ABSTRACT
Objective To assess cervical cancer prevalence and associated mortality in Grenada, West Indies during 2000-2010. Methods Records of visits to hospital and clinical facilities were obtained from the histopathology laboratory of the Grenada General Hospital. Records were de-identified and electronically compiled. Cervical cancer prevalence was assessed via cross-sectional analysis of this secondary data. Of a total 12 012 records, 2 527 were selected for analysis using sampling without replacement. Cases were matched to corresponding patient data from death registries, where possible, and used to calculate associated mortality rates. Results The observed prevalence of cervical cancer was 52.4 per 100 000 women (ages 15 and above). The highest rates of cervical cancer occurred in the 35-44 age group, with the second highest among 45-64-year-olds. A total of 65 deaths were attributable to cervical cancer during 2000-2010, more than 50% of which were among women > 65 years old. The observed mortality rate was 16.7 per 100 000, almost twice the rate estimated by WHO for the region. Conclusions This study demonstrates the need for a comprehensive cervical cancer-screening program in Grenada. Results should contribute to informing future studies on how to appropriately generate and execute public health policy for education, screening, prevention, and control of cervical cancer in Grenada.
Subject(s)
Uterine Cervical Neoplasms/epidemiology , Adolescent , Adult , Age Distribution , Aged , Cross-Sectional Studies , Female , Grenada/epidemiology , Humans , Middle Aged , Prevalence , Registries , Uterine Cervical Neoplasms/mortalityABSTRACT
ABSTRACT Objective To assess cervical cancer prevalence and associated mortality in Grenada, West Indies during 2000–2010. Methods Records of visits to hospital and clinical facilities were obtained from the histopathology laboratory of the Grenada General Hospital. Records were de-identified and electronically compiled. Cervical cancer prevalence was assessed via cross-sectional analysis of this secondary data. Of a total 12 012 records, 2 527 were selected for analysis using sampling without replacement. Cases were matched to corresponding patient data from death registries, where possible, and used to calculate associated mortality rates. Results The observed prevalence of cervical cancer was 52.4 per 100 000 women (ages 15 and above). The highest rates of cervical cancer occurred in the 35–44 age group, with the second highest among 45–64-year-olds. A total of 65 deaths were attributable to cervical cancer during 2000–2010, more than 50% of which were among women > 65 years old. The observed mortality rate was 16.7 per 100 000, almost twice the rate estimated by WHO for the region. Conclusions This study demonstrates the need for a comprehensive cervical cancer-screening program in Grenada. Results should contribute to informing future studies on how to appropriately generate and execute public health policy for education, screening, prevention, and control of cervical cancer in Grenada.
RESUMEN Objetivo Evaluar la prevalencia del cáncer cervicouterino y la mortalidad asociada en Granada, Antillas Menores, entre el 2000 y el 2010. Métodos Se obtuvieron los registros de las visitas al hospital y a consultorios clínicos a partir del laboratorio de histopatología del Hospital General de Granada. Se borraron los datos personales de los registros y se los compiló electrónicamente. La prevalencia de cáncer cervicouterino se evaluó por medio del análisis transversal de estos datos secundarios. De un total de 12 012 registros, fueron seleccionados para el análisis 2 527 mediante un método de muestreo sin reemplazo. Los casos se compararon con los datos correspondientes de pacientes en los registros de defunciones, cuando fue posible, y se usaron para calcular las tasas de mortalidad asociadas. Resultados La prevalencia observada de cáncer cervicouterino fue 52,4 por 100 000 mujeres (de 15 años o más). Las tasas más elevadas de cáncer cervicouterino se observaron en el grupo de edad de 35 a 44 años, seguido por el grupo de 45 a 64 años. Del 2000 al 2010, 65 defunciones fueron atribuibles al cáncer cervicouterino, más del 50% en mujeres mayores de 65 años. La tasa de mortalidad observada fue 16,7 por 100 000, casi el doble de la calculada por la Organización Mundial de la Salud para la región. Conclusiones Este estudio indica la necesidad de establecer un programa integral de detección del cáncer cervicouterino en Granada. Los resultados deben servir como base para estudios futuros sobre cómo generar y ejecutar apropiadamente políticas de salud pública para la educación en la materia, la detección, la prevención y el control del cáncer cervicouterino en Granada.
