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1.
Zootaxa ; 4691(4): zootaxa.4691.4.2, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31719386

RESUMO

The heteronemertean genus Dushia Corrêa, 1963 was established for what was identified as D. atra (Girard, 1851) (originally Meckelia atra) based on material from littoral, shallow waters in Curaçao, while the nominal species Meckelia atra was originally described from deep water off Florida Cape. In this paper, we conclude that the type species for Dushia has been misidentified. Based on specimens from the Caribbean, we establish D. wijnhoffae Schwartz Norenburg sp. nov. to represent the true identity of the genus, according to Article 70.3.2 of the International Code of Zoological Nomenclature; Meckelia atra should be regarded as a nomen dubium. While the genus has remained monotypic since its establishment, our molecular analysis discovered a second member-or rather a group of members-from the West Pacific. This 'group of members', herein termed Dushia nigra (Stimpson, 1855) species complex comb. nov., involves i) at least two genetically separated biological entities, 0.136-0.148 (p-distance) and 0.152-0.168 (K2P) apart in terms of 513-bp COI sequences, which we interpret as likely to represent cryptic species, ii) three color forms, orange, brown, and black, with the last one occurring most frequently, and iii) four nominal species, Meckelia nigra Stimpson, 1855 (now Cerebratulus niger), Meckelia rubella Stimpson, 1855 (now Cerebratulus rubellus), Micrura formosana Yamaoka, 1939, and Micrura japonica Iwata, 1952. At present, however, we have no objective ground as to which of the four potentially available names (i.e., formosana, japonica, nigra, and rubella) should be allotted to the two cryptic species discovered in the analysis, because i) a single locality can harbor two cryptic species, ii) a single cryptic species may contain three different color morphs (i.e., orange, brown, black), and iii) no data from the type localities for these four nominal species are available at the moment. Our multi-locus analysis of heteronemerteans-for which 16S rRNA, COI, 18S rRNA, 28S rRNA, histone H3 genes are available in public databases-shows that Dushia wijnhoffae sp. nov. and Dushia nigra species complex comb. nov. form a clade, which is closely related to Gorgonorhynchus albocinctus Kajihara, 2015 and an undetermined heteronemertean that has been misidentified as Cerebratulus leucopsis (Coe, 1901). Members of Dushia thus show a vicariant Caribbean-West-Pacific distribution, indicating that the lineage predates the rise of the Isthmus of Panama.


Assuntos
Invertebrados , Animais , Região do Caribe , Curaçao , Florida , Invertebrados/genética , Panamá , Filogenia , RNA Ribossômico 16S , Análise de Sequência de DNA , Índias Ocidentais
2.
Artigo em Inglês | PAHO-IRIS | ID: phr-51069

RESUMO

[ABSTRACT]. Caribbean countries are experiencing social, epidemiological, and demographic transitions shaped by the growing elderly population and the rise of noncommunicable diseases (NCDs)—now responsible for 78% of all deaths. These circumstances demand rethinking the model of care to improve health outcomes and build more sustainable health systems with new orientations in policy, service delivery, organization, training, technology, and financing. Policy must be aimed towards healthy living, leveraging interventions that ensure healthy aging. The health system must proactively structure interventions to reduce the incidence of new NCD cases and to prevent related complications. Interventions should be focused on optimizing the individual’s capacity, functional ability, and autonomy within adapted environments, as well as with the necessary preventive, long-term care, self-care, community care, and health system support.


[RESUMEN]. Los países del Caribe están experimentando transiciones sociales, epidemiológicas y demográficas como resultado del envejecimiento de la población y el aumento de la prevalencia de las enfermedades no transmisibles (ENT), que en la actualidad causan el 78% de todas las defunciones. Estas circunstancias exigen replantear el modelo de atención para mejorar los resultados de salud y establecer sistemas de salud más sostenibles mediante nuevos enfoques en políticas, prestación de servicios, organización, capacitación, tecnología y financiamiento. Las políticas deben tener como propósito procurar una vida saludable, aprovechando las intervenciones que garanticen el envejecimiento saludable. El sistema de salud debe ser proactivo, estructurando las intervenciones para reducir la incidencia de nuevos casos de ENT y para prevenir las complicaciones relacionadas. Las intervenciones deben centrarse en optimizar la capacidad funcional, la autonomía y el desenvolvimiento general de la persona dentro de un entorno adaptado y con el apoyo necesario del sistema de salud en materia de atención preventiva, cuidados a largo plazo, de autocuidado y de atención en la comunidad.


