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

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

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

A Study of the Effects of Child Sexual Abuse, Treatment, and Interventions

The last two decades have seen the topic of child sexual abuse emerge from an issue that was considered rare, or at least uncommon, to one currently viewed as a leading concern of mental health professionals. Public reaction to incest and sexual abuse has changed from one of disbelief to one of active concern. Public awareness and education about the issue of child sexual abuse has developed into a critical area of concern. Sexual abuse of children is now recognized as a serious mental health problem, both because it is so widespread, and because of increasing evidence of its traumatic effects. In the very recent past, mental health clinicians were rarely, if ever, exposed to the topic of sexual abuse in class content, supervision, professional conferences, or literature, although therapists now report that rather than seeing a solitary sexual abuse survivor, their client load consists of two-thirds of clients reporting experiences of childhood sexual abuse. The methodology employed in this research project was qualitative. A survey was used to gather information from mental health professionals in a mid-west metropolitan area. One hundred thirty-four surveys were returned from a total of 270 distributed to therapists who were associated with hospitals and agencies that specialized in treating children who had been abused sexually. The intent of the study was to discover whether mental health professionals in the St. Louis metropolitan area agreed about the definition of sexual abuse, the various effects of sexual abuse on children who had experienced this trauma and what kind of treatment modalities were indicated. Questions in the survey focused on the effects of the experience of sexual abuse on children, as well as on the corresponding implications for treatment. The purpose of the study was to gain practical information about a sensitive, but critical area of treatment for therapists and others concerned with the welfare of children

Postcard: Greetings from the Baughmans

This color printed postcard features an illustration of the Earth with Santa standing at the North Pole. An emblem for Kansas Precancel Society is on the left and an emblem for the Society of Philatelic Americans is on the right. A start is in the top right corner. A silhouette of a town is at the bottom. Printed text is above and below the Earth. The same illustration is on the back left side of the card. Red printed text is above the illustration. Typed text is on the right side of the card.https://scholars.fhsu.edu/tj_postcards/1790/thumbnail.jp

The development and evaluation of an experiential computer simulation for animal science students

After reviewing the literature regarding the use of computers in education, the researcher identified a gap between state-of-art educational research and current educational practice; the majority of the presently available CAL software lacked appropriate design features that would enable the computer to meet its potential for the infusion of problem solving, information processing, and model building skills into the existing curriculum. With this gap in mind, the researcher proposed the development of a CAL lesson that could serve as a model of one type of computer use that better met the need for infusion of higher order thinking skills into the curriculum and also to serve as a model of how to develop software with these goals in mind;An experiential computer simulation was designed, using a state-of-the-art software development system, to enhance teaching and learning of a limited concept in animal science. A field test was undertaken with animal science students in order to determine lesson revisions needed to ensure the lesson adequately interacted with the varying student models. Results indicated that this lesson could enhance the existing curriculum, and that much attention throughout the developmental process must be focused on the possible student models and how the lesson can provide appropriate feedback for each student

An exercise device used to achieve bone formation metrics for the strengthening of the proximal femur.

Lateral falls often lead to hip fracture particularly in the elderly who have low bone mineral density. These fractures frequently lead to indirect mortality soon after injury. Normal use over the course over a lifetime leads to optimized adaptation of the bone in the proximal femur according to normal loading. A lateral fall generates non-normal, lateral loading at the proximal hip where the bone has not adapted to withstand such loading. The resulting fracture is generated by reversed strains on the bone tissue in the femoral neck in the hip in contrast to vertical, quotidian loading. Modern practices for preventing hip fractures are largely supplements or medications while standard exercise and vibration therapies are also used. Preventative measures such as these may help but it is apparent that more is needed. A supplementary exercise device intended to stimulate lateral, localized bone formation at the hip while providing user quality feedback could be a promising solution to overcoming such high hip fracture rates. The device consists of: a main body in the form a lap plate, two adjustable pad arms that optimally position two impact pads adjacent to the user’s lateral proximal femur, and a knee plate that helps maintain the device in the optimal position on the lap relative to the hip joint. Anabolic thresholds for strain magnitude and strain rate are both shown to be critical metrics for stimulating bone remodeling such as what occurs in the femoral neck. The objectives of this second-generation prototype are to design, fabricate, and validate a versatile device with user performance feedback to allow the user to comfortably achieve the biological thresholds for appropriate anabolic bone remodeling in the femoral neck. The prototype design was based on anthropometric data representing the typical archetype. Strength of key elements was analyzed via manual calculations and finite element analysis (FEA). Ideal sensor placement was also analyzed via FEA to maximize sensitivity. Quasi-static testing in an MTS machine across the breadth of relevant user settings is performed to translate strain gage output to pad force. The discrete results of this testing were then used to generate a 95% two-sided regression model of continuous predictors for accurate force measurement based on user-specific setting inputs. Custom software was developed to process the raw data and provide user feedback. Additional accelerometer data was processed as a potentially simpler alternative to strain data for feedback to the user regarding proper exercise effort. Dynamic testing was collected on 10 volunteers who perform a swift hip abduction using the prototype which creates three-point bending in the femur that generates strain in the femoral neck. Additional tests were performed to optimize data outcome based on user factors. Pad force rate was converted to theoretical bone strain rate based on data provided by the first-generation device study. Strain and strain rate data were compared to the accepted biological thresholds to stimulate remodeling taken from the prevailing bone biomechanics literature. A prototype was successfully fabricated after calculations were used to validate design integrity. This device was proven functional in acquiring dynamic data via custom software after use by volunteers of varying anthropometry. Before this dynamic data was acquired, preferred strain gage placement was determined to provide the most sensitive measure of pad impact force by calculating stress profiles at minimum and maximum settings and the regression model was validated via four-in-one plot analysis with an R2 of 99.97%. Ideal instruction and performance of the exercise using the device were refined though a series of sub-studies evaluating data acquisition and data metrics. These sub-studies suggested optimal feedback is achieved through an appropriate knee arm setting and a narrow pad arm setting using extra padding under the instruction to swiftly drive through the pad to a 60 beats per minute metronome without pushing down on the plate. Volunteer data revealed an average peak value of 499.5 N surpassing the 350 N minimum and 450 N suggested force to achieve strain magnitudes above the 1000 µε osteogenic threshold. Similarly, the average strain rate of the volunteers averaged 21509.6 µε/s far exceeding the 10000 µε/s bone remodeling threshold. These findings suggest that this device has the potential induce anabolic bone remodeling at the hip, thus encouraging more study toward aims of reduced hip fracture rates. Acceleration data did not prove to be an alternative to strain data for user feedback

Collecting Data from Children Ages 9-13

Provides a summary of literature on common methods used to collect data, such as diaries, interviews, observational methods, and surveys. Analyzes age group-specific considerations, advantages, and drawbacks, with tips for improving data quality