Pattern of Energy Drink Consumption and Associated Adverse Symptoms among University Students.

Aims: This study estimated the prevalence of energy drink consumption among students at the University of the West Indies (UWI), and describes the frequency of consumption and associated adverse symptoms. Study Design: A cross-sectional survey was conducted using a sex-stratified random sample of students residing in the halls of residence at the UWI, in Jamaica. Place and Duration of Study: The study was conducted at the Mona campus of UWI, between October 2011 and January 2012. Methodology: A self-administered questionnaire was used to obtain demographic data, use of energy drinks, frequency of use, symptoms associated with use and perception of benefits. Results: There were 607 participants, consisting of 336 (55.4%) females and 271 (44.6 %) males. The mean age was 20.7 years. Jamaicans constituted 80% of responders. Energy drinks were used by 450 participants (74.1%), with 288 (64%) being once weekly users, consisting of 160 males (74.8%) and 128 females (54.2%). There were 20 students (4.4%) who used energy drinks 2-3 times/week, 11 (2.4%) 4-6 times weekly, 3 (0.7%) were daily users. Adverse symptoms experienced were: palpitation in 133 (29.6%), headache in 64 (14.2%), and nervousness in 58 (12.9%). Insomnia occurred in 236 (52.4%) with 129 (54.7%) females and 107 (50%) males. Chest pain was reported by 27 (6.0%) and fainting occurred in 2 respondents. Perceptions reported about the use of energy drinks included, enhanced sport performance, 38.9%, improved academic performance, 60%, and improved sexual performance, 21.8% and improvement in daily activities (both mental and physical), 22.3%. Conclusion: Energy drink use is common among students on the halls of residence at UWI in Jamaica. Insomnia, palpitation and headache were the most common adverse symptoms, but students perceived benefits in their academic and daily activities.

Effect of coronary bifurcation angle on clinical outcomes in Chinese patients treated with crush stenting: a subgroup analysis from DKCRUSH-1 bifurcation study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Bifurcation angles may have an impact on the clinical outcomes of crush stenting. We sought to compare high (> or = 60 degrees ) with low (< 60 degrees ) bifurcation angle in patients who underwent either classical or double kissing (DK) crush stenting for bifurcation lesions from the DKCRUSH-1 data base.</p><p><b>METHODS</b>There were 212 patients with 220 lesions, some with low-angle (n = 138) and some with high-angle (n = 74). Angiography was indexed at 8-month after procedure. Primary endpoint was the occurrence of major adverse cardiac events (MACEs), defined as cardiac death, myocardial infarction and target lesion revascularization (TLR). Secondary endpoint included late lumen loss, the rate of restenosis, and final kissing balloon inflation (FKBI).</p><p><b>RESULTS</b>At 8 months, clinical follow-up was 100%; angiographic follow-up was 75% in the low-angle group and 83.3% in the high-angle group. There were no significant differences in the FKBI between the high-angle group (91.43%) and the low-angle group (82.39%). In the high angle group, there was a significant difference in contrast volume used (P = 0.005) but no significant difference in acute gain, minimum lumen diameter (MLD), late loss and diameter stenosis in the pre-bifurcation segment, post-bifurcation segment or side branch. When lesions were assigned into with-(n = 133) and without-FKBI (n = 42), significant side-branch late loss was seen in the group without-FKBI ((0.65 +/- 0.49) mm vs (0.47 +/- 0.62) mm, P = 0.02), with a resultant greater restenosis rate (37.68% vs 18.32%, P = 0.001). No difference was detected in the MACE free survival rate between the high and low angle groups (82.39% vs 82.36%, P = 0.84). The rate of stent thrombosis tended to be higher in the lower-angle group although there was no significant difference (P = 0.38). The TLR free survival rate was 87.2% in the with-FKBI group vs 73.5% in the without-FKBI group (P = 0.001). Cox regression analysis showed that the independent predictors for target vessel revascularization were the side branch stent MLD post stenting (hazard ratios (HR) 1.028, 95% CI 2.357 - 16.233, P = 0.002), lack of FKBI (HR 4.910, 95% CI 4.706 - 8.459, P = 0.001) and unsatisfactory kissing (HR 3.120, 95% CI 2.975 - 5.431, P = 0.001).</p><p><b>CONCLUSIONS</b>Bifurcation angles do not influence the clinical outcome of crush stenting. Successful final kissing balloon inflation, regardless of bifurcation angles, can predict TLR.</p>

