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1.
Toxicology ; 192(2-3): 249-61, 2003 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-14580791

RESUMO

Hundreds of thousands of people are dying around the world each year from the effects of the use, or misuse, of pesticides. This paper reviews the different options to reduce availability of the most hazardous chemicals, focusing on issues in developing countries. Emphasis is placed on the fatal poisoning cases and hence the focus on self-harm cases. Overall, it is argued here that restricting access to the most hazardous pesticides would be of paramount importance to reduce the number of severe acute poisoning cases and case-fatalities and would provide greater opportunities for preventive programmes to act effectively. The aim should be to achieve an almost immediate phasing out of the WHO Classes I and II pesticides through national policies and enforcement. These short-term aims will have to be supported by medium- and long-term objectives focusing on the substitution of pesticides with safe and cost-effective alternatives, possibly guided by the establishment of a Minimum Pesticide List, and the development of future agricultural practices where pesticide usage is reduced to an absolute minimum. Underlying factors that make individuals at risk for self-harm include domestic problems, alcohol or drug addiction, emotional distress, depression, physical illness, social isolation or financial hardship. These should be addressed through preventive health programmes and community development efforts.


Assuntos
Países em Desenvolvimento , Doenças Profissionais/prevenção & controle , Praguicidas/envenenamento , Envenenamento/prevenção & controle , Doença Aguda , Poluição Ambiental/prevenção & controle , Humanos , Doenças Profissionais/induzido quimicamente , Doenças Profissionais/mortalidade , Exposição Ocupacional/prevenção & controle , Praguicidas/classificação , Praguicidas/provisão & distribução , Envenenamento/mortalidade , Fatores de Risco , Organização Mundial da Saúde
2.
West Indian med. j ; 48(4): 238-9, Dec. 1999.
Artigo em Inglês | MedCarib | ID: med-1562

RESUMO

Severe aplastic anaemia is uniformly fatal unless treated with immunosuppressive therapy or bone marrow transplantation. The latter is curative in 65 percent of patients and is the treatment of choice in children and young adults. Antilymphocyte globulin (ALG) and cyclosporin may be used successfully in the absence of an HLA matched sibling donor. We report the case of a twelve year old boy with severe aplastic anaemia who received immunosuppressive with ALG and cyclosporin and is alive and well three years an six months post treatment.(AU)


Assuntos
Criança , Relatos de Casos , Humanos , Masculino , Anemia Aplástica/tratamento farmacológico , Soro Antilinfocitário/uso terapêutico , Ciclosporina/uso terapêutico , Imunossupressores/uso terapêutico , /uso terapêutico , Quimioterapia Combinada , Hidrocortisona/uso terapêutico
4.
Vet Hum Toxicol ; 41(1): 23-5, Feb. 1999.
Artigo em Inglês | MedCarib | ID: med-1334

RESUMO

A prospective autopsy study was undertaken at General Hospital in San Fernando, Trinidad, to analyze deaths that occurred form poisoning during 1996 and 1997. During that period 105 deaths occurred from acute poisoning. The major poisons used were: paraquat (80 cases), organophosphate/carbamate insecticides (10 cases), and anti-psychotic drugs (6 cases). Much less frequently, battery acid, ETHREL [Ethephon; (2-chlorethyl) phosphonic acid], phenols, ethanol, kerosene and flavine were the agents of choice. Suicide accounted for 99 (94.29 percent) deaths. Of these, 44.44 percent occurred in the 10-29 y-age-group. Ingestion of paraquat seems almost always fatal, since the large volumes ingested make treatment universally ineffective. Aspiration pneumonitis (100 percent of cases), were remarkable autopsy findings in those dying from paraquat poisoning, while asphyxia due to respiratory paralysis was the mode of death from pesticide ingestion. Efforts to prevent suicide by poisoning may be more useful than treatment protocols.(Au)


Assuntos
Adulto , Adolescente , Criança , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medicina Legal , Idoso de 80 Anos ou mais , Estudos Transversais , Estudos Prospectivos , Suicídio , Trinidad e Tobago/epidemiologia
5.
Suicide Life Threat Behav ; 29(2): 186-91, Summer 1999.
Artigo em Inglês | MedCarib | ID: med-1323

