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1.
West Indian Med J ; 62(7): 632-5, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24831902

RESUMO

OBJECTIVE: The aim of this study is to investigate the effect of a public appeal to encourage voluntary blood donation by comparing the pattern of blood donations in 2000 and 2007. METHODS: A retrospective analysis of blood donation records was conducted at the University Hospital of the West Indies (UHWI) Blood Collection Centre from April to December of 2000 and 2007. Data were analysed to identify any significant changes in donation patterns and donor profiles. RESULTS: The total number of blood donor records reviewed was 3194 in 2000 and 2634 in 2007 representing 69.0% and 72.3% of the total blood donations, respectively. Autologous donations accounted for 1% in 2000 and 2.2% in 2007; however, there was no corresponding change in voluntary donations (3.4% in 2000 and 3.2% in 2007). Despite a reduction in the number of first-time donors (1539 in 2000 and 1115 in 2007), the percentage of units discarded for the presence of a marker of transfusion transmission infection (TTI) increased, being 6.5% in 2000 and 7.4% in 2007. Human T-lymphotropic virus (HTLV) was the most common infectious marker in 2000 (3.4% of donors) whereas reactive Venereal Disease Research Laboratory (VDRL) predominated in 2007 (3.6% of donors). CONCLUSION: The per capita donations (0.99% in 2000 and 0.88% in 2007) failed to meet the World Health Organization (WHO) recommendation for an adequate blood supply of 1-3%. Despite a national effort to improve voluntary donations, the positive changes in the pattern of blood donation over a period of seven years were limited to a decrease in the proportion of first-time donors and an increase in blood donors with one to four previous donations.


Assuntos
Doadores de Sangue/estatística & dados numéricos , Seleção de Pacientes , Adulto , Feminino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Reação Transfusional
2.
West Indian Med J ; 58(4): 375-8, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20099780

RESUMO

OBJECTIVE: This study is a descriptive analysis of the clinical presentations in which cholelithiasis was diagnosed on imaging over a five-year period at the University Hospital of the West Indies, Jamaica and how the clinical presentation varied with age and gender. METHOD: A retrospective review was done of all cases of cholelithiasis recorded in the reports of the Radiology section during the period January 1, 2002 to December 31, 2006. Patients' age and gender were noted. Each case was assigned to one of four clinical categories based on the clinical scenario at the time of referral for imaging: Acute abdomen-Incidental: (not referable to the biliary tract); Acute abdomen-Biliary (biliary colic/acute cholecystitis); Non-acute-Incidental: (not referable to the biliary tract) and Non-acute-Biliary (suspected cholelithiasis). The data were analyzed using post-hoc cross-tabulations, ANOVA, and post-hoc Tukey-tests. RESULTS: Three hundred and forty-four females and 137 males were diagnosed with cholelithiasis with the mean age at diagnosis being 49 and 50 years respectively. Females were diagnosed with cholelithiasis at higher rates in the context of acute abdominal symptoms both referable and unrelated to the biliary tract, while males were diagnosed at higher rates as an incidental finding in a non-acute presentation. There was no significant difference between the genders in the rate of diagnosis of cholelithiasis when this was suspected clinically in the non-acute setting. CONCLUSION: More females were diagnosed with cholelithiasis. There was no gender-related difference in the mean age at which cholelithiasis was diagnosed. There were statistically significant differences between the genders in the rates at which cholelithiasis was identified in different clinical scenarios.


Assuntos
Colelitíase/diagnóstico , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Adulto Jovem
3.
West Indian Med J ; 57(5): 493-6, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19565982

RESUMO

OBJECTIVE: To determine the presenting features and evolution of patients diagnosed with chronic myeloid leukaemia between 1983 and 1999 at the University Hospital of the West Indies. METHODS: Forty-one records were retrospectively analyzed for the patients' demographics, reasons for referral, clinical features, laboratory investigations and the time to blast transformation and death. RESULTS: Seventy-one per cent were males and 29% were females. The male to female ratio was 2.4:1. The median age at presentation was 37 years (range 14-81 years). Seventy-eight per cent of the patients presented in the chronic phase. Weight loss and splenomegaly were the most frequent presenting features being seen in 54 and 83 per cent respectively. The median survival was 36 months. CONCLUSION: In this study, the clinical features and evolution were comparable to existing data. Improved accrual and routine Philadelphia chromosome testing would provide a more accurate reflection of the status of CML in our population.


