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OBJECTIVES: High perinatal autopsy rates are necessary for institutional management protocols and national policy-making. This study reviews perinatal autopsy rates and factors affecting these rates at the University Hospital of the West Indies. METHOD: All perinatal deaths (stillborn infants > or = 24 weeks gestation or 500 g; early neonatal deaths ie 0-7 days old) at the University Hospital of the West Indies, between January 2002 and December 2008, were reviewed retrospectively, using the annual perinatal audit records. The annual autopsy rates were calculated and the reasons why autopsies were not done examined. RESULTS: The average stillbirth (SB) autopsy rate was 59.6% (range 51.9 - 76.7%), while that for early neonatal deaths (ENDs) was 47.9% (range 34.4 - 63.2), with an overall average perinatal autopsy rate of 54.0% (range 42.2 - 62.2). Autopsies were requested in 79.3% and 51.7% of SBs and ENDs, respectively. Of those requested, 81.7% were done (75.2% stillbirths; 92.5% ENDs). In the ENDs, failure to request an autopsy was predominantly noted in premature infants weighing < 1000 g (75.2% of those not requested). In stillbirths, the reasons for failure to request were largely unknown with failure to gain permission accounting for only 20.3% of these cases. CONCLUSIONS: The average annual perinatal autopsy rate at the University Hospital of the West Indies between 2002 and 2008 was 54.0%. This is below the internationally recommended rate of 75%. Failure to request an autopsy was the most significant factor contributing to this. The reasons for this are not entirely clear and require further study.

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OBJECTIVES: High perinatal autopsy rates are necessary for institutional management protocols and national policy-making. This study reviews perinatal autopsy rates and factors affecting these rates at the University Hospital of the West Indies. METHOD: All perinatal deaths (stillborn infants > 24 weeks gestation or 500 g; early neonatal deaths ie 0-7 days old) at the University Hospital of the West Indies, between January 2002 and December 2008, were reviewed retrospectively, using the annual perinatal audit records. The annual autopsy rates were calculated and the reasons why autopsies were not done examined. RESULTS: The average stillbirth (SB) autopsy rate was 59.6% (range 51.9 - 76.7%), while that for early neonatal deaths (ENDs) was 47.9% (range 34.4 - 63.2), with an overall average perinatal autopsy rate of 54.0% (range 42.2 - 62.2). Autopsies were requested in 79.3% and 51.7% of SBs and ENDs, respectively. Of those requested, 81.7% were done (75.2% stillbirths; 92.5% ENDs). In the ENDs, failure to request an autopsy was predominantly noted in premature infants weighing < 1000 g (75.2% of those not requested). In stillbirths, the reasons for failure to request were largely unknown with failure to gain permission accounting for only 20.3% of these cases. CONCLUSIONS: The average annual perinatal autopsy rate at the University Hospital of the West Indies between 2002 and 2008 was 54.0%. This is below the internationally recommended rate of 75%. Failure to request an autopsy was the most significant factor contributing to this. The reasons for this are not entirely clear and require further study.

