tbuckley/cabot-search huggingface dataset:
Hirsutism in women
Authors: Nadia Soliman, Peter G Wardle
Journal: BMJ (2006)

Excessive hair growth in women is usually a psychological concern, but it may indicate underlying morbidity. Nadia Soliman and Peter Wardle consider the options for treatment Hirsutism in women is the presence of unwanted coarse body hair in a male distribution. It affects 5-15% of women,1 and it can have profound psychological sequelae. It undermines the woman's confidence and self esteem, and its effect on quality of life should not be underestimated. Some women live apparently normal lives but may spend two or three hours a day using cosmetic or camouflage methods. Other women may become reclusive and only venture out after dark. In teenagers, hirsutism can be a cause of bullying, social isolation, and poor educational performance. By the time they seek medical advice, many women will have reached a point of desperation. Hirsutism is usually caused by increased production of androgen (a collective term for male sex hormones) or increased sensitivity of hair follicles to androgens. The condition is often associated with acne and seborrhoea. Management of female hirsutism requires, first of all, the exclusion of any underlying sinister cause, such as an androgen secreting tumour, by confirmation that the history is not acute and is not associated with amenorrhoea or virilisation. Measurement of serum testosterone alone is sufficient for basic screening. Urgent referral to a specialist clinic is indicated if the concentration of serum testosterone is more than 5 nmol/l. The other investigations which might be needed are listed in box 1. ### Box 1: Investigations for hirsutism in women Testosterone - The only investigation needed in most cases; urgent referral if >5 nmol/l Gonadotrophins - Luteinising hormone concentration is greater than follicle stimulating hormone in polycystic ovary syndrome Prolactin - Raised in 15% of women with polycystic ovary syndrome 17-hydroxyprogesterone - Raised in congenital adrenal hyperplasia Dehydroepiandrostenedione acetate - Raised in adrenal … RETURN TO TEXT
What did you do last summer?
Authors: Anna Smith
Journal: BMJ (2009)

Breaking free from university digs, stale bed sheets, and a staple diet of cheap baked beans, I’m unable to put university life on a back burner because it continues to burn a hole in the pocket of my already tattered jeans. With a full timetable, maintaining a term time job while keeping the “work hard, play hard” balance is near impossible. After several months of unidirectional cash flow, the hard done by student returns home each …
The big house job hunt
Authors: Omer Aziz
Journal: BMJ (2000)

The big house job hunt Omer Aziz enters the competition Having been on the “conveyor belt” degree that is medicine for the past five years, I have had to make very few choices. Eight months away from sitting my final exams, however, I am faced with my first one: Which post as a preregistration house officer should I apply for?

In deciding whether I want a career in medicine or surgery, I look at my first jobs as a good opportunity to get my foot in the door in a particular specialty. But while searching for the right job, I am left with many unanswered questions. Should I apply for two traditional six month posts, or would the newer one year rotations be a broader experience of medicine? What about working on the general practice rotations? Are teaching hospital jobs better for your …
Picture quiz: Muscle weakness and wasting
Authors: Jocelin Hall, Joaquim Santos-Lima, P Nigel Leigh
Journal: BMJ (2007)

A 74 year old woman presented with a two month history of progressive weakness of her right hand, without sensory symptoms. She had no medical history of note and no family history of neurological or psychiatric problems. On examination, sensation and cranial nerves were normal. Examination of the upper limbs identified bilateral fasciculation of the deltoid and triceps, however. On the right, the power of her grip was 3 on the Medical Research Council scale, as was her finger abduction and abductor pollicis brevis. Her digit muscles had spasticity, and the reflexes of her supinator and biceps were brisk. The power and reflexes of her left upper limb were normal. Coordination was normal in both upper limbs. In the lower limbs the only finding was the presence of symmetrical exaggerated adductor reflexes. Figs 1(F1) and 2(F2) show the patient's right hand at rest, a couple of months after presentation. Fig 1 Fig 2
Educating for Professionalism
Authors: Christopher Bulstrode
Journal: BMJ (2001)

