Journal articles on the topic 'La Pensée (Ship)'

Building on previous studies of satire in Thomas More’s Utopia, this article aims at situating More’s founding text of utopian literature more firmly in the early modern satirical tradition, a tradition that gradually dissociated itself from its conventional generic definition informed by classical Roman verse satura. Key concerns of the analysis touch on the pedagogical function, the dialogic engagement with the reader, and the social reforming spirit that transform satire into a mode and help it incorporate the utopian mindset into its characteristic juxtaposition of blame (of a heavily flawed reality) and praise (of a desirable ideal state of existence). More’s masterpiece is essential in illustrating and promoting this development of early modern satire, as references to an immediate predecessor—the Ship of Fools corpus—as well as a famous successor—François Rabelais—demonstrate. À partir d’études de la satire dans l’Utopie de More, cet article cherche à ancrer plus solidement ce texte utopique dans la tradition satirique de la première modernité, tradition qui s’est graduellement dissociée de la définition générale du genre satirique basée sur la satire classique romaine. Les points principaux de l’analyse mettent en lumière la fonction pédagogique, l’engagement dialogique avec le lecteur et l’esprit de réforme sociale, qui transforment la satire en y intégrant la pensée utopique en tant que façon d’exprimer le blâme (d’une réalité sérieusement déficiente) et la louange (d’un mode hautement souhaitable d’exister). Le chef-d’oeuvre de More occupe une place centrale dans ce développement de la satire des débuts de la modernité, lorsqu’il est situé dans les contextes qui le précèdent immédiatement — le corpus de la Nef des fous —, et le suivent glorieusement — l’oeuvre de François Rabelais.

Abstract. Atmospheric sulfur dioxide (SO2) was measured continuously from the Penlee Point Atmospheric Observatory (PPAO) near Plymouth, United Kingdom, between May 2014 and November 2015. This coastal site is exposed to marine air across a wide wind sector. The predominant southwesterly winds carry relatively clean background Atlantic air. In contrast, air from the southeast is heavily influenced by exhaust plumes from ships in the English Channel as well as near Plymouth Sound. A new International Maritime Organization (IMO) regulation came into force in January 2015 to reduce the maximum allowed sulfur content in ships' fuel 10-fold in sulfur emission control areas such as the English Channel. Our observations suggest a 3-fold reduction in ship-emitted SO2 from 2014 to 2015. Apparent fuel sulfur content calculated from coincidental SO2 and carbon dioxide (CO2) peaks from local ship plumes show a high level of compliance to the IMO regulation (> 95 %) in both years (∼ 70 % of ships in 2014 were already emitting at levels below the 2015 cap). Dimethyl sulfide (DMS) is an important source of atmospheric SO2 even in this semi-polluted region. The relative contribution of DMS oxidation to the SO2 burden over the English Channel increased from about one-third in 2014 to about one-half in 2015 due to the reduction in ship sulfur emissions. Our diel analysis suggests that SO2 is removed from the marine atmospheric boundary layer in about half a day, with dry deposition to the ocean accounting for a quarter of the total loss.

A 65-year-old man is seen in the clinic two months after a robot-assisted bilateral nerve-sparing radical prostatectomy. He is completely continent and has been since the catheter was removed. The main reason for his referral is erectile dysfunction. Pre-operatively his SHIM score was 25 (maximum score 25). He currently experiences some thickening with stimulation, and an erection hardness score of 2. He has a pleasurable sensation of orgasm during which he remains dry. His sex drive remains normal. He has a long-standing history of hypertension and raised LDL cholesterol, managed with amlodipine and simvastatin respectively. He has no other overt cardiovascular or ischaemic heart disease, and he is not a diabetic, but has an elevated fasting glucose of 6.0 mmol per litre. He stopped smoking five years ago, is 5 feet 11 inches tall, a weight of 95 kg, has a waist measurement of 44 inches (BMI 29 – upper end of overweight) (range <18.50 underweight; 18.50–24.99 healthy weight; 25.00–29.99 overweight; >30.00 obese). He performs no regular exercise. His wife is 60. He is keen to try to regain his erectile function.

