Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 409
Filter
1.
Braz. j. biol ; 83: e248493, 2023.
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1339399

ABSTRACT

Abstract Parasites of veterinary importance have been heavily focused on domesticated livestock that was introduced into the neo-tropics. The text used in the teaching parasitology to veterinary students in Trinidad has only investigated the parasites of domesticated species. In the reviewed veterinary parasitology text no mention was made on the parasites that affect wild neo-tropical animals. Information on wild neo-tropical animals had to be sourced from texts on the management of wild life animals in the Neotropics. The texts that were reviewed in this document spanned from the mid-1950s to 2020. The information presented in this review reveals the exhaustive work done on the parasites of domesticated species but also revealed little information on neo-tropical animals with the potential for domestication. In conclusion, this review reveals the gap of information that is missing from parasitology texts used in the teaching of veterinary students. In the future these parasitology texts can be revised to include chapters on the parasites of neo-tropical animals with the potential for domestication. At present students that graduate from the veterinary parasitology course has little information on the parasites of animals which are present in their 'backyards'.


Resumo Parasitas de importância veterinária têm se concentrado fortemente em animais domésticos que foram introduzidos na região neotrópica. O texto usado no ensino de parasitologia para estudantes de veterinária em Trinidad investigou apenas os parasitas de espécies domesticadas. No texto de parasitologia veterinária revisado, nenhuma menção foi feita sobre os parasitas que afetam os animais selvagens neotropicais. As informações sobre animais selvagens neotropicais tiveram que ser obtidas a partir de textos sobre o manejo de animais selvagens nos Neotrópicos. Os textos revisados neste documento vão de meados da década de 1950 até 2020. As informações apresentadas nesta revisão revelam o trabalho exaustivo realizado sobre os parasitas de espécies domesticadas, mas também revelaram poucas informações sobre animais neotropicais com potencial para domesticação. Em conclusão, esta revisão revela a lacuna de informação que existe nos textos de parasitologia utilizados no ensino de estudantes de veterinária. No futuro, esses textos de parasitologia podem ser revisados ​​para incluir capítulos sobre os parasitas de animais neotropicais com potencial para domesticação. Atualmente, os alunos que se formam no curso de parasitologia veterinária têm poucas informações sobre os parasitas de animais que estão presentes em seus "quintais".


Subject(s)
Humans , Animals , Education, Veterinary , Animals, Wild , Schools, Veterinary , Students , Trinidad and Tobago , Universities
2.
Braz. j. biol ; 83: e246781, 2023. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1285625

ABSTRACT

Abstract The agouti (Dasyprocta leporina) is a rodent that is found in the Neo-tropical region. This animal is hunted for its meat but has recently been reared in captivity as a source of meat protein in rural communities. A 20-month experiment was carried out to evaluate the effect of an anthelmintic on the reproductive performance of the agouti (Dasyprocta leporina) reared in captivity. This experiment was conducted in the humid tropics of Trinidad and Tobago. Sixteen animals (15 females, 1 male) placed in each of the two treatment groups in a completely randomized study design. In treatment 1 (T1) animals were given subcutaneous injections of Endovet Ces® (Ivermectin/Praziquantel) at 0.2 mg/kg every three months. Treatment 2 (T2) was the negative control group where animals were not exposed to an anthelmintic. Reproductive data were collected at parturition which included birth weight, litter weight, litter size and gender of offspring. The results showed that there was no statistical difference (p > 0.05) between the treatment groups with respect to birth weight, litter weight, litter size and gender. However, agoutis that were dewormed had a higher birth weight (220.24 g vs 209.1 g) and litter weight (369.8 g vs 343 g). The same values were obtained for the litter size (1.7 vs 1.7) and animals that were dewormed had a higher female offspring to male offspring (2.41:1 vs 1.11:1). This experiment demonstrated that the use of an anthelmintic strategically in the management of captive reared agoutis had no statistical effect (p > 0.05) on the reproductive parameters. Therefore, these animals can be kept in captive conditions without being dewormed and produce efficiently with proper feeding and housing management.


Resumo A cutia (Dasyprocta leporina) é um roedor que se encontra na região neo-tropical. Esse animal é caçado por sua carne, mas recentemente foi criado em cativeiro como fonte de proteína de carne em comunidades rurais. Um experimento de 20 meses foi realizado para avaliar o efeito de um anti-helmíntico no desempenho reprodutivo de cutias (Dasyprocta leporina) criadas em cativeiro. Esse experimento foi conduzido nos trópicos úmidos de Trinidad e Tobago. Dezesseis animais (15 fêmeas, 1 macho) colocados em cada um dos dois grupos de tratamento em um desenho de estudo completamente randomizado. No tratamento 1 (T1) os animais receberam injeções subcutâneas de Endovet Ces® (Ivermectina / Praziquantel) na dose de 0,2 mg / kg a cada três meses. O tratamento 2 (T2) foi o grupo de controle negativo onde os animais não foram expostos a um anti-helmíntico. Os dados reprodutivos foram coletados no parto, incluindo peso ao nascer, peso da ninhada, tamanho da ninhada e sexo da prole. Os resultados mostraram que não houve diferença estatística (p > 0,05) entre os grupos de tratamento com relação ao peso ao nascer, peso da ninhada, tamanho da ninhada e sexo. No entanto, cutias desparasitadas tiveram maior peso ao nascer (220,24 g vs. 209,1 g) e peso da ninhada (369,8 g vs. 343 g). Os mesmos valores foram obtidos para o tamanho da ninhada (1,7 vs. 1,7) e os animais que foram desparasitados tiveram uma prole feminina maior do que a prole masculina (2,41: 1 vs. 1,11: 1). Esse experimento demonstrou que o uso de anti-helmíntico estrategicamente no manejo de cutias criadas em cativeiro não teve efeito estatístico (p > 0,05) sobre os parâmetros reprodutivos. Portanto, esses animais podem ser mantidos em cativeiro sem serem vermifugados e produzir de forma eficiente com alimentação adequada e manejo do alojamento.


Subject(s)
Animals , Male , Female , Dasyproctidae , Anthelmintics , Reproduction , Rodentia , Trinidad and Tobago
3.
Braz. j. biol ; 83: e246780, 2023. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1285620

ABSTRACT

Abstract Anthelmintic drugs have been used strategically in livestock reared in the tropics. These drugs have been used in the treatment of endoparasitism which have resulted in an increase in the animals' performance. The agouti (Dasyprocta leporina) is a neo-tropical rodent with the potential for domestication and has been farmed intensively in Trinidad. However, the objective of this research was to investigate the effect of anthelmintic use of the growth performance of the agouti. In searching the literature, it was found that this type of study on the agouti has not been done. In this experiment fourteen weaned agoutis weighing 1kg were divided into two groups randomly. The first group (T1) was not given any anthelmintic treatment but the second group (T2) was treated with Endovet Ces® subcutaneously every three months. There were no significant differences (p > 0.05) between the two groups in the carcass weight, weight gain, dressing percentage (hot and cold), heart, lungs, skin, head and feet. However, a significant difference (p < 0.05) was seen between groups in the weight of liver and pluck. To the authors knowledge this is the first time that carcass parameters has been presented in literature. The live weight of the animals at the end of the experiment ranged from 2.4 kg to 2.6 kg and animals had a dressing percentage of 57% to 55%. The results are suggestive that the use of anthelmintic drugs in agoutis reared intensively had no significant effect on weight gain and dressing percentage.


Resumo Drogas anti-helmínticas têm sido usadas estrategicamente em rebanhos criados nos trópicos. Essas drogas têm sido utilizadas no tratamento do endoparasitismo, o que resultou em um aumento no desempenho dos animais. A cutia (Dasyprocta leporina) é um roedor neotropical com potencial para domesticação e tem sido criada intensivamente em Trinidad. Porém, o objetivo desta pesquisa foi investigar o efeito do uso de anti-helmínticos no desempenho de crescimento da cutia. Através de uma busca na literatura, constatou-se que esse tipo de estudo na cutia não foi realizado. Neste experimento, quatorze cutias desmamadas pesando 1kg foram divididas em dois grupos aleatoriamente. O primeiro grupo (T1) não recebeu nenhum tratamento anti-helmíntico, mas o segundo grupo (T2) foi tratado com Endovet Ces® por via subcutânea a cada três meses. Não houve diferenças significativas (p> 0,05) entre os dois grupos no peso da carcaça, ganho de peso, porcentagem de cobertura (quente e frio), coração, pulmão, pele, cabeça e pés. No entanto, uma diferença significativa (p <0,05) foi observada entre os grupos no peso do fígado e depenagem. Para os autores, esta é a primeira vez que parâmetros de carcaça são apresentados na literatura. O peso vivo dos animais ao final do experimento variou de 2,4 kg a 2,6 kg e os animais tinham uma porcentagem de curativo de 57% a 55%. Os resultados sugerem que o uso de anti-helmínticos em cutias criadas intensivamente não teve efeito significativo no ganho de peso e na porcentagem de curativo.


