Optimization of a diagnostic platform for oxidation-reduction potential (ORP) measurement in human plasma.

OBJECTIVES: Oxidation-reduction potential (ORP) measurement can demonstrate the extent of oxidative stress in patients with severe illness and/or injury. A novel ORP diagnostic platform using disposable sensors (RedoxSYS) has been validated by comparison to mass spectrometry, but the optimal methods of sample handling for best performance of the device have not been described. METHODS: We sought to optimize ORP measurement in human plasma under controlled conditions. We hypothesized that the anticoagulant, freeze-thawing, and storage duration would influence measured ORP levels. RESULTS: The platform was sensitive to exogenous oxidation with hydrogen peroxide and reduction with ascorbic acid. Plasma anticoagulated with heparin was more sensitive to differences in ORP than plasma prepared in citrate. ORP measurements decreased slightly after a freeze-thaw cycle, but once frozen, ORP was stable for up to one month. DISCUSSION: We confirm that ORP detects oxidative stress in plasma samples. Optimal measurement of plasma ORP requires blood collection in heparin anticoagulant tubes and immediate analysis without a freeze-thaw cycle.

Women's choice for Down's screening--a comparative experience in three district general hospitals.

OBJECTIVES: To look at women's knowledge and understanding of Down's syndrome screening at our hospital and compare the uptake of screening with two other local hospitals in the same trust. STUDY DESIGN: All women attending for their anomaly scan at 20 weeks in the three district general hospitals were given an anonymised questionnaire asking whether they had accepted Down's screening and if not, the reason for their non-acceptance. The study was continued for 6 months and then the results were analysed by an independent team. Pearson's Chi squared test was used to test the statistical significance and the data on the uptake of screening at the three different sites were analysed by logistic regression using the likelihood ratio test. RESULTS: 744 questionnaires were returned with a response rate of 97% and over 95% of women were satisfied with the information provided. Overall only 28% accepted screening with a significant difference between units. 20% of women at one hospital agreed to screening compared with 33% at another (p<0.05). Of those who declined the screening tests 50% gave no specific reason other than not wanting the test. One in six would not consider termination and 12% perceived themselves as low risk. CONCLUSIONS: While most women were well informed of the screening tests available, the majority made a personal choice not to be screened. The uptake of screening in the three hospitals was significantly different despite being in the same geographical location and in all of them was much lower than has been reported in earlier studies. These results need to be taken into consideration prior to implementation of National Screening Committee recommendations.

Polycystic ovary syndrome and epilepsy--a gynaecological perspective.

The prevalence of polycystic ovaries (PCO) and polycystic ovary syndrome (PCOS) in the general population is approximately 20 and 10%, respectively, and published studies suggest a similar prevalence in women with epilepsy. These data do not suggest that epilepsy is associated with a higher prevalence of the condition, and it would appear that the background prevalence of PCO and PCOS is the same as in the general population.

Epilepsy and women's issues: an update.

Although the fundamentals of epilepsy are similar for both males and females, the clinical management of epilepsy in women should take into consideration a variety of factors including: social and cultural issues, age, relationships, diagnosis and characterization, female specific syndromes, the influence of female hormones, hormonal contraceptives and hormonal replacement therapy, the cosmetic side effects of epilepsy treatment, fertility, pregnancy and child care. Regarding the issue of reproduction, there are several misconceptions in relation to fertility in women with epilepsy. In general, women with epilepsy do not have a markedly reduced fertility compared with those without. Standard AEDs in common use have been associated with an increased risk of foetal malformations and with newer AEDs there is very little information regarding teratogenicity. The incidence of congenital malformations is also known to increase with the number of AEDs. Before planning a pregnancy it is imperative that the best possible seizure control is achieved at the lowest possible AED dose, preferably in monotherapy. With this in mind, the importance of effective pre-pregnancy counselling should be stressed and along with appropriate patient management and folic acid supplementation, effective patient education, most women with epilepsy can lead normal lives and deliver healthy children. This report will provide an update on these important considerations for women with epilepsy from both a social and medical perspective.