23 results on '"Do, Corbin"'
Search Results
2. Establishing national noncommunicable disease surveillance in a developing country: a model for small island nations.
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Rose AM, Hambleton IR, Jeyaseelan SM, Howitt C, Harewood R, Campbell J, Martelly TN, Blackman T, George KS, Hassell TA, Corbin DO, Delice R, Prussia P, Legetic B, and Hennis AJ
- Subjects
- Barbados epidemiology, Humans, Incidental Findings, Neoplasms epidemiology, Prospective Studies, Developing Countries statistics & numerical data, Myocardial Infarction epidemiology, Noncommunicable Diseases epidemiology, Population Surveillance, Stroke epidemiology
- Abstract
Objective To describe the surveillance model used to develop the first national, population-based, multiple noncommunicable disease (NCD) registry in the Caribbean (one of the first of its kind worldwide); registry implementation; lessons learned; and incidence and mortality rates from the first years of operation. Methods Driven by limited national resources, this initiative of the Barbados Ministry of Health (MoH), in collaboration with The University of the West Indies, was designed to collect prospective data on incident stroke and acute myocardial infarction (MI) (heart attack) cases from all health care facilities in this small island developing state (SIDS) in the Eastern Caribbean. Emphasis is on tertiary and emergency health care data sources. Incident cancer cases are obtained retrospectively, primarily from laboratories. Deaths are collected from the national death register. Results Phased introduction of the Barbados National Registry for Chronic NCDs ("the BNR") began with the stroke component ("BNR-Stroke," 2008), followed by the acute MI component ("BNR-Heart," 2009) and the cancer component ("BNR-Cancer," 2010). Expected case numbers projected from prior studies estimated an average of 378 first-ever stroke, 900 stroke, and 372 acute MI patients annually, and registry data showed an annual average of about 238, 593, and 349 patients respectively. There were 1 204 tumors registered in 2008, versus the expected 1 395. Registry data were used to identify public health training themes. Success required building support from local health care professionals and creating island-wide registry awareness. With spending of approximately US$ 148 per event for 2 200 events per year, the program costs the MoH about US$ 1 per capita annually. Conclusions Given the limited absolute health resources available to SIDS, combined surveillance should be considered for building a national NCD evidence base. With prevalence expected to increase further worldwide, Barbados' experiences are offered as a "road map" for other limited-resource countries considering national NCD surveillance.
- Published
- 2016
3. Epilepsy care in the southern Caribbean.
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Krauss G, Sandy S, Corbin DO, Bird-Compton J, Jack F, Nelson B, Jalonen TO, Ali A, Fortuné T, Clarke D, Okolie J, and Cervenka MC
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- Anticonvulsants supply & distribution, Barbados, Caribbean Region epidemiology, Developing Countries, Drug Utilization, Electroencephalography, Female, Formularies as Topic, Health Personnel statistics & numerical data, Health Services Accessibility statistics & numerical data, Humans, Male, Neurology statistics & numerical data, Pregnancy, Saint Lucia, Saint Vincent and the Grenadines, Delivery of Health Care statistics & numerical data, Epilepsy epidemiology, Epilepsy therapy
- Abstract
Very little has been reported about the health resources available for patients with epilepsy in the five English-speaking southern Caribbean countries of Trinidad and Tobago, Barbados, Grenada, Saint Vincent and the Grenadines, and Saint Lucia. There is no comprehensive resource describing their health systems, access to specialty care, antiepileptic drug (AED) use, and availability of brain imaging and EEG. The purpose of this study was to profile epilepsy care in these countries as an initial step toward improving the standard of care and identifying gaps in care to guide future policy changes. In each southern Caribbean country, we conducted study visits and interviewed health-care providers, government health ministers, pharmacy directors, hospital medical directors, pharmacists, clinic staff, radiologists, and radiology and EEG technicians. Health-care providers completed extensive epilepsy care surveys. The five countries all have integrated government health systems with clinics and hospitals that provide free or heavily subsidized care and AEDs for patients with epilepsy. Only Trinidad and Tobago and Barbados, however, have neurology specialists. The three smaller countries lack government imaging and EEG facilities. Trinidad had up to one-year waits for public MRI/EEG. Government formularies in Grenada, Saint Vincent and the Grenadines, and Saint Lucia are limited to first-generation AEDs. One or more second-line agents are formulary in Trinidad and Barbados. Nonformulary drugs may be obtained for individual patients in Barbados. Grenada, Saint Lucia, and Saint Vincent and the Grenadines participate in an Organization of Eastern Caribbean States formulary purchasing system, which added levetiracetam following the survey. Newer generic AED formulations with the lowest risks for pregnancy malformation were not in use. In conclusion, patients with epilepsy in the southern Caribbean have excellent access to government clinics and hospitals, but AED choices are limited. Local medical providers reported that the major limitations in care were lack of specialty care, lack of imaging and EEG services, financial barriers to care, long wait times for care, and limited access to additional AEDs., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
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4. A comparison of outcome for stroke patients in Barbados and South London.
