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West Indian med. j ; 48(1): 16-9, Mar. 1999.
Artigo em Inglês | MedCarib | ID: med-1241


Organisms of the mycobacterium fortuitum complex are recognised but uncommon causes of pulmonary disease, primary cutaneous disease and a wide spectrum of nosocomial infections. M fortuitum was isolated from 20 patients over a 15 month period, with a apparent clustering of isolates occurring from January to March 1994. The molecular epidemiology of this clustering eas investigated using an arbitrary primer polymerase chain reaction method (AP-PCR). 21 isolates were studied, which yielded 13 distinct profiles. Multiple isolates from a single patient yielded identical profiles. All of seven isolates recovered during the six week period from January to March 1994 shared a common profile which was distinct from all other isolates, suggesting that a single strain was isolated from specimens from all seven patients. The source of this cluster in uncertain. We can find no epidemilogical basis for an episode of cross-infection within the hospital environment, and it is assumed that contamination of the specimens during collection, transport or processing was responsible for the "pseudo-outbreak" of M fortuitum

Humanos , Infecção Hospitalar/diagnóstico , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Bronquiectasia/microbiologia , Epidemiologia Molecular , Fezes/microbiologia , Pneumopatias Obstrutivas/microbiologia , Pneumonia Bacteriana/diagnóstico , Reação em Cadeia da Polimerase , Infecções Respiratórias/diagnóstico , Estudos Retrospectivos , Manejo de Espécimes , Escarro/microbiologia , Vasculite/microbiologia
Postgrad Doc - Caribbean ; 11(6): 268-77, Dec. 1995.
Artigo em Inglês | MedCarib | ID: med-5032


Skin manifestations are a common feature of HTLV-1 associated disorders and of HTLV-1 infection itself. These include the lymphomatous skin infiltrates in adult T-cell lymphoma/leukaemia, most commonly manifesting as persistent, generalised papules, nodules and plaques with later ulceration, acquired ichthyosis and xeroderma in HAM/TSP, infective dermatitis of children, dermatomyositis, crusted (Norwegian) scabies, psoriasiform rashes which may precede one of the more serious disease associations, and possibly also seborrhoeic dermatitis. Disorders typically associated with immunosuppression such as disseminated herpes zoster, and ulcerative non-healing herpes simplex may also be seen occasionally both in ATK as well as in other wise asymptomatic HTLV-1 infection (AU)

Humanos , Masculino , Feminino , Criança , Adulto , Vírus Linfotrópico T Tipo 1 Humano , Linfoma Cutâneo de Células T , Dermatite , Dermatomiosite , Escabiose , Psoríase , Herpes Zoster , Herpes Simples , Leucemia-Linfoma de Células T do Adulto , Paraparesia Espástica Tropical , Uveíte , Hipercalcemia , Anemia , Complexo Relacionado com a AIDS , Hanseníase , Sarcoidose , Dermatite Esfoliativa , Escleroderma Sistêmico , Dermatopatias Vesiculobolhosas , Eczema , Ictiose , Imunoglobulina G , Anticorpos Anti-HTLV-I , Staphylococcus , Streptococcus , Bronquiectasia , Catarata , Polimiosite , Eritema , Edema , Sarcoptes scabiei , Dermatite Seborreica , Tinha do Couro Cabeludo , Região do Caribe , Estados Unidos , Haiti , Japão , América do Sul , África
Postgrad Doc - Caribbean ; 10(5): 246-57, Oct. 1994.
Artigo em Inglês | MedCarib | ID: med-5031


An antibiotic policy should aim for the safe, effective and economical use of antimicrobial drugs, and to prevent their indiscriminate use and development of resistant bacterial strains. The term 'antibiotic' is used as a general term for all antimicrobial drugs. Antibiotics prescriptions should be based on clinical evidence of bacterial infection, preferably substantiated by appropriate laboratory culture and sensitivity tests. Viral infections are not an indication for antibiotic prescriptions. Patient factors to be considered for choice and dose of an antibiotic are age, pregnancy, lactation, renal and hepatic impairment. Immunodeficient patients should receive only bactericidal drugs. Severity of infection determines the route of administration. Duration of therapy should not exceed five days, unless specifically prescribed by the physician. An antibiotic should, if started as an empirical therapy not be changed before a minimum of three days trial. Prescriptions of drugs such as aztreonam, imipenem, vancomycin, piperacillin and amphotericin are to be restricted due to cost and toxicity and should be reviewed by the microbiologist (AU)

