Subject(s)
Acute Pain , Anemia, Sickle Cell , Adult , Humans , Acute Pain/etiology , Anemia, Sickle Cell/complications , Pain Management/methodsABSTRACT
OBJECTIVES: To compare knowledge, attitudes and risk perception related to blood donation and transfusion in Trinidad and Tobago and Bahamas. BACKGROUND: Trinidad and Tobago and the Bahamas are two Caribbean countries whose national blood transfusion systems are heavily reliant (76.2% and 76%) on family replacement donors. The Pan American Health Organisation/World Health Organisation recommends blood collection from exclusively voluntary nonremunerated donors on the grounds that family replacement donor-based blood systems are unsafe and inadequate compared to those based on voluntary nonremunerated blood donors. METHODS/MATERIALS: A 23-item questionnaire was distributed online by snowball sampling in these two countries to assess knowledge, attitudes, risk perception and behaviour. SPSS version 24 was used for interpretative and descriptive data analysis, chi-square to measure significance and linear regression the strength of associations. p < 0.05 was used to define statistical significance. RESULTS: Four hundred and fifty three (453) responses were obtained from Trinidad and Tobago and 101 from the Bahamas. Knowledge and positive attitudes were high in both countries (75.5% vs. 80.2%, p < 0.001 and 96.6% vs. 100%, p < 0.001). A substantial proportion of respondents held the perception that the local blood donation system was safe or very safe (26.4 and 61.4%, p < 0.001) that was linked to the misconception that the prevalent method of blood donation was voluntary nonremunerated (27.8 and 51.4%, p < 0.001). Concerns about receiving blood were underpinned by mistrust of transfusion-related procedures. CONCLUSION: A social interface to transfer information between blood transfusion services and the community could encourage voluntary nonremunerated blood donation and reduce concerns about receiving transfusion.
Subject(s)
Blood Donors , Health Knowledge, Attitudes, Practice , Blood Transfusion , Caribbean Region , Humans , PerceptionABSTRACT
AIM: To investigate neurogenesis in both adult and 3-week-old genetic absence epilepsy rats from Strasbourg (GAERS) to determine if newly formed neurons within the dentate gyrus (DG) form synaptic contacts with GABAergic (gamma aminobutyric acid) and glutamatergic nerve terminals and compared to the control (non-GAERS) Wistar rats. MATERIAL AND METHODS: Brain tissue was processed for electron microscopic assessment. Thin sections from the hippocampal DG were double-labelled for anti-GABA or anti-VGLUT1 (vesicular glutamate transporter 1) and anti-doublecortin (DCX) antibodies using immunogold methodology and examined with the transmission electron microscope for morphological changes and to quantify the density of gold labeling. RESULTS: DCX immunoreactivity was demonstrated within axon terminals, dendrites and somata in all groups. DCX and GABA or VGLUT1 were found to be co-localized in the axon terminals in all groups. We observed that DCX-immunoreactive (-ir) profiles formed synaptic contacts with GABAergic and glutamatergic terminals. The percentage of DCX labeling in dendrites, compared to axons, and the percentage of DCX-ir terminal profiles forming asymmetrical synapses, compared to those forming symmetrical synapses, were increased in all groups compared to the control group. DCX immunoreactivity in the 21-day-old GAERS group was found to be increased compared to the Wistar group. CONCLUSION: We conclude that newly born neurons are incorporated into the local hippocampal network in both the GAERS and the control Wistar rats. The results suggest that the neurogenesis taking place in the hippocampus may also be involved in the mechanism underlying absence seizures in GAERS.
