tbuckley/cabot-search huggingface dataset:
Recruiting women surgeons: we can learn from the USA
Authors: Amina Hussain
Journal: BMJ (1999)

I commend The Royal College of Surgeons' drive to train more female surgeons, as outlined in last month's Student BMJ News.1 The college has identified key stages to tackle in the progression from school leaver to qualified surgeon, in an attempt to increase recruitment and retention of women. Although I do not doubt the college's commitment, I do wonder about its members' insight into the roots of the problem as illustrated by their proposed strategies.

For a student who has entered medical school the college's suggested tactic for redressing the imbalance of the sexes is to organise social events, giving students the opportunity to talk to male and female surgeons. This is a welcome proposition, but is it really all we can look forward to? Is the college really that bereft of appropriate ideas to entice more women into the profession?

As a female medical student who intends to follow a career in surgery I feel qualified to comment from my own experiences in coming to this evidently monumental decision. The desire to pursue a surgical career has not always been there. Like many others I have experienced fleeting aspirations of becoming a surgeon, usually following a brief stint in theatre, where I have been asked to assist. I would come away expressing my gratitude to the consultant and feeling extremely lucky for this rare opportunity. The excitement would soon disappear, along with the fading memory of the event.

My current and sustained enthusiasm to pursue this career path has come from undertaking …
California medical school criticised for improper use of cadavers
Authors: Fred Charatan
Journal: BMJ (2001)

An audit of the scheme for handling bodies that have been donated to medical science at the University of California at Irvine (UCI) has faulted the programme's former director, Christopher S Brown.

The audit of the “willed body programme,” which took more than a year and a half to complete, uncovered a lack of supervision, poor record keeping, failure to return remains to families …
Liberian aid appeal launched as medical crisis deepens
Authors: Upasana Tayal
Journal: BMJ (2003)

As the humanitarian crisis in Liberia spirals, the United Kingdom has launched a multimedia emergency aid appeal. Coordinated by the UK disasters emergency committee (DEC), money raised from the Liberia crisis appeal will support 11 of the United Kingdom's best known charities and allow them to scale up their aid work.

Brendan Gormley, chief executive of the committee said, “The appalling conditions caused by the climax of the bloody civil war in Liberia will lead to widespread deaths …
Relationship between smoking and wrinkles clarified
Authors: James S Dawson
Journal: BMJ (2001)

The fact that people who smoke develop wrinkles at an earlier age than their non-smoking counterparts seems to be due to an imbalance of extracellular matrix degrading enzymes and their respective inhibiting factors, according to an article in the Lancet (2001;357:935–6).

Researchers investigating the role of ultraviolet light on the expression of matrix metalloproteinase (MMP) enzymes in buttock skin of healthy volunteers incidentally found that this enzyme was already being …
Gene expression regulation and chromatin binding by tumor suppressor protein p53 in human lymphoblastoid cell lines
Authors: Daniel J. Tomso, Michelle R. Campbell, Gary S. Pittman, Douglas A. Bell
Journal: Cancer Research (2005)

4513  The p53 tumor suppressor protein is an important mediator of stress response in mammalian cells. Following activation, p53 binds to specific response element (RE) sequences in DNA and activates expression of nearby genes. We recently identified several genes (SEI1, ADAR2, SCGB1D2, and EOMES) with putative polymorphic p53 RE sequences upstream of their promoters, and showed that expression of these genes is altered both by ultraviolet light (UV) exposure and by transfection of exogenous p53 protein into p53 null cell lines. It is possible that the polymorphisms in these candidate REs will differentially affect these expression changes, and thus the biological activity of the target genes. Measuring the impact of the polymorphic REs, however, will require examination of gene expression in multiple cell lines. Epstein-Barr Virus (EBV) transformed lymphoblastoid cells are an attractive genetic model for these studies, as they are isolated from multiple individuals of diverse heritage. However, we show here that although candidate gene expression is reproducibly altered by UV exposure in some lymphoblastoid cell lines, it is not altered in others. Additionally, both basal and induced expression of some candidate genes vary greatly between lines (>1000 fold for EOMES). Although some of these changes may be caused by genetic variation between lines, the extensive variation we observe suggests a major perturbation of the p53 response pathway in some cultured lines. We also examined the direct binding of p53 to polymorphic RE sequences via chromatin immunoprecipitation (ChIP). In general, binding correlates well with gene expression changes. In particular, the SEI1 and ADAR2 RE sequences are enriched in p53 ChIP DNA fractions by approximately 5.9 and 3.9 fold, respectively, versus mock-precipitated fractions. Interestingly, at least one gene (ADAR2) shows pronounced downregulation of expression, and this correlates with enhanced p53 binding at its promoter RE. We conclude that these candidate genes are in fact bona fide p53 targets. We also suggest that lymphoblastoid cell lines, which are increasingly important models for studying genetic variation in human tissue, may display substantial uncharacterized variation in both basal and induced expression of p53-responsive genes.
Minerva: April 2001
Authors: Samantha Dandekar
Journal: BMJ (2001)