[RESUMO]. Os países do Caribe estão passando por transições sociais, epidemiológicas e demográficas configuradas pela população de idosos cada vez maior e a ascensão das doenças não transmissíveis (DNTs), já responsáveis por 78% de todas as mortes. Essas circunstâncias exigem repensar o modelo de atenção para melhorar os desfechos de saúde e construir sistemas de saúde mais sustentáveis, com novas orientações de política, prestação de serviços, organização, treinamento, tecnologia e financiamento. As políticas devem ser orientadas para a vida saudável, alavancando intervenções que asseguram o envelhecimento saudável. O sistema de saúde deve estruturar proativamente intervenções para reduzir a incidência de novos casos de DNT e a prevenir as complicações relacionadas. As intervenções devem se concentrar na otimização da capacidade do indivíduo, das habilidades funcionais e da autonomia dentro de ambientes adaptados, e também nas ações preventivas a para assistência de longa duração, no autocuidado, na atenção na comunidade e no apoio pelos sistemas de saúde.


Assuntos
Sistemas de Saúde , Envelhecimento , Doenças não Transmissíveis , Aruba , Curaçao , Sistemas de Saúde , Envelhecimento , Doenças não Transmissíveis , Sistemas de Saúde , Envelhecimento , Doenças não Transmissíveis , Curaçao
3.
Neotrop Entomol ; 48(5): 863-865, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31140148

RESUMO

The predatory ladybird species, Cheilomenes sexmaculata (Fabricius), is native to Asia and Australia but has established populations outside its native range, most recently on the eastern and northern coast of South America. Here, we report for the first time the identification of the introduced ladybird beetle, C. sexmaculata, to the Caribbean islands, specifically the island of Curaçao. Although C. sexmaculata is typically considered beneficial and used as a means of biological control in continental ecosystems, due to its high predatory and reproductive ability, it has the potential to cause major ecological impacts as an invader to sensitive Caribbean island ecosystems.


Assuntos
Besouros/classificação , Animais , Curaçao , Ecossistema
5.
Am J Trop Med Hyg ; 99(6): 1415-1418, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30328407

RESUMO

Recent outbreaks of Chikungunya virus (CHIKV) infection confirm the vulnerability of neonates after vertical transmission. In 2014, CHIKV was reported for the first time in the Americas, including the island of Curaçao. We describe the outcomes of symptomatic neonates with vertically transmitted CHIKV infection during the CHIKV epidemic, who were admitted in the Saint Elisabeth Hospital, Willemstad, Curaçao. There were three symptomatic neonates with serologically confirmed infection. Two neonates developed neurological complications, including convulsions and intracerebral bleeding. One newborn, in whom maternal infection occurred 7 weeks before delivery, had a fatal outcome after birth. Maternal-fetal transmission of CHIKV may cause severe neonatal complications. There is a need to share experiences and to implement protocols toward the management of perinatal CHIKV infection.


Assuntos
Febre de Chikungunya/epidemiologia , Vírus Chikungunya/patogenicidade , Surtos de Doenças , Transmissão Vertical de Doença Infecciosa , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Animais , Febre de Chikungunya/fisiopatologia , Febre de Chikungunya/transmissão , Febre de Chikungunya/virologia , Vírus Chikungunya/fisiologia , Curaçao/epidemiologia , Feminino , Humanos , Recém-Nascido , Ilhas , Masculino , Morte Perinatal , Gravidez , Complicações Infecciosas na Gravidez/fisiopatologia , Complicações Infecciosas na Gravidez/virologia , Convulsões/fisiopatologia , Convulsões/virologia
6.
PLoS One ; 13(7): e0199624, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30005066

RESUMO

BACKGROUND: In the Caribbean region, a notable difference in HPV-prevalence and genotypes distribution between the islands is observed. Recently we found in Curaçao a low incidence of HPV16 and 18 in cervical cancer compared to the standard world population. We aimed to determine HPV-prevalence, HPV-genotype distribution and associated risk-factors in women from Curaçao. METHODS: 5000 women aged 25-65 years were randomly selected from the national Population Register. HPV was detected by means of GP5+/6+PCR EIA and GP 5+/6+amplimers from HPV-positive samples were genotyped with a reverse hybridisation assay. We also collected personal data and data on risk-factors. RESULTS: 1075 women were enrolled in the study. Overall HPV-prevalence was 19.7%. Most frequent genotypes were HPV16 (2.3%), 35 (2.1%) and 52 (1.8%). Twenty-seven women detected with abnormal cytology (i.e.≥ASC-US) were referred for biopsy. In women with normal cytology (n = 1048), HPV-prevalence was 17.9% and the most common high-risk HPV (hrHPV)-types were HPV35 (2.0%), 18 (1.8%), 16 (1.5%) and 52 (1.5%). The highest HPV-prevalence (32.8%) was found in the age-group: 25-34 (n = 247). HPV positive women started sex at a younger age (p = 0.032). CONCLUSIONS: HPV-prevalence in the overall population is high and HPV16 was the most common genotype followed by 35 and 18. In women with normal cytology HPV35 is the most common genotype followed by HPV18, 52 and 16. The high HPV-prevalence (32.8%) in women of 25-34 years argue for introduction of cervical cancer prevention strategies. HPV-type distribution found in Curaçao should be taken into account when considering the choice for prophylactic vaccination.