Subject(s)
Animals , Cuniculidae , Dasyproctidae , Anthelmintics , Rodentia , Trinidad and Tobago
4.
Braz. j. biol ; 82: e237869, 2022. tab, graf
Article in English | LILACS | ID: biblio-1249268

ABSTRACT

Abstract Reproductive diseases have been well documented in domestic livestock such as sheep, goat, cattle and pigs. However, there is very little information on these diseases in the agouti (Dasyprocta leporina). The agouti is used for its meat in South America and the Caribbean. More recently, intensive farming of this animal is being practiced in the Neotropics. There is dearth of information on dystocia and vaginal prolapses in the agouti. This document reports on three cases of reproductive diseases in captive reared agoutis in Trinidad and Tobago. The first case was a female agouti weighing approximately 3 kg that was in the last stage of pregnancy, which was found dead in its cage. The vulva of the mother had the protruding hind-limbs of the fetus. Necroscopic evaluation of carcass revealed little fat tissue and the mother had two fetuses in the right horn of the uterus. Each fetus weighed approximately 200 g. The fetuses were well formed with fur, teeth and eyes. The placenta was attached to each fetus. The pathological findings suggested that dystocia resulted from secondary uterine inertia which was the cause of death of the adult female agouti. The second case was that of an adult female agouti weighing 2.5 kg. This female had given birth to an offspring three weeks prior and was observed to have had a vaginal prolapse. Surgery was performed and the prolapsed vagina was placed back into the pelvic cavity. Further to this intervention, the vagina prolapsed twice. Subsequent to the re-insertion of the vaginal tissue the agouti was euthanized. The third case was also that of a dystocia. However, the fetuses weighed 235 g and 165 g respectively and were in normal presentation, posture and positioning. The fetus however was unable to pass via the vagina and was trapped in the pelvic cavity. This caused secondary uterine inertia which was the cause of death. The causes of reproductive diseases in these cases are unknown but the feeding management and space allowance given to the agouti in late gestation may be contributing factors.


Resumo As doenças reprodutivas têm sido bem documentadas em rebanhos domésticos, como ovinos, caprinos, bovinos e suínos. Porém, há muito pouca informação sobre essas doenças na cutia (Dasyprocta leporina). A cutia é usada como carne na América do Sul e no Caribe. Mais recentemente, a criação intensiva desse animal está sendo praticada na região neotropical., Há escassez de informações sobre distocia e prolapsos vaginais na cutia. Este documento relata três casos de doenças reprodutivas em cutias criadas em cativeiro em Trinidad e Tobago. O primeiro caso foi de uma cutia de aproximadamente 3 kg que estava na última fase de gestação, encontrada morta em sua gaiola. A vulva da mãe tinha as patas traseiras salientes do feto. A avaliação necroscópica da carcaça revelou pouco tecido adiposo e a mãe tinha dois fetos no corno direito do útero. Cada feto pesava aproximadamente 200 g. Os fetos eram bem formados com pelos, dentes e olhos. A placenta foi presa a cada feto. Os achados patológicos sugeriram que a distocia resultou de inércia uterina secundária, que foi a causa da morte da cutia adulta. O segundo caso foi o de uma cutia adulta pesando 2,5 kg. Essa fêmea deu à luz uma cria três semanas antes e foi observado que tinha prolapso vaginal., A cirurgia foi realizada e a vagina prolapsada foi colocada de volta na cavidade pélvica. Após essa intervenção, a vagina prolapsou duas vezes. Após a reinserção do tecido vaginal, a cutia foi eutanasiada. O terceiro caso também foi de distocia. No entanto, os fetos pesavam 235 g e 165 g e estavam em apresentação, postura e posicionamento normais. O feto, entretanto, não conseguiu passar pela vagina e ficou preso na cavidade pélvica. Isso causou inércia uterina secundária, que foi a causa da morte. As causas das doenças reprodutivas nesses casos são desconhecidas, mas o manejo da alimentação e o espaço concedido à cutia no final da gestação podem ser fatores contribuintes.


Subject(s)
Animals , Female , Pregnancy , Dasyproctidae , South America , Swine , Trinidad and Tobago , Cattle , Sheep , Caribbean Region
5.
Braz. j. biol ; 81(2): 377-386, 2021. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1153358

ABSTRACT

Poppiana dentata (Randall, 1840) is widely distributed throughout riverine habitats in Trinidad. However, there is a scarcity of information on the biology of this species. This study provides the first baseline examination that describes growth aspects for P. dentata. Juvenile crabs were obtained from berried females collected in northwest Trinidad. Carapace width (CW), length (CL), moult incident, intermoult period and qualitative aspects were recorded for crabs (N = 23) over 9 months. CW, CL and intermoult period were used to derive percentage size increment, specific growth rate (SGR) and size at structural maturity for both sexes. Growth curves and logistic equations were also generated for each sex. Hatched crabs (< 5 mm CW) underwent rapid hardening after their first moult, indicating a fast turnover of moult cycles. SGR and CW percent increment were also the highest for this initial moult (P < 0.05). CW, CL, intermoult period, size increment and SGR did not differ between sexes (P > 0.05), with logistic equations expressed as CW = 32.81 (1+exp (1.481 ̵ 0.031t))-1 for males and CW = 34.07 (1+exp (1.516 ̵ 0.027t))-1 for females. Yet, breakpoint analyses indicated dissimilar sizes for structural maturity (male: 28.40 mm CW; female: 16.84 mm CW). These patterns reflect a shorter life span for this species in comparison to what has been reported for other trichodactylid relatives. This can have implications for P. dentata populations residing in anthropogenically disturbed habitats; thus, highlighting the need for conservation strategies to ensure preservation of native wild stock.


O Poppiana dentata (Randall, 1840) está amplamente distribuído nos habitats fluviais de Trinidad. Existem, porém, poucas informações sobre a biologia dessa espécie. Este estudo fornece a primeira análise de referência que descreve aspectos do crescimento do P. dentata. Caranguejos jovens foram obtidos a partir de fêmeas em desova na região noroeste de Trinidad. A largura da carapaça (LC), o comprimento da carapaça (CC), a incidência de muda, o período de intermuda e aspectos qualitativos foram registrados para caranguejos (N = 23) ao longo de mais de nove meses. A LC, o CC e o período de intermuda foram utilizados para obter o aumento porcentual, a taxa específica de crescimento (TEC), e o tamanho na maturidade estrutural para os dois sexos. Curvas de crescimento e equações logísticas foram também geradas para cada sexo. Os caranguejos que nasceram (com largura de carapaça < 5 mm) apresentaram um endurecimento rápido depois de sua primeira muda, o que indica uma rápida rotação dos ciclos de muda. A TEC e o aumento da porcentual da LC foram também os mais altos para esta muda inicial (P < 0,05). Não houve variação da LC, CC, do período de intermuda, aumento do tamanho e da TEC entre os sexos (P > 0,05), e as equações logísticas foram expressas como: LC = 32,81 (1+exp (1,481 ̵ 0,031t))-1 para machos, e LC = 34,07 (1+exp (1,516 ̵ 0,027t))-1 para fêmeas. Porém, as análises de quebra indicaram tamanhos diferentes para maturidade estrutural (LC para macho: 28,40; para fêmea: 16,84 mm). Esses padrões refletem um período de vida mais curto para esta espécie em comparação com o que tem sido registrado para outras famílias de Trichodactylidae. Isso pode ter implicações para as populações de P. dentata que residem em habitats modificados antropogenicamente; destaca-se, assim, a necessidade de estratégias de conservação para assegurar a preservação das populações selvagens nativas.


