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OBJECTIVES: 'Overweight and obesity' is the second biggest preventable cause of cancer after smoking. In 2018, Cancer Research UK launched an awareness raising campaign about the link between overweight and obesity and cancer risk. This study aimed to evaluate the reach and impact of the campaign. STUDY DESIGN: This study was a repeated cross-sectional online survey. METHODS: The campaign consisted of six elements including the main message that 'Obesity is a cause of cancer'. UK adults and Members of Parliament (MPs) were surveyed before the campaign (W1; n = 2124 and n = 151), 1 month (W2; n = 2050 and n = 151) and 3 months after the campaign (W3; n = 2059 and MPs not surveyed). Outcome measures were campaign reach, awareness of overweight and obesity as risk factors for cancer, attitudes towards individuals who are overweight or obese, support for policies to reduce obesity and reactions to the campaign. RESULTS: Overall, 76.2% of MPs and just under half of the public (47.5% in W2 and 36.8% in W3) reported having seen the campaign. Unprompted awareness of obesity as a risk factor increased among the public from 17.1% at W1 to 43.3% in W2 (odds ratio 3.71, 95% confidence interval 3.18-4.33) and 30.3% in W3 (odds ratio 2.11, 95% confidence interval 1.80-2.47). A similar pattern was seen for prompted awareness and among MPs. There were no consistent changes in attitudes towards overweight individuals or support for policies to reduce obesity. CONCLUSIONS: This evaluation suggests that the campaign achieved the primary objective of increasing awareness of the link between obesity and cancer without increasing negative attitudes towards individuals who are overweight or obese.

We report the case of a 62-year-old patient who developed a carcinomatous meningitis while on second-line chemotherapy for ovarian cancer. Cytologic analyses confirmed that carcinomatous cells of ovarian origin were present in cerebrospinal fluid. Carcinomatous meningitis is a very rare event in the natural history of ovarian carcinoma. We discuss the specificity of our case in the light of the literature. In addition, we present some relevant radiologic and pathologic documents illustrating this rare entity.

In order to expand the repertoire of somatosensory functions that can be effectively studied through functional MRI, we have developed a tactile stimulator which can deliver rich and varied combinations of stimulation that simulate natural tactile exploration. The system is computer controlled and compatible with an MRI environment. Complex aspects of somesthesis can thus be studied independent of confounds introduced by motor activity or problems with precision, accuracy or reproducibility of stimulus delivery.

Clinical trial registration allows interested parties to obtain information about ongoing and completed trials, but there are few data indicating the quality of the information provided during the registration process. We used information in the publicly available ClinicalTrials.gov database to describe patterns of trial registration before and after the implementation by journal editors of a new policy requiring registration as a prerequisite for publication.We reviewed ClinicalTrials.gov records to determine patterns of completion of the "Intervention Name" and "Primary Outcome Measure" data fields for trials registered on May 20 and October 11, 2005, and for trials registered during the interval between these two dates, inclusively.During the interval studied, the number of registrations in ClinicalTrials.gov increased by 73 percent from 13,153 to 22,714. The percentage of interventional trials registered by industry with nonspecific Intervention Name entries (attributable to four drug companies) decreased from 10 percent to 2 percent; all other industry and nonindustry records contained specific entries in this field. Of the 2670 studies registered by industry between the two dates, 76 percent provided information in the Primary Outcome Measure field, although these entries varied markedly in their degree of specificity. In the remaining 24 percent of the records, this field was blank.During the summer of 2005, there were large increases in the number of clinical trial registrations. Overall, the data contained in records were more complete in October than they were in May, but there still is room for substantial improvement.

We present the characteristic imaging findings of hypoplasia of the internal carotid artery (ICA) in two cases, one accompanied by an intracranial aneurysm. Finding of a diffuse luminal narrowing of the ICA on MR angiography or digital subtraction angiography (DSA) could wrongly evoke severe acquired diseases such as dissection or atherosclerosis. Absence of associated wall thickening and flow disturbances on color Doppler sonography (CDS) should suggest carotid hypoplasia. Confirmation of the diagnosis is obtained by CT of the skull showing a small carotid canal. Non-invasive procedures are sufficient to differentiate this rare congenital anomaly from acquired string signs.

