Area Deprivation Index and Distress Community Index Scores Are Not Associated With Short-Term and Long-Term Extracorporeal Life Support Outcomes.

Distressed Communities Index (DCI) and Area Deprivation Index (ADI) are two composite ranking scores that report community level socioeconomic status (SES) by ZIP codes. The objective of this study was to evaluate the impact of SES as estimated by DCI and ADI scores on short-term and long-term outcomes after extracorporeal life support (ECLS) at a quaternary medical center. All patients on ECLS between January 1, 2015 and August 31, 2020 (N = 428) at Vanderbilt University Medical Center in Nashville, Tennessee, had their ADI and DCI scores calculated. Primary outcome was mortality during index hospitalization, and secondary outcome was survival to end of study follow-up. There was no significant difference in primary outcome between the top 25% ADI vs . bottom 75% ADI (53.8% vs . 50.6%; p = 0.56) or between top 25% DCI vs . bottom 75% DCI (56.1 vs . 49.2; p = 0.21). Adjusted odds ratio for the primary outcome with ADI and DCI was 1.13 (95% CI, 0.63-2.0; p = 0.67) and 1.28 (95% CI, 0.70-2.34; p = 0.41), respectively. Additionally, there was no significant difference in long-term survival curves based on their ADI or DCI scores. In conclusion, SES as estimated by baseline DCI and ADI scores does not appear to impact short- or long-term survival post-ECLS at a large volume center. http://links.lww.com/ASAIO/A951.

Hypertension in pregnancy - abstract

Hypertension occurs in 6 to 20 percent of pregnant women, but results in a far greater degree of maternal and foetal morbidity and mortality. It can take the form of pre-existing chronic hypertension, pregnancy induced hypertension (pre-eclampsia and eclampsia) or pregnancy-aggravated hypertension. Aetiology, diagnosis and management of the major forms of hypertension in the pregnant patient will be discussed, and illustrated by case histories of patients treated at a community hospital in Toronto (AU)

Observations on anopheles (Kertezia) bellator D. & K. in British Guiana

The geographic distribution of the subgenus Kertezia Kertezia of Anopheles in general, and of Anopheles bellator in particular is reviewed. A new record for A. bellator is reported in British Guiana where it was found in the upper reaches of all the rivers in the North West District adjoining a known focus in Eastern Venezuela. A. bellator was found also in the Potaro River, on the Kaieteur escarpment, and on the east bank of the Essequibo River. High rainfall was a common feature in all these areas. Larval findings indicative of the presence in the North West District of one or more other species of Kertezia are recorded. The principal bromelaid host plants for A. bellator were the arboreals Guzmania capituligera, G. Altonii, Vriesia platynema, V. albiflora, wittmackia adora; and the large terrestrial plant Brochhinia micrantha. High densities of adult A. bellator were recorded only at Kaieteur Falls, but in a small Amerindian community in the North West District epidemiological evidence of active malaria transmission is presented. The potentialities of extended A. bellator malaria are briefly reviewed in relation to future development in the hinterlands

Reappearance of Anopheles darlingi Root in a controlled area of British Guiana's coastline

In the greater part of the coast of British Guiana, close association has hitherto existed between hydrological bonification and hyperendemic malaria, except on the eastern coastlands. Residual DDT house spraying, as the sole means of control, brought about the elimination of A. darlingi and Ae. aegypti, and an economic technique of control maintenance by "strategic barrier" spraying was gradually developed. In 1951, A. darlingi reappeared suddenly in small numbers on the eastern coastlands in the wake of artificial changes in conditions of physical and human ecology in a localised area. Prompt spraying of houses in the village and along the path of invasion eliminated a potentially dangerous threat from A. darlingi-borne malaria in the district. This incident confirmed rather than weakened the principle of "strategic barrier" spraying in British Guiana (Summary)

The distribution of Anopheles albimanus in the Caribbean Islands

The presence of A. albimanus in the island units of the Caribbean is discussed. Field obsrevations have now established its absence from the Netherlands Leeward and Windward Islands, Trinidad and Tobago, Grenada, St Vincent, Barbados, St Lucia, Martinique, Dominica and St Kitts. The southernmost point of its distribution in the Island chain is established in Marie Galante at latitude 15o53' N. In the Caribbean Islands A. albimanus is limited to Guadeloupe (and Marie Galante), Montserrat, Antigua, Nevis, Virgin Islands (St Croix, St Thomas and Tortola) and the Greater Antilles (Summary)

Re-infestation problems in an aedes aegypti-free area in British Guiana

A brief outline of British Guiana's activities in A. aegypti eradication programmes is given, particularly in relation to operations in Georgetown. Although the greater part of this City had not been treated with residual DDT, it had been free from aegypti since 1946. The constant threat of re-infestation by small ships from the eastern Caribbean, and measures for overcoming this are described. An instance of localised re-infestation occurred in late 1950 and the general pattern of dissemination is recorded. Future policy in A. aegypti vigilance in the Georgetown area is discussed and the implications of aegypti control programmes in the eastern Caribbean is reviewed. It is concluded that the slow rate of dissemination of A. aegypti under local conditions does not warrant adoption of routine DDT spraying in a city previously cleaned by other methods, and in which efficient inspections are maintained on an annual cycle. (AU)

Malaria in the Leeward and Windward Islands, British West Indies

Malaria surveys under the auspices of the Colonial Development Welfare Organization (British West Indies), were made in the British units of the Leeward and Windward Islands during 1943-47. Malariometric rates of importance were recorded in Grenada, St Lucia, Dominica and Antigua where high rates were found in scattered areas. The general picture was one of localized outbreaks distributed periodically throughout each island. Splenometric findings constituted a reliable measure of recent malaria prevalence, and close positive correlation existed between degree of splenic enlargement and parasitemia. All three of the commoner Plasmodium species were present, but P. falciparum predominated; P. malariae was common, and P. vivax infrequent. Mansonella ozzardi was found in Antigua, Nevis, and St Kitts, in addition to those islands previously recorded in the literature. Four species of Anopheles were encountered-A. aquasalis, A. argyritarsis, A. albimanus and A. pseduopunctipennis. Previous records of A. albimanus in Dominica and St Vincent were not confirmed. On epidemiological data presented, both A. aquasalis and A. albimanus appeared to contribute to malaria transmission. Anticipated results in malaria control from residual DDT are briefly discussed (Summary)