Retinoic acid modulates chromatin to potentiate tumor necrosis factor alpha signaling on the DIF2 promoter.

Transcriptional activation by nuclear hormone receptors is well characterized, but their cooperation with other signaling pathways to activate transcription remains poorly understood. Tumor necrosis factor alpha (TNFalpha) and all-trans retinoic acid (RA) induce monocytic differentiation of acute promyelocytic leukemia (APL) cells in a synergistic manner. We used the promoter of DIF2, a gene involved in monocytic differentiation, to model the mechanism underlying the cooperative induction of target genes by RA and TNFalpha.

The nature of borderline personality disorder: multiple dimensions, multiple symptoms, but one category.

Borderline personality disorder (BPD) is a multidimensional syndrome that is not rooted in a single diathesis. Each of its features (affective instability, impulsivity, unstable relationships, and cognitive defects) reflects different diatheses. BPD differs from other Axis II disorders in its high level of symptoms, but is not a variant of an Axis I disorder and is difficult to describe through dimensional traits.

Sarcoma post-embolization for presumed uterine fibroids.

Background: Uterine artery embolization has increasingly been used in the last decade as a conservative treatment approach for uterine fibroids. Rarely sarcomas have been diagnosed shortly after uterine artery embolization. It remains unclear whether a change in diagnostic work-up is required prior to uterine artery embolization in order to avoid missing sarcomas and delaying definitive treatment.

Hypocomplementemia in systemic sclerosis--clinical and serological correlations.

Objective: Although complement fixation is not commonly thought to be part of the pathogenesis of systemic sclerosis (SSc), hypocomplementemia has been associated with SSc. We hypothesized that hypocomplementemia in SSc might indicate the presence of overlap disease. We investigated if SSc patients with hypocomplementemia had more features of overlap disease than those with normal complement levels.

Depression and mortality in the visually-impaired, community-dwelling, elderly population of Quebec.

Purpose: To assess the effect of visual impairment (VI) on the risk of depression or death in the community-dwelling elderly population.

Methods: A population-based, retrospective fixed cohort study was conducted in the community-dwelling elderly (age > or = 65 years) outpatient population of Quebec. The cohort was assembled through the Quebec medical services database and consisted of the 5063 patients aged > or = 65 years who received a diagnosis of VI during the years 2000-2004.

Hyperemesis gravidarum and Helicobacter pylori infection: a systematic review.

Objective: To systematically review studies examining the relationship between hyperemesis gravidarum and Helicobacter pylori (H pylori) infection.

Data Sources: A 1966 to January 2007 search using MEDLINE/PubMed, EMBASE, and Web of Science included MeSH terms: "Helicobacter pylori," "Helicobacter infections," "hyperemesis gravidarum," and the text words "nausea," "vomit," "pregnancy," and "Helicobacter." References of selected papers were examined for additional relevant studies.

Increased blood pressure, vascular inflammation, and endothelial dysfunction in androgen-deficient follitropin receptor knockout male mice.

The relationship between testosterone, vascular function, and blood pressure remains unclear. Here we utilized a mouse model of andropause, follitropin receptor knockout (FORKO) male mice, which are testosterone-deficient, to investigate whether vascular function and structure are altered and whether this is associated with elevated blood pressure. Blood pressure was measured by radiotelemetry, and vascular function and structure were assessed in isolated pressurized mesenteric resistance arteries in wild-type (WT) and FORKO mice.

Should meta-analyses of interventions include observational studies in addition to randomized controlled trials? A critical examination of underlying principles.

Some authors argue that systematic reviews and meta-analyses of intervention studies should include only randomized controlled trials because the randomized controlled trial is a more valid study design for causal inference compared with the observational study design. However, a review of the principal elements underlying this claim (randomization removes the chance of confounding, and the double-blind process minimizes biases caused by the placebo effect) suggests that both classes of study designs have strengths and weaknesses, and including information from observational studies may improve the inference based on only randomized controlled trials. Furthermore, a review of empirical studies suggests that meta-analyses based on observational studies generally produce estimates of effect similar to those from meta-analyses based on randomized controlled trials.

Physicians' efficacy requirements for prescribing medications to persons with Alzheimer's disease.

Physicians (N=803) were contacted via postal survey and given two sets of efficacy measures for drug treatments in Alzheimer's disease: (a) the time that patients spend in a mild or moderate state of disease; (b) levels of modification to disease progression in the areas of cognition, behaviour, and mood, and ability to perform basic activities of daily living. Physicians reported that they would prescribe a hypothetical, new Alzheimer's disease medication if it would allow patients to remain in their current disease state for 15 (mild) or 11 (moderate) additional months. Most physicians required a permanent halt to, or some reversal of, disease progression as a prerequisite for prescribing; a few required substantial reversal.