Antibacterianos , Prática Profissional , Dermatopatias Virais , Prescrições de Medicamentos , Fatores Etários , Gravidez , Lactação , Insuficiência Renal , Imipenem , Piperacilina , Infecções/tratamento farmacológico , Antibacterianos/economia , Antibacterianos/uso terapêutico , Formulação de Políticas , Economia Hospitalar , Resistência Microbiana a Medicamentos , Streptococcus pneumoniae , Infecções por Haemophilus , Sepse , Endocardite , Bronquiectasia , Cloranfenicol , Tetraciclinas , Quinolonas , Sulfonamidas , Bronquite , Sinusite , Tonsilite , Faringite , Sífilis , Hipersensibilidade , Síndrome de Imunodeficiência Adquirida , Aztreonam , Vancomicina , Aciclovir , Anfotericina B , Monitoramento de Medicamentos , Aminoglicosídeos , beta-Lactamases , Região do Caribe
In. Anon. Commonwealth Cribbean Medical Research Council twenty-seventh Scientific Meeting. Kingston, s.n, 1982. p.14-5.
Monografia em Inglês | MedCarib | ID: med-2558
Clin Radiol ; 27(2): 223-6, Apr. 1976.
Artigo em Inglês | MedCarib | ID: med-13114


A series of patients with total destruction of one lung by bronchiectasis and a normal contralateral lung is reported. Eight cases were West Indians of Negro race and four were Australian Aborigines. The bronchiectasis appears to be of post-effective type and is related to the poor social conditions under which the affected people live. It has also been noted in other developing countries or in under-privileged races in developed countries.(AU)

Humanos , Lactente , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Bronquiectasia/diagnóstico , Afro-Americanos , Bronquiectasia/etiologia , Bronquiectasia/patologia , Bronquiectasia/diagnóstico por imagem , Pneumonectomia , Infecções Respiratórias/complicações , Índias Ocidentais/etnologia
Clin Radiol ; 24(3): 354-8, July 1973.
Artigo em Inglês | MedCarib | ID: med-12340


Over fifty cases of tracheobronchomegaly reported in the literature are reviewed and two new cases are described. The radiological appearances of this rare condition are described and its concomitant occurrence with bronchiectasis is noted. The condition is thought to be due to faulty development of the connective tisssues of the tracheobronchial tree. However, a study of the age of presentation showed that the majority presented in the third or later decades which suggests that it is an acquired rather than a developmental anomaly. (AU)

Humanos , Adulto , Feminino , Masculino , Pessoa de Meia-Idade , Broncopatias/diagnóstico por imagem , Doenças da Traqueia/diagnóstico por imagem , Fatores Etários , Antibacterianos/uso terapêutico , Brônquios/diagnóstico por imagem , Bronquiectasia/complicações , Bronquiectasia/diagnóstico por imagem , Bronquiectasia/tratamento farmacológico , Pulmão/diagnóstico por imagem , Escarro , Traqueia/diagnóstico por imagem , Doenças da Traqueia/complicações
West Indian med. j ; 20(4): 257, Dec. 1971.
Artigo em Inglês | MedCarib | ID: med-6341


Statistics of the incidence of cardiothoracic surgical problems in Jamaica are incomplete. An attempt is made to compile currently available data. The potential sources of data are the records of the University Hospital, Kingston Public Hospital, George V Sanatorium, the Registrar General's office and private practitioners. Some published data also exist. Most of the records are incomplete and the information is not available in a way which would highlight the major cardiothoracic surgical problems of Jamaica. Because of this, the author, as the person most engaged to any significant degree in the practice of cardiothoracic surgery in Jamaica, reports in this preliminary communication on his own experience at the University Hospital during the past two years. Thirty-seven major chest injuries were seen and 18 of these required admission to the Intensive Care Unit. Only a small percentage of all chest trauma comes under the author's care. One hundred and twenty diagnostic bronchoscopies were performed. For bronchogenic carcinoma only 6 lung resections were performed from a total of 52 cases. The incidence of this disease in Jamaica rose from 7.2 to 12.8 per 100,000 moles during the two 5-year periods ending in 1969 and it now rivals carcinoma of the oesophagus for a second place as a cause of death from malignant disease in the male. In the case of bronchiectasis, 8 lung resections were done frome amongst 17 cases seen by the author and proved by bronchography. In cardiac surgery, 24 closed and 24 open open-heart operations were performed. In the closed group, 13 patent ductuses were treated by division and suture, there were 2 shunt operations for Tetralogy at Fallot, 2 coarctations were relieved and 7 commissurotomies performed for rheumatic mitral stenosis. In the open-heart group requiring cardiopulmonary bypass, the following congenital cases were corrected without mortality: 4 V.S.D., 6 Tetralogy of Fallot, 3 pulmonary valve stenosis, 1 infundibular stenosis, 2 ostium secundum, 1 ostium primum primum, and 1 double outflow right ventricle. Only a small percentage of the potentially curable congenital cases have had the benefit of surgery. It is estimated that at least 150 of the 400 new cases born annually with congenital heart disease can be cured by surgery. For rheumatic heart disease, the following operations were performed: 3 mitral valve replacements, 1 aortic valve replacement, 1 aortic and mitral valve replacement and 1 mitral valveannulaplasty. Rheumatic heart disease is not uncommon and was present in 7.3 percent of 738 disease hearts examined at autopsy in adults over 17 years of age at U.H.W.I. In a miscellaneous group requiring major surgery, the following opertions were performed; 3 thymectomies for myasthenia gravis, 3 lung resections, 5 decortications, 9 mediastinal tumours were removed, 2 oesophagectomies, 4 colon bypass operations for oesophageal obstruction, and 11 operations on major vessels. In a miscellaneous number of surgical investigations, the following procedures were performed; 9 scalene node clearances, 7 anterior mediastinoscopies, 11 thorascopies and 33 oesophagoscopies. Carcinoma of the oesophagus is regarded as a general surgical problem. Recent rapid strides in the surgery of coronary artery disease suggest that this common condition, which is present in 14.2 percent of adult diseased hearts, will be a major surgical service problem. Only a small percentage of the vast number of cases are seen at the University Hospital. The precise incidence of the various cardiothoracic surgical conditions require urgent investigation (AU)

