Características y resultados del tratamiento aplicado a los pacientes con cáncer de páncreas / Rejuvenation Surgery with High-Superficial Musculoaponeurotic System Flap

Introducción: El cáncer de páncreas mantiene un pronóstico ominoso a pesar de los avances en técnicas quirúrgicas y cuidados perioperatorios. Objetivo: Caracterizar los resultados del tratamiento aplicado a los pacientes con cáncer de páncreas. Métodos: Se realizó un estudio observacional, descriptivo y transversal de una serie de 70 pacientes con diagnóstico de cáncer de páncreas. Se estudiaron las variables: localización, tamaño del tumor, procedimiento quirúrgico, estadificación preoperatoria, diagnóstico histológico, estancia hospitalaria, complicaciones posoperatorias y estado al egreso, mediante el análisis de frecuencias absolutas, relativas y la media así como la prueba de ji al cuadrado y el IC 95 por ciento. Resultados: El procedimiento quirúrgico más frecuente fue derivativo en 47 enfermos (67,1 por ciento). La operación de Whipple se realizó en 10 pacientes (14,3 por ciento) con tumores localizados en la cabeza del páncreas y la pancreatectomía corporocaudal en 11 (15,7 por ciento) con tumores de cuerpo y cola del páncreas. La mayoría correspondió a los estadios III y IV. El 47,1 por ciento de los pacientes presentó un adenocarcinoma poco diferenciado. La estadía fluctuó entre 15 y 30 días en el 54,3 por ciento de la serie. Las complicaciones se presentaron en 19 enfermos (27,1 por ciento). Fallecieron 15 pacientes (21,4 por ciento) del total. Conclusiones: El tratamiento debe ser individualizado mediante equipos multidisciplinarios, con protocolos de actuación uniformes en cada institución que permita realizar estudios multicéntricos, con el objetivo de obtener estadísticas propias en aras de disminuir la morbilidad y la mortalidad, así como aumentar la calidad de vida de estos pacientes(AU)

Introduction: Facial rhytidectomy is the technique for correcting facial aging features, but they are becoming increasingly complex due to the incorporation of deeper planes in the process. The superficial musculoaponeurotic system techniques have the advantage of providing a greater degree of naturalness and permanence in time. Objective: To evaluate the effectiveness of the high-superficial musculoaponeurotic system technique for facial rejuvenation. Methods: A prospective and longitudinal case series study was carried out in the plastic surgery service of Hospital General Universitario "Vladimir Ilich Lenin" with patients who requested facial rejuvenation and were treated with the high-superficial musculoaponeurotic system technique, from January 1, 2018 to June 30, 2020. The variables age, sex, skin type, degree of aging, operative complications, patient satisfaction and aesthetic outcomes were studied. Results: The female sex predominated, together with the age group 50-59 years, the degrees of aging II and III, as well as white and light brown skin colors, while the most frequent operative complication was wound dehiscence of the suture line at the auricle root. The patients' satisfaction with the aesthetic outcomes of the surgical intervention was verified and the aesthetic outcomes was assessed as favorable in 100 percent of the cases for the used surgical technique. Conclusions: The high-superficial musculoaponeurotic system surgical technique for rhytidectomy offers harmonic, long-lasting outcomes with a low percentage of complications, making it a valuable alternative for patients(AU)

Knowledge, Attitude, and Practices of Dentists in Caribbean Countries during the COVID-19 Pandemic: A Multicenter Cross-Sectional Study

Background: The COVID-19 pandemic has affected dentists globally, both financially and mentally. This study aimed to determine the knowledge, attitude, and practices of dentists in Caribbean countries during the COVID-19 pandemic. Methods: A non-probability sample was obtained from dentists in more than ten different Caribbean countries. They were invited to complete a self-reported questionnaire, which was conducted from December 2020 to March 2021. Ethics approval was sought and an exemption was received from the UWI ethics committee. Results: One hundred and fifty-two dentists responded. More than one-third (38.8%) were in the >35­45 age group, and 58.6% were females. Most (84.9%) were general dentists and 75% were stressed by the COVID-19 situation with 80.9% being affected financially. The majority, 94.7%, believed that the highest risk of transmission of COVID-19 was via aerosol-generating procedures and 87.5% were worried about contracting it clinically. The majority (69.1%) were willing to receive the vaccine, the main reason reported for vaccine hesitancy was due to the possible side effects (35.3%). Most (75%) consumed alcohol. When the locus of control was determined, 54.6% felt they were in control of protecting themselves while 52% felt that external factors controlled their lives. Conclusions: The findings suggest that most dentists in the Caribbean were knowledgeable about COVID-19 and followed current guidelines in their practice and were willing to receive the vaccine.

