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1.
Parasite Epidemiol Control ; 24: e00338, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38323192

ABSTRACT

Dengue viruses are a significant global health concern, causing millions of infections annually and putting approximately half of the world's population at risk, as reported by the World Health Organization (WHO). Understanding the spatial and temporal patterns of dengue virus spread is crucial for effective prevention of future outbreaks. By investigating these patterns, targeted dengue surveillance and control measures can be improved, aiding in the management of outbreaks in dengue-affected regions. Curaçao, where dengue is endemic, has experienced frequent outbreaks over the past 25 years. To examine the spatial and temporal trends of dengue outbreaks in Curaçao, this study employs an interdisciplinary and multi-method approach. Data on >6500 cases of dengue infections in Curaçao between the years 1995 and 2016 were used. Temporal and spatial statistics were applied. The Moran's I index identified the presence of spatial autocorrelation for incident locations, allowing us to reject the null hypothesis of spatial randomness. The majority of cases were recorded in highly populated areas and a relationship was observed between population density and dengue cases. Temporal analysis demonstrated that cases mostly occurred from October to January, during the rainy season. Lower average temperatures, higher precipitation and a lower sea surface temperature appear to be related to an increase in dengue cases. This effect has a direct link to La Niña episodes, which is the cooling phase of El Niño Southern Oscillation. The spatial and temporal analyses conducted in this study are fundamental to understanding the timing and locations of outbreaks, and ultimately improving dengue outbreak management.

2.
BMJ Open ; 14(2): e076352, 2024 02 07.
Article in English | MEDLINE | ID: mdl-38326245

ABSTRACT

OBJECTIVE: Long-term chikungunya disease is characterised by persistent rheumatic symptoms following chikungunya virus infection. As there is no specific treatment available, affected individuals need strategies to adapt. However, research on these is scarce. This study aimed to explore which adaptive coping strategies are employed to manage persistent rheumatic symptoms in daily life. SETTING: The study was conducted in Curaçao. DESIGN AND PARTICIPANTS: An explorative qualitative study was conducted between September and October 2020, among a purposive sample of adults, 19 women and 4 men affected by long-term chikungunya disease. In-depth interviews were semi-structured and transcribed verbatim. The data were analysed using inductive thematic analysis. RESULTS: The disease duration for all participants ranged between 68 and 74 months (6 years). In narrating their experiences of coping with long-term chikungunya disease, four themes were identified: (1) learning to live with the disease; (2) resilience for dealing with pain; (3) maintaining positive self-image and attitude; and (4) coping through spirituality. CONCLUSION: To live with long-term chikungunya disease with dignity in spite of physical pain and discomfort, participants tried to retain a sense of control of oneself and one's lives, to not let the disease take over, focusing on the positive in their lives, and finding strength and remain hopeful. Interventions such as cognitive-behavioural therapy and mindfulness exercises may be effective in strengthening or regain affected individual's sense of competence and control by fostering adaptive coping skills and resilience. Subsequently, these interventions may improve health-related quality of life when rheumatic symptoms persist following chikungunya virus infection.


Subject(s)
Chikungunya Fever , Humans , Adult , Male , Female , Quality of Life , Adaptation, Psychological , Curacao , Qualitative Research , Pain
3.
Eur J Med Genet ; 68: 104919, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38355093

ABSTRACT

Hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber disease, is a dominant inherited vascular disorder. The clinical diagnosis is based on the Curaçao criteria and pathogenic variants in the ENG and ACVRL1 genes are responsible for most cases of HHT. Four families with a negative targeted gene panel and selected by a multidisciplinary team were selected and whole-genome sequencing was performed according to the recommendations of the French National Plan for Genomic Medicine. Structural variations were confirmed by standard molecular cytogenetic analysis (FISH). In two families with a definite diagnosis of HHT, we identified two different paracentric inversions of chromosome 9, both disrupting the ENG gene. These inversions are considered as pathogenic and causative for the HHT phenotype of the patients. This is the first time structural variations are reported to cause HHT. As such balanced events are often missed by exon-based sequencing (panel, exome), structural variations may be an under-recognized cause of HHT. Genome sequencing for the detection of these events could be suggested for patients with a definite diagnosis of HHT and in whom no causative pathogenic variant was identified.


