ABSTRACT
We report the clinicopathological features and outcome of four cases of carcinoma of the male breast diagnosed at the University Hospital of the West Indies between 1988 and 1998. Male breast cancer is most commonly seen in men over age sixty years, and it exhibits the same prognosis, stage for stage, as the disease in females. However, some researchers report overall poorer survival in men, and explain this on the basis of advanced disease at presentation. Other researchers maintain that the majority of breast cancers in males present at early stages, and exhibit survival similar to that in females. The published literature concerning this uncommon malignancy is reviewed, and the data are compared with the features of our cases.
Subject(s)
Breast Neoplasms, Male/epidemiology , Carcinoma, Ductal, Breast/epidemiology , Aged , Breast Neoplasms, Male/diagnosis , Breast Neoplasms, Male/surgery , Carcinoma, Ductal, Breast/diagnosis , Carcinoma, Ductal, Breast/surgery , Humans , Incidence , Male , Middle Aged , Risk FactorsABSTRACT
OBJECTIVE: The objective was to compare dual-energy x-ray absorptiometry-measured body composition between large (LGA) and appropriate (AGA) birth weight for gestational age neonates. STUDY DESIGN: LGA term infants (n = 47) with birth weights > or =4000 g were compared with 47 gestational age-matched AGA infants; 11 LGA infants were born to mothers with gestational (9) or pregestational diabetes (2). Dual-energy x-ray absorptiometry scans were performed at 1.8 +/- 1.0 days after birth. RESULTS: Body weight and length were the dominant predictors of body composition in LGA and AGA neonates. However, LGA neonates had significantly (P <.001, all comparisons) higher absolute amounts of total body fat, lean body mass, and bone mineral content and had significantly (P <.001, all comparisons) higher proportions of total body fat and bone mineral content but lower lean body mass as a percent of body weight. The changes for total body fat and lean body mass as a percent of body weight were greatest (P <.001) in LGA infants whose mothers had impaired glucose tolerance. CONCLUSION: LGA neonates have higher body fat and lower lean body mass than AGA infants. Impaired maternal glucose tolerance exaggerated these body composition changes.
Subject(s)
Body Composition , Infant, Postmature , Absorptiometry, Photon , Anthropometry , Birth Weight , Body Height , Body Mass Index , Bone Density , Humans , Infant, NewbornABSTRACT
We report the clinicopathological features and outcome of four cases of carcinoma of the male breast diagnosed at the University Hospital of the West Indies between 1988 and 1998. Male breast cancer is most commonly seen in men over age sixty years, and it exhibits the same prognosis, stage for stage, as the disease in females. However, some researchers report overall poorer survival in men, and explain this on the basis of advanced disease at presentation. Other researchers maintain that the majority of breast cancers in males present at early stages, and exhibit survival similar to that in females. The published literature concerning this uncommon malignancy is reviewed, and the data are compared with the features of our cases.
Subject(s)
Aged , Humans , Male , Middle Aged , Carcinoma, Ductal, Breast , Breast Neoplasms, Male , Incidence , Risk Factors , Carcinoma, Ductal, Breast , Breast Neoplasms, MaleABSTRACT
The 5-year survival data for 62 patients with Stage I breast cancer treated at the University Hospital of the West Indies (UHWI) between 1982 and 1988 were evaluated to determine which factors were affecting outcome. The overall survival rates (66.7%) were below those quoted from large multicentre studies from North America, Western Europe and Australasia. The most significant survival differences emerged in the subset of postmenopausal patients with clinically staged disease who fared worse than those with pathologically staged disease. These data suggest that clinical staging is inadequate for the management of Stage I breast cancer. Consistent pathological staging, utilization of other prognostic predictors, and systemic therapy on a more widespread scale may help to improve the clinical outcome.
Subject(s)
Breast Neoplasms/pathology , Developing Countries , Breast Neoplasms/mortality , Breast Neoplasms/therapy , Combined Modality Therapy , Disease-Free Survival , Female , Follow-Up Studies , Hospitals, University , Humans , Jamaica/epidemiology , Lymph Nodes/pathology , Middle Aged , Neoplasm Staging , Retrospective Studies , Survival RateABSTRACT
A 3-week-old boy presented with severe thrombocytopenia and recurrent infections. He was subsequently found to have Wiskott-Aldrich Syndrome, a rare X-linked disorder. Splenectomy was performed and he died of post-splenectomy sepsis despite prophylactic antibiotic therapy. This is the first recorded case in the English-speaking Caribbean.
