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Clinical Obstetrics and Gynecology

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https://www.readbyqxmd.com/read/28957953/ovarian-cancer-and-prevention
#1
Jessica N McAlpine
No abstract text is available yet for this article.
September 27, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28945615/the-future-of-obstetrical-care
#2
Thomas Gellhaus
No abstract text is available yet for this article.
September 22, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29045299/the-future-of-cesarean-delivery-rates-in-the-united-states
#3
Mark A Clapp, William H Barth
The US cesarean delivery rate remains 30%-32%. Increases in maternal age, obesity, and diabetes put upward pressure on this rate. Alternatives to cesarean delivery, vaginal birth after cesarean (VBAC), and operative vaginal delivery, are underutilized and there are substantial challenges to their resurgence. Practice guidelines offer promise, but demonstrate only minor reductions in cesarean delivery. We estimate that the overall rate in the US will remain 27%-30% for the immediate future. As more states move to recognize the independent practice of midwifery and more payers seek lower cost options for childbirth, we anticipate the overall rate will drop to 20% or 25%, but not for another 15 years or more...
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29045298/foreword
#4
Thomas Gellhaus
No abstract text is available yet for this article.
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29045297/contributors-future-of-obstetrical-care
#5
(no author information available yet)
No abstract text is available yet for this article.
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29045296/taking-the-tube-from-normal-fallopian-tube-epithelium-to-ovarian-high-grade-serous-carcinoma
#6
Alicia A Tone
Detailed pathologic studies over the past decade suggest a distal fallopian tube origin for the majority of "ovarian" high-grade serous carcinomas (HGSC). This review will summarize molecular alterations observed in tubal precursors for HGSC, namely p53 signatures and serous tubal intraepithelial carcinomas, and in nonmalignant fallopian tube epithelial cells obtained from women at increased genetic risk for HGSC. Recent experiments investigating the impact of follicular fluid exposure and retrograde menstruation on tumor development in the fallopian tube will also be discussed...
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29045295/foreword
#7
Jessica N McAlpine
No abstract text is available yet for this article.
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29045294/contributors-ovarian-cancer-and-prevention
#8
(no author information available yet)
No abstract text is available yet for this article.
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29035903/the-future-of-obstetrics-and-gynecology-macra-electronic-health-records-and-more
#9
Deborah A Wing
There is immense change affecting obstetrical and gynecologic medical practice at this moment in time-involving reimbursement with the shift from volume-based to value-based care, increasing regulation, and workforce sustainability. Aspects to be reviewed in this chapter include reimbursements and Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), electronic medical records, physician satisfaction surveys, maintenance of certification, and physician burnout.
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28990986/the-role-of-hereditary-factors-in-ovarian-carcinoma
#10
Kasmintan A Schrader
Cancer is a disease of the genome, in which mutations in particular genes and pathways give rise to tissue-specific genotype-phenotype correlations. In tumors associated with hereditary cancer syndromes, a person is generally born with the first mutation relevant to the development of their cancer. In this chapter we will discuss the genes that have been associated with germline mutations that confer a moderate to high risk for ovarian carcinoma.
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28990985/endometriosis-associated-ovarian-cancers
#11
Michael S Anglesio, Paul J Yong
Endometriosis-associated cancers include clear cell and endometrioid ovarian carcinoma. A history of endometriosis has long been considered to be a risk factor for later development of these malignancies; however, recent molecular genetic evidence has provided unequivocal evidence that these lesions are in fact the precursors for endometriosis-associated cancers. Herein, we will explore the relationship between endometriosis and ovarian carcinomas, similarities between the premalignant lesions and their cancerous counterparts, and the potential role of mutations and the ovarian microenvironment that may contribute to malignant transformation...
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28990984/quality-and-safety-in-obstetrics-and-gynecology
#12
Haywood L Brown
The discipline of obstetrics and gynecology has been a leader for quality and safety in women's health for decades. Obstetrics is the leading cause for admissions, triage, and hospital discharge with over 4 million hospitalizations for births annually. Appropriately, safety initiatives and use of quality measures particularly relevant to obstetrics and gynecology are essential to patient satisfaction, safe and efficient evidence-based care.
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28990983/pathology-of-ovarian-cancer-recent-insights-unveiling-opportunities-in-prevention
#13
Friedrich Kommoss, C Blake Gilks
Ovarian carcinomas were formerly referred to as "surface epithelial carcinomas," reflecting the belief that they all arise from the ovarian surface epithelium. It is now appreciated that most ovarian carcinomas originate from either fallopian tube or endometriotic epithelium, and how we approach prevention will thus differ between histotypes. The 5 histotypes of ovarian carcinoma (high-grade serous, clear cell, endometrioid, mucinous, and low-grade serous, in descending order of frequency) can be reproducibly diagnosed, and are distinct disease entities, differing with respect to genetic risk factors, molecular events during oncogenesis, patterns of spread, and response to chemotherapy...
