A study of pregnancy in relation to the prediabetic state

The only conclusion which can be drawn from this study is that at the present time the criteria listed by Wilkerson (1959) are less common in Jamaica than Boston and are not useful in the Jamaican female in selecting the patients who will be prone to develop abnormality during a pregnancy or to have an abnormal outcome of the type associated with a disturbed carbohydrate tolerance (AU)

Dilatation and unfolding of the aorta in a Jamaican population

In an analysis of 2085 70 mm. chest X-rays of subjects aged 35-64 from a rural population in Jamaica, 79 of the 1090 women (8.4 percent) showed some degree of aortic dilatation. The clinical examination of these people and age and sex balanced control groups drawn by random methods from the same population revealed three main findings. (1) Arterial pressure levels were consistently higher in the affected, than in the controls. (2) The conditions was associated with aortic regurgitation in 20 percent of men and 7 percent of women. (3) Both aortic dilatation and arterial pressure in these subjects were apparently unrelated to their present serological status. Positive serological reactions were found in about 25 percent of affected and controls. The possible role of syphillis and/or yaws in association with hypertension in producing aortic dilatation is discussed. A relationship between aortic dilatation, often gross, and hypertension has been demonstrated and this combination appears to have a high prevalence in West Indian negroes. Whatever the role of treponemal infection it is apparently not the most important single factor in the production of either the aortic dilatation, the associate hypertension, or the resulting aortic regurgitation. The significance of uncomplicated aortic dilatation, in terms of morbidity and mortality, remains to be determined by follow-up studies of these groups (Summary)

"J" type diabetes

The course of 24 "J" -type diabetics attending the University College Hospital of the West Indies was reviewed. The "J" type is not a separate subgroup. So-called "J" -type cases are type-II cases in which the diabetes has been badly treated.(AU)

The prevalence of diabetes mellitus in Jamaica

The prevalence of diabetes in Jamaica has been investigated. The results of five surveys are reported. The indications are that 1.26 per cent of the population aged fifteen years and over have diabetes. (Summary)

Latent diabetes

The records of twelve patients in whom the clinical and biochemical manifestations of diabetes mellitus were of limited duration are reported and discussed. Six presented in diabetic coma or precoma. All have been followed up for periods varying from eleven to seventy-seven months. Five have relasped. Three who have not relasped no longer adhere to a diabetic-type diet. All are considered to be in or to have been in a latent phase of their diabetes. (Summary)

A follow up of J-type diabetes in Jamaica (abstract only)

In 1955 Hugh Jones described a pattern of behaviour in the Jamaican diabetic which fitted neither of the two main types. The subjects were under 40 years of age, underweight, insulin resistant and in the absence of insulin seldom developed ketosis. These he designated Type "J". The original 13 cases and 11 additional cases have been followed up and a number have been subjected to specific investigations. Evidence is presented that "J" type diabetes is a phase in the course of the Type 11 patient and it is not a specific variant of the diabetic syndrome (AU)

Aspects of diabetes mellitus in Jamaica (abstract only)

The prevalence of diabetes in Jamaica is considered. It is likely that there are at least 10,000 adult subjects with diabetes and of these about 60 percentare not recognized. The aetiology of the disease as it applies to the Jamaican diabetic is reviewed from the clinical, autopsy and investigational aspect. Figures are given of the occurence of clinical coronary artery disease in diabetic patients, and of the effect of the disease on the potency of the adult male (AU)

The natural history of syphilitic heart disease as seen in a hospital population (abstract only)

An attempt has been made to give an assessment of aortic incompetence in a hospital population and to show the expectation of life once cardiac failure has developed. Seventy one cases have been analysed and 32 are dead, 15 of these from cardiac failure due directly to the incompetent aortic valve. All but 3 of the cases dying perished within 2 years of the onset of symptoms mainly in the fifth decade of life; in these 3 survival up to 5 years was possible. Of the cases still living the average follow-up period is 28 months, but again survival up to 4 years and beyond is possible even after the onset of cardiac failure (AU)

A syndrome of idiopathic cardiomegaly with mitral incompetence (abstract only)

Ten elderly patients are reported in whom mitral incompetence was the significant clinical finding. All were in heart failure of varying severity. Six are dead and the autopsy findings on 2 cases are reported. The clinical course and the possible mode of development of the cardiac lesion are discussed (AU)