Subject(s)
Telangiectasia, Hereditary Hemorrhagic , Humans , Telangiectasia, Hereditary Hemorrhagic/diagnosis , Telangiectasia, Hereditary Hemorrhagic/genetics , Telangiectasia, Hereditary Hemorrhagic/pathology , Mutation , Endoglin/genetics , Base Sequence , Chromosomes, Human, Pair 9/genetics , Activin Receptors, Type II/genetics
4.
J Fam Psychol ; 38(2): 270-281, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37870779

ABSTRACT

Growing up with a nonresident biological father has been portrayed as problematic for different aspects of father-child relationships, but it is unclear whether experiencing nonresidential fatherhood is less problematic in countries where this family structure is more common and thus probably less stigmatized. Cross-country research into nonresidential fatherhood is scarce, especially including Caribbean countries where many children grow up without their biological father in the home. This study examined associations between nonresidential fatherhood and father-child relationship quality and fathers' parenting behaviors among Curaçaoan and Dutch adolescents and young adults. Curaçaoan (n = 450) and Dutch (n = 585) participants completed a digital questionnaire in class, using the same procedures on Curaçao and in the Netherlands. We estimated structural equation models of perceived avoidant and anxious father-child attachment and paternal emotional warmth, rejection, and monitoring for both groups separately because of measurement variance across countries. Nonresidential fatherhood was unrelated to perceptions of most aspects of father-child relationships among both Curaçaoan and Dutch participants. This study adds an important cross-country perspective to the current literature on nonresidential fatherhood and tentatively suggests that correlates of nonresidential fatherhood for father-child relationships might be less evident than previous studies suggest. Instead, young people's socioeconomic status (SES) and the frequency of contact between fathers and children seem to be more important for father-child attachment and paternal rearing behaviors. Further research across demographic characteristics and child outcomes is required to understand whether, when, and how nonresidence of the biological father might affect child well-being and development in different countries. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Subject(s)
Father-Child Relations , Fathers , Male , Humans , Adolescent , Young Adult , Fathers/psychology , Parenting/psychology , Social Class , Emotions
5.
Eur Arch Otorhinolaryngol ; 281(1): 237-243, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37603052

ABSTRACT

PURPOSE: Hereditary hemorrhagic telangiectasia (HHT) is a dominantly inherited disorder that involves epistaxis, mucocutaneous telangiectases, and visceral arteriovenous malformations (AVMs). This study aims to investigate the genetic causes in a Chinese family with HHT. METHODS: HHT was confirmed according to Curaçao's diagnostic criteria. Three patients diagnosed with HHT and healthy members were recruited. Whole-exome sequencing (WES) and sanger sequencing were performed to define the patient's genetically pathogenic factor. RESULTS: The proband presented with recurrent epistaxis, hepatopulmonary arteriovenous malformation, and adenocarcinoma. A novel frameshift mutation (c.1376_1377delAC, p.H459Lfs*41) of the ENG gene was revealed in affected individuals by WES. There was no report of this variant and predicted to be highly damaging by causing truncation of the ENG protein. CONCLUSION: We report a novel variant in the ENG gene in Chinese that extends the mutational and phenotypic spectra of the ENG gene, and also demonstrates the feasibility of WES in the application of genetic diagnosis of HHT.


Subject(s)
Frameshift Mutation , Telangiectasia, Hereditary Hemorrhagic , Humans , Endoglin/genetics , Telangiectasia, Hereditary Hemorrhagic/complications , Telangiectasia, Hereditary Hemorrhagic/diagnosis , Telangiectasia, Hereditary Hemorrhagic/genetics , Epistaxis , Mutation , China
6.
PLoS Negl Trop Dis ; 17(12): e0011793, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38055664

ABSTRACT

BACKGROUND: Long-term chikungunya is a mosquito-borne disease, characterized by disabling rheumatic symptoms persisting for years, after infection with the chikungunya virus. Previous studies focused on assessing the well-being of affected individuals from a quantitative perspective using generic instruments, and have reported physical and psychological impairment. However, a common critique is that generic instrument's structured responses and pre-defined health domains selected by health professionals, may not capture the full extent of well-being impairment experienced by patients. This study aimed to explore in-depth to which extent long-term chikungunya disease impacts daily living and the physical, psychological, and social well-being from the experiences and perspective of affected individuals. METHODOLOGY/PRINCIPAL FINDINGS: Using open-ended questions, in-depth interviews were conducted with 20 purposively selected individuals with long-term chikungunya disease, in Curaçao. Interview audio-recordings were transcribed verbatim. The data were thematically analyzed. Living with persistent rheumatic symptoms affected the participant's daily living and well-being in several ways: experience of physical impact (restricted physical functioning and limitations in activities of daily life); experience of psychological impact (altered emotional state, fear of walking and running, psychosocial aspects of footwear adaptations, and uncertainty about disease progression and future health); and experience of social impact (social isolation and impaired relational maintenance, social dependency, challenges of social support, at-work productivity loss, and giving up leisure activities after work). CONCLUSIONS/SIGNIFICANCE: This study, the first of its kind, indicated that the adverse impact of long-term chikungunya disease is currently underreported. The persistent rheumatic symptoms had a negative effect on functional ability, which in turn impacted broad aspects of daily life and well-being, beyond what is captured by generic instruments. In the view of the findings, physical exercise programs including manual therapy, aerobics, resistance and stretching exercises, and orthopaedic footwear interventions in a multidisciplinary patient-centred approach may improve physical function and subsequently overall well-being.


