Assuntos
Neoplasias da Mama/epidemiologia , Carcinoma Ductal de Mama/epidemiologia , Carcinoma Lobular/epidemiologia , Etnicidade/estatística & dados numéricos , Adulto , Neoplasias da Mama/diagnóstico , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Lobular/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de Risco , Índias Ocidentais/epidemiologia , Saúde da MulherRESUMO
Caroli's disease or communicating ectasia of the intrahepatic biliary tree is a rare disease with unknown aetiology. The coexistence of this along with the uncommon condition of a gastric diverticulum has never been reported before. A deficiency in the fibromuscular matrix of both the bile ducts and the gastric wall may explain why these two pathologies may coexist in a single patient. (AU)
Assuntos
Adulto , Relatos de Casos , Feminino , Humanos , Doença de Caroli/complicações , Divertículo Gástrico/complicações , Doença de Caroli/diagnóstico , Divertículo Gástrico/diagnósticoRESUMO
Caroli's disease or communicating ectasia of the intrahepatic biliary tree is a rare disease with unknown aetiology. The coexistence of this along with the uncommon condition of a gastric diverticulum has never been reported before. A deficiency in the fibromuscular matrix of both the bile ducts and the gastric wall may explain why these two pathologies may coexist in a single patient.
Assuntos
Adulto , Feminino , Humanos , Divertículo Gástrico/complicações , Doença de Caroli/complicações , Divertículo Gástrico/diagnóstico , Doença de Caroli/diagnósticoRESUMO
The comparative differences in pullout suture strength between rectus muscle and sheath and linea alba were studied in cadaveric models. A suture simulating the rectus repair procedure and one using just linea alba were used. Forces were measured on a tensiometer. Mean rectus force was found to account for over 59 percent variability. Both force uniformly decrease towards the symphysis pubis. This suggests that the rectus, when used for incisional hernia repair, may contributed significantly to wound strength. Additionally, our findings may help to elucidate the observance that incisional hernias are commonly subumbilical and occur mostly in females.(AU)
Assuntos
Humanos , Suturas , Hérnia/etiologiaRESUMO
This is the first report of dengue haemorrhagic fever and dengue shock syndrome in Trinidad. Dengue infection was confirmed serologically or by viral isolation in five patients, aged 15 to 33 years, who presented with fever, thrombocytopenia and haemoconcentration. Three patients developed dengue shock syndrome, which was fatal; although there was no haemorrhagic tendency among these patients, bleeding occurred shortly before death in one of them. Two patients who had dengue haemorrhagic fever survived. The co-circulation of dengue virus serotypes 1, 2 and 4 in the Caribbean facilitates the development of dengue shock syndrome (DSS) or dengue haemorrhagic fever (DHF). Clinicans should therefore be aware of their clinical features, laboratory diagnosis and clinical management. Appropriate public health interventions and improved surveillance should be implemented to reduce the risk of DHS/DSS associated mortality in Trinidad and Tobago.(AU)
Assuntos
Adolescente , Adulto , Relatos de Casos , Feminino , Humanos , Pessoa de Meia-Idade , Masculino , Choque/epidemiologia , Dengue/epidemiologia , Dengue/complicações , Febres Hemorrágicas Virais/epidemiologia , Febres Hemorrágicas Virais/complicações , Surtos de Doenças , Evolução Fatal , Trinidad e Tobago/epidemiologia , Vírus da Dengue/isolamento & purificaçãoRESUMO
This is the first report of dengue haemorrhagic fever and dengue shock syndrome in Trinidad. Dengue infection was confirmed serologically or by viral isolation in five patients, aged 15 to 33 years, who presented with fever, thrombocytopenia and haemoconcentration. Three patients developed dengue shock syndrome, which was fatal; although there was no haemorrhagic tendency among these patients, bleeding occurred shortly before death in one of them. Two patients who had dengue haemorrhagic fever survived. The co-circulation of dengue virus serotypes 1, 2 and 4 in the Caribbean facilitates the development of dengue shock syndrome (DSS) or dengue haemorrhagic fever (DHF). Clinicans should therefore be aware of their clinical features, laboratory diagnosis and clinical management. Appropriate public health interventions and improved surveillance should be implemented to reduce the risk of DHS/DSS associated mortality in Trinidad and Tobago.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Choque/epidemiologia , Dengue/complicações , Dengue/epidemiologia , Trinidad e Tobago/epidemiologia , Surtos de Doenças , Evolução Fatal , Vírus da Dengue/isolamento & purificação , Febres Hemorrágicas Virais/complicações , Febres Hemorrágicas Virais/epidemiologiaRESUMO
