Elective caesarean section and haemodynamic studies in a case of "tight" mitral stenosis

A case of "tight" mitral stenosis in whom an elective caesarean section was performed at term is presented. The result was satisfactory. Whereas vaginal delivery is the treatment of choice for most cases of pregnancy complicated by mitral stenosis we feel there is a place for elective caesarean section in certain cases of "tight" mitral stenosis with severe pulmonary hypertension, where for one reason or another the patient has refused to undergo antepartum valvotomy (AU)

Desquamative interstitial pneumonia

The clinical radiological and pathological features of desquamative interstitial pneumonia in a 55-year old Jamaican male negro are described. Although the patient presented with progressive effort dyspnoea there were minimal abnormal chest signs but marked derangement of the respiratory function tests. The most severe radiological changes were demonstrated in the middle zones of the lung fields, and a follow-up chest film 2 months later showed slight involvement of the lower zones as well. The microscopic appearance was typical of the condition except that the vascular changes overshadowed the other abnormalities present. Although there was an excellent subjective response to steroid therapy, lung function tests repeated 2 months after the onset of the disease showed no significant change. (Summary)

Heights and weights of adults in rural and urban areas of Jamaica

Heights and weights of a random sample of 2,536 Jamaican adults, aged 15 to 74 years, were measured in an urban and in a rural area. Urban and rural women were the same height but urban men were slightly taller than rural men. Urban but not rural persons tended to be heavier with age from 30 to 50 years; for this the greater physical activity in the country than in the town may be responsible. Although comparisons with other races may not be strictly valid, it seems that Jamaicans, like other ethnic groups originating from Africa, possess a height potential similar to that of Caucasians and greater than that of races from South-east and South America. (Summary)

Sarcoidosis in Jamaica

Sarcoidosis is reportedly rare in the West Indies, yet among West Indian immigrants in London the disease has been frequently found. Over the past 10 years there have been 22 histologically proven cases of sarcoidosis at the University Hospital of the West Indies, Jamaica and a review of these cases was presented. The clinical picture differed in several aspects from that reported in other communities. Extrapulmonary lesions were common, and spontaneous remissions were exceedingly rare (AU)

Factors influencing arterial pressure in the general population in Jamaica

Representative rural and urban populations in Jamaica were defined geographically, enumerated by private census, and visited at home by two physicians who carried out indirect arterial blood-pressure measurements. These readings have been related to a number of personal and environmental factors,and this analysis shows the following facts. 1. There was a considerable difference in the prevalence of hypertension, particularly among women, between neighbouring rural and urban negro populations, with relative higher prevalence in the women from the rural area. This was not attributable to differences in survey technique, weight, or pulse rate, nor to differnces in the prevalence of hypertension secondary to renal disease as detected by proteinuria. 2. Bacteriuria (the presence of Gram-negative rods in a concentration of 10E5 or more bacteria per ml. in repeated specimens of clean-voided urine), which was usually asymptomatic, was a common finding among women (4.4 percent of women investigated), was significantly more common in the rural area, was related to hypertension, and was found in 15 percent of females with diastolic pressures exceeding 110 mm Hg in these surveys. Bacteriuria was found in only 0.5 percent of males. 3. The relationship between bacteriuria, as detected in one prevalence study, and hypertension was not sufficient to account for the differences in the prevalence of hypertension between these two female populations. 4. Mean arterial pressures as found in these Jamaican populations were lower than those reported in other surveys of Western Negro populations. 5. Pregnant women in Jamaica had significantly lower systolic and diastolic pressures than those who were not pregnant. The prevalence of diastolic hypertension (100 mm Hg or more) was higher in nulliparous than in parous women, and was least in those with moderate sized families of two to five children. The prevalence of hypertension increased again in those with very large families, as did the presence of bacteriuria. 6. Body build, as measured by the ponderal index, had a small but consistent influence on arterial pressure as measured indirectly, in Jamaican subjects under age 55. The absence of this relationship in the elderly may be due to increased mortality among obese hypertensives. 7. The use of a qualitative method for determining the genetic factor in arterial pressure suggests that its inheritance is graded, the resemblance in pressure between close relatives being independent of the range of pressure considered, and closely similar to the genetic factor in blood-pressure found in the Welsh. 8. The pressures of middle-aged siblings of middle-age hypertensives showed no bimodality in their distribution (Summary)