Friday, February 27, 2009

Free Medical Journals

Have you ever tried to download a very important information on the internet only to discover to your surprise that you have to pay for the article for you to have access to it?
Some organisations and professionals believe that such information should be free. Anyway if that is not possible now, the future points to that. There is a powerful mobilisation going on to ensure that medical journals in all fields are free.
Meanwhile, it is my pleasure to introduce to you journals in the medical field you can enjoy for free.

The categories are:
1. Journals released for free

2. Free medical journals 1 to 6 months after publication

3. Free medical journals 1 year after publication

4. Free medical journals 2 years after publication.


Free On Publication

1. A cancer Journal For Clinicians-http://caonline.amcancersoc.org/

2. The Journal of Clinical Investigation-http://www.freemedicaljournals.com/link5.php?id=552

3. Nucleic Acid Research-http://nar.oxfordjournals.org/

4. Biochemical Journal-http://www.biochemj.org/bj/tocprev/toc2001.htm

5. Emerging Infectious Diseases-http://www.cdc.gov/ncidod/eid/

6. Journal of community Nursing-http://fj4d.com/link5.php?id=2191


Free 1 to 6 Months After Publication
1. New England Journal Of Medicine-http://content.nejm.org/

2. Diabetes (Free after 3 months)-http://intl-diabetes.diabetesjournals.org

3. Molecular Biology of The Cell (Free after 2 months)-http://www.molbiolcell.org/

4. Journal of Virology-http://jvi.asm.org/

5. Journal of Clinical Microbiology-http://intl-jcm.asm.org

6. Journal of Bacteriology-http://jb.asm.org/

7. Antimicrobial agents and Chemotherapy-http://aac.asm.org/contents-by-date.0.shtml

8. Diabetes Care-http://care.diabetesjournals.org/


Free 1 Year After Publication

1. British Medical Journal-http://www.bmj.com/

2. Molecular Pharmacology-http://intl-molpharm.aspetjournals.org

3. Laboratory Investigation-http://www.nature.com/modpathol/index.html

4 Journal of Infectious Diseases-http://www.journals.uchicago.edu/toc/jid/current

5. Endocrinology-http://intl-endo.endojournals.org

Free 2 Years After Publication
Brain-http://brain.oxfordjournals.org/

Sunday, February 22, 2009

Immunohistochemistry Diagnoses Yesterday, Today And Tomorrow

The advent of Immunohistochemistry as a diagnostic tool in characterizing malignant tumours could be traced to the work of Coons and colleagues in 1942. They introducted immunofluorescence for the detection of antigens in frozen tissues.
In the early 1980’s , monoclonal antibodies became commercially available. This led to the science of antigen detection via visibly tagged antibodies through research which popularized immuno-histochemical applications in tissues though initial staining was weak due to the horseradish peroxidase enzyme detection system used then. The system was soon to be replaced by the more sensitive avidin-biotin system.
The visualization system with diaminobenzidine remain useful till today with some improvements with tyramide amplification. Tyramide is a highly sensitive polymer based labeling system.
In the early days, antibodies were only applied to frozen sections. No staining with formalin fixation was advisable.

It is pertinent to note that this revolutionary tumour diagnoses technique was widespread in Europe and America. Most countries in Africa was left behind including Nigeria. Very few research centers and Tertiary health centers knew about and used this technique.

In 1991, Shi etal discovered heat induced epitope retrieval (HIER) using microwave or pressure cooker along with a metal salt buffered solution. Modern histochemical staining depend largely on this work as more antigens could be detected on routine formalin fixed archive tissues. Staining time for most antigens was reduced. The need for frozen sections for lymphomas was eliminated with superior morphology.

The introduction of automation has now made it possible to standardize staining for quantitation though manual staining still subsists in most laboratories especially in Nigeria.. Automation has also made it possible to record the effect of fixation time on preservation of tissue antigen.

