Pharmacodynamic Comparison of Two Aspirin Formulations in the Caribbean: The ARC Study.

Introduction: This prospective, single-arm, crossover pharmacodynamic study assessed the effect of Bayer low-dose enteric-coated aspirin 81 mg tablets (LD EC-ASA) (Bayer AG, Leverkusen, North Rhine-Westphalia, Germany) compared to Vazalore low-dose phospholipid-aspirin liquid-filled 81 mg capsules (LD PL-ASA) (PLx Pharma Inc., Sparta, NJ, USA) on platelet reactivity with respect to aspirin reaction units (ARU).

Methods: Forty-seven healthy volunteers were recruited.

Effectiveness and Safety of Left Distal Transradial Access in Coronary Procedures in the Caribbean.

Introduction: This retrospective study investigated the effectiveness and safety of left distal transradial access (LDTRA) in patients with cardiovascular disease in Trinidad undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI).

Method: Procedural parameters, including technical success and safety outcomes such as vascular complications and radial artery occlusion (RAO), were assessed in 111 consecutive patients undergoing CAG or PCI from January 2023 to June 2023 at the Eric Williams Medical Sciences Complex, Trinidad and Tobago. Eighty-eight patients underwent LDTRA, while 23 received left transradial access (LTRA).

Correlation of RETINAL Artery Diameter with Coronary Artery Disease: The RETINA CAD Pilot Study-Are the Eyes the Windows to the Heart?

Introduction: This study aimed to determine whether there was any correlation between coronary artery disease (CAD) and retinal artery diameter at an academic tertiary medical center in Trinidad and Tobago.

Methods: This prospective study evaluated patients (n = 77) with recent invasive coronary angiography (CAG) and the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score who subsequently underwent optical coherence tomography-angiography (OCT-A) at the Eric Williams Medical Sciences Complex (EWMSC) from January 2021 to March 2021. Routine medical history and cardiovascular medications were also recorded.

Effect of cocoa ( L.) on platelet function testing profiles in patients with coronary artery disease: ECLAIR pilot study.

Introduction: This prospective pharmacodynamic nutraceutical study assessed the effect of a 1-week trial of 30 g/day of 65% cocoa (dark chocolate) ( L.) consumption intervention on platelet reactivity.

Methods: Patients with stable coronary artery disease (CAD) (n=20) who were on maintenance dual antiplatelet therapy of aspirin (ASA) 81 mg/day and clopidogrel 75 mg/day were recruited.

Localizing the seizure onset zone by comparing patient postictal hypoperfusion to healthy controls.

Arterial spin labeling (ASL) MRI can provide seizure onset zone (SOZ) localizing information in up to 80% of patients. Clinical implementation of this technique is limited by the need to obtain two scans per patient: a postictal scan that is subtracted from an interictal scan. We aimed to determine whether it is possible to limit the number of ASL scans to one per patient by comparing patient postictal ASL scans to baseline scans of 100 healthy controls.

Long term sequelae of amygdala enlargement in temporal lobe epilepsy.

Purpose: Amygdala enlargement (AE) has been reported in drug resistant lesional and non-lesional temporal lobe epilepsy (TLE). Its contribution to development of intractability of epilepsy is at best uncertain. Our aim was to study the natural course of AE in a heterogenous group of TLE patients with follow-up imaging and clinical outcomes.

Mesial temporal lobe epilepsy: A West Indian Neurosurgical Experience.

Introduction: We sought to highlight a case of refractory mesial temporal lobe epilepsy managed via an anterior temporal lobectomy. To our knowledge, this is the first of its kind to be performed and published in the English-speaking Caribbean.

Presentation Of Case: A 44-year-old female, known seizure disorder for 25 years was referred to the outpatient clinic.

Prevalence of clOpidogrel 'resIstaNce' in a selected population of patients undergoing elective percutaneous coronary intervention at a tertiary cardiovascular centre in Trinidad: the POINT pilot study.

Objectives: This novel, pilot study aimed to assess the estimated prevalence of high on-treatment platelet reactivity (HPR) in Trinidad and Tobago.

Methods: Patients (n=40) who were awaiting elective percutaneous coronary intervention on maintenance dual antiplatelet therapy (DAPT) with aspirin 81 mg daily and clopidogrel 75 mg or loaded at least 48 hours prior were recruited. Platelet reactivity with the VerifyNow P2Y12 assay (Accriva Diagnostics, San Diego, California, USA) was assessed prior to cardiac catheterisation.

Seizure onset zone localization using postictal hypoperfusion detected by arterial spin labelling MRI.

Neurological dysfunction following epileptic seizures is a well-recognized phenomenon. Several potential mechanisms have been suggested to explain postictal dysfunction, with alteration in cerebral blood flow being one possibility. These vascular disturbances may be long lasting and localized to brain areas involved in seizure generation and propagation, as supported by both animal and human studies.

A systematic review of clinical decision rules for epilepsy.

Clinical decision rules (CDRs) have been empirically demonstrated to improve patient satisfaction and enhance cost-effective care. The use of CDRs has not yet been robustly explored for epilepsy. We performed a systematic review of MEDLINE (from 1946) and Embase (from 1947) using Medical Subject Headings and keywords related to CDRs and epilepsy.

Epilepsy care in the southern Caribbean.

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.

Ictal onset on intracranial EEG: Do we know it when we see it? State of the evidence.

Objective: A major limitation of intracranial electroencephalography (iEEG) is recording from a confined region. This may falsely localize seizure onset if the distinction between ictal onset zone, proximity, and spread is unclear, or if the ictal rhythm is not clearly identified. Delineation of the ictal onset zone is crucial for surgical success.