The joy of being asked to review a book is that sometimes you end up reading something whose title alone would have convinced you that there were better uses of your time. Jude the Obscure would have approved of the title of this book. Some of the contents are equally woolly. However, there are three chapters that have made me think harder than I have for a long time. “Not difficult in an orthopaedic surgeon,” I hear you say. Well, I challenge anyone involved in medical school curriculum design to read the chapters by …
Effect of mix polyethyleneglycol modification contained doxorubicin on cell uptake and cytotoxicity
Authors: Ikumi Sugiyama, Yasuyuki Sadzuka, Naoto Oku, Takashi Sonobe
Journal: Cancer Research (2005)

1395  Liposomes are recognized as one of the useful drug carrier, but have many problems in order to clinical application. Liposomes, bond peculiarly with serum protein (opsonization), are taken up by reticuloendothelial system (RES) cells in the liver and spleen. This is one of the principal causes that is reduced the effectiveness of liposomes as a drug carrier if its purpose is long-term circulation in the blood or targeting to tissues except the RES. It was known that polyethyleneglycol (PEG) modification of the liposome surface produced formation of fixed aqueous layer around the liposomes by interaction between the PEG-polymer and water molecule, and prevented the attraction of opsonins. Namely, PEG-modified liposomes are able to escape trapping by the cells of RES, and have a prolonged circulation time. In this study, the effects of different anchor with same PEG molecular weight on the cell uptake and cytotoxicity of mixed PEG-modified liposomal doxorubicin (DOX) were examined. In PEG-distearoylglycerol (PEG-DSG) modification of liposome, a fixed aqueous layer thickness (FALT) increased with the increase in a molecular weight. Similarly, PEG-cholesterol (PEG-CHO) modification was increased FALT with the increase in a molecular weight, too. FALT of liposome with modification by a mixture of PEG2000 and PEG with a short chain increased, compared to that of the single PEG2000-modified liposome. Mix PEG-modification of liposome by different anchor (PEG2000-(DSG:CHO=1:1)- modified liposome) led to increase in FALT, compared to that of each single PEG-modification. The uptake of DOX into Ehrlich ascites carcinoma cells in PEG-CHO modified group is higher than other liposomes. The effect of PEG-modification on DOX uptake in tumor cells is shown and this order was PEG2000-(DSG:CHO=1:1) = PEG2000-CHO > PEG2000-DSG > unmodified liposomal DOX. This result suggested that PEG-CHO had higher affinity on tumor cells. The effect of PEG-modification on IC50 by DOX reflected in cell uptake of each liposome. Namely, this order was PEG2000-DSG > PEG2000-CHO > PEG2000-(DSG:CHO=1:1). Thus, mixed PEG-modified liposomes with PEG-DSG and PEG-CHO were suggested to be effective to increase cytotoxicity. In conclusion, it was confirmed that mix-modified liposomes by PEG-lipid with different anchor were superior.
Viewpoint: Not another culinary metaphor?
Authors: Joseph Ogirima Ovosi
Journal: BMJ (2007)

Medical education all over the world is challenging for teachers and students. The expansive curriculum and the timeframe for learning the science and art of medicine mean that teachers and students face great physical and mental hurdles.



The situation in Africa is even more challenging, especially for students. Apart from the socioeconomic problems in Africa, medical students have to use Western medical literature if they are to learn medicine to a standard comparable to that in …
Changing our microbiome: probiotics in dermatology
Authors: Y. Yu, S. Dunaway, J. Champer, J. Kim, A. Alikhan
Journal: British Journal of Dermatology (2019)

