Epilepsy: patient perceptions of their condition.

The objective of this study was to ascertain the perceptions of people with epilepsy about their condition. Nine hundred and eight questionnaires were sent to members of epilepsy associations, with a 45% response rate, and 625 questionnaires were sent to neurologists for their patients to complete, with a response rate of 16.5%. The results reinforce and extend previous observations that there is an ongoing need for educating health care professionals and persons with epilepsy about the condition. Matters pertaining to driving, the unpredictability of seizures, lack of employment and cognitive difficulties were of major concern to the respondents. The present data also highlighted the vexed relationship between stress and seizure control, which needs to be further investigated. These data should be of value to doctors and other health care professionals in their dealings with people with epilepsy. It should also provide epilepsy associations with data upon which they might be able to plan education services.     

Cervical epithelial abnormalities among women with vulval warts—no more common than among controls

Eighty-four women with vulval warts and 46 controls were examined for cervical epithelial abnormalities by cytology and colposcopy. The prevalence of colposcopically detected abnormalities was the same in the two groups. Minor cytologic abnormalities (less than moderate dyskaryosis) were more common among women with warts than among controls. It is concluded that women with vulval warts are no more likely than controls to have evidence of cervical epithelial abnormalities. These findings are discussed in the light of apparently contradictory findings by other workers.     

Vitamin D receptor agonists, cancer and the immune system: an intricate relationship

Vitamin D receptor (VDR) agonists can inhibit cell growth, promote apoptosis, and induce differentiation of many cell types, in addition to inhibiting metastasis and angiogenesis, all desirable properties for a drug to control cancer. However, from an immunological perspective, the immunomodulatory properties of VDR agonists are apparently just opposite to the main aims of cancer immunotherapy: boosting the immune response and breaking tumor-related tolerance. While it may be possible to identify VDR agonists with enhanced anti-proliferative/pro-differentiative and reduced immunomodulatory activities as anti-cancer agents, a complementary approach could rely on identifying clinical indications where their systemic immunomodulatory properties could be minimized. Superficial bladder cancer, where treatments are usually administered by vesical instillation, may represent such an indication. We have observed a strong synergism in vitro between calcitriol and doxorubicin or epirubicin in the inhibition of bladder cancer cell proliferation. Thus, calcitriol and doxorubicin or epirubicin in combination may have clinical value in the management of superficial bladder cancer.