The 5th IVI International Congress: Reproductive Medicine and Beyond by ComtecMed 04-Apr-13 to 06-Apr-13 Seville , SPAIN (GYN - Contraception & Reproductive Health)
2013 AIUM Annual Convention by American Institute of Ultrasound in Medicine 06-Apr-13 to 10-Apr-13 New York (New York Marriott Marquis Hotel) , NY USA (CME - Medical Education)
Manejo clínico y terapéutico de la esterilidad. Segundo curso online by Fundacio Dexeus Salud de la Mujer 09-Apr-13 to 31-May-13 online , SPAIN(gynecology)
Pediatric Nursing: Care of the Hospitalized Child by Continuing Education Inc. 10-Apr-13 to 13-Apr-13 Anaheim (Hyatt Regency Orange County) , CA USA (CME - Obstetrics, Gynecology & Women's Health)
Medicina fetal Curso-Taller. Curso de Nivel I y II de la SESEGO by Fundacio Dexeus Salud de la Mujer 15-Apr-13 to 17-Apr-13 Barcelona (Auditorio Salud de la Mujer Dexeus) , SPAIN (OB - Maternal Fetal Medicine)
Female Urology & Urogynecology Symposium (FUUS) by Quadrant HealthCom, Inc 18-Apr-13 to 20-Apr-13 Las Vegas (ARIA) , NV USA (CME - Obstetrics, Gynecology & Women's Health)
Female Urology and Urogynecology Symposium (FUUS) 2013 by Quadrant HealthCom, Inc 18-Apr-13 to 20-Apr-13 Las Vegas (ARIA) , NV USA (CME - Obstetrics, Gynecology & Women's Health)
MEMPHIS—A dose-intense sequential schedule of doxorubicin/docetaxel (Taxotere) plus growth factor was no more effective than standard simultaneous administration in treating metastatic breast cancer. More »
New data from a pair of studies presented at the 36th annual meeting of the American Society of Clinical Oncology (ASCO) suggest that capecitabine (Xeloda) doses can be adjusted without compromising efficacy in patients with advanced breast More »
HANNOVER, Germany—Epirubicin (Ellence)/paclitaxel (Taxol) as first-line treatment significantly slows progression of metastatic breast cancer, compared with epirubicin/cyclophosphamide. Interim results of a multicenter phase III trial comparing the two regimens were reported by Hans-Joachim Luck,... More »
A simple test performed during World War II found that after just a half hour, radar duty observers became more likely to miss signs of enemy submarine activity, and consideration of the findings is being urged for British radiologists.According to More »
This is a comprehensive 701-page volume filled with excellent illustrations, photographs, tables, and schematics. The overall structure of the book takes the reader from molecular oncology issues through pathology, diagnosis, staging, treatment, and a More »
ROCKVILLE, Md—The FDA has proposed rules that would enable it to authorize states to certify, inspect, and enforce quality standards at mammography facilities within their boarders. The rules would implement a provision of the Mammography Quality Standards Act of 1992 (MQSA) and significantly... More »
TAMPA, Fla—Anecdotal reports suggest that the selective serotonin-reuptake inhibitors (SSRIs) commonly prescribed for depression might be efficacious in alleviating hot flashes in breast cancer survivors without the risks associated with hormonal therapies. Vered Stearns, MD, of the Lombardi Cancer... More »
ORLANDO—The technology for mammography to go digital is here, but it may take 5 or 10 years for the transition because of the higher costs that the newer method entails, Maria Kallergi, PhD, said at the Joint Cancer Conference of the Florida Universities. More »
Software designed to automatically locate and highlight subtle abnormalities is part of a computer-aided mammography system that recently gained European marketing approval.The Mammex TR is a computer-aided diagnosis system intended to help More »
Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.
Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.
Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.
