Search

Objective: To evaluate the pregnancy outcomes of all patients who underwent electrosurgical cone biopsy of the cervix between January 2000 and December 2011 and subsequently became pregnant.Study Design: Retrospective cohort study.Settings: District General Hospital in the North East of England.Methods: Patients were identified from the local colposcopy electronic data, Hospital Episode Statistics and Maternity electronic data. Data were collected on a pro forma with two sections: (1) treatment section and (2) pregnancy section. In the treatment section, year and indication for treatment, volume of cervix removed, histological results and marginal status of specimen were documented. In the pregnancy section, time interval between treatment and pregnancy, pre-treatment obstetric history, cervical length measurements, cervical suture, gestation and mode of delivery and neonatal outcome were documented. Data were analysed using SPSS.Results: 25 women achieved 47 pregnancies after electrosurgical cone biopsy treatment. Most common indication for cone biopsy was glandular neoplasia accounting for nearly half of the procedures; 21.2% of pregnancies ended in first-trimester miscarriages. The preterm delivery rate (<37 weeks) was 19.4%. Volume of cervix excised was significantly greater in women who delivered preterm compared to women who delivered at term (p = 0.028). The rate of preterm delivery was significantly higher in post treatment pregnancies when compared to pregnancies before treatment in the same women (p = 0.02). The preterm delivery in post-treatment pregnancies was not related to the time interval between treatment and pregnancy (p = 0.54). There was no significant difference in miscarriage rates in pre- and post-treatment pregnancies (p = 0.98).Conclusion: Electrosurgical cone biopsy of cervix is associated with increased risk of preterm labour that is related to the volume of cervix excised. [ABSTRACT FROM AUTHOR]

ABSTRACT A bioanalytical method was developed and validated to estimate donepezil, 6-desmethyl donepezil and 5-desmethyl donepezil simultaneously in human plasma using galantamine as an internal standard (IS). The chromatographic separation was achieved on a reverse-phase XTerra RP (150 × 4.6 mm, 5 µm) column without affecting recovery (mean recovery > 60% with CV < 10%) for all analytes. ESI-MS/MS multiple reaction monitoring in positive polarity was used to detect mass pairs for donepezil ( m/ z 380.3 → 91.3), 6-desmethyl donepezil ( m/ z 366.4 → 91.3), 5-desmethyl donepezil ( m/ z 366.4 → 91.3) and galantamine m/ z (288.1 → 213.0). The linearity was established over a dynamic range of 0.339-51.870, 0.100-15.380 and 0.103-15.763 ng/mL for donepezil, 6-desmethyl donepezil and 5-desmethyl donepezil, respectively. The current method shows that minimal conversion of labile metabolites to parent donepezil in plasma as stability was successfully achieved for 211 days at −15 °C storage temperature. The method was successfully applied to a clinical study after administration of 10 mg donepezil tablets to healthy male Indian volunteers. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Presents several letters concerning medicine. Use of colposcopy in the management of cervical dyskaryosis; Association between adrenergic drugs and mortality rate in asthma; Comparison between integrated care and conventional care for diabetes.

Comments on issues related to health services in Great Britain. Emphasis on the management of patients who refuse blood transfusion; Maintenance of list of consultant prepared to treat Jehovah's Witnesses; Standard treatment for resectable esophageal cancer.