ABSTRACT
Many countries have reported a change in the profile of infective endocarditis (IE) over the past three decades. The objective of this study was to evaluate the characteristics of IE from the autopsy service of the University Hospital of the West Indies (UHWI) during the last 15 years and to compare the results with that of an earlier study. There were 26 cases of IE during the period under review with a M:F ratio of 1.2:1. The ages ranged from 15 days to 74 years with a mean of 36.4 +/- 24.57 years. The largest number of cases (n = 7) occurred in the 10 to 19-year-age group. Cardiac predisposing factors were identified in 14 patients; nine with rheumatic heart disease, four with prosthetic valves and one with a bicuspid aortic valve. All vegetations were located on valves, the aortic being the most frequently involved followed by the mitral. Streptococcus species were the most common causative organisms followed by Staphylococcus aureus. Compared with the profile seen 15 years ago, there have been only minor changes in the characteristics of IE cases observed in the autopsy service at the UHWI.
Subject(s)
Endocarditis, Bacterial/epidemiology , Adolescent , Adult , Age Factors , Aged , Autopsy , Child , Endocarditis, Bacterial/microbiology , Female , Hospitals, University , Humans , Male , Middle Aged , Risk Factors , West Indies/epidemiologyABSTRACT
Many countries have reported a change in the profile of infective endocarditis (IE) over the past three decades. The objective of this study was to evaluate the characteristics of IE from the autopsy service of the University Hospital of the West Indies (UHWI) during the last 15 years and to compare the results with that of an earlier study. There were 26 cases of IE during the period under review with a M:F ratio of 1.2:1. The ages ranged from 15 days to 74 years with a mean of 36.4 +/- 24.57 years. The largest number of cases (n = 7) occurred in the 10 to 19-year-age group. Cardiac predisposing factors were identified in 14 patients; nine with rheumatic heart disease, four with prosthetic valves and one with a bicuspid aortic valve. All vegetations were located on valves, the aortic being the most frequently involved followed by the mitral. Streptococcus species were the most common causative organisms followed by Staphylococcus aureus. Compared with the profile seen 15 years ago, there have been only minor changes in the characteristics of IE cases observed in the autopsy service at the UHWI
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Endocarditis, Bacterial/epidemiology , Autopsy , Endocarditis, Bacterial/microbiology , Age Factors , Risk Factors , Hospitals, University , West Indies/epidemiologyABSTRACT
OBJECTIVE: To evaluate the significance of a Papanicolaou (Pap) cervico-vaginal smear diagnosis of atypical squamous cells of undertermined significance (ASCUS) using cytohistologic correlation and to determine the ASCUS squamous intraepithelial lesions (SIL) ratios of five cytopathology laboratories. DESIGN AND METHODS: A combined retrospective and prospective study was undertaken to evalute the histologic diagnoses of the biopsies from patients who attended the colposcopy clinic at the Queen Elizabeth Hospital with the Pap smear cytologic diagnosis of ASCUS during the period, January 1 - April 15, 1998. The laboratory from which the Pap reports were issued was recorded. RESULTS: During this three and a half month period three hundred and sixty-four (364) patients with abnormal smears diagnosed at five different cytology laboratories were investigated. One hundred and fifty (42.1 percent) patients has a Pap smear diagnosis of ASCUS, followed by 161 (46.5 percent) SIL, 130 (35.8 percent) wit low grade intraepithelial lesions (LSIL) and 31 (10.7 percent) high grade intraepithelial lesions (HSIL). Three cases with ASCUS were subsequently excluded from the study because of insufficient data. The histologic diagnosis of the remaining 147 biopsies from patients with the Pap smear diagnosis of ASCUS were LSIL 49 (33.6 percent), HSIL 9 (6.2 percent), atypia/metaplasia 66 (45.2 percent) and inflammation/normal 23 (15.1 percent). The overall ASCUS/SIL ratio was 0.90 and the individual laboratory ratios ranged from 0.25 to 1.70 with a mean of 0.84 ñ 0.63. CONCLUSION: The histologic diagnosis of a cervical cytologic smear assessed as ASCUS may vary from normal to HSIL. Just under 40 percent are likely to be SIL with LSIL predominant. The ASCUS/SIL ratios of Barbadian cytopathology laboratories are less than the ASCUS/SIL ratio (2.0-3.0) suggested by the 1992 NCI Workshop at Bethesda. Hence a diagnosis of ASCUS in Barbados requires careful follow-up.(AU)