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Biomedical subjects

Anne Thompson

Publications and source records attributed to Anne Thompson.

6 recordsLinked to original sources

Significant clinical impact and prognostic stratification provided by FDG-PET in the staging of oesophageal cancer.

PURPOSE: To evaluate the clinical impact of FDG-PET in staging oesophageal cancer and whether this information improves prognostic stratification. METHODS: Impact was based on comparison of a prospectively recorded pre-PET plan with post-PET treatment in 68 consecutive patients undergoing primary staging. Survival was analysed using the Kaplan-Meier product limit method and the Cox proportional hazards regression model. RESULTS: FDG-PET findings impacted on the management of 27/68 patients (40%): in 12 therapy was changed from curative to palliative and in three from palliative to curative, while in 12 other patients there was a change in the treatment modality or delivery but not in the treatment intent. The median survival was 21 months, with post-PET stage and treatment intent both strongly associated with survival (p<0.001). Conventional stage was not able to clearly stratify this population. CONCLUSION: The use of FDG-PET for primary staging of oesophageal cancer changed the clinical management of more than one-third of patients and provided superior prognostic stratification compared with conventional investigations.

Adult↗

Alternative mammary oncogenic pathways are induced by D-type cyclins; MMTV-cyclin D3 transgenic mice develop squamous cell carcinoma.

The three human D-type cyclins, cyclin D1, D2 and D3 share the ability to bind to and activate cdk4 and 6. MMTV-cyclin D1 transgenic mice develop mainly adenocarcinoma, while MMTV-cyclin D2 mice show a lack of alveologenesis during pregnancy and only develop carcinoma at low frequency. The effect of cyclin D3 overexpression in mammary glands remains hitherto unknown. We generated MMTV-cyclin D3 transgenic mice and report here that they develop exclusively squamous cell carcinoma. We show that although cyclin D3 transgene expression was detected early in puberty, postnatal development and mammary gland proliferation were normal in virgin animals. In contrast, multiparous mice develop multiple foci of abnormal growth that correspond to various stages of squamous metaplasia. Therefore, our results support a role for cyclin D3 in squamous differentiation. In addition, we found that p16 expression during involution is abolished, while p27 expression increased in MMTV-cyclin D3 mice, two modifications that have been reported in the other MMTV-D-type cyclin transgenic models. Our observations indicate that despite biochemical redundancy in vitro and in vivo, D-type cyclins promote distinct oncogenic pathways.

Animals↗

Authoritarian parenting attitudes as a risk for conduct problems Results from a British national cohort study.

This study examines the associations, and possible causal relationship, between mothers' authoritarian attitudes to discipline and child behaviour using cross-sectional and prospective data from a large population sample surveyed in the 1970 British Cohort Study. Results show a clear linear relationship between the degree of maternal approval of authoritarian child-rearing attitudes and the rates of conduct problems at age 5 and age 10. This association is independent of the confounding effects of socio-economic status and maternal psychological distress. Maternal authoritarian attitudes independently predicted the development of conduct problems 5 years later at age 10. The results of this longitudinal study suggest that authoritarian parenting attitudes expressed by mothers may be of significance in the development of conduct problems.

Authoritarianism↗

A prospective, randomized pilot trial of perfluorocarbon-induced lung growth in newborns with congenital diaphragmatic hernia.

BACKGROUND/PURPOSE: Initial laboratory and clinical data suggest that partial liquid ventilation (PLV) can enhance pulmonary function and that lung growth can be induced via distension of the newborn lung using perfluorocarbon in patients with congenital diaphragmatic hernia (CDH). The authors, therefore, performed a prospective, randomized pilot study evaluating PLV and perfluorocarbon-induced lung growth (PILG) in newborns with CDH on extracorporeal life support (ECLS) at 6 medical centers. METHODS: Patients were selected randomly using a permuted block design to PLV/PILG (n = 8) or conventional mechanical ventilation (CMV/control, n = 5). Patients in the PILG group received daily doses which filled the lungs with perflubron for up to 7 days and were placed on continuous positive airway pressure of 5 to 8 cm H2O. CMV patients were treated with standard mechanical ventilation while on extracorporeal membrane oxygenation (ECMO). RESULTS: A total of 13 patients were evaluated in this study. All 3 patients enrolled without being on ECLS rapidly transitioned to ECLS. The study, therefore, effectively evaluated PILG (n = 8) versus standard ventilation (control, n = 5) on ECLS. Mean (+/- SE) gestational age was 37 +/- 1 weeks and weight was 3.1 +/- 0.1 kg. Time on ECMO was 9.8 +/- 2.3 days in the PILG and 14.5 +/- 3.5 days (P =.58) in the control group. Survival rate in the PILG group was 6 of 8 (75%), whereas survival rate was 2 of 5 (40%) in the control group (P =.50). The number of days free from the ventilator in the first 28 days (VFD) was 6.3 +/- 3.3 days with PILG and 4.6 +/- 4.6 days with control (P =.9). Causes of death in the PILG group included sepsis and renal failure in one patient and pulmonary hypertension in the other. There were no safety issues, and the deaths in the PILG group did not appear to be related to the administration of perflubron. CONCLUSIONS: These data show that PILG can be performed safely. The survival rate, VFD, and time on ECMO data, although not conclusive, are encouraging and indicate the need for a definitive trial of this novel intervention in these neonates with high mortality.

Combined Modality Therapy↗

Bridging the gap: teaching ethics in midwifery practice.

Teaching is an integral part of all midwives' practice, wherever they work. Midwives face ethical issues of greater or lesser significance throughout their careers. In a multitude of different situations and cultures worldwide midwives confront, on a daily basis, the need to make or help others make critical decisions that will impact lives. Midwives need tools to address this reality constructively, consistently, and respectfully if they are to remain true to themselves. They need also to be able to transmit such skills to the students they teach and the women to whom they offer care. Translating ethical thought and reflection into action--bridging the theory-practice gap--is the perennial challenge. This article presents some of the tools available to professionals who take up the challenge of using ethical thinking to shape best practice in any setting.

Curriculum↗