78 research outputs found
Bone mineral density in Jamaican men on androgen deprivation therapy for prostate cancer
<p>Abstract</p> <p>Background</p> <p>Androgen deprivation therapy (ADT) has been reported to reduce the bone mineral density (BMD) in men with prostate cancer (CaP). However, Afro-Caribbeans are under-represented in most studies. The aim was to determine the effect of androgen deprivation therapy (ADT) on the bone mineral density (BMD) of men with prostate cancer in Jamaica.</p> <p>Methods</p> <p>The study consisted of 346 Jamaican men, over 40 years of age: 133 ADT treated CaP cases (group 1), 43 hormone-naïve CaP controls (group 2) and 170 hormone naïve controls without CaP (group 3). Exclusion criteria included metastatic disease, bisphosphonate therapy or metabolic disease affecting BMD. BMD was measured with a calcaneal ultrasound and expressed in S.D. units relative to young adult men (T score), according to the World Health Organization definition. Patient weight, height and BMI were assessed.</p> <p>Results</p> <p>Mean ± sd, age of patients in group 1 (75± 7.4 yrs) was significantly greater than groups 2 and 3 (67 ± 8.1 yrs; 65±12.0 yrs). There was no significant difference in weight and BMI between the 3 groups. . The types of ADT (% of cases, median duration in months with IQR) included LHRH (Luteinizing hormone releasing hormone) analogues (28.6%, 17.9, IQR 20.4), oestrogens (9.8%, 60.5, IQR 45.6) anti-androgens (11.3%, 3.3, IQR 15.2) and orchiectomy (15.7%, 43.4, IQR 63.9). Unadjusted t score of group 1, mean ± sd, (-1.6± 1.5) was significantly less than group 2 (-0.9±1.1) and group 3 (-0.7±1.4), p <0.001. Ninety three (69.9%), 20 (45%) and 75 (42%) of patients in groups 1, 2 and 3 respectively were classified as either osteopenic or osteoporotic (p<0.001). Adjusting for age, there was a significant difference in t scores between groups 1 and 2 as well as between groups 1 and 3 (p<0.001). Compared with oestrogen therapy and adjusting for duration of therapy, the odds of low bone mineral density (osteopenia or osteoporosis) with LHRH analogue was 4.5 (95%CI, 14.3 to 3.4); with anti-androgens was 5.9 (95%CI, 32.7 to 5); with orchiectomy was 7.3 (95%CI, 30 to 5.8) and multiple drugs was 9.2 ((95%CI, 31 to 7.1).</p> <p>Conclusions</p> <p>ADT is associated with lower BMD in Jamaican men on hormonal therapy for prostate cancer.</p
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Children of Legba: African-American musicians of the jazz age in literature and popular culture
Among the Dahomey of West Africa, the spirit Legba presides over all transitions, and African-American blues and jazz musicians can be considered his children, or followers, since their music provides a link between the physical and spiritual worlds, the past and the present, and between cultures. Chapter one provides a cross-cultural perspective on the role of the musician in various societies, with the emphasis on Western Europe and West Africa, including a description of the special status of female musicians. Chapter two considers how the derogatory stereotypes of black musicians created by the nineteenth-century minstrel show allowed performers to cross the racial, sexual, and class boundaries of American society. Only if we recognize the paradox of freedom offered by this vestige of slavery will we be able to make sense of the fact that black performers adapted the minstrel roles after the Civil War. The third chapter describes the social role of the black musician of the jazz age, beginning with the controversy surrounding jazz in the early twenties, and tracing the survival of African musical practices and beliefs in jazz and the blues. The careers of many musicians are analyzed to demonstrate the range of opportunities open to black performers in the period. Langston Hughes and Sterling Brown wrote poetry inspired by the blues, adopting the persona of the musician in order to speak with an authentic folk voice. Chapter four considers how musicians are represented in their writing and compares their blues poems to the recordings of contemporary blues performers. The great jazz musicians of the twenties and thirties fired the imaginations of many modern African-American writers by providing a living link to African spiritual traditions and a new model of what history can be when it breaks free from the academy. Chapter five examines the representations of blues and jazz musicians in novels by Ralph Ellison, Alice Walker and Ishmael Reed, showing that all three writers assume the role of improvising historian by adapting the narrative techniques of the West African griot and the repetition with variation of the jazz musician
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