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Obstetrics and Gynecology Clinics of North America

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https://www.readbyqxmd.com/read/28499540/maintenance-of-knowledge
#1
EDITORIAL
Janice L Bacon, Paul G Tomich
No abstract text is available yet for this article.
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28499539/lifelong-learning-requires-maintenance-of-knowledge
#2
EDITORIAL
William F Rayburn
No abstract text is available yet for this article.
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28499538/burnout-in-obstetricians-and-gynecologists
#3
REVIEW
Roger P Smith
It is estimated that 40% to 75% of obstetricians and gynecologists currently suffer from professional burnout, making the lifetime risk a virtual certainty. Although these statistics make for a dismal view of the profession, if the causes and symptoms can be identified simple steps can be implemented to reverse the threat. With a little care, the enjoyment of practice can be restored and the sense of reward and the value of service can be returned.
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28499537/the-menopausal-transition
#4
REVIEW
Janice L Bacon
A clear understanding of the physiology of the menopausal transition, clinical symptoms, and physical changes is essential for individualized patient management, maximizing benefits and minimizing risks for the present and the future. Menopause, defined by amenorrhea for 12 consecutive months, is determined retrospectively and represents a permanent end to menses. Many physical changes occur during the menopausal transition and beyond. Knowledge of symptoms and findings experienced by women undergoing the menopausal transition allow individualized care- improving quality of life and enhancing wellbeing for years to come...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28499536/recognizing-and-managing-common-urogynecologic-disorders
#5
REVIEW
Denise M Elser
Many women experience urogynecologic or pelvic floor disorders, especially urinary incontinence and pelvic organ prolapse. The obstetrician/gynecologist is often the first health care professional to evaluate and treat these disorders. Treatments include pelvic floor muscle training, behavioral therapies, oral medications, neuromodulation, intradetrusor medications, and surgery. When approaching the woman with symptomatic prolapse, familiarity with pessaries and various surgical procedures aid in counseling...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28499535/cancer-recognition-and-screening-for-common-breast-disorders-and-malignancy
#6
REVIEW
Constance Bohon
Breast cancer is predicted to be the most common newly diagnosed cancer in women in 2016. Screening mammography is the most commonly used method for the detection of breast cancer in women of average risk. A genetic risk assessment is recommended for women with a greater than 20% to 25% chance of having a predisposition to breast and ovarian cancer. Evaluation of a breast mass begins with a detailed history, assessment for cancer risk, and physical examination.
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28499534/prenatal-diagnosis-screening-and-diagnostic-tools
#7
REVIEW
Laura M Carlson, Neeta L Vora
The American Congress of Obstetricians and Gynecologists recommends that all pregnant women be offered aneuploidy screening or diagnostic testing. A myriad of screening and testing options are available to patients based on their risk profile and gestational age. Screening options include traditional serum analyte screening, such as first-trimester screening or quadruple screening, and more recently, cell-free DNA. Diagnostic testing choices include chorionic villus sampling and amniocentesis. The number of screening and diagnostic modalities complicates prenatal counseling for physicians and can be difficult for patients to grasp...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28499533/obstetric-emergencies-shoulder-dystocia-and-postpartum-hemorrhage
#8
REVIEW
Joshua D Dahlke, Asha Bhalwal, Suneet P Chauhan
Shoulder dystocia and postpartum hemorrhage represent two of the most common emergencies faced in obstetric clinical practice, both requiring prompt recognition and management to avoid significant morbidity or mortality. Shoulder dystocia is an uncommon, unpredictable, and unpreventable obstetric emergency and can be managed with appropriate intervention. Postpartum hemorrhage occurs more commonly and carries significant risk of maternal morbidity. Institutional protocols and algorithms for the prevention and management of shoulder dystocia and postpartum hemorrhage have become mainstays for clinicians...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28499532/updates-on-the-recognition-prevention-and-management-of-hypertension-in-pregnancy
#9
REVIEW
Jessica R Jackson, Anthony R Gregg
Systematic reviews with meta-analysis represent the highest level of evidence used to guide clinical practice. The defining criteria used to diagnose preeclampsia have evolved, and will likely continue to evolve. Proteinuria is sufficient but not necessary when defining preeclampsia. Hypertension without proteinuria but with severe features is diagnostic. The methods used to measure urinary protein have changed. The gold standard remains the 24-hour urine test. The efficacy of low-dose aspirin in preventing preeclampsia is a function of baseline risk...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28499531/gestational-diabetes-diagnosis-classification-and-clinical-care
#10
REVIEW
Lynn R Mack, Paul G Tomich
Gestational diabetes mellitus (GDM) affects approximately 6% of pregnant women, and prevalence is increasing in parallel with the obesity epidemic. Protocols for screening/diagnosing GDM are controversial with several guidelines available. Treatment of GDM results in a reduction in the incidence of preeclampsia, shoulder dystocia, and macrosomia. If diet and lifestyle changes do not result in target glucose levels, then treatment with metformin, glyburide, or insulin should begin. It is generally recommended that pregnancies complicated by GDM do not go beyond term...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28499530/recognition-and-therapeutic-options-for-malignancy-of-the-cervix-and%C3%A2-uterus
#11
REVIEW
Elizabeth R Burton, Joel I Sorosky
An update on the current epidemiology and a review of the risk factors of cervical and endometrial cancers are discussed. Cervical cancer prevention with a focus on human papillomavirus vaccination and cervical cancer screening is reviewed, emphasizing the new focus of less frequent intervention in an effort to maintain high rates of early detection of disease while decreasing unnecessary and anxiety-provoking colposcopies, biopsies, and excisional procedures. The replacement of traditional endometrial hyperplasia terminology with more relevant clinical categories, with an emphasis on the introduction of endometrial intraepithelial neoplasia, is presented...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28499529/abnormal-uterine-bleeding-current-classification-and-clinical-management
#12
REVIEW
Janice L Bacon
Abnormal uterine bleeding is now classified and categorized according to the International Federation of Gynecology and Obstetrics classification system: PALM-COEIN. This applies to nongravid women during their reproductive years and allows more clear designation of causes, thus aiding clinical care and future research.