Commensal bacteria are a major factor in human health and disease pathogenesis. Interest has recently expanded beyond the gastrointestinal microbiome to include the skin microbiome and its impact on various skin diseases.Here we present current data reviewing the role of the microbiome in dermatology, considering both the gut and skin microflora. Our objective was to evaluate whether the clinical data support the utility of oral and topical probiotics for certain dermatological diseases.The PubMed and ClinicalTrials.gov databases were searched for basic science, translational research and clinical studies that investigated differences in the cutaneous microbiome and the impact of probiotics in patients with atopic dermatitis, acne vulgaris, psoriasis, chronic wounds, seborrhoeic dermatitis and cutaneous neoplasms.Few clinical trials exist that explore the utility of probiotics for the prevention and treatment of dermatological diseases, with the exception of atopic dermatitis. Most studies investigated oral probiotic interventions, and of those utilizing topical probiotics, few included skin commensals. In general, the available clinical trials yielded positive results with improvement of the skin conditions after probiotic intervention.Oral and topical probiotics appear to be effective for the treatment of certain inflammatory skin diseases and demonstrate a promising role in wound healing and skin cancer. However, more studies are needed to confirm these results. What's already known about this topic? The microbiome plays a role in human health and disease pathogenesis. Probiotics can manipulate the host microbiome and may confer health benefits for patients. Research to date has already begun to explore the utility of oral and topical probiotics for certain dermatological diseases. What does this study add? This review presents basic science and clinical trial data to support the role of the gut and skin microbiome in dermatology. Current data are reviewed on the use of probiotics in the prevention and treatment of skin diseases, including atopic dermatitis, acne vulgaris, psoriasis, seborrhoeic dermatitis, chronic wounds and cutaneous neoplasms. Future probiotic interventions are proposed.
BMA book competition winners
Authors: Lucy Butler
Journal: BMJ (2008)

Emery's Elements of Medical Genetics, includes sections on the principles of human genetics.



The winner of the student textbook category, Emery's Elements of Medical Genetics , is a book written for students of various disciplines who need some knowledge of medical genetics. It includes sections on the principles of human genetics, genetics in medicine, and genetics in clinical medicine. It covers everything that a medical student might be expected to know about genetics and probably a lot more. Because genetics is a rapidly changing …
The challenge of de‐labeling penicillin allergy
Authors: Cosby A. Stone, Jason Trubiano, David T. Coleman, Christine R. F. Rukasin, Elizabeth J. Phillips
Journal: Allergy (2019)

Even though 8%-25% of most populations studied globally are labeled as penicillin allergic, most diagnoses of penicillin allergy are made in childhood and relate to events that are either not allergic in nature, are low risk for immediate hypersensitivity, or are a potential true allergy that has waned over time. Penicillin allergy labels directly impact antimicrobial stewardship by leading to use of less effective and broader spectrum antimicrobials and are associated with antimicrobial resistance. They may also delay appropriate antimicrobial therapy and lead to increased risk of specific adverse healthcare outcomes. Operationalizing penicillin allergy de-labeling into a new arm of antimicrobial stewardship programs (ASPs) has become an increasing global focus.We performed an evidence-based narrative review of the literature of penicillin allergy label carriage, the adverse effects of penicillin allergy labels, and current approaches and barriers to penicillin allergy de-labeling. Over the period 1928-2018 in Pubmed and Medline, search terms used included "penicillin allergy" or "penicillin hypersensitivity" alone or in combination with "adverse events," "testing," "evaluation," "effects," "label," "de-labeling," "prick or epicutaneous," and "intradermal" skin testing, "oral challenge or provocation," "cross-reactivity," and "antimicrobial stewardship".Penicillin allergy labels are highly prevalent, largely inaccurate and their carriage may lead to unnecessary treatment and inferior outcomes with alternative agents as well as adverse public health outcomes such as antibiotic resistance.Operationalizing penicillin allergy de-labeling as an aspect of ASP has become an increasing global focus. There is a need for validated approaches that optimally combine the use of history and ingestion challenge with or without proceeding formal skin testing to tackle penicillin allergy efficiently within complex healthcare systems. At the same time, there is great promise for penicillin allergy evaluation and de-labeling as an individual and public health strategy to reduce adverse healthcare outcomes, improve antimicrobial stewardship, and decrease healthcare costs.
Abstract #4394: Lnk expression in leukemia cells
Authors: Sigal Gery, Saskia Guller, Verena Nowak, Jee Hoon Song, Wolf Hofmann, H Phillip Koeffler
Journal: Cancer Research (2009)