RESUMO

The suicide rate in Trinidad and Tobago is much greater than that of its English-speaking Caribbean neighbors. Many of these suicides are paraquat induced. This research reviewed the deaths due to suicide in the area with the greatest agricultural activity in Trinidad for 1996 and identified, for further demographic and etiological investigation, cases in which paraquat was ingested as the agent of suicide. Of 48 cases of suicide for the year, 39 (81.3 percent) were due to paraquat poisoning. The incidence of paraquat-induced suicide was 8.0 per 100,000. Among the males, 47.8 percent were in the age group 25-34 (p< 0.001), and among the females 50.0 percent were in the 15-4 age group (p < 0.05). Family-of-origin disputes were the most frequently cited precipitant, folllowed by marital problems. Individuals of East Indian origin accounted for 89 percent of the suicide victims (p < 0.001). When compared with suicide by other methods in the country, these findings confirm that paraquat poisoning is a significant means of suicide in Trinidad and that young East Indian individuals are particularly vulnerable.(AU)


Assuntos
Adulto , Pessoa de Meia-Idade , Idoso , Feminino , Humanos , Masculino , Adolescente , Herbicidas/envenenamento , Paraquat/envenenamento , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Escalas de Graduação Psiquiátrica , Trinidad e Tobago/epidemiologia
6.
West Indian med. j ; 47(suppl. 2): 55, Apr. 1998.
Artigo em Inglês | MedCarib | ID: med-1816

RESUMO

The rate of suicide in Trinidad and Tobago is much greater than in most of its Caribbean neighbours and self poisoning is the most common form of suicidal gesture. Paraquat poisoning in particular has been identified as one of the main agents of completed suicide. We therefore reviewed the deaths due to suicide in 1996 in South Trinidad, which is the area of Trinidad with the greatest agricultural activity, in an attempt to characterize paraquat induced suicide in terms of demographic and aetiological features. Case notes and clinical interviews were reviewed in all deaths due to deliberate self harm for the year 1996 at the General Hospital, San Fernando, Trinidad. There were 48 cases of completed suicide for the year and 39 (81 percent) of these were due to paraquat poisoning, giving an incidence of 8 per 100,000 population. Among the males, 48 percent were in the 25-34 year age group (p<0.001) and among the females 50 percent were in the 15-24 year age group (p<0.05). Family of origin disputes and marital problems were the most cited precipitants (p<0.003). Individuals of East Indian descent accounted for 89 percent of the cases (p<0.001). Psychiatric diagnoses were made in 20 percent of the cases with depression being the most frequently identified condition. While the ingestion of paraquat was often accompanied by heavy alcohol dependence. These findings confirm that paraquat poisoning continues to be a very significant problem and that young East Indian individuals seem particularly likely to attempt suicide by this means.(AU)


Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Suicídio/estatística & dados numéricos , Paraquat/envenenamento , Envenenamento , Trinidad e Tobago , Estudos Transversais
8.
New York; PJD Publications Limited; 1997. 12 p. tab.
Monografia em Inglês | MedCarib | ID: med-16228

RESUMO

Deep seated mycoses were the most common findings in cocaine addicts who died of AIDS in Trinidad, West Indies with Candida species, Histoplasma capsulatum and Aspergillus species being the most common. Contaminated smoke either from crack cocaine, marijuana or hemp was the suspected risk factor for the acquisition of Histoplasma capsulatum and Aspergillus infection. Pneumocysitis carinii was seen in 50 percent of cases. Pulmonary infections were a feature in all cases in the study and massive hepato-splenomegaly were the most common pathological findings in Histoplasmosis. In regions where Histoplasma capsulatum is endemic, the findings of massive Hepatosplenomegaly in patients should alert the physicians to the possibility of the Acquired Immune Deficiency Syndrome as a differential diagnosis. Efforts should be made to expeditiously identify and treat these organism since they contribute significantly to the morbidity and mortality of cocaine addicts afflicted with AIDS. Prophylaxis for these specific infectious organisms should also be considered (AU)


Assuntos
Humanos , Síndrome de Imunodeficiência Adquirida , América Latina/epidemiologia , Cocaína , Infecções por HIV , Países em Desenvolvimento
10.
West Indian med. j ; 42(1): 37-9, Mar. 1993.
Artigo em Inglês | MedCarib | ID: med-15303

RESUMO

Metastic calcification of the heart, lungs and kidneys is described in a 42-year-old male who had an HTLV-I-associated lymphoma. This fatal complication of HTLV-I-associated lymphoma has been infrequently reported, and the case in question is the first to be recorded in the Caribbean, where HTLV-I is common. Aggressive therapy of hypercalcaemia should be instituted early in its genesis in these lymphomas, so as to avoid its fatal outcome (AU)


Assuntos
Humanos , Adulto , Masculino , Leucemia-Linfoma de Células T do Adulto/complicações , Calcinose/complicações , Hipercalcemia/complicações , Cardiopatias/patologia , Pneumopatias/patologia , Nefropatias/patologia , Trinidad e Tobago
11.
West Indian med. j ; 42(1): 37-9, Mar. 1993.
Artigo em Inglês | LILACS | ID: lil-130634

RESUMO

Metastic calcification of the heart, lungs and kidneys is described in a 42-year-old male who had an HTLV-I-associated lymphoma. This fatal complication of HTLV-I-associated lymphoma has been infrequently reported, and the case in question is the first to be recorded in the Caribbean, where HTLV-I is common. Aggressive therapy of hypercalcaemia should be instituted early in its genesis in these lymphomas, so as to avoid its fatal outcome.


