17 However, recent findings of associations between specific HLA haplotypes and DILI,18, 19 and 20 which does not have hypersensitivity

features, have highlighted the DLST’s potential value.21 In fact, a recent diagnostic scale, the Digestive Disease Week-Japan, already includes DLST.17 Nevertheless, low sensitivity (around 50%), lack of causality between a positive result and liver injury, lack of standardization and restricted availability outside Japan limit its use.21 and 22 And so, some authors advocate that it should be considered in selected cases, such as those in which a single causative agent cannot be determined.22 We considered that DSLT was not mandatory in our patient since fosfomycin was the only drug used. In a prospective study, drug-induced liver injury was caused by a single prescription medication in 73% of the cases

and antibiotics were the single largest class Nivolumab of hepatotoxic agents.15 In summary, we report a potential case of acute hepatocellular lesion caused by fosfomycin. Being a commonly used antibiotic, physicians should be aware of this rare but potentially serious adverse drug reaction. The authors declare that there is any financial support for this manuscript. The authors have no conflicts of interest to declare. “
“The anal canal tumors are unusual lesions whose frequence is about 1.5% of the gastrointestinal tract neoplasias.1 The predominant check details histological type is the squamous cells cancer (SCC) (47%), followed by cloacogenic carcinoma and less commonly melanoma

or mucinous adenocarcinoma.2 In relation to the neuroendocrine tumor (NET) occurrence on this Inositol monophosphatase 1 location, its undeniable rarity justifies this case report. A 49-year-old woman presented with anal bleeding, small-caliber stool with purulent discharge and severe proctalgia in the last three months. She had no abominal pain, no bowel habit changes, no fever, no loss weight and no inguinal lymphadenopathy. Investigation was conducted by the Colorectal Service of Hospital de Base, São José do Rio Preto, and started in August 2007. Two perianal condylomas and a hard anal mass were detected in the rectal exam and the pathological evaluation revealed condylomatosis and a poorly differentiated, ulcerated and invasive SCC. The patient was treated with Nigro. An incisional biopsy of the residual lesion was performed that resulted in no sign of malignancy. One year later, colonoscopy was normal and there were no metastasis in the imaging follow-up. After 7 months, the patient returned with 5 cm bilateral mammary and axillary protuberances (Fig. 1), right inguinal lymphadenopathy (Fig. 2) and ipsilateral thigh abscess (Fig. 3). In face of the possibility of canal anal tumor recurrence, it was sought colonoscopy and biopsy with immunohistochemical markers search in the potentially metastatic lesions. Neoplastic cells were immunoreactive for cytokeratin (CK) 35 (Fig. 6), cromogranin A (CgA) (Fig.

34 Among other factors, successful check details PDT depends on the pre-irradiation time (PIT),35 which is the time required by the PS to remain in contact with the

target cells before irradiation. This period will enable the PS to bind to the cytoplasmic membrane and/or penetrate into the cells.33 and 34 The following exposure to light will allow the PSs to exert their function in promoting cell death. Many researchers have focused their attention on effective PSs for the photoinactivation of microorganisms.26, 27, 29, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44 and 45 Curcumin (Cur) is a yellow-orange dye extracted from the rhizomes of the plant Curcuma longa. 46 It is commonly used as a spice in traditional Asian cookery, and has been shown to exhibit a variety of pharmacological properties such as antitumor, anticancer, anti-inflammatory, antioxidants, and antimicrobial activities, 18, 46 and 47 some of which can be enhanced by light application. 44 and 48 Cur has been used as a PS in antimicrobial PDT, mainly on photoinactivation of Candida species, with positive results. 41 However, some studies have stated that in contrast to that which occurs with several PSs, Cur does not bind to cells, or binds to them weakly, leaving about 90% in an extracellular bulk phase. 37 The removal

of the non-associated Cur promotes a substantial reduction in its phototoxic effects. 36 and 41 The aim of this study was to evaluate Selleck AG-14699 the effects of PIT on curcumin-mediated PDT in the Sulfite dehydrogenase inactivation of planktonic and biofilm cultures of three Candida species: C. albicans, C. glabrata, and C. dubliniensis. Two Candida strains obtained from American Type Culture Collection (ATCC) and one from the Centraal bureau voon Schimmelcultures (CBS) were evaluated in this study: C. albicans (ATCC 90028), C. glabrata (ATCC 2001), and C. dubliniensis (CBS 7987). All three Candida strains were maintained in a freezer