Subject(s)
Uterine Cervical Diseases/prevention & control , Women's Health , Papillomavirus Infections/complicationsABSTRACT
OBJECTIVE: To assess (1) the incidence and survival rates of PC, (2) the distribution of prostatic-specific antigen (PSA) and Gleason score in Grenada. DESIGN AND METHODS: A PC hospital-based series from the only urologist in the island was assembled. Age-adjusted incidence rates, PSA levels and Gleason scores for Grenada were analyzed and compared with US-Blacks and incidence rates from International Agency for Research on Cancer (IARC)-contributing Caribbean registries. RESULTS: 601 new cases of PC diagnosed between 1997-2013 equate to an annual age-adjusted incidence rate of 69.3 per 100,000 in Grenada. This is similar to the Jamaica rate of 77.3, but much inferior to those of US-Blacks 197.7 and Martinique 177.8. The median PSA level in Grenada was 18.0 ng/ml compared to 7.0 among US-Blacks (P<0.05). 47% of Grenadians with PC were in the high risk PSA category (>20ng/ml), compared to only 17% US-Blacks. Lower tract urinary infection and positive digital rectal examination were both significantly associated with high risk PSA and high risk Gleason score (Gleason sum ≥ 8). CONCLUSION: The lower PC incidence in Grenada and Jamaica is likely a reflection of lower prevalence of PSA-testing. Thus, PSA levels fall more substantially in the high risk category.
Subject(s)
Prostate , Prostatic Neoplasms , Incidence , Survival Rate , Prostate-Specific Antigen , GrenadaABSTRACT
OBJECTIVE: To study the epidemiology of OPC and assess the impact of age, stage at diagnosis, gender and treatment outside of Grenada on OPC survival. DESIGN AND METHODS: An OPC population-based series from the only ENT surgeon in the island was assembled. Age-adjusted incidence rates, and stage distribution were analyzed and compared with US-Blacks and incidence rates from regional registries. RESULTS: 93 cases of OPC diagnosed during 1991-2010 resulted in an annual age-adjusted incidence rate of 9.5 per 100,000 in Grenadian males and 1.7 among females. Jamaicas rates were 5.2 and 2.3; Martiniques 13.1 and 1.6; US-Blacks 15.1 and 5.0 respectively. The median age in Grenada was 58 years of age. In Grenada 73% of the cases presented with stage III/IV compared to 72% among US Blacks. Nearly 24% of patients had treatment outside of Grenada. CONCLUSION: OPC rates in Grenada were comparable to others in the region, attesting to the population basis of this series. Grenadian males show medium risk for OPC while the risk is low among females. Surprisingly, the tumor, node and metastasis (TNM) stage distribution in Grenada does not differ significantly from that among US Blacks for OPC, a cancer for which screening is rarely performed or possible.
Subject(s)
Incidence , Survival Rate , Mouth Neoplasms/epidemiology , Pharyngeal Neoplasms/epidemiology , GrenadaABSTRACT
OBJECTIVE: To investigate prevalence of cancers affecting women in Grenada, a study was conducted using de-identified patient records from the Grenada General Hospital Histopathology Laboratory of women who visited hospital and clinic facilities during 2000 - 2010. DESIGN AND METHODS: De-identified records of 12,012 entries, 9,023 female (7,172 individuals) between ages 8 94 years presumably to seek preventative care or medical treatment were assessed during this cross-sectional study. Sampling without replacement resulted in approximately 3,000 entries for analysis. Prevalence of each type of cancer reported amongst women was determined. RESULTS: Of the 3,000 pathology diagnoses, 601 of the samples were classified as cancerous. The most prevalent cancer in Grenadian women from 2000 2010 was cervical cancer at (34%), followed by breast cancer at (31%). All other reported cancers were analyzed and their prevalence determined. CONCLUSION: Overall, the rate of cancer among Grenadian women for the ten-year period from 2000 2010 was determined to be 8.4%. There are implications for prevention and creation of health policies to address cancer burden in Grenada.
Subject(s)
Prevalence , Neoplasms , Uterine Cervical Neoplasms , Breast Neoplasms , GrenadaABSTRACT
We report a case of unsuspected penetrating trauma with intraorbital foreign body, namely a needlefish jaw. A 44-year-old fisherman presented with vertical diplopia and discrete swelling of the upper lid near the medial canthus after being hit by a fish. He was unaware of any penetrating lesion or foreign body. There was no entry wound. CT-scan showed a foreign body between the globe and the medial orbital wall. Surgical exploration found that it was a 4.5cm long needlefish jaw. Removal resulted in complete resolution of symptoms. Needlefish can be very dangerous. This is the first reported case of a needlefish jaw in the orbit with no associated lesion, infection or inflammation.