Subject(s)
Animals , Male , Female , Brachyura/anatomy & histology , Brachyura/growth & development , Trinidad and Tobago , Ecosystem , Conservation of Natural Resources/methods , Animal Experimentation , Fresh Water
6.
Braz. j. biol ; 80(3): 529-534, July-Sept. 2020. tab, graf
Article in English | LILACS | ID: biblio-1132425

ABSTRACT

Abstract Wildlife rehabilitation facilities in the Caribbean region are limited, yet they can provide relevant information on wild populations. Didelphis marsupialis insularis is a popularly hunted, under-studied, neo-tropical marsupial species that is increasingly being admitted for rehabilitation. The aim of this study was 1. To record the experiences of rehabilitating D. marsupialis insularis in the neo-tropical island of Trinidad and Tobago and 2. To extract and highlight information on the biology of this opossum sub-species. Using admission records, obtained over a roughly four year period, two breeding periods (February to March and August to October) were illustrated. Litter sizes averaged five individuals, with a range of 1 to 8 young. This species was found to be common in urban areas of the country, with dog attacks reported as the major cause for admission. Thus the information recorded by this wildlife rehabilitation facility has provided great insight on the sparsely studied opossum, D. marsupialis insularis.


Resumo As instalações de reabilitação e assistência à vida selvagem na região neotropical do Caribe são limitadas, mas informações relevantes sobre populações selvagens podem ser obtidas nesses locais. Didelphis marsupialis insularis é uma espécie de marsupial neotropical, subestimada e popularmente caçada; no entanto, essa espécie está sendo cada vez mais admitida para a reabilitação. Os objetivos deste estudo foram: 1. Registrar as experiências de reabilitação de D. marsupialis insularis na ilha neotropical de Trinidad e Tobago; e 2. Extrair e destacar informações sobre a biologia dessa subespécie de gambá. Utilizando registros de admissão, obtidos ao longo de um período de aproximadamente quatro anos, foram mostrados dois períodos de reprodução, de fevereiro a março e de agosto a outubro. O tamanho da ninhada foi em média de cinco indivíduos, variando de um a oito jovens. Comumente encontrado em áreas urbanas do país, os ataques de cães foram relatados como a principal causa de internação dessa espécie. Assim, a informação registrada por essa instalação de reabilitação de vida selvagem forneceu uma grande visão sobre o gambá D. marsupialis insularis, que tem sido pouco estudado.


Subject(s)
Animals , Dogs , Bites and Stings , Didelphis , Opossums , Trinidad and Tobago , Caribbean Region , Animals, Wild
7.
Braz. j. biol ; 78(3): 540-547, Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-951574

ABSTRACT

Abstract The red-rumped agouti (Dasyprocta leporina) produces precocial young and is the most hunted and farmed game species in several Neotropical countries. An understanding of the reproductive biology, including the relationship between litter size and teat functionality is crucial for conservation management of this animal. In precocial mammals, as the red-rumped agouti, maintaining maternal contact to learn foraging patterns may be more important than the energy demands and nutritional constraints during lactation and suckling may not play important roles when compared to altricial mammals. Therefore, in this study we evaluated the relationship between mammary functionality with litter size, litter birth weight, and parturition number in captive red-rumped agouti. Functionality was assessed by manual palpation of teats from un-sedated females (N=43). We compared the average birth weight of all newborns, male newborns and female newborns among agoutis with different litter sizes and different parturitions by one way ANOVA's, while Pearson's Chi-squared tests were used to detect relationships between teat functionality, litter size, and parturition number. Parturition number had no effect on the mean birth weight of all young (F0.822, P > 0.05), male young (F0.80, P > 0.05) or female young (F0.66, P > 0.05) in the litters. We found (i) no significant correlations (P > 0.05) between teat functionality and litter size and (ii) no significant correlations (P > 0.05) between teat functionality and parturition number. This suggests that whilst all teat pairs were functional, functionality was a poor indicator of litter size; suggesting that female agouti young may not have a high dependency on maternal nutrition; an possible evolutionary strategy resulting in large wild populations; hence its popularity as a game species.


Resumo A cutia (Dasyprocta leporina) produz filhotes precoces, e é a espécie cinegética mais caçada e criada em muitos países neotropicais. O entendimento da biologia reprodutiva, incluindo a relação entre o tamanho da ninhada e a funcionalidade das glândulas mamárias é crucial para o manejo conservacionista deste animal. Nos mamíferos precoces, como a cutia, manter o contato materno para a aprendizagem de padrões de forrageamento pode ser mais importante do que a demanda energética e de restrição nutricional durante a lactação, e a amamentação pode não desempenhar um papel importante quando comparado aos mamíferos altriciais. Portanto, neste estudo nós avaliamos a relação entre a funcionalidade mamária com o tamanho da ninhada, peso ao nascer da ninhada, e o número de partos em cutias cativas. A funcionalidade foi avaliada por meio de palpação manual das glândulas mamárias em fêmeas não sedadas (N=43). Nós comparamos a média do peso ao nascer de todos os recém-nascidos, macho e fêmeas recém-nascidos entre cutias com diferentes tamanhos de ninhadas e diferentes parturições, por meio da análise one-way ANOVA unifatorial; enquanto o teste do chi-quadrado de Pearson foi utilizado para detectar as relações entre a funcionalidade da glândula mamária, o tamanho da ninhada e o número de partos. O número de partos teve efeito na média de peso ao nascer dos filhotes (F0,822, P > 0,05), filhotes machos (F0,80, P > 0,05) ou filhotes fêmeas (F0,66, P > 0,05) nas ninhadas. A análise bivariada de Pearson (i) não mostrou correlação (P > 0,05) entre a funcionalidade da glândula mamária e o tamanho da ninhada e (ii) nenhuma correlação significativa (P > 0,05) entre a funcionalidade da glândula mamária e o número de parições. Os resultados sugerem que, embora todos os pares de tetas fossem funcionais, as cutias recém-nascidas podem não depender da nutrição materna para sobreviver; .embora todos os pares de tetas sejam funcionais, as cutias recém nascidas aparentemente não dependem da nutrição materna para sua sobrevivência; esta é, provavelmente, uma estratégia evolutiva que resulta em grandes populações da cutia em vida livre; e que pode explicar sua popularidade como espécie cinegética


Subject(s)
Animals , Male , Female , Pregnancy , Birth Weight/physiology , Lactation/physiology , Conservation of Natural Resources , Dasyproctidae , Litter Size/physiology , Mammary Glands, Animal/physiology , Trinidad and Tobago , Animals, Newborn , Animals, Suckling
8.
West Indian med. j ; 67(4): 334-343, Oct.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-1045859

ABSTRACT

ABSTRACT Objective: To compare all-cause-mortality in screening-detected prostate cancer cases versus non-cases after a median 12.2-year follow-up. Methods: In this prospective, population-based study of 3089 Afro-Caribbean men aged 40-79 years in Tobago, Trinidad and Tobago, West Indies, all men were screened for prostate cancer (serum prostate specific antigen and/or digital rectal exam) one to three times between 1997 and 2007 and followed for mortality to 2012. Among 502 men diagnosed with prostate cancer, 81 younger men underwent radical retropubic prostatectomy. Minimal treatment was available for older men. Survival curves compared all-cause-mortality in cases versus non-cases within 10-year age groups at first screening. Results: There were 350 all-cause-deaths over 34 089 person-years of follow-up. All-cause-survival curves in men aged 60 years or above at first screening did not diverge between cases and non-cases until after 10-12 years of follow-up (p > 0.36). In contrast, among men first screened at age 50-59 years, survival was lower in cases, with survival curves diverging at seven years (p = 0.003). Survival in men aged 50-59 years who underwent prostatectomy was similar to survival in non-cases (p = 0.63). Conclusion: Among men aged 60 years or above, the absence of excess all-cause-mortality among screening-detected prostate cancer cases provides argument against the utility of routine prostate cancer screening in this older population of African descent. However, the significantly poorer survival in men aged 50-59 years with screening-detected prostate cancer, compared with screened men without prostate cancer, along with the potential for prostate cancer treatment to improve survival, supports the continuation of prostate cancer screening in this age group, pending further research to assess the risks and benefits.