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Smeeton NC, Corbin DO, Hennis AJ, Hambleton IR, Rose AM, Fraser HS, Heuschmann PU, and Wolfe CD
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- Aged, Aged, 80 and over, Barbados epidemiology, Female, Humans, Logistic Models, London epidemiology, Male, Middle Aged, Registries, Socioeconomic Factors, Activities of Daily Living, Outcome Assessment, Health Care, Stroke mortality
- Abstract
Background and Aims: Little is known about the poststroke outcome in Caribbean populations. We investigated differences in the activities of daily living, level of social activities, living circumstances and survival for stroke patients in Barbados and London., Methods: Data were collected from the South London Stroke Register and the Barbados Register of Strokes for patients with a first-ever stroke registered between January 2001 and December 2004. The ability to perform activities of daily living was measured by the Barthel Index and level of social activities by the Frenchay Activities Index. Living circumstances were categorised into private household vs. institutional care. Death and dependency, activities of daily living and social activities were assessed at three-months, one- and two-years using logistic regression, adjusted for differences in demographic, socioeconomic and stroke severity characteristics., Results: At three-months, a high level of social activities was more likely for the Barbados Register of Strokes (odds ratio 1.84; 95% confidence interval 1.03-3.29); there were no differences in activities of daily living; and Barbados Register of Strokes patients were less likely to be in institutional care (relative risk ratio 0.38; 95% confidence interval 0.18-0.79). Following adjustment, Barbados Register of Strokes patients had a higher risk of mortality at three-months (relative risk ratio 1.85; 95% confidence interval 1.03-3.30), one-year (relative risk ratio 1.83; 95% confidence interval 1.08-3.09) and two-years (relative risk ratio 1.82; 95% confidence interval 1.08-3.07). This difference was due to early poststroke deaths; for patients alive at four-weeks poststroke, survival thereafter was similar in both settings., Conclusions: In Barbados, there was evidence for a healthy survivor effect, and short-term social activity was greater than that in the South London Stroke Register., (© 2010 The Authors. International Journal of Stroke © 2010 World Stroke Organization.)
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- 2011
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5. Differences in risk factors between black Caribbean patients with stroke in Barbados and South london.
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Smeeton NC, Corbin DO, Hennis AJ, Hambleton IR, Fraser HS, Wolfe CD, and Heuschmann PU
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- Aged, Aged, 80 and over, Barbados epidemiology, Female, Glasgow Coma Scale, Humans, London epidemiology, Male, Middle Aged, Population, Registries, Risk Factors, Sex Factors, Socioeconomic Factors, Stroke classification, Stroke pathology, Black People statistics & numerical data, Stroke epidemiology
- Abstract
Background and Purpose: Risk of stroke is higher in black Caribbeans in the United Kingdom compared with black Caribbeans in their country of origin. We investigated if these differences were caused by variations in prior-to-stroke risk factors., Summary of Report: Data were collected from the South London Stroke Register (SLSR) and the Barbados Register of Strokes (BROS). Differences in prevalence and management of stroke risk factors were adjusted for age, sex, living conditions prestroke, stroke subtype, and socioeconomic status by multivariable logistic regression. Patients in BROS were on average older (mean difference 4 years) and more likely to have a nonmanual occupation. They were less likely to have a prestroke diagnosis of myocardial infarction (OR, 0.39; 95% CI, 0.19 to 0.77) or diabetes (OR, 0.65; 95% CI, 0.46 to 0.92) and were less likely to report smoking (OR, 0.31; 95% CI, 0.19 to 0.49). They were also more likely to receive appropriate prestroke antihypertensive (OR, 1.88; 95% CI, 1.21 to 2.92) and antidiabetic treatment (OR, 3.33; 95% CI, 1.44 to 7.70) and less likely to receive cholesterol-lowering drugs (OR, 0.19; 95% CI, 0.05 to 0.71)., Conclusions: The higher risk of stroke in black Caribbeans in the United Kingdom might be caused by a higher prevalence of major prior-to-stroke risk factors, differences in treatment patterns for comorbid conditions, and less healthy lifestyle practices compared with indigenous black Caribbean populations.
