Neurosurgery Morbidity and Mortality: A Prospective Surgical and Medical Analysis.

Objective: The analysis of morbidity and mortality is fundamental for improving the quality of patient care. The objective of this study was to evaluate the combined medical and surgical morbidity and mortality of neurosurgical patients.

Methods: We performed a daily prospective compilation of morbidities and mortalities during a consecutive 4-month period in all the patients who were 18 years of age or older and had been admitted to the neurosurgery service at the Puerto Rico Medical Center.

The Limited Effects of Estradiol Administration Immediately after Spinal Cord Injury.

Objective: We aimed to investigate estradiol (E2) as a therapeutic drug for spinal cord injury (SCI) and elucidate the disagreement in the field about the use of this hormone after an injury.

Methods: Eleven animals underwent surgery (laminectomy at the T9-T10 levels) followed by an intravenous injection (100 μg) of an E2 bolus and the implantation of 0.5cm of Silastic tubing containing 3 mg of E2 (sham E2 + E2 bolus) immediately after the laminectomy.

Predictors of reoperation in hispanic-americans with recurrent lumbosacral disc herniation following primary hemilaminectomy and discectomy surgery.

Background: Multiple risk factors for recurrent lumbosacral disc herniation (rLDH) have been evaluated. However, it has been difficult to establish a consensus due to conflicting results. Therefore, the aim of our study was to evaluate the predictors of reoperation in Hispanic-Americans with rLDH following primary hemilaminectomy and discectomy surgery.

A live dengue virus vaccine carrying a chimeric envelope glycoprotein elicits dual DENV2-DENV4 serotype-specific immunity.

The four dengue virus serotypes co-circulate globally and cause significant human disease. Dengue vaccine development is challenging because some virus-specific antibodies are protective, while others are implicated in enhanced viral replication and more severe disease. Current dengue tetravalent vaccines contain four live attenuated serotypes formulated to theoretically induce balanced protective immunity.

Systematic Review: Neurodevelopmental Benefits of Active/Passive School Exposure to Green and/or Blue Spaces in Children and Adolescents.

Today more than half of the world's population lives in urban areas. Children spend about 40 h a week in the school environment. Knowing the influence of school exposure to green/blue spaces could improve the children's health, creating healthier environments and preventing exposure to legal/illegal drugs.

Pre- and peri-natal hurricane exposure alters DNA methylation patterns in children.

Hurricane Maria was the worst recorded natural disaster to affect Puerto Rico. Increased stress in pregnant women during and in the aftermath of the hurricane may have induced epigenetic changes in their infants, which could affect gene expression. Stage of gestation at the time of the event was associated with significant differences in DNA methylation in the infants, especially those who were at around 20-25 weeks of gestation when the hurricane struck.

Perceptions of preparedness, timing of cancer diagnosis, and objective emergency preparedness among gynecological cancer patients in Puerto Rico before and after Hurricane Maria.

Objectives: This study investigated the impact of cancer diagnosis status, individual feelings of preparedness, and other covariates on objective emergency preparedness among women diagnosed with gynecological cancers before or after the 2017 Hurricanes Irma and Maria in Puerto Rico.

Methods: This study included 240 women who were interviewed by telephone from 9/2019-11/2020. Objective emergency preparedness was assessed using a list of six items.

Opioid-Sparing Multimodal Analgesia Efficacy in Hispanic Patients Undergoing Total Knee Arthroplasty.

Unlabelled: Adequate pain control after total knee arthroplasty (TKA) has been associated with improved patient mobility and satisfaction, and is a task that has historically relied on opioids. Multimodal analgesic regimens can be considered a therapeutic alternative for postoperative pain control to avoid opioid consumption and its adverse side effects. This study aimed to evaluate the use of a multimodal analgesia protocol based on nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen as an alternative to reduce opioid consumption in Hispanic patients undergoing primary TKA.

Somatotopic organization among parallel sensory pathways that promote a grooming sequence in .

Mechanosensory neurons located across the body surface respond to tactile stimuli and elicit diverse behavioral responses, from relatively simple stimulus location-aimed movements to complex movement sequences. How mechanosensory neurons and their postsynaptic circuits influence such diverse behaviors remains unclear. We previously discovered that perform a body location-prioritized grooming sequence when mechanosensory neurons at different locations on the head and body are simultaneously stimulated by dust (Hampel et al.

