Cervical cytology screening: a comparison of two call systems.

Abstract

The best way to manage blisters in minor burns is controversial. Recommended procedures include deroofing,'2 aspiration,3 and leaving blisters intact.4 The choice of treatment is usually based on clinical impression and experience. We investigated'the effects of these three treatments on bacterial colonisation of the blister fluid or surface of the burn and on wound pain in patients with minor burns. Methods and resultsAltogether 202 patients attending two accident departments for treatment of minor burns were included in the investigation. The extent ofinjury averaged 1% of body surface area; all burns except one were partial thickness and healed with conservative treatment. Only thermnal burns of the arms and legs that could be treated with paraffin gauze dressings were included; most were of mixed depth. All residual sprays and ointments used in first aid were removed by washing with sterile saline. The patients were asked to attend the next weekday burns clinic and were seen thereafter two or three times a week for dressings.During the first part of the study blisters were left intact for up to 10 days to determine the risk of colonisation or infection of blister fluid; fluid was aspirated through a single puncture hole. In the second part blister fluid was aspirated through a single puncture hole at the first follow up visit and the blister dressed.The lumen ofthe blister was swabbed once during the next 12 days. Throughout the investigation exposed tissue burns were swabbed once up to 12 days after injury. Sampling times were comparable in aspirated and exposed burns. The sample of fluid (intact burns) and swab (aspirated and exposed burns) were analysed according to standard bacteriological methods. Some of the blisters which were aspirated in the second part of the study were actively deroofed. Patients whose blisters were aspirated or deroofed were asked at least one day later whether the pain in the burnt area had increased, decreased, or remained unchanged after treatment. Differences were assessed by x2 tests. (18) 45 (44) The table records the incidence of colonisation in the three study groups. The overall incidence of colonisation with micro-organisms was much lower in the intact blisters than in either the aspirated blisters or the'exposed tissue burns (p<<005). The incidence of infection with the potential pathogen Staphylococcus aureus was significandy lower in both the intact and aspirated blisters compared with the exposed burns (p<<005). Furthermore, aspiration and deroofing had a different effect on the patients' perception ofwound pain. None ofthe 37 patients whose blisters were deroofed experienced a reduction in pain (in 16 pain increased and in 21 it was unchanged), but aspiration reduced pain in 27 out of 73 patients (15 increased, 36 unchanged). This difference was significant (p<005). Effect ofdifferent treatments on bacterial colonisation CommentOur results sho'w that an intact blister roof prevents colonisation of minor burns by bacteria, especially Staph aureus. This conclusion s...

Methods to increase participation in organised screening programs: a systematic review

“…Five studies compared scheduled screening appointments with open appointments: one for breast [96], one for colorectal [73], two for cervical [97,98], and one for both breast and cervical cancer screening [61]. Of these five studies, two [61,73] were pragmatic trials with very high power.…”

Improving cervical cancer screening attendance in Finland

“…3 Women received a letter informing them about the upcoming self-sampling test and giving an opportunity to decline beforehand. 4 Out of all women invited to self-sampling. 5 Not included in the analysis.…”

Impact of scheduled appointments on cervical screening participation in Norway: a randomised intervention

“…A large Italian study, also published in 1995, studied the impact of scheduled appointments on participation in a cluster-randomised design and reported an effect corresponding to an RR of 1.6 compared with open invitation 24. A UK study from 1987 reported results of 240 women randomly assigned a standard open or scheduled invitation with a significant increase in the response rate of 15% from 32% to 47%, corresponding to an RR of 1.5 25. The effects of the intervention in our study are similar or somewhat larger than these previous findings.…”