ABSTRACT
Background/Objective@#Coronary Artery Disease (CAD) is the leading cause of mortality among patients with type 2 diabetes mellitus. Several studies evaluated glycemic control and MPS resultswith good correlation. In the Philippines, data concerning this matter are few, hence this study.@*Methodology@#This is a cross-sectional study of selected Filipino patients with type 2 diabetes mellitus without previous cardiac events who underwent stress or pharmacologic stress MPS (TI-201 or Tc-99m sestamibi) over an 18-month period at the Philippine Heart Center. Electrocardiogram and 2D echocardiogram results were also noted. Patients were grouped into adequate glycemic control (HbA1c<7.0%) and inadequate glycemic control (HbA1c >7.0%). Binary logistic regression was computed to determine association of glycemic control to MPS defects. @*Results@#A total of 206 subjects (114 HBa1C <7.0%, 92 with HbA1c ? 7.0%), were included in the study; with male predominance. Mean HbA1c values showed direct correlation; the higher the HbA1c values, the more MPS defects. Inadequate glycemic control group had significanlty higher subjects with mild and moderate to severe degree of myocardial ischemia (p<0.001). the relative risk of having a significant CAD in the inadequate glycemic control group is 4.30 times more than their counterpart (p<0.001). Factoring the duration of inadequate glycemic control to > 10 years, relative risk increased to 7.63@*Conclusion@#The study shows that patients with type 2 diabetes mellitus with inadequate glycemic control have increased MPS defects and highter relative risk for having significant CAD. Diabetic patients with inadequate glycemic control for > 10 years have an even higher risk of having significant CAD.
Subject(s)
Myocardial Perfusion Imaging , Coronary Artery Disease , Diabetes Mellitus, Type 2 , Glycated Hemoglobin , Diabetes ComplicationsABSTRACT
Between September 1998 and February 2003, 204 children underwent cardiac surgery in Trinidad and Tobago to correct or palliate congenital heart disease. The defects included isolated ventricular or atrial septal defects as well as tetralogy of fallot and coarctation of the aorta. A few patients also had complex cyanotic congenital heart disease. The patients ranged in age from 2 days to 17 years. In some cases, palliative surgery was undertaken as a first step towards complete correction but the majority of patients underwent complete repair. The commonest postoperative complications were haemorrhage and small transient pericardial effusions. The overall mortality rate was < 1. This paper describes the cardiac lesions, post-operative morbidity and mortality of these patients
Entre septiembre de 1998 y febrero de 2003, 204 niños fueron sometidos a cirugía cardíaca en Trinidad y Tobago, a fin de corregir o paliar la enfermedad cardíaca congénita. Las cardiopatías incluían defectos septales atriales o venticulares aislados, así como tetralogía de Fallot y coartación de la aorta. Algunos pacientes también presentaban cardiopatía congénita cianótica compleja. Los pacientes tenían edades que fluctuaban de dos días a 17 años. En algunos casos, la cirugía paliativa se emprendió como un primer paso hacia la corrección completa pero a la mayoría de los pacientes se les practicó la reparación completa. Las complicaciones más comunes del post-operatorio fueron hemorragias y pequeñas efusiones pericadiales transitorias. La tasa general de mortalidad fue <1%. Este trabajo describe las lesiones cardíacas, la morbilidad y mortalidad post-operatoria de estos pacientes.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Heart Defects, Congenital/surgery , Cardiac Surgical Procedures , Palliative Care , Postoperative Complications/epidemiology , Postoperative Complications/mortality , Morbidity , Trinidad and TobagoABSTRACT
Se revisa la casustica, complicaciones y mortalidad del traumatismo encefalo craneano grave, en la Unidad de Terapia Intensiva del Hospital de Clinicas Santa Barbara desde febrero del 2001 hasta agosto del 2003. ademas analizar, el protocolo de tratamiento medico.
Subject(s)
Humans , Male , Female , Brain Injuries , Multiple Trauma/classification , Multiple Trauma/diagnosis , Brain Edema , Brain Injuries , Encephalocele , Hematoma, SubduralABSTRACT
The first twenty-one cases of Paediatric Acquired Immunodeficiency Syndrome (PAIDS) in Trinidad and Tobago were studied. An overwhelmingmajority of patients were of African descent. Most of the children presented within the first year of life, the average time between presentation and death was and a half months, and the majority presented with either diarrhoea or pneumonia or failure to thrive, common conditions in the West Indies. Fever lasting longer than two weeks as well as hepatomegaly were clues which led to a definite diagnosis
Subject(s)
Humans , Infant , Child, Preschool , Male , Female , Acquired Immunodeficiency Syndrome/epidemiology , Diarrhea/etiology , Failure to Thrive/etiology , Hepatomegaly/etiology , Acquired Immunodeficiency Syndrome/mortalityABSTRACT
The availability of drugs and the supply systen in Jamaica were examined. The Jamaica Commodity Trading Company imports all drugs through an international tendering system for the public health sector, and vital drugs for private distributors. For the 18-month period from January 1988, 652 awards were made, consisting of 426 (65%) brand and 226 (35%) generic drugs. There were several strengths and formulations for many drugs, including 19 preparations of 2 antibiotics. The University Hospital of the West Indies (UHWI) has been experiencing recurrent delays in the supply of several important drugs. In contrast, the private hospitals and pharmacies surveyed were adequately supplied. Many brands of several classes of drugs were available, including 51 antibiotics 18 different anti-inflammatory analgesic and anti-hypertensive agents. However, several drugs used in special situations were only available at the UHWI. There is a need for the supply of drugs to be a priority in the public health sector and for the use of several drugs to be rationalized
Subject(s)
Humans , Pharmaceutical Preparations/adverse effects , Pharmaceutical Preparations/supply & distribution , Drug Therapy , Hospitals , Delivery of Health Care , Medication SystemsABSTRACT
Os autores fazem uma revisäo da técnica cirúrgica empregada para o tratamento de aneurismas da aorta ascendente associados a lesöes da valva aórtica. Apresentam resultados obtidos com 11 (onze) pacientes operados pela técnica de BENTALL e DE BONO, com enxerto tubular valvulado aberto de pericárdio bovino IMC, sem mortalidade devida à técnica ou ao enxerto utilizado. Desses pacientes, 8 eram do sexo masculino, com idades variando entre 31 e 65 anos, média de 50 anos; 3 eram do sexo feminino, com idade entre 20 e 53 anos, média de 38 anos. Duas cirurgias foram realizadas, em regime de urgência, e 9 de emergência. O tubo de pericárdio bovino utilizado foi de n§ 23 em 1 caso, n§ 25 em, 2, n§ 29 em 6 e n§ 31 em dois casos. Dois pacientes tiveram lesäo mitral associada com troca valvar (prótese biológica IMC). Um paciente necessitou de ponte de veia safena para coronária direita, por dissecçäo do óstio coronário. O diagnóstico histopatológico mostrou: degeneraçäo mixomatosa em 4 casos, fibrose em 4 casos, doença reumática cicatrizada em 2 casos e pancardite em apenas 1 caso. Após discorrerem sobre dificuldades e complicaçöes do método, concluem que a técnica utilizada é a de escolha no tratamento da referida patologia e que o tubo valvulado de pericárdio bovino facilita o ato cirúrgico, por sua alta flexibilidade e por ser altamente hemostático, näo necessitando de medidas pré-coagulativas