at −70 °C until the assay. Curcumin (Sigma–Aldrich, Saint Louis, Missouri, USA) was prepared with 10% of Dimethyl Sulfoxide (DMSO) to originate a stock solution, from which other solutions were prepared at final concentrations of 5.0, 10.0, 20.0, 30.0 and 40.0 μM. A light emitting diode (LED) was used to activate the PS. The LED device emitted 22.0 mW/cm2 of light intensity and 455 nm of predominant wavelength, and was designed at São Carlos Physics Institute, University of São Paulo, Brazil. Aliquots of 25 μL of each microorganism were spread in Petri dishes containing Sabouraud Dextrose Agar with chloramphenicol (SDA) and were incubated for 48 h at 37 °C. After this, a loopful of each cultivated yeasts was individually subcultured in 5 mL of Tryptic Soy Broth (TSB) and grown aerobically overnight at 37 °C. Each culture tube was centrifuged at 4000 rpm for 7 min and the supernatants were discarded.

, 2009 for details). During laser positioning

white noise was played to disguise any potential auditory cues from the servo-motors controlling the laser beam. An audio cue was then played instructing the participant to judge either the intensity or location of the subsequent stimulus, which consisted in a laser pulse of either high or medium intensity. A single TMS pulse was delivered 120 msec after the laser stimulus. This latency was chosen on the basis of the results of previous EEG studies to coincide with the selleck compound onset of the N1 sensory component of the LEP, which is largely generated in the S1 (Valentini et al., 2012). Each trial lasted a minimum of 5 sec to limit any TMS carry over effects and to ensure that the laser did not stimulate each location more than once a minute (see above). A break of at least 1 min was given at the end of each block in order to change the laser stimulation sequence, reposition Bax apoptosis the TMS coil

and measure the participants’ skin temperature. Participants’ baseline skin temperature was kept at approximately 30 °C [mean ± standard deviation (SD), 30.2 ± .2]. The experimental session consisted of six blocks (one block per each TMS stimulation site repeated twice) of 48 trials, resulting in 288 trials in total. The order of TMS conditions was counterbalanced across participants, and reversed using an ABCCBA design to minimize time-dependent effects. One participant spontaneously

observed that she had not understood the definitions of the ‘proximal’ and ‘distal’ response categories used in the location judgement task, and was replaced. One further participant showed an outlying pattern of very low accuracy (3.2 SDs below the group mean in the vertex control condition, and significantly below chance) on the final block of the experiment (intensity judgement, vertex control). This participant was excluded, but not replaced, leaving a sample of 17 participants. Preliminary analyses showed that location Aspartate and intensity judgement tasks had been successfully matched for difficulty (localisation mean % accuracy = 70.3%, SD = 8.5; intensity judgement mean % accuracy = 72.3%, SD = 6.2). Next, we investigated whether areas S1 and S2 contributed to pain perception by simultaneously analysing the accuracy of intensity and location judgements, using one-way multivariate analyses of variance (MANOVA) with a single factor of TMS condition having three levels (S1, S2, and vertex). The MANOVA revealed a multivariate effect of TMS on pain perception which achieved the boundary of statistical significance [Wilks' Lambda = .742, approximated by F(4, 62) = 2.50, p = .05, Δη2 = .139].

, 2010). In another study after click here 22 weeks of inhalation exposure to the MS of a non-filter reference cigarette at 250 mg TPM/m3, 44 and 33% neutrophils were found for male and female A/J mice, respectively (March et al., 2006). Applying nonlinear regression to the results of the three studies conducted in three different

laboratories, a reasonable inter-laboratory reproducibility for this major inflammatory endpoint with an R2 of 0.90 was obtained. There are some limitations inherent to this A/J mouse model for MS-induced pulmonary tumorigenesis. The most striking difference between this murine model and the human situation is the lack of any reduction of the lung cancer risk in the model upon cessation of MS inhalation, while the relative risk for developing lung cancer in former smokers decreases with the duration since smoking cessation (US Department of Health and Human Services, 1990). Another limitation is the apparent balance of pro-tumorigenic activities with the delaying or inhibiting activities of concomitant MS exposure,

