Search PubMed⌕ Search

Biomedical subjects

H S Fraser

Publications and source records attributed to H S Fraser.

At least 37 records · Page 2Linked to original sources
PubMed1995

Writing a scientific paper.

There are many varieties of medical writing. This paper suggests a sound, practical approach for writing up a research project in the conventional format for a medical or scientific journal. The structure of a scientific paper is well established, to accommodate the "Why" of the project (the Introduction), the "Who, when, where and how" (the Methods) and the "What" (the Results). The Discussion (the "So what") should be in three parts--discussion and explanation of results, disputation, and disquisition (implications for practice and for future work). Guidelines are given for getting started and for producing a paper that will, hopefully, be published and read.

Authorship↗
PubMed1994

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.

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.

DNA, Viral↗
PubMed1994

Incidence of type I diabetes in people under 30 years of age in Barbados, West Indies, 1982-1991.

OBJECTIVE: To determine the incidence of type I diabetes among individuals < 30 years of age on the island of Barbados in the Caribbean. The population is predominantly African in origin but exhibits a relatively westernized lifestyle. RESEARCH DESIGN AND METHODS: Cases occurring during the years 1982-1991 were drawn from records at Queen Elizabeth Hospital and from physicians treating insulin-dependent diabetes mellitus (IDDM) patients. Patients using insulin and < 30 years of age at onset were included. Ascertainment was estimated at 94%. RESULTS: The average annual incidence of type I diabetes among Barbadians was 4.1/100,000 when age-adjusted to the world's population. There were 59 incident cases during this 10-year interval. The risk for males was 4.4 and for females 4.0/100,000. Among those 0-14 years of age, the risk was 5.0/100,000. Mean age at onset (+/- SD) was 14.7 +/- 6.9 for males and 12.5 +/- 5.7 for females. Males showed marked seasonal variation in risk and a more than threefold increase in annual incidence during 1984-1985. In contrast, females exhibited a stable pattern of IDDM risk during the 10-year interval. CONCLUSIONS: The incidence rate in Barbados falls near the lower limits of rates reported for Caribbean populations. There was a marked seasonal effect among males, even though the climate varies little throughout the year. This observation, and the incidence peak during 1984-1985, provide support for the role of environmental factors in the etiology of IDDM.

Adolescent↗
PubMed1993

Use by visitors of the services of the Queen Elizabeth Hospital, Barbados, W.I.

This paper analyses data for 1990 culled from the medical records of the Queen Elizabeth Hospital, Barbados and examines the use of inpatient and emergency services by visitors to Barbados. The 473 visitors admitted represented 2.1% of all admissions. The records of 425 contained information on country of origin: 145 were from non-Caribbean and 280 from Caribbean countries. The distribution by country of non-Caribbean visitors was the same as that of regular tourist arrivals--the majority came from the USA. Canada and the UK. Caribbean visitors represented 14.4% of the tourists, but accounted for 65.9% of visitor admissions. Non-Caribbean visitors were 85.6% of tourists, but 34.1% of admissions. Young patients predominated among Caribbean, and older patients among non-Caribbean. Accidents, cardiovascular disease, alcohol-related illnesses and near drowning were commoner in the non-Caribbean visitors, while cancer and obstetrical/gynaecological problems were commoner in Caribbean visitors. Seven per cent of visitor admissions went to the Intensive Care Unit as against 0.15% of other patients. The average hospital stay of visitors was 11.7 days compared with 7.0 days for Barbadians. There were 898 visitors treated in the Accident and Emergency Department and the commonest problems were lacerations, abrasions and infections. The UK provided most of these patients. These data show that there is appreciable visitor use of the public health services. Non-Caribbean visitors use them because they fall ill on holiday, but many Caribbean visitors may come specifically for health care. The cost to the Barbadian health service is not insignificant: at the 1990 estimated bed-day cost of Bds$250, it represents a cost of Bds$1.1 million per annum to the Government for inpatient services alone, or 2% of total hospital costs.

