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Jameson C, Boulton KA, Silove N, Nanan R, Guastella AJ. Ectodermal origins of the skin-brain axis: a novel model for the developing brain, inflammation, and neurodevelopmental conditions. Mol Psychiatry 2023; 28:108-117. [PMID: 36284159 PMCID: PMC9812765 DOI: 10.1038/s41380-022-01829-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/16/2022] [Accepted: 10/03/2022] [Indexed: 01/09/2023]
Abstract
Early life development and its divergence is influenced by multiple genetic, neurological, and environmental factors. Atypical neurodevelopment, such as that observed in autism spectrum disorder, likely begins in early gestation during a period of entwined growth between the brain and epithelial barriers of the skin, gastrointestinal tract, and airway. This review coalesces epidemiological and neuroinflammatory evidence linking cutaneous atopic disease with both reduced skin barrier integrity and determinants of neurodivergence. We consider the shared developmental origin of epidermal and neural tissue with related genetic and environmental risk factors to evaluate potential pre- and postnatal modifiers of the skin-brain connection. Initial postnatal skin barrier integrity may provide a useful marker for both cortical integrity and meaningful subgroups of children showing early neurodevelopmental delays. It may also modify known risk factors to neurodevelopment, such as pathogen caused immune system activation. These novel insights of a skin-brain-neurodevelopment connection may advance detection and intervention opportunities.
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Affiliation(s)
- C. Jameson
- grid.1013.30000 0004 1936 834XClinic for Autism and Neurodevelopmental Research, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW Australia ,grid.1013.30000 0004 1936 834XChild Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, NSW Australia
| | - K. A. Boulton
- grid.1013.30000 0004 1936 834XClinic for Autism and Neurodevelopmental Research, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW Australia ,grid.1013.30000 0004 1936 834XChild Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, NSW Australia
| | - N. Silove
- grid.1013.30000 0004 1936 834XChild Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, NSW Australia ,grid.413973.b0000 0000 9690 854XChild Development Unit, The Children’s Hospital at Westmead, Westmead, NSW Australia
| | - R. Nanan
- grid.1013.30000 0004 1936 834XChild Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, NSW Australia ,grid.1013.30000 0004 1936 834XCharles Perkins Centre Nepean’s and Sydney Medical School Nepean, The University of Sydney, Nepean, Discipline of Paediatrics, University of Sydney, Camperdown, NSW Australia
| | - A. J. Guastella
- grid.1013.30000 0004 1936 834XClinic for Autism and Neurodevelopmental Research, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW Australia ,grid.1013.30000 0004 1936 834XChild Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, NSW Australia
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Jameson C, Boulton KA, Silove N, Guastella AJ. Eczema and related atopic diseases are associated with increased symptom severity in children with autism spectrum disorder. Transl Psychiatry 2022; 12:415. [PMID: 36171195 PMCID: PMC9519885 DOI: 10.1038/s41398-022-02185-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Growing evidence indicates that autism spectrum disorder (ASD) has diverse genetic, neurological, and environmental factors that contribute to its neurodevelopmental course. Interestingly, childhood ASD is often accompanied by skin disorders, such as eczema, and other related atopic manifestations. This link may be due to the shared embryonic origin of epidermal and neural tissue. Accordingly, we consider the potential influence of a skin-brain co-vulnerability and ensuing atopic cascade on ASD symptomatology by investigating whether atopic disorders (asthma, allergies, eczema and hay fever) are associated with increased symptom severity in children with ASD. Overall, 45 atopic and 93 non-atopic children with ASD were assessed using the ADOS-2 on scores of total, social and non-social symptoms. Differences in ASD symptom severity were further evaluated as a function of atopic disease type. Atopic children displayed greater symptom severity overall and in the social domain, relative to non-atopic participants. Atopic children were 2.4 times more likely to experience overall impairments classified within the ADOS-2 highest-level severity bracket and 2.7 times more likely to show social difficulties in this range. Moreover, those reporting comorbid eczema displayed increased symptom severity relative to both their non-atopic peers and those reporting asthma and allergies. Taken together, findings indicate that atopic disorders, and particularly comorbid eczema, are associated with increases in ASD symptom severity. Findings provide grounds for future investigations into this link between childhood skin diseases and ASD symptom severity to advance our understanding of neurodevelopment and to develop targeted assessment and intervention opportunities.
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Affiliation(s)
- C. Jameson
- grid.1013.30000 0004 1936 834XClinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - K. A. Boulton
- grid.1013.30000 0004 1936 834XClinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia ,grid.1013.30000 0004 1936 834XChild Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - N. Silove
- grid.1013.30000 0004 1936 834XChild Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, Australia ,grid.413973.b0000 0000 9690 854XChild Development Unit, The Children’s Hospital at Westmead, Westmead, NSW 2145 Australia
| | - A. J. Guastella
- grid.1013.30000 0004 1936 834XClinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia ,grid.1013.30000 0004 1936 834XChild Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, Australia
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Kravvas G, Ge L, Ng J, Shim TN, Doiron PR, Watchorn R, Kentley J, Panou E, Dinneen M, Freeman A, Jameson C, Haider A, Francis N, Minhas S, Alnajjar H, Muneer A, Bunker CB. The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature. J DERMATOL TREAT 2020; 33:1047-1062. [DOI: 10.1080/09546634.2020.1800574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- G. Kravvas
- Department of Dermatology, University College London Hospitals, London, UK
| | - L. Ge
- Department of Dermatology, University College London Hospitals, London, UK
| | - J. Ng
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
| | - T. N. Shim
- Department of Dermatology, University College London Hospitals, London, UK
| | - P. R. Doiron
- Department of Dermatology, University College London Hospitals, London, UK
| | - R. Watchorn
- Department of Dermatology, University College London Hospitals, London, UK
| | - J. Kentley
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
| | - E. Panou
- Department of Dermatology, University College London Hospitals, London, UK
| | - M. Dinneen
- Department of Urology, Chelsea & Westminster Hospital, London, UK
| | - A. Freeman
- Department of Histopathology, University College London Hospitals, London, UK
| | - C. Jameson
- Department of Histopathology, University College London Hospitals, London, UK
| | - A. Haider
- Department of Histopathology, University College London Hospitals, London, UK
| | - N. Francis
- Department of Histopathology, Imperial College Hospitals, London, UK
| | - S. Minhas
- Department of Urology, Imperial College Hospitals, London, UK
| | - H. Alnajjar
- Department of Urology, University College London Hospitals, London, UK
| | - A. Muneer
- Department of Urology, University College London Hospitals, London, UK
| | - C. B. Bunker
- Department of Dermatology, University College London Hospitals, London, UK
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