RESUMEN Objetivo: Comparar la mortalidad por todas las causas en casos de cáncer de próstata frente a no casos tras un seguimiento medio de 12.2 años. Métodos: En este estudio prospectivo poblacional de 3089 hombres afrocaribeños de 40-79 años en Tobago, Trinidad y Tobago, West Indies, todos los hombres fueron expuestos a tamizaje de cáncer de próstata (antígeno prostático específico en suero y/o examen rectal digital) de una a tres veces entre 1997 y 2007, y a un seguimiento de la mortalidad hasta 2012. De entre los 502 hombres diagnosticados con cáncer de próstata, a 81 hombres de los más jóvenes se les practicó una prostatectomía retropúbica radical. El tratamiento mínimo estuvo disponible para los hombres mayores. Las curvas de supervivencia compararon la mortalidad por todas las causas en los casos frente a los no casos dentro de los grupos de edades de 10 años en la primera tamización. Resultados: Hubo 350 muertes por todas las causas con más de 34 089 persona-años de seguimiento. Las curvas de supervivencia por todas las causas en hombres de 60 años o más en el primer tamizaje, no divergieron entre casos y no casos hasta después de 10 a 12 años de seguimiento (p > 0.36). En cambio, entre los hombres tamizados por primera vez a la edad 50-59 años, la supervivencia fue menor en los casos, con curvas de supervivencia divergentes a los siete años (p = 0.003). La supervivencia en los hombres de 50-59 años que tuvieron prostatectomía fue similar a la supervivencia en los no casos (p = 0.63). Conclusión: Entre los hombres de 60 años o más, la ausencia de exceso de mortalidad por todas las causas entre los casos de cáncer de próstata detectados por tamizaje proporciona argumentos contra la utilidad de la tamización rutinaria del cáncer de próstata en esta población mayor de ascendencia africana. Sin embargo, la supervivencia significativamente más pobre en hombres de 50 a 59 años con cáncer de próstata detectado mediante tamizaje - en comparación con los hombres tamizados sin cáncer de próstata, además de las posibilidades de tratamiento del cáncer de próstata para mejorar la supervivencia - respalda la continuación del tamizaje del cáncer de próstata en este grupo etario, quedando pendiente una investigación ulterior a fin de evaluar sus riesgos y beneficios.


Subject(s)
Humans , Male , Adult , Middle Aged , Aged , Prostatic Neoplasms/diagnosis , African Continental Ancestry Group , Prostatic Neoplasms/ethnology , Prostatic Neoplasms/mortality , Trinidad and Tobago/epidemiology , Survival Analysis , Mass Screening , Prospective Studies
9.
Rev. biol. trop ; 66(3): 1101-1117, jul.-sep. 2018. tab, graf
Article in English | LILACS, SaludCR | ID: biblio-977370

ABSTRACT

Abstract Human pressures have placed many tropical estuaries in developing countries under increased levels of stress. The Caroni Swamp Ramsar Site, the largest mangrove swamp along the west coast of Trinidad, has been subjected to high levels of anthropogenic impacts including hydrological alteration and pollution from land-based sources since the 1920's. While most of these impacts have been well documented, limited information exists on the macrobenthic communities in the swamp. This study addresses the paucity of information. The macrobenthic fauna in the main waterways of Caroni Swamp was sampled at 12 locations using a Van Veen 0.025 m2 grab, once in the dry (April) and wet (August) season of 2015 with a total of 144 samples. The samples were sorted, counted and species were identified to the lowest possible taxonomic level. A total of 55 taxa were identified with polychaetes being the most abundant taxa. The ecological status of the macrobenthos was assessed using AZTI's Marine Biotic Index (AMBI) and the multivariate-AMBI (M-AMBI). Physicochemical parameters were measured with a YSI multiparameter metre. Chemical analyses were also conducted on nitrates, nitrites, ammonia and reactive phosphates using standard methods. Overall, AMBI characterised the Caroni Swamp as "slightly disturbed" with a macrobenthic community of "poor" ecological status according to M-AMBI. Generally, the quality of the environment improves from the dry season to the wet season. However, seasonal variations in AMBI and M-AMBI were found to be site specific as some showed improvement in ecological status and macrozoobenthos quality while others showed degradation from the dry season to the wet season. The stations to the North of the swamp showed improvement from the dry season to the wet season while the opposite was observed in the more Southern stations. One notable characteristic of the swamp was the high levels of pollutants, particularly ammonia, recorded in one of its major waterways, the Caroni River. This is in contrast to the other waterways within the swamp which experience much lower levels of pollutant input from land-based sources. The assessment of the Caroni Swamp using AMBI and M-AMBI may be useful for informing management strategies to conserve the wetland and improve environmental quality. Rev. Biol. Trop. 66(3): 1101-1117. Epub 2018 September 01.


Resumen Los estuarios tropicales de países en desarrollo han experimentado un aumento en los niveles de estrés debido a la presión humana. El sitio Ramsar pantano Caroní, el manglar más grande de la costa oeste de Trinidad, ha estado sujeto a altos niveles de impacto antropogénico, incluyendo alteraciones hidrológicas y contaminación de fuentes terrestres desde la década de 1920. Aunque la mayoría de estos impactos han sido bien documentados, existe información limitada sobre las comunidades macrobentónicas en el pantano. Este estudio aborda esta escasez de información. Se muestreó la fauna macrobentónica en el canal principal del pantano Caroní en 12 localidades utilizando una draga Van Veen de 0.025 m2, una vez durante la época seca (Abril) y la época lluviosa (Agosto) 2015, con un total de 144 muestras. Las muestras fueron ordenadas, contadas y las especies se identificaron al menor nivel taxonómico posible. Se identificaron un total de 55 taxa, siendo los poliquetos el taxa más abundante. El estatus ecológico del macrobentos se evaluó utilizando el Índice Marino Biótico de AZTI (AMBI) y el AMBI-multivariado (M-AMBI). Los parámetros fisicoquímicos se midieron con un multiparámetro YSI. Los análisis químicos también se realizaron para nitratos, nitritos, amonio y fostatos activos utilizando métodos estándar. En conjunto, el índice AMBI caracterizó el pantano Caroní como "levemente alterado" con una comunidad macrobentónica de categoría "pobre" de acuerdo al M-AMBI. Generalmente, la calidad de los ambientes incrementa desde la época seca hasta la época lluviosa. Sin embargo, las variaciones estacionales en los índices AMBI y M-AMBI fueron específicas a la localidad, mostrando algunas un incremento en el estatus ecológico y calidad del macrozoobentos, mientras que otros mostraron una degradación de la época seca a la época lluviosa. Las estaciones al norte del pantano mostraron una mejora de la época seca a la época lluviosa, mientras que se presentó lo contrario en las estaciones más al sur. Una característica notable del pantano fueron los altos niveles de contaminantes, particularmente amonio, registrado en uno de los canales principales del río Caroní. Esto contrasta con los otros canales del pantano que experimentan niveles menores de aporte de contaminantes de fuentes terrestres. La evaluación del pantano Caroní utilizando los índíces AMBI y M-AMBI puede ser una base útil de información para las estrategias de manejo y conservación del humedal y mejorar su calidad ambiental.


Subject(s)
Polychaeta/growth & development , Seasons , Trinidad and Tobago , Benthic Fauna/analysis , Benthic Fauna/adverse effects , Benthic Flora/analysis , Wetlands , Ammonium Compounds/adverse effects , Human Activities , Water Pollutants/adverse effects , Environment
10.
West Indian med. j ; 67(2): 122-130, Apr.-June 2018. tab, graf
Article in English | LILACS | ID: biblio-1045833

ABSTRACT

ABSTRACT Objective: To determine the feasibility of recommending a screening process for non-communicable diseases (NCDs) and their risk factors, as a national and regional model. Methods: A cross-sectional, six-station process was carried out. It consisted of invitation and consent, history (personal and family history of NCDs), biometrics (waist circumference and body mass index), blood levels (lipids and glycosylated haemoglobin) and urinalysis (microalbuminuria), basic examinations (blood pressure, peripheral neuropathy, presence of acanthosis nigricans and visual acuity), and an exit interview. Net present value (NPV) calculations were carried out for very high-risk patients (those with a > 30% risk of a cardiovascular event (limb amputation) in the next 10 years) for two discount rates: 0.75% (United States of America) and 3.4% (Trinidad and Tobago). Results: A convenience sample of 514 walk-in patients (56.2% recruitment rate) was screened (about 23 patients per day). The median time for a patient attending all stations was 21 minutes (range: 11-59 minutes). Of the six stations, the laboratory took the longest: median 10 minutes (range: 2-50 minutes). The entire project cost US$20 439 (US$39.76 per patient). Between one and seven very high-risk patients (three sub-groups of patients had this risk profile) were identified. The cost of identifying a very high-risk patient ranged from US$2907 to US$20 349. The NPV of identifying these high-risk patients ranged from -US$6748.71 to US$14 725 and was favourable for three of four monetary scenarios. Conclusion: A six-station process to provide rapid screening of walk-in patients for NCDs was found to be feasible and provided monetary value in three of four scenarios in a Trinidad and Tobago setting.


