New therapeutic concepts in prostate cancer.
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Biomedical subjects
Publications and source records attributed to B G Thomas.
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The mechanisms by which prostate cancer metastasizes to bone with a strong osteoblastic reaction remain poorly understood. Several factors have been previously implicated, including transforming growth factor-beta, fibroblast growth factors, endothelin-1 and bone morphogenetic proteins (BMPs). BMP-6 expression has been shown exclusively in the malignant epithelial cells of prostate cancers that have metastasized, but not in organ confined disease. Expression of BMP-6 in radical prostatectomy specimens has been shown to correlate with increased recurrence rates and decreased survival. This article presents the results of work by the authors' group in this field and a current literature review. Prostate Cancer and Prostatic Diseases (2000) 3, 283-285
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The delivery of the head with or without forceps may have been quite easy, but more commonly there has been a little difficulty in completing the extension of the head. The hairy scalp slides with reluctance. When the forehead has appeared it is necessary to press back the perineum to deliver the face. Fat cheeks eventually emerge. A double chin has hooked over the posterior commissure, to which it remains tightly opposed. Restitution seldom occurs spontaneously for the head seems incapable of movement as a result of friction with the girdle of contact at the vulva... time passes. The child's face becomes suffused. It endeavours unsuccessfully to breathe. Abdominal efforts by the mother or by her attendants produce no advance, gentle traction is equally unavailing... Usually equanimity forsakes the attendants. They push, they pull. Alarm increases. Eventually, by greater strength of muscle or some infernal struggle, the difficulty seems to be overcome... It dawns upon the attendants that their anxiety was not ill founded.
Making use of best available evidence has clearly become an important part of midwifery practice. As educational programmes are preparing the practitioners of the future, it is believed that midwifery education should also be informed by evidence. At Thames Valley University, a BSc Midwifery curriculum, using the principles of problem-based learning, has been implemented following a review of both appropriate research and evaluation. This article explains the process undertaken in preparation for the course as well as the proposed means of ongoing evaluation.
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