Glioblastoma multiforme (GBM) cells are characterised by their extreme chemoresistance. The activity of multiple-drug resistance (MDR) transporters that extrude antitumor drugs from cells plays the most important role in this phenomenon. To date, the mechanism controlling the expression and activity of MDR transporters is poorly understood. Activity of the enzyme ecto-5'-nucleotidase (CD73) in tumor cells, which hydrolyses AMP to adenosine, has been linked to immunosuppression and prometastatic effects in breastcancer and to the proliferation of glioma cells. In this study, we identify a high expression of CD73 in surgically resected samples of human GBM. In primary cultures of GBM, inhibition of CD73 activity or knocking down its expression by siRNA reversed the MDR phenotype and cell viability was decreased up to 60% on exposure to the antitumoral drug vincristine. This GBM chemosensitization was caused by a decrease in the expression and activity of the multiple drug associated
Night work involving disruption of circadian rhythm was suggested as a possible cause of breastcancer. We examined the role of night work in a large population-based case-control study carried out in France between 2005 and 2008. Lifetime occupational history including work schedules of each night work period was elicited in 1,232 cases of breastcancer and 1,317 population controls. Thirteen percent of the cases and 11% of the controls had ever worked on night shifts (OR = 1.27 [95% confidence interval = 0.99-1.64]). Odds ratios were 1.35 [1.01-1.80] in women who worked on overnight shifts, 1.40 [1.01-1.92] in women who had worked at night for 4.5 or more years, and 1.43 [1.01-2.03] in those who worked less than three nights per week on average. The odds ratio was 1.95 [1.13-3.35] in women employed in night work for >4 years before their first full-term pregnancy, a period where mammary gland cells are incompletely differentiated and possibly more susceptible to circadian disruption
Tissue polypeptide-specific antigen (TPS), a specific epitope structure of a peptide in serum associated with human cytokeratin 18, is linked to the proliferative activity of tumors. Here, we aimed to identify the association between the preoperative serum TPS level and outcome in breastcancer patients. We assayed preoperative serum TPS levels in 1,477 breastcancer patients treated between June 2000 and December 2006. The TPS level was measured with a one-step solid phase radiometric sandwich assay detecting the M3 epitope on cytokeratin 18 fragments. The cutoff value was 80 U/L. Among the 1,477 breastcancer patients examined, preoperative serum TPS level was elevated (>80 U/L) in 290 patients (19.6%). Age (>45 years), tumor size (>2 cm), nodal metastasis, negative progesterone receptor and human epidermal growth factor receptor 2 were associated with elevated TPS. Evidence of recurrence was observed in 229 patients (15.6%). Elevated TPS was associated with poor disease-free
We previously reported an inverse association between sleep duration and breastcancer risk in the prospective, population-based Singapore Chinese Health Study (SCHS) cohort (Wu et al., Carcinogenesis 2008;29:1244-8). Sleep duration was significantly positively associated with 6-sulfatoxymelatonin (aMT6s) levels determined in a spot urine, but aMT6s levels in breastcancer cases were lacking (Wu et al., Carcinogenesis 2008;29:1244-8). We updated the sleep duration-breastcancer association with 14 years of follow-up of 34,028 women in the SCHS. In a nested case-control study conducted within the SCHS, randomly timed, prediagnostic urinary aMT6s concentrations were compared between 248 incident breastcancer and 743 individually matched cohort controls. Three female controls were individually matched to each case on age at baseline interview (within 3 years), dialect group, menopausal status, date of baseline interview (within 2 years), date of urine sample collection (within 6 months)
Cancer of unknown primary site (CUP) is a fatal cancer ranking among the five most common cancer deaths. CUP is diagnosed through metastases, which are limited to lymph nodes in some patients. Cause-specific survival data could guide the search for hidden primary tumors and help with therapeutic choices. The CUP patients were identified from the Swedish Cancer Registry between 1987 and 2008; 1,444 patients had only lymph node metastasis of defined histology (adenocarcinoma, squamous cell or undifferentiated). Site-specific cancer deaths were analyzed by lymph node location and histology. Kaplan-Meier survival curves were compared with metastatic primary cancer at related sites. Among the patients with metastasis to head and neck lymph nodes, 117 (59.1% of the specific cancer deaths) died of lung tumors. Patients with axillary lymph node metastasis died of lung and breast tumors in equal proportions (40.2% each). Also, squamous cell CUP in head and neck lymph nodes was mainly
Has anyone tried FetalGrowth app (App Store for iPhone/iPad) ? I'm interested in using a simple and handy tool to calculate fetal percentiles, and I came across this app, which seems it does the job (plots growth charts, as well). I haven't seen anything else, besides this app, so I was wondering if there are people who have already tried it.
Had a case the other day with the above finding on a pap. She was age 36 and had a Mirena in place. How do people feel about the idea of trying to do an EMB with an IUD in place? If not, how do we proceed?
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I helped another physician with removal of a retained placenta last night, we were unsuccessful in removing it vaginally, her cervix was too closed to allow manual removal and we could only get a few pieces out with ring forceps and a large curette, so we did a laparotomy/hysterotomy and were able to preserve the uterus. The placenta turned out not to be an accreta and it was easily removed via that route through a low vertical incision on the uterus. Any thoughts on the appropriate CPT code would be appreciated. The patient came in through the ER five days after home delivery by her husband. She was severely anemic, rcvd 7 units of blood and is still quite ill and in the ICU but improving.
Recently, I had the occasion to review a case of a term primigravida with PROM in a private hospital (no housestaff or in house obstetricians). She was seen by an obstetrician soon after arrival, evaluated, and pitocin induction begun.
She did not deliver for around 29 hours after admission, and the delivering obstetrician (a different physician) was physically present during the last 2 hours of labor prior to delivery.
Simply put, while the two involved obstetricians were in communication by phone with the nursing staff throughout labor (separately as their "shifts" did not overlap), no one actually came to the bedside and wrote a note) from admission until around 2 hours before delivery.