Self-reported percutaneous injuries of students and interns at the School of Dentistry in Trinidad: A follow up study of an updated sharps protocol

Objective: To report the results of a survey of all percutaneous injuries that occurred between 2009 ­ 2014 among students and interns at the dental school in Trinidad and to evaluate compliance with the protocol for the management of percutaneous injuries. Methods: Data was collected via questionnaires administered to 186 clinical students and interns in 2012 and 2014. Data were analysed using SPSS® 17.0 Statistical software. Results: A 90% response rate was obtained. Forty-eight persons (29%) reported one or more sharps injuries at the dental school. Of the 76 sharps injuries reported, 55 were percutaneous. Needle sticks and burs accounted for the majority of injuries and mostly occurred while working on patients. There were no significant relationships (p>0.05) between sex nor student year with the occurrence of injuries. 76% of the respondents described their concern for contracting blood borne injuries from sharps injuries as "high." After injury, 41% of the respondents followed the school's protocol for sharps injuries. Conclusion: The prevalence of percutaneous injuries among students and interns at the UWI dental school in Trinidad is 23% and occur most commonly while working on patients. Compliance with the protocol for percutaneous injuries needs to be improved. The protocol needs to be audited to improve efficiency and reinforced to the students, interns and clinical supervisors during their clinical years.

COVID-19: Social Displacement and Glucocorticoid Resistance

This study aims to evaluate the effect or lack thereof, of glucocorticoids on Black, Asian, and Minority ethnic groups (BAME) when compared to white populations in the setting of COVID-19 treatment

COVID-19: A sustainable development approach to stabilization and recovery

The objectives of this study are to explore the impacts of COVID-19 on economic, social and environmental systems among CARICOM countries and to propose guidelines for stabilisation using the sustainomics framework.

A Preliminary Investigation into the Dietary and Oral Practices Associated with Fractured Teeth and Prostheses in a Trinidadian Population

Objectives: This preliminary study seeks to determine the relationship between fractured teeth, restorations, prostheses, and specific dietary practices. Methodology: Anonymous questionnaires were randomly distributed to a convenience sample of Trinidadian adults at various locations around the country, after gaining consent. Data were analyzed using the software; Statistical Package for the Social Sciences for significant associations between various types of food and broken teeth or prosthesis using odds ratios. Results: Three hundred questionnaires were completed. Seventy­five percent of the patients preferred crunchy or hard foods and 51% of the respondents liked crushing bones, mostly chicken bones. It was observed that respondents with a dietary preference for fried whole chana, split chana, crab, and sugarcane were significantly associated with broken dentures. Respondents eating whole chana also had a significant association with broken teeth and broken dentures. Associations were found between some dietary preferences, ethnicities, and age groups. Conclusions: Significant associations between age, ethnicity, sex, and certain dietary practices and habits were found. There also appears to be a significant relationship between patients with fractured teeth, restorations, and prostheses with certain dietary preferences.

Characterization of the patients who attended the admission, diagnosis and emergency clinic (CIDU) of the dentistry service of a higher education institution in southwestern Colombia - 2015 / Caracterización de los pacientes que acudieron a la clínica de ingreso, diagnóstico y urgencias (CIDU) del servicio de odontología de una institución de educación superior del suroccidente colombiano - 2015

Aim: To characterize the patients who came to the Insitute, Diagnosis and Emergency Clinic (ICID) of the dentistry service of an institution of higher education in southwes-tern Colombia during the year 2015. Materials and methods: We reviewed 772 patient admission formats, consolidated the data in a database and selected socio-demographic variables of clinical interest.Results: It was found that 63% were female patients, the main reason for consultation is oral rehabilitation with 30%, the most frequent medical precedent was surgery with 57%, 33% of men at the clinical examination presented values of arterial hypertension, but only 13% reported it; while 25% of women presented HTA, but 15% reported it and the treatment of choice was oral rehabilitation with 42%. Conclusions: We found important aspects related to the reason for consultation, medical history and the relevant specialty for its treatment, as well as the importance of education and awareness of systemic compromised diseases such as arterial hypertension.

