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1.
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-18042

RESUMO

OBJECTIVES: To study the prevalence and pattern of major congenital malformations of the gastrointestinal tract among the newborns in Barbados. DESIGN AND METHODS: This study includes all newborns with major congenital malformations of the gastrointestinal tract in Barbados from 1993 to 2012. The birth register and the neonatal admission register at the Queen Elizabeth Hospital, where over 90% of all deliveries in this country take place, were the main source of data. RESULTS: The overall prevalence of major congenital malformations of the digestive system in newborns was 7.28 per 10,000 live births. There were 15 (32.6%) cases of congenital absence, atresia, and stenosis of the small intestine giving a prevalence rate of 2.37 / 10,000 live births and 13 cases (28.3%) of esophageal atresia giving a prevalence rate of 2.06 / 10,000 live births. The overall prevalence of major congenital malformations of the gastrointestinal tract increased from 4.46 / 10,000 live births during 1993 – 1997 to 10.50 / 10,000 live births during 2008 – 2012. The prevalence of the absence, atresia or stenosis of the small intestine increased from 0.64 / 10,000 live births during 1993 – 1997 to 5.25 / 10,000 live births during 2008 – 2012. Overall, 1.1% of all neonatal deaths were attributed to major malformations of the digestive system. CONCLUSIONS: Congenital absence, atresia and stenosis of the small intestine were the most common malformations, with increasing prevalence over the study period. Tracheoesophageal fistula was the second most prevalent malformation and it had a high case fatality rate.


Assuntos
Anormalidades Congênitas , Recém-Nascido , Trato Gastrointestinal , Prevalência , Barbados
2.
The British journal of psychiatry ; 191(supl. 51): s111-s116, Dec. 2007. tab
Artigo em Inglês | MedCarib | ID: med-17797

RESUMO

BACKGROUND: Grey matter and other structural brain abnormalities are consistently reported in first-onset schizophrenia, but less is known about the extent of neuroanatomical changes in first-onset affective psychosis. AIMS: To determine which brain abnormalities are specific to (a) schizophrenia and (b) affective psychosis. METHOD: We obtained dual-echo (proton density/T2-weighted) magnetic resonance images and carried out voxel-based analysis on the images of 73 patients with first-episode psychosis (schizophrenia n=44, affective psychosis n=29) and 58 healthy controls. RESULTS: Both patients with schizophrenia and patients with affective psychosis had enlarged lateral and third ventricle volumes. Regional cortical grey matter reductions (including bilateral anterior cingulate gyrus, left insula and left fusiform gyrus) were evident in affective psychosis but not in schizophrenia, although patients with schizophrenia displayed decreased hippocampal grey matter and increased striatal grey matter at a more liberal statistical threshold. CONCLUSIONS: Both schizophrenia and affective psychosis are associated with volumetric abnormalities at the onset of frank psychosis, with some of these evident in common brain areas.


Assuntos
Humanos , Research Support, Non-U.S. Gov't , Esquizofrenia , Anormalidades Congênitas , Transtornos Psicóticos , Trinidad e Tobago
3.
Kingston; s.n; Aug. 12, 1998. 66 p.
Tese em Inglês | MedCarib | ID: med-1670

RESUMO

Even with the constant decline in the incidence of Hansen's disease in Jamaica and declared elimination status in 1981, there is still a high percentage of patients being registered with multibacillary type of Hansen's disease and with disabilities at the time of diagnosis. This increase is noted, at a time when the global focus is on Hansen's eradication by the year 2000. Young adults are the group most a risk for Hansen's disease and its complications. Delayed diagnoses have resulted in an increase in deformities. Men are more prone to disabilities and the severe type of the disease (RR=1.00). Children have been diagnosed with the multibacillary type of disease. A retrospective study was conducted, over the period 1982 to 1996, in order to anlayse the disability trends and what it means for the Hansen's disease control programme in Jamaica. It was demonstrated that among the 88 patients graded 42 percent had disability, of which the most common was that of the hand (OR=5.33 p=0.03). These findings indicate that there is an urgent need for active case finding of Hansen's disease patients in Jamaica. Early case finding must be seen as the key to an effective "prevention of disability" programme.(AU)