which requires the inclusion of post-inhalation periods at least after shorter-term chronic MS inhalation periods (Stinn et al., 2012). While this is not so much a limitation in long-term comparative inhalation studies, e.g., for a comparison of various types of cigarettes, a situation of smoking cessation or switching to a potential modified risk tobacco product after having smoked conventional cigarettes cannot be modeled by this animal model, and misleading results would be obtained upon such application. Furthermore, there find more is no real relationship between the MS inhalation duration (or accumulated dose) and an increase in lung tumor multiplicity over the sham-exposed control using this A/J mouse model, while smoking duration has been identified as an important parameter Branched chain aminotransferase determining the risk for developing lung cancer

in humans (Flanders et al., 2003 and Hazelton et al., 2005), although with the least impact on adenocarcinoma among the major smoking-associated histologic types of cancer (Kenfield et al., 2008). Lung cancer in humans shows a high malignancy and is often associated with metastasis leading to a fatal outcome. In the current A/J model, MS-induced lung cancers are not the cause of death during the study, which may be due to the lower malignancy compared to the human situation and due to the fact that no metastasis is induced by MS inhalation. In conclusion, data have been accumulated suggesting that the A/J mouse model for long-term MS inhalation-induced pulmonary tumorigenesis is reliable and relevant, two basic requirements towards validation of such models. Reliability was shown for intra- and inter-laboratory reproducibility, the robustness using historic data on spontaneous and ETSS-induced tumorigenesis, and the power to discriminate MS from different cigarette types within limits.

The point bending data are summarized in Table 1. In all the mice analysed (both wild type and oim, vibrated and sham), bone calcein double labels were clearly defined in both periosteum and endosteum of the tibia mid-diaphyseal cross-sections. Bone apposition parameters (MS/BS, MAR, BFR) were not significantly different selleck chemicals llc in the endosteum and periosteum between the vibrated and sham mice when both genotype groups were considered together (p > 0.05 for all parameter). When the genotypes were considered separately, only the MS/BS of the endosteum in the wild type group was significantly increased (p = 0.036)

in the wild type group while all other parameters were not significantly different. In the oim group, CAL-101 purchase only a non-significant trend toward higher MAR and BFR values was observed in both endosteum and periosteum. Cortical bone histomorphometry data are summarized in Table 2. In the wild type mice group, morphology of the trabecular bone was well developed with numerous trabeculae and clearly visible calcein double labels. In the oim mice, the trabeculae were scarcely present with unclear calcein labels and very few or no visible double labels. No

significant differences were found between vibrated and sham mice in the wild type group. In the oim group, no statistically significant difference was observed between the vibrated and sham mice. Tibia trabecular bone histomorphometry data are summarized in the Table 2. In the present study, whole body vibration (WBV) treatment improved the trabecular and the cortical bone morphology during the growth in very young oim mouse hind limbs. In the femur, this improvement of the cortical bone morphology correlates with a trend toward an

increase of the mechanical properties observed during the three point bending. However the heterogeneity of the oim phenotype resulted in large standard deviations as previously reported [52] and the increase in mechanical integrity was not sufficient to reach statistical significance. In the vibrated wild type mice, the osteogenic effect of WBV on the cortical bone Bay 11-7085 morphology was apparent when the full lengths of the femur and tibia diaphysis were considered. This “global” improvement was sufficient to obtain a significant positive impact on the femur rigidity and yield limit during the three point bending test. The improvement of both cortical and trabecular bone compartment in the oim mice tibial metaphysis when subjected to WBV is in accordance with the findings of Xie et al. in slightly older but still growing BALB mice [39] and suggests that growing bone may be particularly sensitive to WBV. In addition, we also observed a positive response in the cortical bone of both femur and tibia, indicating that the WBV could be beneficial for both hind limb long bones in oim mice. Interestingly, Xie et al.

