Visceral hypersensitivity is extremely common in endometriosis and could be intensifying the pain. This finding might explain why mildly affected individuals often complain of severe symptoms out of proportion to the extent of their disease. This study has introduced a completely new concept into the understanding of pain in endometriosis and could open up new opportunities for treatment.

No abstract

Invasive group B streptococcus (GBS) disease is a leading cause of neonatal death. There is no UK national screening programme for GBS in pregnancy, hence colonisation rates are unknown. Intrapartum antibiotic prophylaxis is given during labour to colonised women to reduce neonatal GBS transmission and subsequent invasive infection. Data about prevalence of other haemolytic streptococci in pregnancy, including group A streptococcus (GAS), are uncommon despite increasing importance. This study investigated colonisation in 100 pregnant women using conventional culture methods; 19% had GBS. This suggests that GBS carriage is common in the UK. The role of other β-haemolytic streptococci remains undefined.

Objectives: To assess the attitudes of post-menopausal women having a transvaginal ultrasound (TVUS) examination. Methods: A cross-sectional questionnaire survey included 100 consecutive post-menopausal women undergoing TVUS for different indications. They were asked to complete two questionnaires, one before and one after the examination. The main outcomes were acceptability of TVUS, anxiety, embarrassment (before and during) and pain/discomfort (during) the examination. Results: The incidence of anxiety prior to TVUS was significantly higher than anxiety during and after (p,0 . 001). Good rapport, with reassurance from the staff may have reduced anxiety. Pre-examination anxiety (reported by 43% of women) was mostly due to the procedure and fear of results (77%). Post-examination anxiety was due mainly to anticipation of results. Women found TVUS less painful and less embarrassing than they had expected. The majority of women did not have a specific preference regarding the gender of the sonographer or the presence of a chaperone during the examination. All women attending for TVUS found the procedure acceptable and would 'recommend it to friends or family'. Conclusions: Post-menopausal women find TVUS acceptable. Before attending they are anxious about both the procedure and the result. Women can be reassured that TVUS is unlikely to be as painful or embarrassing as they fear. Anxiety about results persists after the examination.

HPV types are carcinogenic agents in cervical cancer. This view is supported by epidemiological and biological evidence. The oncogenic products and capsid proteins of high risk HPV types are potential targets against which effective immunity may be generated by vaccination. Both therapeutic and prophlylactic immunisation are potential strategies to deal with the widespread problem of HPV infection and possibly established cervical neoplasia. Clinical trials are now underway to evaluate candidate vaccines.