Specific examples of the impact of IHC in tumour diagnoses was summarized in a recent work by Jargidir etal. as follows:
‘The availability of immunostains for myoepithelium has helped delete breast diagnoses such as "highly suspicious for microinvasion" from our lexicon to the more definitive "microinvasion identified/not identified." In addition, the use of immunohistochemical markers in breast cancer has transformed pathology from simple diagnoses to predictive and prognostic necessities. Immunohistochemistry has assisted in guiding adjuvant therapy decisions and sentinel node staging; subtyping a carcinoma as ductal or lobular, basal (cytokeratin [CK] 5/6) or luminal; distinguishing invasive carcinoma from mimics; and establishing that a metastatic carcinoma of unknown primary site has originated in the breast or elsewhere. In the thyroid, CK19 has been considered a useful ancillary to diagnosing papillary carcinoma of thyroid especially in cytology specimens with a high sensitivity and specificity with the caveat that proper sample and controls need to be used when applying IHC to cytology. Another marker that is useful, although not sensitive and not entirely specific, in detection of thyroid malignancies, is HBME-1. HBME-1 detects an unknown antigen on micro-villi of mesothelioma cells and elsewhere.
Very few markers are specific to the lung and lung tumors. The best marker that we have now is thyroid transcription factor 1 (TTF-1), which is widely used in differentiating a lung primary from other neoplasms, including mesothelioma. However, it is not without its shortcomings and is close to desired specificity but lacks sensitivity, being absent or sparsely positive in poorly differentiated lung cancers and primary squamous cell carcinomas of the lung. Another promising marker on the horizon that appears to complement TTF-1 in detecting a lung primary is napsin A. In our study of more than 1000 carcinomas of diverse origin, we found that napsin A was complementary to TTF-1 in the detection of lung primary and more sensitive than TTF-1 (I. Sainz, P. T. Cagle, MD, J. Jagirdar, MD, unpublished data, September 2007). Napsin A is a functional aspartic proteinase that is expressed in the normal lung parenchyma in type II pneumocytes and in the proximal and convoluted tubules of the kidney. It is weakly expressed in pancreatic tumors and is well expressed in some renal tumors and thyroid carcinomas. Until now there were no good positive mesothelial markers, and a diagnosis of mesothelioma was one of exclusion and depended on having several negative epithelial markers. Now we have calretinin, which is the single best sensitive marker for mesothelial differentiation. The source of calretinin is important, with Zymed antibodies (Zymed Laboratories, South San Francisco, Calif) outperforming the others. Cytokeratin 5/6 is another positive marker for mesothelioma. The issue of separating benign mesothelial proliferation from mesothelioma still relies on morphology. However, it is aided by desmin, which is most frequently positive in benign mesothelial proliferations, whereas epithelial membrane antigen and p53 are positive in malignant ones.
Immunohistochemistry has proven to be a useful tool in the diagnosis of infectious diseases in tissue samples. It is especially useful in the identification of microorganisms that are present in low numbers, stain poorly, are fastidious to grow, are noncultivable, or exhibit an atypical morphology. A caveat to remember when staining pathogens is that there may be widespread occurrence of common antigens among bacteria and pathogenic fungi and both monoclonal and polyclonal antibodies must be tested for possible cross-reactivity with other organisms. Examples of some newer pathogens that can be immunostained now are Hantavirus, parvovirus B19, Rocky Mountain spotted fever, Candida, Aspergillus, and mycobacteria.
By using IHC in selected cases, the rate of false-negative and false-positive diagnoses can be reduced in the genitourinary tract, with some patients getting more specific or effective therapy. Prostate-specific antigen remains one of the best organ-specific markers with sensitivity available for the prostate. Uroplakin III is specific for terminally differentiated urothelial cells and is present in 60% of bladder cancers. α-Methylacyl CoA racemase (clone P504S) was identified using expression profiling and was found preferentially in prostatic carcinoma as compared with normal tissue. It is also positive in prostatic intraepithelial neoplasia and less commonly in nodular hyper-plasia, atrophic glands, and nephrogenic adenoma. Cocktails of high-molecular-weight keratin, keratin 903, p63 (a basal cell marker), and α-methylacyl CoA racemase is used in confirming a morphologic diagnosis of minimal prostatic carcinoma. In testicular tumors, hematopoietic marker CD30 is used to distinguish seminoma (except spermatocytic seminoma and intratubular germ cell tu-mor) and embryonal carcinoma from other germ cell tumors. In seminomas, the staining is focal. CD117, a trans-membrane tyrosine kinase receptor protein, is also strongly positive in seminoma as opposed to other nonsemino-matous germ cell tumors. Conversely, CAM 5.2 is positive in nonseminomatous germ cell tumors. Eighty-five percent of clear cell renal cell carcinomas are positive for CD10, another hematopoietic marker. Inhibin is a highly specific marker for ovarian and testicular sex cord tumors and a sensitive marker for adrenal cortical neoplasms.
