Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC
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Domestic violence has been recognized as a public health concern worldwide with serious social and health consequences, including adverse pregnancy outcome. Although health-care professionals are becoming better informed about domestic violence, and women accept being questioned in this regard, studies have shown that fewer than 10% of physicians ask women routinely about domestic violence, even during pregnancy. Further, based on traditional criteria for screening, reviews have not supported screening programs for domestic violence. ⋯ Recent studies suggest that merely asking about violence and providing validation and support reduces violent incidents. The term "screening" in this context may be a misnomer better replaced by "routine enquiry." Published systematic reviews and guidelines about domestic or relationship violence acknowledge the seriousness of the problem from a health perspective and the justification to include routine enquiry about domestic violence as part of health care, even when concluding that the evidence is lacking to justify screening programs as traditionally defined. Continued education and support for health professionals is essential in ensuring that women are not unknowingly left at greater risk due to a non-systematic approach.
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Breast cancer is reported to occur in from 1 in 3000 to 1 in 10,000 pregnancies worldwide. In the United States, 10% to 20% of breast cancers occur in women of childbearing age. Diagnosis and treatment of breast cancer during pregnancy present many additional challenges.
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J Obstet Gynaecol Can · Nov 2003
Practice Guideline GuidelineManagement of the third stage of labour to prevent postpartum hemorrhage.
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Rosiglitazone and pioglitazone are two new additions to the therapeutic options for the treatment of type 2 diabetes mellitus. These agents differ from our current therapies in their mode of action. ⋯ However, special precaution is warranted in patients with congestive heart failure or hepatic disease, and monitoring of liver enzymes is recommended for the first year of therapy. Despite their effectiveness, rosiglitazone and pioglitazone remain second-line agents to metformin and glyburide, agents that have demonstrated efficacy in decreasing the microvascular and macrovascular complications associated with type 2 diabetes mellitus.