Prostate-specific antigen (PSA) testing of men in UK general practice: a 10-year longitudinal cohort study.

Objectives: Cross-sectional studies suggest that around 6% of men undergo prostate-specific antigen (PSA) testing each year in UK general practice (GP). This longitudinal study aims to determine the cumulative testing pattern of men over a 10-year period and whether this testing can be considered equivalent to screening for prostate cancer (PCa).

Setting, Participants And Outcome Measures: Patient-level data on PSA tests, biopsies and PCa diagnoses were obtained from the UK Clinical Practice Research Datalink (CPRD) for the years 2002 to 2011.

The consultant practitioner: an evolving role to meet changing NHS needs.

Unlabelled: Since the introduction of the consultant practitioner role, with its huge variability in purpose and context, it has had to evolve in response to the changing needs of the NHS to achieve sustainability and transformation of services.

Aim: This article reflects on the relevance of the consultant practitioner role and the impact of an action learning set in hastening its evolution in one NHS foundation trust.

Method: From a process of collective critical reflection on their practice, six consultant practitioners analysed the impact they have had on influencing services and empowerment of their patients.

Randomized clinical study of wear of enamel antagonists against polished monolithic zirconia crowns.

Objectives: To test the hypothesis that there is no difference in the in vivo maximum wear of enamel opposing monolithic zirconia crowns, enamel opposing porcelain fused to metal crowns and enamel opposing enamel.

Methods: Thirty patients needing single crowns were randomized to receive either a monolithic zirconia or metal-ceramic crown. Two non-restored opposing teeth in the same quadrants were identified to serve as enamel controls.

Appraising the relevance of DNA copy number loss and gain in prostate cancer using whole genome DNA sequence data.

A variety of models have been proposed to explain regions of recurrent somatic copy number alteration (SCNA) in human cancer. Our study employs Whole Genome DNA Sequence (WGS) data from tumor samples (n = 103) to comprehensively assess the role of the Knudson two hit genetic model in SCNA generation in prostate cancer. 64 recurrent regions of loss and gain were detected, of which 28 were novel, including regions of loss with more than 15% frequency at Chr4p15.

Novel Testing for Corrosion of Glass-Ceramics for Dental Applications.

The effects of pH cycling immersion on the corrosion of glass-based ceramic materials were investigated by examining the silicon release level in the immersion solution and the surface morphology of the ceramic after immersion. The hypothesis that pH cycling causes more surface degradation than constant immersion was tested. An inductively coupled plasma atomic emission spectrometer was used for Si ion concentration determination and scanning electron microscopy for surface morphology analyses.

Postoperative lead migration in deep brain stimulation surgery: Incidence, risk factors, and clinical impact.

Introduction: Deep brain stimulation (DBS) is an effective treatment for multiple movement disorders and shows substantial promise for the treatment of some neuropsychiatric and other disorders of brain neurocircuitry. Optimal neuroanatomical lead position is a critical determinant of clinical outcomes in DBS surgery. Lead migration, defined as an unintended post-operative displacement of the DBS lead, has been previously reported.

Synthetic lethality between androgen receptor signalling and the PARP pathway in prostate cancer.

Emerging data demonstrate homologous recombination (HR) defects in castration-resistant prostate cancers, rendering these tumours sensitive to PARP inhibition. Here we demonstrate a direct requirement for the androgen receptor (AR) to maintain HR gene expression and HR activity in prostate cancer. We show that PARP-mediated repair pathways are upregulated in prostate cancer following androgen-deprivation therapy (ADT).

Height, selected genetic markers and prostate cancer risk: results from the PRACTICAL consortium.

Background: Evidence on height and prostate cancer risk is mixed, however, recent studies with large data sets support a possible role for its association with the risk of aggressive prostate cancer.

Methods: We analysed data from the PRACTICAL consortium consisting of 6207 prostate cancer cases and 6016 controls and a subset of high grade cases (2480 cases). We explored height, polymorphisms in genes related to growth processes as main effects and their possible interactions.

DESNT: A Poor Prognosis Category of Human Prostate Cancer.

Background: A critical problem in the clinical management of prostate cancer is that it is highly heterogeneous. Accurate prediction of individual cancer behaviour is therefore not achievable at the time of diagnosis leading to substantial overtreatment. It remains an enigma that, in contrast to breast cancer, unsupervised analyses of global expression profiles have not currently defined robust categories of prostate cancer with distinct clinical outcomes.

Association Of Plasma And Urinary Mutant DNA With Clinical Outcomes In Muscle Invasive Bladder Cancer.

Muscle Invasive Bladder Cancer (MIBC) has a poor prognosis. Whilst patients can achieve a 6% improvement in overall survival with Neo-Adjuvant Chemotherapy (NAC), many do not respond. Body fluid mutant DNA (mutDNA) may allow non-invasive identification of treatment failure.

