PurposeBreast cancer is among the leading causes of death resulting from cancer in
Caribbean women. Studies examining exogenous and genetically predetermined
endogenous risk factors are critical to define breast cancer susceptibility
in Caribbean women. The purpose of this systematic review is to assess the
existing scientific literature in the last 42 years (1975 to 2017) to
describe the body of research generated for the population of this region
and determine future research directions.MethodsWe selected published research articles using a combination of definite
keyword searches in PubMed. Only articles presenting the Caribbean
population as the focus of their research objectives were included in this
analysis.ResultsStudies on breast cancer in the Caribbean are limited. A majority of
publications on Caribbean populations were descriptive, focusing on cancer
trends and clinicopathologic factors. High incidence and mortality rates for
breast cancer are reported for the region, and there seem to be some
differences between countries in the frequency of cases according to age at
presentation. A limited number of epidemiologic, behavioral, and genetic and
molecular studies were conducted in more recent years.ConclusionA regional strategy for cancer registration is needed for the Caribbean to
address possible underestimates of breast cancer incidence. Furthermore,
behavioral, molecular, genetic, and epidemiologic investigations of breast
cancer are critical to address the concerns related to currently described
high incidence and mortality rates in the Caribbean.
Infections secondary to snakebite occur in a number of patients and are potentially life-threatening. Bothrops lanceolatus bites in Martinique average 30 cases per year and may result in severe thrombotic and infectious complications. We aimed to investigate the infectious complications related to B. lanceolatus bite. A retrospective singlecenter observational study over 7 years (2011-2018) was carried out, including all patients admitted to the hospital because of B. lanceolatus bite. One hundred seventy snake-bitten patients (121 males and 49 females) were included. Thirty-nine patients (23%) presented grade 3 or 4 envenoming. Twenty patients (12%) developed wound infections. The isolated bacteria were Aeromonas hydrophila (3 cases), Morganella morganii (two cases), group A Streptococcus, and group B Streptococcus (one case each). Patients were treated empirically with third-generation cephalosporin (or amoxicillin-clavulanate), aminoglycoside, and metronidazole combinations. Outcome was favorable in all patients. The main factor significantly associated with the occurrence of infection following snakebite was the severity of envenoming (P < 0.05). Our findings clearly point toward the frequent onset of infectious complications in B. lanceolatus-bitten patients presenting with grade 3 and 4 envenoming. Thus, based on the bacteria identified in the wounds, we suggest that empiric antibiotic therapy including third-generation cephalosporin should be administered to those patients on hospital admission.
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