Assuntos
Humanos , Adulto , Masculino , Calcinose/complicações , Hipercalcemia/complicações , Leucemia-Linfoma de Células T do Adulto/complicações , Cardiopatias/patologia , Nefropatias/patologia , Pneumopatias/patologia , Trinidad e Tobago
14.
West Indian med. j ; 41(Suppl. 1): 64, Apr. 1992.
Artigo em Inglês | MedCarib | ID: med-6526

RESUMO

The clinical features in five cases (two fatal) of acute myocarditis induced by scorpion stings in Trinidad included hypovolaemic shock, restlessness, convulsions, cerebral oedema, pulmonary oedema, pancreatitis and myocarditis. The 2 fatal cases showed myocarditis (round cell perivascular infiltrate) and marked perivascular oedema of the endomysium, pulmonary oedema and marked cerebral oedema. The clinical course in these 5 patients suggests that generalized oedema occurred within minutes which would indicate that vascular endothelial damage occurred early, It is postulated that the venom complex of the scorpion, Tityus trinitatis, acts directly on endothelial cells leading to marked vascular permeability, and/or indirectly through agents such as serotonin and kinins to produce the same effect. Therapy should therefore be directed towards correction of the hypovolaemic shock, removal of oedematous fluid from the extravascular space, maintenance of adequate ventilation, reduction of cerebral oedema, digitalization and stabilization of the vascular endothelial membrane (AU)


Assuntos
Humanos , Miocardite/etiologia , Venenos de Escorpião/efeitos adversos , Trinidad e Tobago
15.
Trop Med Parasitol ; 42(4): 404-6, Dec. 1991.
Artigo em Inglês | MedCarib | ID: med-15961

RESUMO

Of 1089 healthy blood donors screened for HTLV-I using ABBOTTS HTLV-I EIA: 18 (1.7 percent) were positive; and 16 (1.5 percent) were confirmed positive using HTLV-I/11 Cambridge Biothec Western Blot method. HTLV-I antibodies were found amongst the major ethnic groups, viz. Africans, 11 cases (68.75 percent) and East Indians 4 cases (25 percent). The mean age of the donors who tested positive for HTLV-I was 30.75 years; and the male to female ratio was 4.3:1. (AU)


Assuntos
Humanos , Adulto , Masculino , Feminino , Doadores de Sangue , Anticorpos Anti-HTLV-I/sangue , Infecções por HTLV-I/epidemiologia , África/etnologia , Fatores Etários , Western Blotting , Infecções por HTLV-I/etnologia , Técnicas Imunoenzimáticas , Índia/etnologia , Prevalência , Estudos Prospectivos , Estudos Retrospectivos , Fatores Sexuais , Trinidad e Tobago/epidemiologia
16.
West Indian med. j ; 40(2): 69-73, June 1991. tab
Artigo em Inglês | MedCarib | ID: med-13529

RESUMO

An epidemiological evaluation was conducted on 270 patients who died at the General Hospital, Port-of-Spain after presenting with deliberate self-poisoning between January, 1986 and June, 1990. The cause of death was confirmed by autopsy and toxicological analysis. Epidemiological variables of age, sex, race, precipitating factors and types of poison used were assessed. It was found that the male to female ratio was 2.7:1. East Indians accounted for 54.4percent , Africans 42.0 percent, people of mixed ethnic origin 3 percent and Caucasians 0.6 percent. The majority of cases (52.6 percent) were seen in the age group 11-34 years. "Lovers' quarrels" (35.4 percent of cases), psychiatric illness (27.8 percent of cases) and family disputes (27 percent of cases) were reported as the most frequent precipitating events in suicide. East Indians predominated in those suicides precipitated by "lovers' quarrels" and family disputes, accounting for 63.2 percent and 58.9 percent of these cases, respectively; while for those suicides in which psychiatric illnesses were the main precipitating event, Africans were represented by 53.3 percent and East Indians 45.3 percent. Depression was the most common psychiatric illness diagnosed. Paraquat was the most popular poison used in 63.7 percent of the suicidal cases, and other agrochemicals were used in 20 percent of the cases. (AU)


