The West Indian medical journal最新文献

{"title":"Effect of clopidogrel with or without omeprazole in patients with carotid artery stenting.","authors":"B. Ma, L. Hang, G. Chen, Y. Du","doi":"10.7727/WIMJ.2012.041","DOIUrl":"https://doi.org/10.7727/WIMJ.2012.041","url":null,"abstract":"BACKGROUND\u0000Recent concerns have been raised about the potential for proton pump inhibitors (PPIs) to blunt the efficacy of clopidogrel. We observed the effect of clopidogrel plus aspirin with or without omeprazole in patients with carotid stenoses after they received placement of carotid stents.\u0000\u0000\u0000METHODS\u0000Sixty-four consecutive patients treated with percutaneous carotid artery stenting (CAS) comprised the sample. All enrolled patients underwent the C13 urea breath test (C13 UBT) before CAS. Patients with Helicobacter pylori infection and a history of peptic ulcer were assigned dual antiplatelet combination with omeprazole. Others received dual antiplatelet without omeprazole. Transcranial Doppler and ultrasonography were performed to assess the middle cerebral artery and carotid artery in follow-up at three months and six months.\u0000\u0000\u0000RESULTS\u0000Eight patients had gastrointestinal bleeding; the event rate was 22.6% without omeprazole and 3.8% with omeprazole. The rate of gastrointestinal bleeding was reduced with omeprazole as compared without omeprazole (p = 0.026, p < 0.05). The two groups did not differ significantly in the rate of in-stent restenosis and thrombus through transcranial Doppler and ultrasonography.\u0000\u0000\u0000CONCLUSION\u0000Among patients receiving dual antiplatelet therapy, prophylactic use of omeprazole reduced the rate of upper gastrointestinal bleeding. There was no apparent interaction between clopidogrel and omeprazole in patients with carotid artery stenting.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122086970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic foot complications among patients attending a specialist diabetes clinic in Jamaica: prevalence and associated factors.","authors":"T. Ferguson, M. Tulloch-Reid, Nom Younger, R. Wright-Pascoe, M. Boyne, SR McFarlane, D. Francis, R. Wilks","doi":"10.7727/WIMJ.2012.031","DOIUrl":"https://doi.org/10.7727/WIMJ.2012.031","url":null,"abstract":"OBJECTIVES\u0000To estimate the prevalence of diabetic foot complications among patients at a specialist diabetes clinic in Jamaica and identify factors associated with foot complications.\u0000\u0000\u0000METHODS\u0000A stratified random sample of 188 patients were interviewed and examined between 2009 and 2010. Trained nurses obtained demographic and clinical data, measured anthropometrics and performedfoot examinations including inspection for amputations, ulcers or infection and assessment of pain, vibration and pressure perception.\u0000\u0000\u0000RESULTS\u0000Participants included 143 women and 45 men (mean age 56years; mean diabetes duration 16 years). The prevalence of amputations was 8.5% (95% CI 4.5, 12.5%) and was higher among men (22.2%) compared to women (4.2%, p < 0.05). Prevalence of current ulcers and current foot infections was 4.3% and 3.7%, respectively. Overall, 12% ofpatients had at least one of these foot complications. Foot complications were more prevalent among men, patients with high blood pressure (BP > or = 130/80 mmHg) or peripheral neuropathy In multivariable logistic regression models, factors associated with foot complications were: neuropathy (OR 9.3 [95% CI 2.8, 30.3]), high BP (OR 7.9 [1.3, 49.7]) and diabetes duration (OR 1.32 [1.02, 1.72]).\u0000\u0000\u0000CONCLUSION\u0000Approximately one of every eight patients in this specialist clinic had a major foot complication. Associated factors were neuropathy, high blood pressure and longer duration of diabetes.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122389851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of overweight and obesity among children six to ten years of age in the north-east health region of Jamaica.","authors":"B. E. Blake-Scarlettl, Novie Younger, Colin A. McKenzie, J. V. Broeck, Christine Powell, S. Edwards, S. Win, R. Wilks","doi":"10.7727/WIMJ.2012.157","DOIUrl":"https://doi.org/10.7727/WIMJ.2012.157","url":null,"abstract":"OBJECTIVE\u0000To estimate the prevalence and correlates of overweight and obesity among children six to ten years old in the North-East Health Region (NEHR) ofJamaica.