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Bass EJ, Donaldson IA, Freeman A, Jameson C, Punwani S, Moore C, Arya M, Emberton M, Ahmed HU. Magnetic resonance imaging targeted transperineal prostate biopsy: a local anaesthetic approach. Prostate Cancer Prostatic Dis 2017; 20:311-317. [PMID: 28485391 DOI: 10.1038/pcan.2017.13] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/29/2017] [Accepted: 02/22/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Despite high rates of disease misclassification and sepsis, the use of transrectal biopsy remains commonplace. Transperineal mapping biopsies mitigate these problems but carry increased cost and patient burden. Local anaesthetic, multiparametric magnetic resonance imaging (MRI)-targeted transperineal biopsy may offer an alternative. Here, we aim to determine the feasibility, tolerability and detection rates of clinically significant prostate cancer using a local anaesthetic, transperineal, MRI-targeted biopsy technique. METHODS Tertiary referral centre in which 181 consecutive men underwent local anaesthetic, transperineal MRI-targeted prostate biopsy (September 2014 to January 2016). A standardized local anaesthetic technique was used to obtain targeted biopsies using visual estimation with the number of targeted cores determined by each of a number of users. We assessed adverse events, patient visual analogue pain scores and detection rates of clinically significant cancer (defined by University College London (UCL) definitions one and two and separately by the presence of dominant and non-dominant Gleason pattern 4). We secondarily assessed detection of any cancer, rates of detection by MRI (Likert) score and by presenting PSA. Differences were assessed using Chi-squared tests (P<0.05). RESULTS One hundred eighty-one men with 243 lesions were included. There were no episodes of sepsis or re-admissions and one procedure was abandoned owing to patient discomfort. Twenty-three out of 25 (92%) men would recommend the procedure to another. Median visual analogue pain score was 1.0 (interquartile range: 0.0-2.4). A total 104/181 (57%) had UCL definition 1 disease (Gleason ⩾4+3 and/or maximum cancer length ⩾6 mm) and 129/181 (71%) had UCL definition 2 cancer (Gleason ⩾3+4 and/or maximum cancer length ⩾4 mm). Fifty-four out of 181 (30%) and 124/181 (69%) had dominant and non-dominant pattern 4 disease or greater (irrespective of cancer length). Any cancer was detected in 142/181 (78%). Significant disease was more likely in higher MRI-scoring lesions and in men with PSAs ⩾10 ng ml-1. CONCLUSIONS This approach to prostate biopsy is feasible, tolerable and can be performed in ambulatory settings.
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Affiliation(s)
- E J Bass
- Division of Surgery and Interventional Science, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - I A Donaldson
- Division of Surgery and Interventional Science, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - A Freeman
- Department of Histopathology, University College London Hospitals NHS Foundation Trust, London, UK
- The Prostate Unit, BUPA Cromwell Hospital, London, UK
| | - C Jameson
- Department of Histopathology, University College London Hospitals NHS Foundation Trust, London, UK
- The Prostate Unit, BUPA Cromwell Hospital, London, UK
| | - S Punwani
- Centre for Medical Imaging, University College London, London, UK
- Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK
| | - C Moore
- Division of Surgery and Interventional Science, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - M Arya
- Division of Surgery and Interventional Science, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - M Emberton
- Division of Surgery and Interventional Science, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
| | - H U Ahmed
- Division of Surgery and Interventional Science, University College London, London, UK
- Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK
- The Prostate Unit, BUPA Cromwell Hospital, London, UK
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Kravvas G, Shim T, Doiron P, Freeman A, Jameson C, Minhas S, Muneer A, Bunker C. The diagnosis and management of male genital lichen sclerosus: a retrospective review of 301 patients. J Eur Acad Dermatol Venereol 2017; 32:91-95. [DOI: 10.1111/jdv.14488] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 07/19/2017] [Indexed: 11/27/2022]
Affiliation(s)
- G. Kravvas
- Department of Dermatology; University College London Hospitals; London UK
| | - T.N. Shim
- Department of Dermatology; University College London Hospitals; London UK
| | - P.R. Doiron
- Department of Dermatology; University College London Hospitals; London UK
| | - A. Freeman
- Department of Histopathology; University College London Hospitals; London UK
| | - C. Jameson
- Department of Histopathology; University College London Hospitals; London UK
| | - S. Minhas
- Department of Urology; University College London Hospitals; London UK
| | - A. Muneer
- Department of Urology; University College London Hospitals; London UK
| | - C.B. Bunker
- Department of Dermatology; University College London Hospitals; London UK
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Kanthabalan A, Abd-Alazeez M, Arya M, Allen C, Freeman A, Jameson C, Kirkham A, Mitra A, Payne H, Punwani S, Ramachandran N, Walkden M, Emberton M, Ahmed H. Transperineal Magnetic Resonance Imaging-targeted Biopsy versus Transperineal Template Prostate Mapping Biopsy in the Detection of Localised Radio-recurrent Prostate Cancer. Clin Oncol (R Coll Radiol) 2016; 28:568-76. [DOI: 10.1016/j.clon.2016.04.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 01/19/2016] [Accepted: 03/08/2016] [Indexed: 12/14/2022]
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El-Shater Bosaily A, Valerio M, Hu Y, Freeman A, Jameson C, Brown L, Kaplan R, Hindley RG, Barratt D, Emberton M, Ahmed HU. The concordance between the volume hotspot and the grade hotspot: a 3-D reconstructive model using the pathology outputs from the PROMIS trial. Prostate Cancer Prostatic Dis 2016; 19:322. [PMID: 27502740 PMCID: PMC5411669 DOI: 10.1038/pcan.2016.37] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Valerio M, Anele C, Bott SRJ, Charman SC, van der Meulen J, El-Mahallawi H, Emara AM, Freeman A, Jameson C, Hindley RG, Montgomery BSI, Singh PB, Ahmed HU, Emberton M. The Prevalence of Clinically Significant Prostate Cancer According to Commonly Used Histological Thresholds in Men Undergoing Template Prostate Mapping Biopsies. J Urol 2015; 195:1403-1408. [PMID: 26626221 DOI: 10.1016/j.juro.2015.11.047] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2015] [Indexed: 12/14/2022]
Abstract
PURPOSE Transrectal prostate biopsies are inaccurate and, thus, the prevalence of clinically significant prostate cancer in men undergoing biopsy is unknown. We determined the ability of different histological thresholds to denote clinically significant cancer in men undergoing a more accurate biopsy, that of transperineal template prostate mapping. MATERIALS AND METHODS In this multicenter, cross-sectional cohort of men who underwent template prostate mapping biopsies between May 2006 and January 2012, 4 different thresholds of significance combining tumor grade and burden were used to measure the consequent variation with respect to the prevalence of clinically significant disease. RESULTS Of 1,203 men 17% (199) had no previous biopsy, 38% (455) had a prior negative transrectal ultrasound biopsy, 24% (289) were on active surveillance and 21% (260) were seeking risk stratification. Mean patient age was 63.5 years (SD 7.6) and median prostate specific antigen was 7.4 ng/ml (IQR 5.3-10.5). Overall 35% of the patients (424) had no cancer detected. The prevalence of clinically significant cancer varied between 14% and 83% according to the histological threshold used, in particular between 30% and 51% among men who had no previous biopsy, between 14% and 27% among men who had a prior negative biopsy, between 36% and 74% among men on active surveillance, and between 47% and 83% among men seeking risk stratification. CONCLUSIONS According to template prostate mapping biopsy between 1 in 2 and 1 in 3 men have prostate cancer that is histologically defined as clinically significant. This suggests that the commonly used thresholds may be set too low.
