Heterotopic pregnancy is a life-threatening condition. A recent case at our institution prompted a systematic review of the literature from 2005 to 2010. In the majority (71%) of cases reviewed, risk factors for a heterotopic pregnancy were present. However, in several instances (33%), previous sonographic reports of a normal intrauterine pregnancy gave false reassurance. These results highlight the complexity of diagnosis. In addition, our findings were compared with two previous reviews covering cases from 1971 to 2004. This comparison highlighted two important trends: first, the increasing role of ultrasound in the definitive diagnosis of a heterotopic pregnancy, and second, the development of conservative approaches to management. Medical knowledge and technology may be improving, but ultimately, even in the presence of a known intrauterine pregnancy, the simple dictum 'think ectopic' must not be forgotten.

SUMMARYIn the 15

At 90%, isopropanol is as effective as n-propanol 60%, which was proposed by the European Committee for Standardization as a reference in testing products for surgical hand disinfection. It could, therefore, serve as an alternative if the proposed agent is undesirable for any reason. In parallel experiments by two investigators, the proposed test method proved well workable; the results were very similar and the conclusions identical.

The plasma level of Big ET-1 is significantly raised in patients with colorectal cancer. Patients with liver metastases have significantly higher levels than those with localized disease.

In-patients with venous leg ulcers showed increased healing rates with a hydrocolloid dressing (Granuflex), as compared with a traditional paraffin gauze dressing (Jelonet), in a randomized sequential crossover trial, although the difference was not statistically significant. Bacteriological studies showed that the hydrocolloid dressing favoured growth of both aerobes and anaerobes in significantly greater numbers compared with paraffin gauze. Heavy bacterial colonization had no effect on the healing rates of the ulcers. Granuflex is said to produce an anaerobic environment--survival of Pseudomonas aeruginosa, a strict aerobe, under Granuflex dressings, makes this seem unlikely.