Variation in the management of elderly patients in two neighboring breast units is due to preferences and attitudes of health professionals

Introduction: Elderly breast cancer patients have been shown to be managed less aggressively than younger patients. There is evidence that their management varies between institutions. We audited the management of elderly patients in two neighboring units in Glasgow and aimed to identify reasons for any differences in practice found. Methods: Patients aged ≥70 years, who were managed for a new diagnosis of breast cancer in the two units between 2009 and 2013, were identified from a prospectively maintained database. Tumor pathology, treatment details, postcode and consultant in charge of care were obtained from the same database. Comorbidities were obtained from each patient’s electronic clinical record. Questionnaires were distributed to members of each multidisciplinary teams. Results: 487 elderly patients in Unit 1 and 467 in Unit 2 were identified. 76.2% patients in Unit 1 were managed surgically compared to 63.7% in Unit 2 (p<0.0001). There was no difference between the two units in patient age, tumor pathology, deprivation or comorbidity. 16.2% patients managed surgically in Unit 1 had a comorbidity score of 6 and above compared to 11% of surgically managed patients in Unit 2 (p=0.036). Responses to questionnaires suggested that staff at Unit 1 were more confident of the safety of general anesthetic in elderly patients and were more willing to consider local anesthetic procedures. Conclusion: A higher proportion of patients aged >70 years with breast cancer were managed surgically in Unit 1 compared to Unit 2. Reasons for variation in practice seem to be related to attitudes of medical professionals toward surgery in the elderly, rather than patient or pathological factors

The Grizzly, March 9, 2006

Two Juniors Attend C.O.O.L. Idealist National Conference in Tennessee • Celebration of Student Achievement • SPINT: Overview of House Projects • Understanding Abortion • Imperfect World of Auguste Rodin • Kelly Stirs Up Laughs • Marche aux Puces and Other Shopping Advice • Opinions: Letter to the Editor; Gimme Fiction Drips with Musical Ambition; Line Between Personal Offense and Free Speech • Bears Crush Crusaders • Respect!https://digitalcommons.ursinus.edu/grizzlynews/1709/thumbnail.jp

The Grizzly, February 26, 1988

Art Expo • Patterns Campaign Nears Completion • Is He a Dummy or Isn\u27t He? • Patterns Campaign Nears Completion • Editorial: Boo! Hiss! to Prof. Epistle • Letter: Doughty to Grizzly Editor - Kiss Off; Get a Room; Cookbooks Stew Students • Zimmers Open Hearts • Curious George to the Rescue • Teams Sport Banner Seasons • Lady Bears Net Successful Record • Wrestlers Reaching Peak • The Grizzly Proudly Salutes Our Bear Pack Champions • Bears Making Tracks • Harrison Floating on Cloud Nine • Ensemble Enchanting • Projected Art Center Plans • Air Band Acts Wow Wismer Crowdhttps://digitalcommons.ursinus.edu/grizzlynews/1206/thumbnail.jp

The Grizzly, April 6, 1993

Mr. Ursinus, 1993 • ProTheatre\u27s Actors Deliver in Thornwood • Another Weekend of Fighting in Reimert • Changes in Housing Selection • Wismer Renovations • Waco Standoff Continues • Your Chance to Give • Access to the Vault • Congratulations to P.O.D. for Excelling in Blood Drive • Daffodils for Service • Senior Profile: Allen Clowers • Why Can\u27t I Pick my Classes? • Letters to the Editor • Seniors Return, but Bears Fall • Men\u27s LAX Wants to Be Official • Men\u27s Tennis Young and Improvinghttps://digitalcommons.ursinus.edu/grizzlynews/1314/thumbnail.jp

The Grizzly, December 4, 1981

Dealing With Financial Pressure • EcBA Department Interviews for New Positions • Freshman Relates Pre-Collegiate Experiences in Japan • Union Evaluation Prompts Improvement • Campus-wide Planning Meeting Sets Competitive Goals for UC • Residents Fix Up Curtis Hall • Lucas Named To PaCIE • \u27Messiah\u27 Rehearsal Open to Public • Jarvis and Rutherford in Last Coffeehouse • Best Albums of 1981 • Senior Poet Honored Nationally • New Wrestlers Lead the Way • Girls B-Ball Prime for Opener • Baseball Team Has New Skipper • Men\u27s Swimmers Take Third Place • Hoopsters Off to Slow Start • Gymnasts Pleasing • Women\u27s Swim Team Prepares for Tough Schedule • Mike Fagan All-MAChttps://digitalcommons.ursinus.edu/grizzlynews/1069/thumbnail.jp

Lipid-soluble smoke particles damage endothelial cells and reduce endothelium-dependent dilatation in rat and man