Subject(s)
Beloniformes , Eye Foreign Bodies/diagnosis , Eye Injuries/diagnosis , Occupational Injuries/diagnosis , Adult , Animals , Dacryocystitis/diagnosis , Diagnosis, Differential , Eye Foreign Bodies/diagnostic imaging , Eye Injuries/diagnostic imaging , Eye Injuries/etiology , Humans , Jaw , Male , Occupational Injuries/diagnostic imaging , Occupational Injuries/etiology , Orbit/diagnostic imaging , Orbit/injuries , RadiographyABSTRACT
Three Afro-Caribbean women presented with a decreased visual acuity associated with preeclampsia during the third trimester of pregnancy. Fundus examination exhibited a serous retinal detachment (SRD). Postpartum fluorescein and indocyanine green angiography indicated subretinal leakage induced by choroidal ischemia. The three patients had an improvement of their visual acuity to 20/20 within 2 to 3 months of the onset of symptoms. Fundus exam and fluorescein angiography showed no further abnormality. SRD in preeclampsia may have an impressive acute presentation but seems to resolve favorably spontaneously without intervention, upon delivery. Nevertheless, SRD must be considered to be a sign of imminent worsening of preeclampsia.
Subject(s)
Pre-Eclampsia , Pregnancy Complications/diagnosis , Retinal Detachment/diagnosis , Adult , Black People , Female , Fluorescein Angiography , Humans , Pre-Eclampsia/diagnosis , Pregnancy , Retinal Detachment/complications , West Indies , Young AdultABSTRACT
INTRODUCTION: Non-Hodgkin lymphomas (NHLs) constitute a group of heterogeneous diseases that can arise in lymphatic nodal or extranodal sites. Ocular lymphomas account for 1% of all NHLs. Tumor of the orbit, which can lead to compression of the optic nerve, is the most frequent presentation of the disease. Primary infiltration of the optic nerve and its sheath remains exceptional. OBSERVATION: We report the case of a 51-year-old female patient treated for a NHL. While she was considered to be in remission after four courses of chemotherapy, she presented a right visual loss with hand motion acuity. Her examination revealed a right afferent pupillary defect. Brain MRI emphasized an infiltration of her right optic nerve with no other orbit abnormality. Cerebrospinal fluid analysis showed lymphomatous meningitis. She was then considered to have lymphomatous optic neuropathy (LON). Despite initial improvement of the visual acuity with treatment, the patient died of bone marrow aplasia 6 weeks later. CONCLUSION: LON can be suspected in a painful and sudden visual loss in a context of neoplasia. The diagnosis is confirmed by MRI and cerebrospinal fluid analysis. LON may occur as the sole ocular manifestation of disease recurrence in a patient with systemic NHL, otherwise thought to be in clinical remission.
Subject(s)
Central Nervous System Neoplasms/secondary , Lymphoma, Non-Hodgkin/complications , Lymphoma, Non-Hodgkin/pathology , Meningeal Neoplasms/secondary , Optic Nerve Diseases/etiology , Central Nervous System Neoplasms/complications , Central Nervous System Neoplasms/diagnosis , Female , Humans , Meningeal Neoplasms/complications , Meningeal Neoplasms/diagnosis , Middle Aged , Optic Nerve Diseases/complications , Optic Nerve Diseases/diagnosis , Optic Neuritis/diagnosis , Optic Neuritis/etiology , Visual AcuityABSTRACT
We present a case of an 85-year-old Caribbean man initially presenting with lachrymal gland enlargement and a large subcutaneous extension responsible for a hemifacial "lion-like" deformation. The most important diagnoses to suggest are adenocarcinoma of the lachrymal gland, lymphoma, leprosy, tuberculosis, and sarcoidosis. Based on the clinical, biological, and radiological findings, sarcoidosis was suspected with lachrymal gland and pulmonary lesions. Biopsy of the enlarged lachrymal gland revealed a non caseating granuloma compatible with the diagnosis of sarcoidosis. The value of this case is the atypical field and sarcoidosis revealed as a unilateral lesion in an elderly male.