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- 2009
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6. A comparison of acute and long-term management of stroke patients in Barbados and South London.
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Smeeton NC, Corbin DO, Hennis AJ, Hambleton IR, Fraser HS, Wolfe CD, and Heuschmann PU
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- Aged, Aged, 80 and over, Barbados epidemiology, Female, Follow-Up Studies, Humans, Logistic Models, London epidemiology, Male, Middle Aged, Prospective Studies, Risk Factors, Severity of Illness Index, Socioeconomic Factors, Stroke epidemiology, Stroke Rehabilitation, Emergency Medical Services statistics & numerical data, Long-Term Care statistics & numerical data, Registries, Stroke therapy
- Abstract
Background: To compare health care utilisation between stroke patients living in a middle-income country with similar patients in a high-income country in terms of the type and amount of health care received following a stroke., Methods: Data were collected from the population-based South London Stroke Register (SLSR) and the Barbados Register of Strokes (BROS) from January 2001 to December 2004. Differences in management and diagnostic procedures used in the acute phase were adjusted for age, sex, ethnic group, living conditions pre-stroke and socio-economic status by multivariable logistic regression. Comparison of subsequent management was made for 3 months and 1 year post-stroke., Results: Patients in BROS were less likely to be admitted to a hospital ward (OR 0.22; 95% CI 0.13-0.37), but the difference for the lower use of brain scans in BROS was smaller (OR 0.62; 95% CI 0.25-1.52). Additional adjustment for stroke severity (Glasgow Coma Score) showed that BROS patients were more likely to have a swallow test on admission (OR 2.95; 95% CI 1.17-7.45). BROS patients were less likely to be in nursing care at 3 months (OR 0.37; 95% CI 0.17-0.81), and less likely to be receiving speech and language therapy at 3 months (OR 0.10; 95% CI 0.03-0.33) and 1 year (OR 0.05; 95% CI 0.00-0.55)., Conclusions: The lower use of hospital admission and nursing care at 3 months suggests that in Barbados, family and friends take greater responsibility for patient care around the time of the stroke and in the medium term thereafter., (Copyright 2009 S. Karger AG, Basel.)
- Published
- 2009
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7. Poststroke survival for black-Caribbean populations in barbados and South london.
- Author
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Wolfe CD, Corbin DO, Smeeton NC, Gay GH, Rudd AG, Hennis AJ, Wilks RJ, and Fraser HS
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- Aged, Aged, 80 and over, Atrial Fibrillation complications, Barbados epidemiology, Caribbean Region ethnology, Deglutition Disorders etiology, Female, Humans, Ischemic Attack, Transient complications, London epidemiology, Male, Middle Aged, Poverty Areas, Proportional Hazards Models, Registries, Severity of Illness Index, Stroke complications, Stroke physiopathology, Survival Analysis, Urban Population, White People statistics & numerical data, Black People statistics & numerical data, Stroke mortality
- Abstract
Background and Purpose: There are variations in mortality rates for stroke in black communities, but the factors associated with survival remain unclear., Methods: The authors studied population-based stroke registers with follow up in South London (270 participants, 1995 to 2002) and Barbados (578 participants, 2001 to 2003). Differences in sociodemographic factors, stroke risk factors and their management, case severity, and acute management between London and Barbados were studied. Survival analysis used Kaplan-Meier curves, log-rank test, and Cox proportional hazards model with stratification., Results: There were 1411 person-years of follow-up. Patients in Barbados had poorer survival (log-rank test P=0.037), particularly those with a prestroke Barthel index scores between 15 and 20 (1-year survival, 56.4% versus 74.3%; P<0.001). This disadvantage remained significant (hazard ratio [HR], 1.99; 95% CI, 1.23 to 3.21, P=0.005) after adjustment for age and year of stroke and stratification for stroke subtype and socioeconomic status (SES). After stratification by SES, clinical stroke subtype, and Glasgow Coma Score, and adjustment for other potential confounders, additional factors reducing survival were untreated atrial fibrillation (AF; HR, 8.54; 95% CI, 2.14 to 34.08, P=0.002), incontinence after stroke (HR, 2.64; 95% CI, 1.79 to 3.89), and dysphagia (HR, 2.25; 95% CI, 1.57 to 3.24). Patients not admitted to the hospital had improved survival (HR, 0.35; 95% CI, 0.21 to 0.58). Interaction terms between location and Barthel score, location and AF, and location and transient ischemic attack were included in the final model to reflect the greater difference in survival with a high Barthel score of 15 or more, absence of untreated AF, and having untreated transient ischemic attack., Conclusions: Black-Caribbean people with stroke living in Barbados have worse survival than similar patients in South London, particularly if they have good mobility before the stroke. Further exploration and refinement of measurement of confounding factors such as SES and poststroke management along with exploring the cultural/environmental differences between the communities is required to understand these stark differences.
