Parathyroid hormone related protein and hypercalcaemia in breast cancer.

Abstract

The ethical issues surrounding orders not to resuscitate are complex and increasingly a matter for legislative acts and judicial decisions."I 13 Furthermore, decisions on resuscitation have implications for resource management. Despite these issues "Do not resuscitate" orders in many British hospitals are used without guidelines and without assessment of their effectiveness in preventing futile cardiopulmonary resuscitation.This survey indicates that in the absence of local guidelines about decisions on resuscitation many crash calls may be inappropriate. We advocate more discussion of patients' suitability for resuscitation between doctors, nurses, patients, and patients' relatives. We suggest that the most senior available doctor of the admitting team should be responsible for making initial resuscitation decisions, writing these in the medical notes, and communicating them to the ward nurses. Such decisions should follow locally agreed criteria based on knowledge of pre-arrest characteristics in relation to outcome. Patients' suitability for resuscitation should be reviewed on every consultant ward round, taking into account the views of all the staff caring for the patient and, when appropriate, the views of the patient or the patient's relatives, or both.We thank the nurses and junior doctors at Fazakerley Hospital for filling in the questionnaires, and Dr F J Nye for his comments on the manuscript.

Parathyroid hormone related protein

“…The results were similar with 52 and 60% of the tumours being positive (Southby et al, 1990;Bundred et al, 1991).…”

“…The availability of antibodies has also allowed the cellular distribution of PTHrP to be studied using immunocytochemistry. The combination of the two techniques has recently permitted interesting new insights into metastatic breast cancer (Bundred et al, 1991).…”

Transforming Growth Factor-β Stimulates Parathyroid Hormone-related Protein and Osteolytic Metastases via Smad and Mitogen-activated Protein Kinase Signaling Pathways

“…Concentrations for p38 inhibitors SB203580 and SB202190 (1,5,10,20, and 40 M) and for MEK inhibitor PD98059 (2,10,20,40, and 80 M) were tested. The concentrations of 10 and 20 M were selected for p38 inhibitors and MEK inhibitor, respectively, based on the capacity to inhibit PTHrP production without affecting cell viability.…”

“…Tumor-produced PTHrP stimulates osteoclastic bone resorption to result in the bone destruction associated with breast cancer metastases (1,2). Neutralizing antibodies to PTHrP not only decreased osteoclastic bone resorption but also inhibited the development of metastases to bone by the human breast cancer cell line, MDA-MB-231 (3).…”

Parathyroid hormone (PTH)/PTH-related protein (PTHrP) receptor expression and mitogenic responses in human breast cancer cell lines

“…The peptide has been isolated from a mammary tumour (Burtis et al, 1987;Stewart et al, 1987) and identified in cultures of breast cancer cells (Walsh et al, 1992;Francini et al, 1993 (Southby et al, 1990). In addition, immunocytochemistry (Bundred et al, 1991;Powell et al, 1991) and in situ hybridisation (Vargas et al, 1992) have revealed that a significant number of skeletal metastases arising from breast carcinoma express PTHrP. We have demonstrated that the human breast cancer cell line Hs578T produces PTHrP, while MCF-7 cells do not (Walsh et al, 1992).…”