The reconstruction of large skin defects originated from the excision of large tumors or trauma may require the use of reconstructive techniques given the possibility of there not being enough skin to cover the skin wound in some situations. Axial pattern flaps from the caudal superficial epigastric artery are skin flaps supplied by a large artery and, therefore, have a larger chance of survival. They are the most versatile flaps for closing defects in the caudal part of the body and may be employed to close defects on the lateral abdomen, sacrum, dorsal pelvis, base of the tail, perineum, penile sheath, inguinal region, proximal pelvic member, knee, shin and metatarsal region in cats. This study aimed at reporting 16 cases of repairs of defects originated from tumoral resection and trauma employing axial pattern flaps from the caudal superficial epigastric artery in dogs and cats.

El propósito principal de este número especial de Tabula Rasa es expandir el canon descolonial a través de la inclusión de una diversidad de voces en el mundo que apuntan a un descentramiento de Occidente en el terreno ontológico, epistemológico y capitalocénico. La expansión del canon descolonial conlleva no solo pensar en experiencias coloniales que se dan dentro y fuera, antes y después, del colonialismo europeo, sino que requiere de nuestra parte tomar nota de cómo aquellos que piensan fuera del canon descolonial perciben y conciben los discursos de la colonialidad y la descolonialidad que surgen del ámbito latinoamericano. El texto de Shu-mei Shih que abre la discusión es interesante en este sentido porque no solo ofrece una crítica profunda de cómo se ha estudiado el mundo colonial hasta ahora, sobre todo en los intentos de romper con el excepcionalismo europeo desde el punto de vista de la literatura e historia universal, sino que nos demuestra cómo hemos de emprender un estudio del mundo que no caiga en la trampa de sustituir un centro de poder por otro.

e18545 Background: Priapism, a urological emergency that needs prompt treatment, is an uncommon presenting feature of chronic myeloid leukemia (CML). CML frequently occurs in younger males and adolescents in developing countries. Occurrence of erectile dysfunction (ED) in this particular age group can severely decrease the quality of life. It is known that immediate treatment of priapism preserves erectile function. The data on the outcome of priapism in CML patients from developing world is limited. Methods: We analysed the CML patients treated at PGIMER Chandigarh from January 2003 to December 2018. Baseline spleen and liver size, hematological parameters, Sokal and Hasford score were documented. Duration of priapism, treatment received by the patients, and response to Imatinib were recorded. The severity of ED was assessed by SHIM (Sexual Health Inventory for Men) score. Results: Twenty-three patients (1.7%) out of total 1350 male CML-CP patients had priapism at diagnosis. The median age was 24 years (range 13 – 50 years); 60.8% patients belonged to 21 – 40 years age group. Median duration of priapism was 8 days (range 2 – 25 days). Splenomegaly and hepatomegaly were found in 91.3% and 56.5% patients, respectively. Baseline median hemoglobin was 9.9 g/dL; TLC was 283000/mm3 and platelet count was 352000/mm3. Based on Sokal score, 4/23, 16/23 and 3/23 patients belonged to low, intermediate and high risk categories, respectively. According to Hasford score, 7/23, 14/23 and 2/23 patients belonged to low, intermediate and high risk categories, respectively. All patients received cytoreductive therapy [hydroxyurea and Imatinib]; 21 patients underwent penile aspiration, 13 patients underwent therapeutic leucapheresis and 8 patients underwent distal penile shunt surgery. Majority of the patients (78.2%) achieved CHR at 6 weeks and 21 patients achieved MMR at 12 months. ED could be assessed in 14 patients on follow up. As per SHIM score, 2/14 and 12/14 patients had moderate and severe ED, respectively. The occurrence and severity of ED was unaffected by leucapheresis or shunt surgery. Conclusions: We found severe ED on follow up among majority of CML-CP patients with priapism at presentation. Despite favourable response to Imatinib, long duration of symptoms and hyperleucocytosis probably contributed to ischemic priapism and severe ED in the study cohort. We conclude that prolonged and untreated priapism in CML-CP patients is a major risk factor for ED. There is a need to sensitise the primary care physicians and surgeons in the developing world regarding this grave complication in CML patients.