By using IHC in selected cases, the rate of false-negative and false-positive diagnoses can be reduced in the genitourinary tract, with some patients getting more specific or effective therapy. Prostate-specific antigen remains one of the best organ-specific markers with sensitivity available for the prostate. Uroplakin III is specific for terminally differentiated urothelial cells and is present in 60% of bladder cancers. α-Methylacyl CoA racemase (clone P504S) was identified using expression profiling and was found preferentially in prostatic carcinoma as compared with normal tissue. It is also positive in prostatic intraepithelial neoplasia and less commonly in nodular hyper-plasia, atrophic glands, and nephrogenic adenoma. Cocktails of high-molecular-weight keratin, keratin 903, p63 (a basal cell marker), and α-methylacyl CoA racemase is used in confirming a morphologic diagnosis of minimal prostatic carcinoma. In testicular tumors, hematopoietic marker CD30 is used to distinguish seminoma (except spermatocytic seminoma and intratubular germ cell tu-mor) and embryonal carcinoma from other germ cell tumors. In seminomas, the staining is focal. CD117, a trans-membrane tyrosine kinase receptor protein, is also strongly positive in seminoma as opposed to other nonsemino-matous germ cell tumors. Conversely, CAM 5.2 is positive in nonseminomatous germ cell tumors. Eighty-five percent of clear cell renal cell carcinomas are positive for CD10, another hematopoietic marker. Inhibin is a highly specific marker for ovarian and testicular sex cord tumors and a sensitive marker for adrenal cortical neoplasms.
In soft tissue tumors, the characteristic translocation in Ewing sarcoma/primitive neuroectodermal tumor, t(11; 22)(q24;q12) involving Ewing sarcoma (EWS) gene on chromosome 22 and the FLI-1 gene on chromosome 11 results in overexpression of FLI-1 protein, which can be detected immunohistochemically in nuclei of ~70% of Ewing sarcoma/primitive neuroectodermal tumors. Another new abnormally expressed protein product of chromosomal aberration 2p23, ALK1(p80), is present in approximately 50% of pediatric inflammatory myofibroblastic tumors and in some other malignant soft tissue tumors. The staining is usually cytoplasmic in inflammatory myofi-broblastic tumor as opposed to nuclear and cytoplasmic in anaplastic large cell lymphoma. Alveolar soft part sarcomas are now theorized to be related to muscle tumors because of their desmin positivity. However, staining with newer muscle markers such has MyoD1 and myogenin are negative. Recently, a characteristic X:17 translocation has been identified in alveolar soft part sarcomas resulting in an ASPL-TFE3 fusion gene. Antibody TFE3 detects the presence of overexpressed gene product in alveolar soft part sarcomas. The same protein is also overexpressed in certain pediatric renal cell carcinomas.
Some liver lesions can be problematic. Differentiation between hepatic adenoma and focal nodular hyperplasia can be problematic and can now be aided by β-catenin, which is found in hepatic adenomas. Hepatocellular carcinomas can be distinguished from cirrhotic nodules and benign liver tumors with the aid of a new marker glypican 3. Hepar-1 is a liver-specific antigen that can be used in the context of hepatocellular carcinoma look-alikes such as renal cell carcinoma and adrenal carcinoma. However, it is not specific for the liver and must be used with a panel of markers. Distinguishing an appendiceal adeno-carcinoma from a colonic carcinoma is now possible via MUC5AC, which is positive in appendiceal carcinoma and not in colonic carcinoma, whereas β-catenin is negative in appendiceal lesions and almost always positive in colonic cancers. β-Catenin and villin are both highly unusual in ovarian mucinous carcinomas as compared with colonic mucinous carcinomas.
In summary, we will continue to make significant progress as more organ-specific markers emerge as a result of proteomics and genomics in conjunction with microar-rays’.
Outlook for the future tends toward evidence based meta analysis in conjuction with tissue microarrays. This is expected to facilitate rapid evaluation of antibody profiles on thousands of cases. It is also expected that the art of immunohistochemistry will develop into a full blown ‘science’..
References s
1. Coons AH, Creech HJ, Jones RN. Immunological properties of an antibody containing a fluorescent group. Proc Soc Exp Biol Med. 1941;47:200.
2. Shi SR, Key ME, Kalra KL. Antigen retrieval in formalin-fixed, paraffin-embedded tissues: an enhancement method for immunohistochemical staining based on microwave oven heating of tissue sections. J Histochem Cytochem. 1991;39:741-748.
3.Immunohistochemistry: Then and Now
Archives of Pathology & Laboratory Medicine , Mar 2008 by Jagirdar, Jaishree

