Altered localization and activity of the intracellular tyrosine kinase BRK/Sik in prostate tumor cells

Breast tumor kinase (BRK) is an intracellular tyrosine kinase expressed in differentiating epithelial cells of the gastrointestinal tract and skin, and in several epithelial cancers including carcinomas of the breast and colon. We examined expression of BRK and its mouse ortholog Src-related intestinal kinase (Sik) in prostate tissues and detected it in the nuclei of normal luminal prostate epithelial cells. BRK localization was then examined in 58 human prostate biopsy samples representing various grades of prostate cancer. While nuclear localization of BRK was present in well-differentiated tumors, it was absent in poorly differentiated tumors. However localization of Sam68, a nuclear substrate of BRK/Sik, was unaltered in all prostate tumors examined. Consistent with these results, nuclear BRK was detected in the more differentiated androgen-responsive LNCaP human prostate cancer cell line that is poorly tumorigenic in host animals, but it was primarily cytoplasmic in the undifferentiated androgen-unresponsive PC3 prostate cancer cell line that forms aggressive tumors. While PC3 cells expressed higher levels of endogenous BRK than LNCaP cells, BRK was less active in these cells. Our data suggest that BRK plays a role in differentiation of prostate epithelial cells. Altered BRK localization and/or activity may provide a prognostic indicator for prostate tumor progression and be a potential target for therapeutic intervention.     

American Cancer Society guidelines for breast cancer screening: update 2003

In 2003, the American Cancer Society updated its guidelines for early detection of breast cancer based on recommendations from a formal review of evidence and a recent workshop. The new screening recommendations address screening mammography, physical examination, screening older women and women with comorbid conditions, screening women at high risk, and new screening technologies.     

Population-density and county-level variation in breast cancer mortality rates among white women residing in the Northeastern and Southern United States

OBJECTIVE: We assessed the contribution of variation in risk factor prevalence to population-density and county-level variation in breast cancer mortality rates. METHODS: In 1995 we collected risk factor information in a telephone interview of a random digit dialed sample of: (1) 1241 women from counties in the upper and lower tertiles of population density as of 1970 in the Northeast and South of the United States (Design A); (2) 2492 women from counties in the upper and lower tertiles of 1970-1979 breast cancer mortality rates in the four populations from Design A, and; (3) 276 women in Nassau County in New York State. We calculated 1990-94 mortality ratios (MRs) adjusted for breast cancer risk factors. RESULTS: The high/low population-density fully-adjusted MRs in women > or = 55 years were 1.01 (95% CI 0.9-1.2) and 1.00 (95% CI 0.8-1.2). The fully-adjusted MRs for high versus low mortality counties ranged from 0.95 (95% CI 0.8-1.2) to 1.29 (95% CI 1.0-1.6) in women > or = 55 years. CONCLUSIONS: Differences in risk factor prevalence explained higher rates in high-density versus low-density areas in older women. Modest elevations in the adjusted high/low breast cancer MRs among older women in certain groups of counties may reflect unidentified risk factors but more likely are due to chance.     

Cancer‐related fatigue – a difference of opinion? Results of a multicentre survey of healthcare professionals,patients and caregivers

The objective of this study was to investigate the perceptions of patients with cancer, their caregivers and healthcare professionals (HCPs) about fatigue and its impact on quality of life. It was a cross-sectional survey, the respondents were patients with cancer attending three UK regional cancer centres ( n  = 1370), their informal caregivers ( n  = 1370) and a random selection of HCPs (oncologists/nurses/radiographers/haematologists; n  = 1098). The response rates for patients, caregivers and HCPs were 42%, 33% and 34% respectively. Fatigue was reported to affect 56% of patients and to have a considerable impact on quality of life. Caregivers also recognized that fatigue was a common problem, with significant effects on patients' quality of life and impact on themselves. Healthcare professionals recognized that fatigue was a common problem for their patients but overestimated its impact on some aspects of patients' daily lives. Although most HCPs reported that they prescribed/recommended treatment for over half of their patients, only 14% of patients reported receiving any such treatment. The most common advice was to take more rest and relaxation. Conclusions: patients with cancer report that fatigue is a common and distressing symptom and the importance of this symptom is generally recognized by both HCPs and lay-carers. Healthcare professionals need more information about the effectiveness of existing interventions for cancer-related fatigue and further research is required to improve the current management of this debilitating symptom.     

