Lifestyle guidelines for managing adverse effects on bone health and body composition in men treated with androgen deprivation therapy for prostate cancer: an update

BACKGROUND: Men treated with androgen deprivation therapy (ADT) for prostate cancer are prone to multiple treatment-induced adverse effects, particularly with regard to a deterioration in bone health and altered body composition including decreased lean tissue mass and increased fat mass. These alterations may partially explain the marked increased risk in osteoporosis, falls, fracture and cardiometabolic risk that has been observed in this population. METHODS: A review was conducted that assessed standard clinical guidelines for the management of ADT-induced adverse effects on bone health and body composition in men with prostate cancer. RESULTS: Currently, standard clinical guidelines exist for the management of various bone and metabolic ADT-induced adverse effects in men with prostate cancer. However, an evaluation of the effectiveness of these guidelines into routine practice revealed that men continued to experience increased central adiposity, and, unless pharmacotherapy was instituted, accelerated bone loss and worsening glycaemia occurred. CONCLUSIONS: This review discusses the current guidelines and some of the limitations, and proposes new recommendations based on emerging evidence regarding the efficacy of lifestyle interventions, particularly with regard to exercise and nutritional factors, to manage ADT-related adverse effects on bone health and body composition in men with prostate cancer

Cosmic distance-duality as probe of exotic physics and acceleration

In cosmology, distances based on standard candles (e.g. supernovae) and standard rulers (e.g. baryon oscillations) agree as long as three conditions are met: (1) photon number is conserved, (2) gravity is described by a metric theory with (3) photons travelling on unique null geodesics. This is the content of distance-duality (the reciprocity relation) which can be violated by exotic physics. Here we analyse the implications of the latest cosmological data sets for distance-duality. While broadly in agreement and confirming acceleration we find a 2-sigma violation caused by excess brightening of SN-Ia at z > 0.5, perhaps due to lensing magnification bias. This brightening has been interpreted as evidence for a late-time transition in the dark energy but because it is not seen in the d_A data we argue against such an interpretation. Our results do, however, rule out significant SN-Ia evolution and extinction: the "replenishing" grey-dust model with no cosmic acceleration is excluded at more than 4-sigma despite this being the best-fit to SN-Ia data alone, thereby illustrating the power of distance-duality even with current data sets.Comment: 6 pages, 4 colour figures. Version accepted as a Rapid Communication in PR

Mechanism, localization and cure of atrial arrhythmias occurring after a new intraoperative endocardial radiofrequency ablation procedure for atrial fibrillation

AbstractOBJECTIVESThe purpose of this study was to test a new pattern of radiofrequency ablation for atrial fibrillation (AFib) intended to optimize atrial activation, and to demonstrate the usefulness of catheter techniques for mapping and ablation of postoperative atrial arrhythmias.BACKGROUNDLinear radiofrequency lesions have been used to cure AFib, but the optimal pattern of lesions is unknown and postoperative tachyarrhythmias are common.METHODSA radial pattern of linear radiofrequency lesions (Star) was made using an endocardial open surgical approach in 25 patients. Postoperative arrhythmias were induced and characterized during electrophysiological studies in 15 patients.RESULTSThe AFib was abolished in most patients (91%), but atrial flutter (AFlut) occurred in 96% of patients postoperatively. At postoperative electrophysiological studies, 37 flutter morphologies were studied in 15 patients (46% spontaneous, cycle length [CL] 223 ± 25 ms). Seven mechanisms (lesions discontinuity, n = 6; focal mechanism, n = 1) of AFlut were characterized in six patients. In these cases, flutter was abolished using further catheter radiofrequency ablation. In the remaining cases, flutter was usually localized to an area involving the interatrial septum, but no critical isthmus was identified for ablation. After 16 ± 10 months, 15 patients (65%) were asymptomatic with (n = 3) or without (n = 12) antiarrhythmic medications. Eight (35%) patients had persistent arrhythmias. Postoperative atrial electrical activation was near physiological.CONCLUSIONSThe AFib may be abolished using a radial pattern of linear endocardial radiofrequency lesions, but postoperative AFlut is common even when lesions are made under optimal conditions. Endocardial mapping techniques can be used to characterize the flutter mechanisms, thus enabling subsequent successful catheter ablation

