Coexistence of colonic carcinoma, renal cell carcinoma and gastrointestinal stromal tumour-A case report.

The occurrence of synchronous primary neoplasms remains an issue of great interest to surgeons and oncologists in particular, and the medical field in general. The question of common genetic pathways in the pathogenesis of such neoplasms is always raised when such associations are seen-whether metachronously or synchronously. The possibility of the coexistence of multiple tumours in the same patient must be taken into consideration when preparing patients for operation and a thorough search of the intraperitoneal organs for such coexistence remains important.

All-cause mortality after diabetes-related amputation in Barbados: a prospective case-control study.

Objective: To determine the mortality rate after diabetes-related lower-extremity amputation (LEA) in an African-descent Caribbean population.

Research Design And Methods: We conducted a prospective case-control study. We recruited case subjects (with diabetes and LEA) and age-matched control subjects (with diabetes and no LEA) between 1999 and 2001.

A case of T-tube dislocation.

In environments where endoscopic retrograde cholangio-pancreatogram (ERCP) services may at time be limited or unavailable, the surgeon must also decide between the insertion of a conventional T-tube or primary choledochorrhaphy when it is operatively perceived that the common bile duct (CBD) has been adequately cleared. Where the hospital stay of the patients with a T-tube in situ is prolonged, there is a higher incidence of postoperative bacteraemia with a moderate morbidity from biliary leakage after T-tube withdrawal. We report here a case as well as methods designed to prevent tube dislocation and alternatives to T-tube insertion after choledochotomy, whether performed open or laparoscopically.

Knowledge, attitudes and practice of healthcare ethics and law among doctors and nurses in Barbados.

Background: The aim of the study is to assess the knowledge, attitudes and practices among healthcare professionals in Barbados in relation to healthcare ethics and law in an attempt to assist in guiding their professional conduct and aid in curriculum development.

Methods: A self-administered structured questionnaire about knowledge of healthcare ethics, law and the role of an Ethics Committee in the healthcare system was devised, tested and distributed to all levels of staff at the Queen Elizabeth Hospital in Barbados (a tertiary care teaching hospital) during April and May 2003.

Results: The paper analyses 159 responses from doctors and nurses comprising junior doctors, consultants, staff nurses and sisters-in-charge.

Explanations for the high risk of diabetes-related amputation in a Caribbean population of black african descent and potential for prevention.

Objective: Diabetes-related lower-extremity amputation (LEA) rates are elevated in blacks compared with whites in the U.S., but are lower in African Caribbeans in the U.

Futility-of-care decisions in the treatment of moribund intensive care patients in a developing country.

Purpose: To analyze the characteristics of moribund patients in a surgical intensive care unit (ICU) and highlight the dilemmas inherent in treating such patients.

Methods: Data on all patients admitted to the surgical ICU during the period of three years from July 1999 to June 2002 were collected prospectively. Data were collected on very ill patients who died, in whom it appeared obvious that treatment could not have improved their condition and whose death could have been anticipated.

Spectrum of microbes and antimicrobial resistance in a surgical intensive care unit, Barbados.

Background: To survey the epidemiologic findings of infections and antibiotic resistance patterns in the surgical intensive care unit (ICU) of a tertiary care university teaching hospital.

Methods: The microbiologic culture-sensitivity reports of patients admitted to a surgical ICU were prospectively studied for 6 months each of 3 consecutive years. The antibiotic usage for these patients also was studied concurrently.