But this is the main article to read to understand why the Task Force wants to limit mammograms:

http://jama.ama-assn.org/cgi/content/full/302/15/1685

Many researchers and doctors express the inability to prevent and treat aggressive cancers which develop between routine checkups with current mammogram practices. The science and medical communities now push not only early detection, but research focused on differentiating invasive and non-invasive cancers by dependable biomarkers. In addition, the statistics proving the inadequacy of routine mammograms have prompt some leaders to advocate only biannual screenings for women 50 and older. This recommendation by US Preventative Services Task Force has fueled a political debate just as Obamacare has gained ground.

Along with universal healthcare, comes a large price and liberals are under attack of attempting to ration healthcare. A main argument is that detection of harmless abnormalities leads to overdiagnosis, excessive treatment, and anxiety. Political leaders have used scientific data to push the initiative of less screening in order to lessen the burden on families who may be worrying about an indolent tumor, but ultimately to cut the costs of screening and treatment of many cancers which would not cause any symptoms. Regardless of increased stress, survey shows that 75% of women would rather undergo treatment than allow a cancer to live, which illustrates the divide between individual interests with that of public health affairs. While most women feel unsafe knowing that a form of cancer exists in their body, some lawmakers and healthcare professionals suggest reducing screening to avoid complications of addressing minimal-risk tumors for healthcare providers and for the patient. Currently, doctors still recommend regular screening for women starting at the age of 40 and to continue doing self exams.

From the standpoint of a premedical student with an interest in molecular imaging, continuing routine screening for women starting at the age of 40 until research as identified a biomarker specifically distinguishing invasive cancer from indolent forms seems the most reasonable path. With time and collaboration between different fields of science, we can start identifying people most at risk of breast cancer accurately and spare the less vulnerable population from the anxiety and complications of unnecessary procedures. However, this research must be a priority because allowing physicians to classify small lesions as high or low risk will significantly reduce deaths from regional and metastatic spread. The fact is that most lesions will not metastasize, and some even regress. Focusing on these passive tissues will waste resources and impair the patient with anxiety and complications of therapy.

After validation of newly synthesized or discovered biomarkers, doctors can reduce the treatment of minimal risk cancers. Along with this, there needs to be intense and widespread education of the public so people understand that having non-invasive malignant cells in your body will cause no symptoms. This may include renaming passive tumors are “IDLE (indolent lesions of epithelial origin).” Because this contradicts the general idea that cancer must be detected early and removed, it will require much outreach and intervention. Once a profile of high risk patients have been identified, I believe that they next step would be to research ways for prevention of cancer for these populations. A means to preventing cancer by focusing energy on invasive cancers and having the indolent lesions under control but untreated is definitely a new idea for the public and for the field of molecular imaging.

Seeing the need to tell the difference between non-invasive and invasive cancers, I believe that future research in molecular imaging and biology will be the key. Because one form of cancer metastasizes and grows rapidly, while its counterpart remains stagnant and inactive, there has to be metabolic differences which potentially can be observed by MRI or fluorescence. An idea is to tag the proteins localized in invadopodia, protrusions on malignant cells responsible for proteolysis and degradation of the extracellular matrix, because it can potentially tell us about the activity level of the lesion. For example, lesions that are highly active have more seprase and these can be potentially tagged with fluorescent nanoparticles such as activatable cell penetratable peptides, quantum dots, or iron oxides. Designing particles to highlight invasive cancers and to pinpoint populations vulnerable to cancer will provide productive intervention.

As for policy, I promote funding for research projects and grants for laboratories which will improve cancer detection. Also, the most beneficial policies will be ones which help the economy recover. Once that is under control, health care reform and new recommendations which have economic impact can be most efficiently performed.

References:

http://jama.ama-assn.org/cgi/content/full/302/15/1685

Multiple alleles at the same locus: hierachy of dominance makes deviations from common ratios. An example is the color of ducks which are coded for by 3 different alleles. Restricted color is more dominant than mallard which is more dominant than dusky.