RESUMEN Objetivo: Determinar la viabilidad de recomendar un proceso de cribado de las enfermedades no transmisibles (ENT) y sus factores de riesgo, como modelo nacional y regional. Métodos: Se realizó un proceso transversal de seis estaciones. El mismo consistió en invitación y consentimiento; historia (antecedentes personales y familiares de ENT); biometría (circunferencia de la cintura e índice de masa corporal); niveles sanguíneos (lípidos y hemoglobina glicosilada); y análisis de orina (microalbuminuria); exámenes básicos (presión arterial, neuropatía periférica, presencia de acantosis nigricans y agudeza visual); y una entrevista de salida. Se realizaron cálculos del valor actual neto (VAN) para pacientes de muy alto riesgo - pacientes con riesgo de un 30% de evento cardiovascular (amputación de extremidades) en los próximos 10 años - para dos tasas de descuento: 0.75% (Estados Unidos de América) y 3.4% (Trinidad y Tobago). Resultados: Una muestra de conveniencia de 514 pacientes ambulatorios (tasa de reclutamiento de 56.2%) fue sometida a pruebas de detección (unos 23 pacientes por día). El tiempo promedio para que un paciente asistiera a todas las estaciones fue de 21 minutos (rango: 11-59 minutos). De las seis estaciones, el laboratorio tomó el tiempo más largo: un promedio de 10 minutos (rango: 2-50 minutos). El proyecto entero costó $20 439 USD (39.76 USD por paciente). Entre uno y siete pacientes de muy alto riesgo (tres subgrupos de pacientes tenían este perfil de riesgo) fueron identificados. El costo de identificar a un paciente de muy alto riesgo osciló entre $2907 USD y $20 349 USD. El VAN de identificación de estos pacientes de alto riesgo fluctuó de $6748.71 a $14 725 USD, y fue favorable para tres de cuatro escenarios monetarios. Conclusión: Se halló que un proceso de seis estaciones para pruebas de detección rápidas de ENT a pacientes ambulatorios, es factible y proporciona valor monetario en tres de cuatro escenarios en un contexto de Trinidad y Tobago.


Subject(s)
Humans , Male , Female , Adolescent , Middle Aged , Aged , Mass Screening/economics , Chronic Disease , Diagnostic Techniques and Procedures/economics , Ambulatory Care , Noncommunicable Diseases , Trinidad and Tobago , Pilot Projects , Cross-Sectional Studies , Risk Factors
11.
West Indian med. j ; 67(2): 157-159, Apr.-June 2018. tab
Article in English | LILACS | ID: biblio-1045829

ABSTRACT

ABSTRACT Objective: To identify cardiac risk factors that contribute to sudden cardiac death in a haemodialysis population and thus optimize them, in an effort to minimize death in this population. Methods: This was a retrospective study and audit. The medical records of the patients receiving chronic haemodialysis were reviewed for the period January to December 2014. Data collected included age, gender, comorbidities, types of access, length of time on haemodialysis, laboratory indices, and main electrocardiographic and echocardiographic findings. Results: All patients had elevated intact parathyroid hormone. Some patients had hypocalcaemia, hyperphosphataemia and mild anaemia. Prominent echocardiographic findings were left ventricular hypertrophy and pulmonary hypertension. Conclusion: Sudden cardiac death in end-stage renal disease patients on haemodialysis may be predicted by certain abnormal laboratory findings and echocardiographic findings which may all be positively correlated.


RESUMEN Objetivo: Identificar los factores de riesgo cardíaco que contribuyen a la muerte cardíaca súbita en una población de hemodiálisis, y de este modo optimizarlos, en un esfuerzo por minimizar los fallecimientos por tal motivo en esta población. Métodos: Se trata de un estudio retrospectivo y auditoría. Se revisaron las historias clínicas de los pacientes que recibían hemodiálisis crónica, correspondientes al período de enero a diciembre de 2014. Los datos recogidos incluyeron edad, sexo, comorbilidades, tipos de acceso, tiempo de hemodiálisis, índices de laboratorio, y los principales hallazgos electrocardiográficos y ecocardiográficos. Resultados: Todos los pacientes tenían hormona paratiroides intacta elevada. Algunos pacientes tenían hipocalcemia, hiperfosfatemia y anemia leve. Los resultados ecocardiográficos más sobresalientes fueron la hipertrofia ventricular izquierda y la hipertensión pulmonar. Conclusión: La muerte cardíaca repentina en pacientes con la enfermedad renal en fase terminal sujetos a hemodiálisis, puede predecirse por ciertos resultados de laboratorio anormales y los resultados de la ecocardiografía, todos los cuales se pueden correlacionar positivamente.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Renal Dialysis , Death, Sudden, Cardiac/prevention & control , Trinidad and Tobago , Echocardiography , Retrospective Studies , Risk Factors , Electrocardiography
12.
West Indian med. j ; 67(1): 57-59, Jan.-Mar. 2018. tab, graf
Article in English | LILACS | ID: biblio-1045818

ABSTRACT

ABSTRACT Objective: Methicillin-resistant Staphylococcus aureus (MRSA) is associated with soft tissue infections in surgical patients. In severe cases, it may result in pneumonia, septicaemia and osteomyelitis. Limited data are available with regard to its prevalence and associations in the Caribbean. This study aimed to assess the prevalence of MRSA in patients hospitalized in the surgical wards of the Port-of-Spain General Hospital (POSGH), Trinidad and Tobago, and determine associated risk factors. Methods: Over the period of April 1 to August 1, 2013, all patients from the surgical wards of the POSGH who had had wound swabs taken were identified. Demographic data included duration of hospital stay, surgical and medical history, antibiotic use and type of wound swab. Microbiological reports were then retrieved and analyses done. Results: A total of 153 patients had wound swabs taken. There were 38 patients (24%) infected with Staphylococcus aureus, with 15 (39.5%) growing MRSA. Increased susceptibility to MRSA was associated with age, gender, ethnicity, duration of hospital stay, co-morbidities, previous antibiotic use, previous surgery and the type of wound (p < 0.05). Conclusion: The prevalence of MRSA in the surgical wards of the POSGH was 39.5% of Staphylococcus aureus isolates. Risk factors included the age range of 60-69 years, patients with co-morbidities, hospital stays of longer than one week, previous surgery and prior use of antibiotics. We recommend more awareness of this problem in the practice of Caribbean medicine to improve infection rates.