Toute pensée de l'origine des choses n'est jamais qu'une revérie de leur disposition actuelle, une manière de dégénérescence du réel, une variation sur ce qui est. Paul Valéry in his Preface to Poe's Eureka. The World of Hesiod is familiar as a title, but the world of Hesiod is difficult to locate in a single place. Indeed, it is a number of places. It seems to have its centre in Askra in Boiotia and to extend out in space as far as the high slopes of Mount Helikon. It is a land-locked world and its severe limitations are apparent from what the poet says about the sea and the short sea passage from the mainland at Aulis to Chalkis on Euboia. Even as he offers his advice to the seafarer, he admits that he has no experience in seafaring or ships himself (W&amp;D 649). He had only made the trip across to the island of Euboia once to compete as a poet at the funeral games of Amphidamas (W&amp;D 646-60). Hesiodic poetry, when it centres on Hesiod's home, seems to crowd into a very small and disagreeable patch of typical Greek countryside. But his Muses enlarge this world. They provide him with a knowledge that he cannot gain himself—both of seafaring and of the vast expanse of the physical world whose origins go beyond the very beginnings of human time. Hesiod's local Muses transport him from the springs of Permessos to the deep currents of Ocean and they disclose to him a universe vaster in its extent and deeper in time than that of the Homeric poems. A sign of these enlarged horizons is the fact that in the Theogony Hesiod begins to sing of the Muses of Helikon (1-4), but then shifts attention to the Muses of Olympos (36-80).

Abstract Background A variety of penile rehabilitation (PR) therapies are available to improve post-prostatectomy erectile dysfunction (ED) with mixed results. It is uncertain how adherent men are to PR therapies. The aim of this study is to determine adherence to and identify barriers to PR treatment. Methods A longitudinal cross-sectional approach was used in men who underwent radical prostatectomy over 2 years. Men were instructed to take a PDE5 inhibitor (PDE5i) three times per week, and if required, utilize a vacuum constriction device (VCD) daily. Outcomes were measured by multiple validated questionnaires. In addition, penile stretched length, side effects, compliance to PR regimen & barriers to participation were documented. Results Seventy-seven patients were enrolled, however only 49 completed evaluation at 3 or more timepoints and were included in analysis. This cohort was an average age of 58.1 years (±7.7), had robotic laparoscopic radical prostatectomy (91.7%), and had bilateral nerve sparing procedures (95.8%). Majority (62.5%) reported normal SHIM pre-operatively, however 79% used PDE5i. Erectile function as measured by IIEF and Erection Hardness Rating were negatively affected post-operatively, with gradual improvement in parameters throughout the 24 month follow up. Of the participants who had normal pre-op SHIM, only 23.1 and 28.6% regained baseline function at 1 and 2 years, respectively. Orgasm was significantly diminished immediately post-operatively, however, at the end of the study period only 37% of men reported diminished climax and no men reported absent orgasm. Adherence to penile rehabilitation therapies declined overtime. Men took oral PDE5i on average 2.3 times weekly at 12 and 24 months (p < 0.001). Men used the VCD 2.3–3.9 days a week, which declined overtime (p = 0.014). Conclusions Improvement in erectile and orgasm parameters was observed over time, but most men did not return to baseline function. Despite comprehensive instructions and a frequent follow up schedule, PDE5i and VCD adherence was poor. High attrition rates were noted with only 55.8% of men remaining at 12 months and 45% of men completing 24 months. The most common barriers to PR adherence were cost, inconvenience and perceived ineffectiveness.

Introduction: Peyronie’s disease (PD) affects approximately 0.7–11% of men1 and has numerous proposed treatments. Invasive management options include surgical or injectable therapy, while penile traction therapy with vacuum erection device (VED) represents a noninvasive approach. Our objective is to assess outcomes for patients with PD who opt for noninvasive management. Methods: We performed a retrospective analysis for patients with PD who were followed for at least three months and opted for non-invasive therapy. All patients were instructed to initiate VED traction therapy for 10 minutes twice per day. Patients were assessed for degree of PD deformity and erectile function (Sexual Health Inventory for Men [SHIM] score) at initial and subsequent encounters. Results: Fifty-three patients met the inclusion criteria. The mean (standard deviation [SD]) age was 57 (12) years, and the mean (SD) duration of PD prior to assessment was 25 (15) months. The mean (SD) duration of followup was 14 (11) months. Among untreated patients who did not use a VED, nine showed improvement, 20 remained stable, and four had worsening curvature. The untreated group had a significant change in curvature, with a mean improvement (SD) of 3.6 (12)º (p=0.048). All 20 men who initiated VED traction therapy had an improvement in curvature with a significant mean (SD) improvement of 23 (16)º (p=2.6x10-6). Changes in SHIM scores did vary significantly between groups. No complications were noted. Conclusions: In patients who opt for non-invasive management of PD, VED traction therapy provides improved curvature resolution compared to those who do not use such a device. The limitations of this study include the retrospective nature and a small sample size at a single treatment center.