This protocol documents the construction of a custom microscope stage system currently in widespread use by a wide variety of investigators. The current design and construction of this stage is the result of multiple iterations, integrating input from a number of electrophysiologists working with a variety of preparations. Thus, this tool is a generally applicable solution, suitable for a wide array of end-user requirements; its flexible design facilitates rapid and easy configuration, making it useful for multi-user microscopes, as individual researchers can reconfigure the stage system or have their own readily replaceable stage plates. Furthermore, the stage can be manufactured using equipment typically found in small research machine shops, and by keeping the various parts on hand, machinists can quickly satisfy new requests and/or modifications for a wide variety of applications.

We report one cervical and two thoracic vertebral haemangiomas with neurological disturbance successfully treated by percutaneous vertebroplasty followed by decompression surgery. Vertebroplasty consolidates the vertebral body and reduces the risk of haemorrhage. Subsequent surgery may be limited to decompressive laminectomy and resection of the epidural extension of the haemangioma. Embolisation was also carried out in one case. Complete neuroimaging workup, including CT, myelo-CT and MRI, is necessary prior to treatment.

The aim of percutaneous laser disk decompression (PLDD) is to vaporize a small portion of the nucleus pulposus of an intervertebral disk, thereby reducing the volume and pressure of a diseased disk. This minimally invasive technique can be performed in patients who need surgical intervention for disk herniation with leg pain. PLDD is usually performed under fluoroscopic guidance with or without diskoscopy. However, it can also be performed under dual computed tomographic (CT) and fluoroscopic guidance as an outpatient procedure. CT and fluoroscopic guidance increases the safety and accuracy of PLDD, with high precision of instrument guidance, direct visualization of nucleus pulposus vaporization, and reduced risk of complications. Of 119 patients with lumbar disk herniation treated with PLDD under CT and fluoroscopic guidance, 91 (76.5%) had a good or fair response. PLDD performed with CT and fluoroscopic guidance appears to be a safe and effective treatment for herniated intervertebral disks.

We describe a case of Castleman's disease in a 8-year-old-boy who presented with a slowly growing mass in the upper neck. MRI showed a well-defined homogeneous mass with nonspecific signal features. Unusual features were a kidney-bean shape and the deep location in the suprahyoid region, the mass originating in the left retropharyngeal space.

Despite a growing number of available Web-based health information resources, consumers continue to face a variety of barriers as they attempt to access these resources. Developing a system that appropriately responds to user queries poses several challenges. Guided by an earlier study that analyzed a large number of queries submitted to ClinicalTrials.gov, we developed a variety of techniques to assist user information seeking. We tested the efficacy of these techniques by submitting the original user queries to our new search engine to determine if these techniques would result in better system performance. Overall, the number of query failures was reduced, but the largest improvement was found in the system's query suggestion capability. For a subset of query failures, the current system was able to cut the earlier failure rate almost in half, in most cases providing a suggestion rather than directly finding records. The techniques described here provide a new approach for responding to user queries. The techniques are tolerant of certain types of errors and provide feedback to assist users in reformulating their queries.

Background The water permeability barrier of the stratum corneum seems to be regulated primarily by lamellar bodies situated between the corneocytes; the lamellar bodies originate largely from polar lipid precursors, mainly sphingomyelin (SM), provided by the cells of the stratum granulosum via exocytosis of their lamellar body content. Objectives The aim of our study was to evaluate the cellular distribution of SM during development of the epidermis. Methods In this study, we investigated the expression and localization of SM in both adult and fetal mouse skin by a cytochemical detection method, immunofluorescence microscopy and immunoelectron microscopy, using anti-SM antibody, a specific binding protein to SM (lysenin), and Nile red stain. In addition, we measured transepidermal water loss to estimate the barrier function of the fetal skin. Results We observed that SM was widely distributed from the basal layer to the granular layer in the adult mouse epidermis. An intense cytochemical reaction for SM was observed on embryonic day E14·5 of gestation just before the differentiation of the granular and squamous cells from the intermediate cells. The immunofluorescence indicating SM was detected in two regions, i.e. the most superficial zone of the granular layer and the upper spinous layer after the cell differentiation at the late gestational age. This distribution was not detected by conventional lipid staining, such as with Nile red stain. Immunoelectron microscopy revealed that SM was mainly localized in the intercellular spaces of the adult mouse epidermis and in the intracellular vesicles without a complete lamellar structure in the cytoplasm of epidermal cells of E14·5 fetuses. It is well known that the formation of the structurally mature cornified cell envelope occurs at E15·5 of development. The skin of fetuses at E16·5 showed a definite barrier function. Conclusions These findings suggest that SM dynamics is related to the formation of the lipid envelope, cell differentiation, and epidermal barrier function during development.