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Affiliation(s)
- M Valerio
- Division of Surgery and Interventional Science, University College London, London, United Kingdom; Department of Urology, University College Hospitals NHS Foundation Trust, London, United Kingdom; Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - C Anele
- Division of Surgery and Interventional Science, University College London, London, United Kingdom; Department of Urology, University College Hospitals NHS Foundation Trust, London, United Kingdom
| | - S R J Bott
- Department of Urology, Frimley Park Hospital NHS Foundation Trust, Frimley, United Kingdom
| | - S C Charman
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - J van der Meulen
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - H El-Mahallawi
- Department of Histopathology, Basingstoke and North Hampshire NHS Foundation Trust, Basingstoke, Hampshire, United Kingdom
| | - A M Emara
- Department of Urology, Basingstoke and North Hampshire NHS Foundation Trust, Basingstoke, Hampshire, United Kingdom; Department of Urology, Ain Shams University, Cairo, Egypt
| | - A Freeman
- Department of Histopathology, University College Hospital London, London, United Kingdom
| | - C Jameson
- Department of Histopathology, University College Hospital London, London, United Kingdom
| | - R G Hindley
- Department of Urology, Basingstoke and North Hampshire NHS Foundation Trust, Basingstoke, Hampshire, United Kingdom
| | - B S I Montgomery
- Department of Urology, Frimley Park Hospital NHS Foundation Trust, Frimley, United Kingdom
| | - P B Singh
- Department of Urology, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - H U Ahmed
- Division of Surgery and Interventional Science, University College London, London, United Kingdom; Department of Urology, University College Hospitals NHS Foundation Trust, London, United Kingdom
| | - M Emberton
- Division of Surgery and Interventional Science, University College London, London, United Kingdom; Department of Urology, University College Hospitals NHS Foundation Trust, London, United Kingdom
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Orczyk C, Punwani S, Kirkham A, Ramachandran N, Walkden M, Freeman A, Jameson C, Shehada M, Moore C, Arya M, Emberton M, Ahmed H. [Not Available]. Prog Urol 2015; 25:829-30. [PMID: 26544420 DOI: 10.1016/j.purol.2015.08.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- C Orczyk
- University College London, Londres, Royaume-Uni
| | - S Punwani
- University College London, Londres, Royaume-Uni
| | - A Kirkham
- University College London, Londres, Royaume-Uni
| | | | - M Walkden
- University College London, Londres, Royaume-Uni
| | - A Freeman
- University College London, Londres, Royaume-Uni
| | - C Jameson
- University College London, Londres, Royaume-Uni
| | - M Shehada
- University College London, Londres, Royaume-Uni
| | - C Moore
- University College London, Londres, Royaume-Uni
| | - M Arya
- University College London, Londres, Royaume-Uni
| | - M Emberton
- University College London, Londres, Royaume-Uni
| | - H Ahmed
- University College London, Londres, Royaume-Uni
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Michel C, Freeman A, Jameson C, Waddington W, Cathcart P. Détection des marges chirurgicales en imagerie par Cerenkov Luminescence au cours des prostatectomies radicales cœliosocpiques robot-assistées – résultats initiaux de l’étude PRIME. Prog Urol 2015; 25:796-7. [DOI: 10.1016/j.purol.2015.08.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mura M, Hopkins TG, Michael T, Abd-Latip N, Weir J, Aboagye E, Mauri F, Jameson C, Sturge J, Gabra H, Bushell M, Willis AE, Curry E, Blagden SP. LARP1 post-transcriptionally regulates mTOR and contributes to cancer progression. Oncogene 2015; 34:5025-36. [PMID: 25531318 PMCID: PMC4430325 DOI: 10.1038/onc.2014.428] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 09/20/2014] [Accepted: 10/21/2014] [Indexed: 12/24/2022]
Abstract
RNA-binding proteins (RBPs) bind to and post-transcriptionally regulate the stability of mRNAs. La-related protein 1 (LARP1) is a conserved RBP that interacts with poly-A-binding protein and is known to regulate 5'-terminal oligopyrimidine tract (TOP) mRNA translation. Here, we show that LARP1 is complexed to 3000 mRNAs enriched for cancer pathways. A prominent member of the LARP1 interactome is mTOR whose mRNA transcript is stabilized by LARP1. At a functional level, we show that LARP1 promotes cell migration, invasion, anchorage-independent growth and in vivo tumorigenesis. Furthermore, we show that LARP1 expression is elevated in epithelial cancers such as cervical and non-small cell lung cancers, where its expression correlates with disease progression and adverse prognosis, respectively. We therefore conclude that, through the post-transcriptional regulation of genes such as mTOR within cancer pathways, LARP1 contributes to cancer progression.
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Affiliation(s)
- M Mura
- Division of Cancer, Department of Surgery and Cancer, Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London, UK
| | - T G Hopkins
- Division of Cancer, Department of Surgery and Cancer, Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London, UK
| | - T Michael
- Division of Cancer, Department of Surgery and Cancer, Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London, UK
| | - N Abd-Latip
- Division of Cancer, Department of Surgery and Cancer, Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London, UK
| | - J Weir
- Department of Cellular Pathology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - E Aboagye
- Division of Cancer, Department of Surgery and Cancer, Cancer Research UK Laboratories, Imperial College London, Hammersmith Campus, London, UK
| | - F Mauri
- Department of Histopathology, Centre for Pathology, Imperial College London, Hammersmith Campus, London, UK
| | - C Jameson
- Department of Histopathology, University College Hospital, London, UK
| | - J Sturge
- Division of Cancer, Department of Surgery and Cancer, Cancer Research UK Laboratories, Imperial College London, Hammersmith Campus, London, UK
- School of Biological, Biomedical & Environmental Sciences, The Allam Building, University of Hull, Hull, UK
| | - H Gabra
- Division of Cancer, Department of Surgery and Cancer, Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London, UK
| | - M Bushell
- MRC Toxicology Unit, Hodgkin Building, University of Leicester, Leicester, UK
| | - A E Willis
- MRC Toxicology Unit, Hodgkin Building, University of Leicester, Leicester, UK
| | - E Curry
- Division of Cancer, Department of Surgery and Cancer, Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London, UK
| | - S P Blagden
- Division of Cancer, Department of Surgery and Cancer, Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London, UK
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Kanthabalan A, Shah T, Arya M, Punwani S, Bomanji J, Haroon A, Illing RO, Latifoltojar A, Freeman A, Jameson C, van der Meulen J, Charman S, Emberton M, Ahmed HU. The FORECAST study - Focal recurrent assessment and salvage treatment for radiorecurrent prostate cancer. Contemp Clin Trials 2015; 44:175-186. [PMID: 26184343 DOI: 10.1016/j.cct.2015.07.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 06/29/2015] [Accepted: 07/03/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND One-third of men may experience biochemical failure by 8years following radical radiotherapy for localised prostate cancer. Over 90% of men are started on androgen deprivation therapy (ADT) which is non-curative and confers systemic side-effects. Focal salvage therapy (FST) limits collateral tissue damage and may improve therapeutic ratios. In order to deliver FST, distant disease must be ruled-out and intra-prostatic disease must be accurately detected, localised and characterised. AIM FORECAST - Focal Recurrent Assessment and Salvage Treatment - is a study designed to evaluate a novel imaging-based diagnostic and therapeutic complex intervention pathway for men who fail radiotherapy. METHODS Men with biochemical failure following radical prostate radiotherapy, prior to salvage therapy will be recruited. They will undergo whole-body multi-parametric MRI (WB-MRI), choline PET/CT, bone-scan and pelvic-mpMRI and then MRI transperineal-targeted biopsies (MRI-TB) and Transperineal Template Prostate Mapping Biopsy (TPM). Those suitable for FST will undergo either high intensity focused ultrasound (HIFU) or cryotherapy. RESULTS Primary outcome measures: a) the accuracy of WB-MRI to detect distant metastatic disease; b) accuracy of prostate mpMRI in local detection of radiorecurrent prostate cancer; c) detection accuracy of MRI-TB; and d) rate of urinary incontinence following FST. CONCLUSION Focal salvage therapy may confer lower rates of morbidity whilst retaining disease control. In order to deliver FST, intra- and extra-prostatic disease must be detected early and localised accurately. Novel diagnostic techniques including WB-MRI and MRI-TB may improve the detection of distant and local disease whilst reducing healthcare burdens compared with current imaging and biopsy strategies.