Subject(s)
Epilepsy, Absence/genetics , Epilepsy, Absence/physiopathology , Neurogenesis/physiology , Animals , Doublecortin Protein , Epilepsy, Absence/diagnosis , Epilepsy, Absence/metabolism , Hippocampus/diagnostic imaging , Hippocampus/metabolism , Hippocampus/pathology , Hippocampus/ultrastructure , Immunohistochemistry/methods , Male , Microscopy, Electron/methods , Neurons/metabolism , Neurons/pathology , Neurons/ultrastructure , Rats , Rats, Transgenic , Rats, Wistar , Synapses/physiology , Synapses/ultrastructure , gamma-Aminobutyric Acid/metabolismABSTRACT
OBJECTIVE: To describe the process, challenges and impact of developing a voluntary non-remunerated blood donor programme in a replacement- based blood donation system. BACKGROUND: Trinidad and Tobago is a developing country whose blood transfusion service is based on replacement and remunerated donors. The University of the West Indies Blood Donor Foundation was formed to promote voluntary non-remunerated donation through education, research and example. METHODS/MATERIALS: The process of establishing the Blood Donor Foundation was documented. Age, gender, number, history (first-time or repeat) and serological tests of donors attending 12 consecutive sessions between 2015 and 2018 were analyzed. Comparisons were made to published PAHO data for TTO's replacement blood donor system and the programme's impact on national policy described. Chi square analysis was used to measure significance of associations and pâ¯<⯠0.05 to assign statistical significance. RESULTS: After research and sensitization, 951 units of blood were collected, 50% from people in the 17-25 age group, 54% from females and 55% from repeat donors. Deferrals were <10% and initially reactive serological tests 1.2% compared to 43.6% and 3.04% respectively (pâ¯<â¯0.05 for both) for the national donor pool. The model was accepted for application nationally. CONCLUSION: A voluntary non-remunerated blood donation programme was successfully established within a replacement-based system providing a model for national adoption.
Subject(s)
Blood Donors/education , Universities , Female , Humans , Male , Trinidad and TobagoABSTRACT
The current state of many freshwater fish stocks worldwide is largely unknown but suspected to be vulnerable to exploitation from recreational fisheries and habitat degradation. Both these factors, combined with complex ecological dynamics and the diffuse nature of inland fisheries could lead to an invisible collapse: the drastic decline in fish stocks without great public or management awareness. In this study we provide a method to address the pervasive knowledge gaps in regional rates of exploitation and habitat degradation, and demonstrate its use in one of North America's largest and most diffuse recreational freshwater fisheries (Ontario, Canada). We estimated that (1) fish stocks were highly exploited and in apparent danger of collapse in management zones close to large population centres, and (2) fish habitat was under a low but constant threat of degradation at rates comparable to deforestation in Ontario and throughout Canada. These findings confirm some commonly held, but difficult to quantify, beliefs in inland fisheries management but also provide some further insights including (1) large anthropogenic projects greater than one hectare could contribute much more to fish habitat loss on an area basis than the cumulative effect of smaller projects within one year, (2) hooking mortality from catch-and-release fisheries is likely a greater source of mortality than the harvest itself, and (3) in most northern management zones over 50% of the fisheries resources are not yet accessible to anglers. While this model primarily provides a framework to prioritize management decisions and further targeted stock assessments, we note that our regional estimates of fisheries productivity and exploitation were similar to broadscale monitoring efforts by the Province of Ontario. We discuss the policy implications from our results and extending the model to other jurisdictions and countries.
Subject(s)
Fisheries , Fishes/physiology , Population Dynamics , Animals , Canada , Ecosystem , Fresh Water , Lakes , OntarioABSTRACT
The ophthalmic presentation of relapse in a patient with human T-lymphotropic virus type 1 (HTLV1) associated adult T-cell lymphoma leukaemia is described. Epidemiology, clinical features and therapeutic options are briefly reviewed. Antenatal screening and inclusion of HTLV1 in the differential diagnosis of inflammatory and neuromuscular eye conditions should be considered in endemic regions.
Subject(s)
Human T-lymphotropic virus 1/drug effects , Human T-lymphotropic virus 1/radiation effects , Trinidad and TobagoABSTRACT
The ophthalmic presentation of relapse in a patient with human T-lymphotropic virus type 1 (HTLV1) associated adult T-cell lymphoma leukaemia is described. Epidemiology, clinical features and therapeutic options are briefly reviewed. Antenatal screening and inclusion of HTLV1 in the differential diagnosis of inflammatory and neuromuscular eye conditions should be considered in endemic regions.
