Erythema nodosum as a result of estrogen patch therapy for prostate cancer: a case report.

© 2015 Coyle et al.Introduction: Erythema nodosum is often associated with a distressing symptomatology, including painful subcutaneous nodules, polyarthropathy, and significant fatigue. Whilst it is a well-documented side-effect of estrogen therapy in females, we describe what we believe to be the first report in the literature of erythema nodosum as a result of estrogen therapy in a male. Case presentation: A 64-year-old Afro-Caribbean man with locally advanced carcinoma of the prostate agreed to participate in a randomized controlled trial comparing estrogen patches with luteinizing hormone-releasing hormone analogs to achieve androgen deprivation, and was allocated to the group receiving estrogen patches. One month later he presented with tender lesions on his shins and painful swelling of his ankles, wrists, and left shoulder. This was followed by progressive severe fatigue that required hospital admission, where he was diagnosed with erythema nodosum by a rheumatologist. Two months after discontinuing the estrogen patches the erythema nodosum, and associated symptoms, had fully resolved, and to date he remains well with no further recurrence. Conclusion: Trial results may establish transdermal estrogen as an alternative to luteinizing hormone-releasing hormone analogs in the management of prostate cancer, and has already been established as a therapy for male to female transsexuals. It is essential to record the toxicity profile of transdermal estrogen in men to ensure accurate safety information. This case report highlights a previously undocumented toxicity of estrogen therapy in men, of which oncologists, urologists, and endocrinologists need to be aware. Rheumatologists and dermatologists should add estrogen therapy to their differential diagnosis of men presenting with erythema nodosum

Interaction design and emotional wellbeing

The World Health Organisation has concluded that emotional wellbeing is fundamental to our quality of life. It enables us to experience life as meaningful and is an essential component of social cohesion, peace and stability in the living environment [21]. This workshop will bring together a diverse community to consolidate existing knowledge and identify new opportunities for research on technologies designed to support emotional wellbeing. The workshop will examine uses of technology in mental health settings, but will also consider the importance of emotional needs in physical healthcare and wellbeing more generally. The design of technology to provide social support and to extend traditional care networks will be key workshop themes

Resilient Families Help Make Resilient Children

Many children are resilient despite dysfunctional families and communities. Resilience theory and research describe families’ positive impact on children’s resilience, yet it can often be challenging to identify these factors in children’s multi-problem families. Strategies for enhancing family resilience can strengthen the family treatment approaches that are commonly used to help children. This paper explains how family resilience influences children\u27s resilience and applies this knowledge to a case example of a struggling family. It proposes methods for identifying and enhancing family protective factors that support children’s resilience

B mixing at LEP

Recent results from LEP on mixing in the $B$ sector are reviewed. The new LEP $95\%$ CL lower limit on $B_s$ mixing of $\Delta m_s > 9.5~{\rm ps^{-1}}$ combined with the LEP average for $\Delta m_d$ of $0.469 \pm 0.017~{\rm ps^{-1}}$, starts to significantly constrain the unitarity triangle for the first time

Real-world Gyroscope-based Gait Event Detection and Gait Feature Extraction

Falls in older adults are a major clinical problem often resulting in serious injury. The costly nature of clinic-based testing for the propensity of falling and a move towards homebased care and monitoring of older adults has led to research in wearable sensing technologies for identifying fall-related parameters from activities of daily living. This paper discusses the development of two algorithms for identifying periods of walking (gait events) and extracting characteristic patterns for each gait event (gait features) with a view to identifying the propensity to fall in older adults. In this paper, we present an evaluation of the algorithms involving a small real-world dataset collected from healthy adults in an uncontrolled environment. 92.5% of gait events were extracted from lower leg gyroscope data from 5 healthy adults (total duration of 33 hours) and over 95% of the gait characteristic points were identified in this data. A user interface to aid clinicians review gait features from walking events captured over multiple days is also proposed. The work presents initial steps in the development of a platform for monitoring patients within their daily routine in uncontrolled environments to inform clinical decision-making related to falls