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28499528/vaginitis-beyond-the-basics
#13
REVIEW
Benjie Brown Mills
Vaginal complaints are one of the most common reasons women seek the advice of a health care provider. Uncomplicated infections such as vulvovaginal candidiasis, bacterial vaginosis, or trichomoniasis are easy to diagnose and treat. However, about 8% of patients will have a more complicated course with failure to respond to treatment or rapid recurrence of symptoms. Understanding the need for a methodical, diagnostic approach to help these women with recurrent or refractory cases of vaginal symptoms will aid the clinician achieve successful patient outcomes...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28499527/contraception-menarche-to-menopause
#14
REVIEW
Erin E Tracy
Contraception services should be part of routine health care maintenance in reproductive-aged women, especially in light of the fact that approximately 50% of pregnancies in the United States remain unplanned. Barrier methods, especially condoms, may play a role in sexually transmitted disease prevention but are less efficacious for pregnancy avoidance. There are several available hormonal contraceptive options, including the combination hormonal pill, progestin-only pill, combination hormonal patches and rings, injectable progestins, implantable progestins, intrauterine devices (copper or progestin), and permanent sterilization...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160898/multilevel-barriers-to-optimizing-care-in-underserved-women
#15
EDITORIAL
Wanda Kay Nicholson
No abstract text is available yet for this article.
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160897/reducing-barriers-to-invest-in-improved-health-care
#16
EDITORIAL
William F Rayburn
No abstract text is available yet for this article.
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160896/patient-centered-care-to-address-barriers-for-pregnant-women-with-opioid-dependence
#17
REVIEW
Mary Beth Sutter, Sarah Gopman, Lawrence Leeman
Pregnant women affected by substance use often encounter barriers to treatment, including housing insecurity, poverty, mental health issues, social stigma, and access to health care. Providers may lack the resources needed to provide quality care. Clinicians offering prenatal care to women with substance use disorder are encouraged to support family-centered, multidisciplinary care to women and their infants, focusing on harm reduction. Collaboration between providers of maternity care, substance abuse treatment, case management, family primary care, and pediatric developmental care can improve outcomes during pregnancy and through the early years of parenting...
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160895/disparities-in-fibroid-incidence-prognosis-and-management
#18
REVIEW
Shannon K Laughlin-Tommaso, Vanessa L Jacoby, Evan R Myers
Health disparities in fibroid prevalence, prognosis, and treatment exist for underserved women. Access to fibroid treatment alternatives can have significant effect on choices and outcomes of fibroid disease.
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160894/addressing-health-care-disparities-among-sexual-minorities
#19
REVIEW
Kesha Baptiste-Roberts, Ebele Oranuba, Niya Werts, Lorece V Edwards
There is evidence of health disparities between sexual minority and heterosexual populations. Although the focus of lesbian, gay, bisexual, and transgender health research has been human immunodeficiency virus/acquired immunodeficiency syndrome and sexually transmitted infection among men who have sex with men, there are health disparities among sexual minority women. Using the minority stress framework, these disparities may in part be caused by individual prejudice, social stigma, and discrimination. To ensure equitable health for all, there is urgent need for targeted culturally sensitive health promotion, cultural sensitivity training for health care providers, and intervention-focused research...
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160893/leveraging-opportunities-for-postpartum-weight-interventions
#20
REVIEW
Alexander Berger, Wanda Kay Nicholson
Approximately 20 million US women are considered overweight or obese. African American women share a disproportionate burden of obesity. To date, few studies have assessed the effects of behavioral interventions, tailored to the specific lifestyle challenges of postpartum African American women. Efforts to address the disparate rates of obesity in African American women should include assessment of knowledge and knowledge gaps, development and testing of behavioral interventions, and translation of evidence into clinical practice...
March 2017: Obstetrics and Gynecology Clinics of North America
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