RESUMEN Objetivo: El estafilococo dorado resistente a la meticilina (EDRM) se asocia con infecciones de tejidos blandos en pacientes quirúrgicos. En casos severos, puede dar lugar a pulmonía, septicemia y osteomielitis. Los datos disponibles con respecto a su prevalencia y asociaciones en el Caribe son limitados. Este estudio persigue evaluar la prevalencia de EDRM en pacientes hospitalizados en las salas quirúrgicas del Hospital General de Puerto de España (POSGH, siglas en inglés) en Trinidad y Tobago, y determinar los factores de riesgo asociados. Métodos: Durante el período del 1 de abril al 1 de agosto de 2013, fueron identificados todos los pacientes de las salas quirúrgicas del Hospital POSGH a quienes se les había practicado frotis de las heridas. Los datos demográficos incluyeron la duración de la estadía hospitalaria, las historias clínicas y quirúrgicas, el uso de antibióticos, y el tipo de frotis de la herida. Luego se obtuvieron los informes microbiológicos y se realizaron los análisis. Resultados: A un total de 153 pacientes se le tomaron frotis de heridas. Hubo 38 pacientes (24%) infectados con estafilococos dorados, de los cuales 15 (3.5%) presentaban EDRM creciente. El aumento de la susceptibilidad a EDRM se asoció con la edad, el género, la etnicidad, la duración de la estadía hospitalaria, las co-morbilidades, el uso previo de antibióticos, las cirugías previas, y el tipo de herida (p < 0.05). Conclusión: La prevalencia de EDRM en las salas quirúrgicas del Hospital POSGH fue 39.5% de aislados de estafilococos dorados. Los factores de riesgo incluyeron un rango de edad de 60-69 años, pacientes con co-morbilidades, estancia hospitalaria de más de una semana, cirugía previa, y uso previo de antibióticos. Recomendamos tomar más conciencia de este problema en la práctica médica en el Caribe a fin de mejorar las tasas de infección.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Staphylococcal Infections/microbiology , Surgical Wound Infection/microbiology , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Trinidad and Tobago , Prevalence , Risk Factors , Hospitals, General
13.
Article in English | LILACS | ID: biblio-1043205

ABSTRACT

ABSTRACT An emerging mosquito-borne flavivirus, Zika virus (ZIKV) is a significant public health concern because of the syndromes associated with the infection. In addition, ZIKV is considered a major problem due to large-scale spread of the disease and the possible clinical complications for the central nervous system, especially Guillain-Barré syndrome (GBS) and microcephaly. Since the introduction of ZIKV in the Caribbean, molecular detection of the viral RNA has been utilized as a more specific and sensitive approach to demonstrating acute infection. However, it is generally accepted that the virus has a short viremic period, generally less than 5 days. Serologic testing has the inconvenience of strong cross-reactivity among flaviviruses, such as dengue and yellow fever. As part of the laboratory surveillance activities for Zika and other arboviruses at the Caribbean Public Health Agency, in 2016 a sample from a male who was clinically diagnosed with GBS tested positive for Zika virus by real-time polymerase chain reaction (rRT-PCR). The serum sample had been taken on day 21 after the onset of symptoms. The case had initially been characterized as a typical ZIKV infection (mild fever with a generalized maculopapular rash). Later, weakness of limbs and other peripheral neurological symptoms appeared. Enzyme-linked immunoassay (ELISA) showed that the sample was negative for IgM antibodies against Zika, Chikungunya, and dengue viruses. The plaque reduction neutralization test was positive for ZIKV. This indicated parallel development of viremia and immune response against ZIKV. Recent reports have demonstrated a longer duration of the viremia in ZIKV infections. However, our report is the first one that links the infection with extended viremia and the development in parallel of a GBS case.(AU)


RESUMEN El virus del Zika (ZIKV), un flavivirus emergente transmitido por mosquitos, es una inquietud importante en el ámbito de la salud pública por los síndromes asociados con la infección. Además, el ZIKV se considera un problema acuciante debido a la propagación a gran escala de la enfermedad y a las posibles complicaciones clínicas en el sistema nervioso central, en concreto, el síndrome de Guillain-Barré y la microcefalia. Desde que el ZIKV se introdujera en el Caribe, la detección molecular del ARN viral ha sido el método más específico y sensible utilizado para comprobar una infección aguda. Sin embargo, se cree que el virus tiene un período virémico corto, de menos de 5 días en general. La prueba serológica presenta el inconveniente de la fuerte reactividad cruzada entre los flavivirus, como el dengue y la fiebre amarilla. Como parte de las actividades de vigilancia de laboratorio para el Zika y otros arbovirus del Agencia Caribena de Salud Publica, en el 2016 la muestra de un hombre diagnosticado con la enfermedad de Guillain Barré dio positiva para el virus del Zika por medio de una reacción en cadena de la polimerasa en tiempo real (rRT-RCP). La muestra de suero se había tomado en el día 21 después de la aparición de los síntomas. En un principio, el caso se calificó como una infección por ZIKV típica (fiebre leve con una erupción maculopapular generalizada). Posteriormente, apareció la debilidad de los miembros y otros síntomas neurológicos periféricos. La prueba de inmunoadsorción enzimática (ELISA) fue negativa para los anticuerpos de tipo IgM contra los virus del Zika, el chikunguña y el dengue. La prueba de neutralización por reducción del número de placas dio positivo para el ZIKV, lo que probó que paralelamente se había desarrollado una respuesta virémica e inmune contra el ZIKV. En informes recientes se ha demostrado que en las infecciones de ZIKV el periodo virémico es más largo. Sin embargo, nuestro informe es de los primeros que relaciona un periodo virémico prolongado con el desarrollo paralelo del síndrome de Guillain-Barré.(AU)


RESUMO O vírus zika é um flavivírus emergente transmitido por mosquitos e tem sido motivo de grande preocupação em saúde pública por causa das síndromes associadas à infecção. É também considerado um importante problema devido à propagação em grande escala e possíveis complicações clínicas no sistema nervoso central decorrentes da infecção, sobretudo síndrome de Guillain-Barré e microcefalia. Desde a introdução do vírus zika no Caribe, a detecção molecular do RNA viral tem sido usada como método mais específico e sensível para demonstrar infecção aguda. Porém, admite-se em geral que o vírus tem um curto período virêmico, inferior a 5 dias. O teste sorológico tem o inconveniente de produzir intensa reação cruzada com outros flavivírus, como os vírus da dengue e febre amarela. Como parte da vigilância laboratorial do vírus zika e outros arbovírus pela Agência de Saúde Pública do Caribe, em 2016, foi examinada uma amostra de um paciente do sexo masculino com diagnóstico clínico de síndrome de Guillain-Barré e o resultado foi positivo para o vírus zika com a técnica de reação em cadeia da polimerase em tempo real. A amostra sérica havia sido coletada no dia 21 após o início dos sintomas. O caso foi inicialmente descrito como infecção típica pelo vírus zika (febre baixa com erupção cutânea maculopapular generalizada) e, posteriormente, o paciente apresentou fraqueza dos membros e outros sintomas neurológicos periféricos. A amostra foi testada com a técnica de imunoensaio enzimático (ELISA) e foi negativa para anticorpos da classe IgM contra o zika vírus, vírus chikungunya e vírus da dengue. O teste de neutralização por redução de placas foi positivo para o vírus zika, indicando aumento em paralelo da viremia e resposta imunológica ao vírus. Informes recentes têm demonstrado viremia de duração mais prolongada em infecções por vírus zika. Porém, este é o primeiro relato que associa a infecção com viremia prolongada ao surgimento em paralelo da síndrome de Guillain-Barré.(AU)


Subject(s)
Humans , Male , Polymerase Chain Reaction/instrumentation , Guillain-Barre Syndrome/physiopathology , Zika Virus/isolation & purification , Zika Virus Infection/diagnosis , Trinidad and Tobago/epidemiology
14.
Anatomy & Cell Biology ; : 12-16, 2017.
Article in English | WPRIM | ID: wpr-193193

ABSTRACT

Currently, the importance of human anatomical dissection have come under debate in many countries but there are not references in Venezuela on this concern. This survey's aim is to assess the insights of Venezuelan surgeons and their outlines of usage of human anatomical dissection in teaching and learning human anatomy. Sixty-five Venezuelan surgeons at the Centro Médico Docente La Trinidad completed an anonymous survey on current and future teaching practices in human anatomy. Eighty-nine point two three percent of surveyed (n=58) conferred importance to human anatomical dissection despite the arrival of new innovations in learning human anatomy. The group surveyed view human anatomical dissection-based teaching as the most beneficial method of teaching human anatomy and it should be bolstered in human anatomical education with matching use of three-dimensional computerized tomography imaging as a complementary form for teaching and learning.