Assuntos
Papillomaviridae , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Adulto , Idoso , Curaçao/epidemiologia , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Papillomaviridae/genética , Prevalência , Vigilância em Saúde Pública , Sistema de Registros , Fatores de Risco , Comportamento Sexual , Inquéritos e Questionários
7.
Proc Biol Sci ; 285(1881)2018 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-29925618

RESUMO

Cleaner shrimp and their reef fish clients are an interspecific mutualistic interaction that is thought to be mediated by signals, and a useful system for studying the dynamics of interspecific signalling. To demonstrate signalling, one must show that purported signals at minimum (a) result in a consistent state change in the receiver and (b) contain reliable information about the sender's intrinsic state or future behaviour. Additionally, signals must be perceptible by receivers. Here, we document fundamental attributes of the signalling system between the cleaner shrimp Ancylomenes pedersoni and its clients. First, we use sequential analysis of in situ behavioural interactions to show that cleaner antenna whipping reliably predicts subsequent cleaning. If shrimp do not signal via antenna whipping, clients triple their likelihood of being cleaned by adopting darker coloration over a matter of seconds, consistent with dark colour change signalling that clients want cleaning. Using experimental manipulations, we found that visual stimuli are sufficient to elicit antenna whipping, and that shrimp are more likely to 'clean' dark than light visual stimuli. Lastly, we show that antenna whipping and colour change are perceptible when accounting for the intended receiver's visual acuity and spectral sensitivity, which differ markedly between cleaners and clients. Our results show that signalling by both cleaners and clients can initiate and mediate their mutualistic interaction.


Assuntos
Comunicação Animal , Peixes/fisiologia , Palaemonidae/fisiologia , Simbiose , Percepção Visual , Animais , Sinais (Psicologia) , Curaçao , Estimulação Luminosa
8.
Mar Pollut Bull ; 131(Pt A): 38-44, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29886962

RESUMO

A wide range of ecological and environmental factors influence metal bioaccumulation in fish. Studies of mercury and other metal contaminants in invasive Indo-Pacific lionfish are limited, yet consumption of the invasive predator is increasingly utilized as a management strategy. In this study, we examined the effects of body size, body condition, sex, trophic level, carbon source, diet, depth and capture location on mercury concentrations in lionfish collected from Curaçao. In addition, we examined whether or not a local petroleum refinery is the source of metal contamination in lionfish. Mercury concentrations ranged from 0.008 to 0.106 mg/kg and we found no effect of the petroleum refinery on metal bioaccumulation in lionfish. Low concentrations of metal contaminants indicate lionfish from Curaçao are safe for human consumption.


Assuntos
Mercúrio/farmacocinética , Perciformes/metabolismo , Poluentes Químicos da Água/farmacocinética , Fenômenos Fisiológicos da Nutrição Animal , Animais , Tamanho Corporal , Curaçao , Ecotoxicologia/métodos , Feminino , Contaminação de Alimentos/análise , Espécies Introduzidas , Masculino , Mercúrio/análise , Indústria de Petróleo e Gás , Perciformes/fisiologia , Poluentes Químicos da Água/análise
9.
PLoS One ; 13(5): e0197824, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29847572