Subject(s)
Chikungunya Fever , Chikungunya virus , Humans , Social Support , Qualitative Research , Curacao
7.
Org Divers Evol ; 23(4): 811-832, 2023.
Article in English | MEDLINE | ID: mdl-38046836

ABSTRACT

Molecular genetic analyses of Caribbean populations of the supposedly widespread intertidal oribatid mite Alismobates inexpectatus revealed the existence of a cryptic species. The new species, Alismobates piratus sp. n., shows considerable COI and 18S rRNA gene sequence divergences and although morphometric analyses indicate considerable variation between the taxa, no distinguishing morphological feature could be detected. The extreme intertidal environment is suggested to be responsible for the observed morphological stasis of the two species and vicariance is supposed to be responsible for their speciation. Alismobates piratus sp. n. was found on Hispaniola, Guadeloupe, Barbados and Curaçao indicating a predominant distribution on the Greater and Lesser Antilles, whereas the occurrence of A. inexpectatus is primarily restricted to Central America, the northern Caribbean and the Greater Antilles. Haplotype network analyses indicate distinct geographic structuring and the absence of recent gene flow among the Antillean A. piratus sp. n. populations. Central American and Antillean populations of A. inexpectatus show similar patterns but populations from Bermuda and the Bahamas are characterized by a common origin and subsequent expansion. Genetic landscape analysis demonstrates that vast stretches of open ocean, like the Caribbean Basin and the Western Atlantic, act as rather effective barriers, whereas the continuous continental coastline of Central and North America may facilitate dispersal. Genetic data also indicates that the Gulf Stream plays an important role for the biogeography of intertidal oribatid mites as it may be responsible for the strong link between Central and North American populations as well as for the colonization of Bermuda. Supplementary Information: The online version contains supplementary material available at 10.1007/s13127-023-00624-9.

8.
Ter Arkh ; 95(7): 580-585, 2023 Sep 29.
Article in Russian | MEDLINE | ID: mdl-38159009

ABSTRACT

Rendu-Osler-Weber disease or hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant disease. It is characterized by vascular dysplasia with the formation of telangiectasias on the skin, mucous membranes of the respiratory and digestive tracts, arteriovenous malformations (AVMs) in the internal organs, which is manifested by bleeding. Diagnosis is based on Curacao criteria: recurrent and spontaneous nosebleeds, multiple telangiectases on the characteristic localizations, AVMs in one or more of the internal organs, a family history of HHT (i.e. first-degree relative who meets these same criteria for definite HHT). Therapy is aimed at preventing and stopping gastrointestinal, nosebleeds, correction of iron deficiency anemia. A promising method of therapy is the use of angiogenesis inhibitors, in particular bevacizumab. The article presents a description of a clinical case of HHT in a 49-year-old woman with telangiectisia on the mucous membrane of the tongue, gastrointestinal tract and liver AVMs.


Subject(s)
Anemia, Iron-Deficiency , Telangiectasia, Hereditary Hemorrhagic , Female , Humans , Middle Aged , Telangiectasia, Hereditary Hemorrhagic/complications , Telangiectasia, Hereditary Hemorrhagic/diagnosis , Telangiectasia, Hereditary Hemorrhagic/drug therapy , Anemia, Iron-Deficiency/drug therapy , Epistaxis/complications , Epistaxis/drug therapy , Bevacizumab/therapeutic use , Angiogenesis Inhibitors
9.
EJVES Vasc Forum ; 60: 73-76, 2023.
Article in English | MEDLINE | ID: mdl-37928168

ABSTRACT

Introduction: Hepatic hereditary haemorrhagic telangiectasia (HHHT) is a rare autosomal dominant genetic disease. Some patients may develop cardiac failure, portal hypertension, and biliary ischaemia. To date, there is no standard surgical treatment for HHHT. The present authors propose a move from open to laparoscopic surgery; however, laparoscopic surgery has not been reported previously as a surgical treatment for HHHT. Report: Two women were admitted with histories of exertional dyspnoea and upper abdominal pain, respectively. Combined with recurrent epistaxis and their positive family history, a diagnosis of clinical HHHT was made based on Curacao criteria after comprehensive evaluation of imaging features. Next generation sequencing (NGS) results also confirmed typical gene mutations responsible for HHT. Both patients underwent laparoscopic double hepatic artery banding and or ligation successfully and were discharged four to six days after operation without severe complications. The symptoms of cardiac insufficiency including exertional dyspnoea and shortness of breath of the first patient improved six months after the operation. The second patient, with epigastric pain, remained pain free without medication three months after the operation. Discussion: Laparoscopic surgery for HHHT is technically challenging. Clinical data and follow up information showed that laparoscopic double hepatic artery banding and or ligation was a technically feasible surgical approach for HHHT patients with simple hepatic artery dilation.