Assuntos
Leucemia Mielogênica Crônica BCR-ABL Positiva/diagnóstico , Leucemia Mielogênica Crônica BCR-ABL Positiva/epidemiologia , Cromossomo Filadélfia , Redução de Peso , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Esplenomegalia/diagnóstico , Esplenomegalia/epidemiologia , Fatores de Tempo , Índias Ocidentais/epidemiologia , Adulto Jovem
4.
West Indian Med J ; 55(2): 100-2, 2006 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16921703

RESUMO

The use of radiological studies as diagnostic tools in patients with suspected acute appendicitis has increased recently. In this setting, abdominal ultrasonography is viewed as a possible means of avoiding unnecessary surgery. This retrospective study of patients who underwent laparotomy for suspected acute appendicitis was undertaken to determine the sensitivity and specificity of ultrasound in diagnosing acute appendicitis and the frequency of leucocytosis in patients in whom the diagnosis was confirmed by histology. The ultrasound and surgery registers were reviewed to identify 254 referrals for abdominal ultrasound between January 2001 and December 2002 because of a clinical suspicion of acute appendicitis. Of these cases, 223 did not proceed to surgery. The study sample comprised 31 patients who had appendectomies after abdominal ultrasonography. The ultrasound reports, pathological diagnoses and white blood cell counts of these patients were obtained and formed the basis for the analysis. A histological diagnosis was available for 30 cases, in 17 of whom appendicitis was confirmed In these patients, positive ultrasound and leucocytosis were present in five (29%) and nine (53%) respectively. Ultrasound showed 92% specificity and 29% sensitivity for the pre-operative diagnosis of appendicitis. The positive predictive value of ultrasonography (83%) was higher than that of leucocytosis (69%). The sensitivity and specificity of ultrasound and leucocytosis in this study indicate limited utility as preoperative diagnostic tools.


Assuntos
Apendicite/sangue , Apendicite/diagnóstico por imagem , Contagem de Leucócitos , Doença Aguda , Adolescente , Adulto , Apendicectomia , Apendicite/patologia , Apendicite/cirurgia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Cuidados Pré-Operatórios , Estudos Retrospectivos , Sensibilidade e Especificidade , Ultrassonografia
5.
West Indian med. j ; 55(2): 100-102, Mar. 2006.
Artigo em Inglês | LILACS | ID: lil-472657

RESUMO

The use of radiological studies as diagnostic tools in patients with suspected acute appendicitis has increased recently. In this setting, abdominal ultrasonography is viewed as a possible means of avoiding unnecessary surgery. This retrospective study of patients who underwent laparotomy for suspected acute appendicitis was undertaken to determine the sensitivity and specificity of ultrasound in diagnosing acute appendicitis and the frequency of leucocytosis in patients in whom the diagnosis was confirmed by histology. The ultrasound and surgery registers were reviewed to identify 254 referrals for abdominal ultrasound between January 2001 and December 2002 because of a clinical suspicion of acute appendicitis. Of these cases, 223 did not proceed to surgery. The study sample comprised 31 patients who had appendectomies after abdominal ultrasonography. The ultrasound reports, pathological diagnoses and white blood cell counts of these patients were obtained and formed the basis for the analysis. A histological diagnosis was available for 30 cases, in 17 of whom appendicitis was confirmed In these patients, positive ultrasound and leucocytosis were present in five (29) and nine (53) respectively. Ultrasound showed 92specificity and 29sensitivity for the pre-operative diagnosis of appendicitis. The positive predictive value of ultrasonography (83) was higher than that of leucocytosis (69). The sensitivity and specificity of ultrasound and leucocytosis in this study indicate limited utility as preoperative diagnostic tools.


