Vitamin D supplements may cut breast cancer risk
August 1st 2010Although vitamin D and calcium absorbed from food and total combined intake from food and supplements do not seem to influence breast cancer risk, vitamin D supplement intake greater than 10 mcg/d compared with no intake reduced the risk of breast cancer by about 25% according to results of a Canadian study.
Use of bar-code technology drastically reduces medication errors
July 1st 2010Using bar-code verification technology within an electronic medication administration system substantially reduces transcription and medication administration errors along with related potential drug-related adverse events, according to a new study.
Screen with cytology triage catches more cancers than cytology alone
July 1st 2010Primary human papillomavirus DNA screening with cytology triage in a routine organized screening program detects more cervical intraepithelial neoplasia III+ lesions in all age groups than conventional cytology, according to new study findings.
Perceptions about cause of dystocia lead to litigation
July 1st 2010A patient presents to a hospital with onset of contraction and spontaneous rupture of the fetal membranes. The rupture revealed clear amniotic fluid. The resident evaluating the patient noted that her cervix was 3 cm dilated and 70% effaced, and the fetus was at -2 station and in vertex position. The patient was placed on oxytocin and was 6 cm to 7 cm dilated within 90 minutes.
Surgical debulking of ovarian cancer: Past, present or future
July 1st 2010Ovarian cancer is the "silent killer," causing more deaths in the United States than all other gynecologic malignancies combined. This article focuses on the recent debate or whether or when patients with advanced disease should undergo debulking surgery.
Cervical cerclage for the woman with prior adverse pregnancy outcome
June 1st 2010A 19-year-old patient (gravida 2, para 1) at 12 weeks' gestation had a preterm birth at 23 weeks in her last pregnancy. Delivery was preceded by spontaneous rupture of the membranes and a brief time of irregular contractions. Certain information would assist in determining whether cervical insufficiency was part of her pregnancy outcome.
Preventing retained foreign objects in ob/gyn surgery
June 1st 2010A 44-year-old woman underwent an uneventful abdominal supracervical hysterectomy. Sponge and needle counts were reported as correct on multiple occasions during surgery. On postoperative day 2, the patients reported abdominal pain and mild abdominal distention. Despite conservative measures taken, the pain and distention did not resolve. On postoperative day 4, she was vomiting and her abdomen appeared further distended. An X-ray revealed an intra-abdominal laparatomy pad and small bowel obstruction.
Commentary: How to respond to the trend of increasing cesarean delivery
June 1st 2010In 2007, 31.8% of deliveries in the United States were accomplished by cesarean delivery, with more than 1,370,000 women undergoing the procedure. This marks a 2% increase over 2006 and a more than 50% increase since 1996. This figure is not accounted for by repeat procedures only.
Conference Addresses Vaginal Birth After Cesarean
June 1st 2010In March, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) convened a consensus conference on vaginal birth after cesarean (VBAC). Various experts described what is known and not known about the safety of trials of labor after prior cesarean delivery.
Legally Speaking: Did misoprostol cause this postpartum hemorrhage?
May 1st 2010The patient, a then 34-year-old gravida 1, para 0, was admitted to the defendant hospital on May 8 under the care of defendant ob/gyn "A." Her blood pressure on admission was 150/90 mmHg (up from 140/90 mmHg at the o ce that morning), and she was past her expected delivery date,April 30. Prenatal records were signi cant for an anatomic ultrasound re ecting a partial placenta previa.
Grand Rounds: Practical perspective on cesarean hysterectomy: When, why, and how
May 1st 2010Cesarean hysterectomy and postpartum hysterectomy are commonly performed emergently for severe uterine hemorrhage that is unresponsive to conservative therapies. These procedures differ in timing. Cesarean hysterectomy is performed immediately after a cesarean delivery for severe hemorrhage or, less commonly, as a planned procedure to treat preexisting gynecologic disease. Postpartum hysterectomy is performed after a vaginal delivery for delayed hemorrhage or infectious complications.
Funded breast cancer screening/diagnosis decreases diagnostic delays
May 1st 2010A case-management program that is part of the National Breast and Cervical Cancer Early Detection Program (BCCEDP) has had a positive effect on the timeliness of care in women with an abnormal mammogram, according to a new report.
NAMS Notes: Position statement addresses hormone therapy in postmenopausal women
May 1st 2010Data on hormone therapy (HT) for treating menopause-related symptoms and preventing disease in postmenopausal women are evolving rapidly. To guide therapy and to put the risks and benefits of HT, estrogen therapy (ET), or combined estrogen-progestogen therapy (EPT) in perspective for healthcare professionals and the public, the North American Menopause Society (NAMS) has updated its evidence-based 2008 statement in light of subsequently published scientific data.
Stop screening for inherited thrombophilias in patients with adverse pregnancy outcomes
May 1st 2010It's important to understand that most positive associations between inherited thrombophilias and adverse pregnancy outcomes were derived from small case-control studies subject to selection and ascertainment biases.