Blood gas measurements using the Bayer Rapid Point 405: are we basing our decisions on accurate data?

Objective: Therapeutic decisions in the Operating Room (OR) are often made based solely upon results obtained from arterial blood gas machines. We evaluated how precise and accurate the results obtained from Bayer Rapid Point 405 (RP405) were vis-à-vis those of our blood gas laboratory and if they met the standards of the members of the anesthesia department.

Methods: About 3 ml of blood from an indwelling arterial catheter were drawn into a heparinized syringe (FIMS Portex Inc.

Oxysterols, cholesterol homeostasis, and Alzheimer disease.

Aberrant cholesterol metabolism has been implicated in Alzheimer disease (AD) and other neurological disorders. Oxysterols and other cholesterol oxidation products are effective ligands of liver X activated receptor (LXR) nuclear receptors, major regulators of genes subserving cholesterol homeostasis. LXR receptors act as molecular sensors of cellular cholesterol concentrations and effectors of tissue cholesterol reduction.

Experimental image-guided endoscopic pituitary surgery: a useful learning model.

Objectives: The purpose of this study, which combined image guidance and endocscopic pituitary surgery (EPS), was to test its practicability as a learning tool to acquire the necessary skills in an experimental setting.

Methods: Ten cadaver-heads were explored using a standard endoscopic transsphenoidal surgical technique combined with the InstaTrak 3500 (GE Medical Systems, Lawrence, MA, USA) image guidance system. The time taken for the experimental setup and the optic-radiologic correlations of topographic landmarks were recorded and photographed.

Intermittent psychotherapy: an alternative to continuous long-term treatment for patients with personality disorders.

Open-ended psychotherapies have a limited evidence base for the treatment of personality disorders. In patients with personality disorders, in whom pathology tends to remit with time, intermittent rather than continuous therapy could be an option. Patients might be treated more briefly and then either allowed or encouraged to take breaks, while being allowed to return as new issues arise.

Understanding causal inference: the future direction in sports injury prevention.

Although physical activity reduces mortality and morbidity, injuries associated with activity may increase both short- and long-term musculoskeletal disability. On the basis of basic science and injury epidemiology studies, authors have made conclusions about cause and effect (causal inferences) and have suggested various interventions to decrease the rate of injuries. However, recent advances in epidemiology suggest that the regression/stratification approach to adjustment for confounding does not provide an appropriate foundation for causal inference; therefore, hypotheses based on traditional analyses may be misleading.

Use of warfarin and risk of urogenital cancer: a population-based, nested case-control study.

Background: Indirect evidence suggests that prolonged treatment with warfarin might be associated with a decreased incidence of urogenital cancer. We aimed to assess this association in a large population-based study.

Methods: Beneficiaries of Saskatchewan Health who were eligible for prescription drug benefits and aged 50 years or over with no history of cancer since 1967 were enrolled into a nested, matched case-control study.

Mixed ovarian germ cell tumor in a BRCA2 mutation carrier.

BRCA2 germ-line mutations confer an increased risk of developing breast and ovarian cancer. We report the occurrence of a mixed ovarian germ cell tumor (GCT) (50% embryonal carcinoma, 20%-25% choriocarcinoma, 10%-15% dysgerminoma, and 10%-15% immature teratoma) in a 33-year-old Ashkenazi Jewish woman, carrier of the BRCA2:6174delT mutation. The mutation is also present in the patient's father, who was diagnosed with breast cancer at age 59 and with prostate cancer at age 69.

The effect of anticoagulants on cancer risk and survival: systematic review.

Objectives: Several in vitro and in vivo studies have shown that low molecular weight heparin and warfarin may directly inhibit tumour cell growth and prevent metastatic spread. However, the clinical evidence in support of an anti-cancer effect is less conclusive. We summarize the evidence from clinical studies that examine the effect of these anticoagulants on cancer development and briefly describe the current understanding of the potential mechanisms by which anticoagulants may exert an anti-cancer effect.

The interface between borderline personality disorder and bipolar spectrum disorders.

Objective: This review examines whether borderline personality disorder (BPD) should be considered part of the bipolar spectrum.

Methods: A literature review examined studies of co-occurrence, phenomenology, family prevalence, medication response, longitudinal course, and etiology.

Results: Borderline personality disorder and bipolar disorder co-occur, but their relationship is not consistent or specific.

Linear lichen planopilaris of the trunk: first report of a case.

Background: Lichen planopilaris (LPP) is believed to be a follicular variant of lichen planus that affects pilosebaceous units, mainly of the scalp. An extremely rare variant of LPP is a linear form, which follows the lines of Blaschko. Of the five previously documented cases of linear LPP, all were limited to the face.