Tyrosine kinases involved in cytokine signaling are frequently aberrantly activated in hematological malignancies. Lnk, a negative regulator of cytokine signaling, plays critical non-redundant roles in hematopoiesis. By binding to phosphorylated tyrosine kinases, Lnk inhibits major cytokine receptor signaling including c-KIT, EpoR-JAK2 and MPL-JAK2. In the present study, we investigated Lnk expression and possible function in transformed hematopoietic cells. We show that in parallel to binding wild-type JAK2 and c-KIT, Lnk associates with and is phosphorylated by mutant alleles of JAK2 and c-KIT. In contrast, Lnk does not bind to and is not phosphorylated by BCR-ABL fusion protein. Ectopic expression of Lnk strongly attenuates growth of some leukemia cell lines while others, as well as most solid-tumor cancer cell lines, are either moderately inhibited or completely insensitive to Lnk. Furthermore, Lnk mediated growth inhibition is associated with differential downregulation of PI3K/Akt/mTOR and MAPK/Erk signaling in leukemia cell lines. Surprisingly, analysis of Lnk in a large panel of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) patient samples revealed high levels of Lnk in nearly half of the samples. Although how leukemic cells overcome the anti-proliferative affects of Lnk is not yet clear, our data highlight the multifaceted role negative feedback mechanisms play in malignant transformation.  Citation Information: In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. Abstract nr 4394.
Core Clinical Skills for OSCEs
Authors: Geraldine A O'Hara
Journal: BMJ (2001)

OSCEs (objective structured clinical examinations) were set up in the UK in response to the General Medical Council's document Tomorrow's Doctors, expanding the emphasis in medical exams from factual knowledge to skills. Written by a hospital dean and an associate dean in Manchester, this book focuses on the OSCE system used twice a year to exam. ine all Manchester clinical students. With an OSCE looming on the horizon I couldn't think of a …
A Portrait of the Brain
Authors: Christopher Martyn
Journal: BMJ (2008)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following A Portrait of the Brain Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Soft Wearable Pressure Sensors for Beat‐to‐Beat Blood Pressure Monitoring
Authors: Joshua Kim, En‐Fan Chou, Jamie Le, Sabrina Wong, Michael Chu, Michelle Khine
Journal: Advanced Healthcare Materials (2019)

Wrinkled gold thin films on elastomeric substrates are used as robust parallel plate electrodes for soft capacitive pressure sensors. The wrinkled structures create a robust integration with the polymer, allowing repeated normal force to deform the thin film without failure. By incorporating microridged structures that support the counter electrodes to create air cavities within the elastomeric dielectric layer, pressure sensitivity is further increased to 0.148 kPa-1 over a wide dynamic range of up to 10 kPa. The wide dynamic range and pressure sensitivity of the pressure sensor allow for consistent measurements of the pressure exerted by the radial artery located on the wrist. The soft capacitive pressure sensor displays comparable results when tested against an FDA approved device (Clearsight, Edwards Lifesciences, Irvine, CA) measuring beat-to-beat blood pressure. These soft pressure sensors using wrinkled thin films, therefore, illustrate considerable potential to continuously monitor beat-to-beat blood pressure.
China kills 10 000 civet cats in “patriotic” campaign against SARS
Authors: Richard Hurley
Journal: BMJ (2004)

A cull of thousands of civet cats, badgers, racoons, dogs, and cockroaches has been started in response to China's first new case of SARS (severe acute respiratory syndrome) in six months.

The infected man, from the city of Guangzhou, in the southern province of Guangdong, has made a full recovery. He had caught a similar strain of SARS to one found in civet cats but said that he had never eaten nor even seen the animals. In Guangdong, civets--weasel-like members of the mongoose family--are an expensive delicacy.

“We …
Physician - heal thyself?
Authors: Sonali Dutta
Journal: BMJ (2003)

A woman who had been recently diagnosed as having cancer decided not to accept any treatment because she felt that there was ‘no point.’ I was surprised by this because the chances sounded quite good to me.