Eletrodos com superfície fractal: princípios, tecnologia e resultados clínicos / Fractally-coated leads: principles, technology and clinical results

Este artigo aborda os fatos e achados clínicos relacionados ao revestimento fractal. A introdução, enfocando sucintamente o princípio do revestimento fractal, é seguida pela revisão das propriedades da estrutura. São feitas considerações sobre publicações de trabalhos clínicos que mencionam tal tecnologia. A principal característica do revestimento fractal é sua superfície ativa ser aproximadamente 1.000 vezes maior que eletrodos de área equivalente, do que decorrem as três vantagens desta tecnologia: captação dos sinais intracardíacos sem distorção (potencial de ação monofásico / "Monophasic Action Potential - MAP " / potencial evocado), ausência do efeito de polarização e transferência de carga otimizada. Conseqüentemente, os limiares de estimulação agudo e crônico desses eletrodos são comparáveis àqueles observados em eletrodos com liberação de esteróides. Este artigo também trata das novas tendências em eletrodos cardíacos implantáveis, apresentando o que vem sendo pesquisado atualmente na área

Domestic and School Violence Among High School Students in Jamaica

This study determined the prevalence of domestic and school violence among high school students in Jamaica. A self-report questionnaire was administered to 3,124 students (1,468 boys and 1,657 girls) from 34 randomly selected high schools in 13 of the 14 parishes in Jamaica. There were 1,590 tenth graders (mean age 16 years) and 1,534 eleventh graders (mean age 17 years). One thousand six hundred and seventeen students were from rural and 1,507 from urban communities and 1,642 and 1,482 were children of professionals and nonprofessionals, respectively. The results revealed that 78.5 percent of the students had witnessed violence in their communities, 60.8 percent in their schools, and 44.7 percent in their homes. Twenty-nine percent of the students had caused injury to persons. Several weapons and techniques were used by the students during violent acts and these included the use of hands or feet 59.8 percent, nasty words 59.1 percent, kicks and punches 54.5 percent, blunt objects 26.5 percent, knives 18.4 percent, ice picks 9.3 percent, machetes 8.9 percent, scissors 8.5 percent, forks 7.5 percent, guns 6.9 percent, other weapons (e.g. bottles, dividers) 6.7 percent, acids 5.5 percent, and alkalis 4.9 percent. Significantly higher numbers of boys, 10th graders, and urban students indicated that they used more of the 14 weapons than girls, 11th graders and rural students, respectively. Effective programmes are urgently need to address the high rate of violence recorded in this study among high school youths in Jamaica.

Interferências da telefonia celular em marcapassos cardíacos implantáveis / Cellular phone interference with permanent cardiac pacemakers

O avanço tecnológico produz continuamente equipamentos que podem ser fontes potenciais de interferências eletromagnéticas para os marcapassos cardíacos artificiais implantáveis. O principal objetivo deste trabalho é fornecer esclarecimentos aos profissionais que atuam na área de estimulação cardíaca artificial sobre o potencial de interferência dos telefones celulares analógicos e digitais sobre os marcapassos cardíacos, para que o paciente portador de marcapasso cardíaco implantável seja orientado de forma adequada quanto à sua utilização

