Endometrial expression of LIF during the luteal phase can be used as a predictor of IVF success.

Breast cancer remains a leading cause of morbidity and mortality worldwide yet methods for early detection remain elusive. We describe the discovery and validation of biochemical signatures measured by mass spectrometry, performed upon blood samples from patients and controls that accurately identify (>95%) the presence of clinical breast cancer. Targeted quantitative MS/MS conducted upon 1225 individuals, including patients with breast and other cancers, normal controls as well as individuals with a variety of metabolic disorders provide a biochemical phenotype that accurately identifies the presence of breast cancer and predicts response and survival following the administration of neoadjuvant chemotherapy. The metabolic changes identified are consistent with inborn-like errors of metabolism and define a continuum from normal controls to elevated risk to invasive breast cancer. Similar results were observed in other adenocarcinomas but were not found in squamous cell cancers or hematologic neoplasms. The findings describe a new early detection platform for breast cancer and support a role for pre-existing, inborn-like errors of metabolism in the process of breast carcinogenesis that may also extend to other glandular malignancies.Statement of Significance: Findings provide a powerful tool for early detection and the assessment of prognosis in breast cancer and define a novel concept of breast carcinogenesis that characterizes malignant transformation as the clinical manifestation of underlying metabolic insufficiencies.

Critical Care 2008, 12(Suppl 5):P1 (doi: 10.1186/cc7034)Background The morbidity and mortality from severe sepsis depends largely on how quickly and comprehensively evidencebased therapies are administered. As such, a huge opportunity exists. However, optimal care requires not only factual knowledge, but also numerous practical strategies including the ability to recognize a disease, to identify impending crises, to communicate effectively, to run a team, to work under stress and to simultaneously coordinate multiple tasks. Medical simulation offers a way to practice these essential crisis management skills, and without any risk to patients. Methods Following a didactic lecture on the key components of the Surviving Sepsis Campaign Guidelines, we trained 20 emergency medicine residents on a portable Laerdal Patient Simulator. Pre-programmed sepsis scenarios were developed following a needs assessment and modified Delphi technique. To maximize realism, this was performed in the acute care area of the Emergency Department and included a pre-briefed respiratory therapist and nurse. We videotaped resident performance and provided nonpunitive feedback, focusing on the comprehensiveness of therapy (for example, whether broad-spectrum antibiotics were given) and crisis resource management strategies (for example, whether help was asked for and tasks were appropriately allocated). Results Evaluation using a five-point Likert scale demonstrated that participants found this very useful (4.5/5), that lessons were complementary and supplementary to those learned from lectures (4.5/5) and that medical simulation was realistic (4/5). In addition, despite prior sepsis lectures, comparison of pre-tests and posttests showed that more emergency medicine residents would: administer broad-spectrum antibiotics as soon as possible following hypotension Conclusion Medical simulation appears to be an effective way to change both knowledge and behaviours in the treatment of severe sepsis. Many education and licensing boards also expect trainees to become not only content experts, but also effective communicators, collaborators, resource managers and advocates. These laudable goals are difficult to capture with traditional lectures but are comparably easy using medical simulation. We hope others will consider medical simulation as a complementary teaching and quality-assurance strategy in the fight against sepsis.Background The incidence of sepsis or systemic inflammatory response syndrome in both developing countries as well as in the developed countries is rising despite the extensive research in understanding the molecular basis of sepsis pathogenesis. Sepsis is currently treated with antibiotics along with various adjunctive therapies. However, current existing therapies do not provide much efficacy in terms of patient survival and development of multiorgan dysfunction during sepsis. Methods In the present study, we have developed the murine model of sepsis by placing Klebsiella pneumoniae B5055 entrapped in fibrin-thrombin clot in th...