An atypical aggressive Kaposi's sarcoma in a HIV-negative bisexual man

We describe a case of Kaposi's sarcoma in a previously healthy 35-year-old bisexual West Indian man of African descent who was seronegative for the human immunodeficiency virus (HIV) and human T-cell lymphotropic virus-1 (HTLV-1) and who presented with extensive mucocutaneous lesions, weight loss, visceral and generalized lymph node involvement, poor response to combination therapy with vinblastine and inter feron alfa-2a and a short survival of eight months from onset of illness. This is the first document case of Kaposi's sarcoma in Domonica. The presentation is unusal in that it is similar to the aggressive and disseminated Kaposi's sarcoma seen only in AIDS and florid variant of the endemic disease in young men in Equatorial Africa. (AU)

Cardiovascular risk factors among Afro-Guyanese in a bauxite mining community - abstract

A cross-sectional study of a bauxite mining community was conducted between August and November, 1992, to determine the prevalence of specified cardiovascular risk factors. It was carried out by interns and staff of the Faculty of Health Sciences, University of Guyana. Three Hundred and eighty-five subjects out of an over-18-year-old population (4,400) were randomly selected from the electoral register. A risk profile was recorded for each subject with general data on age, gender, ethnicity, marital status and occupation. Other data collected and evaluated included family history of heart disease, daily cigarette smoking, height, hypertension (blood pressure level > 140/90 mm Hg), hypercholesteraemia (serum cholesterol > 230 mg percentage) and diabetes mellitus (fasting blood sugar > 120 mg percentage). Analysis of resultls of 242 (63 percent) cases, so far, of the 385 subjects, revealed 50.8 percent males and 49.2 percent females; 78 percent Afro-Guyanese, 12.8 percent Mixed and 7.9 percent Indo-Guyanese; 11.9 percent 65 years and over. Prevalence rates of 32.3 percent for hypertension, 14.5 percent for hypercholesteraemia, 2.9 percent for diabetes mellitus and 21.5 percent for obesity were observed, while 27.7 percent of the subjects smoked, 50.4 percent drank alcohol and 38 percent had at least one family member with heart disease. When risk factors for cardiovascular disease in hypertensive subjects were compared to those in nonhypertensive subjects were compared to those in nonhypertensives, it was found that hypercholesteraemia was 4.7 times greater and that obesity and diabetes mellitus was twice as great. This study indicates that risk factors for cardiovascular disease in a predominantly Afro-Guyanese mining community in Guyana are common and that educational and other strategies should be undertaken to reduce this risk (AU)

Research in health sciences: the Caribbean issues

Research is an integral part of our growth and development in the context of transfer of technology, human resource development and international competitiveness. Caribbean scientists have the responsibility of ensuring that the appropriate impetus is given to this vital activity. Thomas Young MD. FRS, in his address to the Royal Society on December 11th, 1828 said: "The way in which science ougth to be encouraged in this country, is not by tormenting the Government to do this, that and the other for us, but in doing what is wanted for ourselves." This statement is as relevant to Scientists in the Caribbean today as it was in the UK one hundred and sixty-four years ago

Ecotourism and health tourism in the Caribbean

Sees the region as having a great potential for ecotourism, however the environment must be preserved and concept of sustainable development must be central to the success of such ventures. Acknowledges that the region has particular advantages in health and tourism and this should be part of the ecotourism investment package. (AU)

Social factors mediating social class differences in blood pressure in a Jamaican community

Research on the factors mediating social class differences in blood pressure was carried out in a Jamaican community. It was found in a previous report that higher social class is related to higher blood pressure. These differences are examined in greater detail here, especially in terms of the historical context of the specific community studies, which is on the fringe of the Kingston urban area, and in terms of the continuing importance of a social class system established under colonial rule. In the current study it is shown that social class differences in blood pressure for males are mediated by perceptions of economic stress. It is suggested that specific patterns of the growth of the city, and the the historically-based social class system, have resulted in the juxtaposition of lower and middle class Jamaican within this community, who in turn are influenced by different factors affecting blood pressure (AU)

Social factors mediating social class differences in blood pressure in a Jamaican community

Research on the factors mediating social class differences in blood pressure was carried out in a Jamaican community. It was found in a previous report that higher social class is related to lower blood pressure for females, while for males higher social class is related to higher blood pressure. These differences are examined in greater detail here, especially in terms of the historical context of the specific community studied, which is on the fringe of Kingston urban area, and in terms of the continuing importance of a social class system established under colonial rule. In the current study it is shown that class differences in blood pressure for males are mediated by perceptions of social support. Social class differences in blood pressure for females are mediated by perceptions of economic stress. It is suggested that specific patterns of the growth of the city, and the historically-based social class system, have resulted in the juxtaposition of lower and middle class Jamaicans within this community, who in turn are influenced by different factors affecting blood pressure(AU)

Comparative research in social epidemiology: measurement issues

The aim of comparative research in soical epidemiology is to determine how risk factors for disease may vary within and between sociocultural and ethnic groups and in relation to outcomes. This aim assumes that measurement equivalence within and between social groups can be established, an assumption usually left untested. A model is presented here for deriving cross-culturally valid measures that are also intraculturally sensitive. Measurements so derived can then be used to compare cross-cultural and intracultural effects in a single analytic model. This approach is illustrated by pooling data on social stressors, social supports, and blood pressure from three studies. (AU)

Persistence of high leucocyte sodium and blood pressure after pre-eclampsia

Blood pressure and leucocyte sodium content were measured in black Jamaican patients with pre-eclampsia and pregnant controls. Similar measurements were made in a group of mothers who had pre-eclampsia 36-38 weeks previously and their controls. An increase in cell sodium accompanied the high blood pressure in patients with pre-eclampsis. There was also some elevation of both blood pressure and cell sodium in patients who had had pre-eclampsia 36-38 weeks previously. These findings suggest that disturbances of cellular electrolytes continue into the post-partum period. Changes in intracellular sodium may be important in the pathogenesis of pre-eclampsia as they parallel the increase in blood pressure levels (AU)

Neuropsychiatric manifestations of typhoid fever

Neuropsychiatric manifestations of typhoid fever are not uncommon, occurring in 18 of 40 consecutive patients at the University hospital of the West Indies. The clinical presentation ranges from a confusional state to hallucinations or meningism, and the diagnosis may be missed or unduly delayed unless there is a strong index of suspicion (AU)

Success of didactic gastroenterology teaching for postgraduate medical residents

Although the Doctor of Medicine programme in Internal Medicine at the U.W.I. is a structured course with several teaching formats, the optimally effective form of teaching remains unknown. An experimental didactic teaching course in Gastroenterology was preceded and followed by an examination. This was conducted to determine the effectiveness of this form of teaching. The majority of residents ranked the course favourably. The mean examination score increased by 6.4 percent, from 25.4 percent before the course to 31.8 percent at the end. Although the more senior residents scored higher than their juniors in the pre-test, this difference disappeared in the post-test. Structured didactic teaching requires close supervision, active participation by trainee and reinforcement for the full benefit to be attained. (AU)