As a consequence a person’s phenotype is considered dynamic and resilience becomes a key parameter. Resilience is best evaluated during a system response, so challenge-tests will become more common in metabolomics research

[9•]. A classic example is the oral glucose tolerance test, but also high fat challenges, exercise, stress or mixed diets are used. Phenotype dynamics will differ between individuals, and concepts as homeostasis and allostasis can be considered (Figure 1). However, a precise (dynamic) description of the clinical phenotype Target Selective Inhibitor Library cell line is currently missing, which is of utmost importance to guide the discovery of diagnostic and mechanistic biochemical biomarkers. Another challenge is that mostly body fluids such as blood and urine are available, but most studied biochemical networks

are at the cellular level and not at the systems regulatory level. Therefore, we need to address cross-compartment communication and system organization more than only the pathways within cells. We expect that with the proper phenotyping/genotyping, metabolomics will play an important role in systems diagnosis, with an emphasis on following the changes over time of an individual [15], and on PLX-4720 chemical structure a somewhat longer term on integrated interventions and Immune system personalized wellness (Figure 2). The analytical strategy needed to be developed for achieving this is discussed below. In metabolomics the general tendency is to analyze as many low-molecular weight compounds (less than 2000 Da) as possible in a given biological sample at a certain point in time with the aim to obtain maximal biochemical information. The most recent version of the Human Metabolome Database contains 40 335 metabolite entries, of which a major part consists of lipids [16]. This number does

not only include endogenous metabolites but also exogenous compounds originating from nutrients, microbiota, drugs and other sources. However, it is our opinion that this number is still an underestimation of the actual size of the human metabolome. Despite the fact that advanced analytical techniques like nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry (MS) hyphenated to gas chromatography (GC), liquid chromatography (LC) and/or capillary electrophoresis (CE) have become well-established tools for metabolomics studies [17, 18••, 19, 20 and 21], they still can only capture a part of the human metabolome and, therefore, provide inherently biased results. We expect that new developments or further refinements of analytical technologies, especially with regards to sensitivity, will significantly increase the coverage of metabolites.

Our study was performed at 13 sites (Figure 1) in the Lithuanian part of the Curonian Lagoon during a two-day cruise at the end of July 2005. Samples were collected from the surface water

(0.5 m depth) with a Ruttner collector and treated according to standard requirements. Physicochemical parameters, chlorophyll a concentration (representing phytoplankton biomass) and bacteria abundance were determined at each station. Salinity was measured in situ with this website a WTW MulstiLine F/Set 3 portable universal meter; chlorophyll a was extracted with 90% acetone and analysed spectrophotometrically ( Jeffrey & Humphrey 1975). The material for virioplankton morphological studies (1000 ml) was collected in PE bottles rinsed with water from the study sites and kept cold (+4°C) until further processing. In the laboratory the samples were passed through a 0.45 μm pore size membrane filter to remove larger particles. Viruses were concentrated 200 times by filtration onto Pragopor 11 nitrocellulose filters under Cobimetinib order vacuum

and stored at + 4°C until analysis. The particles from the filter surface were resuspended by ablution with a new dose (5 ml) of 1% glutaraldehyde aqueous solution. Three microlitres of the concentrated phage stock preparation were placed onto a Formvar-carbon-coated 400-mesh palladium grid and allowed to adsorb on the grid until complete evaporation. The grid was then immediately stained with 1 drop of a 2% (wt/vol) aqueous uranyl acetate solution for 30 s and blotted with filter paper. At least 10 fields and 200 phage-like particles were examined under

a JEOL JEM-100S transmission electron microscope at an accelerating voltage of 60 kV and 10–25 000x instrumental magnification. Different types of particles were recognized on the basis of size, head morphology and tail characteristics (if present) from all the randomly taken micrographs. Estimates of particle PTK6 abundance were based on a count of the virus-like particles on the calculable area of the screen. This calculation was performed assuming that 0.425 μl of the concentrated solution was applied onto 1 mm 2 of the grid area. The virus-like particles were counted on the area of the whole EM screen (45.36 cm 2). The original volume of the corresponding liquid was calculated by multiplying the picture area and the magnification. Samples (50 ml) for bacteria abundance were collected in PE bottles and immediately fixed with 0.2-μ-pore-size pre-filtered 37% formaldehyde (to a final concentration of 1%) and stored at –20°C until processing. Direct counts of bacteria were obtained using epifluorescence microscopy (OLYMPUS IX70 with a long-pass (LP) green-emission filter at 488 nm wavelengths to take close-ups at 1000×magnifications) by the examination of at least 10 randomly selected fields per slide, as described in Noble & Fuhrman (1998).

