BACKGROUND Recent 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. METHODS Sixty-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. RESULTS Eight 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. CONCLUSION Among 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.
背景:最近人们开始关注质子泵抑制剂(PPIs)可能会削弱氯吡格雷的疗效。我们观察了氯吡格雷加阿司匹林加或不加奥美拉唑对接受颈动脉支架置入后颈动脉狭窄患者的影响。方法连续64例经皮颈动脉支架植入术(CAS)患者。所有入组患者在CAS前均进行C13尿素呼气试验(C13 UBT)。有幽门螺杆菌感染和消化性溃疡史的患者给予双抗血小板联合奥美拉唑。其他患者接受不含奥美拉唑的双重抗血小板治疗。随访3个月和6个月，分别行经颅多普勒和超声检查大脑中动脉和颈动脉。结果8例患者有消化道出血;未使用奥美拉唑的发生率为22.6%，使用奥美拉唑的发生率为3.8%。与未使用奥美拉唑相比，使用奥美拉唑可降低胃肠道出血发生率(p = 0.026, p < 0.05)。经颅多普勒及超声检查两组支架内再狭窄及血栓发生率无显著差异。结论在接受双重抗血小板治疗的患者中，预防性使用奥美拉唑可降低上消化道出血的发生率。氯吡格雷和奥美拉唑在颈动脉支架置入术中无明显的相互作用。
{"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}
T. Ferguson, M. Tulloch-Reid, Nom Younger, R. Wright-Pascoe, M. Boyne, SR McFarlane, D. Francis, R. Wilks
OBJECTIVES To estimate the prevalence of diabetic foot complications among patients at a specialist diabetes clinic in Jamaica and identify factors associated with foot complications. METHODS A 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. RESULTS Participants 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]). CONCLUSION Approximately 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.
目的评估牙买加一家糖尿病专科诊所患者糖尿病足并发症的患病率，并确定与足部并发症相关的因素。方法对2009 ~ 2010年188例患者进行分层随机抽样调查。训练有素的护士获得人口统计和临床数据，测量人体测量并进行足部检查，包括检查截肢，溃疡或感染以及评估疼痛，振动和压力感知。结果女性143例，男性45例，平均年龄56岁;平均糖尿病病程16年)。截肢率为8.5% (95% CI 4.5, 12.5%)，男性(22.2%)高于女性(4.2%，p < 0.05)。当前溃疡和当前足部感染的患病率分别为4.3%和3.7%。总的来说，12%的患者至少有一种足部并发症。在多变量logistic回归模型中，与足部并发症相关的因素有:神经病变(or 9.3 [95% CI 2.8, 30.3])、高血压(or 7.9[1.3, 49.7])和糖尿病病程(or 1.32[1.02, 1.72])。结论:该专科诊所每8例患者中约有1例有严重足部并发症。相关因素为神经病变、高血压和糖尿病病程延长。
{"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}
B. E. Blake-Scarlettl, Novie Younger, Colin A. McKenzie, J. V. Broeck, Christine Powell, S. Edwards, S. Win, R. Wilks
OBJECTIVE To estimate the prevalence and correlates of overweight and obesity among children six to ten years old in the North-East Health Region (NEHR) ofJamaica. METHODS Weights 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. RESULTS Overweight 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. CONCLUSIONS Overweight/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.
{"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}
Y. Cesur, S. Yuca, A. Kaya, Cahide Yılmaz, Ali Bay
AIM Hypocalcaemia evaluation of the clinical, biochemical and radiologicalfeatures of 91 infants with rickets who presented as hypocalcaemic convulsions. SUBJECTS AND METHODS Ninety-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. RESULTS Mean 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. CONCLUSION Vitamin 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.
{"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}
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.
{"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}
M. Bubonja-Šonje, D. Rubinić, F. Anić, S. Novak, D. Vučković, M. Abram
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.
{"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}
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.
{"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}
P. Yuan, Q. Wang, R. Huang, F. Cao, Z. Zhu, D. Sun, H. Zhou, B. Yu
OBJECTIVE We 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. METHODS A 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. RESULTS With 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). CONCLUSIONS Thyroid 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.
{"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}
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.
{"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}
OBJECTIVES The 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. METHODS A 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). RESULTS After 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). CONCLUSION Orthodontic treatment influences the hyoid position of patients with different vertical skeletal craniofacial patterns of mandibular deviations by varying degrees.
目的观察正畸治疗对不同垂直骨面型下颌偏差患者舌骨位置的影响。方法选取下颌畸形患者60例，男30例，女30例，平均年龄15.4岁。他们平均分为平均角度组、高角度组和低角度组，性别比例为1:1。在正畸治疗前后分别测量舌骨位置。采用配对t检验和方差分析(ANOVA)对数据进行分析。结果治疗后，高角度组舌骨体有明显的向前和向上运动(p = 0.012和p = 0.005)。低角度组舌骨体明显前移(p = 0.048)，舌骨倾斜明显增加(p = 0.00)。平均角度组舌骨体明显下移(p = 0.031)，甲状舌骨明显上移(p = 0.046)。方差分析显示，正畸治疗对舌骨垂直位置和倾斜程度有显著影响(F = 6.37, p = 0.003;F = 6.204, p = 0.004;F = 3.393, p = 0.025)。与高角度组和低角度组相比，平均角度组在这些指标上表现出显著差异。正畸治疗对高角组下颌平面角有显著影响(p = 0.012)。结论正畸治疗对不同垂直骨面型患者舌骨位置有不同程度的影响。
{"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}
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