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By Jorge Santiago ObGyn -Oncology
Ekta Kapoor, Daniel Benrubi, Stephanie S Faubion
Gynecologic cancers are common in the United States and represent a significant health burden. Treatment of these cancers often causes premature cessation of ovarian function, with resultant symptoms that are often more severe than those associated with natural menopause. Hormone therapy is the most effective treatment for menopausal symptoms, but the decision-making process about its use can be complex for survivors of gynecologic cancer. In this review, we provide evidence-based recommendations about the use of hormone therapy after gynecologic cancer...
May 14, 2018: Clinical Obstetrics and Gynecology
G Calì, I E Timor-Tritsch, J Palacios-Jaraquemada, A Monteaugudo, D Buca, F Forlani, A Familiari, G Scambia, G Acharya, F D'Antonio
OBJECTIVE: To explore the outcome in women managed expectantly following the diagnosis of Cesarean scar pregnancy (CSP). METHODS: An electronic search of MEDLINE, EMBASE and databases was performed utilizing combinations of relevant medical subject headings for 'Cesarean scar pregnancy' and 'outcome'. Reference lists of relevant articles and reviews were hand-searched for additional reports. Observed outcomes included: severe first-trimester vaginal bleeding; clinical symptoms (abdominal pain, vaginal bleeding) requiring treatment; uncomplicated miscarriage; complicated miscarriage requiring intervention; first- or second-trimester uterine rupture or hysterectomy; third-trimester bleeding, uterine rupture or hysterectomy; maternal death; incidence of abnormally invasive placenta (AIP); prevalence of placenta percreta; ultrasound signs suggestive of AIP; and live birth...
February 2018: Ultrasound in Obstetrics & Gynecology
(no author information available yet)
Pain and fatigue are the most common problems reported by women in the early postpartum period. Pain can interfere with a woman's ability to care for herself and her infant. Untreated pain is associated with a risk of greater opioid use, postpartum depression, and development of persistent pain. Nonpharmacologic and pharmacologic therapies are important components of postpartum pain management. Because 81% of women in the United States initiate breastfeeding during the postpartum period, it is important to consider the drug effects of all prescribed medications on the mother-infant dyad...
May 17, 2018: Obstetrics and Gynecology
Marcel Levi
BACKGROUND: Recently, a new generation of direct-acting oral anticoagulants (DOACs) with a greater specificity towards activated coagulation factors was introduced based on encouraging results for efficacy and safety in clinical studies. An initial limitation of these new drugs was the absence of an adequate strategy to reverse the effect if a bleeding event occurs or an urgent invasive procedure has to be carried out. MAIN TEXT: Specific reversing agents for DOACs have become available, however, and are now evaluated in clinical studies...
August 20, 2016: Critical Care: the Official Journal of the Critical Care Forum
Marie E McDonnell, Guillermo E Umpierrez
It has long been established that hyperglycemia with or without a prior diagnosis of diabetes increases both mortality and disease-specific morbidity in hospitalized patients and that goal-directed insulin therapy can improve outcomes. This article reviews the pathophysiology of hyperglycemia during illness, the mechanisms for increased complications and mortality due to hyperglycemia and hypoglycemia, and beneficial mechanistic effects of insulin therapy and provides updated recommendations for the inpatient management of diabetes in the critical care setting and in the general medicine and surgical settings...
March 2012: Endocrinology and Metabolism Clinics of North America
Linda Shiber, William J Todia
OBJECTIVE: We sought to determine the clinical utility and cost of repeating syphilis testing in the third trimester of pregnancy in a high-risk urban population. STUDY DESIGN: A retrospective cohort analysis was performed for patients delivering from January 1993 through December 2009 with at least 1 venereal disease research laboratory (VDRL) test sent during pregnancy. Chart review was performed for patients with confirmed syphilis to determine the temporal relationship of syphilis diagnosis to the pregnancy...
March 2014: American Journal of Obstetrics and Gynecology
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