Post-diagnosis serum insulin-like growth factors in relation to dietary and lifestyle changes in the Prostate testing for cancer and Treatment (ProtecT) trial.

Purpose: The insulin-like growth factor (IGF) system is modifiable by diet and lifestyle, and has been linked to prostate cancer development and progression.

Methods: We conducted a prospective cohort study of 621 men diagnosed with localized prostate cancer to investigate the associations of dietary and lifestyle changes with post-diagnosis circulating levels of IGF-I and IGFBP-3. We used analysis of covariance to estimate the associations, controlling for baseline IGF-I or IGFBP-3, respectively.

Development of a validated model to predict 30-day stroke and 1-year survival after carotid endarterectomy for asymptomatic stenosis using the Vascular Quality Initiative.

Objective: Carotid endarterectomy (CEA) has been shown to be an effective treatment for patients with asymptomatic carotid artery stenosis when perioperative stroke rates are low and patients survive long enough to benefit from the intervention. Our objective was to develop and to validate a simple risk prediction model for 30-day stroke and 1-year mortality to guide optimal selection of patients for CEA.

Methods: Asymptomatic patients undergoing first-time elective CEA within the Vascular Quality Initiative (VQI) from 2010 to 2015 were selected.

Serpiginous hypopigmentation secondary to intra-articular corticosteroid injection.

Corticosteroids have been a mainstay of therapy for the treatment of many inflammatory diseases for well over 50 years. Cutaneous side effects of local corticosteroid therapy include striae, thinning of the skin, hypopigmentation, and atrophy, which are well known complications of this treatment modality.Herein, we present an unusual cutaneous adverse side effect rarely seen in intra-articular corticosteroid injections.

Variation in hospital costs and reimbursement for endovascular aneurysm repair: A Vascular Quality Initiative pilot project.

Objective: Comparing costs between centers is difficult because of the heterogeneity of vascular procedures contained in broad diagnosis-related group (DRG) billing categories. The purpose of this pilot project was to develop a mechanism to merge Vascular Quality Initiative (VQI) clinical data with hospital billing data to allow more accurate cost and reimbursement comparison for endovascular aneurysm repair (EVAR) procedures across centers.

Methods: Eighteen VQI centers volunteered to submit UB04 billing data for 782 primary, elective infrarenal EVAR procedures performed by 108 surgeons in 2014.

Supporting clinical leadership through action: The nurse consultant role.

Aims And Objectives: To evaluate the effectiveness of an action learning set to enhance clinical leadership and extend their scope and confidence more strategically.

Background: As the most senior clinical role in most healthcare systems, the consultant nurse role is a solitary one. They are required to develop personal resilience, commitment and a belief in their ability to lead, with new consultants needing a strong support network to succeed.

Cutaneous Mycobacterium chelonae in a 95-year-old woman.

We present an interesting case of cutaneousMycobacterium chelonae in a 95-year-old woman.The lesion in question was localized to her rightarm; subsequent biopsy and culture studies wereconsistent with a mycobacterial infection. Historically,these infections are treated based on the immunologicstate of the patient.

ALS patients' regulatory T lymphocytes are dysfunctional, and correlate with disease progression rate and severity.

Neuroinflammation is a pathological hallmark of ALS in both transgenic rodent models and patients, and is characterized by proinflammatory T lymphocytes and activated macrophages/microglia. In ALS mouse models, decreased regulatory T lymphocytes (Tregs) exacerbate the neuroinflammatory process, leading to accelerated motoneuron death and shortened survival; passive transfer of Tregs suppresses the neuroinflammation and prolongs survival. Treg numbers and FOXP3 expression are also decreased in rapidly progressing ALS patients.

Asporin is a stromally expressed marker associated with prostate cancer progression.

Background: Prostate cancer shows considerable heterogeneity in disease progression and we propose that markers expressed in tumour stroma may be reliable predictors of aggressive tumour subtypes.

Methods: We have used Kaplan-Meier, univariate and multivariate analysis to correlate the expression of Asporin (ASPN) mRNA and protein with prostate cancer progression in independent cohorts. We used immunohistochemistry and H scoring to document stromal localisation of ASPN in a tissue microarray and mouse prostate cancer model, and correlated expression with reactive stroma, defined using Masson Trichrome staining.

Loss of hSef promotes metastasis through upregulation of EMT in prostate cancer.

We have previously reported that the negative signaling regulator Similar Expression to FGF (hSef) is downregulated in prostate cancer and its loss is associated with clinical metastasis. Here, we explored the mechanistic basis of this finding. We first confirmed our clinical observation by testing hSef manipulation in an in vivo metastasis model.