So here we are at the start of another year. Am I getting old or is it just that people keep telling me that I am? For some of us (20%, I think) it will be a year of revalidation and so a good place to start is with the news that we are further expanding the range of knowledge based CPD questions through collaboration with BJOG: An International Journal of Obstetrics and Gynaecology; you will find questions based on an article from a recent issue (Homer C et al. BJOG 2011;118:480–7). The Editorial Boards of both journals are keen to see this collaboration progress in 2013 to keep TOG as a ‘fit for purpose’ platform for knowledge-based assessments for revalidation.
I'm also delighted that we can update on the progress of MBRRACE-UK and the Maternal Confidential Enquiry; in this issue, as well as the UKOSS update, Marian Knight has also provided a brief update on progress so far, which will I'm sure be of interest.
So what else do we have on offer as a post-festivity tonic? Due to some necessary editorial juggling we have a fairly gynaecological issue. This will balance out over the year, so obstetricians – don't despair. There are only rare opportunities for TOG to publish on the male of our species but Stamatios Karavalos and the reproductive medicine teams from Gateshead and Newcastle have provided an excellent update of the latest issues in male infertility on page 1. Epidemiology, investigation and treatment of male factor infertility are covered, as well as a brief consideration of the ethics in this area. I was also very pleased to see that – given my tendency to spend all my spare time on a mountain bike – cyclists didn't get a mention!
On page 11 Keith Edmonds and Gillian Rose have done a superb job on congenital outflow tract disorders. Their approach to these rare disorders with suggestions as to referral patterns for complex disorders is clear and concise and their description of the relevant embryology a useful inclusion for all. As I face another group of medical students and speciality trainees I relish the opportunity to reinforce the importance of basic science in understanding the work we do and providing the best care for women (first grumpy old man moment!).
The nonpharmacological treatment of postmenopausal symptoms is covered in a review from Iris Tong on page 19. Again, I thoroughly recommend this to all as it provides a fascinating insight into ‘non-pharmacological’ treatments and the evidence for their efficacy. Given women's access to this information through everything from the scientific press to social media we have to understand both the motivation to seek alternative treatments as well as the efficacy they possess to be able to provide holistic care for any condition – a great read (second grumpy old man moment!).
Next up is an interesting review (I think for all gynaecologists) on page 26 from Andreas Stavroulis and colleagues describing the techniques for specimen retrieval from the peritoneal cavity following laparoscopic surgery. I enjoyed this despite the fact that the only thing I ever remove from the abdomen is the baby (hopefully). I suspect that this field is rapidly developing and, as such, may well generate useful debate through the correspondence section – let's wait and see.
Finally (in gynaecology) Raj Mathur and colleagues, on page 31, have reviewed ovarian hyperstimulation syndrome (OHSS) and present us with a very comprehensive update from diagnosis to management including those who are severe enough to require ‘high dependency’ or ‘intensive care’ support. I'm also sending this to all my physician colleagues who see women for prepregnancy counselling so that when they happen to mention that they are going for ‘IVF’ their discussions can include OHSS (third grumpy old man moment!).
So to obstetrics, and equally likely I'm sure to populate the correspondence section is the article from Rahat Khan and colleagues on pregnancy outcome after bariatric surgery. I know that this subject is currently a UKOSS topic and that our evidence will grow but this is a useful guide to counselling and managing women who have either had or who are contemplating this surgery to manage obesity during reproductive years.
The other obstetric paper is on page 45 and from Marie Smith and Cathy Nelson-Piercy (and one other) who have reviewed and proposed management for postpartum hypertension, an area of obstetric medicine where morbidity abounds but practice is far from consistent. I think this paper provides a comprehensive review relevant to all obstetricians and probably most community midwives and GPs – just got to get it out to them …
To wrap up this issue we have a thought-provoking piece from Monique Latibeaudiere and colleagues in the South West on page 51 discussing the implementation of evidence-based medicine through implementation strategies rather than guidelines alone. ‘I already know all this,’ I hear you cry, but in fact, bringing this together and discussing the evidence is a useful starting point for those of us who are held to account for why effective change can be difficult to bring about despite everyone accepting the evidence for it.
So there it is. I hope you agree that it's a good read, that 2013 doesn't contain too many revalidation challenges and that I am only a year older, if that.
Jason Waugh MRCOG
Royal Victoria Infirmary, Newcastle
Mohamed Abdel-Fattah MRCOG
University of Aberdeen, Aberdeen
Jo Anthony MA FRCOG
Northampton General Hospital NHS Trust
(Chair of the RCOG Revalidation Committee)
Kate Harding FRCOG
Guy's and St Thomas’ NHS Foundation
Justin Konje FMCOG (Nig) FWACS MRCOG
University of Leicester, Leicester (CPD Editor)
Kate Langford MA MD FRCOG
Guy's and St Thomas’ NHS Foundation
Kay McAllister DFFP MRCOG
The Sandyford Initiative, Glasgow
David Parkin MD FRCOG
Aberdeen Royal Infirmary, Aberdeen
Mark Roberts MD MRCOG
Royal Victoria Infirmary,
Newcastle Upon Tyne
Thomas Tang MD MRCOG
Regional Fertility Centre, Royal Maternity Hospital, Belfast
International advisory board
Ben CP Chan FRCOG
Private practice and Queen Mary Hospital, Hong Kong
Ki-Hong Chang MD PhD
Ajou University School of Medicine, Korea
Peter L Dwyer FRANZCOG FRCOG CU
Mercy Hospital for Women, Melbourne, Australia
Amr El-Shalakany MSc MD FRCOG
Ain Shams University Maternity Hospital, Cairo, Egypt
Gary Frishman MD
Warren Alpert Medical School of Brown
University and Women & Infants Hospital
of Rhode Island, USA
Henry Murray MRCOG
Dimitrios Koleskas MRCOG
Euroclinic, Athens, Greece
Duru Shah MD FCPS FICS FICOG DGO DFP FICMCH
Jaslok Hospital, Sir Hurkinsondas Hospital
and Breach Candy Research Centers, India
David Shaker FRCSEd FRCOG FRANZCOG
University of Queensland, Rockhampton Base Hospital and Mater Private Hospital, Australia
Ian Symonds DM MRCOG FRANZCOG ILTM
John Hunter Hospital, New South Wales,
Dirk Timmerman MD PhD
University Hospitals Leuven, Belgium