\u0000\u0000\u0000METHODS\u0000Weights and heights were measured in a representative sample of 5710 children between the ages of six and ten years in 34 schools between October 2008 and March 2009. Overweight and obesity were defined as body mass index (BMI) Z-score > 1SD and >2SD, respectively based on the World Health Organization (WHO)-endorsed age and gender-specific growth standards for children. Point prevalence estimates of overweight and obesity were calculated. Odds ratios (OR) and 95% confidence intervals (CI) were used to estimate associations between overweight and obesity and age, gender and school location.\u0000\u0000\u0000RESULTS\u0000Overweight and obesity prevalence among children six to ten years old in NEHR, Jamaica, was 10.6% and 7.1%, respectively. Overweight (OR = 1.11, 95% CI: 1.04, 1.18) and obesity (OR = 1.17, 95% CI: 1.08, 1.26) prevalence increased significantly with age. Overweight (OR = 1.51, 95% CI: 1.27, 1.80) and obesity (OR = 1.36, 95% CI: 1.11, 1.67) prevalence was significantly higher among girls than boys. Children attending rural-public schools had less risk of being overweight (OR = 0.57, 95% CI: 0.46, 0.70) and obese (OR = 0.35, 95% CI: 0.28, 0.44) when compared with urban-public schools and private schools. Both overweight (OR = 2.11, 95% CI: 1.60, 2.78) and obesity (OR = 1.68, 95% CI: 1.24, 2.28) were significantly more common among children attending private schools. After adjusting for age and gender the results still remained statistically significant.\u0000\u0000\u0000CONCLUSIONS\u0000Overweight/obesity prevalence among children six to ten years old in NEHR of Jamaica is 17.7% with older children and girls having higher rates. Children attending urban-public and private schools have higher prevalence than those attending rural schools. Appropriately targeted interventions are needed to combat this problem.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133206719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D deficiency rickets in infants presenting with hypocalcaemic convulsions.","authors":"Y. Cesur, S. Yuca, A. Kaya, Cahide Yılmaz, Ali Bay","doi":"10.7727/WIMJ.2012.269","DOIUrl":"https://doi.org/10.7727/WIMJ.2012.269","url":null,"abstract":"AIM\u0000Hypocalcaemia evaluation of the clinical, biochemical and radiologicalfeatures of 91 infants with rickets who presented as hypocalcaemic convulsions.\u0000\u0000\u0000SUBJECTS AND METHODS\u0000Ninety-one hypocalcaemic infants who were brought to hospital with convulsion and diag-nosed with rickets related to vitamin D deficiency according to their clinical, biochemical and radio-logicalfeatures were retrospectively reviewed.\u0000\u0000\u0000RESULTS\u0000Mean values of the laboratory data were as follows: calcium 5.55 +/- 0.79 mg/dL, phosphorus 4.77 +/- 1.66 mg/dL, alkaline phosphatase 1525.5 +/- 925.4 U/L and parathormone 256.8 +/- 158.3 pg/mL. Serum 25-OH vitamin D levels were below normal (< 20 ng/mL) in 37 infants.\u0000\u0000\u0000CONCLUSION\u0000Vitamin D deficiency should be considered in infants presenting with hypocalcaemia. To avoid complications such as convulsions, clinicians should give vitamin D supplementation to such infants.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114660418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cuba: healthcare and the revolution.","authors":"L. Binns","doi":"10.7727/WIMJ.2012.336","DOIUrl":"https://doi.org/10.7727/WIMJ.2012.336","url":null,"abstract":"This paper depicts Cuba as a relic of the Cold War Its coverage of healthcare demonstrates steadfastness and success in surmounting hurdles of complacency and disregard to socialized medicine - an extension of Soviet patronage and third world alliances. The literature relays a mission of inclusivity underpinned by political ideology and a conviction to humanity. With the aid ofendorsements, it speaks to contrasts and critiques in service and results by reflecting on the delivery offree healthcare for all Cuban citizens and its impression on the eradication of numerous diseases, reduced mortality rate and increased life expectancy. Punished by the longest trade