BACKGROUND: Cigarette smoking is a strong risk factor for vascular disease and known to cause dysfunction of the endothelium. However, the molecular mechanisms involved are still not fully understood. METHODS: In order to reveal the direct effects of lipid-soluble smoke particles on the endothelium, ring segments isolated from rat mesenteric arteries and human middle cerebral arteries (MCA) obtained at autopsy were incubated for 6 to 48 hrs in the presence of dimethylsulphoxide (DMSO)-soluble particles from cigarette smoke (DSP), i.e. lipid-soluble smoke particles. The endothelial microstructure was examined by transmission electron microscopy. The endothelial function was evaluated by acetylcholine (ACh)-induced endothelium-dependent vasodilatation, using a sensitive myograph. RESULTS: After DSP treatment, the arterial endothelium was swollen and loosing its attachment. In functional tests, the total ACh-induced dilatation, the nitric oxide (NO)-mediated and the endothelium-derived hyperpolarization factor (EDHF)-mediated dilatations were significantly decreased by DSP in a time- and concentration-dependent manner (p < 0.05). Nicotine, an important compound in cigarette smoke had, in an equivalent concentration as in DSP, no such effects (p > 0.05). Similar results were obtained in the human MCA. CONCLUSION: Thus, we demonstrate that the lipid-soluble smoke particles, but not nicotine, caused damage to arterial endothelium and reduced the endothelium-dependent dilatation in man and rat

The Grizzly, February 10, 1989

Ursinus Seeks Mid-States Reaccreditation • Heck Beats Traffic Blahs • Letter: Doughty Expresses Doubts • U.C. Salutes French Bicentennial • Medieval Fest Needs You • Ginsberg to Give Revolutionary Forum • Casa Maria: Muy Bien • de la Hoya Happy • Ursinus Slays F & M • U.C. Aims for Title • O\u27Malley Leaps to Nationals • Women\u27s Indoor Inspiring • U.C. Fields Strong Squad • A\u27Bears Peaking at Right Time • Scholarships to Scotland • Guess Who\u27s Coming for Dinner? • His Cheating Makes Twice the Test for You • Hallinger Argues for Proposal 42: Academics Before Athlete • Greenstein Grabs Grim \u27Just Right\u27 • Valentine No-No\u27s • From America With Love: Students Flock to U.C.https://digitalcommons.ursinus.edu/grizzlynews/1228/thumbnail.jp

The Grizzly, October 2, 1990

Books Stolen From Students and Professors: Suspect Arrested, 81 Books Confiscated • New Era of Recycling to Change Actions and Minds • Utilities Tunnel Nears Completion • Hardman\u27s Biography of Finney Turns Paperback • Gender Stereotypes by Dr. Englund • Speech Exemption Exam • Stolen Book List • Foreign Spotlight • Ghost Search Continues • AC/DC High Voltage Rock N\u27 Roll • Cop Rock Off-Key • Prince Premier • WVOU Schedule • Medieval Melodies Fill Forum • Homecoming Candidates • Vital Signs of the Trauma Center • Summer Science at Ursinus • Facelift for LSB • Bear Pack Wins Mets • Come Sailing! • Bears Lose 12-7 • Flag Football Kicks Off • Wagner Takes First in Mets Meet • US Must Aid Soviet Economic Woes • Temple Strike: Avoiding The Real Issue • Letters: Doughty Appreciates Grizzly; Wall Destruction Coincidental? • Soccer Working Hard • Hockey Splitshttps://digitalcommons.ursinus.edu/grizzlynews/1259/thumbnail.jp

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Mineral deficiency and the presence of Pinus sylvestris on mires during the mid- to late Holocene: Palaeoecological data from Cadogan's Bog, Mizen Peninsula, Co. Cork, southwest Ireland

Pollen records across parts of Ireland, England and northern Scotland show a dramatic collapse in Pinus pollen percentages at approximately 4000 radiocarbon years BP. This phenomenon has attracted much palaeoecological interest and several hypotheses have been put forward to account for this often synchronous and rapid reduction in pine from mid-Holocene woodland. Explanations for the 'pine decline' include prehistoric human activity, climatic change, in particular a substantial increase in precipitation resulting in increased mire wetness, and airborne pollution associated with the deposition of tephra. Hitherto, one largely untested hypothesis is that mineral deficiency could adversely affect pine growth and regeneration on mire surfaces. The discovery of pine-tree remains (wood pieces, stumps and trunks) within a peat located at Cadogan's Bog on the Mizen Peninsula, southwest Ireland, provided an opportunity to investigate the history of Pinus sylvestris and also to assess the importance of mineral nutrition in maintaining pine growth on mires. Pollen, plant macrofossils, microscopic charcoal and geochemical data are presented from a radiocarbon dated monolith extracted from this peat together with tree ring-width data and radiocarbon dated age estimates from subfossil wood. Analyses of these data suggest that peat accumulation commenced at the site around 6000 years BP when pine was the dominant local tree. Thereafter Pinus pollen percentages diminish in two stages, with the second decline taking place around 4160 ± 50 years BP. Concomitant with this decline in Pinus pollen, there is a noticeable, short-lived increase in wet-loving mire taxa and a decrease in the concentration of phosphorus, potassium, magnesium, calcium, sodium, iron and zinc. These results suggest that increased mire surface wetness, possibly the result of a change in climate, created conditions unsuitable for pine growth c. 4000 years BP. Mire surface wetness, coupled with a period of associated nutrient deficiency, appears to be a possible explanation for a lack of subsequent pine-seedling establishment for most of the later Holocene