Incidence of childhood cancer in Trinidad and Tobago / Incidencia del cáncer infantil en Trinidad y Tobago

BACKGROUND: The Government of Trinidad and Tobago is in the process of developing a comprehensive National Oncology Programme. Regarding Paediatric Oncology, it is necessary to characterize this population to adequately direct its development. This report describes the incidence of childhood cancer in Trinidad and Tobago. PROCEDURE: The data were extracted from the National Cancer Registry of Trinidad and Tobago and the Eric Williams Medical Sciences Complex. Malignancies were coded with the International Classification of Childhood Cancer, 3rd edition. Incidence rates were calculated for the period 2001-2006, age 0-14 years and by county. RESULTS: The crude incidence rate of childhood cancer was 1.9 per 100 000 patient years (pyrs). One hundred and forty-five cases were reviewed for the six-year period with an incidence rate of 7.5 per 100 000 pyrs. The highest incidence was in children < 5 years: 14 per 100 000pyrs for males and 11.4 per 100 000 pyrs for females. Leukaemias and central nervous system tumours formed the majority of the cancers (58.6%), however nephroblastoma was more common than neuroblastoma especially in females < 5 years: 2.7 per 100 000 pyrs compared with 1.2 per 100 000 pyrs for neuroblastoma. The incidence of all childhood cancers did not vary across counties, however, there was a higher incidence of leukaemia in three counties. CONCLUSION: The results provide insight into the incidence of childhood cancer in Trinidad and Tobago. It is lower than in developed countries. There are some unique findings in the incidence of nephroblastoma in girls less than five years of age and the relatively higher incidence of leukaemia in three counties. Further analysis is required in these areas.

ANTECEDENTES: El Gobierno de Trinidad y Tobago está en proceso de desarrollar un Programa Nacional de Oncologia integral. Con respecto a la Oncología Pediátrica, es necesario caracterizar esta población adecuadamente para dirigir su desarrollo. Este informe describe la incidencia de cáncer infantil en Trinidad y Tobago. PROCEDIMIENTO: Los datos se extrajeron del Registro Nacional del Cáncer en Trinidad y Tobago y el Complejo Eric Williams para las Ciencias Médicas. Los tumores malignos fueron codificados con la Clasificación International de Cáncer Infantil, 3 era. edición. Se calcularon las tasas de incidencia para el periodo 2001-2006; en la edad 0-14 años y por condado. RESULTADOS: La tasa bruta de incidencia de cáncer infantil fue de 1.9 por 100 000 años-paciente. Se estudiaron ciento cuarenta y cinco casos por un periodo de seis años con una tasa de incidencia de 7.5 por 100 000 años-paciente. La incidencia más alta se encontró en los niños < 5 años: 14 por 100 000 años-paciente para los varones y 11.4 por 100 000 años-paciente para las hembras. Las leucemias y los tumores del sistema nervioso central constituyeron la mayor parte de los cánceres (58.6%). Sin embargo, el nefroblastoma fue más comun que el neuroblastoma, especialmente en las hembras < 5 años: 2.7 por 100 000 años-paciente en comparación con 1.2 por 100 000 años-paciente del neuroblastoma. La incidencia de todos los cánceres infantiles no varió en los condados. Sin embargo, hubo una incidencia mayor de leucemia en tres condados. CONCLUSIÓN: Los resultados dan una vision de la incidencia de cáncer infantil en Trinidad y Tobago. Esta es más baja que en los países desarrollados. Hallazgos de interés único fueron la incidencia de nefroblastomas en niñas menores de cinco años de edad y la incidencia relativamente más alta de leucemia en tres condados. Se requiere análisis ulterior en estas áreas.

Incidence of childhood cancer in Trinidad and Tobago.