10.
BMC Health Serv Res ; 23(1): 1247, 2023 Nov 13.
Article in English | MEDLINE | ID: mdl-37957621

ABSTRACT

BACKGROUND: Long-term chikungunya disease, characterized by persistent disabling rheumatic symptoms, including poly-arthralgia/arthritis of severe pain intensity, can persist for years after infection with the re-emerging mosquito-borne chikungunya virus. Although persistent symptoms and pain severity are important determinants of health-care seeking and self-management of symptoms, research on these in relation to long-term chikungunya disease is scarce. This study aimed to explore the perceived benefits and perceived barriers concerning health-care seeking, based on the Health Belief Model, and the symptoms self-management strategies used for health outcome improvement among individuals affected by long-term chikungunya disease. METHODS: An exploratory qualitative descriptive study was conducted with 20 purposively selected adults (17 females and 3 males) with persistent rheumatic symptoms, recruited from an ongoing longitudinal chikungunya cohort, in Curaçao. Semi-structured interviews were carried out, audio-recorded, and transcribed. An iterative coding process was used for themes identification through inductive thematic analyses. RESULTS: No perceived benefits in health-care seeking were reported. Identified themes in relation to perceived barriers were: (1) health-care seeking at disease onset; (2) general practitioners (GPs) perceptions and awareness of persistent symptoms; (3) challenges for medical referrals and support; (4) no validation of symptoms and challenges accessing therapy; (5) health system restrictions; and (6) social stigmatization of psychological help. These perceived barriers have led participants to self-manage persistent symptoms. Over-the-counter pharmacological and/or non-pharmacological treatments were used without consulting GPs. Identified themes were: (1) self-medication of symptoms; and (2) self-management true non-pharmacological treatments. CONCLUSIONS: To promote the benefits of long-term health-care seeking and subsequently reduce the possible harmful use of analgesics, a collaborative physician-patient therapeutic relationship need to be encouraged. To facilitate this, important shifts may be needed in chikungunya sequalae education of both patients and health-care professionals, and policy makers need to revise health systems for the long-term provision of multidisciplinary care to achieve beneficial health outcomes in long-term chikungunya disease.


Subject(s)
Chikungunya Fever , Physicians , Self-Management , Adult , Male , Female , Animals , Humans , Chikungunya Fever/therapy , Curacao , Patient Acceptance of Health Care , Qualitative Research
11.
Sci Rep ; 13(1): 21050, 2023 11 29.
Article in English | MEDLINE | ID: mdl-38030717

ABSTRACT

Microturbellarians are abundant and ubiquitous members of marine meiofaunal communities around the world. Because of their small body size, these microscopic animals are rarely considered as hosts for parasitic organisms. Indeed, many protists, both free-living and parasitic ones, equal or surpass meiofaunal animals in size. Despite several anecdotal records of "gregarines", "sporozoans", and "apicomplexans" parasitizing microturbellarians in the literature-some of them dating back to the nineteenth century-these single-celled parasites have never been identified and characterized. More recently, the sequencing of eukaryotic microbiomes in microscopic invertebrates have revealed a hidden diversity of protist parasites infecting microturbellarians and other meiofaunal animals. Here we show that apicomplexans isolated from twelve taxonomically diverse rhabdocoel taxa and one species of proseriate collected in four geographically distinct areas around the Pacific Ocean (Okinawa, Hokkaido, and British Columbia) and the Caribbean Sea (Curaçao) all belong to the apicomplexan genus Rhytidocystis. Based on comprehensive molecular phylogenies of Rhabdocoela and Proseriata inferred from both 18S and 28S rDNA sequences, as well as a molecular phylogeny of Marosporida inferred from 18S rDNA sequences, we determine the phylogenetic positions of the microturbellarian hosts and their parasites. Multiple lines of evidence, including morphological and molecular data, show that at least nine new species of Rhytidocystis infect the microturbellarian hosts collected in this study, more than doubling the number of previously recognized species of Rhytidocystis, all of which infect polychaete hosts. A cophylogenetic analysis examining patterns of phylosymbiosis between hosts and parasites suggests a complex picture of overall incongruence between host and parasite phylogenies, and varying degrees of geographic signals and taxon specificity.


Subject(s)
Apicomplexa , Parasites , Platyhelminths , Animals , Platyhelminths/genetics , Phylogeny , Parasites/genetics , DNA, Ribosomal/genetics , Apicomplexa/genetics
12.
J Neurosurg Case Lessons ; 6(22)2023 Nov 27.
Article in English | MEDLINE | ID: mdl-38011699

ABSTRACT

BACKGROUND: Within the Caribbean, Curaçao provides a neurosurgical hub to other Dutch Caribbean islands. At times, the inefficiency of neurosurgical referrals leads to unsatisfactory patient outcomes in true emergency cases. OBSERVATIONS: This article reports an illustrative case of a patient in need of emergency neurosurgical care, who was referred to a tertiary health institution in Curaçao. This case highlights the challenges of timely neurosurgical referrals within the Dutch Caribbean. LESSONS: Highlighting this case may provide a foundation for further discussions that may improve neurosurgical care and access. Limiting long-distance surgical referrals in the acute care setting will aid in saving lives.