Hepatic cirrhosis in Jamaica

The aetiology, biochemistry, clinical features and complications of histologically confirmed hepatic cirrhosis in 45 patients (26 females, 19 males) seen at the University Hospital of the West Indies, Jamaica, between 1984 and 1994 was presented. The age range was 1 to 72 years (mean 48 years). Abdominal swelling and weight loss were the commonest symptoms, occurring in 51 percent and 47 percent of patients, respectively. Jaundice was a presenting feature in 44 percent. Hepatomegaly was present in 71 percent of patients and splenomegaly in 33 percent. The aetiological factors were: alchol (36 percent), bush tea (18 percent), chronic active hepatitis (11 percent), drugs (7 percent), and haemochromatosis (2 percent). Hepatitis B surface antigen was detected in 2 of 20 patients tested. 24 percent of the patients also had diabetes mellitus, 29 percent were anaemic, 29 percent were thrombocytopenic, 4 percent were leukopenic, and the prothrombin time was prolonged in 22 percent. The albumin/globulin ratio was reversed in 71 percent of the patients. The alkaline phosphatase was elevated in 56 percent, the aspartate aminotransferase was increased in 58 percent and the gamma glutamyl transpeptidase in 56 percent. 56 percent of the patients had macronodular cirrhosis; the liver showed a micronodular pattern in 18 percent; 7 percent had biliary cirrhosis; 7 percent chronic active hepatitis with cirrhosis; and 13 percent showed a mixed macro-micronodular pattern. Ascites and fluid overloaded developed in 44 percent of the patients. Hepatic encephalopathy occurred in 18 percent and upper gastrointestinal bleeding in 18 percent.

Childhood portal hypertension in Jamaica

Portal hypertension and bleeding from oesophageal varices in children remain a difficult medical problem. The clinical course and management of children with portal hypertension seen over a 14-year period was reviewed. There were 5 females and 2 males with a mean age of 3.6 years at presentation. Five patients presented with severe upper gastrointestinal bleeding and two with severe hypersplenism. All patients had extra-hepatic portal hypertension. Five patients were treated with endoscopic sclerotherapy, including one who had bleeding five years post-splenectomy. A mean of 9 sclerotherapy sessions was performed in each patient. Complete obliteration of varices was not achived in any patient and a single rebleeding episode occurred in four. Three children underwent operative management consisting of splenectomy in two and splenectomy and central spleno-renal shunt in one. There was no mortality in either group after a mean follow-up of 4.3 years. Sclerotherapy may not be totally successful in long-term management of childhood portal hypertension. Surgical therapy or a combination of sclerotherapy and surgery may be the best approach

Peptic ulcer disease and Jamaican patients' awareness of their disorders

In the management and prevention of recurrence of peptic ulcer disease, patients' awareness of their disorder is essential. Fifty-one patients with peptic ulcer disease were studied regarding their awareness of their disorder and compliance with medications. There were 30 women and 21 men with a mean age of 45 years. Thirty-five per cent had secondary school education; 22 per cent had tertiary training and 10 per cent had no formal education. Sixty-three per cent of patients knew their ulcer location but 37 per cent were unaware of their diagnosis. Twenty-nine per cent received most of their information from their pharmacists. Twenty per cent of patients smoked cigarettes; 31 per cent drank alcohol, and 14 per cent took non-steroidal analgesics. Seventy-six per cent thought that poor eating habits were a contributory cause of their ulcer, 39 per cent thought that stress was a cause and 16 per cent implicated heredity. Seventy-six per cent of patients took their medications daily, and 24 per cent only when symptomatic. Jamaican patients' awareness of their ulcer disease is inadequate. There is a need for more physician education of their patients as well as public health promotion about peptic ulcer disease.