Subject(s)
Blepharoptosis/pathology , HTLV-I Infections/diagnosis , Human T-lymphotropic virus 1 , Leukemia-Lymphoma, Adult T-Cell/pathology , Blepharoptosis/virology , Enzyme-Linked Immunosorbent Assay , Humans , Lymphoma, T-Cell , Male , Middle Aged , Neoplasm Recurrence, Local , RecurrenceABSTRACT
Dengue fever is endemic to Trinidad and Tobago. A retrospective analysis of all adult admissions at a tertiary hospital in Trinidad treated for dengue during January 1-December 31, 2008 was performed. A total of 186 patients were treated during this period: 98.9% (184) of the patients were thrombocytopenic; 45.2% were severely thrombocytopenic; 13 patients showed development of minor hemorrhage and only one case of major hemorrhage; platelet transfusion was given for 7% (13) of the cases; and 6 cases for which platelet transfusion was given did not show evidence of plasma leakage (12 of these cases did not show evidence of hemorrhage). There was a strong association between the lowest platelet value and hemoconcentration (χ(2) = 13.16, P < 0.025). No association was found between giving a platelet transfusion and hemoconcentration or hemorrhage. Thrombocytopenia seen in dengue resolves spontaneously and independent of any transfusion used.
Subject(s)
Platelet Transfusion/methods , Severe Dengue/epidemiology , Severe Dengue/therapy , Adolescent , Adult , Female , Hemorrhage/blood , Hemorrhage/pathology , Hemorrhage/therapy , Humans , Male , Middle Aged , Retrospective Studies , Thrombocytopenia/blood , Thrombocytopenia/pathology , Thrombocytopenia/therapy , Trinidad and Tobago/epidemiology , Young AdultABSTRACT
Trinidad and Tobago is a former British Colony with population 1.3 million and a member state of the Pan American Heath Organization, World Health Organization. This is a brief history of the development of blood transfusion services on the island from its first documentation to the present day.
Subject(s)
Humans , Blood Transfusion , Trinidad and TobagoABSTRACT
A male infant presented at birth with severe coarctation of the aorta and marginal left ventricular and mitral valve dimensions associated with a large secundum atrial septal defect. Following successful arch repair, the left ventricle remained small with preferential left-to-right atrial shunting and a dilated right ventricle. Clinically, the infant continued with tachypnea, poor feeding, and failure to thrive. At 4 months of age, the defect was closed with an Amplatzer Atrial Septal Occluder which resulted in immediate left ventricular cavity enlargement and clinical improvement.
Subject(s)
Aortic Coarctation/complications , Heart Septal Defects, Atrial/complications , Heart Septal Defects, Atrial/surgery , Ventricular Dysfunction, Left/congenital , Ventricular Dysfunction, Left/complications , Aortic Coarctation/surgery , Cardiac Catheterization , Echocardiography , Heart Septal Defects, Atrial/diagnosis , Humans , Infant, Newborn , Infant, Premature , Male , Prosthesis Implantation/instrumentation , Prosthesis Implantation/methods , Ventricular Dysfunction, Left/diagnosisABSTRACT
La drepanocitosis incluye un grupo heterogéneo de procesos patológicos, tanto desde el punto de vista genético como clínico. Con el advenimiento de nuevas modalidades terapéuticas, la expectativa de vida para estos pacientes se ha elevado. Diversos estudios en pacientes de edad avanzada han sido publicados, pero no se conoce si estos presentan características fisiológicas ventajosas. Se analizó el cuadro clínico y los resultados de laboratorio de 40 pacientes mayores de 40 años que asistieron a consulta en el Servicio de Hematología del Hospital General de Puerto de España entre enero y junio del año 2004. La edad promedio fue de 48,82 (40-66) años: 25 (62,5 por ciento) tenían entre 40 y 49 años de edad; 11 (27,5 por ciento) entre 50-59 años; y 4 (10 por ciento) 60 años ó más. Trece (32,5 por ciento) eran del sexo masculino y 27 (67,5 por ciento) del femenino; 33 (82,5 por ciento) presentaron fenotipo SS y 7 (17,5 por ciento) el SC. El promedio de edad al diagnóstico fue de 14,6 (0-38) años. Se encontró un grupo numeroso de pacientes con drepanocitosis y edad avanzada. Las características del cuadro clínico y los resultados de las pruebas de laboratorio evidenciaron en ellos poca severidad de la enfermedad, por lo que pudieran constituir un subgrupo con características fisiopatológicas distintivas. Sería conveniente realizar nuevos estudios para identificar factores relacionados con la severidad del cuadro clínico y la sobrevida de este tipo de pacientes(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Anemia, Sickle Cell , Aged , Trinidad and TobagoABSTRACT