Assuntos
Adulto , Pessoa de Meia-Idade , Feminino , Humanos , Masculino , Hanseníase/complicações , Anormalidades Congênitas , Deformidades Adquiridas da Mão/etiologia , Jamaica , Hanseníase/epidemiologia
4.
St. Augustine; [Department of Livestock Sciences and School of Veterinary Medicine, The University of the West Indies]; 1995. 5 p. ilus., 24
Monografia em Inglês | MedCarib | ID: med-16250
6.
West Indian med. j ; 40(suppl. 1): 14-15, Apr. 1991.
Artigo em Inglês | MedCarib | ID: med-5612

RESUMO

This survey was conducted from August 13, 1990 to September 14, 1990 at the Mount Hope Women's Hospital and the Port-of-Spain General Hospital. A total of 613 well full-term neonates were examined within 24 hours of birth for physical anomalies including mongolian spots, cafe-au-lait spots, haemangiomas, supernumerary nipples, extra digits, clubfoot, single transverse palmar crease, cleft lip and cleft palate. Diagnosis of the various anomalies was made by systematic physical examination and literature references. Data were obtained from hospital records, interviewing the mother, and examination of the baby and were recorded in a standardized form. There were 299 males and 314 females (M:F = 1:1.04). Mongolian spots were the commonest anomaly (56.4 percent) followed by cafe-au-lait spots (9.3 percent) and haemanigomas (2.1 percent). There was a slightly greater incidence of anomalies among females, particularly haemangiomas (1:2.25) and extra digits (1:1.25). A ratio of 1.2:1 existed for accessory nipples. In the sample there were more Negro (45.5 percent) than East Indian (31.5 percent) babies. Interestingly, of the babies with haemangiomas, 39.5 percent were East Indian and 39.5 percent mixed (AU)


Assuntos
Humanos , Gravidez , Recém-Nascido , Recém-Nascido , Anormalidades Congênitas , Trinidad e Tobago
7.
In. Levett, Paul N; Fraser, Henry S; Hoyos, Michael D. Medicine and therapeutics update 1990: proceedings of Continuing Medical Education symposia in Barbados, November 1988 & June 1989. St. Michael, University of the West Indies, (Cave Hill). Faculty of Medical Sciences, 1990. p.29-33, tab.
Monografia em Inglês | MedCarib | ID: med-15008

RESUMO

In this article the author accepts the WHO definition of symptoms to establish a diagnosis of AIDS in children. Risk factors and roster of transmission list parents with Aids Related complex (ARC) or AIDS or at risk for AIDS, receipt of contaminated blood products, infection during treatment of haemophila or coagulation disorders, multiple use of needles in drug abuse and sexual activity or abuse. Age and sex distribution, clinical features, non-specific clinical manifestations of Aids in children and varying clinical manifestations in children versus adults with HIV are examined


Assuntos
Infecções por HIV/classificação , Infecções por HIV/diagnóstico , Infecções por HIV/transmissão , Sinais e Sintomas , Sistema Imunitário , Anormalidades Congênitas/classificação , Anormalidades Congênitas/diagnóstico , Fatores de Risco , Infecções Oportunistas/classificação , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/terapia , Cuidados de Enfermagem , Barbados
8.
Pediatr Pathol ; 10(5): 729-42, 1990.
Artigo em Inglês | MedCarib | ID: med-12253

RESUMO

Babies with major malformations were identified during the Jamaica Perinatal Morbidity and Mortality Survey. They were found in 96 (8.6 percent) of 1112 perinatal and neonatal deaths coming to necropsy and in 28 (2.6 percent) of 1085 not so examined. The central nervous system was most commonly affected, followed by the renal, gastrointestinal, and cardiovascular systems in decreasing order of frequency. Many infants had abnormalities in more than one system and 10 malformations syndromes/sequences were identified. Although at the present time, major malformations make only a small contribution to perinatal and neonatal mortality in Jamaica, their importance will increase when deaths from other causes, such as birth asphyxia, decline. The type of malformation currently fatal in a particular population is relevant when planning diagnostic and surgical services for neonates and infants. It is also important to any discussions about provision of prenatal diagnostic services. (AU)


Assuntos
Humanos , Recém-Nascido , Anormalidades Congênitas/mortalidade , Morte Fetal , Mortalidade Infantil , Anormalidades Congênitas/embriologia , Anormalidades Múltiplas/mortalidade , Vasos Sanguíneos/anormalidades , Osso e Ossos/anormalidades , Sistema Nervoso Central/anormalidades , /anormalidades , Cardiopatias Congênitas/mortalidade , Jamaica , Rim/anormalidades , Pulmão/anormalidades , Músculos/anormalidades , Sistema Urinário/anormalidades
9.
Arch dis child ; 64(10): 1457-62, Oct. 1989.
Artigo em Inglês | MedCarib | ID: med-10012