- Published
- 2006
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8. Estimation of the risk of stroke in black populations in Barbados and South London.
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Wolfe CD, Corbin DO, Smeeton NC, Gay GH, Rudd AG, Hennis AJ, Wilks RJ, and Fraser HS
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- Adult, Age Distribution, Aged, Barbados epidemiology, Caribbean Region ethnology, Cerebral Hemorrhage complications, Cerebral Infarction complications, Female, Humans, Incidence, Infant, Newborn, London epidemiology, Male, Middle Aged, Risk Assessment, Stroke classification, Stroke epidemiology, Subarachnoid Hemorrhage complications, White People statistics & numerical data, Black People statistics & numerical data, Stroke ethnology, Stroke etiology
- Abstract
Background and Purpose: The incidence of stroke in black populations is a public health issue, but how risk varies between black communities is unclear., Methods: Population-based registers in South London (SLSR) and Barbados (Barbados Register of Strokes [BROS]). Stroke incidence estimated by age group, gender and stroke subtype from January 1995 to December 2002 (SLSR), and October 2001 to September 2003 (BROS). Incidence rate ratios [IRR] estimated adjusting for age and sex., Results: Two hundred and seventy-one cases registered in SLSR and 628 cases in BROS. Average age of stroke was 66.1 years (SD 13.7) in SLSR and 71.5 years (SD 14.9) in BROS (P<0.001). The incidence rate/1000 population in SLSR was 1.61 (European adjusted; 95% CI, 1.41 to 1.81) and 1.08 (world adjusted; 95% CI, 0.95 to 1.21). For Barbados incidence rates were 1.29 (European adjusted; 95% CI, 1.19 to1.39) and 0.85 (world adjusted; 95% CI, 0.78 to 0.92). Overall IRR for SLSR: BROS adjusted for age and sex was 1.26 (95% CI, 1.09 to 1.46). Statistically significant subtype differences included total anterior cerebral infarction (IRR, 1.82; 95% CI, 1.23 to 2.69), posterior cerebral infarction (IRR, 2.12; 95% CI, 1.28 to 3.53), primary intracerebral hemorrhage (IRR, 1.56; 95% CI, 1.03 to 2.35) and subarachnoid hemorrhage (IRR, 5.04; 95% CI, 2.54 to 9.97)., Conclusions: The risk of stroke in black Caribbeans is higher in South London than Barbados, and particularly so for specific stroke subtypes. The risk in Barbados approaches that in the white population in South London and strokes occur at an older age. Whether environmental factors mediate these differences in migrant populations requires further study.
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- 2006
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9. Incidence and case fatality rates of first-ever stroke in a black Caribbean population: the Barbados Register of Strokes.
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Corbin DO, Poddar V, Hennis A, Gaskin A, Rambarat C, Wilks R, Wolfe CD, and Fraser HS
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- Adolescent, Adult, Aged, Barbados epidemiology, Female, Humans, Incidence, Male, Middle Aged, Registries, Stroke mortality, Black People, Stroke ethnology
- Abstract
Background and Purpose: Estimation of stroke incidence among black populations outside the USA and the UK has been hampered by the lack of community-based studies. We aimed to document the incidence of first-ever stroke in Barbados, a Caribbean island with a population of 268,000 people., Methods: A national community-based prospective register of first-ever strokes, using multiple overlapping sources of notification, was established., Results: During the first year, 352 patients (95.2% black) were registered, 142 males and 210 females (59.7%), with a mean age of 72.5 years (range 24 to 104; SD 14.8). Cerebral infarction (IS) occurred in 81.8%, intracerebral hemorrhage (ICH) in 11.9%, subarachnoid hemorrhage (SAH) in 2.0%, whereas 4.3% of strokes were unclassified (UC). The crude annual incidence rate for the black population was 1.40 (95% CI: 1.25,1.55) per 1000 (1.35 standardized to the European population) for all strokes, 1.20 (1.07,1.34) for IS, 0.18 (0.12,0.23) for ICH, and 0.03 (0.01,0.05) for SAH. Lacunar infarction (LACI) accounted for 50.7% of IS among the black population, whereas 15.6% and 26.8% were caused by total anterior circulation infarction (TACI) and partial anterior circulation infarction (PACI), respectively. At 7 and 28 days, respectively, case fatality rates for blacks were 13.1% and 27.8% for all strokes, 46.3% and 58.5% for ICH, 7.6% and 21.7% for IS, 32.6% and 65.1% for TACI, and 2.1% and 9.0% for LACI., Conclusions: Stroke incidence among the black population of Barbados is lower than among African-origin populations in the USA and UK. Lacunar infarction is the predominant stroke subtype.
