Eyelid angiosarcoma: a case report and review of the literature

A 77-year-old woman presented with a 3-month history of a lesion on her left lower eyelid. External examination showed a tan-colored nodule with an overlying crust-covered ulcer on the left lower eyelid, nasally. The ulcer measured 12 mmx7 mm. Complete surgical excision with a frozen section margin control was performed. Histopathological examination showed islands and sheets of spindle and epithelioid cells with little intervening stroma. The cells had copious amounts of either rounded or tapered eosinophilic cytoplasm with occasional intracytoplasmic lumina and large vesicular nuclei with prominent nucleoli. There was intense immunoreactivity for CD34, CD31, factor VIII, and Ki-67. The diagnosis was eyelid angiosarcoma. The patient refused any further therapy. At 1-year follow-up, there was no recurrence or development of metastasis. In conclusion, tan-colored eyelid nodules with overlying ulcer are usually a basal cell carcinoma; however, rarely it can be an eyelid angiosarcoma

Correlation of hepatitis C and prostate cancer, inverse correlation of basal cell hyperplasia or prostatitis and epidemic syphilis of unknown duration

PURPOSE: The accuracy of prostate specific antigen (PSA) to detect prostate cancer has not yet been determined. Autopsy evidence suggests one-third of men have evidence of prostate cancer. Correlation between prostate cancer and sexually transmitted infection is indeterminate. MATERIALS AND METHODS: A retrospective database was created of all men who underwent transrectal ultrasound guided prostate biopsy over 3 years. Men were 49 percent African or African Caribbean, and 51 percent Central or South American. Information about prostate specific antigen, cholesterol, hepatitis A, B and C, human immunodeficiency virus, syphilis, tuberculin skin testing and histology were collected. RESULTS: Hepatitis C antibody detection correlated with prostate cancer OR 11.2 (95 percent CI 3.0 to 72.4). The odds of prostate cancer increased annually (p = 0.0003). However, no correlation was found between prostate cancer and the following: PSA, biopsy date, repeat biopsy, more than 12 cores at biopsy, total cholesterol, high density lipoprotein, triglycerides, low density lipoprotein, risk measure reported with free and total PSA, hepatitis B surface antibody, high grade prostatic intraepithelial neoplasia or atypical small acinar proliferation. Histologic prostatitis and basal cell hyperplasia were inversely correlated with prostate cancer. Syphilis of unknown duration occurred in 17 percent of men with indeterminate correlation to prostate cancer. CONCLUSION: In inner city men of African and African-Caribbean, or Central and South American descent, prostate specific antigen levels did not correlate with prostate cancer. Hepatitis C antibody detection correlates significantly with prostate cancer. One prostate biopsy is sufficient to diagnose statistically significant prostate cancer. Histologic prostatitis and basal cell hyperplasia decrease odds of prostate cancer. Atypical small acinar proliferation may not correlate to prostate cancer and is pending further investigation. Men should be screened for epidemic syphilis of unknown duration.

Substance use among university students at the St Augustine Campus of The University of the West Indies / Uso de sustancias entre los estudiantes universitarios en el Campus de Saint Augustine de la Universidad de West Indies

OBJECTIVE: Substance use and abuse is a well known public health risk that peaks in persons between 18 and 25 years of age and is prevalent among university students. While this has been repeatedly documented in developed nations, there have been limited studies in the English-speaking Caribbean. This study therefore sought to assess the prevalence of alcohol, tobacco and marijuana use among university students in the English-speaking Caribbean and any associated risk factors. METHODS: The study was designed as a descriptive, cross-sectional study to assess substance use in full-time, undergraduate students of The University of the West Indies (UWI), Trinidad and Tobago, over a six-month period. Questionnaires were distributed and students asked to self-report on their use of alcohol, tobacco and marijuana during the preceding six months. RESULTS: The six-month prevalence rate for alcohol was 70% and 28% of students were identified as regular users. Binge drinking was estimated at 31%. Muslims were least likely to have used alcohol when compared to other religious groupings. The prevalence rate for tobacco and marijuana was 17% and 13%, respectively. Ten per cent used all three substances. The use ofall three substances was associated with multiple problems. CONCLUSION: We conclude that substance use is common among many students of the UWI but generally lower than reports from other regions of the world. Despite this, substance use is associated with a number ofproblems and immediate educational interventions may be necessary to assist students in making informed and responsible choices.

OBJETIVO: El uso y abuso de sustancias es un riesgo bien conocido de la salud pública, que alcanza sus niveles más altos en personas entre los 18 y 25 años de edad, y es prevaleciente entre estudiantes universitarios. Si bien este fenómeno ha sido documentado una y otra vez en países desarrollados, los estudios en el Caribe anglófono han sido limitados. Por lo tanto, este estudio se propuso evaluar la prevalencia del uso del alcohol, el tabaco, y la marihuana, entre los estudiantes universitarios del Caribe angloparlante, y cualquier factor de riesgo asociado. MÉTODOS: El estudio se diseñó como un estudio descriptivo transversal para evaluar el uso de sustancias en estudiantes de pregrado a tiempo completo en la Universidad de West Indies (UWI), Trinidad y Tobago, por un periodo de seis meses. Se distribuyeron encuestas y se les pidió a los estudiantes entregar auto-reportes sobre el uso que habían hecho del alcohol, el tabaco y la marihuana en los seis meses precedentes. RESULTADOS: La tasa de prevalencia de seis meses para el alcohol fue del 70% y 28% de los estudiantes fueron identificados como usuarios regulares. El consumo de alcohol en forma de borracheras deliberadas se estimó en un 31%. Los musulmanes fueron los menos propensos al consumo de alcohol, en comparación con los restantes grupos religiosos. La tasa de prevalência para el tabaco y la marihuana fue de 17% y 13% respectivamente. El diez por ciento hacía uso de las tres sustancias. El uso de las tres sustancias estaba asociado a múltiples problemas. CONCLUSIÓN: Concluimos que el uso de sustancias es común entre muchos estudiantes de UWI, pero de modo general se halla por debajo de lo que se reporta desde otras regiones del mundo. No obstante, el uso de sustancias se encuentra asociado con un número de problemas, y puede que se requieran intervenciones educacionales inmediatas para ayudar a los estudiantes, de modo que estos puedan tomar decisiones responsables e informadas.