Healthcare and Social Organizations' Disaster Preparedness, Response, and Recovery Experience: Lessons Learned From Hurricanes Irma and Maria.

Background: Healthcare and social organizations (HSOs) are first respondents after natural disasters. Hence, their preparedness and resilience are critical components for addressing future disasters. However, little is known about HSOs' experiences prior to, during, and after hurricanes.

A Five-Year Cost-Utility Analysis Comparing Synthetic Cage Versus Allograft Use in Anterior Cervical Discectomy and Fusion Surgery for Cervical Spondylotic Myelopathy.

Study Design: Retrospective cost-utility analysis.

Objective: To conduct a cost-analysis comparing synthetic cage (SC) versus allograft (Allo) over a five-year time horizon.

Summary Of Background Data: SC and Allo are two commonly used interbody choices for anterior cervical discectomy and fusion (ACDF) surgery.

Short- and mid-term outcomes in systemic lupus erythematosus patients presenting with disease exacerbation after SARS-CoV-2 mRNA vaccination: A cohort study from Puerto Rico.

Objective: To determine if SARS-CoV-2 mRNA vaccination has an impact on the clinical course of systemic lupus erythematosus (SLE).

Methods: Puerto Ricans with SLE who received mRNA COVID-19 vaccines were studied. Demographic parameters, clinical manifestations, disease activity (per Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), disease damage (per Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index), emergency room visits, hospitalizations, and pharmacologic therapy were determined.

Looking Towards 2030: Strengthening the Environmental Health in Childhood-Adolescent Cancer Survivor Programs.

Childhood and adolescent cancer survivors (CACS) are a high-risk population for non-communicable diseases and secondary carcinogenesis. The Environmental and Community Health Program for Longitudinal Follow-up of CACS in the region of Murcia, Spain, is an ongoing pioneering program that constitutes a model for social innovation. This study aims to present the program tools and protocol as a whole, as well as a profile of the incidence, survival, and spatiotemporal distribution of childhood cancer in the region of Murcia, Spain, using 822 sample cases of cancer diagnosed in children under 15 years of age (1998-2020).

Myelin lipid metabolism and its role in myelination and myelin maintenance.

Myelin is a specialized cell membrane indispensable for rapid nerve conduction. The high abundance of membrane lipids is one of myelin's salient features that contribute to its unique role as an insulator that electrically isolates nerve fibers across their myelinated surface. The most abundant lipids in myelin include cholesterol, glycosphingolipids, and plasmalogens, each playing critical roles in myelin development as well as function.

The Statistical Fragility of Platelet-Rich Plasma as Treatment for Plantar Fasciitis: A Systematic Review and Simulated Fragility Analysis.

Background: Plantar fasciitis (PF) is the most common cause of heel pain and can be a source of extensive physical disability and financial burden. Platelet-rich plasma (PRP) offers a potentially definitive, regenerative treatment modality that, if effective, could change the current paradigm of PF care. However, randomized controlled trials (RCTs) on the clinical benefits of PRP for refractory PF offer inconsistent conclusions, potentially because of the broader limitations of using value thresholds to declare statistical and clinical significance.

Research Infrastructure Core Facilities at Research Centers in Minority Institutions: Part I-Research Resources Management, Operation, and Best Practices.

Funded by the National Institutes of Health (NIH), the Research Centers in Minority Institutions (RCMI) Program fosters the development and implementation of innovative research aimed at improving minority health and reducing or eliminating health disparities. Currently, there are 21 RCMI Specialized (U54) Centers that share the same framework, comprising four required core components, namely the Administrative, Research Infrastructure, Investigator Development, and Community Engagement Cores. The Research Infrastructure Core (RIC) is fundamentally important for biomedical and health disparities research as a critical function domain.

Prognostic Significance of p16 and Its Relationship with Human Papillomavirus Status in Patients with Penile Squamous Cell Carcinoma: Results of 5 Years Follow-Up.

Penile Squamous Cell Carcinoma (PSCC) is associated with high-risk human papillomavirus (HR-HPV). The immunohistochemical (IHC) test for p16 (p16) is highly correlated with HR-HPV expression in other SCCs. To investigate whether the expression of p16 IHC or HR-HPV is associated with survival in PSCC, we conducted a single institution analysis of 143 patients with a diagnosis of PSCC and, available tissue were tested for p16 IHC staining patterns, histological subtype, tumor grade, and lymphovascular invasion (LVI) by an experienced pathologist.