Objetivo: Caracterizar a los pacientes que acudieron a consulta a la Clínica de Ingreso, Diagnóstico y Urgencias (CIDU) de las clínicas odontológicas de una institución de educación superior del Suroccidente Colombiano durante el año 2015. Materiales y Métodos: Se revisaron 772 formatos de ingreso de pacientes, se hizo el consolidado en una base de datos y se seleccionaron variables sociodemográficas y de interés clínico.Resultados: Se encontró que el 63% fueron pacientes femeninos, el motivo de consulta principal fue la rehabilitación oral con 30%, el antecedente médico que más se repitió fue el de cirugías con 57%, 33% de hombres al examen clínico presentaron valores de hipertensión arterial (HTA), pero solo 13% de ellos lo reportaron; mientras que 25% mujeres presentaron valores de HTA, sin embargo, fueron 15% quienes lo reportaron y el tratamiento de elección fue rehabilitación oral con un 42%. Conclusiones: Se encontraron aspectos importantes relacionadas con el motivo de consulta, antecedentes médicos y la especialidad pertinente para su tratamiento, así como se evidenció la importancia de la educación y concientización de enferme-dades de compromiso sistémico como el caso de la HTA.

Adjuvant endocrine therapy in premenopausal patients with hormone receptor-positive early breast cancer: evidence evaluation and GRADE recommendations by the Italian Association of Medical Oncology (AIOM)

Premenopausal women with hormone receptor-positive early breast cancer are candidates for adjuvant endocrine therapy, as recommended by the major international guidelines. To date, adjuvant endocrine options for premenopausal women include tamoxifen with or without ovarian function suppression (OFS) or an aromatase inhibitor with OFS. Multiple strategies for endocrine treatment of premenopausal women with hormone-responsive breast cancer have been assessed, and the results of randomised clinical trials have been reported over the last years. Despite this evidence, the optimal algorithm for endocrine therapy for premenopausal women with hormone receptor-positive early stage invasive breast cancer shows open questions regarding the role of OFS in addition to tamoxifen and the optimal use of hormonal agents. The panel of the Italian Association of Medical Oncology (AIOM) Clinical Practice Guidelines on Breast Cancer applied the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methodology on three critical questions on the choice of the adjuvant hormonal therapy in premenopausal breast cancer patients to summarise available evidence and to create recommendations to help physicians in their clinical practice.

Employer and graduate perceptions of the competence of graduates from a dental school in Trinidad

Objective: The objective of this study was to evaluate employers' and graduates' perceptions of the competence of dental graduates from the School of Dentistry, University of the West Indies (UWI). Method: Anonymous questionnaires were sent to employers of the dental graduates in 2013. Similar questionnaires were also completed by graduates of the class of 2011 and 2012. Respondents were asked to rate employees or self assess the UWI School of Dentistry (SoD) curriculum's 23 competency areas and 6 domains of dental practice including: professionalism, assessment of a patient, establishment and maintenance of oral health. Results: Response rates of 48.3%, 100% and 95.7% were obtained from the employers, class of 2011 and class of 2012 respectively. The graduates' self-rated competency means were satisfactory or higher (better) in all competency areas. Employers rated the competency of UWI graduates higher than average in all competency areas except temporomandibular joint/occlusion therapy, orthodontic therapy and dental office administration. Overall, the graduates consistently rated themselves significantly higher than the employers except for periodontal therapy, minor oral surgery, removable prosthodontics and dental office administration. The graduating class of 2011 rated themselves significantly higher than class of 2012 in most (15 out of 23) competency areas. Conclusion: Employers and graduates rated UWI dental graduate competency above average in all areas except orthodontics and dental office administration. UWI dental graduates have a better perception of their competency than do their employers. The School of Dentistry needs to pay particular attention to the areas highlighted and review the curriculum accordingly.