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Affiliation(s)
- A Kanthabalan
- Division of Surgery and Interventional Science, University College London, UK; Department of Urology, UCLH NHS Foundation Trust, UK.
| | - T Shah
- Division of Surgery and Interventional Science, University College London, UK
| | - M Arya
- Department of Urology, UCLH NHS Foundation Trust, UK
| | - S Punwani
- Department of Radiology, UCLH NHS Foundation Trust, UK; Centre for Medical Imaging, Division of Medicine, University College London, UK
| | - J Bomanji
- Institute of Nuclear Medicine, UCLH NHS Foundation Trust, UK
| | - A Haroon
- Centre for Medical Imaging and Computing, University College London, UK
| | - R O Illing
- Department of Radiology, UCLH NHS Foundation Trust, UK
| | - A Latifoltojar
- Department of Urology, UCLH NHS Foundation Trust, UK; Centre for Medical Imaging, Division of Medicine, University College London, UK
| | - A Freeman
- Department of Pathology, UCLH NHS Foundation Trust, UK
| | - C Jameson
- Department of Pathology, UCLH NHS Foundation Trust, UK
| | | | - S Charman
- London School of Hygiene and Tropical Medicine, London, UK
| | - M Emberton
- Division of Surgery and Interventional Science, University College London, UK; Department of Urology, UCLH NHS Foundation Trust, UK
| | - H U Ahmed
- Division of Surgery and Interventional Science, University College London, UK; Department of Urology, UCLH NHS Foundation Trust, UK
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Michel C, Freeman A, Jameson C, Waddington W, Tuch D. 2533 Intra-operative margin detection using Cerenkov luminescence Imaging during radical prostatectomy - initial results from the PRIME study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31352-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Beynon R, Hawkins J, Laing R, Higgins N, Whiting P, Jameson C, Sterne JAC, Vergara P, Hollingworth W. The diagnostic utility and cost-effectiveness of selective nerve root blocks in patients considered for lumbar decompression surgery: a systematic review and economic model. Health Technol Assess 2014; 17:1-88, v-vi. [PMID: 23673151 DOI: 10.3310/hta17190] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diagnostic selective nerve root block (SNRB) involves injection of local anaesthetic, sometimes in conjunction with corticosteroids, around spinal nerves. It is used to identify symptomatic nerve roots in patients with probable radicular pain that is not fully concordant with imaging findings. OBJECTIVES (1) Determine the diagnostic accuracy of SNRB in patients with low back and radiating pain in a lower limb; (2) evaluate whether or not accuracy varies by patient subgroups; (3) review injection-related adverse events; and (4) evaluate the cost-effectiveness of SNRB. DATA SOURCES MEDLINE, EMBASE, Science Citation Index, Bioscience Information Service (BIOSIS), Latin American and Caribbean Health Sciences Literature (LILACS) and grey literature databases were searched from inception to August 2011. Reference lists of included studies were screened. METHODS A systematic review (SR) of studies that assessed the accuracy of SNRB or adverse events in patients with low back pain and symptoms in a lower limb for the diagnosis of lumbar radiculopathy. Study quality was assessed using the quality assessment of diagnostic accuracy studies (QUADAS)-2 checklist. We used random-effects meta-analysis to pool diagnostic accuracy data. Decision tree and Markov models were developed, combining SR results with information on the costs and outcomes of surgical and non-surgical care. Uncertainty was assessed using probabilistic and deterministic sensitivity analyses. RESULTS Five studies assessed diagnostic accuracy: three diagnostic cohort and two within-patient case-control studies. All were judged to be at high risk of bias and had high concerns regarding applicability. In individual studies, sensitivity ranged from 57% [95% confidence interval (CI) 43% to 70%] to 100% (95% CI 76% to 100%) and specificity from 9.5% (95% CI 1% to 30%) to 86% (95% CI 76% to 93%). The most reliable estimate was judged to come from two cohort studies that used post-surgery outcome as the reference standard; summary sensitivity and specificity were 93% (95% CI 86% to 97%) and 26% (95% CI 5% to 68%), respectively. No study provided sufficient detail to judge whether or not accuracy varied by patient subgroup. Seven studies assessed adverse events. There were no major or permanent complications; minor complications were reported in 0-6% of patients. The addition of SNRB to the diagnostic work-up was not cost-effective with an incremental cost per quality-adjusted life-year of £1,576,007. Sensitivity analyses confirmed that SNRB was unlikely to be a cost-effective method for diagnosis and planning surgical therapy. LIMITATIONS We identified very few studies; all were at high risk of bias. The conduct and interpretation of SNRBs varied and there was no gold standard for diagnosis. Limited information about the impact of SNRB on subsequent care and the long-term costs and benefits of surgery increased uncertainty about cost-effectiveness. CONCLUSIONS There were few studies that estimated the diagnostic accuracy of SNRB in patients with radiculopathy and all were limited by the difficulty of making a reference standard diagnosis. Summary estimates suggest that specificity is low, but results are based on a small number of studies at a high risk of bias. Based on current weak evidence, it is unlikely that SNRB is a cost-effective method for identifying the symptomatic nerve root prior to lumbar spine surgery. Future research should focus on randomised controlled trials to evaluate whether or not SNRB improves patient outcomes at acceptable cost. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- R Beynon
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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15