“
“Event Date and Venue Details from 2012 1st INTERNATIONAL WORKSHOP ON BAC-TERIAL DISEASES OF STONE FRUITS AND

NUTS 14–17 FebruaryZurich, SWITZERLAND B. Duffy, Agroscope FAW, Schloss, Postfach 185, 8820 Waedenswil, SWITZERLANDE-mail: [email protected]. 25th GERMAN CONFERENCE ON WEED BIOLOGY AND CONTROL 13–15 MarchBraunschweig, GERMANY Info: www.unkrauttagung.de 7th INTERNATIONAL IPM SYMPOSIUM 2012 – March USA, in planning phase E. WolffE-mail: [email protected] 4th EUROPEAN WORKSHOP ON THE STANDARDIZED PROCEDURE FOR THE INSPECTION OF SPRAYERS Alectinib in vivo IN EUROPE 27–29 March Lana, ITALY Info: http://tinyurl.com/6wolvs2 *8th CONGRESO ARGENTINO DE ENTOMOLOGIA 17–20 AprilBariloche, ARGENTINA

Info: http://tinyurl.con/659gqpz 64th INTERNATIONAL SYMPOSIUM ON CROP PROTECTION 22 May Ghent, BELGIUM Info: B. Vandekerkhove, Fac. of Biosci., Ghent Univ., Coupure Links 653, BE-9000 Gent, BELGIUM Fax: 32-09-264-6223 Voice: 32-09-264-6145 E-mail: [email protected] Web: www.iscp.ugent.be. INTERNATIONAL FUSARIUM LAB WORKSHOP 03–08 June Bari, ITALY Info: www.mycotox-society.org/fusarium-2012 VI INTERNATIONAL WEED SCIENCE CONGRESS 17–22 JuneDynamic Weeds, Diverse Solutions, Hangzhou CHINA H.J. Huang, IPP, CAAS, No. 2 West Yuanmingyuan Rd., Beijing 100193, CHINA Fax/voice: 86-10-628-15937 E-mail: [email protected] Web: www.iwss.info/coming_events.asp 2nd MEETING OF THE TEPHRID WORKERS OF EUROPE AFRICA AND THE MIDDLE EAST 02–06 July Kolymbari Crete, GREECE Info: [email protected] 2nd INTERNATIONAL SYMPOSIUM–TEPHRITID WORKERS OF EUROPE, AFRICA, AND THE MIDDLE PTC124 ic50 EAST 03–06 July Kolymbari, Crete,

GREECE N. Papadopoulos E-mail: [email protected]: www.diptera.info/news.php *8th MEETING OF TEPHRID WORKERS OF THE WESTERN HEMISPHERE 30 July–03 AugustPanama City, PANAMA Info: www.8twwh.org *JOINT MEETING ENTOMOLOGICAL SOCIETIES OF CANADA and ALBERTA 04–07 NovemberEdmonton, ALB, CANADA Info: www.esc-sec.ca/annmeet.html 2013 INTERNATIONAL HERBICIDE RESISTANCE CONFERENCE 18–22 February Perth, AUSTRALIA S. Powles, AHRI, School of Plant Biol., Univ. of Western Australia, 35 Stirling Hwy., Crawley, Perth 6009, WA, AUSTRALIA check details Fax: 61-8-6488-7834 Voice: 61-8-6488-7870 E-mail: [email protected] AMERICAN PHYTOPATHOLOGICAL SOCIETY ANNUAL MEETING 10–14 August Providence, RI, USA Info: APS, 3340 Pilot Knob Rd., St. Paul, MN 55121, USAFax: 1-651-454-0755 Voice: 1-651-454-3848 E-mail: [email protected] Web: www.apsnet.org Full-size table Table options View in workspace Download as CSV “
“Inflammatory bowel disease (IBD) refers essentially to 2 different but closely related chronic intestinal disorders: Crohn disease and ulcerative colitis. Although much progress has been made in understanding the pathogenesis of human IBD, its etiology has not yet been defined.

