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Sangre Grande, Trinidad and Tobago

Pinkney J.A.,University of the West Indies | Nagassar R.P.,Eastern Regional Health Authority | Roye-Green K.J.,University of the West Indies | Ferguson T.,University of the West Indies
BMJ Case Reports | Year: 2014

A previously healthy 27-year-old Jamaican man presented to the University Hospital of the West Indies with recurrent joint pain, remitting and relapsing fever, and shortness of breath. He was subsequently found to have Abiotrophia defectiva endocarditis. This was the first time this organism had been isolated at our institution. Despite culture directed antibiotics, his clinical course was quite severe with mitral regurgitation and congestive cardiac failure requiring mitral valve replacement. He recovered well postoperatively and is currently being followed at our outpatient cardiology clinic. This report highlights the severe presentation and often poor outcome associated with A. defectiva endocarditis and stresses that the outcome may be improved by early and appropriate surgical intervention. Copyright 2014 BMJ Publishing Group. All rights reserved.

Sledge J.,Larson Bone and Joint Clinic | Mahadevappa K.,Eastern Regional Health Authority | Stacey P.,Hamilton Health Sciences | Graham A.,Hamilton Health Sciences | Nesathurai S.,Hamilton Health Sciences
American Journal of Physical Medicine and Rehabilitation | Year: 2016

Therefore, to answer the original question, what would I want for my loved one, in a nutshell, we think this combination of treatment is potentially efficacious and relatively safe.We recognize that proposing a combination of medications is speculative, and perhaps, contentious. However, currently, most patients with SCI are not enrolled in any trial of pharmacotherapy. Furthermore, Bfirst do no harm[ is not synonymous with Bdoing nothing[. In fact, not offering reasonable treatments is tantamount to doing nothing. We hope that this communication spurs dialog related to treating traumatic SCI. Footnote: Shanker Nesathurai and John Sledge are currently investigating the safety and efficacy of combination treatment in an animal model of SCI. Paul Stacey is the principal investigator of a pilot human clinical trial evaluating selenium and vitamin E in people with chronic SCI. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

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