An Exploratory Qualitative Analysis of the Stanford-Templeton Convenings on Islam and Suicide.

For over 70 years, studies have reported lower rates of completed suicide in Muslim-majority countries and individuals who identify as Muslim. To this point, the mechanisms underlying the relationship between Islam and lower risk of suicide remain understudied. In an effort to advance our understanding, we convened a bilingual international interdisciplinary panel of experts for a discussion of the current state and future directions of the field. In this paper, we present an exploratory qualitative analysis of the core themes that emerged from the group interviews. We also derive a general theoretical model of the association between Islam and suicide risk.

Nodular fasciitis presenting in an adult woman.

The authors report a 30-year-old Caucasian woman with nodular fasciitis presenting as a nontender lesion to right temporal area. The lesion was removed by en bloc excision and the base was cauterized. Six months later, the patient returned to the clinic for possible recurrence of lesion or for residual lesion; the patient was then injected with a total of 1 cc of kenalog at 20 mg/kg. Two weeks later, the lesion had greatly subsided and the patient was satisfied with the esthetic appearance. Nodular fasciitis is a rare reactive growth with even fewer cases of recurrence. In young patients, steroid injection is an alternative to repeat resection.

Comparison of complication rates of porous anophthalmic orbital implants.

BACKGROUND AND OBJECTIVE: Porous anophthalmic orbital implants are used widely. This study evaluates risk factors for porous anophthalmic orbital implant complications and compares complication rates of hydroxyapatite, porous polyethylene, and polyglactin mesh-wrapped aluminum oxide implants. PATIENTS AND METHODS: The records of 105 patients (110 eyes) who received porous anophthalmic orbital implants for any indication were reviewed retrospectively. Complications were recorded and correlated with potential risk factors, including implant material. All patient records were de-identified to protect privacy. RESULTS: Porous polyethylene and aluminum oxide implants were associated with higher exposure rates (porous polyethylene: odds ratio 6.1 [1.29, 29.1]; aluminum oxide: odds ratio 6.0 [1.58, 23.1]; P = .004) and higher overall complication rates compared to hydroxyapatite implants. CONCLUSION: Implant material may be a risk factor for several anophthalmic clinical outcomes.

Treatment and outcomes for metastatic sebaceous cell carcinoma of the eyelid.

OBJECTIVE: To report the management and outcomes in patients with metastatic eyelid sebaceous cell carcinoma. METHODS: The clinical records of four patients with metastatic eyelid sebaceous cell carcinoma treated between January 1999 and August 2006 were reviewed. RESULTS: The study included four women with a mean age of 66 years. Metastatic sites included the lung in three patients, regional lymph nodes in two, liver in two, and bone in one. Time from diagnosis of eyelid carcinoma to metastasis ranged from 0 to 62 months. Treatment of regional nodal metastasis consisted of complete neck dissection followed by radiation therapy. One patient developed lung metastasis 5 years after the diagnosis of eyelid tumor; she was treated with systemic chemotherapy followed by subtotal lung resection. Systemic chemotherapy was considered for two additional patients: in one, chemotherapy was deferred due to poor performance status and ongoing medical problems; and another patient died before chemotherapy could be started. The patient with bony metastasis was treated with radiation therapy to the spine. Two patients died during the study period. The follow-up time from diagnosis of metastasis to last contact or death ranged from 1 month to 3 years (median of 21 months). CONCLUSION: Eyelid sebaceous cell carcinoma can result in systemic metastasis and death. Metastasis can be discovered as late as 5 years after treatment of the eyelid carcinoma, warranting continued surveillance. Treatment of metastatic disease may include a combination of chemotherapy, radiation, and surgical neck dissection.

Meta-analyses of the association between Chlamydia psittaci and ocular adnexal lymphoma and the response of ocular adnexal lymphoma to antibiotics.

BACKGROUND: There are conflicting reports regarding the association between Chlamydia psittaci (Cps) and ocular adnexal lymphoma (OAL) and the efficacy of antibiotics for OAL. In the current study, the authors attempted to clarify the association between Cps and OAL and the efficacy of antibiotics for OAL. METHODS: Two meta-analyses were conducted. One focused on the association between Cps and OAL across geographic regions and among different studies. The other was a meta-analysis of the response of OAL to antibiotic treatment. RESULTS: The authors identified 11 studies of Cps prevalence that included 458 cases of OAL from 10 different countries. Four studies regarding the efficacy of oral antibiotics to treat OAL were found. One hundred four of the 458 OAL specimens (23%) and 87 of the 346 mucosa-associated lymphoid tissue (MALT) lymphoma specimens (25%) were found to be positive for Cps. Ninety-four of the 104 Cps-positive OAL specimens (90%) came from 3 of the 11 studies. There was wide variation noted between geographic regions and even between studies from the same geographic region with regard to the rate of Cps positivity. The 4 studies concerning the efficacy of antibiotics for OAL were from Italy, Austria, Taiwan, and the U.S. and included 42 patients. Twenty patients (48%) achieved some response (complete response in 8 patients, partial response in 8 patients, and minimal response in 4 patients). Twenty patients also had stable disease, and 2 patients progressed during antibiotic therapy. Objective documentation of response (radiographs or clinical slit-lamp photographs) was available for only 3 of the 42 patients. Seven additional patients developed disease recurrence after their initial response or stable disease after antibiotic therapy; 6 of these cases of disease recurrence occurred during the first 12 months of follow-up. CONCLUSIONS: The findings of the current study suggest a striking variability in the association between Cps and OAL across geographic regions and even between studies from the same geographic regions. The overall rate of Cps positivity in our meta-analysis (23%) was much lower than that reported in the original report. The current study findings also suggest that antibiotics have variable efficacy against OAL. Future prospective trials with standard objective response criteria and a longer follow-up period would be necessary to evaluate the role of antibiotics in the treatment of OAL further.