Monday, February 16, 2009

Post Graduate Education Opportunities For Biomedical Scientists

The crave for education worldwide is on the increase. Professionals from around the world seek continuous education opportunities to give their career advancement a filip and to enhance their knowledge and competence in a fast changing world.
The problem is that where to find these educational opportunities is hard to come by. Ready information is desperately needed to find Institutions that offers post-graduate education opportunities to Biomedical Scientists.
This guide is an attempt to solve this problem and make the information available at your finger tips.

Post Graduate Education Opportunities In The U.K.
These courses are accredited by the London Institute of Biomedical Science. You'll find full time and part time opportunities you may decide to enrol in. The contact addresses of resource persons are made available for easy follow up or query.
Information on courses from Institutions in U.K., Singapore, Canada, Australia, Ireland etc are included.

Guide To IBMS ACCREDITED POST GRADUATE DEGREE COURSES
Go to http://www.ibms.org/pdf/ibms_accredited_higher_feb09.pdf

OR
click here Now for Instant Download!

Monday, February 2, 2009

Pat Letendre Internet Search Secrets

Pat Letendre-Professor of Transfusion medicine and an internet expert shares her search strategies with you. Enjoy it.

PERSONAL SEARCH STRATEGIES

1. Search Medline via PubMed

Below are notes on how to search PubMed and how to save searches for later updating.

SEARCH

Find terms using PubMed's MeSH browser. If MeSH terms do not fit well, use free-text keywords. Combine terms using boolean operator AND. Limit the search using one of PubMed "Search Field Descriptions and Tags," for example:

* english[la]
* editorial[pt]
* review[pt]
* 1999:2005[dp]
* vox sang[ta]
* Free Full Text [Filter] - see my On TraQ blog

If an author has written extensively on an issue, use something like 'heddle nm[au]' (e.g., for causes of non-hemolytic febrile transfusion reactions ) or 'judd wj[au]' (e.g., for appropriate serological testing). Limit the hits to the past 5 years (or shorter) using "Entrez Date limit." Take advantage of the "See related articles" option.