13.
Pediatr Infect Dis J ; 42(12): 1077-1085, 2023 Dec 01.
Article in English | MEDLINE | ID: mdl-37823702

ABSTRACT

BACKGROUND: SARS-CoV-2 variant evolution and increasing immunity altered the impact of pediatric SARS-CoV-2 infection. Public health decision-making relies on accurate and timely reporting of clinical data. METHODS: This international hospital-based multicenter, prospective cohort study with real-time reporting was active from March 2020 to December 2022. We evaluated longitudinal incident rates and risk factors for disease severity. RESULTS: We included 564 hospitalized children with acute COVID-19 (n = 375) or multisystem inflammatory syndrome in children (n = 189) from the Netherlands, Curaçao and Surinam. In COVID-19, 134/375 patients (36%) needed supplemental oxygen therapy and 35 (9.3%) required intensive care treatment. Age above 12 years and preexisting pulmonary conditions were predictors for severe COVID-19. During omicron, hospitalized children had milder disease. During population immunity, the incidence rate of pediatric COVID-19 infection declined for older children but was stable for children below 1 year. The incidence rate of multisystem inflammatory syndrome in children was highest during the delta wave and has decreased rapidly since omicron emerged. Real-time reporting of our data impacted national pediatric SARS-CoV-2 vaccination- and booster-policies. CONCLUSIONS: Our data supports the notion that similar to adults, prior immunity protects against severe sequelae of SARS-CoV-2 infections in children. Real-time reporting of accurate and high-quality data is feasible and impacts clinical and public health decision-making. The reporting framework of our consortium is readily accessible for future SARS-CoV-2 waves and other emerging infections.


Subject(s)
COVID-19 , Adolescent , Child , Humans , COVID-19/epidemiology , COVID-19 Vaccines , Prospective Studies , SARS-CoV-2
14.
BMC Public Health ; 23(1): 1730, 2023 09 05.
Article in English | MEDLINE | ID: mdl-37670248

ABSTRACT

BACKGROUND: Aedes aegypti, the vector of arboviral diseases such as dengue and Zika virus infections, is difficult to control. Effective interventions must be practicable, comprehensive, and sustained. There is evidence that community participation can enhance mosquito control. Therefore, countries are encouraged to develop and integrate community-based approaches to mosquito control to mitigate Aedes-borne infectious diseases (ABIDs). Health professionals must understand the contexts motivating individuals' behaviour to improve community participation and promote behavioural change. Therefore, this study aimed to determine how contexts shaped individuals' protective behaviours related to ABIDs in Curaçao. METHODS: From April 2019 to September 2020, a multi-method qualitative study applying seven (n = 54) focus group discussions and twenty-five in-depth interviews with locals was performed in CuraÒ«ao. The study was designed based on the Health Belief Model (HBM). Two cycles of inductive and deductive coding were employed, and Nvivo software was used to manage and analyse the data. RESULTS: In this study, low media coverage (external cue to action) and limited experience with the symptoms of ABIDs (internal cue to action) were linked with a low perceived susceptibility and severity of ABIDs (low perceived threat). The low perceived threat was linked with reduced health-seeking behaviour (HSB) to prevent and control ABIDs. We also found that the perceived barriers outweigh the perceived benefits of ABID prevention and control interventions, obstructing HSB. On the one hand, insufficient knowledge reduced self-efficacy but contrary to expected, having good knowledge did not promote HSB. Lastly, we found that our participants believe that they are responsible for preventing ABIDs (internal locus of control) but at the same time indicated that their success depends on the efforts of the community and the health system (external locus of control). CONCLUSIONS: This study used the HBM to explain individual changes in HSB concerning ABIDs prevention and control in Curaçao. We can conclude that the perceived threat (perceived susceptibility and severity) and perceived barriers played an essential role in changing HSB. Health professionals must consider these two concepts' implications when designing a bottom-up approach for ABIDs control; otherwise, community participation will remain minimal.


Subject(s)
Aedes , Communicable Diseases , Zika Virus Infection , Zika Virus , Humans , Animals , Curacao , Mosquito Vectors , Health Behavior
15.
Cureus ; 15(7): e42706, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37654935

ABSTRACT

Hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, is a rare autosomal dominant multisystem disorder. It is a mucocutaneous and fibrovascular dysplasia, the diagnosis of which is based on the fulfillment of the four Curaçao criteria: 1) recurrent epistaxis; 2) dermatovascular mucosal telangiectasias at characteristic sites: skin of the face, ears, fingertips, lips, tongue, and oral and nasal cavity; 3) arteriovenous malformations (AVMs) of visceral organs and central nervous system; and 4) family history: diagnosis of HHT in a first-degree relative. We describe a case of a 76-year-old patient who presented to our department with clinical manifestations of HHT in the skin (face, fingertips), lips, hard palate, tongue, ears, and nasal cavities. Individual and family history was obtained, as well as clinical laboratory examination, pan-endoscopy of the ear, nose, and throat (ENT) systems, and treatment of active foci of bleeding from the above areas. The otolaryngologist may be the first doctor to suspect Rendu-Osler-Weber syndrome and the one responsible for treating patients with HHT since recurrent epistaxis is the most frequent (90-96% of patients) and the earlier manifestation of the disease and the main reason for the arrival of these patients in the Emergency Department. The purpose of this study is to present a clinical case of Rendu-Osler-Weber syndrome with multiple ENT manifestations, as well as a review of the literature on their management and treatment.

