Prognostication of co-morbidity clusters on hospitalisation and mortality in advanced COPD.

Rationale: As the prevalence of multimorbidity increases, understanding the impact of isolated comorbidities in people COPD becomes increasingly challenging. A simplified model of common comorbidity patterns may improve outcome prediction and allow targeted therapy.

Objectives: To assess whether comorbidity phenotypes derived from routinely collected clinical data in people with COPD show differences in risk of hospitalisation and mortality.

HO-1 drives autophagy as a mechanism of resistance against HER2-targeted therapies.

Purpose: Targeted therapies have resulted in major advances in the treatment of HER2-positive breast cancers. Despite this, up to 70% of patients will develop resistance to treatment within 2 years and new strategies for targeting resistant disease are needed.

Methods: To identify potential resistance mechanisms, we used the mouse MMTV-NIC-PTEN spontaneous model of HER2-positive breast cancer and the pan-HER family kinase inhibitor sapatinib.

Mouse models of metastasis: progress and prospects.

Metastasis is the spread of cancer cells from a primary tumor to distant sites within the body to establish secondary tumors. Although this is an inefficient process, the consequences are devastating as metastatic disease accounts for >90% of cancer-related deaths. The formation of metastases is the result of a series of events that allow cancer cells to escape from the primary site, survive in the lymphatic system or blood vessels, extravasate and grow at distant sites.

Use of a genetically engineered mouse model as a preclinical tool for HER2 breast cancer.

Resistance to human epidermal growth factor receptor 2 (HER2)-targeted therapies presents a major clinical problem. Although preclinical studies have identified a number of possible mechanisms, clinical validation has been difficult. This is most likely to reflect the reliance on cell-line models that do not recapitulate the complexity and heterogeneity seen in human tumours.

Mucocele-like lesions of the breast: an audit of 2 years at BreastScreen Auckland (New Zealand).

It is recommended that mucocele-like lesions be excised to enable differentiation between benign lesions and carcinoma. In addition, ductal carcinoma in situ may be found in close association. A small series of 12 lesions audited at BreastScreen Auckland has shown six benign, one atypical, and five malignant lesions.

Primary leiomyosarcoma of the breast: diagnosis, management and outcome. A report of a new case and review of literature.

Primary leiomyosarcoma of the breast is very rare and represents a diagnostic challenge. Only 16 cases have been reported in the English language literature. We report another new case and have analysed reports of the previous cases aiming to present a simple evidence-based approach to the clinical, radiological and pathological diagnosis of this rare tumour.

The construction and implementation of a psychosocial interventions care pathway within a low secure environment: a pilot study.

This paper builds on previous articles that explore the use of psychosocial interventions within inpatient settings. There are obvious difficulties in the implementation of psychosocial interventions in practice. The authors suggest that one method of developing psychosocial interventions within services is to provide organizational support to clinicians.

Staff expressed emotion and causal attributions for client problems on a low security unit: an exploratory study.

This is an exploratory study that sought to investigate a number of measures of staff-patient relationships on a continuing care, low security inpatient facility for patients with severe mental illness. Twenty staff members were assessed for expressed emotion (EE) using the Camberwell Family Interview (CFI) in regard to a client for whom they were a designated key worker. Their spontaneous attributions for the patient's problems were also assessed, along with self-report staff and patient ratings of their expressed and perceived feelings and thoughts about their staff or patient counterpart.

Guidelines for lumbar spine radiography in acute low back pain: effect of implementation in an accident and emergency department.

Guidelines for lumbar spine radiography were agreed by consultation between staff in the radiology, accident and emergency and neurosurgical departments of a large teaching hospital. Study of 322 consecutive patients over an eight month period showed that the proportion of patients referred for radiography was reduced from 48.4% to 27.