Two years have later I have seen patients with quite different attitudes towards the news of their own deaths—tears, shock, lack of surprise, and complete denial. These …
Abstract #2232: Role of the TFIZ2 protein, a potential tumor suppressor in gastric cancer
Authors: Claire Worrall, Felicity May
Journal: Cancer Research (2009)

TFIZ2 (Gastrokine 1) is an 18.3 kDa protein that is expressed at high levels in gastric mucosal cells and secreted into the mucous layer. TFIZ2 expression is reduced after  H. pylori  infection and is lost in 80% of gastric cancers. The homologous protein TFIZ1 forms a heterodimer with TFF1, a protein that stimulates cell motility and is involved in repair of the gastric mucosal layer following injury. Nothing is known about the function of TFIZ2. The purpose of this study is to elucidate if TFIZ2 has a protective function in the stomach and if loss of TFIZ2 expression could promote the progression to cancer. The TFIZ2 protein was produced in an  E. coli  recombinant periplasmic expression system and purified by affinity chromatography followed by anion exchange chromatography. It was analysed by non-denaturing poly-acrylamide gel electrophoresis including western transfer analysis and matrix-assisted laser desorption mass spectrometry. The expression of TFIZ2 in gastric cancer cell lines was assessed by qRT PCR and western transfer analysis. The paracrine effect of TFIZ2 was tested by addition of recombinant TFIZ2 to the gastric cancer cell lines AGS and NUGC3 using cell wounding and proliferation assays. A panel of 7 gastric cancer cell lines showed no detectable expression of TFIZ2 mRNA or protein, which is consistent with the reported loss of TFIZ2 expression in gastric cancer. Recombinant TFIZ2 has been produced, purified to homogeneity and shown to have the predicted molecular mass of 18.3 kDa. Data from functional assays in which the gastric cancer cell lines NUGC3 and AGS were treated with recombinant TFIZ2 show that TFIZ2 affects gastric cancer cell motility. We have produced and purified recombinant TFIZ2 and confirmed it is the predicted molecular mass. We have shown that none of the gastric cancer cell lines tested express TFIZ2. The recombinant TFIZ2 is biologically active and has allowed us to demonstrate, using  in vitro  functional assays, that TFIZ2 has motogenic activity in gastric cancer cells.   Citation Information:  In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. Abstract nr 2232.
Comprehensive Supportive Care for Patients with Fibrosing Interstitial Lung Disease
Authors: Marlies S. Wijsenbeek, Anne E. Holland, Jeffrey J. Swigris, Elisabetta A. Renzoni
Journal: American Journal of Respiratory and Critical Care Medicine (2019)

Idiopathic pulmonary fibrosis and other forms of fibrosing interstitial lung disease (F-ILD) are life-altering conditions that increasingly deprive patients and their caregivers of their quality of...
The girl with the mumble in her heart
Authors: Simon Stephenson
Journal: BMJ (2001)

She was small for our age but we all ascribed it to the fact she had been born with a mumble in her heart. Sometimes she would let you listen through her T shirt, and though it just sounded like putting a shell to your ear, we knew that we were supposed to be able to hear the mumble and would all claim that we could. Nobody's bluff was ever called, as would later happen in medical school, by being asked to describe what we heard.

“D'you hear it?”

“Yeah.”

“Me too.”

And that would be that.

Back then, having a mumble didn't seem like a bad thing at all. It was a party trick and “a get out of games note” rolled into one. More, it meant that you knew all about the strange and fascinating world of hospitals and had stories to tell about what went on there.

There were stories about how they had their own school there but you didn't have to go …
Synergistic adhesive interactions and signaling mechanisms operating between platelet gp ib/ix and integrin αiibβ3: studies in human platelets and transfected K562 and CHO cells
Authors: S. P. Jackson, T. Domagala, S. C. Hughan, S. L. Cranmer, W. S. Nesbitt, S. Kulkarni, S. M. Dopheide, Y. Yuan, F. Lanza, C. L. Yap
Journal: Blood (2000)