Breast cancer stromal clotting activation (Tissue Factor and thrombin): A pre-invasive phenomena that is prognostic in invasion
Author(s) Shaker H.; Bundred N.J.; Castle J.; Kirwan C.C.; Landberg G. et al.
Source Cancer Medicine; Mar 2020; vol. 9 (no. 5); p. 1768-1778
Background: Tumor stroma, of which fibroblasts are the most abundant cell, resembles a non-healing wound, where a procoagulant environment creates a permissive milieu for cancer growth. We aimed to determine if tumor expression of coagulation factors (procoagulant phenotype), and systemic hypercoagulability, occur at the preinvasive (ductal carcinoma in situ; DCIS) stage and correlate with breast cancer subtype, disease-free survival (DFS), and overall survival (OS).
Development of Quantitative Methylation-Specific Droplet Digital PCR (ddMSP) for Assessment of Natural Tregs
Author(s) Husseiny M.I.; Du W.; Gu A.; Garcia P.; Ferreri K. et al.
Source Frontiers in Genetics; Apr 2020; vol. 11
Regulatory T cells (Tregs) suppress immune responses in vivo in an antigen-specific manner. Of clinical relevance, Tregs can be isolated and expanded in vitro while maintaining immunoregulatory function.
Gynaecological morbidity associated with caesarean niche: increasing awareness, prevention and management
Author(s) Brook A.J.; Clarke F.R.; Bhatia K.
Source Obstetrician and Gynaecologist; Apr 2020; vol. 22 (no. 2); p. 122-130
Key content: Caesarean section rates are rising globally; while obstetric consequences are well defined, long-term gynaecological sequelae are frequently overlooked. Caesarean niche results from poor healing of the uterine scar and is being increasingly reported as an important factor in a variety of new gynaecological symptoms reported after caesarean section. Until recently, a lack of high-quality evidence has hampered diagnostic assessment. Recent publications provide a useful consensus for improved diagnosis and guidance on management, with thoughts that caesarean section technique potentially contributes to niche development. Learning objectives: To describe the gynaecological morbidity associated with caesarean niche. To understand theories regarding caesarean niche development, its sonographic assessment for clinical relevance and subsequent management. To reflect on surgical techniques for caesarean section to minimise niche development. Ethical issues: With rising caesarean section rates, caesarean niche is an emerging clinical problem. Should we advise women of the possibility of long-term gynaecological consequences of the caesarean niche?
Diagnosis and management of psychodermatological problems: confidence levels among dermatologists and psychiatrists
Author(s) Muralidharan V.; Zahedi D.; Kaur B.; Goulding J.M.R.
Source Clinical and Experimental Dermatology; Jun 2020; vol. 45 (no. 4); p. 482-483
Available in full text at Clinical and experimental dermatology from Wiley Online Library Medicine and Nursing Collection 2019 - NHS
Author(s) Cheung T.; Din A.; Zubairy A.
Source Journal of Orthopaedics; 2020; vol. 20 ; p. 286-292
Publication Date 2020
Background: Total ankle replacement (TAR) is a high-risk procedure with significant revision rates, post-op complications and implant failures. Long term follow-up data is less available for TAR compared to other joint replacement surgeries. To identify optimal follow-up parameters for patients with TAR, we conducted a study on the clinical outcomes and patient-reported outcome measurements (PROMs) in patients who had TAR performed in a non-designer's centre belonging to one of the hospitals of East Lancashire Hospitals NHS Trust (ELHT). Method(s): 60 TAR procedures were identified. Clinical outcomes being studied include post-op ankle range of movement (ROM), American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot scores, reoperation/revision rates, radiological parameters and general surgical outcomes. A Kaplan-Meier survival analysis was also conducted. PROMs data included the EQ-5D index and the Manchester-Oxford Foot Questionnaire (MOX-FQ). Result(s): Ankle range of movement and AOFAS scores improved from pre-op to post-op with statistical significance. The reoperation rate and revision rate were 3.3% and 8.3% respectively. 5-year survival of implant was 97.3% and 10-year survival was 84.2%. Overall PROMs data showed improvement from pre-op to post-op. Conclusion(s): The clinical outcomes of TARs were comparable with conventional literature. Improvements in clinical, radiological and patient-reported outcomes were observed from pre-op to post-op. Further follow-up studies are required to assess the long-term survival of implants.
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