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Clinical Obstetrics and Gynecology

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https://www.readbyqxmd.com/read/27906745/should-we-add-pravastatin-to-aspirin-for-preeclampsia-prevention-in-high-risk-women
#1
Caroline C Marrs, Maged M Costantine
Preeclampsia is a multisystem disorder that affects 3% to 5% of pregnant women and remains a significant source of short-term and long-term maternal and neonatal mortality and morbidity. Many professional societies recommend the use of low-dose aspirin to prevent preeclampsia in high-risk women. Owing to the similarities in pathophysiology between preeclampsia and atherosclerotic cardiovascular disease, and the encouraging data from preclinical and pilot clinical studies, pravastatin has been proposed for preventing preeclampsia...
November 30, 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27749367/trends-in-breast-cancer-treatment-striving-to-deliver-optimal-cancer-treatment-while-avoiding-morbidity
#2
Mary L Gemignani
No abstract text is available yet for this article.
October 5, 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27749366/surgical-and-locoregional-treatment-of-dcis-and-early-invasive-breast-cancer
#3
David J Hetzel
Surgical and radiation therapy for DCIS and early stage 1 and 2 invasive breast cancer is detailed and described.
October 5, 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27660928/benign-breast-diseases-evaluation-and-management
#4
Brian Orr, Joseph L Kelley
Benign breast disease is a spectrum of common disorders. The majority of patients with a clinical breast lesion will have benign process. Management involves symptom control when present, pathologic-based and imaging-based evaluation to distinguish from a malignant process, and counseling for patients that have an increased breast cancer risk due to the benign disorder.
September 22, 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27662541/recurrent-shoulder-dystocia-risk-factors-and-counseling
#5
Edith D Gurewitsch Allen
A prior history of delivery complicated by shoulder dystocia confers a 6-fold to nearly 30-fold increased risk of shoulder dystocia recurrence in a subsequent vaginal delivery, with most reported rates between 12% and 17%. Whereas prevention of shoulder dystocia in the general population is neither feasible nor cost-effective, directing intervention efforts at the particular subgroup of women with a prior history of shoulder dystocia has merit. Potentially modifiable risk factors and individualized management strategies that may reduce shoulder dystocia recurrence and its associated significant morbidities are reviewed...
September 21, 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27763939/index
#6
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27763938/contributors-shoulder-dystocia
#7
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27763937/foreword
#8
Mary L Gemignani
No abstract text is available yet for this article.
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27763936/contributors-trends-in-breast-cancer-management
#9
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27749365/pregnancy-associated-breast-cancer
#10
Ashley S Case
Breast cancer is one of the most common malignancies affecting pregnancy. Pregnancy-associated breast cancer refers to breast cancer that is diagnosed during pregnancy or within the first postpartum year. The incidence is increasing as more women delay childbearing. Breast cancer can be safely diagnosed, staged, and treated during pregnancy while protecting the fetus and mother with excellent outcomes for both. Avoiding diagnostic delays is vital to prognosis. This article provides an overview of the diagnosis, staging, management, and prognosis of pregnancy-associated breast cancer...
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27749364/breast-cancer-genetics-and-risk-assessment
#11
Trevor Tejada-Bergés
As health care providers, we play a crucial role in the assessment of a patient's risk for hereditary breast cancer syndromes. The panorama of genetic assessment and testing has evolved dramatically since the identification of the BRCA genes. Next-generation sequencing technology has facilitated the development of multigene panels, but 1 consequence has been an increased identification of pathogenic variants at odds with a family history as well as variants of uncertain significance for which treatment guidelines are not defined...
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27741213/systemic-therapies-for-nonmetastatic-breast-cancer-the-role-of-neoadjuvant-and-adjuvant-chemotherapy-and-the-use-of-endocrine-therapy
#12
Brittany L Bychkovsky, Don S Dizon, William M Sikov
Breast cancer is a heterogenous disease, comprised of at least 3 major subtypes: hormone receptor-positive/HER2-(HR+), HER2+, and HR-/HER2-(triple negative) breast cancers. The medical management of each subype is distinct. In this article, we review contemporary data supporting the use of chemotherapy, endocrine therapy and biologic therapies, especially HER2-directed agents, in the adjuvant and neoadjuvant setting in patients with newly diagnosed nonmetastatic (stage I-III) breast cancer.