A Comparative Assessment of the Surface Roughness of Thermoplastic Denture Base Resins Following Adjustment and Re-Polishing

This study assessed the roughness of two injection-molded, thermoplastic materials used for denture bases compared with a polyamide material and compression molded Polymethylmethacrylate (PMMA) after the adjustment and re-polishing with either a laboratory protocol or a chair side protocol. Methods: Forty specimens, each of PMMA, Valplast, DuraFlex, Dura Cetal were fabricated and finished according to individual manufactures' instructions. These materials were adjusted with tungsten carbide (TC) burs to mimic gross adjustments, and then re-polished either on a lathe or bonded silicon carbide (B-SC). Following instrumentation, the specimens were assessed using contact profilometry and scanning electron microscopy. Two-factor ANOVA was used to determine significant differences in mean surface roughness (Ra and Rmax), with included factors being material type and re-polishing regimen. Results: Mean Ra values ranged from 0.26 (DuraFlex control) to 1.82 (Valplast adjusted with TC burs). Mean Rmax values ranged from 1.88 (Dura Flex control) to 13.76 (Valplast adjusted with TC burs). Two-factor ANOVA revealed that interaction of both factors was significant (p < 0.05) for Ra and Rmax. There was a statistically significant increase in both Ra (p < 0.05) and Rmax (p < 0.05) for all material types following the gross adjustment. With the exception of DuraFlex, re-polishing of samples that were previously adjusted with TC burs, on the dental lathe produced surfaces that were comparable to control samples. Conclusion: Adjustment of DuraFlex should be kept to a minimum since the adjustment produced the significant surface detriment that could not be corrected with either of the polishing regimens.

Severity of acute Zika virus infection: A prospective emergency room surveillance study during the 2015­2016 outbreak in Suriname

Acute Zika virus (ZIKV) infection is usually mild and self-limiting. Earlier, we reported three cases of fatal acute ZIKV infection in patients without typical signs of ZIKV, but rather with criteria of systemic inflammation response syndrome (SIRS). To follow up these observations, we prospectively included patients at the emergency room with temperature instability and suspected to have acute ZIKV infection, SIRS, or both. A total of 102 patients were included of whom N =21 (21%) were suspected of acute ZIKV infection, N =56 (55%) of acute ZIKV infection with SIRS criteria, and N =25 (24%) of SIRS alone. ZIKV-PCR was positive in N =21 (20%) patients. Eight (38%) ZIKV-positive patients needed admission to the hospital of whom four (50%) presented with SIRS alone. One ZIKV-positive patient had vascular co-morbidity and died following shock and severe coagulopathy. We confirm the hypothesis that acute ZIKV infection can present atypical and severely with systemic inflammation and have lethal course particularly amongst patients with significant prior disease...(AU)

Core competencies and challenges among nurses transitioning into positions of leadership ­ a Caribbean perspective

Purpose ­ Nurses are a significant part of the professional workforce, but leaders may be promoted without the requisite competencies. This study aims to explore the perspectives of nurse managers about the core competencies necessary for promotion as leaders in health. Design/methodology/approach ­ This was a mixed-methods study that targeted nurses (N= 126) who were promoted in four Caribbean countries over the past five years. A 30-item questionnaire was used for quantitative data collection and analyzed using SPSS version 25. Interviews yielded the qualitative data, which were analyzed using open coding and thematic analysis. Ethical approvals were received from ethics committees at the university and country level. Findings ­ Most participants were female (n= 112), had 15 or more years' experience (n= 71) and an associate degree/diploma in nursing (n= 62). Leadership was the most important competency required of nurse leaders in spite of their position within the organization, followed by team building and motivation. Challenges to the transitioning into leadership positions included the prevailing culture and a lack of a systematic approach to building capacity in leadership. There was also between-group statistical significance, as determined by oneway ANOVA for delegation, motivation and leadership as core competencies based on occupations roles.

Perceptions of "Male Sensitive" Health Services Among Men in Trinidad and Tobago

Introduction: While Caribbean researchers have explored masculinity, socialization, and behavior, the literature has been silent on masculinity and "male sensitive" health services. This study explored masculinity and perceptions of "male sensitive" health services. Method: An interpretative, phenomenological, qualitative design that used 14 focus groups and 12 semistructured interviews among men between the ages 18 and 65 years. Results: The notion of "male sensitive" services were more of preferences like having more females, timeliness, and privacy of services rather than a specific set of services unique to men. Services were expected to be professional, offered in private spaces, timely, and as an "all in one" service with more male service providers. Discussion: Male utilization of health services may be a problem if they are not considered "sensitive" to their needs. This has implications for the reorientation of services, as well as, personnel, including increased involvement of males as health care providers.