COVID-19 Pandemic Experiences and Symptoms of Pandemic-Associated Traumatic Stress Among Mothers in the US.

Importance: The primary outcomes of the COVID-19 pandemic on the mental health of women with children remain largely unknown.

Objectives: To identify and describe clusters of mothers of children participating in the Environmental influences on Child Health Outcomes (ECHO) Program that characterize pandemic-associated hardships, coping mechanisms, and behaviors, and to evaluate associations between pandemic-associated hardships, coping strategies, and behavior changes with pandemic-associated traumatic stress symptoms.

Design, Setting, And Participants: This multicenter cohort study investigated experiences during the COVID-19 pandemic between April 2020 and August 2021 among maternal caregivers of children participating in the ECHO Program.

Report of a Primary Testicular Embryonal Rhabdomyosarcoma.

Primary testicular rhabdomyosarcoma is a rare pediatric genitourinary tumor with few cases reported in the literature. The clinical presentation is identical to that of other common testicular neoplasms. Diagnosis entails careful microscopic examination and immunohistochemical analysis to rule out other primary testicular malignancies.

Increasing Proportion of Elderly Patients that make use of the Surgery Services of the UPR-affiliated Hospitals.

Objective: To evaluate how the proportion of elderly patients aged 65 and above has increased in our surgical services over a 5-year period.

Methods: We compared the ages and characteristics of the surgical cases in 2014 with those in 2019, a 5-year interval, using the information from the University of Puerto Rico (UPR) General Surgery Database. The variables examined included age, gender, American Society of Anesthesiology (ASA) classification and outcome.

Psychometric Properties of the Generalized Anxiety Disorder 7-item Scale in Adolescents: An Effective Screening Tool for School and Community Settings.

Objective: Anxiety disorders are prevalent among children and adolescents. Identifying anxiety symptoms in primary care, school, and community settings has implications for service planning, resource allocation, and prevention and treatment programming. The Generalized Anxiety Disorder 7-item (GAD-7) scale is a commonly used instrument for evaluating anxiety symptoms.

Spine Trauma Secondary to Diving Accidents: A Seven-year Retrospective Study in Puerto Rico.

Objective: Review the profile of patients with spinal trauma after diving accidents referred to the Puerto Rico Medical Center. This study intended to develop more awareness of the risks of spinal cord injury after diving.

Methods: The patient's records for diving accident cases referred to our center during January 2014 until December 2020 were assessed retrospectively.

The Puerto Rico Community Cancer Control Outreach Program: Developing Capacity-Building Activities on Cancer Screening Guidelines and HPV Vaccination Recommendations for Health Care Professionals.

Objective: This study evaluated physicians' knowledge of cancer screening guidelines and human papillomavirus (HPV) recommendations.

Methods: The Puerto Rico Community Cancer Control Outreach Program in collaboration with the Comprehensive Cancer Control Program and the Breast and Cervical Cancer Early Detection Program developed an educational activity for physicians who attended a professional annual meeting. This activity consisted of 2 sessions: one about cancer screening guidelines and the other about HPV and HPV vaccination.

Socio-Demographic and Medical Characteristics of Patients With Odontogenic Infection Admitted to the Adult University Hospital in Puerto Rico: A Cross-sectional Study.

Objective: We aimed to estimate the overall distribution of odontogenic infection by socio-demographic and medical characteristics in patients admitted to the Adult University Hospital (AUH) in Puerto Rico (PR).

Methods: A cross-sectional study was undertaken with the medical charts of 129 patients (≥21 years) with odontogenic infection who had been admitted (2011-2015) to the AUH and treated by the Oral and Maxillofacial Surgery Post - graduate Program of the University of PR. The patients were selected from the hospital's billing database after having been identified using the International Classification of Diseases (9th and 10th revisions).

Decreased CSTB, RAGE, and Axl Receptor Are Associated with Zika Infection in the Human Placenta.

Zika virus (ZIKV) compromises placental integrity, infecting the fetus. However, the mechanisms associated with ZIKV penetration into the placenta leading to fetal infection are unknown. Cystatin B (CSTB), the receptor for advanced glycation end products (RAGE), and tyrosine-protein kinase receptor UFO (AXL) have been implicated in ZIKV infection and inflammation.