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- 2004
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10. Neurological and neurosurgical referrals overseas from the Queen Elizabeth Hospital, Barbados, 1987-1996.
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Corbin DO, Bynoe C, and Fraser HS
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- Barbados, Cost-Benefit Analysis, Female, Health Expenditures statistics & numerical data, Hospitals, General economics, Hospitals, General statistics & numerical data, Humans, Male, Neurology economics, Neurosurgery economics, Patient Transfer economics, Referral and Consultation economics, Neurology statistics & numerical data, Neurosurgery statistics & numerical data, Patient Transfer statistics & numerical data, Referral and Consultation statistics & numerical data
- Abstract
This paper reports on neurological and neurosurgical referrals overseas from the Queen Elizabeth Hospital (QEH) for the period November 1987 to November 1996, and is a follow up to an earlier report for the period January 1984 to November 1987. It outlines the pattern of referral, diagnoses, referral centres and costs based on examination of the files of all QEH patients transferred overseas under a government aided scheme. There were 203 transfers of 191 patients (69 males, 122 females) including 10 patients who were transferred twice and one patient who was transferred three times. Patients' ages ranged from 1 to 80 years (mean 37 years). Twenty overseas centres were used during the period but most patients were transferred to Brooklyn Hospital, New York in 1988, Mount Sinai Medical Center, New York, between 1989 and 1994, and Hospital de Clinicas Caracas, Venezuela (1992 to 1996). 65% of the referrals were for neurosurgery and 25% were for magnetic resonance imaging scans for diagnosis. The largest diagnostic categories were central nervous system tumors (40%) and subarachnoid haemorrhage (25%). Estimated costs reached almost BDS$11 million, but the mean actual cost was BDS$63,916 based on information from 123 patient transfers. Thus, the actual total government expenditure was probably closer to BDS$13 million. This study demonstrates the urgent need to establish a neurosurgical service at the QEH and the cost effectiveness of doing so.
- Published
- 1998
11. Human T-cell lymphotropic virus type I infection in Barbados: results of a 20-year follow-up study.
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Rabkin CS, Corbin DO, Felton S, Barker H, Davison D, Dearden C, Blattner WA, and Evans AS
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- Adolescent, Adult, Barbados epidemiology, Dermatitis complications, Female, Follow-Up Studies, HTLV-I Infections complications, HTLV-I Infections immunology, HTLV-I Infections physiopathology, Humans, Male, Middle Aged, Risk Factors, HTLV-I Antibodies blood, HTLV-I Infections epidemiology
- Abstract
Forty-one human T-cell lymphotropic virus type I (HTLV-1)-seropositive individuals were identified among 1,012 subjects with stored serum samples from a health and seroepidemiological survey conducted in Barbados in 1972. These 41 subjects plus 79 HTLV-1 seronegative household members were targeted in a follow-up study 20 years later. Sixteen seropositive subjects and 22 seronegative subjects were interviewed, examined, and phlebotomized. There were no changes in HTLV-1 serostatus between the 1972 and follow-up serum samples. Three (19%) of the seropositive subjects had HTLV-1-associated disorders: two with dermatitis and one with "smoldering" adult T-cell leukemia. Neurologic and immunologic function was similar in HTLV-1-seropositive and HTLV-1-seronegative subjects. HTLV-1 antibodies persist over many years, and the risk for seroconversion of household contacts is low.
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- 1996
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12. Anterior horn cell degeneration in polymyositis associated with human T lymphotropic virus Type-1 in patients from Barbados.