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Shim TN, Hawkins D, Muneer A, Minhas S, Freeman A, Jameson C, Francis N, Dinneen M, Bunker CB. P2.182 Male Genital Dermatoses in HIV. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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Robertson NL, Moore CM, Ambler G, Bott SRJ, Freeman A, Gambarota G, Jameson C, Mitra AV, Whitcher B, Winkler M, Kirkham A, Allen C, Emberton M. MAPPED study design: a 6 month randomised controlled study to evaluate the effect of dutasteride on prostate cancer volume using magnetic resonance imaging. Contemp Clin Trials 2012; 34:80-9. [PMID: 23085153 DOI: 10.1016/j.cct.2012.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 09/20/2012] [Accepted: 10/10/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To evaluate the percentage change in volume of prostate cancer, as assessed by T2-weighted MRI, following exposure to dutasteride (Avodart) 0.5mg daily for six months. PATIENTS AND METHODS MRI in Primary Prostate cancer after Exposure to Dutasteride (MAPPED) is a double-blind, placebo-controlled trial, supported by GlaxoSmithKline (GSK). Men with prostate cancer suitable for active surveillance (low-intermediate risk prostate cancer on biopsy), and a visible lesion on T2-weighted MRI of at least 0.2 cc, were eligible for consideration. Forty-two men were randomised to 6 months of daily dutasteride 0.5mg or placebo. Multi-parametric MRI (mpMRI) scans were performed at baseline, 3 and 6 months. The percentage changes in cancer volume over time will be compared between the dutasteride and placebo groups. Planned analyses will examine the association between tumour volume and characteristics (perfusion and contrast washout) as seen on mpMRI, HistoScan ultrasound and biopsy histopathology in both groups. DISCUSSION MAPPED is the first randomised controlled trial to use mpMRI to look at the effect of dutasteride on the volume of prostate cancer. If dutasteride is shown to reduce the volume of prostate cancer, it might be considered as an adjunct for men on active surveillance. Analysis of the placebo arm will allow us to comment on the short-term natural variability of the MR appearance in men who are not receiving any treatment. CONCLUSION MAPPED will evaluate the short-term effect of dutasteride on prostate cancer volume, as assessed by mpMRI, in men undergoing active surveillance for low or intermediate risk prostate cancer. The study completed recruitment in January 2012.
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Affiliation(s)
- N L Robertson
- Division of Surgical & Interventional Science, University College London, UK.
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17
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Jameson C. Practice management. SADJ 2012; 67:518-522. [PMID: 23951752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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18
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Abstract
We report the late relapse of a patient following 43 years of surveillance of a germ cell tumour, thought to be a pure seminoma, having undergone yolk sac differentiation. The longest previous recorded time to relapse was 32 years (malignant teratoma with adenocarcinoma de-differentiation).(1) This case report demonstrates a late relapse of a testicular germ cell tumour is possible whatever the initial stage. European Association of Urology guidelines state close and active follow-up is mandatory for at least five years' surveillance due to the high and often late rate of relapse. Furthermore, they also suggest continuing follow-up although it is unclear as to how long this should last.(7)
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Roy AA, Jameson C, Christmas TJ, Aslam Sohaib S. Retroperitoneal oncocytoma: case report and review of the imaging features. Br J Radiol 2011; 84:e161-3. [PMID: 21750133 DOI: 10.1259/bjr/63620790] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Oncocytomas are uncommon tumours that occur in a number of specific anatomical locations within the head, neck, chest, abdomen and pelvis. When occurring in the retroperitoneum, oncocytomas almost always arise from either the kidney or adrenal gland. With this case we present the imaging findings of an exceptionally rare retroperitoneal oncocytoma whose site of origin is neither the kidney nor adrenal gland.
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Affiliation(s)
- A A Roy
- Department of Radiology, The Royal Marsden NHS Trust, London, UK.
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20
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Mitra AV, Bancroft EK, Barbachano Y, Page EC, Foster CS, Jameson C, Mitchell G, Lindeman GJ, Stapleton A, Suthers G, Evans DG, Cruger D, Blanco I, Mercer C, Kirk J, Maehle L, Hodgson S, Walker L, Izatt L, Douglas F, Tucker K, Dorkins H, Clowes V, Male A, Donaldson A, Brewer C, Doherty R, Bulman B, Osther PJ, Salinas M, Eccles D, Axcrona K, Jobson I, Newcombe B, Cybulski C, Rubinstein WS, Buys S, Townshend S, Friedman E, Domchek S, Ramon Y Cajal T, Spigelman A, Teo SH, Nicolai N, Aaronson N, Ardern-Jones A, Bangma C, Dearnaley D, Eyfjord J, Falconer A, Grönberg H, Hamdy F, Johannsson O, Khoo V, Kote-Jarai Z, Lilja H, Lubinski J, Melia J, Moynihan C, Peock S, Rennert G, Schröder F, Sibley P, Suri M, Wilson P, Bignon YJ, Strom S, Tischkowitz M, Liljegren A, Ilencikova D, Abele A, Kyriacou K, van Asperen C, Kiemeney L, Easton DF, Eeles RA. Targeted prostate cancer screening in men with mutations in BRCA1 and BRCA2 detects aggressive prostate cancer: preliminary analysis of the results of the IMPACT study. BJU Int 2010; 107:28-39. [PMID: 20840664 DOI: 10.1111/j.1464-410x.2010.09648.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the role of targeted prostate cancer screening in men with BRCA1 or BRCA2 mutations, an international study, IMPACT (Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted screening in BRCA1/2 mutation carriers and controls), was established. This is the first multicentre screening study targeted at men with a known genetic predisposition to prostate cancer. A preliminary analysis of the data is reported. PATIENTS AND METHODS Men aged 40-69 years from families with BRCA1 or BRCA2 mutations were offered annual prostate specific antigen (PSA) testing, and those with PSA > 3 ng/mL, were offered a prostate biopsy. Controls were men age-matched (± 5 years) who were negative for the familial mutation. RESULTS In total, 300 men were recruited (205 mutation carriers; 89 BRCA1, 116 BRCA2 and 95 controls) over 33 months. At the baseline screen (year 1), 7.0% (21/300) underwent a prostate biopsy. Prostate cancer was diagnosed in ten individuals, a prevalence of 3.3%. The positive predictive value of PSA screening in this cohort was 47·6% (10/21). One prostate cancer was diagnosed at year 2. Of the 11 prostate cancers diagnosed, nine were in mutation carriers, two in controls, and eight were clinically significant. CONCLUSIONS The present study shows that the positive predictive value of PSA screening in BRCA mutation carriers is high and that screening detects clinically significant prostate cancer. These results support the rationale for continued screening in such men.
