Surgery and minimally invasive treatments for uterine fibroids.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of surgery and minimally invasive treatments for uterine fibroids.

Fluid and pharmacological agents for adhesion prevention after gynaecological surgery.

Background: Adhesions are fibrin bands that are a common consequence of gynaecological surgery. They are caused by conditions that include pelvic inflammatory disease and endometriosis. Adhesions are associated with comorbidities, including pelvic pain, subfertility, and small bowel obstruction.

Surgical treatment of fibroids for subfertility.

Background: Fibroids are the most common benign tumours of the female genital tract and are associated with numerous clinical problems including a possible negative impact on fertility. In women requesting preservation of fertility, fibroids can be surgically removed (myomectomy) by laparotomy, laparoscopically or hysteroscopically depending on the size, site and type of fibroid. Myomectomy is however a procedure that is not without risk and can result in serious complications.

"He looks gorgeous" - iuMR images and the transforming of foetal and parental identities.

The MERIDIAN study examined whether in-utero MRI (iuMRI) improves the accuracy of diagnosis of foetal brain abnormalities, when used as an adjunct to ultrasound anomaly scanning. A diagnostic iuMRI differs from routine ultrasound screening because of its infrequent use and scanning procedure. Nested within this trial, this sociological study explored the acceptability of iuMRI as a technology and its contribution to parental decision-making.

British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice.

Background: Testosterone deficiency (TD) is an increasingly common problem with significant health implications, but its diagnosis and management can be challenging.

Aim: To review the available literature on TD and provide evidence-based statements for UK clinical practice.

Methods: Evidence was derived from Medline, EMBASE, and Cochrane searches on hypogonadism, testosterone (T) therapy, and cardiovascular safety from May 2005 to May 2015.

Optic neuritis: the eye as a window to the brain.

Purpose Of Review: Acute optic neuritis is a common clinical problem, requiring a structured assessment to guide management and prevent visual loss. The optic nerve is the most accessible part of the central nervous system, so optic neuritis also represents an important paradigm to help decipher mechanisms of damage and recovery in the central nervous system. Important developments include the advent of optical coherence tomography as a biomarker of central nervous system axonal loss, the discovery of new pathological antibodies, notably against aquaporin-4 and, more recently, myelin oligodendrocyte protein, and emerging evidence for sodium channel blockade as a novel therapeutic approach to address energy failure in neuroinflammatory disease.

Transgender people: health at the margins of society.

In this paper we examine the social and legal conditions in which many transgender people (often called trans people) live, and the medical perspectives that frame the provision of health care for transgender people across much of the world. Modern research shows much higher numbers of transgender people than were apparent in earlier clinic-based studies, as well as biological factors associated with gender incongruence. We examine research showing that many transgender people live on the margins of society, facing stigma, discrimination, exclusion, violence, and poor health.

A proteomic analysis of the endometrium in obese and overweight women with recurrent miscarriage: preliminary evidence for an endometrial defect.

Background: Overweight and obese women have been shown to have an increased risk of recurrent miscarriage as well as other adverse reproductive outcomes, but it is yet unclear whether this is due to an effect on the endometrium, embryo or both. The current study employs proteomic analysis to examine for a potential endometrial defect in obese and overweight women with recurrent miscarriage.

Methods: Proteomic tissue analysis of 21 endometrial samples obtained In the midluteal phase from 16 women with recurrent miscarriage (obese, n=12 and lean, n=4) and 5 fertile volunteers (Obese, n=2 and Lean, n=3).

The afferent system and its role in lower urinary tract dysfunction.

Purpose Of Review: Lower urinary tract disorders such as overactive bladder syndrome (OABS) and interstitial cystitis/painful bladder syndrome (IC/PBS) are debilitating conditions with serious adverse effects on quality of life. Common to both OABS and IC/PBS are the sensory symptoms of urgency and frequency, implicating the afferent system in the aetiology of these disorders. Thus, understanding the role that afferent pathways play in the function of the lower urinary tract is the focus of much current research.

A systematic review of the literature on the effects of dexamethasone on the brain from in vivo human-based studies: implications for physiological brain imaging of patients with intracranial tumors.

Background: Among glucocorticoids, dexamethasone is most widely used for treatment of cerebral edema because of its long biological half-life and its low mineralocorticoid activity (sodium retaining).

Objective: A systematic review of the literature on the effects of dexamethasone on the brain from in vivo studies in humans.

Methods: A MEDLINE database search (via the PubMed interface) and an EMBASE database search (via the Dialog interface) of the past 35 years was performed.

Vagus nerve stimulation in children with intractable epilepsy: indications, complications and outcome.

Purpose: To analyze the indication, complications and outcome of vagus nerve stimulation in intractable childhood epilepsy.

Materials And Methods: We retrospectively reviewed the data of 69 children who had insertion of vagal nerve stimulator (VNS) between June 1995 and August 2006 for medically intractable epilepsy. Outcome was based on the Engel's classification.

Methylation status of a single CpG site in the IL6 promoter is related to IL6 messenger RNA levels and rheumatoid arthritis.

Objective: Genetic variation in the gene for interleukin-6 (IL-6) contributes to the pathogenesis of inflammatory arthritis, but the role, if any, of epigenetic variability has not been reported. The aims of this study were to compare the DNA methylation status of the IL6 promoter in rheumatoid arthritis (RA) patients and control subjects and to study the effects on gene expression.

Methods: Genomic DNA was isolated from peripheral blood mononuclear cells (PBMCs) obtained from RA patients and healthy controls.

Mechanisms of cell death and treatment prospects in motor neuron disease.

Scientific evidence is emerging to indicate that motor neuron injury in motor neuron disease may reflect a complex interplay between genetic factors, oxidative stress, and imbalance of the glutamatergic excitatory control of motor neurons, which may result in damage to critical target proteins and organelles. The relative importance of these factors is likely to vary in different subgroups of patients. Protein aggregation may play a role in some forms of motor neuron injury, and the eventual demise of motor neurons may occur by a programmed cell death pathway.

Late relapsing childhood lymphoblastic leukemia.

Childhood lymphoblastic leukemia (ALL) is usually assumed to have been permanently eradicated in patients in long-term remission, but occasionally can recur after many years. To learn more about the problem, we studied a group of children whose leukemia had been in remission for 10 or more years before relapse and tried to determine whether they had true recurrences or second malignancies. We studied children treated on Medical Research Council ALL protocols between 1970 and 1984 and followed up by the Clinical Trial Service Unit in Oxford.

Case report: humero-spinal dysostosis.

We report a case of humero-spinal dysostosis which is only the fourth reported in the literature. The condition is characterized by distal bifurcation of humeri, elbow joint dislocation, spinal malformation, widened iliac bones and talipes equinovarus.

Gastrointestinal dynamics and pharmacology for the optimum design of controlled-release oral dosage forms.

This article encompasses a brief discussion of the principles of pharmacodynamics of different types of drugs and the mechanisms of absorption at different sites in the gastrointestinal tract. The importance of factors such as the pH, the unstirred layer or microclimate, gastric emptying, intestinal contact time, metabolism in the gut wall, and bacterial degradation in the colon is discussed. Methods that can be used to alter the absorption of drugs such as formulation in a viscous form, a form that floats in the stomach, position release forms, combination with other drugs that may influence absorption, etc.