Passing to América: Antonio (née María) Yta's transgressive, transatlantic life in the twilight of the Spanish empire

New York Universit

A feasibility study of a home-based exercise intervention for prostate cancer patients on androgen deprivation therapy

Purpose: Androgen deprivation therapy (ADT) is an effective treatment for advanced-stage prostate cancer. Unfortunately, ADT has several adverse effects that significantly impair health-related quality of life (HRQOL). In patients receiving ADT, resistance training has been shown to improve important physical and psychosocial outcomes. However, little is known about the effects of aerobic exercise in this population. This feasibility study compares the effects of aerobic and resistance exercise interventions on a panel of psychological, physical fitness, and biological outcomes related to prostate cancer and ADT. Methods: 66 men receiving ADT for prostate cancer were recruited for this prospective, randomized trial. Participants are assigned to either a resistance or aerobic, moderate-intensity exercise 3-5 times per week for 30-60 minutes/session. Participants were provided with equipment so that they could exercise at home. The primary outcomes were related to feasibility for future, large-scale trials. Secondary outcomes included: fatigue, HRQOL, physical fitness, adipokines, insulin-like growth factor axis proteins, and exercise adherence. Outcomes were assessed at baseline and at 3, 6, and 12 months. Results: Preliminary findings are presented. 205 patients were approached for participation, 66 of which agreed to participate (n=34 in the resistance training group and 32 in the aerobic training group). Over the intervention period we experienced an attrition rate of 33%. There were no adverse events and biweekly booster sessions were poorly attended (n=27 aerobic training participants and n=22 resistance training participants did not attend any booster sessions). Intention-to-treat analyses showed that fatigue and HRQOL were not significantly different between groups; however, in a per-protocol analysis the resistance-training group demonstrated clinically significant improvements in HRQOL. Differential within-groups effects on physical fitness and biomarkers were also observed at various time-points. At all time-points, the aerobic training group engaged in significantly more physical activity than the resistance training group. Conclusion: Our findings suggest that both resistance and aerobic training can have positive effects on body composition with differential effects on psychosocial and biological outcomes. It appears that the aerobic exercise intervention was more effective at producing long-term, clinically significant increases in physical activity volume than resistance training. Our study has set the framework to conduct future clinical trials investigating the effects of exercise in men treated for prostate cancer

Orbital inflammatory complications of Crohn’s disease: a rare case series

Orbital inflammatory disease is a rare ophthalmic manifestation of Crohn’s disease. Inflammation is characteristically non-specific, involving one or multiple structures of the orbit. Mechanisms of disease and optimal methods of treatment are poorly understood. The aim of this report is to present three cases of orbital involvement in Crohn’s disease. A retrospective case note review of patients with orbital inflammatory disease and Crohn’s disease was performed at our academic centre to determine the clinical, imaging and histopathological features of this condition and its relationship to intestinal Crohn’s disease. Three patients were identified with orbital inflammatory manifestations complicating Crohn’s disease. All patients described were female with active intestinal disease and had a history of treatment with immunosuppressive therapies. Similarities were observed in clinical presentations with variance noted in radiological and histopathological findings. In all cases, symptoms improved with oral corticosteroids or non-steroidal drugs in combination with anti-tumour necrosis factor (anti-TNF) agents. Inflammatory bowel disease-related orbital complications are rare but potentially vision-threatening. It is important to consider mimics of orbital inflammatory disease such as systemic inflammatory disease, malignancy, congenital malformations, infection and trauma when formulating a comprehensive differential diagnosis. Therapeutic intervention is directed towards preservation of vision and orbital function and reducing the acute inflammatory process. Corticosteroids are typically the initial treatment of choice for moderate-to-severe disease, although several classes of immunomodulatory agents have been variably useful in treating this condition. Heightened awareness and close cooperation between gastroenterologists and ophthalmologists is mandatory

Managing for change: October 11, 1989

Bi-weekly newsletter of University Hospital's Change Project, provided to managers at the hospital

Planetary Interiors

This report identifies two main themes to guide planetary science in the next two decades: understanding planetary origins, and understanding the constitution and fundamental processes of the planets themselves. Within the latter theme, four specific goals related to interior measurements addressing the theme. These are: (1) Understanding the internal structure and dynamics of at least one solid body, other than the Earth or Moon, that is actively convecting, (2) Determine the characteristics of the magnetic fields of Mercury and the outer planets to provide insight into the generation of planetary magnetic fields, (3) Specify the nature and sources of stress that are responsible for the global tectonics of Mars, Venus, and several icy satellites of the outer planets, and (4) Advance significantly our understanding of crust-mantle structure for all the solid planets. These goals can be addressed almost exclusively by measurements made on the surfaces of planetary bodies