BACKGROUND: The Government of Trinidad and Tobago is in the process of developing a comprehensive National Oncology Programme. Regarding Paediatric Oncology, it is necessary to characterize this population to adequately direct its development. This report describes the incidence of childhood cancer in Trinidad and Tobago. PROCEDURE: The data were extracted from the National Cancer Registry of Trinidad and Tobago and the Eric Williams Medical Sciences Complex. Malignancies were coded with the International Classification of Childhood Cancer, 3rd edition. Incidence rates were calculated for the period 2001-2006, age 0-14 years and by county. RESULTS: The crude incidence rate of childhood cancer was 1.9 per 100,000 patient years (pyrs). One hundred and forty-five cases were reviewed for the six-year period with an incidence rate of 7.5 per 100,000 pyrs. The highest incidence was in children <5 years: 14 per 100,000 pyrs for males and 11.4 per 100,000 pyrs for females. Leukaemias and central nervous system tumours formed the majority of the cancers (58.6%), however nephroblastoma was more common than neuroblastoma especially in females <5 years: 2.7 per 100,000 pyrs compared with 1.2 per 100,000 pyrs for neuroblastoma. The incidence of all childhood cancers did not vary across counties, however there was a higher incidence of leukaemia in three counties. CONCLUSION: The results provide insight into the incidence of childhood cancer in Trinidad and Tobago. It is lower than in developed countries. There are some unique findings in the incidence of nephroblastoma in girls less than five years of age and the relatively higher incidence of leukaemia in three counties. Further analysis is required in these areas.

Bioisosteric phentolamine analogs as potent alpha-adrenergic antagonists.

The synthesis and biological evaluation of a new series of bioisosteric phentolamine analogs are described. Replacement of the carbon next to the imidazoline ring of phentolamine with a nitrogen atom provides compounds (2, 3) that are about 1.6 times and 4.1 times more potent functionally than phentolamine on rat alpha1-adrenergic receptors, respectively. In receptor binding assays, the affinities of phentolamine and its bioisosteric analogs were determined on the human embryonic kidney (HEK) and Chinese Hamster ovary (CHO) cell lines expressing the human alpha1- and alpha2-AR subtypes, respectively. Analogs 2 and 3, both, displayed higher binding affinities at the alpha2- versus the alpha1-ARs, affinities being the least at the alpha1B-AR. Binding affinities of the methoxy ether analog 2 were greater than those of the phenolic analog 3 at all six alpha-AR subtypes. One of the nitrogen atoms in the imidazoline ring of phentolamine was replaced with an oxygen atom to give compounds 4 and 5, resulting in a 2-substituted oxazoline ring. The low functional antagonist activity on rat aorta, and binding potencies of these two compounds on human alpha1A- and alpha2A-AR subtypes indicate that a basic functional group is important for optimum binding to the alpha1- and alpha2A-adrenergic receptors.

Pregnancy in women with Marfan's Syndrome.

Marfan's Syndrome (MFS) is an autosomal dominant condition resulting in a generalised weakness of the supporting tissues of the body. In its classical form it is associated with abnormalities of the eye, the skeletal system and the cardiovascular system. The prevalence of classical Marfan's Syndrome is 4-6 per 100,000 people. It has significant implications for affected women who are contemplating pregnancy. A multidisciplinary approach involving the specialities of maternal fetal medicine, cardiology and clinical genetics is optimal for provision of care to women with Marfan's Syndrome.

Obstetric profiles and pregnancy outcomes of immigrant women with refugee status.

This paper describes the obstetric profiles and pregnancy outcome of immigrant women with refugee status. A retrospective analysis of two hundred and seventy one immigrant women with confirmed refugee status who delivered in our hospital between June 1999 and May 2000 was performed. The average gestational age at booking was 33 weeks. The majority (63%) were multiparous, had low rates of epidural analgesia, instrumental delivery and episiotomies. There were no differences in the gestational age at delivery, incidence of caesarean section and birth weights from the hospital population. In this small study group there were four perinatal deaths giving a corrected perinatal mortality of 14.8 compared to 5.6 in the hospital population. Seven patients (3%) tested positive for Human Immunodeficiency Virus (HIV). Two patients (0.8%) were diagnosed with active tuberculosis. The majority of patients (80%) were living in emergency accommodation. In conclusion, this population has specific obstetric, medical and social problems.

Yohimbine dimers exhibiting binding selectivities for human alpha2a- versus alpha2b-adrenergic receptors.

A series of yohimbine dimers was prepared and evaluated at the human alpha2a- and alpha2b-adrenergic receptors (ARs) expressed in Chinese hamster ovary (CHO) cells. All dimers display higher binding selectivities for alpha2a versus alpha2b subtype than yohimbine, and four compounds (3d, 3e, 3g and 3i) represent the most potent and alpha2a versus alpha2b-AR selective ligands identified so far.