The West Indian medical journal最新文献

{"title":"Cloning and Constructing a Plasmid Encoding Leishmania Eukaryotic Initiation Factor Gene of Leishmania major Fused with Green Fluorescent Protein Gene as a Vaccine Candidate.","authors":"N. Maspi, F. Ghaffarifar, Z. Sharifi, A. Dalimi","doi":"10.7727/wimj.2014.201","DOIUrl":"https://doi.org/10.7727/wimj.2014.201","url":null,"abstract":"Objective\u0000Leishmaniasis is usually treated with chemotherapy; however, toxicity, resistance and high-cost limit use of the chemical drugs. Leishmania eukaryotic initiation factor (LeIF) protein acts the same as interleukin (IL)-12 and reduces the secretion of IL-4 in lymph node cells of mice infected with Leishmania major. The aim of this study was cloning of the gene encoding LeIF antigen into eukaryotic expression plasmid pEGFP-N1.\u0000\u0000\u0000Methods\u0000DNA was extracted from Iranian strain of the L major (MRHO/IR/75/ER) promastigotes. The full-length sequence of LeIF was amplified with Pfu DNA polymerase using a specific primer. The amplified LeIF was cloned into a pJET1.2/blunt vector. Then this fragment was digested with HindIII and EcoRI and was subcloned into the pEGFP-N1 vector. Confirmation of the cloning was done by colony polymerase chain reaction (PCR).\u0000\u0000\u0000Results\u0000Leishmania eukaryotic initiation factor gene was successfully cloned and subcloned into pJET1.2 and pEGFP-N1 plasmids, respectively. The results of colony PCR, restriction analysis and sequencing confirmed them.\u0000\u0000\u0000Conclusions\u0000We cloned LeIF gene which could be expressed in eukaryotic cells in vivo and could be used as a vaccine candidate against leishmaniasis in future studies.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115058808","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":"Global Registry of Acute Coronary Events (GRACE) Risk Score as a Predictor of In-hospital Mortality for Acute Coronary Syndrome in Trinidad and Tobago.","authors":"M. Chin, T. Cummings, C. Thomas, T. Seemungal","doi":"10.7727/wimj.2014.172","DOIUrl":"https://doi.org/10.7727/wimj.2014.172","url":null,"abstract":"Objective\u0000To determine whether risk stratification using the Global Registry of Acute Coronary Events (GRACE) risk score is a predictor of in-hospital mortality for patients with acute coronary syndrome (ACS) in a multi-ethnic Caribbean population.\u0000\u0000\u0000Method\u0000During a six-month period, all patients meeting the GRACE diagnostic criteria for one of the acute coronary syndromes were entered into a prospective single-centre study at one of the major public hospitals in Trinidad and Tobago. Clinical data, the GRACE risk score and in-hospital morbidity and mortality were recorded. Patients were placed into three GRACE risk categories: low, intermediate or high risk.\u0000\u0000\u0000Results\u0000There were 372 patients (mean age 63 years; males 56% and females 44%; hypertension 69%, diabetes mellitus 58%, positive smoking history 43%, previous myocardial infarction 34%), of which 25% were ST-segment elevation myocardial infarction, 56% non-ST-segment myocardial infarction and 19% unstable angina pectoris. In-hospital mortality was 8.3%. There were 35%, 33% and 32% of patients in the high, intermediate and low GRACE risk categories, respectively. The GRACE risk score demonstrated good discrimination (C statistic 0.82, 95% CI 0.755, 0879; p < 0.001) and good calibration (Hosmer-Lemeshow; p = 0.096) for in-hospital mortality in this ACS cohort.\u0000\u0000\u0000Conclusion\u0000The GRACE risk score was found to be a reliable predictor of in-hospital mortality in this ACS population and therefore can be used to identify those high-risk patients who may benefit from aggressive management strategies, thereby allowing for more effective use of limited resources.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130640688","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":"Combination Therapy in Pulmonary Arterial Hypertension: Single Centre Long-term Experience.","authors":"G. Taçoy, A. Çengel, Yakup Alsancak, Serkan Ünlü, Sedat Türkoğlu","doi":"10.7727/wimj.2014.148","DOIUrl":"https://doi.org/10.7727/wimj.2014.148","url":null,"abstract":"Background\u0000Pulmonary arterial hypertension (PAH) is a progressive disease of the pulmonary vascular bed and causes right heart failure and death. Combination therapy which targets three different pathways is necessary due to the progressive nature of the disease. In patients with PAH, there are two approaches in combination therapy: \"first-line up-front\" and \"sequential add-on\" treatment. In \"firstline up-front\" treatment, patients receive double or triple drug therapy from the start. In the \"sequential add-on\" approach, a single drug is initially started and then according to the patient's requirements, a second or third drug is added. There is insufficient evidence about the efficiency and safety of treatment approaches. In this study, we aimed to evaluate the treatment approach in patients with PAH at a tertiary centre.\u0000\u0000\u0000Methods\u0000Pulmonary arterial hypertension was diagnosed according to clinical, echocardiographic and right heart catheterization findings. The patients received bosentan, sildenafil and iloprost treatment in accordance with guidelines recommendations. Clinical worsening in patients was defined as death, requirement of hospitalization for PAH, a 15% decline in the six-minute walk test (6MWT) distance, deterioration in functional capacity, and symptoms and findings of right heart failure.