Medical staff bylaws call for a daily progress note; this bylaw was easily met.
In reviewing the case, it did not "feel good" that no one came to the bedside.
My questions:
1. Does anyone have or know of any guidelines to mandate such bedside attendance? Of course, we all hope that the involved physicians would not need said guidelines. 2. Does anyone have a suggestion of hospital/nursing protocols? Simply, in this case I would like to have had a charge nurse or bedside nurse simply say, "Hey, no one has been by for a while. What's up?"
I really need help from OB/GYNs and I'm having a hard time getting it. I find your opinions really valuable. I'm researching recommendations for cosleeping. This is for my dissertation, so your time is truly appreciated! Please complete the full survey. It will help me tremendously.
The study takes about 5 to 10 minutes to complete. Please don't hesitate to contact me at bhamel@pacificu.edu with any questions.
If you are interested in participating, please follow the link provided below:
Our hospital bought an electronic medical record (EMR) system for the clinics. There is a large hosptial group practice including pediatrics, medicine, FP, OB/GYN, and other specialities and sub-specialities. Furthermore, the hospitalists and the ER doctors are also employed in the same hosptial group practice.
The hospital spent millions of dollars on an EMR. As best I can tell there are only two useful things that the EMR does. One is to automatically calcualte the BMI, which it does very well. THe other is to make records available on any patient to any doctor anywhere in the practice. It does not do this well -- it requires lots of mouse movements and clicks and different documents come up in different formats, making it labor intenisve. But, with enough time, effort, and frustration, one can obtain copies of every document in the sustem, either on a computer screen or on paper.
Swith to the ER now. A paitnet whom I had seen the previous week in consultatio comes into the ER for a non-pregnancy problem. They call me on the telephone in the evening. "No problem", I say. I did a torough evaluation and wrote a detailed note on the patient and her OB and non-OB problems only a few days ago. "Just go to the EMR and you can print out my note with all the details."
Seems, however, that for some reason the EMR is not available in the ER (or on the wards for that matter). When I asked the hosptial administrator about it the next morning, he said that he and the hosptial lawyers were working on the problem.
Apparently the government thinks that the ER doctors and hospitalists have nothing better to do with their time than to print out copies of patients' medical records from the EMR and sell them on the black market. Therefore, we cannot let those nasty doctors have access to the EMR records. Nevermind that the ER doctors are in the same group practice as all the other doctors. Never mind that the patient is willing to sign a release so that the doctor who is taking care of her can see the records of the practice. We have to protect the patient even if it means that vital information is rendered unavailable and that things are made more difficult, complicated, and expensive. It reminds me of the Army in Viet Nam where they would have to "destroy a village in order to save it!" Apparently the EMR makes us destroy a patient in order to save her.
Thank GOD for the EMR. Three million dollars and the only benefit is that we can get a BMI 10 seconds faster.
I think the NEJM got it correct last month when they said in an atricle that the only ones who truly benefit from electronic medical record systems are the people who make and sell them.
There are a variety of complications that can occur during laparoscopic surgery. In this tutorial learn some of the complications and tips to avoid them.
CC is a 31 year old primigravida who was referred for ultrasound at a community hospital due to suspected cardiac anomalies noted on a screening sonogram at her doctor's office. Due to concern about a probable cardiac abnormality an amniocentesis was performed at the local hospital.
Single umbilical artery color doppler, transverse scan of urinary bladder shows single umbilical artery (left), transverse section of umbilical cord showing only two vessels: one vein and one artery (right).
Five Steps to Improving Patient Access Judy Capko, May 21, 2013 Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office.
Growing HIPAA Threat – Ignore Windows XP at Your Own Peril Marion K. Jenkins, May 21, 2013 Chances are good that you have some major ticking software time bombs lurking in your medical practice's computer environment, namely Windows XP and Server 2003.
Three Areas to Reduce Costs at Your Medical Practice Greg Mertz, May 19, 2013 By taking a hard look at reducing costs for staffing, overhead, and technology at your medical practice, you may see increased physician compensation.
Dos and Don’ts for Starting a Physician Blog Michael Woo-Ming, MD, May 18, 2013 Starting a physician blog can provide your medical practice with marketing benefits, but it's important to do it right.
B mode and 3D Ultrasound images of a fetal abdomen (35wks) revealing gallbladder calculi
This case study shows a 26 week gestation with a cystic mass close to the sacrum.
CC is a 31 year old primigravida who was referred for ultrasound at a community hospital due to suspected cardiac anomalies noted on a screening sonogram at her doctor's office. Due to concern about a probable cardiac abnormality an amniocentesis was performed at the local hospital.
Single umbilical artery color doppler, transverse scan of urinary bladder shows single umbilical artery (left), transverse section of umbilical cord showing only two vessels: one vein and one artery (right).
Normal 35 week pregnancy