Subject(s)
Lacrimal Apparatus Diseases/diagnosis , Sarcoidosis/diagnosis , Aged, 80 and over , Humans , Lacrimal Apparatus Diseases/etiology , Male , Sarcoidosis/complicationsABSTRACT
This paper summarizes and discusses the available cancer incidence (1996-2000) and mortality data (1990-2000) for the tri-island Caribbean nation of Grenada, Carriacou and Petit Martinique. Data for the analysis came from three sources: the Grenada Department of Statistics, the histopathology specimen books from St George's General Hospital and the Death Registry of the Ministry of Health, Grenada. The age-standardized rates (ASR) per 100 000 for all cancer sites combined were 170.2 in females and 158.2 in males. The four most frequent diagnoses (ASR) by cancer site in females were cervix (60.7), breast (49.1), uterus (28.4) and skin (13.3); and among males, prostate (61.4), bladder (16.3), skin (19.3) and stomach (10). Age-standardized mortality rates per 100 000 for all cancer sites combined were 105.4 in females and 165 in males. The four most frequent cancer associated mortalities (ASR) in females were breast (17.9), uterus (11.2), colon (10.3) and cervix (9.7); and among males, prostate (53.6), lung (18.7), stomach (14.5) and colon (10.9). This study found statistically significant spatial trends for overall cancer mortality and temporal trends in incidence and mortality rates for prostate and for incidence rates of stomach cancer. These rates are compared with those from other areas in the Caribbean and the United States of America and encourage efforts to establish a cancer registry in Grenada
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Neoplasms/epidemiology , Population Surveillance , Grenada/epidemiology , Incidence , Neoplasms/mortalityABSTRACT
This paper summarizes and discusses the available cancer incidence (1996-2000) and mortality data (1990-2000) for the tri-island Caribbean nation of Grenada, Carriacou and Petit Martinique. Data for the analysis came from three sources: the Grenada Department of Statistics, the histopathology specimen books from St George's General Hospital and the Death Registry of the Ministry of Health, Grenada. The age-standardized rates (ASR) per 100 000 for all cancer sites combined were 170.2 in females and 158.2 in males. The four most frequent diagnoses (ASR) by cancer site in females were cervix (60.7), breast (49.1), uterus (28.4) and skin (13.3); and among males, prostate (61.4), bladder (16.3), skin (19.3) and stomach (10). Age-standardized mortality rates per 100 000 for all cancer sites combined were 105.4 in females and 165 in males. The four most frequent cancer associated mortalities (ASR) in females were breast (17.9), uterus (11.2), colon (10.3) and cervix (9.7); and among males, prostate (53.6), lung (18.7), stomach (14.5) and colon (10.9). This study found statistically significant spatial trends for overall cancer mortality and temporal trends in incidence and mortality rates for prostate and for incidence rates of stomach cancer. These rates are compared with those from other areas in the Caribbean and the United States of America and encourage efforts to establish a cancer registry in Grenada.
Subject(s)
Neoplasms/epidemiology , Population Surveillance , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Grenada/epidemiology , Humans , Incidence , Infant , Infant, Newborn , Male , Middle Aged , Neoplasms/mortalityABSTRACT
O artigo não apresenta resumo.
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O artigo não apresenta resumo.
ABSTRACT
This article reports results of the in vitro study for potential evaluation of the laser-induced fluorescence spectroscopy in the differentiation between normal and neoplastic human breast tissue. A coumarine dye laser pumped by nitrogen laser generated an excitation light centered at 458 nm. In order to collect the fluorescence signal was used an optical fiber catheter coupled to a spectrometer and CCD detector. Fluorescence spectra were recorded from normal and neoplastic (benign and malignant) human breast tissue, adding up 94 different areas. The discrimination between normal and neoplasm groups reach a sensitivity and specificity of 100%.
Subject(s)
Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , Lasers , Spectrometry, Fluorescence/instrumentation , Breast Diseases/diagnosis , Breast Diseases/pathology , Diagnosis, Differential , Female , Humans , Sensitivity and SpecificityABSTRACT
The developing island-nation of Grenada undertook a major road improvement project between 1995 and 1998. In order to determine the effect of those improvements on crash injury and mortality, we reviewed the number of crash-related injuries and deaths for the years 1994 and 1999. After the road improvements, the proportion of crashes that resulted in injury decreased from 22% to 15%. The raw number of crashes (818 vs. 1233), deaths (4 vs. 12) and deaths per 100,000 population (4.1 vs. 11.9) increased, but the proportion of crashes that resulted in death (0.5% vs. 0.7%) remained effectively unchanged.
Subject(s)
Accidents, Traffic/statistics & numerical data , Automobile Driving , Wounds and Injuries/mortality , Accidents, Traffic/mortality , Grenada , Humans , Retrospective StudiesABSTRACT
Reports on a study to assess the magnitude of oral and oropharyngeal cancer in Grenada with emphasis on early diagnosis and prevention. Data collected covered the period 1985-1992. The results show that the annual percentage of neoplasm as cause of death is about 12 per cent, and oral and oropharyngeal neoplasms account for three (3) per cent of all death caused by cancer
Subject(s)
Humans , Oropharyngeal Neoplasms/epidemiologyABSTRACT
Describes a study conducted among school children to identify hearing disorders. 174 children were examined and concludes from the results of this sample survey that an estimated 50 - 60 children among the 2578 first graders in 1990 could be experiencing some sort of hearing loss
Subject(s)
Ear/abnormalities , Hearing Disorders/diagnosis , Speech Disorders/diagnosis , Data Collection , Mass ScreeningABSTRACT
Bilateral choanal atresia in the newborn is generally considered to be incomprehensible with life if not treated. A case of congenital bilateral bony atresia in an adult woman is reported and the procedures used to correct it are described