Percutaneous balloon mitral valvuloplasty for severe rheumatic mitral stenosis in Jamaica: the initial experience

Although percutaneous balloon mitral valvuloplasty has been performed in the Caribbean before, there has not been any detailed description in the English-speaking West Indian Medical literature hitherto. This report provides a description of the first four case of percutaneous balloon mitral valvuloplasty performed in Jamaica(AU)

Fetal growth and cardiovascular risk factors in Jamaican school children

OBJECTIVE-- To determine relationship between school children's blood pressure, glycated haemoglobin level and cholesterol concentration and their anthropometry, socioeconomic status, and birth measurements. DESIGN--Retrospective cohort study. SETTING--27 schools closest to University Hospital of the West Indies, Kingston, Jamaica. SUBJECTS--2337 children aged 6-16 years who were born at University Hospital were recruited, and their birth records were recovered: 1610 had suitable records, 659 had records including birth length, and 610 of these were prepubertal. MAIN OUTCOME MEASURES--Blood pressure, glycated haemoglobin level, serum cholesterol concentration, anthropometry at birth, current anthropometry, and socioeconomic status. RESULTS--Multiple regression analysis showed that children's systolic blood pressure was inversely related to their birth weight (P < 0.0001) and directly related to their currrent weight. Glycated haemoglobin level was higher in children with thicker triceps skinfolds (P < 0.001) and who had been shorter at birth (P = 0.003). Serum cholesterol concentration was inversely related to current height (P = 0.001) and to length at birth (P = 0.09) and was directly related to triceps skinfold thickness and higher socio-economic status (P = 0.001). CONCLUSIONS--Blood pressure in children was inversely related to birth weight and directly to current weight. Glycaemic control and serum cholesterol were related to short length at birth, height deficit in childhood, and childhood obesity (Au).

The Jamaican childhood cardiovascular risk status study: serum total cholesterol concentration in Jamaican schoolchildren - abstract

The pathogenesis of atherosclerosis occurs over decades and begins in childhood. Hypertension, elevated serum cholesterol levels and obesity are major risk factors for the development of cardiovascular disease. In population-based studies, the presence of these two risk factors in childhood has been shown to be predictive of hypertension and hypercholesterolaemia in adulthood and ultimately of coronary heart disease mortality rates. There is evidence that much of the risk of developing hypercholesterolaemia is due to exposure to an unfavourable environment. Therefore it should be possible to reduce or eliminate this risk. In this study of 2337 Jamaican school children aged 6 to 16 years, girls were found to have higher cholesterol levels than boys (4.2ñ0.82vs4.1ñ0.83mM;p<0.003). At all ages (except 11), the cholesterol concentration in girls was higher than in boys, and girls had significantly more body fat. Cholesterol levels were found to be associated with socio-economic status (SES), 4.0mM in children from the lowest SES and 4.4mM in those from the highest (p<0.0000). Multiple regression analysis revealed signigicant correlation between cholesterol, weight, body fat and SES. This result for SES is different from studies in the developed world which report an inverse relationship between cholesterol and SES. In our population there was also correlation between SES and height and weight. Obesity and weight are important contributors to the risk of developing hypercholesterolaemia. Differences in dietary intake and levels of activity between the SES groups may contribute to this difference. The greater adiposity evident from the first decade of life is also worthy of note. Combined with the higher serum total of cholesterol levels, this may be an important indicator of the likelihood of future cardiovascular disease in this group (AU)

Chronic pancreatitis in Jamaica

Thirty-five patients with chronic pancreatitis (CP) treated with over a 15-year period were studied. There were 29 men and 6 women with a mean age of 47 years (range 21-67). Twenty-seven (77 percent) were chronic alcoholics, two (6 percent) had gallstones, one had stenosis of the Ampulla of Vater and in five (14 percent) no obvious cause was found. Thirty patients (86 percent) presented with abdominal pain. Chronic diarrhoea was present in 8 (23 percent), and steatorrhoea was documented in 6 of these. Fifteen (43 percent) had pancreatic calcifications. Five developed pseudocysts and 16 (46 percent) developed diabeted mellitus. Twelve patients required surgery. Three continue to have severe recurrent relapses of pain but the majority (91 percent) have had a relatively stable course with medical management. (AU)