El uso de estudios radiológicos como herramientas de diagnóstico en los pacientes con sospecha de apendicitis aguda ha aumentado recientemente. En este escenario, la ultrasonografía abdominal se ve como un posible medio de evitar una cirugía innecesaria. Este estudio retrospectivo de pacientes sometidos a laparotomía por sospecha de apendicitis aguda, fue realizado a fin de determinar la sensibilidad y especificidad del ultrasonido a la hora de diagnosticar la apendicitis aguda así como la frecuencia de leucocitos, en pacientes en quienes el diagnóstico fue confirmado mediante histología. Se revisaron las historias de ultrasonido y cirugía con el propósito de identificar 254 remisiones para la realización de ultrasonido abdominal entre enero de 2001 y diciembre de 2002, debido a una sospecha clínica de apendicitis aguda. De estos casos, 223 no pasaron a cirugía. La muestra del estudio abarcó 31 pacientes a los que se les realizaron apendicectomías tras del ultrasonido abdominal. Se obtuvieron los reportes de los ultrasonidos, los diagnósticos patológicos y los conteos de glóbulos blancos de estos pacientes. Estos reportes constituyeron la base del análisis. Se tuvo a disposición un diagnóstico histológico en 30 casos, en 17 de los cuales se confirmó apendicitis. En estos pacientes, el ultrasonido resultó positivo en cinco casos (29%) y la leucocitosis estuvo presente en nueve (53%). El ultrasonido arrojó un 92% de especificidad y 29% de sensibilidad para el diagnóstico preoperativo de la apendicitis. El valor predictivo positivo de la ultrasonografía (83%) fue mayor que el de la leucocitosis (69%). En este estudio, la sensibilidad y especificidad del ultrasonido y la leucocitosis, indican una limitada utilidad tanto del ultrasonido como del conteo de glóbulos blancos como instrumentos preoperativos de diagnóstico.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Apendicite/sangue , Apendicite , Contagem de Leucócitos , Apendicectomia , Apendicite/patologia , Apendicite/cirurgia , Cuidados Pré-Operatórios , Doença Aguda , Estudos Retrospectivos , Sensibilidade e Especificidade , Valor Preditivo dos Testes
6.
West Indian Med J ; 50(1): 78-80, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11398297

RESUMO

The case of a 25-year-old woman with recurring and metastasizing clear cell sarcoma of soft parts (CCS) is presented. The clinical setting and pathological appearance were in agreement with the original cases described. This report serves to highlight the clinico-pathological features of this rare and aggressive malignancy with specific reference to prognostic markers and treatment.


Assuntos
Sarcoma de Células Claras/patologia , Neoplasias de Tecidos Moles/patologia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Feminino , Humanos , Imuno-Histoquímica , Valor Preditivo dos Testes , Prognóstico , Sarcoma de Células Claras/tratamento farmacológico , Neoplasias de Tecidos Moles/tratamento farmacológico
7.
West Indian med. j ; 50(1): 78-80, Mar. 2001.
Artigo em Inglês | LILACS | ID: lil-333405

RESUMO

The case of a 25-year-old woman with recurring and metastasizing clear cell sarcoma of soft parts (CCS) is presented. The clinical setting and pathological appearance were in agreement with the original cases described. This report serves to highlight the clinico-pathological features of this rare and aggressive malignancy with specific reference to prognostic markers and treatment.