\u0000\u0000\u0000Results\u0000At the end of the follow-up period, clinical and echocardiographic findings, brain natriuretic peptide (BNP) levels and oxygen saturation were similar between patients who completed the study with monotherapy and with combination therapy. The follow-up period was significantly longer in patients who required combination treatment. Two patients (6.9%) died and four patients (13.8%) were hospitalized due to recurrent symptoms and findings of right heart failure. At the end of follow-up, 10 patients (34.5%) completed the study with a single drug, 15 patients (51.7%) with two drugs and four patients (13.8%) with three drugs.\u0000\u0000\u0000Conclusion\u0000In this study, combination therapy was given to patients as \"sequential add-on therapy\". At the end of the follow-up period, monotherapy was sufficient in 34.5% of patients of the study group and in eight patients, sildenafil or prostaglandin analogues were added; a total of 15 patients (48.4%) completed the study under dual therapy. Four patients (12.9%) received combination therapy with three drugs.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115774207","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":"Utility of the Tono-Pen in Measuring Intraocular Pressure in Trinidad: A Cross-sectional Study.","authors":"A. Billy, PE David, AK Mahabir, CP Seerattan, JM Street, VD Walcott, RJ Yarna, D. Murray, R. Maharaj","doi":"10.7727/wimj.2014.125","DOIUrl":"https://doi.org/10.7727/wimj.2014.125","url":null,"abstract":"AIM\u0000To determine the sensitivity and specificity of the Reichert™ Tono-Pen AVIA® when used by novice medical students in an ethnically diverse population in Trinidad.\u0000\u0000\u0000SUBJECTS AND METHOD\u0000Participants were residents of Trinidad between the ages of 20 and 90 years attending the Ophthalmology Clinic at the Eric Williams Medical Sciences Complex (EWMSC). Intraocular pressure (IOP) was measured using the Goldmann applanation tonometer (the gold standard) for ophthalmology clinic patients as part of their routine care. Intraocular pressure measurements were then taken using the Tono-Pen.\u0000\u0000\u0000RESULTS\u0000One hundred persons participated, consisting of Indo-Trinidadians (55%), Afro-Trinidadians (36%), Mixed (8%) and 1% of Caucasian descent. Fourteen per cent reported a diagnosis of glaucoma, with 70.6% of these being of African descent. One hundred and ninety-eight readings of IOP were taken. At a cut-off point of 21 mmHg, there were nine true positives, four false positives, seven false negatives and 178 true negatives. The sensitivity and specificity were found to be 56.3% (95% CI 33.2, 76.9) and 97.8% (95% CI 94.5, 99.1), respectively. The positive predictive value was calculated as 69.2% (95% CI 42.4, 87.3) while the negative predictive value was 96.2% (95% CI 92.4, 98.2). The prevalence of elevated IOP in this population was 8.1% (95% CI 4.8, 13.0). The likelihood ratio of a positive result was calculated to be 25.6 (95% CI 8.6, 73.9).\u0000\u0000\u0000CONCLUSION\u0000The high specificity and negative predictive value suggests that the Tono-Pen can be used with minimal training, and can prove beneficial at the primary care level in the exclusion of increased IOP in an ethnically diverse high-risk Caribbean population.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124008377","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 Congenital Malformations in Grenada.","authors":"B. Nelson, V. Naraine, C. Patterson, S. Rodrigo","doi":"10.7727/wimj.2013.331","DOIUrl":"https://doi.org/10.7727/wimj.2013.331","url":null,"abstract":"Objectives\u0000To determine the prevalence of congenital malformations in Grenada for the period January 2000-December 2004.\u0000\u0000\u0000Methods\u0000The study included neonates diagnosed with congenital malformations as well as those who were part of the Grenada Heart Foundation for the same time period. Patient delivery records from the three government hospitals were reviewed. Parents were contacted and a questionnaire administered to obtain demographic and maternal history related to the birth.\u0000\u0000\u0000Results\u0000The prevalence of birth defects was 0.78% (95%CI: 0.61, 0.98) for the five-year period among the 9004 live births. Cardiovascular malformations were the most prevalent (0.32%; 95% CI: 0.22, 0.45%), with abnormalities of the genitourinary system being the least prevalent (0.04%; 95% CI: 0.01, 0.11%).\u0000\u0000\u0000Conclusion\u0000The prevalence of congenital malformations in Grenada is low in comparison to other developed and developing countries.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130565488","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 Profile of Familial Mediterranean Fever in a Paediatric Population in Eastern Turkey.","authors":"C. Koşan, N. Diri, A. Çayır, M. Turan","doi":"10.7727/wimj.2014.173","DOIUrl":"https://doi.org/10.7727/wimj.2014.173","url":null,"abstract":"Objective\u0000Clinical and genetic findings of familial Mediterranean fever (FMF) may vary in different populations. Environmental factors may also affect phenotypic features of FMF. In this study, we investigated demographic, clinical and mutational features of FMF patients treated in a single reference hospital in Turkey.