16.
Mar Pollut Bull ; 194(Pt B): 115354, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37573671

ABSTRACT

A coral community was examined on a semi-submersible platform that was moored at the leeward side of Curaçao, in the southern Caribbean, from August 2016 until August 2017. This community included several non-native or cryptogenic species. Among them were two scleractinian corals (Tubastraea coccinea and T. tagusensis) and two octocorals (Chromonephthea sp. and an unidentified Nephtheidae sp.). This is the first reported presence of T. tagusensis in the southern Caribbean, and the genus Chromonephthea in the Caribbean region. An ascidian, Perophora cf. regina, is also reported from the southern Caribbean for the first time, as well as a coral-associated vermetid gastropod, Petaloconchus sp., first recorded in the Caribbean in 2014. Lack of biofouling management could potentially harm indigenous marine fauna through the introduction of non-native species. Therefore monitoring communities associated with semi-submersible platforms is essential to track the presence and dispersal of non-native, potentially invasive species.


Subject(s)
Anthozoa , Biofouling , Animals , Caribbean Region , Introduced Species , Curacao , Coral Reefs
17.
Rev Panam Salud Publica ; 47: e129, 2023.
Article in English | MEDLINE | ID: mdl-37609527

ABSTRACT

Objective: This study aimed to describe and critically evaluate the COVID-19 vaccination program for high-risk children in Curacao and provide information about important factors such as parents' vaccination hesitancy and effective strategies for communicating and delivering information about vaccination. Methods: This was a cross-sectional study. It was important to identify children aged 12-17 years who were at high risk of severe COVID-19 infection because of the limited medical facilities on the island; children considered to be at high risk were those with diseases such as obesity, hypertension or diabetes mellitus type 2. These children or their caregivers were invited by their pediatricians to be vaccinated as part of a program run by the Public Health Department of Curacao. These high-risk patients were vaccinated between 30 May 2021 and 25 February 2022 in designated child-friendly spaces, with a pediatrician present for guidance and reassurance. Children received the Pfizer-BioNTech COVID-19 vaccine at the recommended dose for their age. The primary outcome was a description and evaluation of the attendance for vaccination. The secondary outcomes were side effects after vaccination for the age groups 12-15 years and 16-17 years. Reasons for refusal or nonadherence were also registered. Results: Altogether 51% (24/47) of those aged 16-17 years who were invited were vaccinated compared with 42% (26/69) of those aged 12-15 years who were invited. Altogether, 46% of these high-risk children were vaccinated compared with 48% of children aged 12-17 years without risk factors. In our population, most patients did not experience any side effects and if they did, the side effects were mild. No cases of myocarditis or pericarditis were observed. A lack of trust in the vaccine and a lack of prioritization of vaccination when scheduling daily activities were important factors in refusal and nonadherence. Conclusions: To organize a successful vaccination program in a small community with limited resources for treating high-risk children it is crucial for medical professionals to provide reliable information. Public health initiatives should focus on assuaging parents' fears about vaccines. In addition, ensuring there is good cooperation between doctors and the Public Health Department can help to make implementation successful. Finally, involving pediatricians and using dedicated areas for vaccinating children can help build trust with parents and caregivers.

18.
J Pediatr ; 263: 113665, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37572862

ABSTRACT

OBJECTIVE: To assess the utility of the Curaçao criteria by age over time in children with hereditary hemorrhagic telangiectasia (HHT). STUDY DESIGN: This was a single-center, retrospective analysis of patients attending the HHT clinic at the Hospital for Sick Children (Toronto, Canada) between 2000 and 2019. The evaluation of the Curaçao criteria was completed during initial and follow-up visits. Screening for pulmonary and brain arteriovenous malformations was completed at 5 yearly intervals. RESULTS: A total of 116 patients with genetic confirmation of HHT were included in the analysis. At initial screening at a median (IQR) age of 8.4 (2.8, 12.9) years, 41% met criteria for a definite clinical diagnosis (≥3 criteria). In children <6 years at presentation, only 23% fulfilled at least 3 criteria initially. In longitudinal follow-up, 63% reached a definite clinical diagnosis, with a median (IQR) follow-up duration of 5.2 (3.2, 7.9) years (P = .005). Specifically, more patients met the epistaxis and telangiectasia criteria at last visit compared with initial (79% vs 60%; P = .006; 47% vs 30%; P = .02) but not for the arteriovenous malformation criterion (59% vs 57%; P = .65). CONCLUSIONS: In the pediatric population, most patients do not meet definite clinical criteria of HHT at initial presentation. Although the number of diagnostic criteria met increased over time, mainly due to new onset of epistaxis and telangiectasia, accuracy remained low during follow-up visits. Relying solely on clinical criteria may lead to underdiagnosis of HHT in children.