Ethnic and sex-specific cut-off values for adult obesity in the Suriname health study

Sex-specific body mass index (BMI) and waist circumference (WC) cut-off values have been validated for a limited number of ethnic groups. We aimed to derive these cut-off values for Amerindians, Creoles, Hindustani, Javanese, Maroons and Mixed living in Suriname.

Methods Data from individuals aged 20­65, in the Suriname Health Study was used to derive optimal cut-off values for BMI and WC for the prediction of hypertension (n = 4910) and cardio-metabolic risk (n = 2924). Results from the analysis with Receiver Operating Curves were calculated and compared these with recommended values.

Results The area under the ROC curve was consistently higher for WC compared to BMI among Creoles, Hindustani, Maroons and Mixed. The BMI cut-off values ranged from 24.8 kg/m2 for Creole men and 26.9 kg/m2 for Maroon women to 28.4 kg/m2 and 30.2 kg/m2 for Amerindian men and women, respectively. The WC cut-off values ranged from 80.7 cm for Maroon men, 86.7 cm for Javanese women to 90.8 cm for Hindustani men and 95.7 cm for Amerindian women. Optimal BMI cut-off values approximated Asian cut-off values from the World Health Organization whilst those of WC for men approximated and for women exceeded cut-off values from the International Diabetes Federation.

Demographic profiling of Caribbean and United Kingdom student nurses' use of social media for professional development

Background: Most students are adept in using technology and have developed skills and confidence utilising SoMe for professional purposes. SoMe is used by both registered nurses and student nurses. Purpose: The purpose of this study was to investigate the professional use of SoMe by student nurses in Trinidad and Tobago, Jamaica and the UK to guide, support and develop implementation of effective and appropriate use of SoMe for professional development. Methods: An online cross-sectional survey was completed by student nurses from the three countries. Data were analysed using descriptive statistics. Results: The main reason for using social media among Caribbean participants was to watch videos or short clips whereas in UK it was downloading articles. Over 75% participants of all ages believed that social media was likely to help their career. There is no social media guidance for student nurses in Trinidad and Tobago and Jamaica. Conclusion: Our study demonstrated that social media is embedded in student nurses' professional development throughout their education, with some variation in their use by country. Despite the fundamental place that social media plays in student nurses' professional development, there is no national or international guidance on how student nurses should use social media for professional development.

International student nurses' use of social media for learning: A cross sectional survey

Background: Students use social media for sharing information and connecting with their friends, also for peer support, peer learning and student engagement. Research indicates that approximately twice the number of students were using social media for educational purposes compared to academic staff and almost all students discuss academic issues on social media. However, little is known about how diverse cohorts of student nurses use social media for specific purposes at different stages of their learning. Objectives: Identify how student nurses in each country of study use social media for learning. Identify how each generation of student nurses use social media for learning. Identify how student nurses use social media as their education progresses. Design: A cross-sectional survey. Settings: The study was undertaken across three countries Jamaica, Trinidad and Tobago and the UK. Participants: Student nurses from each of the countries that consented to participate met the inclusion criteria. Methods: 1050 student nurses across the three countries self-completed the cross-sectional survey between March and September 2019. Data was analysed using descriptive and inferential statistics. Results: WhatsApp® was the most used platform for learning amongst participants. Watching videos and downloading articles represented two-thirds of social media usage for learning. Smart phones were the most used device to access social media. Kruskal-Wallis tests were significant (≤0.001) for checking social media and messaging in lecture, use of social media for studies and classroom activities by country, generation (except classroom activities) and year of education. Use of social media for classroom activities had no significance by generation. Conclusion: Country, generation and year of education are factors that influence the use of social media in student nurses' learning. These should be considered by Universities in curriculum development and in teaching and learning delivery. From a pragmatic approach, social media is available and used by a majority of student nurses and can be widely assimilated into the nursing curriculum

A Retrospective Study To Determine Patients' Satisfaction With Fixed Dental Prostheses Provided During The Period 2008 ­ 2012 at The School of Dentistry In Trinidad