Co-dominance: cystic fibrosis at the molecular level, but a more obvious one is blood groups with A, B, or O phenotypes. A and B are co-dominant.

Epistasis: When one gene masks the expression of another gene. The gene doing the masking is the epistatic gene while the gene being hidden is the hypostatic gene. Epistasis changes the 9:3:3:1 ratio seen in dihybrid crosses of heterozygotes. [Post Chart]

Huntington’s Disease: autosomal dominant.

Muscular dystrophy: X-linked recessive.

Sickle Cell Anemia: autosomal recessive.

I despise her and caught myself staring at her belongings with disgust. I thought I didn’t harbor any ill will, but I have to be an adult now and refrain from any malicious activity. I hope she moves out…I will probably at the end of the year. I realized that my roommates are not supportive and they showed their “true colors.” They don’t care or even like me. Given my “offense” was rudeness in negotiation, that’s not an excuse for a threat of a punching and throwing her massive body on me.

What the hell am I going to do? I guess just be chill and normal and avoid confrontation as much as possible. She said as long as I “don’t give her attitude,” she can control herself. Crazy mofo. But yah I have to get this off my chest so I can study. Basically I can just be chill and happy about other things. And when I meet other people and make new friends, I’ll be much happier and calm.

But people, screaming insanities and threats at your roommates is not acceptable behavior and is no where on the same level as “not listening..” Everyone is telling me it’s just a figure of speech and not a big deal, but come on now. This shit happens at parties when ppl are drunk…not over a small and ridiculous problem like noise. Anyways there is documentation in case something else happens which requires more serious action. I just want to be smart about it.

1. Problems from Lehninger Principles of Biochemistry. Will get to after reviewing study guide material

2. BIOENERGETICS. High energy phosphate compounds are important, especially in glycolysis. They have a free energy value of -30 kj/mol or more negative. Some examples are of course ATP, phosphoenolpyruvate (PEP) which is catalyzed by pyruvate kinase to make pyruvate. ATP has 2 bonds which are high energy and they are the bonds which connect the last two phosphate compounds to the entire molecule. Therefore the last 2 bonds are high energy.  The hydrolysis of ATP gives off -30.5kj/mol so therefore it can drive unfavorable reactions. For example adding H2O to ATP to relieve the electron repulsion and allowing the phosphate group to be on its own and resonate, can drive the phosphorylation of glucose into glucose 6-phosphate with the help of hexokinase and MG2+ as a cofactor. Also, because the biochemical pathways in our bodies use enzymes, allosterically inhibiting them with concentrations of ATP, ADP, or AMP can cause some pathways to shut down while others increase. Catabolic pathways bring molecules down for energy. They include glycolysis, and glycogenolysis. When ATP is low, cells will break down glucose and glycogen to make more ATP. Anabolic pathways include gluconeogenesis (pyruvate–>glucose)  and glycogenesis (glucose to glycogen). Here, ATP and energy are hi so we do not need any more. Therefore we are building up from biosynthetic molecules and saving energy like by making glycogen.

ATP essential controls the fate of the cell…will it live or die. The cell must try and keep levels of ATP high. In glycolysis, 6 out of 10 steps are near equilibrium. This is known by comparing the Q and Keq values. There fore small changes in concentration can even reverse the net flow. The other steps are far from equilibrium are are points of regulation. These are kept far from equilibrium so that they are exergonic during cellular conditions. The Kinetic effect of low ATP concentration in cells is that enzymes that rely on the energy released in ATP hydrolysis would slow down and hundreds of reactions would not happen. Also there is a thermodynamic reason; if ATP decreases, which is the denominator in the Q mass ratio, then the value of Ln(x) would increase and be positive and the over all free energy would be more positive and unfavorable.

3. Metabolic Pathways to remember:

Now Glycogen! and how glycogen phosphorylase breaks down alpha1-4linkages using just inorganic phosphate

…g