Subject(s)
Wiskott-Aldrich Syndrome/diagnosis , Humans , Infant, Newborn , Jamaica , Male , Pneumococcal Infections/etiology , Postoperative Complications , Recurrence , Splenectomy , Wiskott-Aldrich Syndrome/surgeryABSTRACT
This paper analyses data for 1990 culled from the medical records of the Queen Elizabeth Hospital, Barbados and examines the use of inpatient and emergency services by visitors to Barbados. The 473 visitors admitted represented 2.1% of all admissions. The records of 425 contained information on country of origin: 145 were from non-Caribbean and 280 from Caribbean countries. The distribution by country of non-Caribbean visitors was the same as that of regular tourist arrivals--the majority came from the USA. Canada and the UK. Caribbean visitors represented 14.4% of the tourists, but accounted for 65.9% of visitor admissions. Non-Caribbean visitors were 85.6% of tourists, but 34.1% of admissions. Young patients predominated among Caribbean, and older patients among non-Caribbean. Accidents, cardiovascular disease, alcohol-related illnesses and near drowning were commoner in the non-Caribbean visitors, while cancer and obstetrical/gynaecological problems were commoner in Caribbean visitors. Seven per cent of visitor admissions went to the Intensive Care Unit as against 0.15% of other patients. The average hospital stay of visitors was 11.7 days compared with 7.0 days for Barbadians. There were 898 visitors treated in the Accident and Emergency Department and the commonest problems were lacerations, abrasions and infections. The UK provided most of these patients. These data show that there is appreciable visitor use of the public health services. Non-Caribbean visitors use them because they fall ill on holiday, but many Caribbean visitors may come specifically for health care. The cost to the Barbadian health service is not insignificant: at the 1990 estimated bed-day cost of Bds$250, it represents a cost of Bds$1.1 million per annum to the Government for inpatient services alone, or 2% of total hospital costs.
Subject(s)
Hospitals, Public/statistics & numerical data , Travel , Adolescent , Adult , Barbados , Child , Child, Preschool , Emergency Service, Hospital/statistics & numerical data , Hospitalization/statistics & numerical data , Humans , Infant , Medical Records , Middle AgedABSTRACT
The POEMS syndrome is an unusual disorder manifesting primarily as a peripheral sensorimotor neuropathy in association with a monoclonal gammopathy. The importance of its recognition is that significant clinical improvement may result from localization and treatment of the underlying plasma cell tumour.
Subject(s)
POEMS Syndrome/diagnosis , Humans , Male , Middle Aged , POEMS Syndrome/radiotherapyABSTRACT
The POEMS syndrome is an unusual disorder manifesting primary as peripheral sensorimotor neuropathy in association with a monoclonal gammopathy. The importance of its recognition is that significant clinical improvement may result from localization and treatment of the underlying plasma cell tumour.
Subject(s)
Humans , Middle Aged , Male , Pigmentation Disorders/diagnosis , Plasmacytoma/complications , Endocrine System Diseases/diagnosis , Neuritis , Plasmacytoma/therapy , Edema/etiology , Erectile Dysfunction/etiology , SyndromeABSTRACT
Glanzmann's thrombasthenia is a rare congenital disorder of platelet function manifesting as defective primary haemostasis. Bleeding episodes often require platelet transfusions, and allo-immunization to donor platelets may occur. The problems of ensuring adequate haemostatic potential for delivery of an allo-immunized pregnant female with Glanzmann's thrombasthenia are presented.
Subject(s)
Blood Transfusion , Platelet Transfusion , Pregnancy Complications, Hematologic/therapy , Thrombasthenia/therapy , Adult , Blood Platelets/immunology , Female , Humans , Pregnancy , Thrombasthenia/bloodABSTRACT
Glanzmann's thrombasthenia is a rare congenital disorder of platelet function manifesting as defective primary haemostasis. Bleeding episodes often require platelet transfusions, and allo-immunization to donor platelets may occur. The problems of ensuring adequate haemostatic potential for delivery of an allo-immunized pregnant female with Glanzmann's thrombasthenia are presented