RESUMO

Excavating sponges are among the most important macro-eroders of carbonate substrates in marine systems. Their capacity to remove substantial amounts of limestone makes these animals significant players that can unbalance the reef carbonate budget of tropical coral reefs. Nevertheless, excavating sponges are currently rarely incorporated in standardized surveys and experimental work is often restricted to a few species. Here were provide chemical and mechanical bioerosion rates for the six excavating sponge species most commonly found on the shallow reef of Curaçao (southern Caribbean): Cliona caribbaea, C. aprica, C. delitrix, C. amplicavata, Siphonodictyon brevitubulatum and Suberea flavolivescens. Chemical, mechanical and total bioerosion rates were estimated based on various experimental approaches applied to sponge infested limestone cores. Conventional standing incubation techniques were shown to strongly influence the chemical dissolution signal. Final rates, based on the change in alkalinity of the incubation water, declined significantly as a function of incubation time. This effect was mitigated by the use of a flow-through incubation system. Additionally, we found that mechanically removed carbonate fragments collected in the flow-through chamber (1 h) as well as a long-term collection method (1 wk) generally yielded comparable estimates for the capacity of these sponges to mechanically remove substratum. Observed interspecific variation could evidently be linked to the adopted boring strategy (i.e. gallery-forming, cavity-forming or network-working) and presence or absence of symbiotic zooxanthellae. Notably, a clear diurnal pattern was found only in species that harbour a dense photosymbiotic community. In these species chemical erosion was substantially higher during the day. Overall, the sum of individually acquired chemical and mechanical erosion using flow-through incubations was comparable to rates obtained gravimetrically. Such consistency is a first in this field of research. These findings support the much needed confirmation that, depending on the scientific demand, the different approaches presented here can be implemented concurrently as standardized methods.


Assuntos
Recifes de Corais , Fenômenos Mecânicos , Poríferos/química , Animais , Curaçao , Simbiose
10.
Travel Med Infect Dis ; 23: 34-43, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29614385

RESUMO

BACKGROUND: Dengue and chikungunya co-infections are an emerging threat to public health in tropical and sub-tropical areas. This study investigates acute and long-term clinical presentation patterns of chikungunya against a backdrop of preceding dengue infection and determines predicting factors for long-term chikungunya sequelae. METHODS: A retrospective cohort study was performed in 2015, including 299 previously confirmed chikungunya cases, of which 162 subjects were assessed for dengue serology at disease onset. RESULTS: Those with previous dengue infection (35.2% of the examined population) had a similar acute disease presentation, and suffered (not statistically significantly) more frequently from long-term musculoskeletal and neuropsychological symptoms compared to chikungunya-only patients. Patients with a preceding dengue infection (vs. those without) (OR = 4.17; p = 0.004), female sex (OR = 3.17; p = 0.034) and pre-existing joint disease (OR = 2.95; p = 0.031) had a higher risk of developing aggravated long-term chikungunya. Chronic disease (sequelae lasting >90 days) was predicted by an age between 41 and 60 (OR = 3.07; p = 0.009) and concomitant cardiovascular disease (OR = 4.08; p = 0.010), but not by a preceding dengue infection. CONCLUSIONS: This study suggests several predicting factors of, and a possible link between preceding dengue and chikungunya infection and aggravated long-term sequelae, which should be interpreted in the light of the limitations of this study.


Assuntos
Febre de Chikungunya/imunologia , Dengue/imunologia , Adolescente , Adulto , Anticorpos Antivirais/sangue , Febre de Chikungunya/diagnóstico , Febre de Chikungunya/epidemiologia , Estudos de Coortes , Curaçao , Dengue/diagnóstico , Dengue/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
11.
Zootaxa ; 4378(2): 257-264, 2018 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-29690028

RESUMO

Astrophiura caroleae, new species, is described from off Curacao in the southern Caribbean, and from the western Gulf of Mexico, in depths of 244 to 434 meters. This new species, the first in the genus Astrophiura to be described from the Atlantic Ocean, has a distinctive combination of characters, including regularly arranged primary plates, large radial shields whose radial edges are in contact for their entire visible length, and prominent tubercles on central and radial plates. The mottled reddish coloration of the dorsal surface of this species usually contrasts with the color of the substratum, rendering it readily visible in situ, despite its disc diameter of less than 10 mm. Like its congeners, A. caroleae is gonochoric, the gonads of females containing conspicuous masses of bright orange eggs that are approximately 165 µm in diameter. DNA Barcoding data are provided for this new species, these are the first for Astrophiura.


Assuntos
Equinodermos , Animais , Oceano Atlântico , Região do Caribe , Curaçao , Feminino , Golfo do México , Óvulo , Índias Ocidentais
12.
J Pediatr ; 197: 207-213, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29655863

