University of Puerto Rico Emergency Medicine Program: impact throughout the country.

OBJECTIVES: Determine distribution, job description, and board certification status of the University of Puerto Rico Emergency Medicine Program (UPREMP) graduates. METHODS: A telephone survey was performed of all UPREMP graduates from 1995 to 2007, asking for the following information: practitioner or non practitioner, working place, job description (e.g. Fellow, Staff or Emergency Room Directors), and board certification status. In cases in which the person could not be reached by phone, the last information available at the UPREMRP department was used to fill the survey. The board certification was verified using The American Board of Medical Specialties web site. Worksheets were used to organize data and then analyzed statistically with Excel 2003. RESULTS: Of the 102 graduates, 59% are males and 41% are women, 50% are board certified, 30% are not and 20% are pending certification. Of the female graduates, 77% are board certified, while only 60% of male graduates are board certified. Sixty percent (60%) of the graduates stayed in Puerto Rico and 40% moved to the United States. The distribution of graduates among PR senatorial districts (counties) was as follows: San Juan 22%, Bayamón 17%, Arecibo 0%, Mayagüez 5%, Ponce, 23%, Guayama 6%, Humacao 12% and Carolina 20%. The job description among graduates was: 54% full time Emergency Department (ED) Staff, 3% part time ED staff, 23% academic faculty, 10% directors, 5% fellows and 5% other. CONCLUSION: From our study, we can conclude that although the vast majority of UPREMP graduates stay in PR after graduation, most of them practice in four of the eight PR senatorial districts. Further studies are needed to determine: the reasons why graduates have moved to the mainland US and for working mostly in four PR senatorial districts.

Extracellular matrix remodeling and metalloproteinase involvement during intestine regeneration in the sea cucumber Holothuria glaberrima.

The sea cucumber, Holothuria glaberrima, has the capacity to regenerate its internal organs. Intestinal regeneration is accomplished by the thickening of the mesenteric border and the invasion of this thickening by mucosal epithelium from the esophagus and the cloaca. Extracellular matrix (ECM) remodeling has been associated with morphogenetic events during embryonic development and regeneration. We have used immunohistochemical techniques against ECM components to show that differential changes occur in the ECM during early regeneration. Labeling of fibrous collagenous components and muscle-related laminin disappear from the regenerating intestine and mesentery, while fibronectin labeling and 4G7 (an echinoderm ECM component) are continuously present. Western blots confirm a decrease in fibrous collagen content during the first 2 weeks of regeneration. We have also identified five 1,10-phenanthroline-sensitive bands in collagen gelatin zymographs. The gelatinolytic activities of these bands are enhanced during early stages of regeneration, suggesting that the metalloprotease activity is associated with ECM remodeling. Inhibition of MMPs in vivo with 1,10-phenanthroline, p-aminobenzoyl-Gly-Pro-D-Leu-D-Ala hydroxamate or N-CBZ-Pro-Leu-Gly hydroxamate produces a reversible inhibition of intestinal regeneration and ECM remodeling. Our results show that significant changes in ECM content occur during intestine regeneration in the sea cucumber and that the onset of these changes is correlated to the proteolytic activities of MMPs.