Cervical tissue uptake of all-trans-retinoic acid delivered via a collagen sponge-cervical cap delivery device in patients with cervical dysplasia

The present study was undertaken to evaluate the systemic absorption and cervical tissue uptake of all-transretinoic acid (TRA), delivered via a collagen spongecervical cap delivery device in patients with intraepithelial cervical dysplasia. Ten patients with histologically proven mild or moderate cervical dysplasia were included in this pharmacologic study. The two TRA concentrations (0.05% and 0.372%) selected for study represent the starting and maximally tolerated doses used in phase I clinical trial. All-trans-retinoic-11-³H acid (³H-TRA, 500 Ci) was used to facilitate cervical tissue uptake studies. Cervical biopsies and post-treatment blood samples were obtained from each patient after TRA exposure. The uptake of TRA into cervical tissues four hours after drug administration was significantly increased at the maximally tolerated TRA dose. There was a rapid decrease in cervical tissue concentration of TRA at the 0.372% dose between 4 and 24 h after drug exposure, suggesting a relatively short elimination half-life of TRA in cervical tissues. HPLC analysis of post-treatment blood samples indicate that there was no systemic absorption of TRA after local cervical administration.     

Malingering and malingering-like behavior: Some clinical and conceptual issues

Malingering phenomena are reconceptualized along a continuum of other-deceptive, and malingering-like mixed-deceptive and self-deceptive categories, depending upon the degree of the subject's conscious self-awareness. This schema heuristically expands the malingering concept to include its multivaried range of clinical presentations which are ubiquitously encountered but underdiscussed in the literature.     

Association of Insulin Resistance and Higher Oncotype DX™ Recurrence Score

Annals of Surgical Oncology - Black women with breast cancer have a worse overall survival compared with White women; however, no difference in Oncotype DX? (ODX) recurrence scores has been...     

Rurality and resource allocation in the UK

Unlike many other countries, the health and health care of rural populations are not often seen as specific concerns by the United Kingdom's health service. This paper considers the present ways in which resource allocation within the National Health Service takes account of rural areas and highlights a number of inconsistencies. It goes on to discuss ways in which rurality could influence future resource allocation formulas, and identifies priorities for future research.     

Health policy. Time to turn the tide

The government should not increase funding to the NHS until it can be demonstrated that this will improve population health and that the money cannot be made available from reducing current inefficiencies. The absence of an information base in the NHS is one of the greatest challenges. The new administration needs to acquire a deeper understanding of how resources are being used. New untested organisational structures and policy stunts should be avoided. Waiting lists should be prioritised according to urgency and ability to benefit.