A review of all available cervical smears from 96 consecutive women diagnosed as having invasive cervical carcinoma during 1985 - 1991 was undertaken. The purpose of the study was to determine the incidence of confirmed negative smears prior to the histologic diagnosis of carcinoma and to investigate the relationship between the duration and grade of smear abnormality, the patient's age and the histological types of cervical carcinoma. The slides of the smears were mixed and examined "blind" by at least two pathologists separately. The degree of concordance was 95 percent. Thirty-four patients had microinvasive disease and 62 had invasive carcinoma. Review of 54 smears initially reported as "negative" revealed that 44 (81 percent) were assessed as abnormal; 42 ( 44 percent) of the 96 patients in this study had abnormal cytology reported correctly at varying time intervals prior to diagnosis of carcinoma and there was inadequate clinical follow-up of 16/42 (38 percent) of these women with knowm abnormality. The review revealed that 43 (70 percent) of the 61 younger (< 40 years) women had significant or high grade abnormality in smears (or histology) taken > 1 year before diagnosis of carcinoma. This study revealed that 81 percent of the reviewed smears were falsely reported as negative. There is evidence to suggest that the preinvasive phase of cervical cancer may be shorter in younger women and the less common types of cervical cancer occur more frequently in this group. The combination of inadequate clinical follow-up and false negative cytology may have allowed a significant proportion of these women to develop invasive cervical carcinoma (AU)
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Esfregaço Vaginal , Neoplasias do Colo do Útero/patologia , Trinidad e Tobago , IncidênciaRESUMO
Dengue is endemic throughout most of the Caribbean, and increased activity has been noted within recent times. The co-circulation of dengue virus serotypes 1, 2 and 4 has been a cause of concern regarding the development of dengue shock syndrome/dengue haemorrhagic fever. The clinical presentation, investigate findings and confirmatory evidence for dengue infection in four patients are described. In all cases, there were fever, marked thrombocytopenia and haemoconcentration. The youngest patient was 15 years old and the oldest was 53 years. In two cases, there was no haemorrhagic tendency but profound shock ensued. Bleeding occurred preterminally in one of these. Both patients with dengue shock syndrome died but the two cases of dengue haemorrhagic fever survived. Dengue infection was confirmed serologically in three cases and by viral isolation in the other. This, to our knowledge, is the first report of dengue haemorrhagic fever/dengue shock syndrome in Trinidad, and clinicians should be aware of the clinical features and management. It is also crucial that public health measures be put in place to minimize dengue virus-associated mortality in Trinidad (AU)
Assuntos
Humanos , Adolescente , Adulto , Dengue/epidemiologia , Trinidad e Tobago/epidemiologiaRESUMO
Drainage in thyroid surgery has been a routine but empirical practice with no scientific evidence to support its benifit. The largest series to date of nondrainage in thyroid surgery is presented, comprising 260 patients over a 15-year perios. No case selection for non-drainage was employed. Two hundred and fifty-nine cases were not drained and included toxic goitres, and bilateral and redo procedures. There was one thyroid storm and two cases of subcantaneous fluid collection, treated by needle aspiration. No cases of recurrent laryngeal nerve injury, airway obstruction or death were recorded. This study strongly demonstrates the safety of non-drainage in routine thyroid surgery (AU)