Vaginal Progesterone May Reduce Miscarriages in Women with Bleeding in Early Pregnancy

MedicalResearch.com Interview with:

Prof. Arri Coomarasamy MBChB, MD, FRCOGInstitute of Metabolism and Systems ResearchProfessor of GynaecologyDirector of Tommy's National Centre for Miscarriage ResearchUniversity of Birmingham

Prof. Coomarasamy

Prof. Arri Coomarasamy MBChB, MD, FRCOG
Institute of Metabolism and Systems Research
Professor of Gynaecology
Director of Tommy’s National Centre for Miscarriage Research
University of Birmingham

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Progesterone hormone is known to be essential to maintain a pregnancy. Researchers and clinicians have debated for over 50 years whether progesterone supplementation in women with early pregnancy bleeding could rescue a pregnancy from miscarrying. There were some clinical studies suggesting progesterone could be useful, but the studies were of poor quality and small, so we could not be certain.

So the current study, called the PRISM trial, was conducted using very sound methods and on a large population of women, in fact over 4000 women in the UK, to produce a definitive answer to this question. Overall, there were more babies in the group of women given progesterone compared with the group of women given the dummy placebo tablets, but there was statistical uncertainty in this finding.

However, when we looked at the sub-population of women who were at high risk of miscarriage because of not only bleeding in early pregnancy but also having a history of previous miscarriage, we found progesterone was shown to have clear benefit. This is a hugely important finding as there is now a treatment option to women with early pregnancy bleeding and a history of previous miscarriages.

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Visual Inspection Alone Can Miss Some Skin Cancers

MedicalResearch.comInterview with:

polarized-light-dermatoscope-wikipedia-image

Jac Dinnes PhD, MSc, MA, PGDip
Senior Researcher
Test Evaluation Research Group
Institute of Applied Health Research
University of Birmingham

MedicalResearch.com:  What is thebackground for this study? Would you briefly explain the benefits of dermoscopy?

Response: This systematic review was one of a series of Cochrane Reviews of studies evaluating different tests for diagnosing skin cancer. Within creasing rates of skin cancer and an increasing number of more specialised tests becoming available in both primary care and in specialist settings, a thorough review of all available evidence was timely.

The diagnosis of melanoma and other skin cancers fundamentally relies on clinical examination, including history taking, and visual inspection of the concerning skin lesion (mole or patch of skin) and surrounding skin (and other lesions). A dermatoscope is a handheld device using visible light (such as from incandescent or LED bulbs), that allows more detailed examination of the skin compared to examination by the naked eye alone.

Knowing the diagnostic accuracy of dermoscopy added to visual inspection alone, across a range of observers and settings, is critical to understanding its contribution for the diagnosis of melanoma and to future understanding of the potential role of the growing number of other high-resolution image analysis techniques.

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