Sample search (try it on PubMed):

creutzfeldt-Jakob AND transfusion AND english[la] AND review[pt] AND 2004:2005[dp]

New SAVE PUBMED SEARCHES

There are many options to save a search. The simplest is to choose the "Save Search" link near the top right beside the search boxes. You will have to register (it's free and easy). Once a search is saved you have an option to get updates sent to you by e-mail daily, weekly, etc.

Other choices are available using the "send to" drop-down box just above the list of "hits":

One is an RSS feed, which are easy to use if you have a gmail account. After you have perfected a search that you are interest in, click on the "SEND TO" drop-down box and select "RSS feed"; then limit your "hits" to 25, 50, whatever you want; and click on "create feed", then click on XML. You should now be able to choose Google as your reader. Then you log-in to your gmail account and the PubMed feed will be there.

If Google is not offered as a choice, copy the URL on this page, as it's the address of your search feed. The URL will look something like this:
http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1D1U_2QMDWYNn0e2T7aI7oJWd7iZrQIfEEjjYZFI_2dvKujkk


Once in Google reader and logged in to your gmail account, select "add subscription", the paste the URL into the address box.

Once you have a gmail account and do this once it will be so easy the next time. Here are examples of PubMed RSS feeds that I did for TraQ:

* Nursing-related transfusion research
* Transfusion education

2. "Anchor" Websites

- Content-specific sites (sites likely to have the information) For example:

* Chagas - WHO and CDC
* vCJD - Br Med J
* With BMJ and many other journals you can ask to be alerted when new articles cite a a paper. You can link directly to Medline abstracts by the same author. Since the link takes you to PubMed, you have direct links to related Medline citations.

- Association sites (Associations) For example:

* AABB - SIGs (members only)
* CBBS - e-Network forum
* AACC - Clinical Laboratory News (interdisciplinary topics)
* CAP - benchmark surveys, CAP Today
* TraQ - Downloadable resources, regulatory, regional and international news in transfusion medicine

3. Online Journals (Journals)

Online journals may offer free full-text articles or only abstracts (to non-subscribers). Examples of free full-text journals:

* Arch Path & Lab Medicine
* Br Med J (partial)
* CMAJ
* CAP Today
* MMWR

4. Electronic mailing lists (Lists)

For topics that may not have been published extensively or are practice-related, use mailing lists, preferably ones with subscribers who are experts in their fields.

* Apply the same critical analysis to list messages as you would to published papers, i.e., consider the author's credentials and experience and whether the advice is evidence-based or anecdotal.

MEDLAB-L: Because the list uses listserv software, archives are searchable by both author and keywords, a major advantage to a list for health professionals.

* Consider using private contacts from MEDLAB-L and other lists such as Canada's Transfusion Safety Officer mailing list ("transfusion")
* MEDLAB-L is a multi-discipline list with many knowledgeable experts as subscribers. For example, there are experienced pathologists, transfusion service medical directors, laboratory technologists, immunologists, toxicologists, microbiologists, LIS specialists, educators, etc.
* Private e-mail has the advantage of being able to make politically sensitive enquiries a more confidentially than on open forums such as the AABB SIGs.

5. Search engines (General - Medical - Specialty)

* Search the WWW using a few favorite search engines, e.g.,
o Google
o Google Scholar (see TraQ blogs)
o All the Web
* Read the Help files and use an advanced search mode if one exists.
* With some search engines try a straight question, e.g., "What is a prion?"
* Depending on the topic, try medical search engines such as MedHunt.

Several search engines allow restricting hits to educational, government, and other sites. For example, with Google's advanced search page, there is an option to return results only from a particular site or domain and to return pages that link to a particular site,

* Tip: If you get hits that are dead links, click on "cached" for Google's last saved page (may be outdated but tells you what was once there)

I also use the WWW extensively for interests such as travel. Accommodations for all recent holidays have been found on the Net.
Big Picture
This website with its organized links is my personal portal to the Web.
CULLED FROM www.patletendre.com