The rise of metastatic bone disease in Ireland.

To describe the expected rise of metastatic bone disease in Ireland, the relative primary types, and the locations of spread within the skeleton. This was a population-based epidemiological study using cancer registry data. We included patients with known metastatic cancer to bone, within 1 year of the primary diagnosis, during the years 1994 to 2012 inclusive. Our main outcome measures were age-specific, gender-specific and age-standardised incidence rates of bone metastasis, primary types and metastatic location within the skeleton. There were 14,495 recognised cases of bone metastasis in Ireland, 1994-2012 inclusive. Cases consistently rose over the time period, with 108% case increase and 51% age-standardised incidence rise. Annual percentage change increased across both genders and over all age groups. Most of this rise was not due to demographic population change. Breast, prostate and lung accounted for the majority of primary types. GI cancers were the fourth most common primary type. There were proportional increases in breast and lung, with proportional decreases in prostate. The spine was the major metastatic site. Bone metastasis is a significant and rising healthcare concern in Ireland. This rise is disproportionate to demographic changes. Breast, prostate and lung cancers account for the majority. GI cancers are implicated in an unexpectedly high number of cases. Spine is the most common location of bony metastasis, especially at presentation. Prudent healthcare planning is necessitated to prepare for the growing consequences of bone metastasis in cancer patients.

Do "Myths" of low back pain exist among Irish population? A cross-sectional study.

INTRODUCTION: Low back pain remains major public health problem in the Western industrialized world. The known prevalence of low back pain in Ireland is approximately 13 %. It is one of the leading causes of sickness compensation and disability pension in our justification. We hypothesized that there is a widespread misconception about the perception of low back pain among the Irish population. The aim of this study was to investigate whether the "Myths" of low back pain existed among the Irish population. MATERIALS AND METHODS: We carried out a cross-sectional study in the Republic of Ireland from April 2013 to August 2013. The Irish population who visited Galway University Hospital, Galway, Ireland, was contacted randomly at point of entry to the hospital. During the survey, the authors obtained verbal consent before handing the questionnaire, which contained the Deyo's seven myths. The responders were asked to mark their response in a three-point scale (agree, unsure, disagree) to the seven statements. RESULTS: Out of 500 responders, 59 (11.8 %) people answered none of the questions correctly. Fifty-six (11.2 %) answered one question correctly, 106 (21.2 %) answered two questions correctly, 85 (17 %) people disagreed with three myths, 88 (17.6 %) disagreed with four myths, 55 (11 %) people answered five questions correctly, and 34 (6.8 %) answered six questions correctly. Therefore, only 17 (3.4 %) people disagreed with all the seven myths. CONCLUSION: In conclusion, this cross-sectional study showed that myths of low back pain widely exist among Irish population studied . The level of education played an important role. The findings from this study suggest that public health information regarding low back pain is inadequate and has not affected attitudes to low back pain in an Irish population.

Cellular Plasticity in Prostate Cancer Bone Metastasis.

Purpose. Experimental data suggest that tumour cells can reversibly transition between epithelial and mesenchymal states (EMT and MET), a phenomenon known as cellular plasticity. The aim of this review was to appraise the clinical evidence for the role of cellular plasticity in prostate cancer (PC) bone metastasis. Methods. An electronic search was performed using PubMed for studies that have examined the differential expression of epithelial, mesenchymal, and stem cell markers in human PC bone metastasis tissues. Results. The review included nineteen studies. More than 60% of the studies used ≤20 bone metastasis samples, and there were several sources of heterogeneity between studies. Overall, most stem cell markers analysed, except for CXCR4, were positively expressed in bone metastasis tissues, while the expression of EMT and MET markers was heterogeneous between and within samples. Several EMT and stemness markers that are involved in osteomimicry, such as Notch, Met receptor, and Wnt/ß pathway, were highly expressed in bone metastases. Conclusions. Clinical findings support the role of cellular plasticity in PC bone metastasis and suggest that epithelial and mesenchymal states cannot be taken in isolation when targeting PC bone metastasis. The paper also highlights several challenges in the clinical detection of cellular plasticity.