It was founded in 1976 in the municipality of Cayey, but since 1990 all its facilities have been integrated into one campus at the grounds of the Dr. Ramón Ruiz Arnau University Hospital in Bayamón..
Early maternal life experiences, such as childhood maltreatment (CM), particularly emotional neglect may disrupt her recall of parental bonding experiences and the development of a healthy mother-infant relationship. This pilot study of thirty-eight postpartum Latina mothers examined preliminary intergenerational associations of maternal retrospective self-reported history of CM, particularly emotional and physical neglect (Childhood Trauma Questionnaire-CTQ), perception of parental bonding (PBI) and postpartum bonding PBQ with her infant. Nonparametric correlations showed that higher emotional neglect, more consistent than physical neglect, was associated with a lower perceived maternal and paternal care, and higher paternal overprotection. Furthermore, hierarchical regression analyses demonstrated preliminary evidence that emotional neglect was the most consistent predictor of postpartum bonding difficulties, including general bonding impairment, rejection/anger, and infant-focused anxiety. Higher maternal gestational age emerged as a possible protective factor across model, associated with more favorable bonding outcomes. These preliminary findings suggest that emotional neglect may exert lasting intergenerational effects on perceived parental bonding and maternal bonding capacities in the postpartum period. These results highlight the need for trauma-informed perinatal care and early screening of adverse childhood experiences (ACEs) to prevent child maltreatment in Hispanic populations.
Epigenetic aging clocks based on DNA methylation patterns across the genome have emerged as a potential biomarker for risk of age-related diseases, like Alzheimer’s disease (AD), and environmental and social stressors. However, methylation clocks have not been comprehensively validated in genetically diverse individuals. Here, we evaluate a set of first-, second-, and third-generation methylation clocks in 621 AD patients and matched controls from African American, Hispanic, and White cohorts. The clocks are less accurate at predicting age in genetically admixed cohorts compared to the White cohort, especially for those with substantial African ancestry. This decreased accuracy holds in >2500 individuals of European and African ancestry from three additional datasets. The clocks also fail to consistently identify age acceleration in admixed AD cases compared to controls. To explore potential causes for the lack of generalization of the clocks, we intersected clock CpGs with methylation, germline genetic variants, and methylation QTL (meQTL) data from global populations. We find differential methylation between African and European ancestry individuals is common for clock CpGs. Genetic variants rarely disrupt clock CpGs between populations, but a substantial fraction of clock CpGs have meQTL with significantly higher frequencies in African genetic ancestries. Our results demonstrate that methylation clocks often fail to predict age and AD risk when applied across populations and suggest avenues for improving their portability by considering differences in genetic and epigenetic patterns across human populations.
Tumor lysis syndrome (TLS) is an oncologic emergency characterized by metabolic abnormalities resulting from rapid tumor cell breakdown. It is most frequently observed following cytotoxic therapy in hematologic malignancies and is rarely encountered spontaneously in solid tumors. Spontaneous TLS associated with ovarian carcinoma remains exceptionally uncommon. A 53-year-old woman with no pertinent medical history presented with progressive abdominal distension, dyspnea, and oliguria. Laboratory evaluation demonstrated acute kidney injury with a serum creatinine of 4.09 mg/dL, accompanied by hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia, fulfilling the Cairo-Bishop criteria for clinical TLS. Computed tomography (CT) revealed massive ascites and a 16.2 × 15 × 15 cm pelvic mass without evidence of obstructive uropathy. Ascitic fluid cytology demonstrated metastatic carcinoma. Tumor markers showed a cancer antigen (CA)-125 level of 445 U/mL and a CA-125:carcinoembryonic antigen ratio greater than 25, strongly supporting a gynecologic primary malignancy. In the absence of recent chemotherapy or other precipitating factors, spontaneous TLS secondary to previously undiagnosed ovarian carcinoma was diagnosed. The patient was treated with aggressive intravenous hydration, rasburicase, electrolyte correction, and close multidisciplinary monitoring, resulting in rapid normalization of metabolic abnormalities and recovery of renal function without dialysis. Following stabilization, the patient underwent neoadjuvant carboplatin-paclitaxel chemotherapy followed by interval cytoreductive surgery. Histopathologic examination demonstrated a complete pathologic response, with no residual invasive carcinoma. Follow-up positron emission tomography/CT imaging showed no evidence of residual or metastatic disease, and CA-125 normalized to 5.2 U/mL. This case highlights spontaneous TLS as a rare initial manifestation of advanced ovarian carcinoma and emphasizes the importance of early recognition and prompt intervention. Timely management may reverse life-threatening metabolic complications, facilitate definitive oncologic treatment, and result in favorable long-term outcomes.