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27741212/breast-cancer-screening-mammography-and-other-modalities
#13
James V Fiorica
This article is an overview of the modalities available for breast cancer screening. The modalities discussed include digital mammography, digital breast tomosynthesis, breast ultrasonography, magnetic resonance imaging, and clinical breast examination. There is a review of pertinent randomized controlled trials, studies and meta-analyses which contributed to the evolution of screening guidelines. Ultimately, 5 major medical organizations formulated the current screening guidelines in the United States. The lack of consensus in these guidelines represents an ongoing controversy about the optimal timing and method for breast cancer screening in women...
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27741211/team-training-and-institutional-protocols-to-prevent-shoulder-dystocia-complications
#14
Samuel Smith
Shoulder dystocia is an obstetrical emergency that may result in significant neonatal complications. It requires rapid recognition and a coordinated response. Standardization of care, teamwork and communication, and clinical simulation are the key components of patient safety programs in obstetrics. Simulation-based team training and institutional protocols for the management of shoulder dystocia are emerging as integral components of many labor and delivery safety initiatives because of their impact on technical skills and team performance...
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27681695/foreword
#15
Robert B Gherman
No abstract text is available yet for this article.
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27681694/breast-cancer-epidemiology-and-risk-factors
#16
Kristin Rojas, Ashley Stuckey
Between the years 2010 and 2012, the lifetime probability of developing female breast cancer was 12.3%, or approximately 1 in 8. Worldwide, breast cancer is the most common cancer in women. Survival is increasing. Between 2005 and 2011, the 5-year relative survival was found to be 89%. This is thought to be due to both the increase in utilization of population-wide screening, as well as advances in treatment. Less than 10% of breast cancers can be attributed to an inherited genetic mutation. Breast cancer is more commonly associated with environmental, reproductive, and lifestyle factors, some of which are potentially modifiable...
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27681693/pathologic-high-risk-lesions-diagnosis-and-management
#17
Melissa Murray
Percutaneous imaging-guided core needle biopsy (CNB) is a less invasive and less expensive alternative to surgical biopsy for the evaluation of breast lesions. After a CNB the radiologist determine if there is concordance between the pathology, imaging, and clinical findings. Patient management after CNB diagnosis of high-risk breast lesion varies. Surgical excision is warranted for lesions yielding a CNB diagnosis of ADH; however controversy exists regarding the need for surgical excision after CNB diagnosis of radial scar, papillary lesion, atypical lobular hyperplasia (ALH), or lobular carcinoma in situ (LCIS)...
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27681692/an-update-on-the-acute-management-of-shoulder-dystocia
#18
Marisa Gilstrop, Matthew K Hoffman
Shoulder dystocia continues to challenge obstetrical providers and therefore the management must evolve. The available literature demonstrates clear value in both simulation training and having a clear algorithmic approach. Similarly, the available literature suggests that delivery of the posterior arm should be prioritized. Several new techniques such as the Menticoglou maneuver, Gaskin's maneuver, and the posterior axilla sling traction technique offer obstetrical choices after more traditional techniques have failed...
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27681691/sonographic-examination-of-the-fetus-vis-%C3%A3-vis-shoulder-dystocia-a-vexing-promise
#19
Morgen S Doty, Leen Al-Hafez, Suneet P Chauhan
Since antepartum and intrapartum risk factors are poor at identifying women whose labor is complicated by shoulder dystocia, sonographic examination of the fetus holds promise. Though there are several measurements of biometric parameters to identify the parturient who will have shoulder dystocia, none are currently clinically useful. Three national guidelines confirm that sonographic measurements do not serve as appropriate diagnostic tests to identify women who will have shoulder dystocia with or without concurrent injury...
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27681690/breast-cancer-posttreatment-surveillance-diagnosis-and-management-of-recurrent-disease
#20
Amer K Karam
There has been a steady decline in breast cancer mortality that has led to a significant increase in the number of patients surviving breast cancer. We will review in this manuscript the evidence and guidelines for posttreatment surveillance of patients with breast cancer as well as the management options for patients who are diagnosed with local-regional and distant recurrences.
December 2016: Clinical Obstetrics and Gynecology
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