ABSTRACT
We describe a case of Kaposi's sarcoma in a previously healthy 35-year-old bisexual West Indian man of African descent who was seronegative for the human immunodeficiency virus (HIV) and human T-cell lymphotropic virus-1 (HTLV-1) and who presented with extensive mucocutaneous lesions, weight loss, visceral and generalized lymph node involvement, poor response to combination therapy with vinblastine and interferon alfa-2a, and a short survival of eight months from the onset of illness. This is the first documented case of Kaposi's sarcoma in Dominica. The presentation is unusual in that it is similar to the aggressive and disseminated Kaposi's sarcoma seen only in AIDS and the florid variant of the endemic disease in young men in Equatorial Africa.
Subject(s)
Adult , Humans , Male , Sarcoma, Kaposi , HIV Seronegativity , Skin Neoplasms/diagnosis , Sarcoma, Kaposi , Vinblastine , Interferon-alpha , Antineoplastic Agents, Phytogenic/therapeutic use , Fatal Outcome , Skin Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic useABSTRACT
Neuropsychiatric manifestations of typhoid fever are not uncommon, occurring in 18 of 40 consecutive patients at the University Hospital of the West Indies. The clinical presentation ranges from a confusional state to hallucinations or meningism, and the diagnosis may be missed or unduly delayed unless there is a strong index of suspicion
Subject(s)
Child, Preschool , Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Typhoid Fever/complications , Delirium/etiology , Cohort Studies , Delirium/epidemiology , Jamaica , Hospitals, UniversityABSTRACT
Although the Doctor of Medicine programme in Internal Medicine at the U. W. I. is a structured course with several teaching formats, the optimally effective form of reaching remains unknown. An experimental didactic teaching course in Gastroenterology was preceded and followed by an examination. This was conducted to determine the effectiveness of this form of teaching. The maajority of residents ranked the course favourably. the mean examination score increased by 6.4%, form 25.4% before the course to 31.8% at the end. Although the more senior residents scored higher than their juniors in the pre-test, this difference disappeared in the post-test. Structured didactic teaching requirs close supervision, active participation by trainee and reinforcement for the full benefit to be attained
Subject(s)
Humans , Teaching , Education, Medical, Continuing/standards , Gastroenterology/education , Clinical Competence , JamaicaABSTRACT
This report of a 30-year-old male Jamaican presenting with severe refractory hypertension describes the uncommon association between renal artery stenosis and neurofigromartosis, and seves to focus attention upon this potentially secondary cause of hypertension in such patients
Subject(s)
Adult , Humans , Male , Renal Artery Obstruction/complications , Skin Neoplasms/complications , Neurofibromatoses/complications , Hypertension/etiology , JamaicaABSTRACT
This report describes the main features of the 5 cases of polyarteritis nodosa seen at the University Hospital of the West Indies over a 10-year period. The disease manifestations are protean and only 2 of the 5 patients were diagnosed antemortem, indicating the need to increase physician awareness, especially since response to therapy has improved significantly in recent years
Subject(s)
Adult , Middle Aged , Humans , Male , Polyarteritis NodosaABSTRACT
A 61-year-old blackhousewife, discovered to be hypertensive 37 years previously, was found to have coarctation of the proximal descending aorta. This disorder is only rarely diagnosed beyond the sixth decade. As coarctation of the aorta is uncommon and may remain undetected as a cause of secondary hypertension in adults, this case highlights the need for proper physical evaluation in all patients. The assumption that coarctation of the aorta is rare in vlacks may be due to inadequate diagnostic facilities available to this population