Assuntos
Adulto , Feminino , Humanos , Neoplasias de Tecidos Moles , Sarcoma de Células Claras/patologia , Neoplasias de Tecidos Moles , Imuno-Histoquímica , Valor Preditivo dos Testes , Prognóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Sarcoma de Células Claras/tratamento farmacológico
8.
West Indian Med J ; 49(3): 226-8, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11076215

RESUMO

An audit of blood donation at the University Hospital of the West Indies (UHWI) was performed between January 1995 and December 1998. During these four years, 21,733 persons attended the blood collection centre and 6711 (30.8%) were rejected as donors. Females accounted for 3,054 (45.6%) of rejected donors while 3,647 (54.4%) were males. Females were rejected primarily because of low haemoglobin levels, while rejection of males was most frequently attributed to symptoms of the common cold and recent drug use. One hundred and two rejected donors (1.5%) admitted to recent treatment for a sexually transmitted disease, and 138 (2.0%) presented within 16 weeks of a prior donation. Of 15,022 units donated, altruistic voluntary donations accounted for 307 (2%) and 53 (0.3%) were autologous donations. Seven hundred and four units (4.6%) were discarded because of positivity on initial testing for a marker of transmissible infection. Overall prevalence for markers of infection was 2.5% for HTLV-1, 0.9% for Hepatitis B and 0.4% for HIV I/II. Donations at the University Hospital of the West Indies (UHWI) collection centre contributed 15.8% of the national blood supply for the period under study.


Assuntos
Bancos de Sangue/estatística & dados numéricos , Auditoria Médica , Adulto , Doadores de Sangue/estatística & dados numéricos , Patógenos Transmitidos pelo Sangue/isolamento & purificação , Feminino , Soroprevalência de HIV , Humanos , Jamaica , Masculino , Seleção de Pacientes , Estudos Retrospectivos
9.
West Indian med. j ; 49(3): 226-8, Sept. 2000. tab, graf
Artigo em Inglês | LILACS | ID: lil-291978

RESUMO

An audit of blood donation at the University Hospital of the West Indies (UHWI) was performed between January 1995 and December 1998. During these four years, 21,733 persons attended the blood collection centre and 6,711 (30.8 percent) were rejected as donors. Females accounted for 3, 054 (45.6 percent) of rejected donors while 3,647 (54.4 percent) were males. Females were rejected primarily because of low haemoglobin levels, while rejection was most frequently attributed to symptoms of the common cold and recent drug use. One hunderd and two rejected donors (1.5 percent) admitted to recent treatment of a sexually transmitted disease, and 138 (2.0 percent) presented within 16 weeks of a prior donation. Of 15,022 units donated, altruistic voluntary donations accounted for 307 (2 percent) and 53 (0.3 percent) were autologous donations. Seven hundred and four units (4.6 percent) were discarded because of positivity on initial testing for a marker of transmissible infection. Overall prevalence for markers of infection was 2.5 eprcent for HTLV-1, 0.9 percent for Hepatitis B and 0.4 percent for HIV I/II. Donations at the University Hospital of the West Indies (UHWI) collection centre contributed 15.8 percent of the national blood supply for the period under study.


Assuntos
Humanos , Masculino , Feminino , Controle de Qualidade , Segurança , Doadores de Sangue/provisão & distribuição , Automedicação , Infecções Sexualmente Transmissíveis/sangue , Resfriado Comum/sangue , Jamaica
10.
West Indian Med J ; 49(2): 161-3, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10948858

RESUMO

The records of one hundred and twenty consecutive patients diagnosed with carcinoma of the breast were examined between July 1996 and June 1999 in order to estimate the prevalence of established risk factors for this disease. Early menarche was present in 5.5% of patients, while 36 subjects (30%) were nulliparous and 6 (5%) had a first live birth after age 30 years. Four subjects had a previous biopsy with histological features of atypical hyperplasia. Fifteen subjects (12.5%) had one or more affected first degree relatives. Fifty-four per cent of subjects possessed none of the risk factors examined in this study while 36% had a single risk factor and 10% possessed two risk factors. There was no significant clustering of risk factors in the group of patients aged thirty-five years or less. Larger studies should be encouraged to identify the risk factors which operate in our population and the degree to which published predictive variables are applicable.