Normal male sexual function requires complex interactions among psychological, neurologic, hormonal, and vascular systems. Under the influence of proper stimulation, the acquisition and maintenance of a penile erection occur. Male sexual dysfunction includes erectile dysfunction (ED), impaired libido, and abnormal ejaculation, which occur due to aberrations in normal male sexual response. Estimates suggest a prevalence of approximately 10 to 20% in the adult male population. Thus, sexual dysfunction is a common problem in this country. This chapter focuses on several key, common components of male sexual dysfunction: namely, ED, premature ejaculation (PE), and Peyronie disease (PD). Figures include management algorithms, a graph depicting distribution of intravaginal ejaculation latency time values in a random cohort of men, and a Sexual Health Inventory for Men (SHIM). Tables list medications associated with ED, oral therapies for the treatment of PD, intralesional therapies for PD, indications for surgical correction of PD, recommended questions to establish the diagnosis of PE, treatment options for PE, and causes of delayed ejaculation, anejaculation, and anorgasmia.This chapter contains 5 highly rendered figures, 8 tables, 116 references, 1 teaching slide set, and 5 MCQs.

Normal male sexual function requires complex interactions among psychological, neurologic, hormonal, and vascular systems. Under the influence of proper stimulation, the acquisition and maintenance of a penile erection occur. Male sexual dysfunction includes erectile dysfunction (ED), impaired libido, and abnormal ejaculation, which occur due to aberrations in normal male sexual response. Estimates suggest a prevalence of approximately 10 to 20% in the adult male population. Thus, sexual dysfunction is a common problem in this country. This chapter focuses on several key, common components of male sexual dysfunction: namely, ED, premature ejaculation (PE), and Peyronie disease (PD). Figures include management algorithms, a graph depicting distribution of intravaginal ejaculation latency time values in a random cohort of men, and a Sexual Health Inventory for Men (SHIM). Tables list medications associated with ED, oral therapies for the treatment of PD, intralesional therapies for PD, indications for surgical correction of PD, recommended questions to establish the diagnosis of PE, treatment options for PE, and causes of delayed ejaculation, anejaculation, and anorgasmia.This chapter contains 5 highly rendered figures, 8 tables, 116 references, 1 teaching slide set, and 5 MCQs.

Normal male sexual function requires complex interactions among psychological, neurologic, hormonal, and vascular systems. Under the influence of proper stimulation, the acquisition and maintenance of a penile erection occur. Male sexual dysfunction includes erectile dysfunction (ED), impaired libido, and abnormal ejaculation, which occur due to aberrations in normal male sexual response. Estimates suggest a prevalence of approximately 10 to 20% in the adult male population. Thus, sexual dysfunction is a common problem in this country. This chapter focuses on several key, common components of male sexual dysfunction: namely, ED, premature ejaculation (PE), and Peyronie disease (PD). Figures include management algorithms, a graph depicting distribution of intravaginal ejaculation latency time values in a random cohort of men, and a Sexual Health Inventory for Men (SHIM). Tables list medications associated with ED, oral therapies for the treatment of PD, intralesional therapies for PD, indications for surgical correction of PD, recommended questions to establish the diagnosis of PE, treatment options for PE, and causes of delayed ejaculation, anejaculation, and anorgasmia.This chapter contains 5 highly rendered figures, 8 tables, 116 references, 1 teaching slide set, and 5 MCQs.

