The relationship between menopausal hormone therapy and keratinocyte carcinoma: A review.

INTRODUCTION: Keratinocyte carcinoma (KC) is the most common malignancy in the United States. The two most common forms of KC are basal cell carcinoma and squamous cell carcinoma (SCC), which account for 80% and 20% of cases, respectively. OBJECTIVE: There are many well-established risk factors for KC, but a more controversial risk factor for KC development is menopausal hormone therapy (MHT). This review synthesizes existing information on this topic and identifies knowledge gaps for future study. METHODS: A systematic review of the literature using the Medical Subject Headings terms "menopausal hormone therapy; skin neoplasms" was conducted in the PubMed database from March 19, 2018 to April 1, 2018. This yielded 168 articles, case reports, and reviews, which were further refined for inclusion during the development of this manuscript. Additional articles were identified from cited references. RESULTS: Four studies pertaining to this topic were identified. The results were evaluated in the context of these studies' strengths and weaknesses. MHT contributes to an increased risk of basal cell carcinoma in Caucasian subjects and may make these tumors histologically more aggressive. There is not enough evidence to make a conclusion with regard to a potential relationship between MHT and SCC. However, one study suggested an increased risk of SCC with MHT use and another demonstrated a temporal association with prolonged MHT use and increased risk of SCC development. CONCLUSION: Ever users of MHT should be screened more frequently for KC. This issue is of importance to dermatologists because patients who receive earlier diagnoses of KC will have a better opportunity to pursue treatment.

Evaluation of the HemoCue compared with the Coulter STKS for measurement of neonatal haemoglobin.

OBJECTIVE: To compare the measurement of haemoglobin concentration ([Hb]) using the HemoCue haemoglobinometer with that using the Coulter STKS haemoglobinometer. DESIGN: Thirty two EDTA samples were taken from neonates. [Hb] was measured in these samples using the HemoCue; the samples were then transferred to the haematology laboratory for [Hb] determination with the Coulter STKS. In addition, [Hb] was determined in 50 different random EDTA neonatal samples already held in the laboratory, using the HemoCue and Coulter STKS. PATIENTS: Neonates in the intensive care and low dependency Units of the Royal Devon and Exeter Hospital. INTERVENTIONS: Samples were collected from arterial lines or by venepuncture or heel prick into an EDTA bottle. MAIN OUTCOME MEASURES: [Hb] using the HemoCue and Coulter STKS methods. RESULTS: The mean [Hb] measured using the HemoCue was 150.3 g/l (range 78-215) compared with 152.8 g/l (range 78-217) measured using the Coulter STKS, with a mean of the differences of 2.5 g/l. The standard deviation of the differences of the 82 samples was 3.73 g/l. The limits of agreement of the two methods (mean difference +/- 2SD) were -4.8 to +9.8 g/l. CONCLUSION: With adequate training and monitoring, the HemoCue can be used directly on the neonatal unit for rapid determination of [Hb] to within 7.5 g/l compared with the laboratory Coulter STKS, using much smaller sample volumes.

The association between gender, race and marital status on functional outcome at rehabilitation discharge after thromboembolic stroke: a prospective analysis.

Appropriate allocation of rehabilitation resources requires that the rehabilitation professional have a knowledge of reliable predictors of functional outcome. To determine what influence pre-morbid demographic variables have on functional outcome following thromboembolic stroke, we analyzed prospectively collected demographic and functional data from consecutive patients admitted to rehabilitation at a tertiary university medical center. Data from 117 patients were statistically analyzed for correlations between demographic factors and functional outcome as measured by the FIM scale and hospital length of stay (LOS). While no significant correlations were found between race or gender and functional outcome, Caucasians were found to stay an average of 5 days longer in acute care than African-Americans. Non-married patients were found to have significantly longer rehabilitation LOS and return home following discharge less often. It is concluded that non-married status is a significant negative prognostic factor for functional outcome after thromboembolic stroke, while gender and race have no correlation.

Trans-complementable copy-number mutants of plasmid ColE1.

Plasmid ColE1, like many other small non-conjugative plasmids, is present in multiple copies (about 15 per chromsome equivalent) in Escherichia coli cells. Because of their high copy number, the replication of such plasmids has been described as 'relaxed', even though there is good evidence that it is strictly controlled: ColE1 derivatives have characteristic but different copy numbers and ColE1 copy-number mutants have been characterised. No plasmid-specified protein is essential for the replication of ColE1 and related plasmids, as extensive replication can occur in chloramphenicol-treated cells, in plasmid-free chloramphenicol-treated cells transfected with a hybrid ColE1/phage replicon and in vitro in extracts derived from plasmid-free cells. Nevertheless, it is possible that a plasmid-specified protein is involved in ColE1 replication control in viable cells. Here we show that deletion of a given non-essential region from ColE1-like plasmids results in a raised copy number. Such plasmids are stably maintained and have their copy number returned to normal when a complementing plasmid is present in the same cell, indicating that a plasmid-specified diffusible gene product regulates the plasmid content of ColE1-containing cells. Deletion of the equivalent region from the cloning vector pBR322 gives a derivative which has a raised copy number and which has also lost its origin for conjugal transfer; unlike pBR322, it cannot be mobilised.

Polypeptides expressed in Escherichia coli K-12 minicells by transposition elements Tn1 and Tn3.

Escherichia coli K-12 minicells were employed to examine polypeptides encoded by plasmids carrying wild-type and mutant Tn1 or Tn3 transposition elements. Tn1- and Tn3-containing minicells express high levels of four transposon-specified polypeptides. Three, of molecular weights 30,000, 28,000, and 25,000, are related immunologically to beta-lactamase, the enzyme responsible for ampicillin hydrolysis. A fourth polypeptide of molecular weight 19,000 is encoded by the Tn1 or Tn3 region which spans the BamHI cleavage site. Mutant transposons which no longer produce this polypeptide transpose at higher than wild-type frequencies to give aberrant transposition products (Gill et al., J. Bacteriol. 136: 742--756, 1978; Heffron et al., Proc. Natl. Acad. Sci U.S.A. 72:3632--3627, 1975). No expression could be detected from a region of the transposons extending from the inverted repeat sequence distal to the beta-lactamase gene to more than half the distance into the Tn1 or Tn3 sequence.

Structure and function of plasmid ColE1 and related plasmids.

Analysis of plasmid ColE1, its naturally occurring relatives ColK and CloDF13, and a wide range of ColE1 derivatives containing either insertions or deletions of genetic material has allowed localization on the ColE1 genome of DNA sequences responsible for colicin E1 synthesis, immunity to colicin killing, conjugal mobility and incompatibility. We have examined incompatibility between pairs of ColE1 derivatives ranging in size from 2.6 to 13.8 Md. Though all the plasmids tested exerted ColE1 incompatibility, a definite pattern was observed regarding the dominant plasmid in any pair tested (i.e. the plasmid that displaces the other from a heterozygote). Usually the larger plasmid is displaced. We conclude that loci for incompatibility reside within 0.7 kb of the ColE1 replication region. A model is presented to explain both the incompatibility data and the observation that the fraction of total DNA occurring as ColE1-like plasmid in a cell is approximately constant. Transposons Tn1 and Tn3 (3.2 Md; Apr and approximately 85% homologous), Tn501 (5.5 Md; Hgr), and Tn7 (9.3 Md; Tpr Smr) can all be transposed into ColE1. Though all have closely related. Tn501 and Tn7 do not complement transposition of Tn3 transposition defective deletions. A Tn3-specified 19,000 dalton protein is absent in one particular class of transposition-defective deletion.