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Ob/gyn review

Susanna R Magee, W Suzanne Eidson-Ton, Larry Leeman, Michael Tuggy, Thomas O Kim, Melissa Nothnagle, Joseph Breuner, Mark Loafman
Maternity care is an integral part of family medicine, and the quality and cost-effectiveness of maternity care provided by family physicians is well documented. Considering the population health perspective, increasing the number of family physicians competent to provide maternity care is imperative, as is working to overcome the barriers discouraging maternity care practice. A standard that clearly defines maternity care competency and a systematic set of tools to assess competency levels could help overcome these barriers...
March 2017: Family Medicine
Reshef Tal, David B Seifer
Ovarian reserve is a complex clinical phenomenon influenced by age, genetics, and environmental variables. Although it is challenging to predict the rate of an individual's ovarian reserve decline, clinicians are often asked for advice about fertility potential and/or recommendations regarding the pursuit of fertility treatment options. The purpose of this review is to summarize the state-of-the-art of ovarian reserve testing, providing a guide for the obstetrician/gynecologist generalist and reproductive endocrinologist...
February 21, 2017: American Journal of Obstetrics and Gynecology
Jeffrey Tin Yu Chow, Kevin Lam, Abdul Naeem, Zarique Z Akanda, Francie Fengqin Si, William Hodge
BACKGROUND: Randomized controlled trials (RCTs) form the foundational background of modern medical practice. They are considered the highest quality of evidence, and their results help inform decisions concerning drug development and use, preventive therapies, and screening programs. However, the inputs that justify an RCT to be conducted have not been studied. METHODS: We reviewed the MEDLINE and EMBASE databases across six specialties (Ophthalmology, Otorhinolaryngology (ENT), General Surgery, Psychiatry, Obstetrics-Gynecology (OB-GYN), and Internal Medicine) and randomly chose 25 RCTs from each specialty except for Otorhinolaryngology (20 studies) and Internal Medicine (28 studies)...
February 2, 2017: Trials
Jonathan D Lehnert, Mallory K Ellingson, Grace W Goryoka, Raghuraj Kasturi, Emily Maier, Allison T Chamberlain
OBJECTIVE: To describe the current use of obstetric practice Web sites to disseminate Zika virus information to patients. DESIGN: Review of 913 randomly selected practice Web sites and associated social media accounts in January and August 2016. SETTING: Obstetric practice Web sites and associated social media accounts, United States of America. PARTICIPANTS: N/A. MAIN OUTCOME MEASURES: Proportion of obstetric practice Web sites and linked social media accounts providing Zika virus information...
January 25, 2017: Journal of Public Health Management and Practice: JPHMP
Seong K Lee, Eddy H Carrillo, Andrew Rosenthal, Rafael Sanchez, Chauniqua Kiffin, Dafney L Davare
BACKGROUND: Overwhelming hemorrhage or other intra-abdominal complications may be associated with obstetrical or gynecologic (OB/GYN) procedures and may require the surgical training of an Acute Care/Trauma Surgeon. The OB Critical Assessment Team (OBCAT Alert) was developed at our institution to facilitate a multidisciplinary response to complex OB/GYN cases. We sought to review and characterize the Acute Care/Trauma Surgeon's role in these cases. METHODS: We conducted a retrospective review of all emergency consults during an OB/GYN case at our institution from 2008 to 2015...
2016: World Journal of Emergency Medicine
Melanie C Raffoul, Stephen M Petterson, William F Rayburn, Peter Wingrove, Andrew W Bazemore
BACKGROUND: The increase in access to healthcare through the Affordable Care Act highlights the need to track where women seek their office-based care. The objectives of this study were to examine the types of physicians sought by women beyond their customary reproductive years and before being elderly. METHODS: This retrospective cohort study involved an analysis of national data from the Medical Expenditure Panel Survey (MEPS) between 2002 and 2012. Women between 45 and 64 years old (n = 44,830) were interviewed, and reviews of corresponding office visits (n = 330,114) were undertaken...
December 2016: Journal of Women's Health
W Teo, P Schalock
The use of metals in the medical field has become increasingly prevalent over the past few decades. Patients find themselves being exposed to metals in a variety of ways, ranging from external exposure to instruments such as the stainless steel in surgical blades to internal exposure via medical devices being implanted in their bodies. There has been a growing interest in the medical field in the possibility of developing hypersensitivity reactions to constituent metals in medical implant devices, both in cutaneous and systemic forms...
