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In the January issue of the American Journal of Obstetrics and Gynecology an article from Japan appeared that will shed new light on the practice of using cerclage in patients with short cervices. Over a 5-year period 16,508 had transvaginal ultrasound evaluations between 20-24 weeks.
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The authors sought to determine the relationship between psychiatric and sexual status of premenopausal women with fibromyalgia compared to a control group of healthy women.
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A medline search was conducted for comparisons of vaginal hysterectomy in patients with/without previous cesarean delivery. As might be anticipated, the studies were heterogeneous. For example, in one study, some cases had laparoscopic assistance.
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Normal circulating plasma glucose concentration is maintained by a delicate constant balance between glucose utilization (i.e., glycolysis or storage as glycogen by various tissues) on one hand and glucose production on the other (i.e., glycogenolysis and gluconeogenesis induced in certain tissues, such as liver, muscle, renal parenchyma, and adipose tissue). During the late post-absorptive period or starvation, normal glucose concentration is maintained by facilitating glucose production while inhibiting glucose uptake.
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Your patient is a 29-year-old mother of three active young children. She has had limited success with using birth control pills and says that the daily dosing schedule is a challenge. She shakes her head "no" to the contraceptive patch and vaginal ring, and she doesn't want to limit her options with the choice of tubal sterilization.
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You have just written a prescription for an adolescent female to treat a chlamydial infection. When you close her file, what are the chances it will reappear in your inbox in the next month or two?
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Access to Gardasil (Merck & Co., Whitehouse Station, NJ) continues to expand as the shot has been added to the federal Vaccines for Children (VFC) program for young women ages 9 to 18. The program is administered at the national level by the Centers for Disease Control and Prevention (CDC) through its National Immunization Program.
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The next patient in your exam room is in her mid-40s. She notes that her last monthly period was 11 months ago. She continues to use condoms for pregnancy prevention. She has a thin body and a small bone frame, and she smokes 15-20 cigarettes a day. Her medical history indicates a family history of osteoporosis. What is your next move?
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When is "that time of month" a problem for some women? When symptoms such as depression, wide mood swings, breast tenderness, or muscle pain enter into the picture, a diagnosis of premenstrual syndrome (PMS) may be in order. However, when symptoms are more severe, clinicians may consider a diagnosis of premenstrual dysphoric disorder (PMDD).