Subject(s)
Arteriovenous Malformations , Telangiectasia, Hereditary Hemorrhagic , Humans , Child , Telangiectasia, Hereditary Hemorrhagic/diagnosis , Telangiectasia, Hereditary Hemorrhagic/genetics , Retrospective Studies , Curacao , Epistaxis/etiology , Mutation , Endoglin/genetics , Activin Receptors, Type II/genetics , Arteriovenous Malformations/diagnosis , Arteriovenous Malformations/genetics
19.
Article in English | PAHO-IRIS | ID: phr-57877

ABSTRACT

[ABSTRACT]. Objective. This study aimed to describe and critically evaluate the COVID-19 vaccination program for high-risk children in Curacao and provide information about important factors such as parents’ vaccination hesitancy and effective strategies for communicating and delivering information about vaccination. Methods. This was a cross-sectional study. It was important to identify children aged 12–17 years who were at high risk of severe COVID-19 infection because of the limited medical facilities on the island; children con- sidered to be at high risk were those with diseases such as obesity, hypertension or diabetes mellitus type 2. These children or their caregivers were invited by their pediatricians to be vaccinated as part of a program run by the Public Health Department of Curacao. These high-risk patients were vaccinated between 30 May 2021 and 25 February 2022 in designated child-friendly spaces, with a pediatrician present for guidance and reassurance. Children received the Pfizer-BioNTech COVID-19 vaccine at the recommended dose for their age. The primary outcome was a description and evaluation of the attendance for vaccination. The secondary outcomes were side effects after vaccination for the age groups 12–15 years and 16–17 years. Reasons for refusal or nonadherence were also registered. Results. Altogether 51% (24/47) of those aged 16–17 years who were invited were vaccinated compared with 42% (26/69) of those aged 12–15 years who were invited. Altogether, 46% of these high-risk children were vaccinated compared with 48% of children aged 12–17 years without risk factors. In our population, most patients did not experience any side effects and if they did, the side effects were mild. No cases of myocardi- tis or pericarditis were observed. A lack of trust in the vaccine and a lack of prioritization of vaccination when scheduling daily activities were important factors in refusal and nonadherence. Conclusions. To organize a successful vaccination program in a small community with limited resources for treating high-risk children it is crucial for medical professionals to provide reliable information. Public health initiatives should focus on assuaging parents’ fears about vaccines. In addition, ensuring there is good coop- eration between doctors and the Public Health Department can help to make implementation successful. Finally, involving pediatricians and using dedicated areas for vaccinating children can help build trust with parents and caregivers.


[RESUMEN]. Objetivo. El objetivo de este estudio consistió en describir y realizar una evaluación crítica del programa de vacunación contra la COVID-19 para adolescentes de alto riesgo en Curazao, así como proporcionar infor- mación sobre factores importantes, como el recelo de los progenitores con respecto a la vacunación y las estrategias eficaces para comunicar y ofrecer información sobre ella. Métodos. Se llevó a cabo un estudio transversal. Debido a las limitaciones de los centros médicos de la isla, era importante seleccionar a los adolescentes de entre 12 y 17 años con un riesgo alto de infección grave por COVID-19; se consideró que tenían un riesgo alto los miembros de este grupo poblacional que presentaban enfermedades como obesidad, hipertensión arterial o diabetes mellitus de tipo 2. Tanto estos adolescentes como sus cuidadores fueron invitados por sus pediatras a vacunarse dentro del marco de un programa impulsado por el Departamento de Salud Pública de Curazao. Estos pacientes de alto riesgo se vacunaron entre el 30 de mayo del 2021 y el 25 de febrero del 2022 en espacios adaptados a la población pediátrica, que contaban con la presencia de un especialista en pediatría para orientarles y tranquilizarles y donde se les administró la vacuna contra la COVID-19 de Pfizer-BioNTech en la dosis recomendada para su edad. El crite- rio de valoración principal fue la descripción y evaluación de la asistencia para recibir la vacuna. El criterio de valoración secundario fueron los efectos secundarios posteriores a la vacunación en los grupos de edad de 12 a 15 años y de 16 a 17 años. También se registraron los motivos para negarse a recibir la vacuna o para el incumplimiento del calendario de vacunación. Resultados. En total, se vacunó al 51% (24/47) de las personas de 16-17 años invitadas, en comparación con el 42% (26/69) de las de 12-15 años. Se vacunó al 46% de esta población de alto riesgo, en comparación con el 48% de la población de 12 a 17 años sin factores de riesgo. En nuestra población, la mayoría de los pacientes no presentaron ningún efecto secundario y cuando los hubo, estos fueron leves. No se observaron casos de miocarditis ni de pericarditis. La falta de confianza en la vacuna y la baja prioridad otorgada a la vacunación a la hora de programar las actividades diarias fueron factores importantes en la negativa a recibir la vacuna o el incumplimiento del calendario de vacunación. Conclusiones. Si se quiere organizar un programa de vacunación exitoso en una comunidad pequeña y con recursos limitados para tratar a la población adolescente de alto riesgo, es crucial que el personal médico proporcione una información fiable. Las iniciativas de salud pública deben centrarse en disipar los temores de los progenitores sobre las vacunas. Asimismo, el hecho de asegurar una buena cooperación entre el personal médico y el Departamento de Salud Pública puede contribuir al éxito de la iniciativa. Por último, la involucración de pediatras y el uso de espacios específicos para la vacunación de la población adolescente pueden ayudar a generar un clima de confianza en progenitores y cuidadores.


