Objective:The purpose of this study is to determine primarily the occurrence of left ventricular hypertrophy (LVH) in normotensive Trinidadians.Design and methods:Enrolment into the study required participants to have normal blood pressure (≤140/90) using the JNC 7 (The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure) classification, free of type 2 diabetes, as well as no existing LVH. Upon entry into the study, participants were first screened for LVH using a standard 12-lead electrocardiogram (ECG), using the Sokolow–Lyon index and the Cornell index. ECHO was used to confirm or refute the diagnosis of LVH.Results:A total of 209 patients met the criteria for entry into the study. Of these, 63.6% had LVH using Cornell criteria and 68.2% using LVH by Sokolow–Lyon criteria. Subsequently, ECHO confirmed the diagnosis in 2.9% using American Society of Echocardiography criteria and 1.5% using World Health Organization criteria. Thus the estimated prevalence of LVH in normotensive individuals was approximately 3%.Conclusion:The estimated prevalence of LVH in normotensive individuals appears to be relatively high if an ECG is the single investigation performed, which is common in our setting and may also be common in the developing world. However, using ECHO, the prevalence of LVH approaches a value similarly reported in the literature. Therefore, these findings raise two important issues: 1) the use of criteria such as the Cornell and Sokolow–Lyon voltage criteria established in the developed world from populations of vastly different ethnic backgrounds may not be widely applicable, and 2) all individuals suspected of having LVH should have an ECHO.
The resolution of food protein induced enterocolitis syndrome (FPIES) is confirmed by an oral challenge (OC). The COVID-19 pandemic has delayed scheduling of OC, due to lockdown barriers to inperson care. Assessing parental attitudes on the possibility of supervised remote at-home OCs may lay the groundwork of selected low risk home OCs in facilitating early reintroduction of FPIES allergenic foods METHODS: A 12 point questionnaire was collected from FPIES parents between the ages of 2-4 years to assess attitudes towards their toddlers' FPIES status. Questions addressed FPIES re-assessment during the pandemic, parental consideration for an home oral challenge from start to finish or the option of a hybrid in-office/ home model. RESULTS: Thirty-six parents (n536) of toddlers with FPIES replied. In five children, FPIES resolved from initial diagnosis. Forty-eight percent (15/31) of parents stated that they would proceed with an FPIES OC during a pandemic, with 52% (16/31) choosing to delay. Eleven of these 16 (69%) parents agreed to proceed with a supervised at-home OC, with 2 preferring a hybrid in-office-home model. Thirteen of 15 (87%) parents agreeing to proceed with an FPIES OC ASAP would also agree for home challenge. CONCLUSIONS: The majority of FPIES families preferred the choice of an in-home OC, 77% (24/31) due to the current pandemic, with a hybrid model being less desired. Resolution of FPIES occurred in 14%. With significant familial interest in home OC for diagnosis of continued FPIES, further research into appropriate selection and monitoring, for home FPIES OC is needed.
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