Pre-discharge home visits with older people: time to review practice

The present review paper uses the available evidence to make a case for a reconsideration of the practice of undertaking pre-discharge home visits with frail older people as part of decisions regarding a return home. This practice is embedded into the routine activity of acute medical wards for older people and occupies a large proportion of the time of hospital employed therapy staff, with consequent financial and resource implications. Assessments are often conducted to provide information on safe discharge rather than being located in the interests of the older person and their carer. The introduction of a new range of services bridging hospital and home raises the need for an urgent, critical appraisal of this practice.     

Contributing factors to engulfments in on-farm grain storage bins: 1980 through 2001

Since 1978 Purdue University has maintained a national database of agriculture-related engulfment cases that have occurred in loose agricultural material in both commercial and on-farm facilities. The database presently contains 502 documented cases of fatal and non-fatal engulfments from the U.S. and Canada. A review of the more recent on-farm fatal and non-fatal engulfment cases, those occurring in 1980 through 2001, was conducted in order to characterize engulfments and identify contributing factors that would be relevant to future intervention strategy development including the implementation of design standards for on-farm structures. From 1980 through 2001, 197 cases were identified that occurred in on-farm grain bins, 156 of which were fatal and 41 were non-fatal. A rate of approximately seven fatal and two non-fatal cases per year were identified from 1980 through 2001. The magnitude of the engulfment problem is continuing, based on six and seven fatal cases reported in the years 2000 and 2001, respectively. Sixteen percent of fatal and six percent of non-fatal victims were children and adolescents under the age of 16. Fifty percent of the survivors were 60 years of age or older. Engulfments were generally reported more often in the top corn-producing states and involved corn in 76% of the fatal cases when product was known. Seventy-seven percent of the fatal victims were unloading the bin at the time of engulfment in cases where activity at the time of engulfment was known. Forty-one percent of the fatality cases involved corn that was out-of-condition where the condition of the grain was known. In survival cases where information about the presence of co-workers at the time of engulfment was known, it was found that a co-worker was present at the time of engulfment in 86% of the cases. In four cases, a survivor was rescued from a bin after being completely engulfed in grain. In all four cases, a co-worker was present at the time of engulfment and out-of-condition grain was involved. Findings are being used to design new injury prevention strategies, including educational materials and recommendations for engineering controls that focus on primary causative factors.     

An interactive voice response system to enhance antidepressant medication compliance

Advances in technology can have direct and indirect benefits to clinical practice. The challenge that clinicians face is to properly match resources and outcomes, along with patient preferences. This article explores the use of an innovative interactive voice response system to increase patient compliance with antidepressant medication prescribed in primary care settings. The development of the interactive voice response system, its implementation, and clinical outcomes are described. The findings underscore the need to carefully match intervention strategies with the needs of specific patient populations, and the importance of human dialog in the context of healing.     

Impact of objective and subjective social status on obesity in a biracial cohort of adolescents

OBJECTIVE: To characterize the associations between socioeconomic status (SES), two levels of subjective social status (SSS), and adolescent obesity. RESEARCH METHODS AND PROCEDURES: Cross-sectional study of 1491 black and white adolescents attending public school in a suburban school district in Greater Cincinnati, Ohio. BMI > or =95th percentile derived from measured height and weight defined overweight. Students rated SSS on separate 10-point scales for society and school. A parent provided information on parent education and household income for SES. RESULTS: Although there were no sex differences in SES, black students were more likely to come from families with less well-educated parents and lower incomes (p < 0.001). Black girls had the lowest societal SSS (p = 0.003), lowest school SSS (p = 0.046), and highest BMI (p < 0.001). Prevalence of overweight was highest among black girls (26.0%) and boys (26.2%), intermediate for white boys (17.2%), and least for white girls (11.6%). Logistic regression modeling revealed that parent education, household income, and school SSS were each associated with overweight. In a fully adjusted model, school SSS retained its association to overweight (odds ratio, 1.16; 95% CI, 1.06,1.26) independent of SES. The association of school SSS was strongest among white girls, intermediate for white and black boys, and absent for black girls. DISCUSSION: Perceptions of social stratification are independently associated with overweight. There were important racial and sex differences in the social status-overweight association. SSS in the more immediate, local reference group, the school, had the strongest association to overweight.