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Corbin DO, Mora CA, Garriques S, Rodgers-Johnson P, and Gibbs CJ Jr
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- Adult, Barbados, Female, Follow-Up Studies, HTLV-I Antibodies blood, HTLV-I Antibodies cerebrospinal fluid, HTLV-I Infections complications, HTLV-I Infections immunology, HTLV-I Infections virology, Human T-lymphotropic virus 1 isolation & purification, Humans, Immunoglobulin G blood, Immunoglobulin G cerebrospinal fluid, Middle Aged, Polymyositis complications, Polymyositis immunology, Polymyositis virology, Anterior Horn Cells pathology, HTLV-I Infections pathology, Polymyositis pathology
- Abstract
Anterior horn cell degeneration has only occasionally been noted in patients with tropical spastic paraparesis associated with human T lymphotropic virus type-1 (HTLV-1) infection. We report on three adult patients with HTLV-1-associated polymyositis who had clinical evidence of anterior horn cell degeneration. One patient had moderate proximal weakness and muscle wasting in all four limbs, while two had mild upper limb weakness with more profound proximal weakness and wasting in the lower limbs. In all three patients, electromyographic findings were compatible with motor unit loss and muscle biopsies showed mononuclear inflammatory cell infiltration; muscle biopsies in two patients showed features of denervation. Immunoglobulin G (IgG) antibodies to HTLV-1 were detected by enzyme-linked immunosorbent assay (ELISA) and confirmed by Western immunoblot in serum and cerebrospinal fluid in all three patients. In two, cell cultures were established from peripheral blood lymphocytes and HTLV-1 antigen was identified by immunofluorescence and the ELISA antigen-capture technique using an anti-p19 HTLV-1 mouse monoclonal antibody. The three cases illustrate the variety of neuromuscular disease, other than spastic paraparesis, that may occur in HTLV-1 infection. In some cases of HTLV-1-associated polymyositis, anterior horn cell degeneration may make a significant contribution to the muscle atrophy observed.
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- 1996
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13. Human T-lymphotropic virus type I DNA in spinal cord of tropical spastic paraparesis with concomitant human T-lymphotropic virus type I-negative Hodgkin's disease.
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Navarro-Román L, Corbin DO, Katz D, Callender DP, Prussia PR, Garriques S, Fraser HS, Jaffe ES, and Román GC
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- DNA, Viral genetics, DNA, Viral isolation & purification, Female, Hodgkin Disease complications, Hodgkin Disease pathology, Human T-lymphotropic virus 1 genetics, Humans, Lymph Nodes pathology, Middle Aged, Paraparesis, Tropical Spastic complications, Paraparesis, Tropical Spastic pathology, Spinal Cord pathology, Hodgkin Disease virology, Human T-lymphotropic virus 1 isolation & purification, Paraparesis, Tropical Spastic virology, Spinal Cord virology
- Abstract
We studied a 58-year-old black woman from Barbados who simultaneously developed myelopathy and lymphoma with human T-lymphotropic virus type I (HTLV-I) antibodies in serum and cerebrospinal fluid and died 3 years after onset. Neuropathological examination showed typical tropical spastic paraparesis (TSP). The polymerase chain reaction (PCR) demonstrated defective proviral genome retaining the HTLV-I pX and env regions in thoracic spinal cord, the level most severely affected. Defective HTLV-I in the nervous system retaining the pX region may be relevant to pathogenesis because circulating CD8+ cytotoxic lymphocytes specific for HTLV-I pX occur in HTLV-I myelopathy. This patient's lymph node biopsy specimen was consistent with Hodgkin's disease (HD), nodular sclerosis subtype, of B-cell origin. The PCR in the paraffin-embedded lymph node involved by HD failed to amplify HTLV-I proviral sequences. Complete HTLV-I proviral amplification was obtained in paraffin-embedded lymph nodes form positive controls (adult T-cell leukemia). To our knowledge the association of TSP and HD has not been reported previously. Despite claims that HD may be associated with HTLV-I, we demonstrated absence of HTLV-I-infected T cells in the lymphoid infiltrate of HD in this case, positive HTLV-I serology notwithstanding.
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- 1994
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14. HTLV-1 and neurological disease.