Adolescent↗
PubMed1990

Clinically significant hemorrhage due to warfarin-carbamazepine interaction.

A 61-year-old woman receiving warfarin for postoperative atrial fibrillation and carbamazepine for a peripheral neuropathy had extreme elevation of prothrombin time associated with clinically significant hemorrhage when the carbamazepine therapy was discontinued. The mechanism of this significant drug interaction involves the withdrawal of carbamazepine-induced enhancement of hepatic warfarin breakdown with resultant delay of warfarin excretion and excessive hypoprothrombinemia. The clinically significant hemorrhage associated with warfarin-carbamazepine interaction is an indication for caution when these two agents are prescribed concomitantly.

Carbamazepine↗
PubMed1990

Blood pressure in blacks. Twin studies in Barbados.

We have recently reported that there are significant genetic influences on the population variation in blood pressure in black twins in Los Angeles. The present cross-sectional study was undertaken to replicate these findings in a black twin population that lives in a different biosocial environment. We chose the Caribbean island nation of Barbados, where 96% of the population is black, the literacy rate is 99%, and the access to health care is guaranteed. The goals were 1) to test the feasibility of twin studies in blood pressure research in a developing country and 2) to estimate the relative contribution of genes and environment to blood pressure variability in blacks in the Caribbean. The names of 200 twin sets were obtained with the assistance of community resources including a twin club, by media advertisement, and by asking people at public blood pressure screenings if they knew any twins. By using these methods, we identified 200 sets of twins. Of these, 37.5% (75/200) met our criteria for study. Although 97% of the sets of twins (73/75) said they were willing to participate, only 69% (52/75) were able to be scheduled during the 1 week of the study when the full team of investigators was in Barbados. Of those scheduled, 83% (43/52) were examined. Examination included medical history, physical examination, recumbent blood pressure measurements by two observers, anthropometric measurements, 24-hour urine collections for sodium and potassium tests, and blood tests for zygosity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

A scoring system for selection of essential drugs.

A scoring system is presented for selection of essential drugs, using criteria of efficacy, safety, cost of a course of therapy, compliance, multiple usage and storage, ease of administration and local availability. Such a system allows for different weighting of factors whose relative importance varies from country to country and would help in choosing the most appropriate and cost-effective drugs for use in developing countries. The importance of such factors as cost and compliance has been illustrated with suitable examples. This approach could also be used for individual patient decisions with the aid of a computer program.

Anti-Bacterial Agents↗
PubMed1986

The Drug Formulary Committee in a developing country.

Most developing countries suffer badly from misguided drug selection and purchases, erratic supplies and distribution, and wasteful or inappropriate drug use. Barbados is one of the few developing countries with an active Drug Formulary Committee. This committee develops a formulary that is revised and updated annually, providing guidance on rational prescribing. The Barbados Drug Formulary Committee has operated for 5 years on principles similar to those of a P & T Committee, but with a more restricted list and a flexible approach geared to specific local problems. The Drug Formulary and ongoing educational activities, which have been effective agents in promoting rational prescribing, are described.

Barbados↗
PubMed1985

The management of severe hypertension with minoxidil in a once-a-day treatment regimen.

We evaluated the antihypertensive efficacy of "once-a-day" minoxidil, given in conjunction with a diuretic and sympatholytic, and the effect of this simple regimen on patient compliance. Twenty-one severely hypertensive patients had their existing antihypertensive regimens changed to a single daily dose of chlorthalidone (50-100 mg) and either nadolol (160 mg) or reserpine (.25 mg) for a 3-week period. After stabilization on these two drugs, a single daily dose of minoxidil (2.5 mg) was added to each patient's regimen. Doses were titrated as necessary to achieve diastolic blood pressures of less than 90 mmHg. After 3 and 6 months of maintenance therapy, blood pressures were measured 24 hours after the previous day's dosing to evaluate the persistence of the antihypertensive effect. Twenty-four-hour blood pressure control was achieved on 76% of these occasions, and on at least one occasion in 90% of the patients. In addition, compliance was excellent.

Adult↗