RESUMO

OBJECTIVE: To evaluate the accuracy of the clinical Curaçao criteria in the diagnosis of hereditary hemorrhagic telangiectasia (HHT) in children and adolescents. STUDY DESIGN: This was a retrospective, multicenter chart review of 673 patients evaluated between 2002 and 2016; 290 were eligible for the study. Genetic testing for a pathogenic mutation was considered the gold standard against which the clinical Curaçao criteria were compared. Patients were divided into 4 age categories: 0-5, 6-10, 11-15, and 16-21-years. Sensitivity and specificity were calculated for each age group, and for the overall population. RESULTS: Overall the Curaçao criteria had a sensitivity of 68% (95% CI 60%-76%) and a specificity of 98% (95% CI 91%-100%). Sensitivity was lowest in the 0- to 5-year group, and increased with advancing age. The Curaçao criteria had the highest sensitivity in the 16- to 21-year-olds. Specificity was 100% in all age groups except for the 11- to 15-year-olds. CONCLUSIONS: This study evaluated the use of the Curaçao criteria for the diagnosis of HHT in the pediatric population with a family history of HHT. In those between the age of 0 and 21 years who meet 1 criterion (unlikely HHT) or 2 criteria (possible HHT), genetic testing is preferred for diagnosis. The Curaçao criteria appear to reliably diagnose HHT in children and adolescents who meet 3 or 4 criteria (definite HHT).


Assuntos
Testes Genéticos/métodos , Telangiectasia Hemorrágica Hereditária/diagnóstico , Receptores de Activinas Tipo II/genética , Adolescente , Adulto , Criança , Pré-Escolar , Curaçao , Endoglina/genética , Feminino , Genótipo , Humanos , Lactente , Masculino , Mutação , Estudos Retrospectivos , Sensibilidade e Especificidade , Proteína Smad4/genética , Telangiectasia Hemorrágica Hereditária/genética , Adulto Jovem
13.
Med Teach ; 40(5): 437-442, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29533104

RESUMO

INTRODUCTION: This study is aimed at explaining the change process followed for the implementation of the new curriculum at Avalon University School of Medicine and its evaluation. BACKGROUND: Self-evaluation at Avalon University School of Medicine identified the need for a change in the curriculum. The main reasons for the change are isolated disciplines and overcrowded curriculum leading to less self-study time for students. The new curriculum is aimed to have an integrated curriculum and to avoid redundancies. The new curriculum is designed, implemented, and evaluation of the same is in place. Evaluation methods and materials: After implementation, quantitative (results from exams) and semi-quantitative (self-administered questionnaire) evaluation methods are being used to evaluate the new curriculum. Feedback is also taken by having discussions with teachers and students to find out what they like and where modifications are needed. In this article, we are presenting the results of course evaluations (semi-quantitative methods) for two courses. The course evaluations were taken from the sample class size of 30 students. RESULTS AND DISCUSSION: The course evaluations demonstrated an improvement. The main reason for the improvement is due to collaborative efforts of the faculty members from different disciplines in teaching, assessments, and providing feedback to the students. CONCLUSIONS: The well-approached change process is required for the successful implementation of the new curriculum. The idea of ownership among all stakeholders is required for a well-managed change process.


Assuntos
Currículo , Educação de Graduação em Medicina/organização & administração , Comportamento Cooperativo , Curaçao , Docentes de Medicina/organização & administração , Feedback Formativo , Humanos , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde
14.
J Clin Neurosci ; 51: 22-28, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29483005

RESUMO

Hereditary hemorrhagic telangiectasia (HHT) is characterized by recurrent spontaneous epistaxis, mucocutaneous telangiectases, and multisystem arteriovenous malformations (AVMs). Brain AVMs typically present at birth and are identified in approximately 10-20% of patients with HHT. A retrospective review was undertaken of all HHT patients with known single or multiple brain AVMs treated at our institution. Thirty-nine patients with brain AVM(s) were diagnosed with HHT. Most patients presented with at least one Curaçao criterion. A total of 78 brain AVMs were identified in 39 patients. Two-thirds of patients had solitary brain AVMs, whereas 33% of patients harbored at least two lesions (range: 2-16). Brain AVMs of the supratentorial cerebral hemispheres comprised 83% of all lesions, whereas infratentorial lesions accounted for only 17%. Of the 55 brain AVMs assigned Spetzler-Martin grading, the majority of patients were Grade 1 (73%), and 23% and 4% were Grades 2 and 3, respectively. Patients were treated with surgery alone (51%), embolization alone (6%), embolization followed by surgery (9%), stereotactic radiosurgery (11%), stereotactic radiosurgery followed by surgery (3%), or observation (20%). Of patients who underwent genetic analysis, 62% possessed mutations in ENG (HHT type 1), whereas 38% had mutations in ACVRL1 (HHT type 2). This robust patient cohort of brain AVMs in 39 patients with HHT advances the collective understanding of this disease's varied presentation, diagnostic workup, genetic underpinnings, and available treatment options.