June 30, 2016: Journal of Investigational Allergology & Clinical Immunology
A Noel Rodriguez, Peter DeWitt, Jennifer Fisher, Kirsten Broadfoot, K Joseph Hurt
OBJECTIVE: To characterize the psychometric properties of a novel Obstetric Communication Assessment Tool (OCAT) in a pilot study of standardized difficult OB communication scenarios appropriate for undergraduate medical evaluation. METHODS: We developed and piloted four challenging OB Standardized Patient (SP) scenarios in a sample of twenty-one third year OB/GYN clerkship students: Religious Beliefs (RB), Angry Father (AF), Maternal Smoking (MS), and Intimate Partner Violence (IPV)...
June 11, 2016: International Journal of Medical Education
Ting Zhao, Hao Zhang, Yan Liu, Hongyuan Jiang, Xiao Wang, Yuan Lu
BACKGROUND: Malignant ovarian germ cell tumours (MOGCTs) are usually detected at an early stage, with patients achieving a satisfactory prognosis. However, the role of staging surgery in the treatment of apparent early-stage MOGCTs remains controversial. AIMS: To investigate the role of staging procedures in apparent early-stage patients. MATERIALS AND METHODS: We performed a retrospective review of 102 patients who were diagnosed with MOGCTs and had malignant lesions confined to their ovaries, between January 1997 and October 2014 at the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China...
August 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Nicole M Tierney, Cheryl Saenz, Michael McHale, Kristy Ward, Steven Plaxe
OBJECTIVE: To evaluate publically available, individually identified data regarding industry payments made to obstetrician-gynecologists (ob-gyns) during 2014 posted on the Centers for Medicare & Medicaid Services' Open Payments website for the purposes of encouraging ob-gyns to partake in disclosure of their fiscal relationships to patients and to take an active role in maintaining accuracy of their payment data. METHODS: In this retrospective study, we reviewed the Centers for Medicare & Medicaid Services' Open Payments website for all 2014 nonresearch payments to ob-gyns...
February 2016: Obstetrics and Gynecology
Dylan Supina, Barry K Herman, Carla B Frye, Alicia C Shillington
OBJECTIVES: Binge eating disorder (BED)--now a designated disorder in the DSM-5--is the most prevalent eating disorder (ED), affecting 2-3% of the US population. This survey of US physicians assesses how BED is diagnosed, treated and referred. METHODS: Internists, family practitioners, obstetrics/gynecologist (OB/GYNs) and psychiatrists were randomly selected from a nationally-representative panel. Participants completed an online survey and reviewed case vignettes consistent with DSM-5-defined BED, then answered questions to elicit whether they would assess for psychiatric conditions including EDs...
2016: Postgraduate Medicine
William F Rayburn, Erin E Tracy
A projected shortage of obstetrician-gynecologists (OB-GYNs) is a result of both the increasing US population and the relatively static number of residency graduates. In addition, generational changes have contributed to increasing subspecialization, more desiring part-time employment, and earlier retirement. This article reviews data regarding changes in the practice of obstetrics and gynecology. Residency education is focusing more on a core curriculum in general obstetrics and gynecology, while subspecialty fellowship training has grown in popularity...
January 2016: Obstetrical & Gynecological Survey
Clay P Wiske, Marguerite Palisoul, Chantal Tapé, Janette Baird, Alyson J McGregor
BACKGROUND: CDC guidelines recommend Neisseria gonorrhoeae, Chlamydia trachomatis, and HIV testing, as well as specific antibiotic regimens in the diagnosis and treatment of pelvic inflammatory disease (PID), although latitude in adhering to these guidelines is common. We hypothesized that adherence to CDC guidelines for antibiotic regimens and laboratory testing, coverage for anaerobic organisms, and the use of diagnostic imaging techniques do not differ significantly between practitioners with emergency medicine (EM) versus obstetrics and gynecology (OB-GYN) training...
July 2016: Journal of Women's Health
Kelsey E Larson, Michael S Cowher, Colin O'Rourke, Mita Patel, Debra Pratt
Both the American Cancer Society and National Comprehensive Cancer Network recommend annual clinical breast examination (CBE) along with screening mammogram (SM) for patients starting at 40 years of age. However, patients with a palpable breast mass should have a diagnostic mammogram (DM) during workup. Review at our institution demonstrated that 11% of patients with newly diagnosed breast cancer and self-identified breast mass had SM instead of DM. This led us to question whether primary care physicians (PCP) perform CBE prior to ordering mammography...