Subject(s)
Anonyms and Pseudonyms , Education , Humans , Learning , Methods , Surgeons , Trinidad and Tobago , Venezuela
15.
Rev. panam. salud pública ; 38(5): 425-430, Nov. 2015. tab
Article in English | LILACS | ID: lil-772139

ABSTRACT

Advances in human genetics and genomic sciences and the corresponding explosion of biomedical technologies have deepened current understanding of human health and revolutionized medicine. In developed nations, this has led to marked improvements in disease risk stratification and diagnosis. These advances have also led to targeted intervention strategies aimed at promoting disease prevention, prolonging disease onset, and mitigating symptoms, as in the well-known case of breast cancer and the BRCA1 gene. In contrast, in the developing nation of Trinidad and Tobago, this scientific revolution has not translated into the development and application of effective genomics-based interventions for improving public health. While the reasons for this are multifactorial, the underlying basis may be rooted in the lack of pertinence of internationally driven genomics research to the local public health needs in the country, as well as a lack of relevance of internationally conducted genetics research to the genetic and environmental contexts of the population. Indeed, if Trinidad and Tobago is able to harness substantial public health benefit from genetics/genomics research, then there is a dire need, in the near future, to build local capacity for the conduct and translation of such research. Specifically, it is essential to establish a national human genetics/genomics research agenda in order to build sustainable human capacity through education and knowledge transfer and to generate public policies that will provide the basis for the creation of a mutually beneficial framework (including partnerships with more developed nations) that is informed by public health needs and contextual realities of the nation.


Los avances en materia de ciencias genéticas y genómicas humanas y la correspondiente expansión de las tecnologías biomédicas han ampliado la comprensión actual de la salud humana y han revolucionado la medicina. En las naciones desarrolladas, ello ha conducido a intensas mejoras en la estratificación del riesgo y el diagnóstico de las enfermedades. Estos avances también han conducido a estrategias de intervención dirigidas a promover la prevención de las enfermedades, retardar su aparición, y atenuar sus síntomas, como en el caso del cáncer de mama y el gen BRCA1. Por el contrario, en Trinidad y Tabago, nación en desarrollo, esta revolución científica no se ha traducido en la elaboración y aplicación de intervenciones eficaces basadas en la genómica para mejorar la salud pública. Aunque las razones de ello son multifactoriales, el motivo subyacente puede radicar en la falta de adecuación de la investigación genómica a escala internacional a las necesidades locales de salud pública del país, así como a la escasa relevancia de la investigación en genética realizada internacionalmente para los contextos genéticos y ambientales de la población. En efecto, para que Trinidad y Tabago pueda aprovechar los sustanciales beneficios en materia de salud pública de la investigación en genética y genómica, es extremadamente necesario, en un futuro próximo, desarrollar la capacidad local para la realización y traducción de ese tipo de investigación. En concreto, es esencial establecer un programa nacional de investigación en genética y genómica humanas con objeto de desarrollar una capacidad humana sostenible mediante la educación y la transferencia de conocimientos, y generar políticas públicas que proporcionen la base para la creación de un marco mutuamente beneficioso (incluidas las alianzas con naciones más desarrolladas) fundamentado en las necesidades de salud pública y en las realidades contextuales del país.


Subject(s)
Chromosome Mapping/statistics & numerical data , Genome/genetics , Trinidad and Tobago
16.
West Indian med. j ; 63(1): 68-77, Jan. 2014. ilus, tab
Article in English | LILACS | ID: biblio-1045790

ABSTRACT

OBJECTIVES: Childhood obesity and poor lifestyle practices are emerging as major public health challenges in the Caribbean. Given the fact that a significant part of childhood is spent at school, curriculum-based interventions aimed at improving good dietary and physical activity patterns may provide a useful vehicle for mass inculcation of long-term healthy lifestyle practices. In this study, we evaluated the long-term impact of a brief curriculum based intervention on dietary behaviour, physical activity and knowledge level of primary schoolchildren. METHODS: The study was a randomized, controlled, school-based nutrition education and physical activity intervention. One hundred students each were then randomly assigned to the intervention (IVG) and non-intervention (NIVG) groups and followed-up for 18 months. Participants in the IVG group were exposed to a curriculum consisting of six one-hour modules followed by school-based activities geared at fostering healthy behaviours. Students in the non-intervention group did not receive any modules and were subject to the information available at school on a regular basis. RESULTS: In multivariate regression equations controlling for age, gender, body mass index (BMI) and baseline values, intervention was associated with lower intake of fried foods and sodas (p < 0.05) and higher knowledge scores (p < 0.01) 18 months later but not significantly associated with improved physical activity or lower BMI. CONCLUSIONS: In this study, participants in the intervention group reported significantly lower intakes of fried foods and sodas and higher knowledge scores than participants in the control group some 18 months post-intervention independent of age, gender, BMI, ethnicity and the intakes at baseline.


OBJETIVOS: La obesidad infantil y las prácticas de estilo de vida pobre se presentan cada vez más como importantes retos para la salud pública en el Caribe. Dado el hecho de que una parte significativa de la infancia transcurre en la escuela, las intervenciones basadas en el currículo dirigidas a mejorar los patrones de actividad física y dietética, pueden proporcionar una vía útil para inculcar masivamente prácticas de estilo de vida saludable a largo plazo. En este estudio, evaluamos el impacto a largo plazo de una intervención basada en un currículo breve de la conducta dietética, la actividad física, y el nivel de conocimientos de los escolares de la escuela primaria. MÉTODOS: El estudio consistió en una intervención de la actividad física y educación sobre la nutrición de base escolar, controlada y randomizada. Cien estudiantes fueron individualmente asignados de forma aleatoria a grupos de intervención (GIV) y grupos de no intervención (GNIV), con un seguimiento de 18 meses. Los participantes en el grupo GIV fueron expuestos a un programa consistente en seis módulos de una hora, seguidos de actividades escolares orientadas a fomentar comportamientos saludables. Los chilestudiantes en el grupo de no intervención no recibieron ningún módulo y estaban sujetos a la información disponible en la escuela de forma regular. The study was a randomized, controlled, school-based nutrition education and physical activity intervention. One hundred students each were then randomly assigned to the intervention (IVG) and non-intervention (NIVG) groups and followed up for eighteen months. Participants in the (IVG) group were exposed to a curriculum consisting of six one-hour modules followed by school-based activities geared at fostering healthy behaviours. Students in the non-intervention group did not receive any modules and were subject to the information available at school on a regular basis. RESULTADOS: En las ecuaciones de regresión multivariante de edad, género, índice de masa corporal (IMC) y valores de referencia, la intervención estuvo asociada con una menor ingesta de alimentos fritos y refrescos (p < 0.05), y una mayor puntuación en cuanto a conocimientos (p < 0.01) 18 meses más tarde, pero no significativamente asociada con una mejor actividad física o un IMC más bajo. CONCLUSIONES: En este estudio, los participantes en el grupo de intervención reportaron ingestas de alimentos fritos y refrescos significativamente menores, y puntuaciones de conocimiento más altas que las de los participantes en el grupo control, unos 18 meses tras la intervención, independientemente de la edad, el género, el IMC, la etnia, y las ingestas, en relación con los valores iniciales del estudio.


Subject(s)
Humans , Male , Female , Child , School Health Services , Exercise , Education, Primary and Secondary , Diet, Healthy , Trinidad and Tobago , Nutrition Programs , Multivariate Analysis , Curriculum
17.
West Indian med. j ; 62(7): 620-627, Sept. 2013. tab
Article in English | LILACS | ID: biblio-1045715

ABSTRACT

The current study investigated the prevalence of depressive symptoms in persons with self-reported cardiovascular disease and the interactions of depressive symptoms, reported cardiovascular disease and gender in a Trinidadian population. Between June 2009 and August 2009, 425 participants were recruited from the Eric Williams Medical Sciences Complex (EWMSC) Heart Clinic and all the participants completed the Center for Epidemiologic Studies Depression Scale. Clinical and demographic variables were obtained from the sociodemographic questionnaire. Forty-seven per cent of the self-reported cardiovascular disease participants were identified as having high depressive symptoms as compared to 32% of those who did not report having a cardiovascular illness. The odds ratio indicated that high depressive symptoms are more likely to occur in individuals with reported cardiovascular disease. The Mann-Whitney test revealed females had significantly higher levels of depressive symptoms than males. Previous studies suggest that depression is a risk factor for adverse prognosis in a cardiac population, therefore future research examining the link between depression and cardiovascular disease is warranted.


