study examines the effects of combining behavioral health and trauma services on the quality of life (QOL) of 136 Latinas with a history of drug use in Puerto Rico.
- Participants showed statistically significant improvements in physical, psychological, social, and environmental QOL after six months of intervention, despite high rates of unemployment and severe substance use disorders.
- The findings indicate that Latinas who experienced trauma had lower QOL scores, highlighting the need for targeted support for this population to address their physical and mental health challenges.
Article Synopsis
- The study analyzes cancer trends among a Puerto Rican Hispanic HIV/AIDS cohort across three periods, focusing on the impact of combination antiretroviral therapy (cART) on cancer incidence.
- A total of 281 cancers were identified, with a notable decrease in AIDS-related cancer incidence during cART eras, but certain cancers like Kaposi's sarcoma and invasive cervical carcinoma remained higher than in the general population.
- High mortality rates after cancer diagnosis (about 50% within a year) highlight the need for improved prevention and intervention strategies, including vaccination, lifestyle changes, screening, and education for this at-risk group.
Article Synopsis
- Late HIV testing (LT) is a serious issue in Puerto Rico, with 47% of patients testing late between 2000 and 2011, leading to worse health outcomes compared to those who tested early.
- While the prevalence of LT decreased from 47% in 2000 to 37% in 2011, factors like being male and older age were linked to higher odds of LT, while a history of amphetamine use lowered those odds.
- Notably, only men who have sex with men (MSM) showed a significant decrease in LT rates, highlighting a need for better early detection strategies and evaluation of HIV-testing guidelines in Puerto Rico.
Article Synopsis
- A study followed 882 Puerto Rican patients undergoing antiretroviral therapy (ART) for HIV over 11 years, focusing on socio-demographic factors and HIV risk behaviors.
- Results showed that 661 patients with consistent ART had a higher persistent HIV viral load, linked to factors like illicit drug use and obesity.
- Findings suggest a need to improve ART adherence strategies andResearch differences in ART tolerance and compliance.
Pancytopenia is seen in late HIV infection; it is associated with medical complications and with decreased survival. We determined the prevalence of pancytopenia at baseline in a cohort of HIV-positive Hispanics living in Puerto Rico, and compared their socio-demographic, immunological and clinical characteristics. A total of 1202 patients enrolled between 2000 and 2010 were included.
View Article and Find Full Text PDFImpact of ASUMA Intervention on HIV Risk Behaviors among Puerto Rican Adolescents.
Int J Environ Res Public Health
December 2015
Article Synopsis
- The study evaluated HIV risk behaviors in early adolescents over three years with 135 junior high school students participating.
- A self-administered questionnaire compared risk behaviors at baseline and after the intervention, revealing significant differences between the intervention and control groups.
- Results showed fewer students in the intervention group engaged in HIV risk behaviors at the end of the study, indicating that the ASUMA initiative could effectively reduce these risks among adolescents.
Barriers for Compliance to Breast, Colorectal, and Cervical Screening Cancer Tests among Hispanic Patients.
Int J Environ Res Public Health
December 2015
Hispanics are less likely to undergo screening tests for colorectal cancer and cervical cancer than non-Hispanic whites. Compliance with mammography, fecal occult blood testing (FOBT), colonoscopy, and cervical smears (PAP) and barriers for compliance were studied. A descriptive study was performed with 194 ambulatory patients while they attended routine medical visits.
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- Late HIV testing (LT) is linked to higher transmission rates and worse health outcomes, particularly among Latinos, who make up a significant portion of LT cases in the US.
- A study conducted in Puerto Rico showed that from 2000 to 2011, 47% of eligible HIV patients were late testers, but this number decreased to 37% over the years, with men and older individuals being more likely to test late.
- The findings reveal a specific improvement in LT rates among men who have sex with men (MSM), but overall, there is still a notable need for earlier HIV detection efforts in Puerto Rico.
The 1st Puerto Rico Biobanking Workshop took place on August 20st, 2014 in the Auditorium of the Comprehensive Cancer Center of the University of Puerto Rico, Medical Sciences Campus in San Juan Puerto Rico. The program for this 1-day, live workshop included lectures by three biobanking experts, followed by presentations from existing biobanks in Puerto Rico and audience discussion. The need for increasing biobanking expertise in Puerto Rico stems from the fact that Hispanics in general are underrepresented in the biobanks in existence in the US, which limits the research conducted specifically to understand the molecular differences in cancer cells compared to other better studied populations.
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- Anemia is common in HIV-infected Hispanic patients, with a prevalence of 41.5%, and is linked to a higher risk of mortality in this group.
- Factors associated with increased odds of anemia include unemployment, low CD4 count, high viral load, low white blood cell count, and having clinical AIDS, while higher BMI is linked to lower odds of anemia.
- Survival rates show significant differences based on anemia status, with one-year mortality rates rising from 2.5% for patients without anemia to 30.8% for those with severe anemia, indicating that anemia is a critical factor in predicting mortality.
Article Synopsis
- HIV in the elderly is often underdiagnosed, leading to significant health and financial challenges for public health systems.