Seeking Evolution of Dark Energy

We study how observationally to distinguish between a cosmological constant (CC) and an evolving dark energy with equation of state $\omega(Z)$. We focus on the value of redshift Z* at which the cosmic late time acceleration begins and $\ddot{a}(Z^{*}) = 0$. Four $\omega(Z)$ are studied, including the well-known CPL model and a new model that has advantages when describing the entire expansion era. If dark energy is represented by a CC model with $\omega \equiv -1$, the present ranges for $\Omega_{\Lambda}(t_0)$ and $\Omega_m(t_0)$ imply that Z* = 0.743 with 4% error. We discuss the possible implications of a model independent measurement of Z* with better accuracy.Comment: 9 pages, LaTeX, 5 figure

Pre-hospital body surface potential mapping improves early diagnosis of acute coronary artery occlusion in patients with ventricular fibrillation and cardiac arrest

Aims: To determine whether 80-lead body surface potential mapping (BSPM) improves detection of acute coronary artery occlusion in patients presenting with out-of-hospital cardiac arrest (OHCA) due to ventricular fibrillation (VF) and who survived to reach hospital. Methods and results: Of 645 consecutive patients with OHCA who were attended by the mobile coronary care unit, VF was the initial rhythm in 168 patients. Eighty patients survived initial resuscitation, 59 of these having had BSPM and 12-lead ECG post-return of spontaneous circulation (ROSC) and in 35 patients (age 69±13 yrs; 60% male) coronary angiography performed within 24. h post-ROSC. Of these, 26 (74%) patients had an acutely occluded coronary artery (TIMI flow grade [TFG] 0/1) at angiography. Twelve-lead ECG criteria showed ST-segment elevation (STE) myocardial infarction (STEMI) using Minnesota 9-2 criteria - sensitivity 19%, specificity 100%; ST-segment depression (STD) =0.05. mV in =2 contiguous leads - sensitivity 23%, specificity 89%; and, combination of STEMI or STD criteria - sensitivity 46%, specificity 100%. BSPM STE occurred in 23 (66%) patients. For the diagnosis of TFG 0/1 in a main coronary artery, BSPM STE had sensitivity 88% and specificity 100% (c-statistic 0.94), with STE occurring most commonly in either the posterior, right ventricular or high right anterior territories. Conclusion: Among OHCA patients presenting with VF and who survived resuscitation to reach hospital, post-resuscitation BSPM STE identifies acute coronary occlusion with sensitivity 88% and specificity 100% (c-statistic 0.94). © 2012 Elsevier Ireland Ltd

Inelastic and transfer reactions in 92Mo+255 MeV 60Ni collisions studied by γγ coincidences

For the 92Mo+255 MeV60Ni system, inelastic and few-nucleon transfer events populating non-collective states of moderately high spin have been studied by γγ coincidence measurements. Besides the strong inelastic scattering channel, twelve transfer processes were identified, ranging from 1 n to 2α transfer; typically, cross coincidences between the γ-rays from both products were observed. Potential spectroscopic applications are indicated

Cosmological scaling solutions in generalised Gauss-Bonnet gravity theories

The conditions for the existence and stability of cosmological power-law scaling solutions are established when the Einstein-Hilbert action is modified by the inclusion of a function of the Gauss-Bonnet curvature invariant. The general form of the action that leads to such solutions is determined for the case where the universe is sourced by a barotropic perfect fluid. It is shown by employing an equivalence between the Gauss-Bonnet action and a scalar-tensor theory of gravity that the cosmological field equations can be written as a plane autonomous system. It is found that stable scaling solutions exist when the parameters of the model take appropriate values.Comment: 10 pages and 5 figure

Neurocognitive outcome in tyrosinemia type 1 patients compared to healthy controls

Development Psychopathology in context: clinical setting