Last December, UK's Nottingham University accepted £3.8m from British American Tobacco to fund an International Centre for Corporate Social Responsibility. Readers who are lost for words at the mendacity of this donation will find them all in a leader in Tobacco Control (2001;10:1.2). It starts by comparing the money with profits from pornography, arms dealing, national plunder, and genocide. Then it argues that at least pornographers and genocidal murders don't torture universities with offers of cash, unlike the tobacco industry “which has hung about university research funding corridors like a wheel of ripe cheese in a sunbaked phone booth.”

We are entering a new phase of scientific uncertainty where meta-analyses, as well as single studies, can contradict each other. General practitioners wanting to know whether or not to eradicate Helicobacter pylori in patients with non.ulcer dyspepsia have two meta.analyses to go on. One (BMJ 1999;319:1040.4) found that it helps, another more recent meta.analysis (Annals of Internal Medicine 2001;134:361.9) insists that it doesn't. Both have their limitations, partly because the term non.ulcer dyspepsia is variably defined. Bigger, better trials will hopefully follow.

There have been many false dawns in the search for an effective treatment for severe sepsis, but the latest treatment, activated protein …
OU to open up medical education
Authors: Jason O'Neale Roach
Journal: BMJ (2000)

The United Kingdom's Open University has announced plans to increase its profile within undergraduate medical education by opening the Open University Centre for Education in Medicine (OUCEM). The centre was formerly a national research unit based in London, devoted to postgraduate and continuing medical education in primary and secondary care.

With the establishment of EUCEM, the Open University will have four strands of medical education activity: continuing, postgraduate, undergraduate, and access.



Open University strives to widen access to undergraduate medical degree courses …
Britain is still a nation of sun worshippers
Authors: Kay Brennan
Journal: BMJ (2001)

One in seven people in Britain want a suntan despite the risks of developing skin cancer.

The finding comes from an Imperial Cancer Research Fund (IRCF) investigation into public attitudes towards sunbathing. Three quarters of people want a tan at some time during the year, while a quarter like to be sun bronzed all year round. Some people actually said that they needed a suntan and even the threat of skin cancer would not put them off.



(AP PHOTO/DOUGLGAS ENGLE)



A telephone …
Leaving South Africa
Authors: Karen Hebert
Journal: BMJ (2003)

“Why would you leave all that beautiful weather to come to this cold and rainy island?” I still get asked this sort of question, six years after leaving Johannesburg to live in the United Kingdom. In fact I was born in London, but my parents decided to move back to South Africa when I was little. Fifteen years later, the apartheid regime had ended, Nelson Mandela was president, and, lets just say, things in South Africa were chaotic.



Bristol

ALEXANDER CAMINADA/REX



At the age of 17, I was like many British students. I was concentrating on getting fantastic matric results (similar to A levels) to get in to the University of Witwatersrand medical school. My interview had gone well, I got the results I needed, and was duly accepted. Everything should have seemed rosy, but six months into my first year of medical school, my mother and I were on a London-bound flight, anxious about what we were leaving behind and fearful of what we were going to encounter.

So what on earth could have made us take such a radical step?

When I try to tell people about the way of life in Johannesburg, they duly reply “Oh, isnt that awful.” But I can tell that most people think I am exaggerating everything, that life cant possibly be like that. People in Johannesburg live their lives in fear—and I am not only referring to the wealthy white population. The crime rate is even worse for the black population who are still living in extreme poverty in shacks in townships like Soweto.