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28990982/futuristic-look-at-genetic-and-birth-defect-diagnoses-and-treatments
#14
Anthony R Gregg
One aim of prenatal care is to provide information to prospective parents. The information provided encompasses prenatal care, intrapartum and postpartum care. Learning the genetic constitution of the parents pre-conception or the ongoing pregnancy allows parents to make decisions and set expectations. Offering screening and diagnostic testing has been the main in satisfying the desire for prenatal genetic information. With rapid advances in genomics and genome sequencing, screening during an ongoing pregnancy may become obsolete...
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28990981/telemedicine-applications-in-obstetrics-and-gynecology
#15
Andrea L Greiner
This article reviews principles to consider when setting up a telemedicine (TM) program to provide care to women in the field of obstetrics and gynecology. There are different types of TM encounters and clinical applications vary widely. The consensus among patients and providers is that TM is convenient to provide needed subspecialty medical care when it is not available locally. These programs are clinically successful, but economic and cost-effectiveness data are lacking. Federal reimbursement policy is limited for TM...
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28957952/risk-reducing-surgery-in-women-at-low-lifetime-risk-of-developing-ovarian-carcinoma-opportunistic-salpingectomy
#16
Gillian E Hanley, Nirit M K Rozenberg, Jessica N McAlpine
Lack of success in ovarian cancer control through screening or advances in treatment in the general population has prompted exploration in new avenues of prevention. "Opportunistic" salpingectomy describes a surgical procedure or risk-reducing intent in women at low-risk/general population risk for developing ovarian cancer who are undergoing pelvic/abdominal surgery for other indications. This chapter reviews the uptake, safety, and anticipated impact of this prevention initiative.
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28957951/cost-effectiveness-of-ovarian-cancer-prevention-strategies
#17
Janice S Kwon
Ovarian cancer remains to be the most lethal of all gynecologic malignancies. There is no effective screening test proven to reduce the mortality associated with this disease. Costs of treating ovarian cancer are substantial and among the highest of all cancer types. Therefore, it is essential to pursue strategies to prevent ovarian cancer that are cost-effective in the context of our health care system. There are 2 subgroups of women for whom ovarian cancer prevention strategies have been evaluated for effectiveness and costs: (1) general population at risk, and (2) BRCA mutation carriers with a high lifetime risk...
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28957950/management-of-preinvasive-lesions
#18
Maria G Patrono, Camila Corzo, Maria Iniesta, Pedro T Ramirez
Serous tubal intraepithelial carcinoma is considered the precursor lesion of high-grade serous carcinoma, and found in both low-risk and high-risk populations. Isolated serous tubal intraepithelial carcinomas in patients with BRCA1/2 mutations are detected in ∼2% of patients undergoing risk-reducing bilateral salpingo-oophorectomy and even with removal of the tubes and ovaries the rate of developing primary peritoneal carcinoma following remains up to 7.5%. Postoperative recommendations after finding incidental STICs remain unclear and surgical staging, adjuvant chemotherapy, or observation have been proposed...
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28957949/ovarian-cancer-prevention-in-high-risk-women
#19
Sarah M Temkin, Jennifer Bergstrom, Goli Samimi, Lori Minasian
Ovarian carcinoma is the most lethal malignancy of the female genital tract. Population-based trials in the general population have not demonstrated that screening improves early detection or survival. Therefore, application of prevention strategies is vital to improving outcomes from this disease. Surgical prevention reduces risk and prophylactic risk-reducing salpingo-oophorectomy is the most effective means to prevent ovarian carcinoma in the high-risk patient although the risks do not outweigh the benefits in average risk patients...
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28945616/new-models-of-care
#20
Hal C Lawrence
The practice of obstetrics and gynecology continues to evolve. Changes in the obstetrician-gynecologists workforce, reimbursement, governmental regulations, and technology all drive new models of care. The advent of the obstetric hospitalist is one new model, and the development of team-based care is another. Increasingly, obstetrician-gynecologists are becoming employees of health care delivery systems, and others are focusing the scope of their practices to subspecialites. As new practice models emerge, the specialty of obstetrics and gynecology will continue to change to meet the health care needs of women...
December 2017: Clinical Obstetrics and Gynecology
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