The problem of diabetic control in the Caribbean

The difficulties in the way of achieving satisfactory diabetic control are considered - dietetic modification is the main problem, but in addition less than 40 percent of those requiring insulin inject themselves, less than 50 percent of the patients test their urine for sugar, and attendance at the diabetic clinic of the University College of the West Indies is expensive for the country patients. The high incidence of complications encountered among Jamaican diabetics make it essential that the facilities available to the patients be improved. Publicity for the disease so that patients attend early in the course of their illness, better education of the patient in the management and implications of diabetes, and more readily available treatment for the country patients should gradually improve the lot of the diabetic subject. (AU)

Liver glutamic-aspartic transaminase activity in diabetes

Liver glutamic-aspartic transaminase activity was investigated in 19 diabetic patients before and after treatment of the diabetic state. In 15 patients who were passing no sugar in the urine at the time of the second biopsy the mean level of transaminase activity was 0.146+- 0.013 units, whereas before treatment the activity had been 0.213+- 0.011 units. This difference is highly significant statistically. There was no apparent relation between the initial level of transaminase activity or the change in activity and the type or duration of the diabetes or of the treatment given (Summary)

Anomalous pulmonary venous drainage through a persistent left superior vena cava: Report of a case

A 31 year old Negro is described in whom total pulmonary venous drainage through a persistent left superior vena cava into the left innominate vein was demonstrated. (AU)

Myocardial infarction in Jamaica: the clinical features

The clinical course of 32 patients with myocardial infarction admitted to the University College Hospital of the West Indies between 1st September 1952 and 31st March 1958 has been reviewed. The sex incidence was approximately 2:1 (male : female). The mortality of the acute cases was high -12 of 32 males died and 11 of 24 females. The course and causes of death follow the pattern recognised in Britain and America. Twenty-six patients were admitted some time after their infarct, heart failure being the main cause of admission. (AU)

Some aspects of myocardial infarction in Jamaica

Myocardial infarction is rare in Jamaica compared with Britain and America, but it is relatively common when compared with the incidence in Central Africa. The possible effect of diet on the plasma cholesterol level, and on the incidence of infarction merits further investigation. (AU)

Heart disease in Jamaica

The cardiac cases admitted to an adult male and female ward of the University College Hospital of the West Indies during 1956 and '57 have been analysed and the autopsy incidence of heart lesions in the first 1258 cases seen in the Pathology Department of the University College of the West Indies has been reviewed. (AU)

A multiplicity of reactions to carbutamide (BZ-55) therapy

The case of a diabetic adult male who exhibited a number of serious toxic reactions to carbutamide administration is reported. The findings included thrombocytopenia, fever, lymphocytosis, generalized lymphadenopathy, exfoliative dermatitis, hepatitis and the development of a secondary anemia. Recovery followed administration of cortisone. Delayed "hypoglycemic" episodes were associated with adminstration of high dosage of the drug.(AU)

A pilot survey of the incidence of diabetes in Jamaica

A survey of 958 subjects aged 14 years and over living in the Lawrence Tavern area of St. Andrew has been undertaken to establish the incidence of diabetes in the community. An evening specimen of urine was tested for sugar. There were 17 patients with diabetes in the group studied; 3 were known diabetics and 4 new diabetics were discovered. The incidence of 7.3 per 1000 is lower than that found in comparable surveys in Trinidad and America. (AU)

Experience in Jamaica with the oral treatment of diabetes (abstract only)

The importance of diabetes as a hospital problem in Jamaica and the difficulties of outpatient management are discussed. Details of the treatment of 10 patients with an oral hypoglycaemic sulfonamide (B.Z. 55) are presented. Three were discharged from hospital taking a maintenance dose of the drug. Toxic effects were common. B.Z. 55 has little part to play in the treatment of diabetes in Jamaica. (AU)

Glucose-6-phosphatase activity in human diabetes

There is increased activity of glucose-6-phosphatase in the liver of diabetics compared with non-diabetics. Stabilisation of the diabetes was followed by decreased activity of the enzyme in 13 patients, whether the diabetes was type I, II, or J, and whether insulin or carbutamide had been administered (AU)