Search for Bs0sB^{0}_{s}s oscillations using inclusive lepton events

A new search for Bs oscillations is performed in a sample of semileptonic b-hadron decays collected by the ALEPH experiment during 1991-1995. Compared to previous inclusive lepton analyses, the proper time resolution and mistag are significantly improved. In addition sub-samples of the data are assigned an enriched or depleted Bs fraction. Maximum likelihood fits are performed to derive a preliminary lower limit of Dms > 10.2 ps-1 at 95L. Combining with the ALEPH Ds based analyses yields Dms>10.4 ps-1 at 95L

The Three-Dimensional Expansion of the Ejecta from Tycho's Supernova Remnant

We present the first three-dimensional measurements of the velocity of various ejecta knots in Tycho's supernova remnant, known to result from a Type Ia explosion. Chandra X-ray observations over a 12-year baseline from 2003 to 2015 allow us to measure the proper motion of nearly 60 "tufts" of Si-rich ejecta, giving us the velocity in the plane of the sky. For the line of sight velocity, we use two different methods: a non-equilibrium ionization model fit to the strong Si and S lines in the 1.2-2.8 keV regime, and a fit consisting of a series of Gaussian lines. These methods give consistent results, allowing us to determine the red or blue shift of each of the knots. Assuming a distance of 3.5 kpc, we find total velocities that range from 2400 to 6600 km s$^{-1}$, with a mean of 4430 km s$^{-1}$. We find several regions where the ejecta knots have overtaken the forward shock. These regions have proper motions in excess of 6000 km s$^{-1}$. Some Type Ia supernova explosion models predict a velocity asymmetry in the ejecta. We find no such velocity asymmetries in Tycho, and discuss our findings in light of various explosion models, favoring those delayed detonation models with relatively vigorous and symmetrical deflagrations. Finally, we compare measurements with models of the remnant's evolution that include both smooth and clumpy ejecta profiles, finding that both ejecta profiles can be accommodated by the observations.Comment: Accepted for publication in ApJ. Some figures slightly degraded to reduce file siz

An investigation into CLIL-related sections of EFL coursebooks : issues of CLIL inclusion in the publishing market

The current ELT global coursebook market has embraced CLIL as a weak form of bilingual education and an innovative component to include in General English coursebooks for EFL contexts. In this paper I investigate how CLIL is included in ELT coursebooks aimed at teenaged learners, available to teachers in Argentina. My study is based on the content analysis of four series which include a section advertised as CLIL-oriented. Results suggest that such sections are characterised by (1) little correlation between featured subject specific content and school curricula in L1, (2) oversimplification of contents, and (3) dominance of reading skills development and lower-order thinking tasks. Through this study, I argue that CLIL components become superficial supplements rather than a meaningful attempt to promote weak forms of bilingual education

Loop Mediated Isothermal Amplification (LAMP) assay for Rapid detection of Streptococcus agalactiae (Group B Streptococcus - GBS) in vaginal swabs - A Proof of Concept Study

Purpose: Neonatal sepsis caused by Streptococcus agalactiae [group B streptococcus (GBS)] is a life-threatening condition, which is preventable if colonized mothers are identified and given antibiotic prophylaxis during labour. Conventional culture is time consuming and unreliable, and many available non-culture diagnostics are too complex to implement routinely at point of care. Loop-mediated isothermal amplification (LAMP) is a method that, enables the rapid and specific detection of target nucleic acid sequences in clinical materials without the requirement for extensive sample preparation.Methodology: A prototype LAMP assay targeting GBS sip gene is described.Results: The assay was 100 % specific for GBS, with a limit of detection of 14 genome copies per reaction. The clinical utility of the LAMP assay for rapid direct molecular detection of GBS was determined by testing a total of 157 vaginal swabs with minimal sample processing using a rapid lysis solution. Compared to a reference quantitative real-time PCR assay, the direct LAMP protocol had a sensitivity and specificity of 95.4 and 100 %, respectively, with positive and negative predictive values of 100 and 98.3 %, respectively. Positive and negative likelihood ratios were infinity and 0.05, respectively. The direct LAMP method required a mean time of 45 min from the receipt of a swab to generation of a confirmed result, compared to 2 h 30 min for the reference quantitative real-time PCR test.Conclusion: The direct LAMP protocol described is easy to perform, facilitating rapid and accurate detection of GBS in vaginal swabs. This test has a potential for use at point of care