We report paradoxical and ambiguous imaging findings in a patient with transient ischaemic attack (TIA). Perfusion-weighted (PW) MRI obtained 2 hours after symptoms onset showed a hypoperfused area in a region compatible with the focal deficit, while diffusion-weighted (DW) MRI was considered negative. Despite the complete resolution of the symptoms which had already begun at the end of the first MR examination, follow up DW MRI at 3 days showed partial conversion to hyperintensity of the initially hypoperfused area. This case illustrates that PW and DW MRI have to be used in combination and at different time points to correctly diagnose and manage ischaemic stroke because PW MRI is more sensitive than DW MRI for very early detection of ischaemia and delayed DW MRI provides the final signature of brain damage even in case of complete clinical recovering.

We report the CT and MR appearance of a nontraumatic hemorrhagic arachnoid cyst presenting with a third nerve paresis in a 37-year-old man. The cyst, located in the left suprasellar area, contained a fluid-blood level with stigmata of subacute hemorrhage on both CT and MR studies.

In recent years, routine endoscopic examination of the nose and advances in medical imaging have led to a better understanding of the pathophysiology of chronic sinusitis and the development of "FESS". The CT san of the sinuses have superseded the conventional standard radiography in the evaluation of the paranasal sinuses as it offers more precise anatomic information to the surgeon on the complex anatomy of the sinus cavities and their drainage pathways, in particularly the ostiomeatal complex. The coronal plane is the best incidence because it most closely correlates with the surgical approach. The utilization of a high resolution bony algorithm is recommended. A window of intermediate type, 2500 with a center of 250 HU, is sufficient for nearly all diagnosis. Complementary direct axial sections are needed by the surgeon to guide the approach to the sphenoid sinus and the posterior ethmoidal cells. MRI plays a limited role in the evaluation of a non complicated sinusitis. But MRI has supplanted the CT scanner in the appreciation of intracranial and orbital complications of sinusitis because it provides better visualisation and differentiation of soft tissues than the CT scan. The injection of contrast is recommended in all cases of complicated sinusitis.

The jararacuçu, one of the most dreaded snakes of Brazil, southern Bolivia, Paraguay and northeastern Argentina, is a heavily-built pit viper which may grow to a length of 2.2 m. Up to 1000 mg (dry weight) of highly-lethal venom may be milked from its venom glands on a single occasion. It has accounted for 0.8% to 10% of series of snake bites in São Paulo State, Brazil. We examined 29 cases of proven jararacuçu bites recruited over a 20-year period in two São Paulo hospitals. Severe signs of local and systemic envenoming, (local necrosis, shock, spontaneous systemic bleeding, renal failure) were seen only in patients bitten by snakes longer than 50 cm; bites by shorter specimens were more likely to cause incoagulable blood. Fourteen patients developed coagulopathy, six local necrosis (requiring amputation in one) and five local abscesses. Two became shocked and four developed renal failure. Three patients, aged 3, 11 and 65 years, died 18.75, 27.75 and 83 h after being bitten, with respiratory and circulatory failure despite large doses of specific antivenom and intensive-care-unit management. In two patients, autopsies revealed acute renal tubular necrosis, cerebral oedema, haemorrhagic rhabdomyolysis at the site of the bite and disseminated intravascular coagulation. In one survivor with chronic renal failure, renal biopsy showed bilateral cortical necrosis; the patient remains dependent on haemodialysis. Effects of polyspecific Bothrops antivenom were not impressive, and it has been suggested that anti-Bothrops and anti-Crotalus antivenoms should be given in combination.