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Affiliation(s)
- Anita V Mitra
- The Institute of Cancer Research, Sutton, Surrey, UK
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21
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Mitra AV, Jameson C, Barbachano Y, Sodha N, Kote-Jarai Z, Javed A, Bancroft E, Fletcher A, Cooper C, Peock S, Easton D, Eeles R, Foster CS. Elevated expression of Ki-67 identifies aggressive prostate cancers but does not distinguish BRCA1 or BRCA2 mutation carriers. Oncol Rep 2010; 23:299-305. [PMID: 20043088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Prostate cancers in men with germline BRCA1 and BRCA2 mutations are more aggressive than morphologically similar cancers in men without these mutations. This study was performed to test the hypothesis that enhanced expression of Ki-67, as a surrogate of cell proliferation, is a characteristic feature of prostate cancers occurring in BRCA1 or BRCA2 mutation carriers. The study cohort comprised 20 cases of prostate cancer in mutation carriers and 126 control sporadic prostate cancers. Of the combined sample cohort, 65.7% stained only within malignant tissues while 0.7% stained in both malignant and benign tissues (p<0.001). Significantly increased expression of Ki-67 occurred in prostate cancers with higher Gleason score (p<0.001). Elevated Ki-67 expression was identified in 71% of prostate cancers in BRCA1 or BRCA2 mutation carriers and in 67% of the sporadic controls (p>0.5). Similar results were obtained when the data were analysed using a threshold set at 3.5 and 7.1%. This study shows that elevated expression of Ki-67 is associated both with aggressive prostate cancers and with high Gleason score irrespective of whether their occurrence is against a background of BRCA1 or BRCA2 mutations or as sporadic disease. The data suggest that, since elevated Ki-67 does not distinguish prostate cancers occurring in BRCA1 or BRCA2 mutation carriers from sporadic prostatic malignancies, the effects of these genetic mutations are probably independent. While all prostate cancers occurring in the presence of BRCA germline mutations are clinically aggressive, their potentially different phenotypes consistently involve maximal rates of cell proliferation.
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Affiliation(s)
- A V Mitra
- Translational Cancer Genetics Team, The Institute of Cancer Research, Surrey, UK
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Abstract
Epithelioid angiomyolipoma is a recently described rare variant of renal angiomyolipoma. It can occur in patients with or without tuberous sclerosis, and may potentially be malignant. We report the imaging findings from two cases of epithelioid angiomyolipoma: the first in a patient with tuberous sclerosis complex, arising in a horse-shoe kidney and growing into the inferior vena cava and right atrium; the second in a 62-year-old hypertensive man.
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Affiliation(s)
- N Bharwani
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London, UK.
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23
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Butler JSB, Milliken DA, Dina R, Eccles SA, Maghami SG, Jameson C, Mason P, Shepherd JH, Soutter WP, Barton DPJ. Isolated groin recurrence in vulval squamous cell cancer (VSCC). The importance of node count. EUR J GYNAECOL ONCOL 2010; 31:510-513. [PMID: 21061790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To determine whether there is a node count which can define an adequate inguinofemoral lymphadenectomy (IFL) in primary VSCC. METHODS A retrospective and prospective review of patients with node negative VSCC who had a full staging IFL. Detection of isolated groin recurrences (IGR) would allow groins with higher risk of groin recurrence to be identified. RESULTS The median node count of 228 IFLs in 139 patients was eight (0-24). There were six IGR (4.3%). Increased rate of IGR was present in patients with increased age, tumour diameter and depth of invasion, lymphovascular space invasion, unilateral IFL, and moderate/poor tumour grade. In the 138 groins with node counts of eight or greater there were no IGRs compared to six in the patients with either undissected groins or groin node counts less than eight (p = 0.030) Interval to IGR was significantly shorter than other sites of recurrence. Both disease-specific and overall survival were significantly reduced in IGR. CONCLUSIONS An inadequate IFL is a nodal count of less than eight per groin; both these groins and undissected groins are at increased risk of IGR and should have close surveillance.
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Affiliation(s)
- J S B Butler
- Royal Marsden Hospital, Department of Gynaecological Oncology, London, UK.
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24
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Attard G, Jameson C, Moreira J, Flohr P, Parker C, Dearnaley D, Cooper CS, de Bono JS. Hormone-sensitive prostate cancer: a case of ETS gene fusion heterogeneity. J Clin Pathol 2008; 62:373-6. [DOI: 10.1136/jcp.2008.061515] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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25
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Mitra A, Fisher C, Foster CS, Jameson C, Barbachanno Y, Bartlett J, Bancroft E, Doherty R, Kote-Jarai Z, Peock S, Easton D, Eeles R. Prostate cancer in male BRCA1 and BRCA2 mutation carriers has a more aggressive phenotype. Br J Cancer 2008; 98:502-7. [PMID: 18182994 PMCID: PMC2361443 DOI: 10.1038/sj.bjc.6604132] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
There is a high and rising prevalence of prostate cancer (PRCA) within the male population of the United Kingdom. Although the relative risk of PRCA is higher in male BRCA2 and BRCA1 mutation carriers, the histological characteristics of this malignancy in these groups have not been clearly defined. We present the histopathological findings in the first UK series of BRCA1 and BRCA2 mutation carriers with PRCA. The archived histopathological tissue sections of 20 BRCA1/2 mutation carriers with PRCA were collected from histopathology laboratories in England, Ireland and Scotland. The cases were matched to a control group by age, stage and serum PSA level of PRCA cases diagnosed in the general population. Following histopathological evaluation and re-grading according to current conventional criteria, Gleason scores of PRCA developed by BRCA1/2 mutation carriers were identified to be significantly higher (Gleason scores 8, 9 or 10, P=0.012) than those in the control group. Since BRCA1/2 mutation carrier status is associated with more aggressive disease, it is a prognostic factor for PRCA outcome. Targeting screening to this population may detect disease at an earlier clinical stage which may therefore be beneficial.
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Affiliation(s)
- A Mitra
- Translational Cancer Genetics Team, Institute of Cancer Research, Surrey, UK
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26
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27
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Jameson C. Towards a unified and interdisciplinary model of ageing – Part 2. Med Hypotheses 2008; 70:193-4. [PMID: 17606329 DOI: 10.1016/j.mehy.2007.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2007] [Accepted: 05/08/2007] [Indexed: 11/24/2022]
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28
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Jameson C. The role of a palliative care inpatient unit in disease management of cancer and HIV patients. S Afr Med J 2007; 97:849-852. [PMID: 17985055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVES To monitor the success of an inpatient palliative care unit combining private and state patients, and accessible to patients with cancer and AIDS. DESIGN An observational study was conducted of patients admitted to the unit in the first 3 months following opening of the ward (1 March - 31 May 2006). METHODS Data were collected on all patients admitted to the ward to establish patient profiles, duration of stay and outcome of palliative care. RESULTS In the first 3 months 51 patients were admitted. Of these patients, 36 (70%) (1 readmission) had AIDS. All the AIDS patients had stage 4 disease and all but 3 were on antiretroviral (ARV) treatment. The death rate in the initial 3 months was 38% in the cancer group and 33% in the AIDS group. By the end of the 5th month the death rate was 37.5% in the cancer group, and 27% in the AIDS group. The remainder of the patients were discharged. The average duration of stay in the ward was 8.3 days. Among those who died, the average stay was 3.8 days for cancer patients and 8.3 days for AIDS patients. Among the patients who were discharged, the average duration of stay was 7 days for cancer patients and 8.5 days for AIDS patients. CONCLUSIONS The profile of terminally ill patients with cancer and AIDS was initially similar in terms of death rate. In the first 3 months 38% of cancer patients and 33% of AIDS patients died. In the following 2 months the death rate was 33% for cancer patients and 19% for AIDS patients. While the numbers of patients are small and only an indication of trend, the AIDS death rate seems to be dropping. This may be because ARV treatment is being introduced earlier, or because the role of palliative care in the treatment of AIDS patients is gaining recognition and introduction of this form of treatment is having a beneficial effect on outcome. In this hospital it is now accepted that AIDS patients developing symptoms on treatment will benefit from admission to a palliative care ward. This intervention may well improve the outcome in stage 4 AIDS. The duration of stay in the ward is longer for AIDS patients, and it appears that AIDS patients who survive will need a longer stay in the palliative care unit than cancer patients if outcome is to improve.