\u0000\u0000\u0000Subjects and Methods\u0000One hundred and ninety-seven patients were included. The 11 mutations most frequently seen in FMF were investigated in these patients. Patients were assessed as homozygous, heterozygous, compound heterozygous or non-mutation bearing. Clinical and laboratory examinations in the attack and attack-free periods were recorded. A disease severity score was calculated for each patient.\u0000\u0000\u0000Results\u0000One hundred patients were female and 97 male. The most commonly seen mutations in our region was M694V (51.7%). The most frequent clinical findings in our patients was gastric pain (90.1%), followed by fever (82.2%). The highest disease severity score was determined in patients with homozygous M694V. Sedimentation values were significantly high in patients with homozygous M694V mutation, while no statistically significant difference was determined among other acute phase reactants and haemoglobin and leukocyte values.\u0000\u0000\u0000Conclusion\u0000Changes in acute phase reactants in attack and attack-free periods are used as diagnostic tools in FMF. Severity and frequency of attacks are clearly correlated with mutations. However, the fact that the clinical course can differ even in individuals with mutations reveals the importance of environmental factors.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"154 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114327105","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 Case of Seborrhoeic Keratosis and Family Survey.","authors":"F. Xie, R. Wang, Y. Chen, Y. Jia, Xin Jia, M. Chen, L. Yang, X. Lan","doi":"10.7727/wimj.2014.221","DOIUrl":"https://doi.org/10.7727/wimj.2014.221","url":null,"abstract":"This study is a family survey based on a typical patient with seborrhoeic keratosis (SK). Family members comprised 47 people of four generations, including 22 affected members (12 males and 10 females). The 17 people of the fourth generation were aged less than 26 years old. The proband in this study had typical clinical manifestations and pathology of SK, and all affected members of the family had characteristic skin rash that was easy to be identified. The pattern is consistent with autosomal dominant inheritance and SK is indicated to have a certain age onset.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"13 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120894039","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":"Molecular Advancements in Forensic Odontology.","authors":"A. Babu Rs, D. Rose","doi":"10.7727/wimj.2014.109","DOIUrl":"https://doi.org/10.7727/wimj.2014.109","url":null,"abstract":"Forensic odontology explores the field of human identification through dental tissues in cases where there is the destruction of body tissues in criminal investigations and mass disasters. Forensic odontology involves dentists participating in legal and criminal issues. Parameters such as age and gender identification are important in identifying the person or persons. Over the last two decades, the molecular aspect of forensic sciences has increased, and these molecular techniques now provide a novel approach to forensic odontology. Molecular advancements in science like DNA analysis have extended the range of forensic dentistry, as teeth possess the character of resistance toward physical or chemical aggressions. Teeth provide the abundant space for DNA, and hence teeth represent an excellent source of genomic DNA. The present paper focusses on molecular advancements in the field of forensic odontology.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126224040","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":"Dose-dependent Hallucinations Due to Baclofen in a Patient with Spastic Cervical Spinal Cord Injury.","authors":"H. Bölük, I. Karabay, C. Polat, Gökhan Tuna Öztürk, E. Erden, Murat Ersöz","doi":"10.7727/wimj.2014.191","DOIUrl":"https://doi.org/10.7727/wimj.2014.191","url":null,"abstract":"","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130719074","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":"Hypertrophic Cardiomyopathy as a Clinical Component of Congenital Cytomegalovirus Infection.","authors":"F. Demir, M. Yılmazer, S. Dalli, İ. Yolbaş, U. Uluca, M. Bilici, M. Turan","doi":"10.7727/wimj.2014.276","DOIUrl":"https://doi.org/10.7727/wimj.2014.276","url":null,"abstract":"We report hypertrophic cardiomyopathy in a newborn with congenital cytomegalovirus infection. The neonate had distinct signs of congenital cytomegalovirus infection including petechiae, jaundice, intracranial calcifications, cerebral ventriculomegaly and chorioretinitis together with hypertrophic cardiomyopathy. Following determination of anti-cytomegalovirus IgM, viral DNA was also isolated from the plasma of the patient by polymerase chain reaction. Although cytomegalovirus is a relatively frequent cause of myocarditis in childhood, it was rarely reported to be associated with cardiac abnormalities such as structural heart disease, atrioventricular block, or dilated cardiomyopathy. To our knowledge, this is the first case with congenital cytomegalovirus infection and hypertrophic cardiomyopathy.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128576899","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}