A Comparative Survey of Pacemaker Implantation in Trinidad and Tobago in 2005 and 2009.

OBJECTIVE: The indications for permanent pacemaker implantations in Trinidad have expanded from initially symptomatic bradycardia to now include complex devices. A retrospective review of the available data was conducted to better understand the evolving trends in device implantation in Trinidad and Tobago. METHODS: Data were collated from the two major implanting teams in Trinidad for the years 2005 and 2009. The two implanting centres were the Advanced Cardiovascular Institute (ACI) at Westshore Medical Centre and the Catheterization Laboratory of the Eric Williams Medical Sciences Complex (EWMSC). Data were based on retrospective collation using the implantation records. RESULTS: The implantation rate for new devices increased from 39 per million to 103 per million population. The most common indications for new device implants in 2009 were high degree atrioventricular (AV) block (53%) and sick sinus syndrome (22%) with the notable appearance of congestive cardiomyopathy (13%) which was not present in the earlier cohort. Of particular note, 23 high-end devices were implanted in 2009. These were five cardiac-resynchronization therapy (CRT-P) devices, 14 automatic implantable cardio-defibrillator (AICD) devices and four combined cardiac-resynchronization therapy with defibrillator (CRT-D) devices versus none in 2005. CONCLUSIONS: In summary, over the period 2005 to 2009, a substantial increase in device implantation rates has occurred which now include high-end, complex devices. Absolute rates, however, remain far below that of developed countries, indicating that the true need remains underserved. Furthermore, adjustment for gross domestic product suggests that the relatively buoyant economy of Trinidad and Tobago is capable of servicing a greater proportion of this need than is currently met.

Knowledge, attitudes and practices of anabolic steroid usage among gym users in Trinidad.

Self-administered questionnaires were completed by 1062 gym-users in 14 gyms in Trinidad from February 1997 to July 1997 to determine the knowledge, attitudes and practices regarding anabolic steroids (AS). Five hundred and sixty (52.7%) females and 502 (48.3%) males completed the questionnaire. Half of the total sample were individuals in the 20 to 29 year age group. From the 17 questions that tested knowledge about AS, the median number of correct responses was 7 with a mode of 8. Increased muscle mass was correctly identified as one of the effects of AS by 841 respondents (79.2%), while 249 (23.6%) of the total sample thought asthma was treated with AS. Most (872 or 82.1%) felt that their knowledge about AS was inadequate and 700 (66.0%) were of the opinion that AS should be banned from use in competitive sports. Similarly, 733 (70.0%) of the gym-users thought AS should only be available by prescription. Thirty respondents reported having used AS (2.9%, 95% CI 2.0-4.1). The prevalence of AS use was higher among males than females (p < 0.001). Improvement of physical appearance and not competitive advantage in sport was the main reason cited for AS use. Anabolic steroid users knew more about the adverse effects of AS than non-AS users but the therapeutic uses of AS were comparatively less well known. This study demonstrated a general lack of knowledge concerning AS use and that a small but significant proportion of persons using gyms admitted to abusing AS.

Patterns of arteriosclerotic lesions of the lower extremity in a West Indian population based on angiographic findings and ethnicity.

INTRODUCTION: This study aimed to determine whether ethnic differences show different patterns of arterial disease in the lower limb. METHODS: A prospective analysis of 100 consecutive patients with 160 lower limb arteriograms was performed looking at the pattern of disease with relation to ethnicity in Trinidad and Tobago. RESULTS: There were 53 male and 47 female patients with an age range of 43-90 years (mean: 66 years). Of the 100 patients, 45 were of East Indian descent, 36 of Afro-Caribbean descent, 14 of mixed descent and 5 had other backgrounds. There were 32 smokers and 69 diabetics. The most commonly affected artery in East Indians was the anterior tibial artery (ATA, 70%) followed by the peroneal artery (60%), superficial femoral artery (SFA, 60%), posterior tibial artery (PTA, 57%) and tibioperoneal trunk (TPT, 39%). In Afro-Caribbeans, the most commonly affected artery was the ATA (79%) followed by the PTA (74%), peroneal artery (66%) and TPT (55%). The mixed group showed the PTA (85%) to be most diseased followed by the peroneal artery (75%), ATA (70%), SFA (70%), dorsalis pedis artery (DPA, 60%) and TPT (50%). Overall, the most diseased vessel in all groups was the ATA (73%) followed by the PTA (66%), peroneal artery (64%), SFA (59%), TPT (46%), DPA (38%), popliteal artery (31%) and medial plantar artery (MPA, 29%), with the proximal vessels not being affected severely. CONCLUSIONS: Ethnic divisions were only statistically significant (p<0.05) with East Indians showing worse disease in the profunda femoris artery and Afro-Caribbeans showing worse disease in the PTA, DPA and MPA. This suggests that environmental factors may play a significant role in the disease process including smoking and dietary factors rather than purely genetics.