Introduction : The School of Dentistry undertakes the training of dental students, where they provide fixed dental prostheses such as crowns bridges and onlays to patients of the dental polyclinic. The aim of this study was to determine the patient satisfaction with their ixed prostheses and the quantity of remakes at the School of Dentistry polyclinic during the period 2008-2012. Methods : The lab records of ixed prosthetic work during the period 2008-2012 were analyzed. Patients who received treatment during this period were contacted via telephone for a structured interview via a questionnaire. Results : Ninety-six (96) patients were contacted via telephone and 72% of patients were female. Fifty-six (56) crowns and onlays, 22 conventional bridges and 18 resin-retained bridges were provided for patients. Ninety-six (96%) of patients were satisied with the aesthetics (appearance) of their prosthesis immediately after itting and 90.7 % were still satisied with the appearance at the time of interview. 79.2% of prostheses were still in place at the time of interview but patients reported that 18% of crowns failed, 22.7% of conventional bridges and 27.8% of resin-retained bridges had failed. Fifteen (15%) of the ixed prostheses were remade. However, the majority of patients (99 %) were overall satisied with their services at the School of Dentistry in Trinidad. Conclusion : Patients are generally satisied with the ixed prosthetic work delivered at the School of Dentistry polyclinic and highly satisied with the services provided. The amount of remakes whilst small can be reduced with more stringent quality assurance measures.

Emergence of zika virus epidemic and the national response in Jamaica

BACKGROUND: Jamaica, along with the Americas, experienced major epidemics of arboviral diseases transmitted by the Aedes aegypti mosquito in recent years. These include dengue fever in 2012, Chikungunya fever in 2014 and Zika virus infection (ZIKV) in 2016. We present the emergence of the ZIKV epidemic in Jamaica and outline the national response. METHODS: The Ministry of Health's preparedness included: heightened surveillance, clinical management guidance, vector control and management, laboratory capacity strengthening, training and staffing, risk communication and public education, social mobilization, inter-sectoral collaboration, resource mobilization and international cooperation. RESULTS: The first case of ZIKV was confirmed on January 29, 2016 with date of onset of January 17, 2016. From January 3 to July 30, 2016 (Epidemiological Week (EW) 1-30), 4648 cases of ZIKV were recorded (4576 suspected, 72 laboratory-confirmed). Leading symptoms were similar among suspected and confirmed cases: rash (71% and 88%), fever (65% and 53%) and joint pains (47% and 38%). There were 17 suspected cases of Guillain Barre syndrome; 383 were reported in pregnant women, with no reports of microcephaly to date. Zika and dengue viruses were circulating predominantly in 2016. At EW30, 1744 cases of dengue were recorded (1661 suspected and 83 confirmed). Dengue serotypes 3 and 4 were circulating with 121 reports of dengue haemorrhagic fever...(AU) CONCLUSION:The possibility exists for endemicity of ZIKV similar to dengue and chikungunya in Jamaica. A ZIKV vaccine, similar to the dengue and chikungunya vaccines, is needed to be fast-tracked into clinical trials to mitigate the effects of this disease.

Chikungunya in Jamaica: Public health effects and clinical features in children / Chikungunya en Jamaica ­ Efectos en la Salud Pública y Características Clínicas en Niños

Chikungunya virus (CHIKV) entered the Caribbean for the first time in 2013 and Jamaica experienced its maiden epidemic with Chikungunya Fever in 2014. We aimed to describe the public health effects and describe the clinical features in children and adolescents in Jamaica. METHODS: This study reviewed the public health effects of the illness in Jamaica by reviewing available data sources and the clinical features in 210 children and adolescents meeting the case definition at two hospitals, Bustamante Hospital for Children and University Hospital of the West Indies between August 23 and October 31, 2014 by chart review. Descriptive analyses and comparisons between groups using the Mann-Whitney U test were performed with SPSS version 22. RESULTS: The majority of households were affected by the illness which caused widespread absenteeism from school and work, loss of productivity and economic losses estimated at 60 billion dollars. The health sector was impacted by increased numbers seen in clinics and emergency departments, increased need for bed space and pharmaceuticals. Ninety-nine per cent of the children were febrile with a median maximal temperature of 102.4 F. Ninety-three per cent had household contacts of 0­20 persons. In addition to fever, maculopapular rash and joint pains, infants six months and younger presented with irritability and groaning (p = 0.00) and those between six months and six years presented with febrile seizures (p = 0.00). Neurologic involvement was noted in 24%. Apart from anaemia, few had other laboratory derangements. Few had severe organ dysfunction and there were no deaths. CONCLUSION: The Chikungunya Fever epidemic had significant public health and economic impact in Jamaica. In children, there were characteristic presentations in neonates and young infants and in children six months to six years. Neurologic involvement was common but other organ dysfunction was rare. These findings underscore the need to prevent further epidemics and the quest for a vaccine.(AU)

