Kathleen C. M Coard

Admixture and Population Stratification in African Caribbean Populations

Throughout biomedical research, there is growing interest in the use of ancestry informative markers (AIMs) to deconstruct racial categories into useful variables. Studies on recently admixed populations have shown significant population substructure due to differences in individual ancestry; however, few studies have examined Caribbean populations. Here we used a panel of 28 AIMs to examine the genetic ancestry of 298 individuals of African descent from the Caribbean islands of Jamaica, St. Thomas and Barbados. Differences in global admixture were observed, with Barbados having the highest level of West African ancestry (89.6%± 2.0) and the lowest levels of European (10.2%± 2.2) and Native American ancestry (0.2%± 2.0), while Jamaica possessed the highest levels of European (12.4%± 3.5) and Native American ancestry (3.2%± 3.1). St. Thomas, USVI had ancestry levels quite similar to African Americans in continental U.S. (86.8%± 2.2 West African, 10.6%± 2.3 European, and 2.6%± 2.1 Native American). Significant substructure was observed in the islands of Jamaica and St. Thomas but not Barbados (K=1), indicating that differences in population substructure exist across these three Caribbean islands. These differences likely stem from diverse colonial and historical experiences, and subsequent evolutionary processes. Most importantly, these differences may have significant ramifications for case‐control studies of complex disease in Caribbean populations.

Pathological outcome and biochemical recurrence‐free survival after radical prostatectomy in African‐American, Afro‐Caribbean (Jamaican) and Caucasian‐American men: an international comparison

Whats known on the subject? and What does the study add?

Leiomyosarcoma of the uterus with a florid intravascular component ("intravenous leiomyosarcomatosis").

A leiomyosarcoma of the uterus in a 54-year-old woman exhibited striking involvement of large vessels of the myometrium and broad ligament on both gross and microscopic examination. The pattern of vascular involvement resembled that seen in intravenous leiomyomatosis. Imaging studies showed recurrent tumor within the inferior vena cava 3 months after hysterectomy. To our knowledge, this is the first reported such case in the literature, for which we propose the designation intravenous leiomyosarcomatosis of the uterus.

Dietary patterns as predictors of prostate cancer in Jamaican men.

Studies of diet and prostate cancer have focused primarily on food and nutrients; however, dietary patterns examine the overall diet, particularly foods eaten in combination, and risk of disease. We evaluated the association of dietary patterns and prostate cancer and low- and high-grade subgroups in Jamaican men. In a case-control study, we enrolled 243 incident cases and 273 urology controls in Jamaican clinics, March 2005–July 2007. Dietary patterns were identified using principal component analysis. Four food patterns were identified: a “vegetable and legume” pattern, a “fast food” pattern, a “meat” pattern, and a “refined carbohydrate” pattern. Men in the highest tertile for the refined carbohydrate pattern, characterized by high intakes of rice, pasta, sugar sweetened beverages, and sweet baked foods were at increased risk of total prostate cancer [odds ratio (OR) = 2.02; 95% confidence interval (CI) = 1.05–3.87 (Ptrend = 0.029)] and low-grade disease [OR = 2.91; 95% CI = 1.18–7.13 (Ptrend = 0.019)] compared with men in the lowest tertile. The vegetable and legumes pattern (healthy), meat pattern, or fast food pattern were not associated with prostate cancer risk. These data suggest a carbohydrate dietary pattern high in refined carbohydrates may be a risk factor for prostate cancer in Jamaican men.

Disseminated Trichosporonosis in a Burn Patient: Meningitis and Cerebral Abscess Due to Trichosporon asahii

ABSTRACT A 44-year-old diabetic female presented to a hospital in Jamaica with thermal burns. Trichosporon asahii was isolated from facial wounds, sputum, and a meningeal swab. Dissemination of the fungus was demonstrated in stained histological sections of the meninges and a brain abscess at autopsy. Pure growth of the fungus from patient samples submitted and an environmental isolate obtained from a wash basin in the hospital supported the diagnosis.

8q24 risk alleles in West African and Caribbean men

Multiple genetic studies have confirmed associations of 8q24 variants with susceptibility to prostate cancer (CaP). However, the magnitude of risk conferred in men living in West Africa is unknown.

A 6-year analysis of the clinicopathological profile of patients with prostate cancer at the University Hospital of the West Indies, Jamaica.

To document the clinicopathological characteristics of prostate cancer in a public hospital‐based population in Jamaica, over a 6‐year period, and examine any trends in these characteristics over time, as prostate cancer is the leading cause of cancer in Jamaican men, but there are few published reports documenting the clinicopathological profile of this disease in the Jamaican population.

Bilateral synchronous carcinoma of the male breast in a patient receiving estrogen therapy for carcinoma of the prostate: cause or coincidence?

An unusual case of bilateral, synchronous breast cancer in a male patient who had a history of long-term estrogen therapy for prostate cancer is presented. The possible role of estrogen in the development of male breast cancer is revisited.

Perinatal mortality in Jamaica 1986-1987

ABSTRACT. A large population‐based study of all stillbirths and neonatal deaths occurring on the island of Jamaica during a 12 month period is described. During this time, 2069 perinatal deaths were identified in an estimated total of 54400 infants born giving a perinatal death rate of 38.0 per 1000 births. The death rate was 5 times higher among twins than singletons. An attempt was made to obtain detailed postmortem examination of as many cases as possible. In the event, 51 % of the infants who died perinatally had such postmortem examination. Postmortem rate was affected by sex, multiplicity of the infant, time of death, month of death and area of delivery. Deaths were classified using the Wigglesworth scheme. The distribution of categories was similar in the months when the postmortem rate was 70 % to the rest of the time period when the post‐mortem rate was only 40 %. The Wigglesworth classification of deaths identified those associated with intrapartum asphyxia as the most important group, accounting for over 40 % of deaths overall and 59 % of deaths in infants of more than 2 500 g birthweight. Antepartum fetal deaths were the second largest group, comprising 20 % of deaths. Sixty percent of the infants in this group weighed less than 2 500 g at birth. Major malformations were responsible for few perinatal deaths in Jamaica. This simple classification is important as it focusses attention on details of labour and delivery that may require change and is useful in planning future delivery of obstetric and neonatal care.

Extramedullary plasmacytoma of the pancreas as an uncommon cause of obstructive jaundice: a case report

IntroductionThough uncommon, extramedullary plasmacytoma of the pancreas should be considered in the differential diagnosis of obstructive jaundice and pancreatic neoplasms. This report highlights a case of obstructive jaundice in a 46-year-old West Indian man that resulted from an extramedullary plasmacytoma.Case presentationA 46-year-old West Indian man presented to our hospital with evidence of a significant upper gastrointestinal bleed. He gave a recent history of jaundice, constitutional symptoms and back pain. Ultrasonography revealed a mass in the head of the pancreas with resultant common bile duct dilatation. The patient required urgent surgical intervention for ongoing bleeding at which time a biopsy of the pancreas was taken. Histological analysis revealed a plasmacytoma of the pancreas. A blood film showing rouleaux formation and a skeletal survey demonstrating multiple lytic lesions confirmed multiple myeloma. Before further evaluation or treatment was carried out, the patient defaulted from follow-up and died from his illness seven months later.ConclusionThis case represents an example of multiple myeloma with visceral involvement, brought to clinical attention through involvement of the pancreas. The report serves to reaffirm knowledge of the various presentations, the optimal diagnostic tools and the current proposed treatment strategies for extramedullary plasmacytomas of the pancreas.