Identification of circulating tumour cells in early stage breast cancer patients using multi marker immunobead RT-PCR

Introduction The ability to screen blood of early stage operable breast cancer patients for circulating tumour cells is of potential importance for identifying patients at risk of developing distant relapse. We present the results of a study of the efficacy of the immunobead RT-PCR method in identifying patients with circulating tumour cells. Results Immunomagnetic enrichment of circulating tumour cells followed by RT-PCR (immunobead RT-PCR) with a panel of five epithelial specific markers (ELF3, EPHB4, EGFR, MGB1 and TACSTD1) was used to screen for circulating tumour cells in the peripheral blood of 56 breast cancer patients. Twenty patients were positive for two or more RT-PCR markers, including seven patients who were node negative by conventional techniques. Significant increases in the frequency of marker positivity was seen in lymph node positive patients, in patients with high grade tumours and in patients with lymphovascular invasion. A strong trend towards improved disease free survival was seen for marker negative patients although it did not reach significance (p = 0.08). Conclusion Multi-marker immunobead RT-PCR analysis of peripheral blood is a robust assay that is capable of detecting circulating tumour cells in early stage breast cancer patients.

Maximum recovery after knee replacement - the MARKER study rationale and protocol

Background There is little scientific evidence to support the usual practice of providing outpatient rehabilitation to patients undergoing total knee replacement surgery (TKR) immediately after discharge from the orthopaedic ward. It is hypothesised that the lack of clinical benefit is due to the low exercise intensity tolerated at this time, with patients still recovering from the effects of major orthopaedic surgery. The aim of the proposed clinical trial is to investigate the clinical and cost effectiveness of a novel rehabilitation strategy, consisting of an initial home exercise programme followed, approximately six weeks later, by higher intensity outpatient exercise classes. Methods/Design In this multicentre randomised controlled trial, 600 patients undergoing primary TKR will be recruited at the orthopaedic pre-admission clinic of 10 large public and private hospitals in Australia. There will be no change to the medical or rehabilitative care usually provided while the participant is admitted to the orthopaedic ward. After TKR, but prior to discharge from the orthopaedic ward, participants will be randomised to either the novel rehabilitation strategy or usual rehabilitative care as provided by the hospital or recommended by the orthopaedic surgeon. Outcomes assessments will be conducted at baseline (pre-admission clinic) and at 6 weeks, 6 months and 12 months following randomisation. The primary outcomes will be self-reported knee pain and physical function. Secondary outcomes include quality of life and objective measures of physical performance. Health economic data (health sector and community service utilisation, loss of productivity) will be recorded prospectively by participants in a patient diary. This patient cohort will also be followed-up annually for five years for knee pain, physical function and the need or actual incidence of further joint replacement surgery. Discussion The results of this pragmatic clinical trial can be directly implemented into clinical practice. If beneficial, the novel rehabilitation strategy of utilising outpatient exercise classes during a later rehabilitation phase would provide a feasible and potentially cost-effective intervention to optimise the physical well-being of the large number of people undergoing TKR.

The cultural and creative industries

A critical and Historical account of the cultural and creative industries as a policy discourse. It argues that the emergence of a cultural policy discourse was part of a progressive democratic politics from the 1960s onwards, taking cognizance of the emergence of new kinds of commercial popular culture. It suggests that this period saw the merging of aesthetics and culture in particular ways. The creative industries come from a different source which combined innovation theory, embedded economics and entrepreneurialism in ways that resulted in a much less progressive politics. The chapter ends by suggesting the the idea of the creative industries is now at an end.

The cultural and creative industries : a literature review [2nd ed.]

This is a short book which gives an introduction and overview of the literature on the cultural and creative industries. This is a revised version of the 2007 edition, with a new conclusion.

Cities, culture and “Transitional Economies”: Developing cultural industries in St Petersburg

In this chapter I look at some issues around the transfer of cultural industry policy between two very different national contexts, the UK and Russia. Specifically it draws on a partnership project between Manchester and St. Petersburg financed by the European Union as part of a program to promote economic development through knowledge transfer between Europe and the countries of the former Soviet Union. This specific project attempted to place the cultural industries squarely within the dimension of economic development, and drew on the expertise of Manchester’s Creative Industries Development Service and other partners to effect this policy transfer

The cultural production sector in Manchester

A quantitative and qualitative review of the cultural industries in Manchester at the end of the 1990s

Summary : Cultural Production in Manchester

Summary of the larger report of the same name

The definition of the ‘Cultural Industries’

The paper attempts to give a concise history of the concept and outline some of the definitional problems that have arisen and have hampered policy-makers.