University of Puerto Rico, Medical Sciences Campus

About: University of Puerto Rico, Medical Sciences Campus is a education organization based out in San Juan, Puerto Rico, United States. It is known for research contribution in the topics: Population & Medicine. The organization has 1711 authors who have published 1496 publications receiving 27756 citations.

Clinical Manifestations Associated with Peripheral Joint Involvement in Patients with Acute Chikungunya Virus Infection

Abstract: Chikungunya virus (CHIKV) causes an acute febrile illness usually accompanied by severe polyarthralgia and polyarthritis. Previous studies have shown that older age, female gender, and some comorbid conditions are associated with chronic CHIKV arthritis. However, the factors associated with acute arthralgia and arthritis are not well known. Thus, we studied the clinical manifestations associated with acute peripheral joint involvement in a group of CHIKV patients from Puerto Rico. Patients with a history of fever for < 7 days evaluated at the emergency department of a university-based hospital were tested for several pathogens including CHIKV. All patients with laboratory-positive CHIKV infection were studied. Demographic features, clinical manifestations, and comorbidities were determined. Patients with and without peripheral joint involvement were compared using bivariable and multivariable analyses. In total, 172 patients with CHIKV fever were evaluated; 52.9% were women. The mean (standard deviation) age was 21.1 years (19.3). Peripheral arthralgia and/or arthritis were seen in 156 (90.7%) patients. In the multivariable analysis adjusted for age and gender, peripheral joint involvement was associated with myalgia (odds ratio [OR] = 4.65, 95% confidence interval [CI] = 1.48–14.72), back pain (OR = 16.77, 95% CI = 3.07–313.82), ocular pain (OR = 8.88, 95% CI = 1.65–165.19), headache (OR = 3.63, 95% CI = 1.06–12.53), anorexia (OR = 5.68, 95% CI = 1.87–18.97), and nausea (OR = 6.88, 95% CI = 2.05–31.49). In conclusion, in this population of patients with acute CHIKV infection, peripheral joint involvement was associated with myalgia and back pain as well as nonmusculoskeletal manifestations such as headache, ocular pain, anorexia, and nausea.

A case of combined Merkel cell carcinoma and squamous cell carcinoma: Molecular insights and diagnostic pitfalls

Abstract: Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine cutaneous tumor with a high mortality rate.1 Evidence supports 2 molecular subclasses of MCC: virus-positive MCC associated with oncogenic Merkel cell polyomavirus (MCPyV), and virus-negative MCC (VN-MCC) associated with UV signature mutations.1, 2, 3 Typically, MCC presents as a pink papule or nodule on sun-exposed skin of white, elderly individuals.1 MCC most frequently presents in the head and neck area, followed by the upper extremities.1 MCC commonly metastasizes to regional lymph nodes and skin, with potential for distant metastases to skin, lung, liver, central nervous system, and bone.3 Patients may have a high burden of satellite and in-transit cutaneous metastases, which may be histologically identical to primary MCC tumors.1, 3 In approximately 1% to 2% of patients with MCC, a second MCC tumor will arise that is clinically compatible with a new primary MCC.1, 4 In such cases, molecular analyses may be useful in distinguishing a second primary MCC tumor from a distant cutaneous metastasis.4, 5, 6, 7, 8 Some MCC tumors have concurrent squamous cell carcinoma (SCC), either in situ or invasive, which has been proposed to favor primary MCC over a cutaneous metastasis.1 Concurrent SCC/MCC is a distinct phenomenon from MCC “mixed tumors” with intratumoral squamous differentiation (multiple foci of squamous differentiation dispersed throughout the tumor, rather than a discrete squamous lesion).1 MCC associated with SCC is usually MCPyV-negative, with rare exceptions.9 Although both SCC and MCC may arise in association with photodamage, it is unknown if concurrent SCC/MCC represent biologically related neoplasms. We present a case of an elderly man found to have MCC of the left forehead. A second focus of MCC was subsequently identified on the left zygoma, in association with a previously diagnosed invasive SCC. Single nucleotide polymorphism (SNP) array analysis confirmed clonal relationship between the foci of MCC, supporting a metastatic process, and demonstrated the SCC to be unrelated. Our findings suggest that concurrent SCC and MCC can represent unrelated collision tumors. Our case also indicates that nonmelanoma skin cancers (NMSCs) in the lymphatic draining area of MCC tumors should be scrutinized for potential involvement by MCC.

Belief in AIDS Origin Conspiracy Theory and Willingness to Participate in Biomedical Research Studies: Findings in Whites, Blacks, and Hispanics in Seven Cities Across Two Surveys

Abstract: Purpose: The purpose of this study was to determine whether a belief in the AIDS origin conspiracy theory is related to likelihood or fear of participation in research studies. Methods: The Tuskegee Legacy Project Questionnaire was administered via random-digit-dialed telephone interview to black, white, and Hispanic participants in 4 cities in 1999 and 2000 (n = 1,133) and in 3 cities in 2003 (n = 1,162). Results: In 1999, 27.8% of blacks, 23.6% of Hispanics, and 8% of whites (P ≤ .001) reported that it was “very or somewhat likely” that AIDS is “the result of a government plan to intentionally kill a certain group of people by genocide.” In 2003, 34.1% of blacks, 21.9% of Hispanics, and 8.4% of whites (P ≤ .001) reported the same. Conclusions: Whereas blacks and Hispanics were more than 3 times more likely than whites to believe in this AIDS origin conspiracy theory, holding this belief was not associated with a decreased likelihood of participation in, or increased fear of participation in, bio...