Surgical resection for non-small cell lung cancer : clinical features and outcomes for a consecutive series at an Irish tertiary referral centre

Background: Few patients diagnosed with lung cancer are still alive 5 years after diagnosis. The aim of the current study was to conduct a 10-year review of a consecutive series of patients undergoing curative-intent surgical resection at the largest tertiary referral centre to identify prognostic factors. Methods: Case records of all patients operated on for lung cancer between 1998 and 2008 were reviewed. The clinical features and outcomes of all patients with non-small cell lung cancer (NSCLC) stage I-IV were recorded. Results: A total of 654 patients underwent surgical resection with curative intent during the study period. Median overall survival for the entire cohort was 37 months. The median age at operation was 66 years, with males accounting for 62.7 %. Squamous cell type was the most common histological subtype, and lobectomies were performed in 76.5 % of surgical resections. Pneumonectomy rates decreased significantly in the latter half of the study (25 vs. 16.3 %), while sub-anatomical resection more than doubled (2 vs. 5 %) (p < 0.005). Clinico-pathological characteristics associated with improved survival by univariate analysis include younger age, female sex, smaller tumour size, smoking status, lobectomy, lower T and N status and less advanced pathological stage. Age, gender, smoking status and tumour size, as well as T and N descriptors have emerged as independent prognostic factors by multivariate analysis. Conclusion: We identified several factors that predicted outcome for NSCLC patients undergoing curative-intent surgical resection. Survival rates in our series are comparable to those reported from other thoracic surgery centres. © 2012 Royal Academy of Medicine in Ireland.

Australian eco-pastoral poetry

Les Murray and Judith Wright are two Australian poets who are widely read as landscape poets. While this framing offers valuable insights into their work it often fails to bring the importance into a contemporary context or to recognise the long tradition Australia has had with , to use Leo Marx’ term, “the complex pastoral”. As Ruth Blair reminds us in her chapter “Hugging the Shore: The Green Mountains of South-East Queensland” in The Littoral Zone: Australian Contexts and their Writers it is accepted that North America has a tradition of the complex pastoral mode but it should be remembered that Australia also has a long history of this form. Both Judith Wright’s and Les Murray’s poetry encourages active campaigning for the environment .These Australian poets are eco-pastoral poets whose poetry encourages active reading rather than passive reflections. Their poetry speaks to the strong connection between the lived everyday landscape and the imagination of past, present and future. Their work is imbued with a strong sense of ecocritical awareness while at the same time drawing on pastoral conventions. These two Australian poets do not offer idealistic pastoral notions but rather reveal the complexities of lived human/nonhuman relationships. This paper will discuss these complexities and how poetry can be experienced as literature in action—ways for readers to connect with and negotiate with the land they inhabit. The research for this paper was, in part, drawn from the responses that local community library groups offered after reading the works of these poets. What became evident from this research was the way the poetry made the readers think not only of landscape as a place of refuge from the urban technological world but also as a contemporary place with connection to agency that motivates readers into active change.

Joy fear and poetry

Joy Fear and Poetry is an original performance work written, designed and directed by Natasha Budd in collaboration with 15 performers aged 7-12 years. It was performed in Brisbane as part of La Boite Theatre’s 2013 Indie Season. The production employs contemporary performance, postdramatic and constructivist methodologies to make an intervention into habituated patterns of positioning children in society. It embodies a model of practice that moves beyond participant empowerment toward a more nuanced process of co-artists creating intersubjective ‘composite texts’ (McCall 2011) for mainstream audiences. Joy Fear and Poetry experiments with techniques for performance making that create conditions conducive to authentic theatre making with children. These focus on dramaturgical, directorial and design strategies harnessed to maintain the performers’ focus, motivation and cognitive engagement within a reflexive, collaborative process.

Fresh Cuttings: A Celebration of Fiction and Poetry from UQP's Black Writing Series

As the first anthology of UQP's indigenous-authored books, Fresh Cuttings represents the very best of fiction and poetry publishing from UQP's Black Australian Writing series. An introduction by the editors and a biography of each author is included.

Suggestive linkage of 2p22-25 and 11q12-13 with low bone mineral density at the lumbar spine in the Irish population

Osteoporosis is a disease characterized by low bone mineral density (BMD) and poor bone quality. Peak bone density is achieved by the third decade of life, after which bone is maintained by a balanced cycle of bone resorption and synthesis. Age-related bone loss occurs as the bone resorption phase outweighs the bone synthesis phase of bone metabolism. Heritability accounts for up to 90% of the variability in BMD. Chromosomal loci including 1p36, 2p22-25, 11q12-13, parathyroid hormone receptor type 1 (PTHR1), interleukin-6 (IL-6), interleukin 1 alpha (IL-1α) and type II collagen A1/vitamin D receptor (COL11A1/VDR) have been linked or shown suggestive linkage with BMD in other populations. To determine whether these loci predispose to low BMD in the Irish population, we investigated 24 microsatellite markers at 7 chromosomal loci by linkage studies in 175 Irish families of probands with primary low BMD (T-score ≤ -1.5). Nonparametric analysis was performed using the maximum likelihood variance estimation and traditional Haseman-Elston tests on the Mapmaker/Sibs program. Suggestive evidence of linkage was observed with lumbar spine BMD at 2p22-25 (maximum LOD score 2.76) and 11q12-13 (MLS 2.55). One region, 1p36, approached suggestive linkage with femoral neck BMD (MLS 2.17). In addition, seven markers achieved LOD scores > 1.0, D2S149, D11S1313, D11S987, D11S1314 including those encompassing the PTHR1 (D3S3559, D3S1289) for lumbar spine BMD and D2S149 for femoral neck BMD. Our data suggest that genes within a these chromosomal regions are contributing to a predisposition to low BMD in the Irish population.

Representations of the Natural World in Old English Poetry

Review of Representations of the Natural World in Old English Poetry, by Jennifer Neville (Cambridge UP, 1999).

HER2 positive gastric and gastroesophageal adenocarcinoma; An Irish tertiary center experience

Background: Trastuzumab has been approved for patients with human epidermal growth factor receptor 2 (HER2) over expression and gene amplification metastatic gastric cancer. Here we present the prevalence of HER2 positive gastric cancer in an Irish population, the use of Trastuzumab in first line and beyond progression. Methods: The study was conducted in St James's Hospital, Dublin. A retrospective analysis of the date of patients with HER2 positive gastric cancer over a period of 3 years was carried out. Her2 positive was defined as immunohistochemistry (IHC) score of +3, of IHC score of +2 and increased gene copy number by fluorescence in situ hybridization (FISH). Overall survival was calculated from the day of initiation of treatment with Trastuzumab until death. Results: During the study period 140 patients with gastric and gastro-esophageal junction adenocarcinoma were treated. Out of those, 30 (21.4%) had HER2 positive disease. Among HER2 positive disease patients 18 (12.8%) were treated with first line Trastuzumab containing regimen with a median overall survival of 13 months. Nine (50%) developed progressive disease while on Trastuzumab and of those, 4 (22.2%) patients continued on Trastuzumab beyond progression, two (11.1%) of whom achieved stable disease and a prolonged survival. Conclusion: HER2 positivity rate in an Irish population with advanced gastric and gastro-esophageal junction adenocarcinoma is 21.4%. Treatment with Trastuzumab in the first line in combination with chemotherapy is a reasonable approach. Continuation of Trastuzumab beyond progression is a feasible strategy that requires further exploration.