Preoperative amygdala fMRI in temporal lobe epilepsy

Purpose: Anterior temporal lobe resections (ATLR) benefit 70% of patients with refractory mesial temporal lobe epilepsy (TLE), but may be complicated by emotional disturbances. We used functional magnetic resonance imaging (fMRI) to investigate the role of the amygdala in processing emotions in TLE and whether this may be a potential preoperative predictive marker for emotional disturbances following surgery. Methods: We studied 54 patients with refractory mesial TLE due to hippocampal sclerosis (28 right, 26 left) and 21 healthy controls using a memory encoding fMRI paradigm, which included viewing fearful and neutral faces. Twenty-one TLE patients (10 left, 11 right) subsequently underwent ATLR. Anxiety and depression were assessed preoperatively and 4 months postoperatively using the Hospital Anxiety and Depression Scale. Results: On viewing fearful faces, healthy controls demonstrated left lateralized, while right TLE patients showed bilateral amygdala activation. Left TLE patients had significantly reduced activation in left and right amygdalae compared to controls and right TLE patients. In right TLE patients, left and right amygdala activation was significantly related to preoperative anxiety and depression levels, and preoperative right amygdala activation correlated significantly with postoperative change of anxiety and depression scores, characterized by greater increases in anxiety and depression in patients with greater preoperative activation. No such correlations were seen for left TLE patients. Discussion: The fearful face fMRI paradigm is a reliable method for visualizing amygdala activation in controls and patients with mesial TLE. Activation of the right amygdala preoperatively was predictive of emotional disturbances following right ATLR

Study protocol to investigate the effect of a lifestyle intervention on body weight, psychological health status and risk factors associated with disease recurrence in women recovering from breast cancer treatment

Background Breast cancer survivors often encounter physiological and psychological problems related to their diagnosis and treatment that can influence long-term prognosis. The aim of this research is to investigate the effects of a lifestyle intervention on body weight and psychological well-being in women recovering from breast cancer treatment, and to determine the relationship between changes in these variables and biomarkers associated with disease recurrence and survival. Methods/design Following ethical approval, a total of 100 patients will be randomly assigned to a lifestyle intervention (incorporating dietary energy restriction in conjunction with aerobic exercise training) or normal care control group. Patients randomised to the dietary and exercise intervention will be given individualised healthy eating dietary advice and written information and attend moderate intensity aerobic exercise sessions on three to five days per week for a period of 24 weeks. The aim of this strategy is to induce a steady weight loss of up to 0.5 Kg each week. In addition, the overall quality of the diet will be examined with a view to (i) reducing the dietary intake of fat to ~25% of the total calories, (ii) eating at least 5 portions of fruit and vegetables a day, (iii) increasing the intake of fibre and reducing refined carbohydrates, and (iv) taking moderate amounts of alcohol. Outcome measures will include body weight and body composition, psychological health status (stress and depression), cardiorespiratory fitness and quality of life. In addition, biomarkers associated with disease recurrence, including stress hormones, estrogen status, inflammatory markers and indices of innate and adaptive immune function will be monitored. Discussion This research will provide valuable information on the effectiveness of a practical, easily implemented lifestyle intervention for evoking positive effects on body weight and psychological well-being, two important factors that can influence long-term prognosis in breast cancer survivors. However, the added value of the study is that it will also evaluate the effects of the lifestyle intervention on a range of biomarkers associated with disease recurrence and survival. Considered together, the results should improve our understanding of the potential role that lifestyle-modifiable factors could play in saving or prolonging lives

Repetition and the prosody-pragmatics interface

Repetition poses certain problems for pragmatics, as evidenced by Sperber and Wilson’s claim that ‘‘the effects of repetition on utterance interpretation are by no means constant’’. This is particularly apposite when we examine repetitions produced in naturally occurring talk. As part of an ongoing study of how phonetics relates to the dynamic evolution of meaning within the sequential organisation of talk-in-interaction, we present a detailed phonetic and pragmatic analysis of a particular kind of self- repetition. The practice of repetition we are concerned with exhibits a range of forms: ‘‘have another go tomorrow . . . have another go tomorrow’’, ‘‘it might do . . . it might do’’, ‘‘it’s a shame . . . it’s a shame’’. The approach we adopt emphasises the necessity of exploring participants’ displayed understandings of pragmatic inferences and attempts not to prejudge the relevance of phonetic (prosodic) parameters. The analysis reveals that speakers draw on a range of phonetic features, including tempo and loudness as well as pitch, in designing these repetitions. The pragmatic function of repetitions designed in this way is to close sequences of talk. Our findings raise a number of theoretical and methodological issues surrounding the prosody– pragmatics interface and participants’ understanding of naturally occurring discourse