Subject(s)
Humans , Male , Penile Prosthesis , Penile Implantation , Diabetes Mellitus , Erectile Dysfunction/surgery , Salvage TherapyABSTRACT
A 74-year old man presented with recurrent attacks of altered sensorium, sometimes with abrupt falls, against the background of a long history of chronic obstructive airways disease and ischaemic heart disease. Investigations revealed evidence of significant cardiac conduction abnormalities and this led to the insertion of a permanent pacemaker. However, he continued to have recurrent 'syncopal'attacks. He was hospitalized to clarify the nature and aetiology of these attacks. Multiple stereotyped events were observed by different medical personnel, lasting up to two hours in duration. An attack was terminated by the administration of intravenous diazepam. Subsequent initiation of anti-epileptic drugs led to the complete abolition of these episodes. He has remained event-free since then ie two years. Because of multiple co-morbidities, the elderly present a greater diagnostic challenge in the evaluation of paroxysmal alterations in sensorium. It is essential that epilepsy, particularly with non-convulsive seizures, be included in the differential diagnosis whenever evaluating these patients.
Subject(s)
Aged , Humans , Male , Anticonvulsants/therapeutic use , Diazepam/therapeutic use , Epilepsy/drug therapy , Recurrence , Syncope/drug therapy , Diagnosis, Differential , Diazepam/administration & dosage , Epilepsy/complications , Epilepsy/diagnosis , Age Factors , Risk Factors , Syncope/etiologyABSTRACT
Intracoronary stent implantation resulted in the complete or near complete dilatation of high grade occlusions of the left anterior descending coronary arteries in the four patients in whom it was undertaken. Intracoronary stent implantation is a useful adjunct to Percutaneous Transluminal Angioplasty (PTCA) and is applicable in selected patients with symptomatic ischaemic heart disease in a developing country with limited health resources like Jamaica. This is so since financial data presented here document the significant savings this technique (when appropriately utilised) could realise compared to the use of balloon angioplasty alone.
Subject(s)
Aged , Humans , Male , Middle Aged , Stents , Coronary Disease , Angioplasty, Balloon/methods , Stents , Coronary Disease , Electrocardiography , Jamaica , Angioplasty, Balloon/economics , Cost SavingsABSTRACT
Although percutaneous balloon mitral valvuloplasty has been performed in the Caribbean before, there has not been any detailed description in the English-speaking West Indian Medical literature hitherto. This report provides a description of the first four cases of percutaneous balloon mitral valvuloplasty performed in Jamaica.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Child , Catheterization , Rheumatic Heart Disease/therapy , Mitral Valve Stenosis/therapy , Rheumatic Heart Disease , Echocardiography, Transesophageal , Mitral Valve Stenosis , Jamaica , Recurrence , Treatment OutcomeABSTRACT
This is the first detailed report from the Anglophone Caribbean of percutaneous transluminal coronary angioplasty (PTCA). The procedure resulted in complete dilatation of the occluded vessels in the five patients in whom it was undertaken, with significant improvement in exercise duration in the Bruce protocol (p < 0.001; 95CI 2.5 to 4.1 minutes) in the four patients who were studied. PTCA can be undertaken in developing countries with limited resources, and should be offered to selected patients with symptomatic coronary artery disease who need a revascularisation procedure.