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Cruickshank JK, Corbin DO, Bucher B, and Vernant JC
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- Adult, Central Nervous System Diseases diagnosis, Central Nervous System Diseases immunology, Central Nervous System Diseases therapy, Female, Humans, Male, Middle Aged, Central Nervous System Diseases microbiology, HTLV-I Infections diagnosis, HTLV-I Infections immunology, HTLV-I Infections therapy
- Published
- 1992
15. Neuroleptic malignant syndrome among acute psychiatric admissions in Barbados.
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Mansoor GA, Corbin DO, Edwards CN, Nicholson GD, Asokan G, and Bannister P
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- Adult, Aged, Barbados, Female, Humans, Male, Middle Aged, Neuroleptic Malignant Syndrome etiology, Neuroleptic Malignant Syndrome therapy
- Abstract
The main features of the Neuroleptic Malignant Syndrome (NMS), a complication of neuroleptic therapy, are fever, muscle rigidity, autonomic dysfunction, and an alteration in consciousness level. We describe five cases of NMS comprising 0.6% of acute neuroleptically-treated admissions to a psychiatric hospital over a one-year period. All patients, four females aged 26 to 63 years, and one male, aged 65 years, were of African origin and received multiple neuroleptic drugs, at least one of which was a depot preparation. Four were being treated for functional psychiatric disorders while one had dementia. All patients had fever and depressed consciousness level while four had rigidity and autonomic dysfunction. Serum creatine phosphokinase was elevated in 4 cases, and there was indirect evidence of myoglobinuria in 3 cases suggested by a positive urine dipstick test for blood despite the absence of red cells on microscopy. Rhabdomyolysis was associated with renal failure in one case. Both bromocriptine mesylate and dantrolene sodium were given in two cases. Three patients died in hospital, one with persistent rigidity and progressive decubitus ulceration, one from peritonitis following peritoneal dialysis, and another suddenly. Early recognition of NMS is important; it should be considered in any patient on neuroleptic therapy who develops fever, rigidity or alteration in consciousness level.
- Published
- 1992
16. A randomized double blind cross-over trial of nifedipine in the treatment of primary Raynaud's phenomenon.
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Corbin DO, Wood DA, Macintyre CC, and Housley E
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- Adolescent, Adult, Blood Pressure drug effects, Clinical Trials as Topic, Double-Blind Method, Female, Fingers blood supply, Fingers physiopathology, Humans, Middle Aged, Nifedipine administration & dosage, Nifedipine adverse effects, Random Allocation, Systole drug effects, Nifedipine therapeutic use, Raynaud Disease drug therapy
- Abstract
During three winter months, 23 women participated in a double blind placebo controlled cross-over clinical trial of nifedipine in the treatment of Raynaud's phenomenon. Nifedipine and placebo were given in random order for two consecutive four-week periods. The dose of nifedipine was increased from 5 mg three times daily (tds) to 15 mg tds. During the final two weeks, the median number of attacks of Raynaud's phenomenon on nifedipine was 2.3 per week compared to 5.0 on placebo (P less than 0.01). Fifteen patients gave nifedipine a higher drug evaluation score than placebo (P less than 0.01). Side-effects were experienced by 14 patients (61%) on nifedipine and by two on placebo (P = 0.005). Finger systolic pressure after digit cooling did not differ significantly at the end of each treatment period. Nifedipine is effective in primary Raynaud's phenomenon in most patients but side effects are common.
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- 1986
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17. Palatal myoclonus influenced by head posture.
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Corbin DO and Williams AC
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- Adult, Female, Head, Humans, Pharynx physiopathology, Posture, Myoclonus physiopathology, Palate physiopathology
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- 1987
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18. Blood flow in the foot, polyneuropathy and foot ulceration in diabetes mellitus.
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Corbin DO, Young RJ, Morrison DC, Hoskins P, McDicken WN, Housley E, and Clarke BF
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- Adult, Angiography, Diabetes Complications, Female, Foot diagnostic imaging, Foot Diseases etiology, Humans, Male, Middle Aged, Peripheral Nerves physiopathology, Regional Blood Flow, Rheology, Skin Ulcer etiology, Vascular Resistance, Diabetes Mellitus physiopathology, Diabetic Neuropathies physiopathology, Foot blood supply, Foot Diseases physiopathology, Skin Ulcer physiopathology
- Abstract
Comparable groups of diabetic patients asymptomatic of neuropathy (Group A), with chronic painful polyneuropathy (Group B) and painless polyneuropathy causing recurrent foot ulceration (Group C) were studied for differences in pedal blood flow, peripheral somatic and autonomic neuropathy and vascular calcification. Blood flow abnormalities detected by doppler waveform analysis, and consistent with reduced peripheral vascular resistance, were found in all three diabetic patient groups. The abnormalities were of similar severity in Group A and B but generally more marked in Group C. Tests of peripheral somatic nerve function became progressively more abnormal from Group A to Group C. Autonomic neuropathy was equally severe in Groups B and C, although mild abnormalities were recorded in diabetic patients asymptomatic of neuropathy. A similar pattern was seen for vascular calcification in the tarsal and metatarsal arteries: marked in both neuropathic groups (B and C) but mild in Group A. It was concluded that abnormal blood flow consistent with reduced peripheral vascular resistance is very common in the feet of diabetic patients whether or not they are symptomatic of neuropathy, and is most severe in those with chronic painless polyneuropathy and recurrent foot ulceration. No clear relationship was found between autonomic nerve dysfunction and the degree of abnormality of blood flow.