Assuntos
Humanos , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Suicídio/tendências , Envenenamento/epidemiologia , Paraquat/envenenamento , Trinidad e Tobago/epidemiologia , Grupos Étnicos/psicologia
17.
West Indian med. j ; 40(suppl.1): 56, Apr. 1991.
Artigo em Inglês | MedCarib | ID: med-5545

RESUMO

A preliminary, retrospective, consecutive, epidemiological study was conducted on 270 patients who died in the General Hospital, Port-of-Spain after presenting with deliberate self-poisoning between January, 1986 and June, 1990. The cause of death was confirmed by autopsy and toxicological analysis. Epidemiological variables of age, sex, race, precipitating events/factors and type of poison used were assessed. It was found that the male to female ratio was 2.7:1. East Indians accounted for 54.4 percent, Africans 42.0 percent, people of mixed race 3 percent and Caucasians 0.6 percent. The 11-34 year age group contributed 52.6 percent, the 35-64 year age group 40.7 percent and the over 65 6.7 percent. Lovers' quarrels were most frequently reported as the precipitating event (35.4 percent), followed by a diagnosed psychiatric illness (27.8 percent) and family disputes (27 percent). East Indians predominated in those suicides precipitated by lovers' quarrels (63 percent) and family disputes (58 percent). Among suicides involving a person with a diagnosed psychiatric illness, there were more Africans (53 percent) than East Indians (45 percent). Depression was the most common psychiatric illness diagnosed. Paraquat was the most popular poison used, accounting for 63 percent of the suicide cases (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Envenenamento/epidemiologia , Tentativa de Suicídio , Fatores Sexuais , Fatores Etários , Trinidad e Tobago
18.
West Indian med. j ; 40(suppl.1): 56, Apr. 1991.
Artigo em Inglês | MedCarib | ID: med-5546

RESUMO

From 1979 to October 1990, Africanized bees have stung 3,955 humans with 10 deaths and 1,071 animals with 715 deaths in Trinidad and Tobago. The medical records of all patients seen at the General Hospital, Port-of-Spain, who developed acute renal failure following stings by Africanized bees were included in the study. Of the 5 patients in the study, 4 were males and 1 was female. One patient was stung by just over 500 bees while the rest were stung by over 1,000 bees. All patients had grossly elevated muscle enzymes. Two of the 5 patients died within 48 hours and causes of death were acute pancreatitis with acute renal failure, and acute pulmonary failure with acute renal failure. Two of the three patients who survived were desperately ill and had to be dialyzed. Renal function in these survivors did not return to normal under 50 days. It is likely that other islands of the Caribbean will soon be presented with this syndrome (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Lesão Renal Aguda/etiologia , Mordeduras e Picadas de Insetos/complicações , Trinidad e Tobago
19.
West Indian med. j ; 39(3): 180-5, Sept. 1990.
Artigo em Inglês | MedCarib | ID: med-14322

RESUMO

Spontaneous pneumothorax as a presenting feature of acuteparaquat toxicity is as yet unreported. A review of the literature has shown that there has been one reported case of spontaneous pneumothorax occurring after paraquat (Nakaoka et al, 1987). The two cases of paraquat ingestion presented in this report are associated with spontaneous pneumothorax in the acute phase. A proposed mechanism for the development of the pneumothorax is discussed (AU)


Assuntos
Humanos , Adolescente , Adulto , Masculino , Feminino , Pneumotórax/induzido quimicamente , Paraquat/envenenamento , Pulmão/patologia
20.
West Indian med. j ; 39(2): 86-90, June 1990.
Artigo em Inglês | MedCarib | ID: med-14177

RESUMO

To investigate the present status of pulmonary embolism as the cause of death in a general hospital population, the author reviewed 610 autopsy reports, and associated hospital records for the period 1985-1989. Pulmonary embolism was the major contributing factor to the cause of death in 61 (10 percent) of the 610 autopsies performed. Of the patients dying from major pulmonary embolism, in only 12 (19.7 percent) was the diagnosis suspected antemortem; and in 44 (72 percent) deep vein thrombosis was detected in the femoralpopliteal vein at autopsy. The mean age of patients dying from major pulmonary embolism was 52.2 years, and 31 (50.8 percent) victims were under the age of 50 years. Fifty-six (92 percent) of patients dying from pulmonary embolism were of African descent while 5 (8 percent) were of East Indian descent. Without autopsies. 49 (80.3 percent) patients dying of pulmonary embolism would have been incorrectly certified and registered in death statistics based on clinical certification only (AU)


Assuntos
Humanos , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Embolia Pulmonar/patologia , Embolia Pulmonar/etiologia
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