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Affiliation(s)
- C Jameson
- Settlers Hospital, Grahamstown, E Cape, South Africa.
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29
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Abstract
Mucinous epithelial ovarian cancer (mEOC) accounts for approximately 10% of EOCs. Patients presenting with early-stage disease have an excellent prognosis, however, those with advanced disease have a poor outcome with relative resistance to standard ovarian cancer chemotherapy. Molecular and genetic studies demonstrate differences between mucinous and serous EOC supporting the concept that these tumors develop along separate pathways. Together with the observed differences in clinical behavior and outcome for mEOC, there is a need to develop specific therapeutic strategies for this histologic subtype. The relative rarity of advanced mEOC has resulted in few patients enrolled in major ovarian cancer trials. The results of such trials may not necessarily reflect those specific to mEOC. Separate trials testing alternative chemotherapeutics are required. Metastatic mucinous tumors from other sites such as the gastrointestinal tract may present with ovarian involvement. For all mucinous tumors of the ovary, establishing primary as opposed to metastatic cancers is important. Clinical presentation, tumor markers, histologic, and immunohistochemical features are helpful in distinguishing most cases.
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Affiliation(s)
- M L Harrison
- Department of Medicine, Royal Marsden Hospital, London, United Kingdom
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30
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Dungarwalla M, Field-Smith A, Jameson C, Riley U, Chapman A, Bunker CB, Dearden CE, Matutes E. Cutaneous Mycobacterium chelonae infection in chronic lymphocytic leukaemia. Haematologica 2007; 92:e5-6. [PMID: 17405741 DOI: 10.3324/haematol.11021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
MESH Headings
- Agammaglobulinemia/complications
- Aged
- Alemtuzumab
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antibodies, Neoplasm/adverse effects
- Antibodies, Neoplasm/therapeutic use
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Combined Modality Therapy
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- Humans
- Immunocompromised Host
- Immunotherapy/adverse effects
- Leukemia, Lymphocytic, Chronic, B-Cell/complications
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Male
- Mycobacterium Infections, Nontuberculous/complications
- Mycobacterium Infections, Nontuberculous/diagnosis
- Mycobacterium Infections, Nontuberculous/microbiology
- Mycobacterium chelonae/isolation & purification
- Opportunistic Infections/complications
- Opportunistic Infections/diagnosis
- Opportunistic Infections/microbiology
- Skin Diseases, Bacterial/complications
- Skin Diseases, Bacterial/diagnosis
- Skin Diseases, Bacterial/microbiology
- Vidarabine/administration & dosage
- Vidarabine/adverse effects
- Vidarabine/analogs & derivatives
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Affiliation(s)
- M Dungarwalla
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
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31
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Affiliation(s)
- C Jameson
- Jameson Management, Inc, Davis, Oklahoma 73030, USA.
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32
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Jameson C. Scheduling: 3 essentials. Productivity. Profitability. Stress control. J Okla Dent Assoc 2001; 91:32-4, 36-41. [PMID: 11496390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Affiliation(s)
- C Jameson
- University of Oklahoma School of Dentistry, USA
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Irving WL, James DK, Stephenson T, Laing P, Jameson C, Oxford JS, Chakraverty P, Brown DW, Boon AC, Zambon MC. Influenza virus infection in the second and third trimesters of pregnancy: a clinical and seroepidemiological study. BJOG 2000; 107:1282-9. [PMID: 11028582 DOI: 10.1111/j.1471-0528.2000.tb11621.x] [Citation(s) in RCA: 162] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine whether maternal influenza virus infection in the second and third trimesters of pregnancy results in transplacental transmission of infection, maternal auto-antibody production or an increase in complications of pregnancy. DESIGN Case-control cohort study. POPULATION Study and control cohorts were derived from 3,975 women who were consecutively delivered at two Nottingham teaching hospitals between May 1993 and July 1994. A complete set of three sera was available for 1,659 women. METHODS Paired maternal ante- and postnatal sera were screened for a rise in anti-influenza virus antibody titre by single radial haemolysis and haemagglutination inhibition. Routine obstetric data collected during and after pregnancy were retrieved from the Nottingham obstetric database. Cord samples were tested for the presence of IgM anti-influenza antibodies, and postnatal infant sera were tested for the persistence of influenza-virus specific IgG. Paired antenatal and postnatal sera were tested against a standard range of auto-antigens by immunofluorescence. MAIN OUTCOME MEASURES Classification of women as having definite serological evidence of an influenza virus infection in pregnancy (cases) or as controls. RESULTS Intercurrent influenza virus infections were identified in 182/1,659 (11.0%) pregnancies. None of 138 cord sera from maternal influenza cases was positive for influenza A virus specific IgM. IgG anti-influenza antibodies did not persist in any of 12 infant sera taken at age 6-12 months. Six of 172 postnatal maternal sera from cases of influenza were positive for auto-antibodies. In all cases the corresponding antenatal serum was also positive for the same auto-antibody. There were no significant differences in pregnancy outcome measures between cases and controls. Overall, there were significantly more complications of pregnancy in the cases versus the controls, but no single type of complication achieved statistical significance. CONCLUSIONS Influenza infection in the second and third trimesters of pregnancy is a relatively common event. We found no evidence for transplacental transmission of influenza virus or auto-antibody production in pregnancies complicated by influenza infections. There was an increase in the complications of pregnancy in our influenza cohort.
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Affiliation(s)
- W L Irving
- Division of Microbiology, School of Clinical Laboratory Sciences, University of Nottingham, UK
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Abstract
There is evidence to suggest that perception of exertion during exercise is based on both local and central sensations. The aim of the present experiment was to determine the relative contributions of different sensations to overall perceived exertion during cycling. Eighteen trained cyclists pedalled on a cycle ergometer for 4 min at each of three work rates (100, 150 and 200 W) and cadences (50, 70 and 90 rev x min(-1)). At the end of each bout, they used Borg's category-ratio (CR-10) scale to rate their overall perceived exertion, leg muscle pain, knee pain, breathlessness and heart beat intensity. The results indicated that cadence only influenced local sensations (muscle pain and knee pain), which were significantly higher at slower pedalling rates. Neither overall perceived exertion nor central sensations (breathlessness and heart beat intensity) were significantly affected by cadence. In contrast, increases in work rate were associated with higher ratings for all sensations. Further analyses revealed that variations in these overall ratings of perceived exertion as a function of work rate were accounted for by variations in ratings of muscle pain and breathlessness. The general implication is that perceived exertion during cycling derives from a combination of muscle and respiratory sensations.