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- 1987
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19. An evaluation of finger systolic-pressure response to local cooling in the diagnosis of primary Raynaud's phenomenon.
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Corbin DO, Wood DA, and Housley E
- Subjects
- Adolescent, Adult, Female, Humans, Middle Aged, Plethysmography, Raynaud Disease physiopathology, Blood Pressure, Cold Temperature, Fingers blood supply, Raynaud Disease diagnosis
- Abstract
Finger systolic-pressure (FSP) in response to local cooling has been evaluated as a diagnostic test in 28 females with primary Raynaud's phenomenon (PRP). The mean FSP (%) at 15 degrees C and 10 degrees C was significantly lower in the patients than in 28 age- and sex-matched controls but there was a large overlap in the individual responses. Diagnostic sensitivity of FSP (%) at 10 degrees C was only 57%. Increasing the sensitivity of the test lowered the specificity as the number of false positives rose. This also reduced the predictive value for a positive test. As a diagnostic test of PRP in individuals, the measurement of FSP appears to be of limited value, except in severe cases when complete vessel closure often occurs. Measurement of FSP will classify groups correctly and this objective physiological measure of Raynaud's phenomenon may have a place in group comparisons.
- Published
- 1985
- Full Text
- View/download PDF
20. Stridor during dystonic phases of Parkinson's disease.
- Author
-
Corbin DO and Williams AC
- Subjects
- Adult, Carbidopa therapeutic use, Drug Combinations therapeutic use, Humans, Levodopa therapeutic use, Male, Middle Aged, Parkinson Disease drug therapy, Respiratory Sounds drug therapy, Parkinson Disease complications, Respiratory Sounds complications
- Published
- 1987
- Full Text
- View/download PDF
21. A review of 98 cases of near-drowning at the Queen Elizabeth Hospital, Barbados.
- Author
-
Corbin DO and Fraser HS
- Subjects
- Adrenal Cortex Hormones therapeutic use, Adult, Anti-Bacterial Agents therapeutic use, Barbados, Child, Child, Preschool, Drowning therapy, Female, Humans, Infant, Male, Drowning epidemiology
- Published
- 1981
22. The use of thiopentone in the treatment of non-organic locomotor disorders.
- Author
-
White A, Corbin DO, and Coope B
- Subjects
- Adolescent, Adult, Child, Female, Follow-Up Studies, Humans, Male, Middle Aged, Pain drug therapy, Conversion Disorder drug therapy, Locomotion drug effects, Thiopental therapeutic use
- Abstract
Eleven patients who had been fully investigated and diagnosed by orthopaedic surgeons as suffering from non-organic locomotor disorders were assessed and treated by a psychiatrist (AW) using a technique involving one or more injections of thiopentone sodium. The patients had been ill for an average of 3.4 yr (3 mths to 10 yr) and suffered severe disablement. Injections of short-acting barbiturates have been used for many years to facilitate the release and discussion of repressed feelings and emotions (narcoanalysis). This paper describes the use of a similar injection but given to facilitate the movement and return to normality of muscles whose function is deranged. The authors suggest that this technique be called 'narcokinesis'. All eleven patients showed initial improvement with seven patients showing moderate or marked benefit from the treatment at the time of discharge from hospital. A detailed case study is described of the advantages of narcokinesis and possible mode of action discussed. The general practitioners of these patients were sent a questionnaire by post and all replied. At the time of follow-up (6-9 yr) the whereabouts of three patients were unknown, three had died, two remained ill and three patients remained well or moderately well.
- Published
- 1988
- Full Text
- View/download PDF
23. Tardive dystonia: which way do schizophrenics twist?
- Author
-
Corbin DO, Williams AC, and White AC
- Subjects
- Adult, Humans, Male, Rotation, Torticollis etiology, Dystonia Musculorum Deformans physiopathology, Schizophrenia physiopathology
- Published
- 1987
- Full Text
- View/download PDF
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