March 2016: Breast Journal
Rosalyn A Jurjus, Kirsten Brown, Ellen Goldman, Artin Galoosian, Gisela Butera, Jill M Krapf
Deficits in retention of anatomy knowledge from the preclinical years to clinical application on the wards have been well documented in the medical education literature. We developed and evaluated a web and laboratory-based curriculum to address deficits in anatomy knowledge retention and to increase anatomy knowledge recall through repetition and application of clinical concepts during the obstetrics and gynecology (Ob/Gyn) core clinical clerkship. Using principles of adult learning and instructional design, a curriculum was designed consisting of (1) interactive, case-based e-modules reviewing clinically relevant anatomical topics and (2) a hands-on laboratory session reinforcing the content of the e-modules, with the practice of clinical techniques using anatomical cadaveric dissections...
July 8, 2016: Anatomical Sciences Education
Shwetha Sequeira, Jake R Morgan, Maura Fagan, Katherine K Hsu, Mari-Lynn Drainoni
BACKGROUND: We examined quality of care across different clinical settings within a large safety-net hospital in Massachusetts for patients presenting with penile discharge/dysuria or vaginal discharge. METHODS: Using a modified Delphi approach, a list of sex-specific sexually transmitted infection (STI) quality measures, covering 7 domains of clinical care (history, examination, laboratory testing, assessment, treatment, additional screening, counseling), was selected as standard of care by a panel of 5 STI experts representing emergency department (ED), obstetrics/gynecology (Ob/Gyn), family medicine (FM), primary care (PC), and infectious disease...
December 2015: Sexually Transmitted Diseases
Lauren D Demosthenes, Andrew S Lane, Dawn W Blackhurst
OBJECTIVES: Our objectives were to assess physician knowledge of costs of products, tests, and services commonly used by obstetrician/gynecologists (OB/GYNs) and identify those items that could be eliminated without decreasing quality of care by performing a prospective observational pilot study. METHODS: An anonymous electronic survey was distributed to 70 OB/GYN providers at Greenville Memorial Hospital. Survey items included common laboratory tests, medications, and clinical services...
November 2015: Southern Medical Journal
Marcela C Smid, Sarah G Smiley, Jay Schulkin, David M Stamilio, Rodney K Edwards, Alison M Stuebe
OBJECTIVE: This study aims to determine preferences of a nationally representative sample of obstetrician/gynecologists (OB/GYNs) regarding cesarean delivery (CD) incision practices for women with morbid obesity (body mass index ≥ 40 kg/m(2)). STUDY DESIGN: We conducted an online survey using the American College of Obstetricians and Gynecologists database. We compared physician demographics, practice characteristics, and CD incision type preference. RESULTS: After exclusion of ineligible participants, 247 OB/GYNs completed the survey (42% response rate)...
April 2016: American Journal of Perinatology
Keimari Méndez, Nilmar Rodríguez, Isalis Sánchez, Yolianne Lozada, Idelvais Piñero, Dora Donate, Josefina Romaguera
OBJECTIVE: Cervical cancer is the fifth most common cancer among women in Puerto Rico (PR). Information about which obstetricians and gynecologists in PR are following current cervical cytology guidelines is not available. Our two objectives were to determine whether current guidelines for abnormal cervical cytology management were being followed adequately by OB-GYN residents and faculty at 3 university hospitals and, in addition, to evaluate the knowledge of the current guidelines that is possessed by these individuals...
September 2015: Puerto Rico Health Sciences Journal
Jennifer A Tessmer-Tuck, William F Rayburn
Obstetrician-gynecologists (OB-GYNs) are the fourth largest group of physicians and the only specialty dedicated solely to women's health care. The specialty is unique in providing 24-hour inpatient coverage, surgical care and ambulatory preventive health care. This article identifies and reviews changes in the OB-GYN workforce, including more female OB-GYNs, an increasing emphasis on work-life balance, more sub-specialization, larger group practices with more employed physicians and, finally, an emphasis on quality and performance improvement...
September 2015: Obstetrics and Gynecology Clinics of North America
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