Assuntos
Malformações Arteriovenosas Intracranianas/etiologia , Malformações Arteriovenosas Intracranianas/patologia , Telangiectasia Hemorrágica Hereditária/complicações , Receptores de Activinas Tipo II/genética , Adolescente , Adulto , Criança , Pré-Escolar , Curaçao , Endoglina/genética , Feminino , Humanos , Lactente , Recém-Nascido , Malformações Arteriovenosas Intracranianas/cirurgia , Masculino , Pessoa de Meia-Idade , Mutação , Radiocirurgia , Estudos Retrospectivos , Telangiectasia Hemorrágica Hereditária/genética , Adulto Jovem
15.
Sex Transm Infect ; 94(4): 263-267, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29021405

RESUMO

BACKGROUND: Curaçao is a Dutch-Caribbean Island located in a high-risk area for cervical cancer.Prior to introduction of a prophylactic human papillomavirus (HPV) vaccine, knowledge of the prevalence of high-risk HPV vaccine genotypes (HPV16, 18, 31, 33, 45, 52 and 58) in cervical (pre)cancer is required. OBJECTIVE: To investigate the prevalence of HPV genotypes in invasive cervical cancers (ICC) and cervical intraepithelial neoplasia (CIN) grade 1, 2 and 3 in Curaçao. METHODS: Paraffin-embedded blocks of 104 cervical cancers (89 squamous, 15 adenocarcinoma), 41 CIN3, 39 CIN2 and 40 CIN1 lesions were analysed for the presence of HPV. Sections were stained by H&E for histopathological evaluation, and DNA was extracted using proteinase K. HPV genotypes were detected using Short PCR Fragment (SPF10) PCR DNA enzyme immunoassay and a Line Probe Assay (LiPA25) . RESULTS: HPV was found in 92 (88.5%) ICC; 87 (94.6%) had a single HPV infection and 86 (93.5%) were high-risk human papillomavirus (hrHPV)-type positive.The three most common HPV types in ICC were 16 (38.5%), 18 (13.5%) and 45 (6.7%), covering 58.7%.HrHPV vaccine genotypes 16, 18, 31, 35, 45, 52 and 58 were responsible for 73.1% of ICC. For precancerous lesions, the HPV attribution was 85.4% for CIN3, 66.7% for CIN2% and 42.5% for CIN1. CONCLUSIONS: Our study, the largest in the Caribbean region in (pre)cancer, shows that the prevalence of HPV-type 16 and 18 in cervical cancer is lower compared with the world population but no differences in prevalence of these two HPV types are seen in precancerous lesions.When considering HPV vaccination in Curaçao, the relatively high contribution of non-HPV 16/18 genotypes in ICC should be taken into account.


Assuntos
Adenocarcinoma/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasia Intraepitelial Cervical/epidemiologia , Infecções por Papillomavirus/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Adenocarcinoma/prevenção & controle , Adenocarcinoma/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Alphapapillomavirus/genética , Carcinoma de Células Escamosas/prevenção & controle , Carcinoma de Células Escamosas/virologia , Neoplasia Intraepitelial Cervical/prevenção & controle , Neoplasia Intraepitelial Cervical/virologia , Curaçao/epidemiologia , Detecção Precoce de Câncer , Feminino , Genótipo , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Infecções por Papillomavirus/genética , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus , Prevalência , Estudos Retrospectivos , Fatores de Risco , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia , Adulto Jovem
16.
Br J Nutr ; 118(10): 804-812, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29103383

RESUMO

Breast-fed infants are susceptible to vitamin D deficiency rickets. The current vitamin D 'adequate intake' (AI) for 0-6-month-old infants is 10 µg/d, corresponding with a human milk antirachitic activity (ARA) of 513 IU/l. We were particularly interested to see whether milk ARA of mothers with lifetime abundant sunlight exposure reaches the AI. We measured milk ARA of lactating mothers with different cultural backgrounds, living at different latitudes. Mature milk was derived from 181 lactating women in the Netherlands, Curaçao, Vietnam, Malaysia and Tanzania. Milk ARA and plasma 25-hydroxyvitamin D (25(OH)D) were analysed by liquid-chromatography-MS/MS; milk fatty acids were analysed by GC-flame ionisation detector (FID). None of the mothers reached the milk vitamin D AI. Milk ARA (n; median; range) were as follows: Netherlands (n 9; 46 IU/l; 3-51), Curaçao (n 10; 31 IU/l; 5-113), Vietnam: Halong Bay (n 20; 58 IU/l; 23-110), Phu Tho (n 22; 28 IU/l; 1-62), Tien Giang (n 20; 63 IU/l; 26-247), Ho-Chi-Minh-City (n 18; 49 IU/l; 24-116), Hanoi (n 21; 37 IU/l; 11-118), Malaysia-Kuala Lumpur (n 20; 14 IU/l; 1-46) and Tanzania-Ukerewe (n 21; 77 IU/l; 12-232) and Maasai (n 20; 88 IU/l; 43-189). We collected blood samples of these lactating women in Curaçao, Vietnam and from Tanzania-Ukerewe, and found that 33·3 % had plasma 25(OH)D levels between 80 and 249·9 nmol/l, 47·3 % between 50 and 79·9 nmol/l and 19·4 % between 25 and 49·9 nmol/l. Milk ARA correlated positively with maternal plasma 25(OH)D (range 27-132 nmol/l, r 0·40) and milk EPA+DHA (0·1-3·1 g%, r 0·20), and negatively with latitude (2°S-53°N, r -0·21). Milk ARA of mothers with lifetime abundant sunlight exposure is not even close to the vitamin D AI for 0-6-month-old infants. Our data may point at the importance of adequate fetal vitamin D stores.