- A study examined 266 elderly patients with HIV/AIDS, focusing on gender and body mass index (BMI) as key factors.
- Results showed that men were more often overweight, while women tended to be underweight and had better immune response metrics (higher CD4 count, lower viral loads), highlighting differing impacts of HIV based on gender and weight.
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- A multimedia educational intervention program was created to combat the spread of hepatitis C among Hispanic injection drug users.
- A pre-post intervention study with 88 low-income Hispanic HIV-infected IDUs showed significant improvements in their knowledge and behaviors related to HCV after six months.
- The findings support using multimedia methods in education to effectively promote HCV prevention strategies among at-risk groups.
The frequency of K-RAS mutations ranges between 30% and 48% among the Caucasian, Asian, and European populations and these mutations are predictors of response to EGFR therapies. We sought to determine the expression of K-RAS gene mutations among colorectal cancer patients in PuertoRico. A retrospective study was conducted to determine the expression of mutant K-RAS among colorectal cancer patients in Puerto Rico between April 2009 and January 2011.
View Article and Find Full Text PDFHighly active antiretroviral therapy (HAART) significantly reduced the toxoplasmic encephalitis (TE) incidence in acquired immunodeficiency syndrome (AIDS) patients. The TE incidence and mortality were evaluated in an AIDS cohort followed in Puerto Rico before, during, and after HAART implementation in the Island. Of the 2,431 AIDS studied patients 10.
View Article and Find Full Text PDFHemophagocytic Lymphystiocytosis is a rare and fatal complication of rheumatic diseases, particularly Adult Onset Still's Disease (AOSD). It may be precipitated with immunosuppressive drugs and with viral and bacterial infections. A diagnosis depends on a high index of suspicion associated to certain clinical manifestations (fever, rash, Splemomegaly, any cytology blood dyscrasia, hipertrigliceridemia, hiperfibrinogenemia, and others), as well as pathologic evidence of hemophagocitosis from bone marrow biopsy or tissue samples of affected organs.
View Article and Find Full Text PDFFamilial Mediterranean Fever (FMF) is an autosomal recessive disorder predominantly affecting people of Mediterranean origin. It is characterized by recurrent episodes of fever and polyserositis of unexplained origin. Most patients with FMF experience their first attack in early childhood with 90% suffering their first bout of pain by the age of 20.
View Article and Find Full Text PDFChanges in the socio-demographics, risk behaviors, clinical and immunological profile of a cohort of the Puerto Rican population living with HIV: an update of the Retrovirus Research Center (1992-2008).
Bol Asoc Med P R
September 2013
Article Synopsis
- The study examines changes over time in HIV patient profiles, including demographics, risk behaviors, and clinical trends, across three distinct periods (1992-1997, 1998-2003, and 2004-2008).
- The research involved a longitudinal cohort of 4,016 HIV/AIDS patients, focusing on various socio-demographic, psychological, and clinical factors.
- Key findings highlighted that chronic conditions became more prevalent than AIDS-defining conditions, emphasizing the need for adaptations in HIV patient care services and programs.
Article Synopsis
- Nephropathy in HIV-infected patients is linked to increased progression to AIDS and higher mortality rates, influenced by the virus and other health conditions.
- A study conducted on 1,283 HIV-positive individuals in Puerto Rico found that those with kidney disease exhibited worse health metrics, including higher HIV viral loads and lower CD4 counts, along with significantly higher mortality rates.
- The findings suggest a critical need for preventive strategies that prioritize management of HIV and related chronic conditions like diabetes and hypertension to reduce health disparities among these patients.
Introduction: With the introduction of highly active antiretroviral therapy, the hepatitis C virus (HCV) infection has become a primary health problem among individuals suffering from HIV/ AIDS in Puerto Rico, principally those who are injecting drug users (IDUs). A multimedia educational intervention, based on the Health Beliefs Model and Social Cognitive Theory was developed and implemented to reduce HCV-associated risk behaviors among IDUs.
Methods: A pre- and post- intervention study evaluated the knowledge and behavioral changes in a group of HIV-infected persons recruited from February 2006 through December 2008.
Article Synopsis
- Teenagers are the fastest growing group of new HIV infections, prompting the ASUMA Project in Puerto Rico to develop a support model aimed at reducing HIV risk in early adolescents.
- The study followed 135 participants over three years, comparing an intervention group with a control group using self-administered questionnaires to measure changes in HIV risk behaviors and developmental factors.
- The results indicated a significant decrease in HIV risk behaviors and positive improvements in developmental factors among the intervention group, highlighting the effectiveness of culturally tailored interventions for HIV/AIDS prevention.
Background: The knowledge and implementation skills of the DNR (do not resuscitate) order amongst physicians in training appears to be quite variable.
Methods: We constructed, validated and implemented an instrument which evaluates knowledge and implementation skills of medical residents regarding the DNR in the 8 accredited teaching hospitals in Puerto Rico.
Results: Participation of 136 residents from 240 approved positions was seen.