[RESUMO]. Objetivo. Este estudo teve como objetivo descrever e avaliar de maneira crítica o programa de vacinação contra a COVID-19 para adolescentes de alto risco em Curaçao e dar informações sobre fatores importantes, como a hesitação vacinal dos pais e estratégias efetivas para comunicar e fornecer informações sobre a vacinação. Métodos. Este foi um estudo transversal. Era importante identificar os adolescentes entre 12 e 17 anos que tinham alto risco de infecção grave por COVID-19 devido à escassez de estabelecimentos de saúde na ilha; os adolescentes considerados de alto risco tinham obesidade, hipertensão arterial ou diabetes mellitus tipo 2. Esses adolescentes e seus cuidadores foram convidados por seus pediatras a serem vacinados como parte de um programa do Departamento de Saúde Pública de Curaçao. Esses pacientes de alto risco foram vacina- dos entre 30 de maio de 2021 e 25 de fevereiro de 2022 em espaços adaptados para adolescentes e com a presença de um pediatra para orientação e segurança. Os adolescentes receberam a vacina Pfizer-BioNTech COVID-19 na dose recomendada para a idade. O desfecho primário foi a descrição e a avaliação do comparecimento à vacinação. Os desfechos secundários foram os efeitos colaterais após a vacinação nas faixas etárias de 12 a 15 anos e de 16 a 17 anos. Os motivos de recusa ou não adesão também foram registrados. Resultados. No total, 51% (24/47) dos adolescentes convidados de 16 a 17 anos de idade foram vacinados, em comparação com 42% (26/69) dos adolescentes convidados de 12 a 15 anos de idade. No total, 46% desses adolescentes de alto risco foram vacinados, em comparação com 48% dos adolescentes de 12 a 17 anos sem fatores de risco. Na população do estudo, a maioria dos pacientes não apresentou nenhum efeito colateral e, quando presentes, os efeitos colaterais foram leves. Não foram observados casos de miocardite ou pericardite. A falta de confiança na vacina e a falta de priorização da vacinação ao programar as ativi- dades diárias foram fatores importantes para recusa e não adesão. Conclusões. Para organizar um programa de vacinação bem-sucedido em uma pequena comunidade com recursos limitados para o tratamento de adolescentes de alto risco, é fundamental que os profissionais médi- cos apresentem informações confiáveis. As iniciativas de saúde pública devem se concentrar em aliviar o medo dos pais em relação às vacinas. Além disso, garantir que haja boa cooperação entre os médicos e o Departamento de Saúde Pública pode ajudar no sucesso da implementação. Por fim, o envolvimento de pediatras e o uso de áreas


Subject(s)
COVID-19 Vaccines , Adolescent , Child , Vaccination Hesitancy , Public Health , Curacao , COVID-19 Vaccines , Adolescent , Child , Vaccination Hesitancy , Public Health , Curacao , COVID-19 Vaccines , Child , Vaccination Hesitancy , Public Health , Curacao
20.
Zootaxa ; 5277(2): 374-380, 2023 May 02.
Article in English | MEDLINE | ID: mdl-37518314

ABSTRACT

During field investigations of deep-reefs off the coast of Curaçao in the Lesser Antilles, Caribbean Sea, a female specimen was collected of an undescribed micro-pagurid crab with striking dorso-ventral flattening of the right cheliped. It was further characterized by a reduced branchial formula, fourth pereopods with grasping-like spines instead of typically pagurid rasp-like scales, nearly symmetrical uropods and telson, and a minute pair of first pleopods (gonopods). The single specimen was discovered in samples from the rariphotic zone (~130-309 m) obtained using a suction sampler operated from the manned submersible R/V Curasub over cryptic habitats and surfaces populated by communities of sessile macro-organisms. As the specimen does not fit any known pagurid taxon, we regard it to represent a new monotypic genus. We fully describe this new micro-pagurid as Raripagurus roseangelae n. gen., n. sp. and also provide photographs of its live coloration. The CO1 barcode for the holotype in the Barcode of Life Database and GenBank accession number are included as part of the description for any future phylogenetic investigations.


Subject(s)
Anomura , Female , Animals , Curacao , Phylogeny , Caribbean Region , Ecosystem
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