Assuntos
Aleitamento Materno , Leite Humano/metabolismo , Necessidades Nutricionais , Luz Solar , Deficiência de Vitamina D , Vitamina D/administração & dosagem , Adulto , Curaçao , Dieta , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Lactação/metabolismo , Malásia , Masculino , Países Baixos , Política Nutricional , Raquitismo/sangue , Raquitismo/etiologia , Tanzânia , Vietnã , Vitamina D/análogos & derivados , Vitamina D/sangue , Vitamina D/metabolismo , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/metabolismo , Vitaminas/administração & dosagem , Vitaminas/metabolismo , Adulto Jovem
17.
Parasit Vectors ; 10(1): 434, 2017 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-28927437

RESUMO

BACKGROUND: As the arboviral diseases dengue, chikungunya and Zika emerge in the Americas, so does the need for sustainable vector control policies. To successfully achieve mosquito control, joint efforts of both communities and governments are essential. This study investigates this important, but by-and-large neglected topic. METHODS: In June and July 2015, a cross-sectional mixed methods study applying a survey questionnaire (response rate of 82.5%; n = 339), in-depth interviews (n = 20) and focus group discussions (n = 7; 50 participants) was performed in Curaçao. The study was designed based on an integrated theoretical framework of the Health Belief Model and the Theory of Planned Behaviour. RESULTS: Participants showed a good knowledge of, and a high-level performance of mosquito breeding site control (MBSC) practices. Personal protection against mosquitoes (e.g. topical repellents) was perceived as relatively less effective thus practiced to lower extent compared to MBSC practices (i.e. larval source management). A lower intention to perform MBSC was independently associated with: (i) satisfaction on governmental MBSC (P = 0.012); (ii) barriers to perform MBSC practices, i.e. 'Government doesn't control other breeding sites' (P = 0.005), 'Don't know how to control breeding sites' (P = 0.041), and 'a mosquito does not transmit dengue' (P = 0.016), (iii) attitudes towards MBSC (P = 0.001) and self-efficacy (person's perceived ability to act) to perform MBSC (P = 0.002). Mixed-methods evidence highlights three possible ways of improving community participation in MBSC. First, it highlights the need for ongoing media coverage, targeting (i) communities' perceptions on transmission routes of dengue and chikungunya, and (ii) presence of car tires in yards. Secondly, it shows that promotion of governmental activities in MBSC can enhance MBSC of communities, if people develop a sense of responsibility to perform MBSC at their own properties. Thirdly, this study describes the presence of key persons in communities, who could be engaged in mosquito control policies to improve MBSC in neighbourhoods. CONCLUSION: This study reveals gaps between policy and communities' lived realities. These gaps might be overcome with the proposed interventions, resulting in a higher performance of MBSC in the community in Curaçao. Furthermore, this study shows how interdisciplinary mixed methods research can provide important, comprehensive, and in-depth insights to inform mosquito control policies.


Assuntos
Aedes/fisiologia , Participação da Comunidade , Conhecimentos, Atitudes e Prática em Saúde , Controle de Mosquitos/métodos , Adolescente , Adulto , Animais , Cruzamento , Febre de Chikungunya/prevenção & controle , Febre de Chikungunya/transmissão , Estudos Transversais , Curaçao , Dengue/prevenção & controle , Dengue/transmissão , Feminino , Grupos Focais , Humanos , Mordeduras e Picadas de Insetos/prevenção & controle , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Projetos de Pesquisa , Inquéritos e Questionários , Adulto Jovem , Infecção por Zika virus/prevenção & controle , Infecção por Zika virus/transmissão
18.
J Negat Results Biomed ; 16(1): 15, 2017 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-28841828

