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1.
Cardiol Ther ; 12(3): 499-509, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37318673

RESUMEN

INTRODUCTION: This study aimed to determine whether there was any correlation between coronary artery disease (CAD) and retinal artery diameter at an academic tertiary medical center in Trinidad and Tobago. METHODS: This prospective study evaluated patients (n = 77) with recent invasive coronary angiography (CAG) and the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score who subsequently underwent optical coherence tomography-angiography (OCT-A) at the Eric Williams Medical Sciences Complex (EWMSC) from January 2021 to March 2021. Routine medical history and cardiovascular medications were also recorded. Spearman's rank correlation coefficient and Mann-Whitney U-tests were used to compare correlations and medians between groups. RESULTS: The average patient age was 57.8 years old, with the majority being male [n = 55 (71.4%)] and of South Asian ethnicity [n = 53 (68.8%)]. Retinal artery diameter was negatively correlated with the SYNTAX score (-0.332 for the right eye, p = 0.003 and -0.237 for the left eye, p = 0.038). A statistically significant relationship was also demonstrated in females and diabetic patients. There were no serious adverse events (SAEs). CONCLUSION: A significantly negative correlation was observed between retinal artery diameter and SYNTAX score. This study alludes to the practical use of optical coherence tomography-angiography (OCT-A) as a noninvasive diagnostic modality for patients with cardiovascular disease (CVD). Further large-scale, multicentric studies are required to confirm these exploratory findings. TRIAL REGISTRATION NUMBER: NCT04233619.

2.
Int Med Case Rep J ; 13: 623-629, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33209063

RESUMEN

Coronary artery disease (CAD) is amongst the leading causes of death in human immunodeficiency virus (HIV)-infected persons. Severe left main disease (LMD) occurs in approximately five percent of HIV-infected patients, with chronic total occlusion (CTO) of this vessel being an even rarer phenomenon. We describe a non-adherent HIV-infected patient with a left main coronary artery (LMCA) CTO that presented with heart failure with mildly reduced ejection fraction (HFrEF) and ventricular tachycardia (VT).

3.
BMC Psychiatry ; 20(1): 498, 2020 10 08.
Artículo en Inglés | MEDLINE | ID: mdl-33032571

RESUMEN

BACKGROUND: This study aimed to screen cardiovascular patients for depressive symptoms at a tertiary centre in Trinidad and Tobago; and to determine any significant associations amongst patients' demographics, comorbidities, and cardiovascular medications with depressive symptoms. METHODS: In this observational, cross-sectional study, patients (n = 1203) were randomly selected from the cardiology outpatient clinics at the Eric Williams Medical Sciences Complex. After meeting selection criteria, informed consent was obtained, and patients were administered a case report form, which included the Patient Health Questionnaire-9 (PHQ-9). Descriptive analyses included frequency, percentage and summary statistics. Inferential analyses included 95% confidence intervals (CIs), independent sample t-test, Fisher's exact test, Chi-square test, and multivariate logistic regression. RESULTS: The study had a 96% respondent rate, whereby the average age was 62 years old. Slightly less than half were male, and 52.5% were female. Over 90 % of the sample had cardiovascular disease (CVD). One-quarter of the sample had a PHQ-9 score of ≥10, with almost one-fifth having no depressive symptoms. Females, lower levels of education and income were all found to be statistically significant at risk for depressive symptoms (all p-values < 0.001). Comorbidities associated with depressive symptoms included hypertension, prior cerebrovascular events, chronic kidney disease, and chronic obstructive pulmonary disease with odds ratios (ORs) and 95% confidence intervals (CIs) of OR 1.988 (CI 1.414-2.797), OR 1.847 (CI 1.251-2.728), OR 1.872 (CI 1.207-2.902) and OR 1.703 (CI 1.009-2.876) respectively. Only the cardiovascular medication of ticagrelor was found to be significantly associated with depressive symptoms (p-value < 0.001). CONCLUSIONS: Twenty-five percent of screened cardiovascular patients displayed significant depressive symptoms with a PHQ-9 ≥ 10. This study also highlights the importance of implementing a multidisciplinary approach to managing cardiovascular disease and screening for depressive symptoms in this subpopulation. Further studies are required to validate these findings. TRIAL REGISTRATION: ClinicalTrials.gov number, NCT03863262 . This trial was retrospectively registered on 20th February 2019.


Asunto(s)
Depresión , Cuestionario de Salud del Paciente , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Trinidad y Tobago/epidemiología
4.
J Investig Med High Impact Case Rep ; 8: 2324709620951652, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32815420

RESUMEN

Penetrative cardiac injury can often result in life-threatening sequelae such as myocardial contusion or rupture, coronary vessel and valvular damage, pericardial effusion with tamponade, and arrhythmias of which gunshot injury is a chief culprit. We report a case of a suspected acute coronary syndrome after a cardiac gunshot injury that was conservatively managed.


Asunto(s)
Síndrome Coronario Agudo/etiología , Cuerpos Extraños/complicaciones , Derrame Pericárdico/etiología , Heridas por Arma de Fuego/complicaciones , Síndrome Coronario Agudo/diagnóstico , Taponamiento Cardíaco/etiología , Cuerpos Extraños/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Derrame Pericárdico/diagnóstico , Radiografía Torácica , Tomografía Computarizada por Rayos X
5.
Epilepsy Behav ; 15(2): 160-5, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19435574

RESUMEN

Epilepsy is poorly understood by the public and has been associated with numerous myths. This, coupled with its sometimes dramatic clinical manifestations, has often resulted in stigmatization of persons with epilepsy. A questionnaire to measure knowledge of, attitudes toward, and perceptions of epilepsy (KAPE) was adapted from previous studies and administered to students of the University of the West Indies, St. Augustine, Trinidad and Tobago. The response rate was 91% (355 students). Knowledge was limited, especially with respect to epilepsy's cause, its incidence, and management of an acute emergency. Attitudes toward epilepsy were generally positive. Students who knew someone with epilepsy scored significantly higher on knowledge and attitude questions. A stigma score was calculated to assess perceived stigmatization. There were no differences between the genders, but persons from rural areas and persons of mixed ethnicity perceived less stigmatization. Hindus perceived greater stigmatization than people of other religions. Overall, students still feel persons with epilepsy are discriminated against and experience stigmatization.


Asunto(s)
Epilepsia/psicología , Conocimientos, Actitudes y Práctica en Salud , Percepción/fisiología , Estudiantes/psicología , Universidades , Comparación Transcultural , Epilepsia/epidemiología , Etnicidad/psicología , Etnicidad/estadística & datos numéricos , Femenino , Humanos , Masculino , Estereotipo , Encuestas y Cuestionarios , Trinidad y Tobago/epidemiología , Trinidad y Tobago/etnología
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