Antecedentes: El virus de Chikungunya (CHIKV) entró en el Caribe por primera vez en 2013, y Jamaica experimentó su primera epidemia de fiebre de Chikungunya en 2014. Nos propusimos como objetivo describir sus efectos en la salud pública y describir sus características clínicas en niños y adolescentes en Jamaica. Métodos: Este estudio examinó los efectos de la enfermedad en la salud pública en Jamaica. El examen se realizó mediante la revisión de fuentes de datos disponibles y las características clínicas en 210 niños y adolescentes que cumplían con la definición del caso en dos hospitales ­ Hospital Pediátrico Bustamante y el Hospital Universitario de West Indies ­ entre el 23 de agosto y 31 de octubre de 201, según las historias clínicas. Se realizaron análisis descriptivos y comparaciones entre los grupos usando la prueba U de Mann-Whitney y la versión 22 de SPSS Resultados: La mayoría de los hogares fueron afectados por la enfermedad, que causó un ausentismo generalizado en escuelas y trabajos, pérdida de productividad, y pérdidas económicas estimadas en 60 billones de dólares. El sector de la salud fue afectado por un aumento del número de personas atendidas en clínicas y departamentos de urgencias, y una mayor necesidad de camas en los hospitales y productos farmacéuticos. Noventa y nueve por ciento de los niños presentaron un estado febril con una temperatura mediana máxima de 102.4 F. Un noventa y tres por ciento tuvo contactos domésticos de personas de 0­20. Además de fiebre, erupciones maculopapulares y dolores en las articulaciones, los niños de seis meses o menos edad, presentaron irritabilidad y quejidos (p = 0.00), y aquellos entre seis meses y seis años de edad presentaron convulsiones febriles (p = 0.00). Se observó compromiso neurológico en el 24%. Aparte de anemia, algunos tenían otros trastornos de laboratorio. Otros presentaban una disfunción orgánica severa y no hubo muertes. Conclusión: La epidemia de fiebre de Chikungunya tuvo un impacto significativo tanto en la salud pública como en la economía de Jamaica. Los niños presentaron manifestaciones características, observadas tanto en recién nacidos y bebés pequeños como en niños de seis meses a seis años. El compromiso neurológico fue común, pero cualquiera otra disfunción orgánica fue rara. Estos hallazgos subrayan la necesidad de hacer más por evitar las epidemias y buscar la solución de una vacuna.(AU)

COVID-19 Stressors among Dental Academics at UWI­A Caribbean Perspective

COVID-19 is a pandemic that has a ected health care personnel worldwide. Dentists have a high risk of contracting COVID-19 given the face-to-face contact required in daily interactions with their patients. This study aimed to determine the stressors experienced by academic dentists due to the COVID-19 situation in Trinidad and Jamaica. All academic staff at the University of the West Indies (UWI) dental schools (St. Augustine and Mona campuses) were invited to complete a self-reported questionnaire, which was conducted for one month from May to June 2020. Thirty-two dental academics responded and the response rate was 61.54%. More than a third (34.4%) were in the 25­35 age group, 71.9% were females. The most common speciality (20.7%) was restorative dentistry. Just over one-third (38.7%) had been in academia for 5­10 years. Most (40.6%) were apprehensive about infecting their family. When the locus of control was determined, just over half (53.1%) felt they were in control of protecting themselves while 34.4% felt that external factors controlled their lives. The findings suggest that academic sta at UWI dental schools (Trinidad and Jamaica) were stressed by the COVID-19 situation. The vast majority were worried about infecting their families.