Helicobacter pylori in patients undergoing upper endoscopy in Jamaica

One hundred and two consecutive patients undergoing upper gastrointestinal endoscopy were tested for H. pylori by a rapid urease test, using antral biopsy specimens. There were 60 men (mean age 54 yrs) and 42 women (mean age 49 yrs). Fifty-six patients (55//) were positive for H. pylori. Of male patients, 36 (60//) and of female patients, 20 (48//) tested positive. Sixty-eight per cent of patients with antral gastritis, 65//with duodenal ulcer and 60//with gastric ulcer had H. pylori. Thirty-nine patients (70//) positive for H. pylori were from major urban areas, and 17 (30//) were from rural areas of Jamaica. In patients without H. pylori, 61//and 39//were from urban and rural areas respectively. Forty-four patients (79//) with H. pylori and 40 (87//) without H. pylori had piped water in their homes. Ninety-three per cent of all patients had electricity and 88//had refrigeration. There was no difference between patients positive or negative for H. pylori with regard to the use of alcohol, marijuana or tobacco. There was also no difference between both groups in exposure to domestic animals in the home environment. H. pylori is associated with antral gastritis and peptic ulcer disease in Jamaican patients. There are no specific environmental or social factors that seem to predispose to infection.

Comparison of three bowel preparation for sigmoidoscopy

The efficacy of three lower bowel preparations in 96 patients undergoing rigid sigmiodoscopy was studied. The maximal length of insertion and clarity of view were assessed in each group and compared to patients without bowel preparation. Blood per rectum and diarrhoea were the main indications for sigmoidoscopy. The maximal insertion of the instrument was similar for all groups and the rectosigmoid junction was examined in the majority. The clarity of view was good in 71 per cent of patients receiving Fleet enema, 68 per cent of those receiving Dulcolax micro-enema, 36 per cent in the Dulcolax suppository and 16 per cent in the group without bowel preparation. There were no adverse effects or complications arising from bowel preparation or sigmoidoscopy. Bowel preparation significantly improves the number of satisfactory sigmoidoscopic examinations, and the use of simple disposable enemas is safe and effective.

Cavernous haemangioma of the duodenum: a rare case of gastrointestinal bleeding

Vascular malformations (VMs), including haemangioma, of the upper gastrointestinal tract, are rare causes of bleeding. Bleeding from these lesions is often recurrent and diagnosis is often delayed for months to years. A patient with severe, recurrent upper gastrointestinal bleeding requiring repeated hospitalization and blood transfusions is presented. Upper endoscopy, barium meal and small bowel enteroclysis were negative. Selective mesenteric angiography revealed a VM in the second part of the duodenum. Segmental resection of the duodenum was performed and microscopial examination showed cavernous haemangioma. VM should be considered in patients with recurrent gastrointestinal bleeding and negative conventional investigations. Mesenteric angiography may be the only investigation which will identify these leisons. Results after excision are excellent.

Chronic pancreatitis in Jamaica

Thirty-five patients with chronic pancreatitis (CP) treated with over a 15-year period were studied. There were 29 men and 6 women with a mean age of 47 years (range 21-67). Twenty-seven (77%) were chronic alcoholics, two (6%) had gallstones, one had stenosis of the Ampulla of Vater and in five (14%) no obvious cause was found. Thirty patients (86%) presented with abdominal pain. Chronic diarrhoea was present in 8 (23%), and steatorrhoea was documented in 6 of these. Fifteen (43%) had pancreatic calcifications. Five developed pseudocysts and 16 (46%) developed diabeted mellitus. Twelve patients required surgery. Three continue to have severe recurrent relapses of pain but the majority (91%) have had a relatively stable course with medical management.

Campylobacter jejuni diarrhoea in humans

Campylobacter jejuni, a gram negative rod, is a common cause of acute bacterial diarrhoea. It is transmitted to humans from domestic animal and poultry reservoirs through contaminated water, milk and food. It affects all age groups but especially the young. The majority of patients have a mild self-limiting diarrhoeal illness which is often preceded by constitutional symptoms. Erythromycin is indicated in those more severely affected. Prevention consists of good hygienic practice in the preparation of food and after contact with animals, animal products and infected individuals