RESUMO
INTRODUCTION: Sexual dysfunction and infertility are common in males with traumatic spinal cord injuries (SCIs). The objective of this study was to determine the prevalence of sexual dysfunction and infertility in males with traumatic SCI managed in Jamaica, as well as the therapeutic options offered. CASE PRESENTATION: A cross-sectional study including males with traumatic SCI managed at the Sir John Golding Rehabilitation Centre, Kingston, Jamaica was carried out between 1 January and 31 December 2015. Sexual function was measured with the International Index of Erectile Function Questionnaire, and further information on social history, fertility desires and treatment options offered were collected. Data were analyzed using Stata 12 for Windows (College Station, TX, USA). The mean age of patients at the time of study was 38.8±15.3 years (range 19-71) with a mean duration of injury of 3.7±2.4 years (range 1.3-15.6). Of 45 patients with traumatic SCI surveyed, 90.7% had erectile dysfunction, with 62.8% being classified as severe and 73.3% of men were unable to ejaculate. Treatment for erectile and ejaculatory dysfunction was offered in only two patients, respectively. Most (71.1%) patients indicated that they wanted to have children in the future, however, no one had been referred for assisted reproductive techniques. DISCUSSION: Men with traumatic SCI have high rates of severe erectile and ejaculatory dysfunctions, but have preserved interests in maintaining fertility. Adherence to guidelines for sexual education for men with traumatic SCI in Jamaica and the Caribbean is needed.
RESUMO
OBJECTIVE: Bicycle spoke injuries represent a peculiar pattern of injury sustained when a child's foot becomes trapped in the spokes of a bicycle. The aim of this study was to higlight the types of injuries sustained and their associated morbidity. METHODS: A retrospective review was made of all children who had sustained a bicycle spoke injury between 1997 and 1999 and who had been admitted to the Bustamante Hospital for Children. Sixty cases were identified but thirteen were excluded, leaving 47 for analysis. Demographic details of each child, along with relevant clinical data, were retrieved. Where indicated, radiographs were reviewed and the data were analysed using the SPSS statistical package. RESULTS: There were 26 males and 21 females (mean age 5 years ñ 22.2 SD; age range 2-10 years). Sixty-four per cent were aged 0-5 years. The mean time to presentation was 4.4 days, although most patients were from the Corporate Area. The commonest injuries (74 percent) were abrasions of varying depths along with lacerations and friction burns. The lateral and medial aspects of the ankle were injured most often (62 percent). Six cases (13 percent) had fractures. Antibotics were required in 77 percent of cases and surgery in 30 percent. Hospitalisation was for a mean of 9 (SD ñ 9.3) days. Time to healing of the soft tissue wounds was a mean of 17 (SD ñ 24.4) days. Two children (4.3 percent) had permanent residual deformities. CONCLUSION: Bicycle spoke injuries caused significant morbidity to the study children. Adequate parental supervision of children on bicylces, along with the recognition that these are not trivial injuries, would go a long way in reducing the associated morbidity.(Au)
