RESUMO
The prevalence of chronic renal failure (CRF)/end stage renal disease and the accessibility of long term renal replacement therapy in Jamaica were evaluated. The study was conducted at six Jamaican healthcare facilities between July 1998 and December 1999 and included 605 patients with CRF. Men with CRF (57% of patients, mean age of 56.7 years) were significantly older than women (mean age 53.2 years). Hypertension was the most commonly associated medical condition (60.8% of patients) followed by diabetes mellitus (31.4% of patients). The estimated crude point prevalence of CRF in persons 20 years and over at the end of 1999 was 327 per million population. More than one-third of patients with CRF (39%) were receiving renal replacement therapy, the most common modality being haemodialysis, and only 1.8% of patients had received kidney transplantation. The prevalence of chronic renal failure was not increased in areas known to have high soil cadmium levels. Chronic renal failure is a significant public health problem in Jamaica and is placing an increasing financial burden on the healthcare sector.
Assuntos
Falência Renal Crônica/epidemiologia , Adulto , Cádmio/toxicidade , Comorbidade , Creatinina/sangue , Feminino , Humanos , Jamaica/epidemiologia , Falência Renal Crônica/induzido quimicamente , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
The prevalence of chronic renal failure (CRF)/end stage renal disease and the accessibility of long term renal replacement therapy in Jamaica were evaluated. The study was conducted at six Jamaican healthcare facilities between July 1998 and December 1999 and included 605 patients with CRF. Men with CRF (57 of patients, mean age of 56.7 years) were significantly older than women (mean age 53.2 years). Hypertension was the most commonly associated medical condition (60.8 of patients) followed by diabetes mellitus (31.4 of patients). The estimated crude point prevalence of CRF in persons 20 years and over at the end of 1999 was 327 per million population. More than one-third of patients with CRF (39) were receiving renal replacement therapy, the most common modality being haemodialysis, and only 1.8 of patients had received kidney transplantation. The prevalence of chronic renal failure was not increased in areas known to have high soil cadmium levels. Chronic renal failure is a significant public health problem in Jamaica and is placing an increasing financial burden on the healthcare sector
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Insuficiência Renal Crônica/epidemiologia , Comorbidade , Creatinina/sangue , Cádmio/toxicidade , Insuficiência Renal Crônica/induzido quimicamente , Jamaica/epidemiologia , PrevalênciaRESUMO
A 19-year-old woman, who delivered a macerated stillborn at 32 weeks' gestation and had persistent postpartum vaginal bleeding, presented with a left hemiparesis three and a half months after delivery. A clinical diagnosis of persistent gestational trophoblastic disease (GTD) was made, based on quantitative serum beta-hCG of more than 200,000 IU/ml, cannon ball metastases on chest X-ray and two ring enhancing lesions, metastases, in the right parietal lobe on Computed Axial Tomography (CAT) scan of the brain. Despite combination chemotherapy, with methotrexate, cyclophosphamide and actinomycin D, her condition worsened and she died.
Assuntos
Neoplasias Encefálicas/secundário , Paresia/etiologia , Complicações Neoplásicas na Gravidez/patologia , Neoplasias Trofoblásticas/secundário , Neoplasias Uterinas/patologia , Adulto , Erros de Diagnóstico , Feminino , Humanos , Gravidez , Complicações Neoplásicas na Gravidez/diagnóstico , Complicações Neoplásicas na Gravidez/terapia , Neoplasias Trofoblásticas/diagnóstico , Neoplasias Trofoblásticas/terapia , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/terapiaRESUMO
A 19-year-old woman, who delivered a macerated stillborn at 32 weeks' gestation and had persistent postpartum vaginal bleeding, presented with a left hemiparesis three and a half months after delivery. A clinical diagnosis of persistent gestational trophoblastic disease (GTD) was made, based on quantitative serum beta-hCG of more than 200,000 IU/ml, cannon ball metastases on chest X-ray and two ring enhancing lesions, metastases, in the right parietal lobe on Computed Axial Tomography (CAT) scan of the brain. Despite combination chemotherapy, with methotrexate, cyclophosphamide and actinomycin D, her condition worsened and she died.
Assuntos
Adulto , Feminino , Humanos , Gravidez , Paresia , Neoplasias Uterinas , Neoplasias Encefálicas , Complicações Neoplásicas na Gravidez/patologia , Neoplasias Trofoblásticas/secundário , Neoplasias Uterinas , Complicações Neoplásicas na Gravidez/diagnóstico , Complicações Neoplásicas na Gravidez/terapia , Erros de Diagnóstico , Neoplasias Trofoblásticas/diagnóstico , Neoplasias Trofoblásticas/terapiaRESUMO
Crptococcosis with meningitis is reported in seven patients, six from Jamaica and one from Belize. All seven had headache, six had fever and five had confusion/coma. Despite biochemical findings of meningitis in the cerebrospinal fluid of five patients, Cryptococcosis was diagnosed antemortem in only three. Two patients treated with oral flucytosine survived. Awareness that Cryptococcosis occurs in the West Indies may assist in early diagnosis which is crucial to successful treatment (AU)