RESUMO

Stillbirth and infant mortality from congenital malformations in England and Wales during 1981-5 was investigated according to the mother's country of birth. Significant differences remained after standardising for maternal age and social class. The highest overall mortality was in infants of mothers born in Pakistan (standardised mortality ratio 237), followed by infants of mothers born in India (standardised mortality ratio 134), East Africa (standardised mortality ratio 126) and Bangladesh (standardised mortality ratio 118). Caribbean and West African mothers showed an overall deficit. Mortality was inversely related to social class in all groups except the Afro-Caribbean. Infants of mothers born in Pakistan had the highest mortality in every social class except I, and for most anomalies investigated. Their ratios were particularly high for limb and musculoskeletal anomalies (standardised mortality ratio 362), genitourinary anomalies (standardised mortality ratio 268), and central nervous anomalies (standardised mortality ratio 239). Our findings highlight the need for further research to identify the causes underlying these differences. (AU)


Assuntos
Humanos , Gravidez , Recém-Nascido , Feminino , Anormalidades Congênitas/mortalidade , Morte Fetal/etnologia , Anormalidades Congênitas/etnologia , África/etnologia , Ásia/etnologia , Sistema Nervoso Central/anormalidades , Inglaterra/epidemiologia , Mães , Classe Social , País de Gales/epidemiologia , Índias Ocidentais/etnologia
10.
West Indian med. j ; 38(Suppl. 1): 58-9, Apr. 1989.
Artigo em Inglês | MedCarib | ID: med-5649

RESUMO

Since 1983, computerised axial tomography (CAT) has been the mainstay of neurological imaging in Trinidad and Tobago. In 1988, magnetic resonance imaging (MRI) became available in nearby South America. This study was done to examine the capabilities, limitations and pitfalls of CAT scanning and to provide guidelines for patients referral for MRI. The most recent 2,000 head and 68 body CAT scans performed from 1984 to 1988 were reviewed. Abnormalities were seen in 759 (38 percent) of head scans: tumours 262 (34.5 percent), cerebral atrophy 128 (17 percent), ischaemic infarcts 121 (16 percent), intracranial haemorrhage 105 (14 percent), hydrocephalus 42 (5.5 percent), traumatic cerebral contusions 40 (5 percent), infection 36 (5 percent) and vascular malformations 14 (2 percent). Abnormalities were seen in 45 (66 percent) body scans: spinal lesions 20 (44 percent), and lesions of the pancreas 8, liver 8, kidneys 4, adrenals 2, and 1 each in the lung, oesophagus and spleen. CAT scanning, however, was sometimes unable to resolve diagnostic dilemmas, and in 1988, 32 patients were referred for 22 head and 10 spine MRI studies. MRI head abnormalities were tumours 4, absceses 3 (1 in the brain stem), and 1 each of subdural haematoma, demyelinating disease and hydrocephalus. There were 12 normal head MRI studies. MRI spine abnormalities (7) were lumbar disc herination, cervical spondylosis 2, and syringomyelia 1, and 3 studies were normal. CAT scan limitations were most apparent with bone artefacts in the posterior and temporal fossae and the pituitary region, isodense subdural collections, differentiating enhancing infarcts from tumour and in demyelinating disease. MRI did not have these limitations and had the advantage of direct multiplanar (coronal and sagittal) imaging, superior tissue type differentiation, no ionizing radiation or allergenic contrast media. MRI is especially useful in imaging pituitary, parasellar and brain stem lesions, the spine and spinal cord, the heart, abdominal viscera, and joints. Its realtive disadvantages include slower scan times, danger to patients with indwelling ferromagnetic material, claustrophobia and higher equipment cost (AU)


Assuntos
Relatos de Casos , Humanos , Tomógrafos Computadorizados , Imageamento por Ressonância Magnética , Anormalidades Congênitas , Trinidad e Tobago
11.
West Indian med. j ; 38(Suppl. 1): 23, April 1989.
Artigo em Inglês | MedCarib | ID: med-5700