It is not advisable to drive at night as this is just asking for your car to be hijacked—if you …
Exostosin 1/Exostosin 2–Associated Membranous Nephropathy
Authors: Sanjeev Sethi, Benjamin J. Madden, Hanna Debiec, M. Cristine Charlesworth, LouAnn Gross, Aishwarya Ravindran, Amber M. Hummel, Ulrich Specks, Fernando C. Fervenza, Pierre Ronco
Journal: Journal of the American Society of Nephrology (2019)

Significance Statement In approximately 70%–80% of cases of primary membranous nephropathy (MN), phospholipase A2 receptor (PLA2R)/Thrombospondin Type-1 Domain–Containing 7A (THSD7A) and anti-PLA2R/THSD7A antibodies form immune complexes along the glomerular basement membrane (GBM) that characterize the condition. In other cases of primary MN and all secondary MN, the target antigen is unknown. Using proteomics and immunohistochemistry, the authors detected two proteins, exostosin 1 (EXT1) and exostosin 2 (EXT2), in the GBM of PLA2R-negative MN. EXT1 and EXT2 were absent in all cases of PLA2R-associated MN and controls. Clinical and biopsy findings showed features of autoimmune disease, including membranous lupus nephritis, in 81% of the 26 EXT1/EXT2-associated MN cases the authors identified. These findings suggest that EXT1/EXT2-associated MN represents a distinct subtype of MN, most commonly associated with autoimmune diseases (secondary MN). Background In membranous nephropathy (MN), which is characterized by deposition of immune complexes along the glomerular basement membrane (GBM), phospholipase A2 receptor (PLA2R) and thrombospondin type 1 domain–containing 7A are target antigens in approximately 70% and 1%–5% of cases of primary MN, respectively. In other cases of primary MN and in secondary MN, the target antigens are unknown. Methods We studied 224 cases of biopsy-proven PLA2R-negative MN and 102 controls (including 47 cases of PLA2R-associated MN) in pilot and discovery cohorts. We also evaluated 48 cases of PLA2R-negative presumed primary MN and lupus MN in a validation cohort. We used laser microdissection and mass spectrometry to identify new antigens, which were localized by immunohistochemistry. Results Mass spectrometry detected exostosin 1 (EXT1) and exostosin 2 (EXT2) in 21 cases of PLA2R-negative MN, but not in PLA2R-associated MN and control cases. Immunohistochemistry staining revealed bright granular GBM staining for EXT1 and EXT2. Clinical and biopsy findings showed features of autoimmune disease, including lupus, in 80.7% of the 26 EXT1/EXT2-associated MN cases we identified. In the validation cohort, we confirmed that EXT1/EXT2 staining was detected in pure class 5 lupus nephritis (eight of 18 patients) and in presumed primary MN associated with signs of autoimmunity (three of 16 patients); only one of the 14 cases of mixed class 5 and 3/4 lupus nephritis was positive for EXT1/EXT2. Tests in seven patients with EXT1/EXT2-associated MN found no circulating anti-exostosin antibodies. Conclusions A subset of MN is associated with accumulation of EXT1 and EXT2 in the GBM. Autoimmune disease is common in this group of patients.
Medical education in Germany slowly reforms
Authors: Tim Rattay
Journal: BMJ (2003)

Current medical students in Germany will be the last to complete their undergraduate training before new federal curriculum regulations are implemented this autumn. The Approbationsordnung, which governs undergraduate training at all German medical schools, has not been changed since 1970, and the new guidelines are meeting mixed reactions.

Lawmakers want theoretical and practical teaching, as well as preclinical and clinical work, to be more integrated. Techniques like case scenarios and …
Abstract 11993: Three Year Clinical and Imaging Data of the Paclitaxel-Eluting Absorbable Magnesium Scaffold (Dreams) From the Biosolve-I Study
Authors: Michael Haude, Raimund Erbel, Paul Erne, Stefan Verheye, Paul Vermeersch, Hubertus Degen, Dirk Böse, Ron Waksman, Neil Weissman, Francesco Prati, Jacques Koolen
Journal: Circulation (2014)