embargo in modern history, the regime is in possession of limited resources to expedite remedy to its subjects. Such, much to the dislike of the authorities, elevates elements of distinction in association with the dispensation of service and drugs demonstrated by an evolving two-tier system for the disenfranchised and privileged clientele while simultaneously impacting the maintenance of facilities and equipment. Consequently, it recognizes harsh ramifications attributed to compliance with ideology and subtle adjustments to withstand external exertion. The Cuban replica is currently a tale of sorts awaiting a comprehensible definition for future generations.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"209 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131120771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salmonella enterica arthritis in a patient with rheumatoid arthritis receiving anti-tumour necrosis factor therapy.","authors":"M. Bubonja-Šonje, D. Rubinić, F. Anić, S. Novak, D. Vučković, M. Abram","doi":"10.7727/WIMJ.2012.169","DOIUrl":"https://doi.org/10.7727/WIMJ.2012.169","url":null,"abstract":"Anti-tumour necrosis factor (TNF) monoclonal antibodies have become an invaluable treatment against chronic inflammatory diseases such as rheumatoid arthritis (RA). However, due to increased risk of opportunistic infections, patients receiving anti-TNF therapy should be closely monitored for serious infections. Here, we describe a case of acute Salmonella_enteritidis infection of a joint arthroplasty that previously was functioning well, in a patient receiving infliximab treatment for RA. After prolonged antimicrobial chemotherapy and interrupted infliximab treatment, reimplantation of a new prosthesis was successfully performed two years after Salmonella septic arthritis. Therefore, because of the possibility of extraintestinal salmonellosis, screening for fecal colonization could be advisable in patients undergoing anti-TNF treatment. Moreover we emphasize the importance of appropriate counselling of these patients concerning food hygiene.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"111 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114243944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ophthalmic manifestations of haematological disorders.","authors":"KS Charles, N. Leelah, L. Boodoo, DC Murray","doi":"10.7727/WIMJ.2011.218","DOIUrl":"https://doi.org/10.7727/WIMJ.2011.218","url":null,"abstract":"Five case histories are presented. Waldenstrom's macroglobulinaemia caused bilateral central retinal vein occlusion, proptosis was the presenting feature of retro-orbital plasmacytoma in relapsed multiple myeloma, a red painful eye was due to neovascular glaucoma in primary polycythaemia, bilateral VIth nerve palsy caused convergent squint and diplopia in meningeal relapse of acute lymphoblastic leukaemia and lymphoma of the eyelid caused complete ptosis. Interdisciplinary management is described. Ophthalmological lesions in haematological disease should be promptly recognized and managed. Collaboration between ophthalmology and haematology departments may be effective for palliative management.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132581724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical evaluation with self-sequential longitudinal reference intervals: pregnancy outcome and neonatal thyroid stimulating hormone level associated with maternal thyroid diseases.","authors":"P. Yuan, Q. Wang, R. Huang, F. Cao, Z. Zhu, D. Sun, H. Zhou, B. Yu","doi":"10.7727/WIMJ.2012.143","DOIUrl":"https://doi.org/10.7727/WIMJ.2012.143","url":null,"abstract":"OBJECTIVE\u0000We attempted to evaluate maternal thyroid function in a new self-sequential longitudinal reference interval (SLRI) which we established recently. By this method, we analysed the correlation between pregnancy outcome, neonatal thyroid stimulating hormone (TSH) level and maternal thyroid diseases.\u0000\u0000\u0000METHODS\u0000A total of 1744 pregnant women participated in the study and 1747 babies were born from those women (three bore twins). The levels of TSH, free thyroxine (FT4) and thyroid peroxidase antibodies (TPO-Ab) of mothers were quantified by electrochemistry immunoassay (ECL). The levels of neonatal blood TSH were detected by time-resolved fluorescence immunoassay (TRFIA). All data were collected and statistically analysed by SPSS 13.0 software.