RESUMO

In developing countries where ultrasonography and nuclear medicine scanning are not widely available, the intravenous pyelogram (IVP) is the principal method of visualizing the urinary tract. As a result, there exists a real potential for over requesting this relatively expensive study which is unpleasant and not without risk, especially in children. To assess the appropriate use of paediatric IVPs at the Port-of-Spain General Hospital, a retrospective study was done of all IVPs (n=373) performed on children at this institution during the 3-year period, 1985-1987. Radiological abnormalities were reported in 29 percent of cases. The most common abnormal findings were consistent with infection (29 percent) and hydronephrosis (26 percent). The most common indications for radiological study were urinary tract infection (23 percent) and haematuria (17 percent). Problems in making the diagnosis of a urinary tract infection in children were identified as the improper collection and handling of the urine specimen. Based on this survey, almost one-third of children who have IVPs at this institution do not have any indication for doing this potentially dangerous and certainly expensive procedure (AU)


Assuntos
Humanos , Criança , Urografia , Criança , Anormalidades Congênitas , Infecções Urinárias/diagnóstico
12.
Paediatr Perinat Epidemiol ; 2(2): 161-84, Apr. 1988.
Artigo em Inglês | MedCarib | ID: med-12480

RESUMO

The literature on the incidence in the UK of congenital and constitutional anomalies in populations deriving from Africa, the Caribbean, the Far East, the Indian subcontinent and the Mediterranean is reviewed. These groups represent an increasing proportion of the whole child population. Comparison with the white population and between groups reveals that the burden of impairment varies with country of origin. Some of the reasons implicated include different gene frequencies and mating patterns, age/parity distribution and uptake of preventive services. Comparisons with prevalence at birth in the countries of origin are made where possible. In general, populations with high rates in their country of origin retain their high rates (e.g. central nervous system anomalies among births to parents deriving from the Indian subcontinent). There is a general lack of data on the prevalence of handicapping conditions such as cerebral palsy, as well as the associated health needs and service utilisation amongst ethnic minorities. (AU)


Assuntos
Humanos , Anormalidades Congênitas/etnologia , Anormalidades Congênitas/epidemiologia , Anormalidades Congênitas/genética , África/etnologia , Ásia Oriental/etnologia , Reino Unido , Necessidades e Demandas de Serviços de Saúde , Índia/etnologia , Itália/etnologia , Migrantes , Índias Ocidentais/etnologia
13.
West Indian med. j ; 34(suppl): 59, 1985.
Artigo em Inglês | MedCarib | ID: med-6684

RESUMO

This study represents an analysis of the types and incidence of congenital malformations seen by a surgeon in 21 years in St. Vincent, with a population of 111,000. Of a total of 887 cases, 636 or 71.7 per cent were general, and 251 or 28.3 per cent orthopaedic malformations. The commonest orthopaedic groups were malposition in utero, contracture and epiphyseal plate growth disparity, constituting 69.7, 13.5 and 6.4 per cent respectively. Talipes equino-varus was the commonest orthopaedic deformity (51.8 per cent). The commonest general malformations were failure of atrophy, forming 30.7 per cent, of which 72.8 per cent were inguinal herniae. The next commonest was failure of fusion (16.3 per cent) with umbilical herniae contributing 50.9 per cent. Phimosis and adhesion of the labia minora together were the third largest group, 10.7 per cent. Of interest were duplication of the entire genital tract in a 20-year-old, and an 18-year-old with imperforate hymen, and no uterus. In a 30-year-old patient with Turner's syndrome, there was an ectopic ovary in her inguinal canal. Two members of one family showed Marfan's syndrome, but the male was also an albino. Most outstanding was the incomplete testicular feminization syndrome in siblings 4 years apart. Both had 46XY chromosomes. There was a case of the ovarian masculinization syndrome in a seeming boy of 11 years, and the Lorain-type hypopituitarism in a man of 30 yrs. There was a 6-year old typical infant Hercules with the features of pituitary gigantism. This study presents the type and incidence of congenital malformations in the practice of a single doctor (AU)


Assuntos
Humanos , Masculino , Feminino , Anormalidades Congênitas/epidemiologia , São Vicente e Granadinas
14.
Br Med J ; 281(6251): 1307-8, Nov. 15, 1980.
Artigo em Inglês | MedCarib | ID: med-9555

