Molecular subtyping of breast cancer: Opportunities for new therapeutic approaches

Evidence is accumulating that breast cancer is not one disease but many separate diseases. DNA microarray-based gene expression profiling has demonstrated subtypes with distinct phenotypic features and clinical responses. Prominent among the new subtypes is 'basal-like' breast cancer, one of the 'intrinsic' subtypes defined by negativity for the estrogen, progesterone, and HER2/neu receptors and positivity for cytokeratins-5/6. Focusing on basal-like breast cancer, we discuss how molecular technologies provide new chemotherapy targets, optimising treatment whilst sparing patients from un-necessary toxicity. Clinical trials are needed that incorporate long-term follow-up of patients with well-characterised tumour markers. Whilst the absence of an obvious dominant oncogene driving basallike breast cancer and the lack of specific therapeutic agents are serious stumbling blocks, this review will highlight several promising therapeutic candidates currently under evaluation. Thus, new molecular technologies should provide a fundamental foundation for better understanding breast and other cancers which may be exploited to save lives.

Prescribing Practices and Polypharmacy in Kitovu Hospital, Uganda.

This audit of prescribing practices explores recent trends at Kitovu Hospital, Uganda. The average number of drugs prescribed per patient was 2.89 ± 0.11, of which 1.79±0.09 were generics and 0.69±0.06 antibiotics. No injections were prescribed. Patient essential drug knowledge was 100% while the adequacy of labelling was 0%. The number of drugs prescribed correlated positively with patient age, was greater for female patients, similar for doctors and clinical officers but greater in medical (3.30±0.15, n=50) than surgical (2.48±0.13, n=50) outpatient clinics. The mean consultation time was 6.56 min and 10.25 min per patient in medical and surgical outpatient clinics respectively. The patient essential knowledge indicators were greatly improved but only modest reduction in polypharmacy was evident compared to the Ugandan Pharmaceutical Sector national survey of 2002. Antibiotic prescription was high and generic prescribing was found to be low. Policy changes are required to enhance rational drug use in the health sector in Uganda.

Evocative Listening : Mediated Practices in Everyday Life

The history of sonic arts is charged with transgressive practices that seek to expose the social, aural and cultural thresholds across various listening experiences, posing new questions in terms of the dialogue between listener and place. Recent work in sonic art exposes the need for an experiential understanding of listening that foregrounds the use of new personal technologies, environmental philosophy and the subject–object relationship. This paper aims to create a vocabulary that better contextualises recent installations and performances produced within the context of everyday life, by researchers and artists at the Sonic Arts Research Centre at Queen's University Belfast.

The Impact of Shame on the Therapeutic Alliance and Intimate Relationships

Objectives


This study examined the role of shame coping styles and state shame in predicting the therapeutic alliance and intimate relationship functioning in individuals with mental health problems.


Method


A sample of 50 treatment-receiving adults aged 21 to 67 years with a mix of common mental health difficulties was recruited from a clinical psychology service. Participants were given questionnaire measures of shame states, shame coping styles, intimate relationship functioning, and the therapeutic alliance.


Results


Regression analyses indicated that the shame coping strategy of physical and psychological withdrawal was the primary risk factor for development of a less effective therapeutic alliance. Both withdrawal and attack self coping styles were significant predictors of impaired intimate relationship functioning.


Conclusions


These findings have implications for the theoretical role of shame in mental health presentations as well as the potential for internalizing shame coping styles (i.e., withdrawal, attack self) to act as a barrier to successful therapy and interpersonal relationships. The inclusion of shame-focused assessments and interventions in the initial stages of treatment with clients exhibiting these strategies could improve prognosis.

Immunovirological Correlates in Human Rabies Treated With Therapeutic Coma

A 37-year-old woman was admitted to hospital and over the next 5 days developed a progressive encephalitis. Nuchal skin biopsy, analyzed using a Rabies TaqMan(C) PCR, demonstrated rabies virus RNA. She had a history in keeping with exposure to rabies whilst in South Africa, but had not received pre- or post-exposure prophylaxis. She was treated with a therapeutic coma according to the

RESIDUES OF CLENBUTEROL IN CATTLE RECEIVING THERAPEUTIC DOSES - IMPLICATIONS FOR DIFFERENTIATING BETWEEN LEGAL AND ILLEGAL USE

Clenbuterol (CBL) can be used legally in the treatment of respiratory diseases and illegally as a growth promoter in animals, Liver and eye have previously been shown to be effective matrices for the detection of residual concentrations of the drug.