AIMS: In order to assess the long term safety, clinical performance and the bioabsorption process of the paclitaxel-pluting absorbable magnesium scaffold (DREAMS) 3-year clinical data and multi-modality imaging outcomes are reported. METHODS AND RESULTS: Forty-six subjects were enrolled in the first-in-man BIOSOLVE-I study in two different cohorts with clinical follow-up at 1, 6, 12, 24 and 36 months; angiographic and IVUS follow-up for cohort 1 at 6-month and for cohort 2 at 12-month. A subgroup of patients underwent OCT and vasomotion testing. The primary endpoint is Target Lesion Failure (TLF) at 6-month for cohort 1 and at 12-month for cohort 2. For some patients also 18-month and 24-month imaging data are available.TLF rate at 36-month was 6.8% including 2 TLRs and 1 peri-procedural MI occurring at the 12-month follow-up angiography; no events emerged from 12- to 36-month. No cardiac death or scaffold thrombosis was observed. Vasoconstriction after acetylcholine at 6-month (delta=-10.04%; p=0.0008 versus baseline) followed by vasodilatation after nitroglycerine (delta=8.69%; p&lt;0.0001 versus baseline) demonstrates the uncaging aspect of the absorption process with no further change at the 12-month follow-up. Six-month virtual histology (VH) data showed a significant decrease in the dense calcium by 39.5% (p=0.0015) remaining stable from 6- to 12-month follow-up.This decrease is interpreted as a surrogate assessment for the bioabsorption process of the scaffold material. Echogenicity data using the decrease in intensity of the ultrasound signal to quantify the change in strut structure demonstrate a continuous decrease in % hyperechogenicity over the follow-up period, with the most pronounced changes within the first 6 months (22 to 16% p&lt;0.001). CONCLUSIONS: DREAMS shows excellent safety and efficacy data with no death and no scaffold thrombosis up to 3 years in the BIOSOLVE-I trial. Multi-modality imaging documented the absorption process and the uncaging aspect of this device already at 6 months.
Abstract 15764: Role Of Cyclooxygenase In Flow-induced Dilation Of Human Coronary Arterioles Depends Upon Age
Authors: Natalya S Zinkevich, April L Wittenburg, David D Gutterman
Journal: Circulation (2010)

Flow-induced dilation (FID) is a physiologically important mechanism contributing to the local regulation of the coronary circulation. Animal studies demonstrate that FID is typically mediated by n...
10 minute consultation: Cervical Chlamydia trachomatis infection
Authors: Pippa Oakeshott, Phillip Hay
Journal: BMJ (2003)

A 23 year old single mother has come back for the result of a test for chlamydial infection. The test is positive. She had seen you a week earlier for a routine smear test and mentioned some mid-cycle bleeding. She has been seeing her current boyfriend intermittently for a year. She has a four year old child, had a termination two years ago, and is on the pill.

Examination showed mucopurulent discharge at the external os. The cervix was friable and bled easily. After the smear test you removed excess mucopus before rotating a swab gently in and around the cervical os and placing it in chlamydia test transport medium. Chlamydia are intracellular bacteria, so specimens should contain columnar epithelial cells rather than discharge. You need sample collection kits appropriate for the test used in your local laboratory. Sensitive and specific chlamydia tests using nucleic acid amplification are now widely available in Britain and may allow testing of a first catch urine or self taken vaginal swab.
The head of a royal college
Authors: Vishnu B Madhok
Journal: BMJ (2007)

<b>Mayur Lakhani</b> is the youngest ever chairman of the UK Royal College of General Practitioners. His family came to the UK in 1972, when Idi Amin expelled Asians from Uganda, and settled in Leicestershire, where Lakhani is still a general practitioner. He spoke to <b>Vishnu B Madhok</b> about his vision of a bright future for today9s medical students-or tomorrow9s general practitioners
Tracing roots: Uganda
Authors: Samena Chaudhry
Journal: BMJ (2002)

Samena Chaudry's grandfather was forced to leave Uganda in the early 1970s. She decided finally to track down any of her family's previous life there, stopping on the way to do some work in Nsambya Christian missionary hospital

Until 1972, Asians constituted the largest non-indigenous ethnic group in Uganda. In that year, the regime of the dictator Idi Amin expelled 50 000 Asians who had been engaged in trade, industry, and various professions. My grandfather was one of those people. Leaving a successful drapery store in Masaka, he left with his children to come to Britain.

My choice in travelling to Uganda for my elective was therefore more than just a hope for some experience in the medical sense. I hoped to trace down my grandfather's (once upon a time) successful business and to meet the people who lived there now. My grandfather seemed to have erased any memories from his younger days. Talking too much about the subject merely led to a fresh revival of regrets over lost money.

So, promising him a photograph if I struck lucky, I left for Uganda with a few British sounding street names in my pocket.



