Obstetrics and gynecology
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Obstetrics and gynecology · Jul 2001
ReviewAntenatal corticosteroids revisited: repeat courses - National Institutes of Health Consensus Development Conference Statement, August 17-18, 2000.
To provide health care providers, patients, and the general public with a responsible assessment of currently available data regarding the benefits and risks of repeat courses of antenatal corticosteroids. ⋯ The collective international data continue to support unequivocally the use and efficacy of a single course of antenatal corticosteroids using the dosage and interval of administration specified in the 1994 Consensus Development Conference report. The current benefit and risk data are insufficient to support routine use of repeat or rescue courses of antenatal corticosteroids in clinical practice. Clinical trials are in progress to assess potential benefits and risks of various regimens of repeat courses. Until data establish a favorable benefit-to-risk ratio, repeat courses of antenatal corticosteroids, including rescue therapy, should be reserved for patients enrolled in clinical trials.
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Obstetrics and gynecology · Jul 2001
Vulvar vestibulitis syndrome: reliability of diagnosis and evaluation of current diagnostic criteria.
To assess the reliability of the diagnosis of vulvar vestibulitis as defined by Friedrich and to evaluate the usefulness of Friedrich's criteria in the diagnostic process. ⋯ Vulvar vestibulitis can be reliably diagnosed in women with dyspareunia. Pain is limited to the vulvar vestibule and can be rated and described in a consistent fashion by these women. Erythema does not appear to be a useful diagnostic criterion.
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Obstetrics and gynecology · Jul 2001
Outcomes after rollerball endometrial ablation for menorrhagia.
To evaluate the outcomes of women undergoing rollerball endometrial ablation for menorrhagia and to identify factors associated with those outcomes. ⋯ The results of this study confirm the effectiveness of rollerball endometrial ablation for the treatment of menorrhagia for a longer duration of follow-up than in most previous reports. Repeated ablation and a younger age at the time of ablation increase the risk of requiring a subsequent hysterectomy.
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Obstetrics and gynecology · Jul 2001
Effects of oxytocin receptor antagonist atosiban on pregnant myometrium in vitro.
To investigate dose-dependent effects of oxytocin receptor antagonist, atosiban, on oxytocin-induced contractions of myometrial strips from healthy pregnant women. ⋯ The oxytocin receptor antagonist atosiban showed a significant, dose-dependent inhibition of oxytocin-induced contractions of human myometrium in vitro. It might be effective in tocolysis at term.
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The President's Program at the 2000 Annual Clinical Meeting of ACOG addressed the question of how best to maintain professional values in the current, market-driven health care environment. The author's presentation during that presidential program provided the basis of this article. In today's corporate environment, the distinction between the practice of medicine and the business of medicine has become blurred. ⋯ To ease the discomfort of practicing in a new corporate age, physicians must maintain medical professionalism and hence reassert the primacy of professional values in caring for patients. Individually, physicians must exercise professionalism in their roles as educators and practitioners. Collectively, the profession of medicine must exercise professionalism by advocating patients' interests and by accepting accountability for both long-established and emerging obligations that physicians have to their patients and to society.