Clinical obstetrics and gynecology
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Endometriosis is associated with infertility; however, the etiology of this association is unclear, thus complicating management. Several mechanisms of pathogenesis have been proposed; however, no one theory has been implicated. Medical therapy can be helpful in managing symptoms, but does not improve pregnancy rates. ⋯ There is little data regarding ovulation induction treatments for endometriosis only, whereas superovulation with intrauterine insemination has shown modest improvement in pregnancy rates in women who may have endometriosis. The most effective treatment for endometriosis-associated infertility is in vitro fertilization. Recent focus on proteomics and genetics of the disease may aid in optimizing treatment options.
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During the past 3 decades, staggering advances have been made in the field of assisted reproductive technology (ART). This review provides an overview of the history of ART, current ART practices, and future directions within the field.
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This article focuses on breast cancer screening in the general population. Using an evidence-based medicine approach, a review of the current literature was undertaken to examine the rationale, risks, and benefits of breast cancer screening. ⋯ Currently, we believe mammography offers significant benefits for breast cancer detection and mortality reduction in the general population. Further research is necessary on methods to minimize false-positive results.
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The use of simulation-based methods for clinical and team training provides an opportunity for health care professionals to develop and maintain the skills required to effectively manage patient care. This is especially true for those rare events when emergency interventions require urgent, accurate, and cohesive team functioning. We present a framework for considering simulation-based training, examine contextual factors and the outcomes of research conducted to date in this area, and provide suggestions for selecting simulation-based approaches for developing obstetrics and gynecology teams in multiple contexts.
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Clin Obstet Gynecol · Sep 2010
ReviewRole of clinician involvement in patient safety in obstetrics and gynecology.
Patient safety is a significant concern for healthcare providers. Involving physicians in clinical quality activities in obstetrics and gynecology can be difficult for many reasons including time demands, lack of knowledge of process improvement activities, or change fatigue due to failure of adequate implementation of previous activities. This overview for improving the culture of safety identifies roles physicians can play from participating in quality assessment and improvement activities, improving teamwork between disciplines, communicating effectively, creating departmental guidelines, and deciding on outcome measures for benchmarking. An improved culture of safety is better for our patients and may reduce malpractice exposure.