OBJETIVOS: Las altas tasas autopsia perinatal son necesarias para los protocolos institucionales de tratamiento, y el establecimiento de políticas a nivel nacional. Este estudio examina las tasas de autopsia perinatal y los factores que afectan estas tasas, en el Hospital Universitario de West Indies. MÉTODO: Todas las muertes perinatales (mortinatos > 24 semanas de gestación o 500 g; muertes neonatales tempranas, es decir, 0-7 días de nacido) en el Hospital Universitario de West Indies, entre el 2002 de enero y el 2008 de diciembre, fueron sometidas a examen retrospectivo, usando los registros de auditoría perinatales anuales.Las tasas de autopsia anuales fueron calculadas y se analizaron las razones por las que no se hicieron autopsias. RESULTADOS: La tasa de autopsia promedio de mortinatos (MN) fue 59.6% (rango 51.9-76.7%), mientras que la tasa de autopsia promedio de las muertes neonatales tempranas (MNT) fue 47.9% (rango 34.4-63.2), con una tasa promedio general de autopsia perinatal de 54.0% (rango 42.2-62.2). Se requirieron autopsias en 79.3% y 51.7% de los MN y las MNT respectivamente. De las autopsias requeridas, se realizaron 81.7% (75.2% mortinatos; 92.5% MNT). En relación con las MNT, la no solicitud de autopsia se notó predominantemente en infantes prematuros de peso < 1000 g (75.2% de aquéllos no solicitados). Con respecto a los mortinatos, se desconoce en gran medida las razones por las que no se hizo una solicitud, excepto el no haber obtenido permiso, lo cual explica sólo el 20.3% de los casos. CONCLUSIONES: La tasa de autopsia perinatal promedio anual en el Hospital Universitario de West Indies entre 2002 y 2008 fue 54.0%. Esta cifra se halla por debajo de la tasa internacionalmente recomendada de 75%. La no solicitud de una autopsia fue el factor más significativo que contribuyó a ello. Las razones para esto no están completamente claras y requieren estudio posterior.

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OBJETIVE: Granular cell tumours are uncommon lesions that occur in a wide variety of sites. They are usually benign, but as they are infrequently diagnosed preoperatively, they may be confused clinically with malignant lesions. The objective of this study was to assess the relative frequency and the clinico-pathologic characteristics of granular cell tumours identified at the University Hospital of the West Indies (UHWI) over a 41-year period. METHODS: The archives of surgical pathology reports in the Department of Pathology at the UHWI from 1965 to 2006 were searched for all cases of granular cell tumour. From these records, a number of demographic and other data were recorded and analyzed. RESULTS: One hundred and thirty cases of granular cell tumours were found in 122 patients. Of these, 99 patients were female and 23 male, providing a male: female ratio of 1 to 4.3. The ages ranged from 5 days to 82 years with a mean age (excluding the 2 youngest cases) of 34.4 years. Lesions ranged in size from 0.2 cm to 10 cm in greatest dimension, the average size being 1.85 cm and were found in a diverse array of anatomic locations, the most common being the vulva, breast and tongue. The correct clinical diagnosis was proffered preoperatively in only one case. In contrast, a malignant diagnosis was suggested in 19 cases. CONCLUSIONS: Compared with other studies, there was a notable difference in the distribution of granular cell tumours in this series. In particular, lesions of the tongue accounted for fewer than expected, while lesions of the breast and vulva were considerably increased. The well-recognized female predominance was also substantially higher than in other studies.

OBJETIVO: Los tumores de células granulares son lesiones poco comunes que ocurren en una amplia variedad de lugares. Por lo general son benignos, pero como son raramente diagnosticados preoperativamente, puede confundírseles clínicamente con lesiones malignas. El objetivo de este estudio fue evaluar la frecuencia relativa y las características clínico-patológicas de los tumores de células granulares identificados en el Hospital Universitario de West Indies (HUWI) en un período de 41 años. MÉTODOS: Se investigaron los archivos de los reportes de patologías quirúrgicas en el Departamento de Patología de la UHWI, de 1965 a 2006, en busca de todos los casos de tumores de células granulares. A partir de estos archivos, se registraron y analizaron un número de datos demográficos y de otra índole. RESULTADOS: Se hallaron un total de ciento treinta casos de tumores de células granulares en 122 pacientes. De estos, 99 pacientes era mujeres y 23 hombres, para una proporción varón: hembra de l a 4.3 Las edades estuvieron en un rango de 5 días a 82 años con una edad promedio (excluyendo los dos casos de menos edad) de 34.4 años. El tamaño de las lesiones fluctuó de 0.2 cm a 10 cm como la mayor dimensión, siendo el tamaño promedio 1.85 cm. Estas lesiones se encontraban distribuidas en una variedad de lugares anatómicos, siendo los más comunes la vulva, el pecho y la lengua. El diagnóstico clínico correcto fue presentado preoperativamente sólo en un caso. En contraste con ello, se sugirió un diagnóstico maligno sólo en 19 casos. CONCLUSIONES: En comparación con otros estudios, hubo una notable diferencia en la distribución de los tumores de células granulares en este serie. En particular, las lesiones de la lengua dan cuenta de menos casos de los que se esperaba, mientras que las lesiones del pecho y la vulva presentaban un aumento considerable. El bien reconocido predominio femenino fue sustancialmente más alto que en otros estudios.