Knowledge, attitudes and practices of anabolic steroid usage among gym users in Trinidad

Self-administered questionnaires were completed by 1062 gym-users in 14 gyms in Trinidad from February 1997 to July 1997 to determine the knowledge, attitudes and practices regarding anabolic steroids (AS). Five hundred and sixty (52.7 percent) females and 502 (48.3 percent) males completed the questionnaire. Half of the total sample were individuals in the 20 to 29 year age group. From the 17 questions that tested knowledge about AS, the median number of correct responses was 7 with a mode of 8. Increased muscle mass was correctly identified as one of the effects of AS by 841 respondents (79.2 percent), while 249 (23.6 percent) of the total sample thought asthma was treated with AS. Most (872 or 82.1 percent) felt that their knowledge about AS was inadequate and 700 (66.0 percent) were of the opinion that AS should be banned from use in competitive sports. Similarly, 733 (70.0 percent) of the gym-users thought AS should only be available by prescription. Thirty respondents reported having used AS (2.9 percent CI 2.0-4.1). The prevalence of AS use was higher among males than females (p<0.001). Improvement of physical appearance and not competitive advantage in sport was the main reason cited for AS use. Anabolic steroid users knew more about the adverse effects of AS than non-AS users but the therapeutic uses of AS were comparatively less well-known. This study demonstrated a general lack of knowledge concerning AS use and that a small but significant proportion of persons using gyms admitted to abusing AS.

Knowledge, attitudes and practices of anabolic steroid usage among gym users in Trinidad

Self-administered questionnaires were completed by 1062 gym-users in 14 gyms in Trinidad from February 1997 to July 1997 to determine the knowledge, attitudes and practices regarding anabolic steroids (AS). Five hundred and sixty (52.7 percent) females and 502 (48.3 percent) males completed the questionnaire. Half of the total sample were individuals in the 20 to 29 year age group. From the 17 questions that tested knowledge about AS, the median number of correct responses was 7 with a mode of 8. Increased muscle mass was correctly identified as one of the effects of AS by 841 respondents (79.2 percent), while 249 (23.6 percent) of the total sample thought asthma was treated with AS. Most (872 or 82.1 percent) felt that their knowledge about AS was inadequate and 700 (66.0 percent) were of the opinion that AS should be banned from use in competitive sports. Similarly, 733 (70.0 percent) of the gym-users thought AS should only be available by prescription. Thirty respondents reported having used AS (2.9 percent CI 2.0-4.1). The prevalence of AS use was higher among males than females (p<0.001). Improvement of physical appearance and not competitive advantage in sport was the main reason cited for AS use. Anabolic steroid users knew more about the adverse effects of AS than non-AS users but the therapeutic uses of AS were comparatively less well-known. This study demonstrated a general lack of knowledge concerning AS use and that a small but significant proportion of persons using gyms admitted to abusing AS.(Au)

Knowledge, attitude and practice of anabolic steroid usage among gym users in Trinidad

Self-administered questionnaires were completed by 1062 gym users in 14 gyms in Trinidad from February to July. 1997 tp determine , attitude and practices regarding anabolic steroids (AS). Five hundred and sixty (53 percent) females and 502 (48 percent) males participated with half of the total sample in the 20 to 29 year age group. From the 17 questions which tested knowledge about AS, the median number of correct responses was 7 with a mode of 8. Increased muscle mass was correctly identified as one of the effects of AS by 841 respondents (79 percent), while 249 (24 percent) of the total sample thought that asthma was treated with AS. Most (872 or 82 percent) felt that their knowledge about AS was inadequate and 700 (66 percent) were of the opinion that AS should be banned from use in competition. Similarly, 733 (70 percent) of the gym users thought AS should be available only by prescription. Thirty respondents reported having used AS (2.9 percent, 95 percent CI 2.0-4.1) and the prevalence of AS use was higher among males than females (X = 13.28, p<0.001, df = 1). Improvement of physical appearance was one of the main reasons cited for AS use. AS users knew more about the adverse effects of AS than non-AS users. However, the therapeutic uses of AS were comparatively less well known amongst both AS and non-AS gym-users. This study demonstrates a lack of knowledge about AS among the gym users and a prevalence of AS use of 2.8 percent which may be an underestimation due to the self-reporting nature of the questionnaire.(AU)