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.

Patient-related barriers to management of cancer pain in Puerto Rico

Abstract: Two hundred and sixty-three ambulatory patients older than 21 years of age who were attending clinics at an oncology hospital in San Juan, Puerto Rico, were studied. They completed a questionnaire (BQ-PR) that measures 8 concerns about reporting pain and using analgesics, such as fears of addiction and tolerance and the belief that reporting pain can distract a physician from focusing on curing one's disease. Ninety percent of the patients had at least some concern about each of the 8 topics, and mean scores on the 8 subscales were near the midpoint on a 0–5 scale. There were significant inverse relationships between level of education, income, and BQ-PR total score. Those persons who experienced cancer-related pain on the day they completed the questionnaire were categorized as using adequate versus not adequate analgesic medication, a determination that was based on a comparison of their level of pain to the medication they were using. Those who were not using adequate analgesic medication had higher BQ-PR total scores than did those who were using adequate medication.

Are adults diagnosed with diabetes achieving the American Diabetes Association clinical practice recommendations

Abstract: Objective: This study assessed the proportion of adults with previously diagnosed diabetes mellitus (DM) who met selected preventive practices and treatment goals according to the American Diabetes Association (ADA) standards of medical care. Methods: A secondary analysis of data collected for a previous epidemiologic study that used a probability cluster design to select 859 persons aged 21-79 years in the San Juan metropolitan area was undertaken. This study focused on 136 (15.8%) adults who self-reported DM. The Standards of Medical Care in Diabetes published by the ADA in 2011 were used to determine the proportion of adults achieving selected clinical practice recommendations. Results: Less than half of adults achieved recommended treatment goals for LDLcholesterol (47.8%), HDL-cholesterol (44.1%), blood pressure (41.2%) and HbA1c (28.7%). The percentage of adults achieving recommended levels of HbA1c, blood pressure and LDL-cholesterol simultaneously was 6.6%; the percentage achieving HbA1c, blood pressure, LDL-cholesterol, HDL-cholesterol, triglycerides and albumin-to-creatinine ratio target levels was only 2.2%. More than half (60.2%) reported daily self-monitoring of foot ulcers and HbA1c testing at least twice over the past year (52.3%). However, less than half reported annual dilated eye examination (49.2%), annual comprehensive foot examination (43.8%), daily self-monitoring blood glucose (37.5%), moderate or vigorous physical activity (33.8%), and self-management DM education (28.9%). Conclusion: This study showed that a substantial proportion of adults with DM did not achieve ADA recommendations on selected preventive practices and treatment goals. Strategies to improve DM medical care and surveillance of preventive-care practices and treatment goals among affected individuals are essential for planning further initiatives that contribute to reduce the burden of DM complications.

Alternative Reproductive Tactics and Reproductive Success in Male Rhesus Macaques

Abstract: Male rhesus macaques on Cayo Santiago use rank-dependent alternative reproductive tactics. High-ranking males can form long-term consorts and guard female mates while low-ranking males frequently resort to quick copulations under the cover of vegetation. No single reproductive tactic provided the Group S males with a definitive reproductive advantage during the one-year study. Males using the long-term tactic and the quick, stealth tactic sired five offspring each, but fewer males used the long-term consort tactic. Males using the long-term reproductive tactic have significantly greater mating success than males using the quick, sneaky tactic, and may have greater reproductive success. The highest-ranking males who form long-term consorts had the greatest degree of reproductive success. This indicates that for the highest-ranking males, forming long-term consorts is the most effective reproductive tactic. The effectiveness of alternative tactics for high-ranking males (i.e. consort disruption and possessive following) was equivocal. Consort disruption had no immediate effect on reproductive success. Possessive following may have resulted in the siring of two offspring by the alpha male, but was ineffective in other cases, where the females were inseminated by subordinate males. The effectiveness of the quick, furtive tactic was demonstrated by the siring of 45% of the infants by males who used this tactic.

Helical computed tomographic angiography for the diagnosis of traumatic arterial injuries of the extremities.

Abstract: Background: The radiologic study of choice for evaluation of traumatic arterial injuries is conventional arteriography, but it poses the risks of an invasive procedure. Computed tomographic arteriography (CTA) is emerging as a new way to study arterial anatomy, with the additional advantages of being noninvasive and a technique that allows evaluation of different body areas simultaneously. Our experience using CTA for evaluation of traumatic arterial injuries is provided in this study. Methods: A retrospective review over a 22-month period of all adult patients undergoing CTA for evaluation of traumatic injuries to the extremities was performed. Results: A total of 97 CTA studies were performed in the 95 patients. CTA adequately demonstrated the nature and location of all the arterial injuries when compared with conventional arteriography or surgical exploration. Abnormal CTA results included 21 arterial occlusions, 2 intimal flap defects, and 2 pseudoaneurysms. Nine of these 25 injuries were confirmed by surgery only, 10 by surgery and arteriography, and 6 by arteriography only. Normal CTA results were confirmed with arteriography in 10 cases. No missed injuries were encountered in patients with normal CTA results. Conclusion: CTA is a reliable technique for the detection and characterization of traumatic extremity arterial injuries. These results suggest CTA may be an alternative to conventional arteriography for the diagnosis of traumatic arterial injuries.

Redundant or separate entities?—roles of Twist1 and Twist2 as molecular switches during gene transcription

Abstract: Twist1 and Twist2 are highly conserved members of the Twist subfamily of bHLH proteins responsible for the transcriptional regulation of the developmental programs in mesenchymal cell lineages. The regulation of such processes requires that Twist1 and Twist2 function as molecular switches to activate and repress target genes by employing several direct and indirect mechanisms. Modes of action by these proteins include direct DNA binding to conserved E-box sequences and recruitment of coactivators or repressors, sequestration of E-protein modulators, and interruption of proper activator/repressor function through protein-protein interactions. Regulatory outcomes of Twist1 and Twist2 are themselves controlled by spatial-temporal expression, phosphoregulation, dimer choice and cellular localization. Although these two proteins are highly conserved and exhibit similar functions in vitro, emerging literature have demonstrated different roles in vivo. The involvement of Twist1 and Twist2 in a broad spectrum of regulatory pathways highlights the importance of understanding their roles in normal development, homeostasis and disease. Here we focus on the mechanistic models of transcriptional regulation and summarize the similarities and differences between Twist1 and Twist2 in the context of myogenesis, osteogenesis, immune system development and cancer.