A higher salinity (18.5 PSU) indicates

more intense mixing with the lower layer of Mediterranean water. On the other hand, a lower salinity (17.5 PSU) indicates mixing with coastal waters originating from the north-west Black Sea. In June and Roxadustat cost July, when CIW is advected to the region, the minimum temperature of (CIW)8 slowly decreases and the salinity at the minimum temperature depth increases. A thicker (CIW)8 with the minimum temperature is observed in the region during those months when there are no anticyclonic eddies. (CIW)8 was studied at two stations – B7 and B2 – in the Strait of Istanbul in 1999 (Figure 1), station B7 being chosen because of its location in the middle of the strait close to the channel contraction, and station B2 in the southern exit of the strait. The temperature, salinity profiles and T-S diagrams (Figure 4) at station B7 indicate that the depth of the interface varies in the range of 30–45 m. The upper layer temperature is between 6.2 and 25.1 ° C and its salinity changes between 15 and 23 PSU. The lower layer temperature is 14.2–15.8 °C and the salinity 36.5–37.8 PSU. The Mediterranean water layer is more saline and thicker at station B7 than at station K0. The salinity of the upper layer is also slightly higher than at station K0. For example, the salinity of the upper layer increases from 14.6 PSU at station K0 to 15.4 PSU at station B7 in July 1999 when Danube-influenced

water is observed in the Black Sea Alpelisib Pregnenolone exit of the strait. The upper layer salinity is almost 23 PSU in November and December 1999 due to an Orkoz event. During this event, strong south-westerly winds oppose the surface flow in the strait and cause the upper layer of the Sea of Marmara to fill the strait (Latif et al. 1991). Cold water is observed at station B7 only in June, July and August 1999, but this is not the original (CIW)8, as the minimum temperature of this cold water is ∼ 11 °C in June 1999. The reason for the increase in temperature of the cold water is mixing with the warm surrounding

waters along the strait. As can be seen from the T-S diagrams (Figure 4), the upper and lower layers at station B7 mix with each other because of entrainment along the strait (Oğuz et al. 1990). As a result of this mixing, the salinity and temperature of the cold water also increase, and it becomes located partly within the halocline. The temperature, salinity profiles and T-S diagrams at station B2 in 1999 indicate that the interface is observed between 20 m and 35 m depth. The upper layer temperature shows seasonal variations in the range from 6.5 to 24.8 °C, and its salinity changes in the 15.5–23 PSU range. The lower layer temperature ranges from 14.5 to 16 °C, its salinity from 36.7 to 38.1 PSU. The cold layer is found at station B2 only in June and August 1999, and its minimum temperature is slightly less than 14 °C during both months.

, 1995 and Stewart, 1995). Furthermore, in developing patient-centred care, clinicians are advised to attend not only to the disease, but to the patient’s experience of symptoms, the impact of the condition and what really matters for the patient (Pollock, 2001 and Walseth et al., 2011). It is imperative that healthcare professionals consider their communication skills right from the outset, as it is reported to take only 39 ms for a first impression to be made (Bar

et al., 2006) and ‘many encounters’ to change (Tongue, 2007). The early stages of the clinical encounter are also when patients present their problems to the clinician. Panobinostat Heritage and Robinson (2006) introduced the term ‘problem presentation’

to describe the stage at which patients disclose information about their symptoms to the clinician. This important component is reported to be the only time in a medical encounter that patients are given the opportunity to describe their condition in their own words and address their selleck chemicals llc own personal agenda (Heritage and Robinson, 2006). When patients are given the opportunity to participate, they are more likely to work alongside the healthcare professional and have increased satisfaction with the outcome (Glueckauf, 1993 and Payton et al., 1998), with both parties sharing knowledge and power (Edwards et al., 2004). However, research has also highlighted that clinicians’ communication, and in particular, how they phrase their questions about the ‘problem presentation’, can affect patient ‘satisfaction’

(Heritage and Robinson, 2006 and Robinson and Heritage, 2006) as well as adherence to treatment (Zolnierek and Dimatteo, 2009). Therefore, the clinician’s communication skills are vital in establishing a good interpersonal relationship with patients, creating a welcoming environment, and enabling patients to freely express their issues. To date, research into how clinicians “should” open their clinical encounters is at an early stage of development Methane monooxygenase and predominantly focuses on physicians working in primary care settings (Heritage and Robinson, 2006 and Robinson and Heritage, 2006). These studies explored opening encounters using video-recorded data; however it has been reported that a camera can alter the natural flow of communication between clinicians and patients (Roberts and Bucksey, 2007). Furthermore, it is unknown how well the findings from medical encounters translate to clinical encounters involving other healthcare professions. Within physiotherapy, communication studies have tended to focus on, interactions and relationships, the content of encounters and the impact upon outcome (Roberts et al., 2013), with none specifically addressing the issue of opening clinical encounters.