\u0000\u0000\u0000RESULTS\u0000With our new SLRI method, we found that 0.11%-3.84% pregnant women would get thyroid diseases. Subclinical hypothyroidism was the most common maternal thyroid disorder. Being positive for thyroid peroxidase antibodies was a significant risk factor of subclinical hypothyroidism during pregnancy. The median, P2.5-P97.5, and interquartile range (IQR) of neonatal TSH (N-TSH) of 1747 babies were 2.72 mIU/L, 0.10-8.01 mIU/L and 2.62 mIU/L, respectively; 28.6% of pregnant women with thyroid diseases developed pregnancy complications. The prevalence was significantly higher than in the normal thyroid function group (p < 0.001). The levels of N-TSH were low correlated with maternal TSH levels (p < 0.05), but there were no significant correlations between N-TSH and maternal FT4 and maternal TPO-Ab (p > 0.05).\u0000\u0000\u0000CONCLUSIONS\u0000Thyroid disorders, especially subclinical hypothyroidism, are common in pregnant women. These disorders are associated with pregnancy and fetal outcome. Routine maternal thyroid function screening is important and should be recommended.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133079831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastroesophageal reflux and reflux oesophageal strictures in children with Cornelia de Lange syndrome.","authors":"M. Vincent, N. Duncan","doi":"10.7727/WIMJ.2012.096","DOIUrl":"https://doi.org/10.7727/WIMJ.2012.096","url":null,"abstract":"Correspondence: Professor ND Duncan, Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Kingston 7, Jamaica, West Indies. E-mail: medicnd@gmail.com INTRODUCTION Due to the early diagnosis and effective treatment options for gastroesophageal reflux (GER), reflux strictures in children are no longer commonly encountered. We report on two cases of reflux oesophageal strictures occurring in children, both having the rare genetic disorder, Cornelia de Lange syndrome, and discuss their management.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116064113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A changes in hyoid bone position after orthodontic treatment of patients with mandibular deviation.","authors":"Q. Yang, C. Wang, C. Fan, J. Chen","doi":"10.7727/WIMJ.2013.099","DOIUrl":"https://doi.org/10.7727/WIMJ.2013.099","url":null,"abstract":"OBJECTIVES\u0000The aim of this study was to observe the influence of orthodontic treatment on the hyoid position of patients with different vertical skeletal craniofacial patterns of mandibular deviations.\u0000\u0000\u0000METHODS\u0000A total of 60 patients with mandibular deviations, including 30 males and 30 females with a mean age of 15.4 years, were recruited. They were equally divided into average angle, high angle, and low angle groups, with a 1:1 gender ratio. Their hyoid position was measured before and after orthodontic treatment. The data were analysed using paired t-tests and analysis of variance (ANOVA).\u0000\u0000\u0000RESULTS\u0000After treatment, the hyoid body in the high angle group presented significant forward and upward movements (p = 0.012 and p = 0.005). The hyoid body in the low angle group exhibited significant forward movement (p = 0.048) and a significant increase in the hyoid inclination (p = 0.00). In the average angle group, the hyoid body significantly moved downward (p = 0.031) and the thyrohyoid moved upward (p = 0.046). The ANOVA showed that orthodontic treatment significantly influenced the vertical position and inclination degree of the hyoid (F = 6.37, p = 0.003; F = 6.204, p = 0.004; and F = 3.393, p = 0.025). The average angle group displayed significant differences in these indices compared with the high angle and low angle groups. Orthodontic treatment significantly influenced the mandibular plane angle in the high angle group (p = 0.012).\u0000\u0000\u0000CONCLUSION\u0000Orthodontic treatment influences the hyoid position of patients with different vertical skeletal craniofacial patterns of mandibular deviations by varying degrees.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129302870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}