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OBJECTIVE: Granular cell tumours are uncommon lesions that occur in a wide variety of sites. They are usually benign, but as they are infrequently diagnosed preoperatively, they may be confused clinically with malignant lesions. The objective of this study was to assess the relative frequency and the clinicopathologic characteristics of granular cell tumours identified at the University Hospital of the West Indies (UHWI) over a 41-year period. METHODS: The archives of surgical pathology reports in the Department of Pathology at the UHWI from 1965 to 2006 were searched for all cases of granular cell tumour. From these records, a number of demographic and other data were recorded and analyzed. RESULTS: One hundred and thirty cases of granular cell tumours were found in 122 patients. Of these, 99patients were female and 23 male, providing a male:female ratio of l to 4.3. The ages ranged from 5 days to 82 years with a mean age (excluding the 2 youngest cases) of 34.4 years. Lesions ranged in size from 0.2 cm to 10 cm in greatest dimension, the average size being 1.85 cm and were found in a diverse array of anatomic locations, the most common being the vulva, breast and tongue. The correct clinical diagnosis was proffered preoperatively in only one case. In contrast, a malignant diagnosis was suggested in 19 cases. CONCLUSIONS: Compared with other studies, there was a notable difference in the distribution of granular cell tumours in this series. In particular lesions of the tongue accounted for fewer than expected, while lesions of the breast and vulva were considerably increased. The well-recognized female predominance was also substantially higher than in other studies.

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This is a study of the prevalence of malnutrition in Dominican children aged 0-5 years, and factors influencing it. Health and other statistical data were compiled and analyzed for the period 1984-1995. A study was also conducted among thirty mothers whose children were attending child health clinics in 1997 to assess their beliefs about nutrition and their feeding practices. Results from the statistical data show there has been a marked decline in under-nutrition (from 5.0 percent to 1.0 percent) over the period and a rise in obesity from (3.4 percent to 9.9 percent). The survey done among mothers showed a 45 percent obesity rate and no case of malnutrition was found. Factors found in association with this trend are: increased employment, reduced fertility rate, increased maternal age, decreased household size, improved immunization coverage and higher levels of education. Childhood obesity is replacing under-nutrition as a public health problem in Dominica.(AU)

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O objetivo deste estudo foi o de comaparar variáveis biomecânicas selecionadas do ato de sentar para crianças portadoras de paralisia cerebral moderada em dois sistema convencional. Dezenove crianças com idade variando de cinco a treze anos, portadoras de paralisia cerebral moderada espástica, participaram do estudo. Pontos de referência foram marcados e fotografias foram tiradas zero, cinco e dez minutos após as crianças atingirem posiçäo sentada a mais cômoda em ambos os sistemas. Após, os sujeitos foram instruídos para que se movessem para uma posiçäo funcional posterior e duas fotografias foram tiradas nesta posiçäo, após a qual os sujeitos retornaram à posiçäo relaxada e duas chapas finais foram feitas. Uma análise de variância 2 x 4 (sistema versus postura) para medidas repetidas foi realizada para cada uma das dez variáveis dependentes pré-selecionadas. Os resultados do estudo mostraram que o sistema de testes foi bem sucedido em distribuir a massa corporal superior reduzindo os momentos negativos lombares e aumentando os momentos positivos isquiáticos. Conclui-se, portanto, que o sistema de testes melhorou a postura sentada de crianças portadoras de paralisia cerebral moderada

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