Humanos , Masculino , Feminino , Cirurgia Torácica/estatística & dados numéricos , Traumatismos Torácicos , Broncoscopia/estatística & dados numéricos , Bronquiectasia/cirurgia , Cirurgia Torácica/estatística & dados numéricos , Jamaica
Am J Clin Pathol ; 53(6): 832-8, June 1970.
Artigo em Inglês | MedCarib | ID: med-14766


Two unusual cases of mural endocarditis are described. The first was that of a 13-year-old boy with infected burns of the legs. Autopsy revealed mural vegetations in both ventricles and cytomegalic viral inclusions were demonstrated in the vegetations, heart muscle, and endothelial cells of various organs. This appears to be the first reported case of cytomegalic inclusion viral endocarditis. A review of the literature revealed only six previous reports of cytomegalic viral myocarditis, which was also present in this case. The second case was that of a 4-year-old girl with bronchiectasis. Autopsy revealed mural vegetations in the right ventricle. Group C beta-hemolytic steptococcus was isolated from th mural vegetations, as well as from the diseased lungs. Only two previous reports of endocarditis caused by this organism are found in the literature (AU)

Humanos , Pré-Escolar , Adolescente , Masculino , Feminino , Infecções por Citomegalovirus/complicações , Endocardite/etiologia , Infecções Estreptocócicas/complicações , Autopsia , Bronquiectasia/complicações , Queimaduras Químicas/complicações , Citomegalovirus/isolamento & purificação , Endocardite Bacteriana/etiologia , Epitélio/microbiologia , Coração/microbiologia , Pulmão/microbiologia , Miocárdio/patologia , Streptococcus/isolamento & purificação , Infecção dos Ferimentos/complicações
West Indian med. j ; 17(2): 120-3, June 1968.
Artigo em Inglês | MedCarib | ID: med-10664


A case of tracheo-bronchomegaly is reported which, on the basis of the radiological appearances, was associated with congenital cystic disease of the lungs. The value of bronchography in the investigation of cystic disease of the lungs is stressed (AU)

Adulto , Humanos , Masculino , Broncopatias/diagnóstico por imagem , Bronquiectasia/diagnóstico por imagem , Doenças da Traqueia/diagnóstico por imagem , Broncografia
Thorax ; 23: 69-75, 1968.
Artigo em Inglês | MedCarib | ID: med-12191


A teratoma in a young West Indian of Negro race is reported. The teratoma presented radiologically in the left upper lobe as an ill-defined shadow which contained a cresent-shaped translucent area and simulated a mycetoma. In addition, the left lung showed widespread nodular shadows. The left lung was resected and the teratoma was found to be endobronchial in position. This is a very rare site for a teratoma as only one of the 15 previously reported intrapulmonary teratomata may have been endobronchial. The remainder of the left lung remote from the tumour showed generalized bronchiectasis both radiologically and pathologically. The bronchiectasis was of follicular type and in addition there was widespread bronchiolectasis. The inflammatory reaction associated with the latter was responsible for the nodular shadows. The significance of these changes in relation to the teratoma is discussed. (AU)

Humanos , Masculino , Neoplasias Brônquicas/complicações , Bronquiectasia/complicações , Teratoma/complicações , Neoplasias Brônquicas/patologia , Neoplasias Brônquicas/diagnóstico por imagem , Bronquiectasia/patologia , Broncografia , Diagnóstico Diferencial , Micetoma/diagnóstico por imagem , Pneumonectomia , Teratoma/patologia , Teratoma/diagnóstico por imagem , Tomografia