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Affiliation(s)
- C Jameson
- School of Sport and Exercise Sciences, University of Birmingham, Edgbaston, UK
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Jameson C. Helping people change, Part 2: The magic of motivation. Dent Today 2000; 19:78-81. [PMID: 12523244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
The consensus of the data and the interviewed doctors was that the five most profound motivators of people in the workplace today include the following: achievement of well-done work; personal pride and satisfaction in being a part of quality treatment and excellent care of patients; continuing education; respect, responsibility, and appreciation; and equitable compensation. "Motivation is the most critical factor in the productivity of my practice," said Dr. Stelly. "Motivation is the key. If everyone is on the same page and the doctor and key team members can continue to motivate and encourage others, then the sky is the limit. The key is to keep everyone goal oriented, unified, and excited about the possibilities."
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Grabowska A, Jameson C, Laing P, Jeansson S, Sj Gren-Jansson E, Taylor J, Cunningham A, Irving WL. Identification of type-specific domains within glycoprotein G of herpes simplex virus type 2 (HSV-2) recognized by the majority of patients infected with HSV-2, but not by those infected with HSV-1. J Gen Virol 1999; 80 ( Pt 7):1789-1798. [PMID: 10423148 DOI: 10.1099/0022-1317-80-7-1789] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A combination of phage peptide display library mapping and pepscanning, with both murine monoclonal antibodies and a panel of well-characterized human sera, have been used in order to define type-specific epitopes of glycoprotein G of herpes simplex virus type 2 (HSV-2) (gG2). Both techniques revealed an immunodominant region of gG2, centred around amino acids 525-587 of the uncleaved gG2 molecule. A soluble peptide, equivalent to amino acids 551-570, when used as antigen in an ELISA format was recognized by three out of five murine MAbs and by 20/26 (77%) Western blot anti-HSV-2-positive human sera, but by only 1/63 Western blot anti-HSV-2-negative sera (specificity, 98%). The sensitivity of detection of human anti-HSV-2 antibodies was increased to 90% using a peptide derived from this region, presented on a nitrocellulose membrane. This highly antigenic and type-specific domain of gG2 is located at the junction between the 'unique' region of gG2 and its C-terminal end, which has approximately 50% identity with gG1. A second antigenic region of gG2, amino acids 351-427, which lies within the 'unique' part of gG2, was also identified by both techniques employed in this study and is recognized by a proportion of anti-HSV-2-positive sera. These findings demonstrate the feasibility of developing a peptide-based type-specific assay for the detection of anti-HSV-2 antibody in human sera based on type-specific epitopes of gG2 and have implications for the understanding of the three-dimensional topography of gG2.
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Jameson C. Stress in dentistry: how can you C-O-N-T-R-O-L it? Dent Today 1998; 17:108-11. [PMID: 10752427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Stress cannot be eliminated. The challenge and opportunity lies in the ability to control or manage your response to stress. Those who choose to control their stress by actively and constructively managing it can learn to turn its potentially harmful force into high-powered energy.
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Jameson C. Broken appointments and no shows: reduce these devastating scheduling glitches!!! Dent Pract Manage 1998:23-6. [PMID: 9791200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Jameson C. The dental computer: a powerful marketing tool. Dent Assist 1998; 62:9-12. [PMID: 9790024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- C Jameson
- Jameson Management Group, Davis, Oklahoma, USA
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Affiliation(s)
- D Agranoff
- Department of Medicine, Kingston Hospital, Kingston upon Thames, Surrey, UK
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Jameson C. Enhance scheduling: give the patient a reason to come back. Dent Pract Manage 1998:35-7. [PMID: 9555263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Jameson C. How to make your hygiene department more profitable. Dent Pract Manage 1998:21-3. [PMID: 9555266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Jameson C. Six ways to maximize a healthcare financing program. J Okla Dent Assoc 1998; 85:15-7. [PMID: 9526232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
There are six proven ways to integrate a healthcare financing program into your practice. Challenge yourself to maximize your financial service. You will see more people receive valuable care. You will grow your practice. You will reap financial reward. You will provide more of the quality dentistry that makes the art and science of your profession a joy.
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Jameson C. Retention: 10 ways to prevent patients from falling through the cracks. J Okla Dent Assoc 1998; 85:8-9. [PMID: 9526222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Jameson C. Increase case acceptance with effective communication skills. Dent Pract Manage 1998:11, 13. [PMID: 9525221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Jameson C. Nurture personal referrals--your best source of new patients. Dent Pract Manage 1998:25-7, 29. [PMID: 9525236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In your morning meetings, identify those patients who would be a great person to ask for a referral--patients who have expressed pleasure in receiving treatment from you. Then, determine who is going to ask for that referral. You wouldn't want to have EVERY-ONE ask them for a referral, so give someone that responsibility. Be sure that you have done some role playing and have practiced the verbal skills of "asking" for a referral. Get comfortable asking. Know that you will never know what you will get unless you ASK!!! All good businesses ask for referrals from their best customers. Learn from the masters. Pattern your own behavior after those who have acquired admirable results. When you identify patients who have accepted and have been pleased with your treatment, have come to their appointments on time, have gladly paid their bills, and have been a joy to treat, ASK these folks for a referral. More than likely they will refer others to you who are of like character. You can build a practice "on good patients just like you" and expect that to happen!!! Together, as a team, develop ways of acknowledging and nurturing your referral sources. If these wonderful people provide 70+ percent of your new patients, it benefits you to invest time and money in maximizing this source of practice growth.
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Abstract
A descriptive analysis was conducted of data from survey instruments completed by 25 trained volunteers serving for more than one year as companions to people with mental retardation. Factors such as a strong orientation process, adequate support from staff, appropriate matching with the people with mental retardation, positive characteristics of the people with disabilities, and a high perceived degree of reciprocity were characteristic of these stable relationships. Volunteers and their partners participated in a variety of recreational activities together. Although they encountered various logistical barriers to the relationships, respondents reported that these barriers did not impede the relationships.
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Affiliation(s)
- C Jameson
- Community Access Program, Newton-Wellesley-Weston Committee for Community Living, Inc., Newton, MA 02166, USA.
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Jameson C. Patient education: the profession's greatest commission. Dent Today 1998; 17:128-9, 137. [PMID: 9590969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Jameson C. The message the body delivers. Dent Econ 1998; 88:52-4, 56. [PMID: 9709590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Jameson C. Ten ways to ensure dental practice success, Part 2. Dent Today 1997; 16:112-3. [PMID: 9560742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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