La drepanocitosis incluye un grupo heterogéneo de procesos patológicos, tanto desde el punto de vista genético como clínico. Con el advenimiento de nuevas modalidades terapéuticas, la expectativa de vida para estos pacientes se ha elevado. Diversos estudios en pacientes de edad avanzada han sido publicados, pero no se conoce si estos presentan características fisiológicas ventajosas. Se analizó el cuadro clínico y los resultados de laboratorio de 40 pacientes mayores de 40 años que asistieron a consulta en el Servicio de Hematología del Hospital General de Puerto de España entre enero y junio del año 2004. La edad promedio fue de 48,82 (40-66) años: 25 (62,5 %) tenían entre 40 y 49 años de edad; 11 (27,5 %) entre 50-59 años; y 4 (10 %) 60 años ó más. Trece (32,5 %) eran del sexo masculino y 27 (67,5 %) del femenino; 33 (82,5 %) presentaron fenotipo SS y 7 (17,5 %) el SC. El promedio de edad al diagnóstico fue de 14,6 (0-38) años. Se encontró un grupo numeroso de pacientes con drepanocitosis y edad avanzada. Las características del cuadro clínico y los resultados de las pruebas de laboratorio evidenciaron en ellos poca severidad de la enfermedad, por lo que pudieran constituir un subgrupo con características fisiopatológicas distintivas. Sería conveniente realizar nuevos estudios para identificar factores relacionados con la severidad del cuadro clínico y la sobrevida de este tipo de pacientes.
Sickle cell anemia includes a heterogenous group of pathological processes from the genetic and clinical point of view. With the appearance of new therapeutic modalities, the life expectancy of these patients has increased. Several studies on advanced age patients have been published, but it is not known if they present advantageous physiological characteristics. The clinical picture and the laboratory results of 40 patients over 40 that received attention at the Hematology Service of Port of Spain between January and June 2004 were analysed. Average age was 48.82 (40-66) years old. 25 (62.5 %) were 40-49 years old; 11 were 50-59, and 4 (10 %) were 60 or over.13 (32.5 %) were males and 27 (67.5 %) were females. 3 presented phenotype SS and 7 had (17.5 %) phenotype SC. Average age at the time of diagnosis was 14.6 (0-38) years old. A numerous group of patients with sickle cell anemia and advanced age was found. The characteristics of the clinical picture and the results of the laboratory tests evidenced a little severity of the disease, so they may be a subgroup with distinctive physiopathological features. It would be convenient to undertake new studies to identify factors related to the severity of the clinical picture and the survival of this type of patients.
Subject(s)
Aging/pathology , Anemia, Sickle Cell/complications , Anemia, Sickle Cell/pathology , Adult , Aged , Anemia, Sickle Cell/physiopathology , Antisickling Agents/therapeutic use , Blood Transfusion , Female , Foot Ulcer/etiology , Foot Ulcer/physiopathology , Foot Ulcer/therapy , Humans , Hydroxyurea/therapeutic use , Kidney Failure, Chronic/etiology , Kidney Failure, Chronic/physiopathology , Kidney Failure, Chronic/therapy , Male , Middle Aged , Necrosis/etiology , Necrosis/physiopathology , Necrosis/therapy , Trinidad and TobagoABSTRACT
To assess the fraction of the blood donated that is allocated to the beta thalassemia major patients on Blood bank at the Eric Williams Medical Sciences Complex., and to assess the adequacy and management of blood donation in Eric Williams Medical Science Complex (AU)