Abstract Introduction Lesions of the cervix are not often associated with a rheumatology illness. A cervical mass is often thought to be due to a neoplasm or an infection. Rheumatologists are tasked with unravelling diagnoses in patients with complex multisystem disease. Our patient presented with a cervical mass as part of a chronic multisystem disorder. Behçet’s disease is rare and often presents with varied symptoms managed by multiple specialities. A diagnosis of Behçet’s disease requires a high index of suspicion. The reason for submitting this case is to raise awareness of an atypical presentation of an uncommon, often severe and chronic illness. Case description A forty-seven-year-old female of Irish and French descent presented with a six months history of bilateral episcleritis, generalised myalgia, arthralgia (knees, ankles, and elbows), recurrent oral ulceration, and skin rash over her shin, hands and chest, weight loss and fatigue. Examination revealed slightly red eyes with evidence of erythema nodosum over her shins, hands and chest. She was tender on palpation of her knees, elbows and ankles with no overt synovitis detected. She had no palpable peripheral lymphadenopathy. Cardiovascular and respiratory system examinations were normal. Initial blood test results showed raised inflammatory markers with CRP-63 (<10), ESR-29. ANA & ANCA negative, Normal C3, C4, ferritin, eosinophil count, creatinine kinase, immunoglobulins. She was HLA B27 and B51 negative. Transthoracic echocardiogram was normal. Chest x-ray showed some left lobar consolidation treated successfully with antibiotics. She had a CT chest, abdomen and pelvis. The result showed a significant soft tissue mass in her cervix with a 13mm lymph node on the left pelvic sidewall. She was referred urgently to the gynaecology team due to a suspicion of malignancy. She underwent a colposcopy, EUA with LLETZ loop under anaesthesia which identified a small sessile polyp at the anterior lip of the os and it was excised. Histology showed a benign fibro-glandular inflamed polyp with no cervical intraepithelial neoplasm or cancer. Following this, a repeat vaginal examination identified a new right vaginal wall nodular swelling not noted on the previous examination. MRI of her pelvis revealed a large cervical tumour. She underwent lymphadenectomy. The result of this was negative for high-grade lymphoma, IgG4 and granulomatous disease but suggested a lymphocytic vasculitis. Blood investigations were negative for IgG4, chlamydia, treponema and lyme serology. She was diagnosed with Behçet’s disease and treated with prednisolone 30mg in the first instance. She is awaiting further review to assess her response to treatment. Discussion Behçet’s disease (BD) is a systemic vasculitis of unknown aetiology. Presentation is variable. It follows a remitting and relapsing course. Genetic and environmental factors play a role in its aetiology. Behçet’s disease is rare in the UK, with an estimated prevalence of 1 in 100,000. Due to this, a delay of at least 6months to diagnosis is not uncommon. It is prevalent in people of Mediterranean, Eastern Asian backgrounds with the highest prevalence in Turkey of 420 in 100,000. Recurrent aphthous and genital ulceration with uveitis is frequent. Blood vessels of all sizes, joints, skin, gut and nervous system are affected by the disease — early diagnosis with the treatment is required to prevent lasting damage to affected organs. Treatment of Behçet’s syndrome involves a combination of topical and oral steroid, colchicine, and disease-modifying therapy. This patient presented with episcleritis, erythema nodosum, arthralgia, oral ulceration and genitourinary tract involvement. A possible diagnosis of Behçet’s was entertained after a thorough evaluation by the gynaecology oncology team to exclude malignancy, with a delay of more than six months to diagnosis. Despite features of a multisystem inflammatory process, the initial CT scan finding on the cervix made a neoplastic process an essential differential in her work up. Oral and genital ulcers are the main diagnostic and classification criteria for Behcet’s disease under the ICBD classification with scores of 2 each while the skin, eye, positive pathergy and vascular lesions each have a score of 1. A score of ≥ 3 suggests the diagnosis. Lesions of the vagina or cervix are uncommon in Behçet’s but recognised. Male patients often have scrotal and penile shaft involvement. As the treatment of Behçet’s disease involves the use of immunosuppressant drugs, the exclusion of a neoplastic process presenting with multisystem involvement is essential. Key learning points Behçet’s disease should always be considered in the differential diagnosis of a cervical mass once other common causes including malignancy and infection have been excluded. This should be considered especially in the background of a multi-systemic illness. As a rheumatologist, dealing with a broad range of systemic illnesses, vasculitis can present in varying and sometimes atypical ways. This can be compounded by the unusual presentation of some cases. One must bear in mind too however that some medical conditions presenting initially with rheumatological symptoms and in fact may be paraneoplastic manifestations of an underlying malignancy. Therefore having a broad differential diagnosis is essential to ensure early diagnosis of other potentially fatal diseases. Conflicts of interest The authors have declared no conflicts of interest.