American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · May 2002
Selection of obstetrics and gynecology residents on the basis of medical school performance.
The purpose of this study was to determine whether United States Medical Licensing Examination scores during medical school predict resident-in-training examination scores and whether other criteria of medical student performance correlate with the faculty's subjective evaluation of resident performance. ⋯ Standardized tests of medical student cognitive function predict the resident's performance on standardized tests. Selection criteria that are based on other medical school achievements do not necessarily correlate with overall performance as residents in obstetrics and gynecology.
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Am. J. Obstet. Gynecol. · May 2002
Linking olfaction with nausea and vomiting of pregnancy, recurrent abortion, hyperemesis gravidarum, and migraine headache.
The experience of women was sought about nausea and vomiting, its relation to olfaction, its occurrence among pregnant women with anosmia, and the potential association of hyperemesis gravidarum and migraine headache. ⋯ The frequency of nausea and vomiting, caused most often by nonpregnancy-related triggers, is high among women. In a small sample of women with congenital anosmia, nausea and vomiting of pregnancy occurred in only 1 pregnancy, suggesting that olfaction is a highly selected trigger for nausea and vomiting of pregnancy. The shared nausea and vomiting experience of hyperemesis gravidarum and migraine headache among women suggests a common mechanism, possibly based on allelic variations within the DRD2 (dopaminergic receptor) gene. Because olfactory receptors, odor types, and MHC antigens are closely integrated, and because olfactory stimuli often incite episodes of pregnancy, nausea, and vomiting, hyperemesis gravidarum, and migraine headache, these genes and their products invite further scrutiny. The pregnancy-conserving effect of PNV and the MHC antigen overlap in couples with recurrent abortion are important clues possibly relating olfaction, MHC antigens, and reproductive success or failure.
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Am. J. Obstet. Gynecol. · May 2002
Randomized Controlled Trial Multicenter Study Clinical TrialEffectiveness of inpatient and outpatient treatment strategies for women with pelvic inflammatory disease: results from the Pelvic Inflammatory Disease Evaluation and Clinical Health (PEACH) Randomized Trial.
Pelvic inflammatory disease (PID) is a common and morbid intraperitoneal infection. Although most women with pelvic inflammatory disease are treated as outpatients, the effectiveness of this strategy remains unproven. ⋯ Among women with mild-to-moderate pelvic inflammatory disease, there was no difference in reproductive outcomes between women randomized to inpatient treatment and those randomized to outpatient treatment.
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Am. J. Obstet. Gynecol. · May 2002
ReviewThe effects of epidural analgesia on labor, maternal, and neonatal outcomes: a systematic review.
Mothers given an epidural rather than parenteral opioid labor analgesia report less pain and are more satisfied with their pain relief. Analgesic method does not affect fetal oxygenation, neonatal pH, or 5-minute Apgar scores; however, neonates whose mothers received parenteral opioids require naloxone and have low 1-minute Apgar scores more frequently than do neonates whose mothers received epidural analgesia. Epidural labor analgesia does not affect the incidence of cesarean delivery, instrumented vaginal delivery for dystocia, or new-onset long-term back pain. ⋯ Analgesic method does not affect lactation success. Epidural use and urinary incontinence are associated immediately postpartum but not at 3 or 12 months. The mechanisms of these unintended effects need to be determined to improve epidural labor analgesia.
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Am. J. Obstet. Gynecol. · May 2002
ReviewThe role of behavioral conditioning in the development of nausea.
Literature related to the prevalence and etiology of anticipatory nausea and vomiting associated with chemotherapy is reviewed. Physiologic causes and psychological factors, including expectations, beliefs, and conditioning, are examined to help explain these phenomena. The efficacy of pharmacologic and behavioral treatments is discussed. Similarities between the experience of anticipatory nausea and vomiting and morning sickness suggest that the conditioning model may be relevant to understanding the development of pregnancy-related nausea.