RESUMO

The 3996 mothers delivered at Dudley Road Hospital, Birmingham, in 1979 were analysed for their ethnic origins. Social classes IV and V predominated in all groups. A high proportion of Indian mothers fell into the low-risk group based on age and parity but had the highest stillbirth and perinatal mortality rates (15.1 and 27.5/1000 respectively) and infants of low mean birth weight (2986 g). Elderly and multiparous mothers were characteristic of the Pakistani and Bangladeshi groups. Young, primiparous mothers were more common among the West Indians and Europeans, in whom the stillbirth and perinatal mortality rates were low; infants in the European group had a mean birth weight higher than in any other group (3231 g). From these findings ethnic origin of the mother is apparently an important factor in perinatal mortality.(AU)


Assuntos
Humanos , Gravidez , Recém-Nascido , Feminino , Etnicidade , Mortalidade Infantil , Anormalidades Congênitas/mortalidade , Bangladesh/etnologia , Estudo Comparativo , Inglaterra , Europa (Continente)/etnologia , Morte Fetal , Índia/etnologia , Recém-Nascido de Baixo Peso , Idade Materna , Paquistão/etnologia , Paridade , Classe Social , Índias Ocidentais/etnologia
15.
West Indian med. j ; 29(2): 123-30, June 1980.
Artigo em Inglês | MedCarib | ID: med-11298

RESUMO

The pregnancies of women 40 years and over who delivered at the Port-of-Spain General Hospital, Trinidad, during 1978, were reviewed in order to establish to what extent such women constitute a high-risk group. Seventy-four per cent were grandmultiparae (5 or more viable pregnancies) and the Caesarian section rate was high as 14.3 per cent. The majority of Caesarian sections (73 per cent) were performed in grandmultiparous patients. Pre-eclampsia occurred in a third of patients studied. Anaemia, pre-mature labour and post-partum haemorrhage were other common complications. In view of these findings, it is strongly recommended that greater emphasis be placed on family planning in order to eliminate parturient women beyond 40 years of age, and in particular, those who are highly parous (AU)


Assuntos
Adulto , Feminino , Humanos , Recém-Nascido , Pessoa de Meia-Idade , Idade Materna , Complicações na Gravidez/epidemiologia , Anormalidades Congênitas/epidemiologia , Parto Obstétrico/métodos , Trabalho de Parto , Paridade , Hemorragia Pós-Parto/epidemiologia , Trabalho de Parto , Gravidez , Trinidad e Tobago
18.
West Indian med. j ; 21(1): 54, Mar. 1972.
Artigo em Inglês | MedCarib | ID: med-6294

RESUMO

During the Infant Mortality Survey, post mortems were performed on 78 Jamaican infants with congential malformations or diseases. The purpose of this paper is to analyse the type of malformation and compare the incidence with other areas. Only adequately documented post mortems were analysed. The total numbers may not be completely representative, as many deaths, especially those at Victoria Jubilee Hospital, were not autopsied. The malformations were classified as in the WHO study of 1966 of Stevenson et al and include only those which were a main contributory cause of death. Cardiovascular malformations were the commonest defect, occurring in 45 percent of cases. Single gene defects and chromosomal abnormalities (16 cases) and mongolism (12 cases) were the next commonest conditions and genito-urinary defects occurred in 17 percent of cases. Sickle cell anaemia though not included as a malformation, accounted for 5 percent of all deaths in the 6-month to 2-year age group. As has been found previously here and in other African groups, neural tube defects are extremely rare (1 case only). Congenital malformations play an important role in Jamaican Infant Mortality, as they occur in 18.5 percent of autopsied cases (AU)


Assuntos
Humanos , Lactente , Anormalidades Congênitas , Mortalidade Infantil , Jamaica
20.
West Indian med. j;19(3): 130-40, Sept. 1970.
em Inglês | MedCarib | ID: med-10960

RESUMO

The clinical findings in 12 cases of 18 Trisomy and 6 cases of D Trisomy, and the post mortem features if 6, 18 and 3 D trisomies are recorded. The sex distribution, maternal age, month of birth and incidence of these trisomies are discussed. There is a seasonal clustering of birth maximum in the winter months. The incidence of 18 trisomy is close to that estimated from other series of cases but the incidence of D Trisomy appears to be less (AU)


Assuntos
Adolescente , Adulto , Feminino , Humanos , Recém-Nascido , Masculino , Anormalidades Congênitas/epidemiologia , Cromossomos Humanos 13-15 , Cromossomos Humanos 16-18 , Trissomia , Anormalidades Congênitas/genética , Anormalidades Congênitas/genética , Cariotipagem , Jamaica
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