AP PHOTO/BRENNAN LINSLEY



The plane was full of Ugandans going back home, and before I had even landed, several offers of taxis I could share to Nsambya had been made. Stepping off the plane, we were surrounded by the natural green beauty of Uganda (the pearl of Africa). It was breathtakingly beautiful. After numerous failed attempts at negotiation with taxi drivers who all seemed to charge a rate even …
International incidence of psychotic disorders, 2002–17: a systematic review and meta-analysis
Authors: Hannah E Jongsma, Caitlin Turner, James B Kirkbride, Peter B Jones
Journal: The Lancet Public Health (2019)

The last comprehensive systematic review of the incidence of psychotic disorders was published in 2004. New epidemiological data from different settings now permit a broader understanding of global variation. We examined the variation in psychosis by demographic characteristics and study method.
Abstract 18525: The Gut Microbiome Modulates Disease Progression and Anti-Inflammatory Treatment in Mouse Herpesvirus-Induced Vasculitis
Authors: Sriram Ambadapadi, Jordan R Yaron, Brian Mahon, Ryan M Thomas, Christian Jobin, Stephanie M Karst, Scott A Tibbetts, Shahar Keinan, Arvind Varsani, Liqiang Zhang, Grant McFadden, Alexandra Lucas
Journal: Circulation (2017)

Introduction: Inflammatory vascular syndromes (IVS) are rare but devastating arterial disorders. A lethal IVS model can be induced by mouse gamma herpesviral (MHV68) infection in interferon gamma r...
Trainee doctor or daughter?
Authors: Wendy Brown
Journal: BMJ (2003)

As a medical student, you expect to see people dying; you also expect to be able to help people. Watching my father die last year was the hardest experience of my life, and it was made harder by my being a medical student and the reasons I chose to study medicine. My father died of a terminal illness that dragged on. He fought 10 times harder than I could have; I would have given up when he had just begun.

You would expect that learning medicine prepares you for people dying. But nothing can prepare you for watching a close relatives final breaths, for seeing them in agony day after day, and your helplessness when you just have to sit and hold their hand. What makes it worse is that although the consultant cannot do any more, friends, family, and sometimes the patient may expect you, a mere second year student, to be able to something.

> You apply to medical school with your standard lines about wanting to help people and enjoying science, and in …
A summer in Sudan
Authors: Dinny Burge
Journal: BMJ (2001)

I looked out at the busy scene around me as we pressed through the crowd of people moving about the souk (market). Men drifting by in their elegant white jalabia, some women in startling shades of every colour, others invisible behind their black veils and gloves. People leant against shop counters enjoying fresh mango and guava juice, chil- dren thrust packets of biscuits through the win- dow in the hope that the khawajia (foreigner) would part with a few of her dinar. Again I marvelled at the fortitude of those who sit all day in sweltering heat selling their wares.

I knew little about Sudan before deciding to join the Sudan Volunteer Programme earlier this year. The size of western Europe, this vast country is populated by multiple ethnic and cultural groups. Since independence from Britain in the 1950s, Sudan has been caught up in a civil war which has devastated the southern region. An estimated 4-5 million …
Easy and effective counter-traction using a clip with a looped thread for colorectal endoscopic submucosal dissection
Authors: Naohiko Indo, Takahiro Anami, Naoki Asaji, Satoshi Urakami, Akihiro Nishio, Yasuaki Kitamura, Akihiko Watanabe
Journal: Endoscopy (2019)

Colorectal endoscopic submucosal dissection (ESD) remains a difficult endoscopic procedure. Several traction methods have been reported that enable an appropriate view of the submucosal layer; however, almost all of these methods have some problems regarding preparation, delivery, ease or cost [1−4]. We have concluded that “ring-shaped thread counter-traction” is the most effective method to overcome some of these problems [5]. Here, we report a treatment strategy for colorectal ESD using a clip with a looped thread, which has been developed to resemble a ring-shaped thread.
Drugs: who cares?
Authors: Marcel Aries
Journal: BMJ (2005)

On an ordinary Monday morning, 11 year old James and his mother visited the surgery. James's medical record contained a referral letter with a reply, about some behavioural problems he was having a year ago, from a community paediatrician. The surgery is located in a poor neighbourhood in Nottingham, and these kind of referral letters are familiar to me, even though I have been working as a junior doctor here for only two months.

Before I can even introduce myself, the mother starts talking about the hopeless situation with James and the way it affects her own depression. After listening for …