Raising St. Louis Evaluation Report

This report presents 2015 evaluation findings from the Raising St. Louis initiative. Raising St. Louis connects with mothers, fathers and other family members to help build and sustain the family unit, reduces the high infant mortality rate, promotes literacy, and increases access to health care.https://openscholarship.wustl.edu/cphss/1057/thumbnail.jp

Raising St. Louis Evaluation Report

This report presents 2016 evaluation findings from the Raising St. Louis initiative. Raising St. Louis connects with mothers, fathers and other family members to help build and sustain the family unit, reduces the high infant mortality rate, promotes literacy, and increases access to health care.https://openscholarship.wustl.edu/cphss/1061/thumbnail.jp

The burden of prostate cancer in Trinidad and Tobago: One of the highest mortality rates in the world

PURPOSE: In Trinidad and Tobago (TT), prostate cancer (CaP) is the most commonly diagnosed malignancy and the leading cause of cancer deaths among men. TT currently has one of the highest CaP mortality rates in the world. METHODS: 6,064 incident and 3,704 mortality cases of CaP occurring in TT from January 1995 to 31 December 2009 reported to the Dr. Elizabeth Quamina Cancer population-based cancer registry for TT, were analyzed to examine CaP survival, incidence, and mortality rates and trends by ancestry and geography. RESULTS: The age-standardized CaP incidence and mortality rates (per 100,000) based on the 1960 world-standardized in 2009 were 64.2 and 47.1 per 100,000. The mortality rate in TT increased between 1995 (37.9 per 100,000) and 2009 (79.4 per 100,000), while the rate in the US decreased from 37.3 per 100,000 to 22.1 per 100,000 over the same period. Fewer African ancestry patients received treatment relative to those of Indian and mixed ancestry (45.7%, 60.3%, and 60.9%, respectively). CONCLUSIONS: Notwithstanding the limitations surrounding data quality, our findings highlight the increasing burden of CaP in TT and the need for improved surveillance and standard of care. Our findings highlight the need for optimized models to project cancer rates in developing countries like TT. This study also provides the rationale for targeted screening and optimized treatment for CaP to ameliorate the rates we report

Incidence and Predictors of Delirium After Cardiac Surgery

Background: The overall purpose of this study was to determine the incidence and perioperative factors that predispose to cause delirium in postoperative cardiac surgery patients in our Intensive Care Unit. Methods: We performed a prospective, observational study. Following institutional review board approval, this study included 234 patients above the age of 18 years meeting the inclusion criteria for cardiac surgery in Shahid Gangalal National Heart Center from July 2018 to December 2018. Preoperative, intraoperative and postoperative data for possible risk factors were obtained. Daily assessment of delirium was done during Intensive Care Unit stay of the patient. Collected data were analysed by means of statistical software SPSS-21. Results: The incidence of delirium was 15.6% (35/224) in our study. Delirium was seen in 14 out of 58 (24.1%) patients with age >60 years which was found to be statistically significant. Preoperative risk factor for developing delirium were carotid artery disease and Hemoglobin level <10gm/dl. Intraoperative risk factor for developing delirium were blood transfusion, longer cardiopulmonary bypass time. Post-operative factors for developing delirium included longer Intensive Care Unit stay, mechanical ventilation time ,duration on inotropes , blood transfusion, use of non-invasive ventilation, sleep deprivation, use of intra-aortic balloon pump, Pao2<70. Conclusions: As shown in our study, delirium is a frequent occurrence in the cardiac surgical population. The incidence of delirium after cardiac surgery was 15.6%. Several risk factors pre-operatively like age>60 years, carotid artery disease, Hb<10gm/dl, intra-operative factors like longer cardiopulmonary bypass time, blood transfusion and post-operatively longer duration of Mechanical ventilation, Intensive Care Unit stay, blood transfusion, use of intra-aortic balloon pump and Non-invasive ventilation were found to be predictors of delirium. Keywords: Keywords: Cardiac surgery; delirium; risk factor

The burden of prostate cancer in Trinidad and Tobago: one of the highest mortality rates in the world

Purpose In Trinidad and Tobago (TT), prostate cancer (CaP) is the most commonly diagnosed malignancy and the leading cause of cancer deaths among men. TT currently has one of the highest CaP mortality rates in the world. Methods: 6,064 incident and 3,704 mortality cases of CaP occurring in TT from January 1995 to 31 December 2009 reported to the Dr. Elizabeth Quamina Cancer population-based cancer registry for TT, were analyzed to examine CaP survival, incidence, and mortality rates and trends by ancestry and geography. Results: The age-standardized CaP incidence and mortality rates (per 100,000) based on the 1960 world-standardized in 2009 were 64.2 and 47.1 per 100,000. The mortality rate in TT increased between 1995 (37.9 per 100,000) and 2009 (79.4 per 100,000), while the rate in the US decreased from 37.3 per 100,000 to 22.1 per 100,000 over the same period. Fewer African ancestry patients received treatment relative to those of Indian and mixed ancestry (45.7%, 60.3%, and 60.9%, respectively). Conclusions: Notwithstanding the limitations surrounding data quality, our findings highlight the increasing burden of CaP in TT and the need for improved surveillance and standard of care. Our findings highlight the need for optimized models to project cancer rates in developing countries like TT. This study also provides the rationale for targeted screening and optimized treatment for CaP to ameliorate the rates we report. Electronic supplementary material The online version of this article (10.1007/s10552-018-1038-8) contains supplementary material, which is available to authorized users

Additional file 1: of Cancer incidence and mortality rates and trends in Trinidad and Tobago

Table S1. Basis of diagnosis for all cancer cases recorded in the National Cancer Registry of TT, 1995–2009. (DOCX 14 kb