RESUMO

BACKGROUND: Drug-induced parkinsonism (DIP) has a high prevalence and is associated with poorer quality of life. To find a practical clinical tool to assess DIP in patients with severe mental illness (SMI), the association between blink rate and drug-induced parkinsonism (DIP) was assessed. METHODS: In a cohort of 204 SMI patients receiving care from the only mental health service of the previous Dutch Antilles, blink rate per minute during conversation was assessed by an additional trained movement disorder specialist. DIP was rated on the Unified Parkinson's Disease Rating Scale (UPDRS) in 878 assessments over a period of 18 years. Diagnostic values of blink rate were calculated. RESULTS: DIP prevalence was 36%, average blink rate was 14 (standard deviation (SD) 11) for patients with DIP, and 19 (SD 14) for patients without. There was a significant association between blink rate and DIP (p < 0.001). With a blink rate cut-off of 20 blinks per minute, sensitivity was 77% and specificity was 38%. A 10% percentile cut-off model resulted in an area under the ROC curve of 0.61. A logistic prediction model between dichotomous DIP and continuous blink rate per minute an area under the ROC curve of 0.70. CONCLUSIONS: There is a significant association between blink rate and DIP as diagnosed on the UPDRS. However, blink rate sensitivity and specificity with regard to DIP are too low to replace clinical rating scales in routine psychiatric practice. TRIAL REGISTRATION: The study was started over 20 years ago in 1992, at the time registering a trial was not common practice, therefore the study was never registered.


Assuntos
Antipsicóticos/efeitos adversos , Piscadela/fisiologia , Transtornos Mentais/diagnóstico , Transtornos Parkinsonianos/induzido quimicamente , Transtornos Parkinsonianos/diagnóstico , Índice de Gravidade de Doença , Adulto , Idoso , Doenças dos Gânglios da Base/induzido quimicamente , Doenças dos Gânglios da Base/diagnóstico , Doenças dos Gânglios da Base/epidemiologia , Estudos de Coortes , Curaçao/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Transtornos Parkinsonianos/epidemiologia , Estudos Prospectivos
19.
Ned Tijdschr Geneeskd ; 161: D1372, 2017.
Artigo em Holandês | MEDLINE | ID: mdl-28612695

RESUMO

Peritoneal tuberculosis was diagnosed in a 38-year-old man from Curaçao, a 42-year-old Dutch man and a 38-year-old woman from Surinam. All patients had been living in the Netherlands for over a decade at the time of diagnosis. Time to diagnosis and treatment varied between patients. Factors contributing to delayed diagnosis were nonspecific symptoms, failure to consider tuberculosis exposure, consulting of more than one physician and delay in obtaining adequate material for histopathologic and microbiologic tests. These cases show that peritoneal tuberculosis can represent a diagnostic challenge. Considering the rising incidence of tuberculosis in the Netherlands, general practitioners and medical specialists will encounter patients with extrapulmonary tuberculosis more frequently. We recommend that tuberculosis exposure should always be considered by clinicians, even in patients originating from non-endemic countries. In case of suspected peritoneal tuberculosis, laparoscopy with peritoneal biopsy is the diagnostic tool of choice and should be performed without delay.


Assuntos
Peritônio/patologia , Peritonite Tuberculosa/diagnóstico , Adulto , Biópsia , Curaçao , Diagnóstico Tardio , Emigrantes e Imigrantes , Feminino , Humanos , Incidência , Laparoscopia , Masculino , Países Baixos , Suriname , Tuberculose
20.
Pharmacogenomics ; 18(10): 1003-1012, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28639468

RESUMO

AIM: This study was aimed to asses the prevalence of CYP2D6 and CYP2C19 polymorphisms in psychiatric patients and in volunteers from Dutch caribbean origin. METHODS: In total, 435 individuals were genotyped for CYP2D6 and CYP2C19. Of these, 269 were psychiatric patients on psychotropic medication, living in Curaçao and 166 were volunteers from the Dutch Caribbean population. RESULTS: No differences in prevalence of alleles were found. CONCLUSION: Although prevalence of alleles appeared to be very different from African and Caucasian populations, the distribution into predicted phenotypes shows an equal distribution as in Caucasians.


Assuntos
Antipsicóticos/uso terapêutico , Citocromo P-450 CYP2C19/genética , Citocromo P-450 CYP2D6/genética , Transtornos Mentais/tratamento farmacológico , Curaçao , Feminino , Genótipo , Humanos , Masculino , Transtornos Mentais/enzimologia , Transtornos Mentais/genética , Pessoa de Meia-Idade , Países Baixos
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