RESUMO
Qualitative research is reported which explores the perceptions of members of the U.K.'s independent Phase I ethics committees (IECs) about key issues identified following a literature review. Audio-recorded interviews were conducted with ten expert and ten lay members from all IECs except the one to which the lead author was attached. Transcripts were thematically analyzed following a broadly hermeneutical approach. The findings-dealing with such matters as recruitment strategies and length of service; attitudes towards member categories, published ethics guidelines, and the adequacy of insurance; levels of training and views on achieving a recognised level of competence-have an intrinsic interest, but it is when the findings are considered collectively using Freidson's theory of professional dominance that they reveal the influence the medical profession can have in shaping ethics review.
Assuntos
Comitês de Ética em Pesquisa , Medicina , Atitude , Inglaterra , Comitês de Ética em Pesquisa/organização & administração , Comitês de Ética em Pesquisa/normas , HumanosAssuntos
Acesso à Informação/ética , Pesquisa Biomédica/ética , Consentimento Livre e Esclarecido/ética , Sistemas Computadorizados de Registros Médicos , Medicina Estatal , Acesso à Informação/legislação & jurisprudência , Pesquisa Biomédica/legislação & jurisprudência , Confidencialidade , Feminino , Humanos , Masculino , Sistemas Computadorizados de Registros Médicos/ética , Defesa do Paciente , Opinião Pública , Medicina Estatal/ética , Reino UnidoAssuntos
Índice de Massa Corporal , Medicina Geral/ética , Ética Médica , Humanos , Obesidade/diagnósticoRESUMO
Between May 1998 and December 2002, neoadjuvant chemotherapy was given to 81 women aiming to reduce tumour size and avoid mastectomy. A coil was inserted under ultrasound guidance into the tumour before treatment started. The impact of coil placement on subsequent surgery was assessed prospectively. Clinical response was seen in 69 patients and breast conservation was achieved in 60 cases. In 19 cases (23%) mammography and ultrasound were normal and localization was achieved exclusively by use of the coil. Eight of these 19 (10% of the total) had a complete pathological response; however in the remaining 11 cases (13%) there was residual invasive cancer. This study suggests that in patients undergoing neoadjuvant chemotherapy surgery is still appropriate even when clinical response appears complete. The use of the coil identifies 13% of patients with otherwise undetectable residual disease and is a valuable guide in identifying the site for further surgery.
Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/tratamento farmacológico , Meios de Contraste/administração & dosagem , Mamografia/instrumentação , Mastectomia Segmentar , Neoplasia Residual/diagnóstico por imagem , Adulto , Idoso , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estudos Prospectivos , Ultrassonografia de IntervençãoRESUMO
We have produced antibodies to the NRG2-alpha, NRG2-beta, NRG3 and NRG4 proteins and used these, and previously described antibodies to NRG1-alpha and NRG1-beta, to detect expression of each ligand by immunocytochemical staining in a series of 45 breast cancers. Each protein was expressed in a proportion of cases. Statistical analysis suggested that expression of one factor was associated with a high probability that other members of the family were co-expressed. NRG2-alpha expression was associated with node positivity (p-value = 0.005). The mRNAs for NRG1, 2, 3 and 4 were found in established breast cancer cell lines and NRG1, 2 and 3 mRNAs were detected in primary breast cancers. Expression of NRG4 mRNA was shown by in situ hybridization in sections from primary breast cancers. This data demonstrates that each member of the NRG family of ligands is expressed in breast cancer and suggests that they may be involved in regulating cell behaviour.