Assuntos
Neoplasias da Mama/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Paridade , Fatores de Risco , Índias Ocidentais
11.
West Indian med. j ; 49(2): 161-3, Jun. 2000. tab
Artigo em Inglês | LILACS | ID: lil-291955

RESUMO

The records of 120 consecutive patients diagnosed with carcinoma of the breast were examined between July 1996 and June 1999 in order to estimate the prevalence of established risk factors for this disease. Early menarche was present in 5.5 percent of patients, while 36 subjects (30 percent) were mulliparous and 6 (5 percent) had a first live birth after age 30 years. Four subjects had a previous biopsy with histological features of atypical hyperplasia. Fifteen subjects (12.5 percent) had one or more affected first degree relatives. Fifty-four percent of subjects possessed none of the risk factors examined in this study while 36 percent had a single risk factor and 10 percent possessed two risk factors. There was no significant clustering of risk factors in the group of patients aged thirty-five years or less. Larger studies should be encouraged to identify the risk factors which operate in our population and the degree to which published predictive variables are applicable.


Assuntos
Adulto , Pessoa de Meia-Idade , Feminino , Humanos , Neoplasias da Mama/epidemiologia , Paridade , Idoso de 80 Anos ou mais , Neoplasias da Mama/patologia , Análise Multivariada , Fatores de Risco , Fatores Etários , Jamaica , Estadiamento de Neoplasias
12.
West Indian med. j ; 49(1): 59-60, Mar. 2000. ilus
Artigo em Inglês | LILACS | ID: lil-291891

RESUMO

The ultrasonographic and computed tomography features of four cases of solid and papillary epithelial neoplasm (SPEN) - a rare pancreatic tumour - are described. Although not diagnostic, the presence of these imaging features in the typical clinical setting may permit pre-operative radiological diagnosis and facilitate planning for curative surgery for this malignant tumour which has an excellent prognosis even without further adjuvant therapy.


Assuntos
Adulto , Feminino , Humanos , Neoplasias Pancreáticas/diagnóstico , Carcinoma Papilar/diagnóstico , Neoplasias Epiteliais e Glandulares/diagnóstico , Pâncreas/patologia , Prognóstico , Biópsia , Tomografia Computadorizada por Raios X , Ultrassonografia , Jamaica
15.
West Indian Med J ; 46(3): 95-6, 1997 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9361500

RESUMO

We report an unusual case of nodular sclerosing Hodgkin's Disease in a 17-year-old woman presenting with intermittent fever, progressive weight loss and enlarged cervical and axillary lymph nodes. Laboratory tests revealed severe Coombs' positive haemolytic anaemia, and progressive thrombocytopenia and leucopenia, associated with erythroid, myeloid and megakaryocytic hyperplasia, but with no evidence of lymphomatous infiltration in the bone marrow. Transfusion of compatible blood became possible only after prednisone therapy and a single intravenous dose of vincristine. Appropriate chemotherapy led to normalization of the peripheral blood counts and a negative direct Coombs' test.


Assuntos
Anemia Hemolítica Autoimune/etiologia , Doenças Autoimunes/etiologia , Doença de Hodgkin/complicações , Leucopenia/etiologia , Trombocitopenia/etiologia , Adolescente , Feminino , Humanos
16.
West Indian med. j ; 46(3): 95-6, Sept. 1997.
Artigo em Inglês | LILACS | ID: lil-199554

RESUMO

We report an unusual case of modular sclerosing Hodgkin's disease in a 17 year old women presenting with intermittent fever, progressive weight loss and enlarged cervical and anxillary lymp nodes. Laboratory test revealed severe Coombs' positive haemolytic anaemia, and progressive thrombocytopenia and leucopenia, associated with erythroid, myeloid and megakaryocytic hyperplasia, but with no evidence of lymphomatous infiltration in the bone marrow. Transfusion of compatible blood became possible only after prednisone therapy and a single intravenous dose of vincristine. Appropriate chemotherapy led to normalization of the peripheral blood counts and a negative direct Coombs' test.


Assuntos
Adolescente , Feminino , Humanos , Trombocitopenia/complicações , Doença de Hodgkin/complicações , Anemia Hemolítica Autoimune , Transfusão de Sangue , Doença de Hodgkin/sangue
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