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Your next patient is a newly divorced 41-year-old woman who wants to use an oral contraceptive (OC). When you check her chart, you note that she smokes 10 cigarettes a day. What is your next move?
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When it comes to prescribing an oral contraceptive (OC) for your patient, which one do you select? Participants in the 2006 Contraception Survey conducted by Contraceptive Technology Update say their No. 1 oral contraceptive (OC) of choice for a 21-year-old nonsmoker is Yasmin, a monophasic pill containing 3 mg drospirenone and 0.030 mg ethinyl estradiol from Berlex, Wayne, NJ.
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The contraceptive vaginal ring (NuvaRing, Organon; West Orange, NJ) and the transdermal contraceptive (Ortho Evra, Ortho-McNeil Pharmaceutical; Raritan, NJ) have become standard options at many facilities since both were approved by the Food and Drug Administration (FDA) in 2001.
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Do you remember in medical school when the professor taught us that unless you think of ectopic pregnancy, you couldn't make the diagnosis? The teaching point wasn't specifically for ectopics, but the generalized concept was that we should have a broad differential diagnosis when confronted by a clinical situation in order to maximize our success in making the correct diagnosis.
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It is well recognized that women in whom a BRCA1 or BRCA2 mutation is identified have an accelerated risk of breast and/or ovarian cancer. Known cases generally undergo heightened surveillance and consider prophylactic salpingo-oophorectomy to reduce their risk of either or both cancers.
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Elnashar and colleagues in Egypt performed a randomized trial assessing the efficacy of adding dexamethasone to clomiphene citrate treatment (up to 150 mg/day). The subjects were 80 women with polycystic ovaries who had demonstrated resistance to clomiphene induction of ovulation and who had normal levels of dehydroepiandrosterone sulfate (DHAS).
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The increased rate of cesarean section in the United States has been the subject of many editorials over the last 3 years and the very recent spurt in elective cesareans has triggered commentary varying from "this is unconscionable" to "why not?"
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The authors reviewed 472 records representing 16 million preventive healthcare visits in women from 50 to 69 years of age in the 2000 National Ambulatory Medical Care Survey. OB/GYN physicians were more likely to follow breast cancer screening guidelines, but, overall, mid-level providers are more likely than medical doctors or osteopaths to adhere to guidelines.
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