Metformin for ovulation induction (excluding gonadotrophins) in women with polycystic ovary syndrome.

Background: Polycystic ovary syndrome (PCOS) is characterised by infrequent or absent ovulation, and high levels of androgens and insulin (hyperinsulinaemia). Hyperinsulinaemia occurs secondary to insulin resistance and is associated with an increased biochemical risk profile for cardiovascular disease and an increased prevalence of diabetes mellitus. Insulin-sensitising agents such as metformin may be effective in treating PCOS-related anovulation.

Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility.

Background: Polycystic ovary syndrome (PCOS) is characterised by infrequent or absent ovulation, and high levels of androgens and insulin (hyperinsulinaemia). Hyperinsulinaemia occurs secondary to insulin resistance and is associated with increased risk of cardiovascular disease and diabetes mellitus. Insulin-sensitising agents such as metformin may be effective in treating PCOS-related anovulation.

Systemic lupus erythematosus or infection with HIV, or both?

The features of both HIV infection and connective tissue disease are often nonspecific and may mimic other disorders as well as each other. We treated a patient with presumed systemic lupus erythematosus (SLE) for 4 years, who finally admitted to longstanding infection with HIV. The coexistence of SLE and HIV is unusual and has, although reported in the rheumatological journals, not often been discussed in the dermatological literature.

Gastrin releasing peptide and gastrin releasing peptide receptor expression in gastrointestinal carcinoid tumours.

Aims: To establish whether gastrin releasing peptide (GRP) and the GRP receptor (GRPR) are expressed together in gastrointestinal carcinoid tumours.

Methods: Twenty six carcinoid tumours from the stomach, small intestine, appendix, and colorectum were investigated by immunohistochemistry for GRP and GRPR.

Results: GRP was detected in nine of 19 tumours and GRPR in 22 of 26.

Rapid (partial) prescreening of cervical smears: the quality control method of choice?

Rapid rescreening of all negative and inadequate smears is the quality control method of choice in the UK. The sensitivity of primary screening of laboratory and individual screeners are major indicators of screening quality and are dependent on the number of false negative smears found by rapid screening for their calculation. High sensitivity may indicate good quality primary screening or poor quality rapid review.

Venous patency after open central-venous cannulation.

To investigate the value of Doppler ultrasound scan (USS) assessment of internal jugular vein (IJV) patency after previous open central-venous cannulation (CVC), a prospective study of 66 consecutive children (median age 4.5 years; range 4 months-17 years) who had previously undergone open insertion of at least one indwelling IJV line and required further CVC for completion of therapy was undertaken. All underwent Doppler USS examination prior to surgery.

The ratio of erythrocyte zinc-protoporphyrin to protoporphyrin IX in disease and its significance in the mechanism of lead toxicity on haem synthesis.

Protoporphyrin and zinc-protoporphyrin were measured in the erythrocytes of normal subjects, workers exposed to lead and patients with iron deficiency and erythropoietic protoporphyria (EPP). Results showed significantly higher levels of zinc-protoporphyrin in the lead-exposed workers (P < 0.0001), patients with iron deficiency (P < 0.

The survivors of gastroschisis.

Aims: To assess the long term morbidity and quality of life in survivors of gastroschisis.

Design: All babies born with gastroschisis between 1972 and 1984 and who survived more than one year were identified. Those who could be traced were questioned about their general health, growth, abdominal symptoms, cosmetic concerns, education, employment, and fertility.

The disappearing vagina syndrome.

We describe the case histories of five women who developed a severe ulcerating and constricting condition of the vagina following hysterectomy. Three of these women had other classic ulcerative conditions of skin, mouth or colon. One of these women has been described previously.

Evaluation of 99Tcm-tetrofosmin as a myocardial perfusion agent in routine clinical use.

Recent trials with selected patients have indicated that 99Tcm-tetrofosmin is a suitable agent for myocardial perfusion imaging. We performed 99Tcm-tetrofosmin perfusion imaging in an unselected group of 297 patients routinely referred to our department. Single photon emission tomographic (SPET) imaging was performed 45-60 min post-injection using a 2-day stress and rest protocol.

Detection and measurement of DNA adducts in the cervix of smokers and non-smokers.

Smoking has been associated, on epidemiologic grounds, with an increased risk of cervical neoplasia. We have investigated this association, using laboratory-based methods. A 32P post-labeling assay was performed on 97 cervical biopsies to detect and measure DNA adducts (additional products formed by the covalent binding of potential chemical carcinogens to nuclear DNA).

A multicentre survey of hand hygiene practice in intensive care units.

A detailed survey of hand hygiene in 16 intensive care units (ICUs) in Yorkshire was undertaken with the aim of following up the results of a national survey of infection control policies and practices which had been conducted in 1990 (Inglis et al., Br J Anaesthesia 1992; 68, 216-220). The main problems associated with infection control were identified as: the limited relevance of some infection control policies to the specialist nature of intensive care, poor compliance by nurses to local infection control policies, sub-optimal hand hygiene by all healthcare professionals and a need for more effective communication of research-based infection control recommendations in the ICU.

Expression of cytochrome P450 enzymes in the cervix. An immunohistochemical study.

The expression of cytochrome P450 isoenzymes (subfamilies) CYP1A, CYP2B, CYP2C, CYP3A and CYP4A in the histologically normal cervix was explored using a panel of polyclonal antibodies. There was variation in the intensity of immunohistochemical reaction between the isoenzymes and between the various components of the cervix. Half the subjects tested were smokers and had increased urinary cotinine levels.

Mixed Mullerian tumors of the uterine corpus: a review.

The literature relating to mixed Mullerian tumors of the uterine corpus has been reviewed. A critical account of the clinico-pathologic features of these tumors, their prognosis and treatment is presented.