El presente estudio investigó la prevalencia de síntomas depresivos en personas con enfermedad cardiovascular autoreportadas y las interacciones de los síntomas depresivos, las enfermedades cardiovasculares reportadas y el género en una población de Trinidad y Tobago. Entre junio y agosto de 2009, 425 participantes fueron reclutados de la Clínica Cardiológica del Complejo de Ciencias Médicas Eric Williams (EWMSC), todos los participantes respondieron la Escala de Depresión del Centro de Estadios Epidemiológicos, y se obtuvieron las variables demográficas y clínicas del cuestionario sociodemográfico. Cuarenta y siete por ciento de los participantes con enfermedades cardiovasculares autoreportadas fueron identificados con síntomas depresivos altos en comparación con el 32% de aquellos que no reportaron tener enfermedad cardiovascular. El cociente de probabilidades (OR) indicó que los síntomas depresivos altos tienen mayor probabilidad de ocurrir en individuos con enfermedades cardiovasculares reportadas. La prueba de Mann-Whitney reveló que las hembras presentaban niveles significativamente mayores de síntomas depresivos que los varones. Los estudios previos sugieren que la depresión es un factor de riesgo para un pronóstico adverso en una población cardiaca. Por lo tanto, es un hecho que la investigación futura necesita examinar el vínculo entre depresión y enfermedad cardiovascular.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Cardiovascular Diseases/epidemiology , Depression/epidemiology , Trinidad and Tobago/epidemiology , Odds Ratio , Sex Factors , Prevalence , Self Report
18.
West Indian med. j ; 62(7): 628-631, Sept. 2013.
Article in English | LILACS | ID: biblio-1045716

ABSTRACT

BACKGROUND: Depression is a common problem among those suffering from diabetes mellitus. The dual diagnoses of a chronic medical disease and mental disorder, symptomatic presentation and stringent treatment regimen are sources ofpsychological distress for patients and present a major challenge for healthcare workers. METHOD: In a cross-sectional study, one hundred and twenty-eight Type 2 diabetic patients were investigated for depression using the Zung Depression Scale. All cases were diagnosed by a physician and patients were selected from outpatient clinics of the four major hospitals in Trinidad. The Pearson product-moment correlation coefficient, stepwise multiple regression and t-test were utilized to examine the relationship between participant's age, gender, glucose control, coexisting medical complications and depression. RESULTS: The patients were primarily Indo-Trinidadians (49%), over 50 years (79.7%) and women (60%). The prevalence of depression was 17.9% of Type 2 diabetic patients reporting mild to moderate levels of depression. Female Type 2 diabetics had higher scores of depression (M = 42.13, SD = 9.83, p = 0.011) than male Type 2 diabetics (M = 38.71, SD = 8.9). Patients with coexisting medical complications had higher levels of depression (M = 44.01, SD = 9.52) than those with diabetes alone (M= 37.74, SD = 8.79, p = 0.000). CONCLUSION: The prevalence of depression in Type 2 diabetic patients highlights the necessity for psychological screening at diabetic health clinics in Trinidad and Tobago, particularly for women and those with co-morbid medical complications. This will aid in better control, quality of life and longevity.


ANTECEDENTES: La depresión es un problema común entre las personas que sufren de diabetes mellitus. El diagnóstico dual de una enfermedad médica crónica y un trastorno mental, la presentación sintomática y un régimen de tratamiento estricto, son fuentes de angustia psicológica para los pacientes y representan un reto importante para los trabajadores de la salud. MÉTODO: En un estudio transversal, ciento veintiocho pacientes con diabetes tipo 2 fueron investigados en relación con estados depresivos, usando la Escala de Depresión de Zung. Todos los casos fueron diagnosticados por un médico, y los pacientes fueron seleccionados de clínicas ambulatorias de los cuatro hospitales principales en Trinidad. El coeficiente de correlación producto-momento de Pearson, la regresión gradual múltiple, y la prueba t, fueron utilizados para examinar la relación entre la edad del participante, el género, el control de la glucosa, las complicaciones médicas coexistentes, y la depresión. RESULTADOS: Los pacientes eran principalmente indotrinitenses (49%), más de 50 años (79.7%) y mujeres (60%). La prevalencia de la depresión fue 17.9% de los pacientes diabéticos tipo 2 que reportaban niveles de depresión de leves a moderados. Las mujeres diabéticas tipo 2 tuvieron puntuaciones de depresión mayores (M= 42.13, SD = 9.83, p = 0.011) en comparación con los hombres diabéticos tipo 2 (M= 38.71, SD = 8.9). Los pacientes con complicaciones médicas coexistentes tenían niveles más altos de depresión (M= 44.01, SD = 9,52) que aquellos sólo con diabetes (M = 37.74, SD = 8.79, p = 0.000). CONCLUSIÓN: La prevalencia de la depresión en pacientes diabéticos tipo 2 señala la necesidad de realizar tamizajes psicológicos en las clínicas para diabéticos en Trinidad y Tobago, en particular para las mujeres y aquellos con complicaciones médicas comórbidas. Esto ayudará a un mejor control, calidad de vida y longevidad de los pacientes con diabetes tipo 2.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Depression/epidemiology , Diabetes Mellitus, Type 2/psychology , Diabetes Mellitus, Type 2/epidemiology , Trinidad and Tobago/epidemiology , Comorbidity , Sex Factors , Prevalence , Cross-Sectional Studies , Ambulatory Care Facilities/statistics & numerical data
20.
West Indian med. j ; 62(6): 543-547, July 2013. tab
Article in English | LILACS | ID: biblio-1045694

ABSTRACT

OBJECTIVE: No country can afford to provide all necessary healthcare for its citizens, so prioritization among interventions must feature in all health systems. Resources in health should be allocated among interventions/facilities/patients in such a way as to be in line with the objectives of the health system. To achieve this, resource allocation decisions must be informed by the relative contributions that prospective interventions will make to societal health and to costs. Internationally, the EQ-5D based quality adjusted life year (QALY) now dominates this kind of analysis. This paper reports on a pilot study to develop an EQ-5D-3L value set for Trinidad and Tobago based on a protocol that avoids some of the issues that are associated with other approaches to developing such value sets such as the complex elicitation tasks that respondents must carry out, and the large respondent samples required for collecting multiple valuation subset values using blocked designs. METHODS: An orthogonal discrete choice experiment design was used to elicit a set of choices from a sample of respondents. RESULTS: The choice data were analysed using mixed multinomial logistic regression to produce an internally valid model that predicts well. CONCLUSION: This paper marks an important milestone in the development of health resource allocation in the Caribbean. It sets out the importance of incorporating the impact of health interventions to inform health resource allocation decisions, describes the elicitation and analysis methods used in the pilot and provides an illustration ofthe use ofthe EQ-5D value set.


OBJETIVO: Ningún país puede permitirse ofrecer toda la atención a la salud necesaria para sus ciudadanos, de modo que la necesidad de establecer prioridades en las intervenciones constituye un rasgo característico de todos los sistemas de salud. Los recursos de salud deben asignarse entre las intervenciones/instalaciones/pacientes de tal manera que se correspondan con los objetivos del sistema de salud. Para lograr esto, las decisiones en cuanto a la asignación de recursos deben reportarse en términos de las contribuciones relativas que las intervenciones prospectivas representarán para la salud social y los costos. Internacionalmente, el EQ - 5D basado en el año de vida ajustado por calidad (AVAC), domina ahora este tipo de análisis. El presente trabajo reporta un estudio piloto para desarrollar un conjunto de valores EQ - 5D - 3L para Trinidad y Tobago, basado en un protocolo que evite algunos de los problemas asociados con otros enfoques usados para desarrollar estos conjuntos de valores, tales como tareas complejas de obtención de datos, que los encuestados tienen que llevar a cabo, y las grandes muestras de respuestas requeridas para recoger varios subconjuntos de valoración múltiple utilizando diseños bloqueados. MÉTODOS: Un diseño de experimento de elección discreta ortogonal se utiliza para obtener un conjunto de opciones de una muestra de encuestados. RESULTADOS: Los datos de la elección se analizaron mediante regresión logística multinomial mixta para producir un modelo internamente válido que predice bien. CONCLUSION: Este documento marca un hito importante en el desarrollo de la asignación de recursos de salud en el Caribe. El mismo establece la importancia de incorporar el impacto de las intervenciones de salud para informar las decisiones de asignación de recursos de salud, describe los métodos de obtención y análisis utilizados en el programa piloto, y proporciona una ilustración del uso del conjunto de valores EQ - 5D.


Subject(s)
Humans , Health Care Rationing , Quality-Adjusted Life Years , Resource Allocation , Trinidad and Tobago , Pilot Projects , Models, Statistical
SELECTION OF CITATIONS
SEARCH DETAIL