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Special Report: HER2 and Trastuzumab in Breast CancerThe recognition and description of tumor growth control factors, together with the development of interventions that modulate their biologic activity, represent a major focus for current cancer research, which already has changed the practice of clinical oncology.
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Electrosurgery for Cervical Intraepithelial NeoplasiaWomen with cervical intraepithelial neoplasia now have a number of treatment options including cold-knife conization, laser ablation, and loop electrosurgery but, all too often, the physician s preference is the determining factor in selection of therapy. This detailed presentation of the advantages and disadvantages of electrosurgery will help the physician to decide whether this procedure truly fits the needs of a given patient.
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Evidence-based Ways to Prevent Prematurity Caused by InfectionEvidence-based Ways to Prevent Prematurity Caused by Infection Including Bacterial Vaginosis (BV) and Sexually Transmitted Infections (STIs)
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IncontinenceUrinary incontinence (leakage) refers to the involuntary loss of urine from the bladder, which constitutes a social or hygienic problem for the individual. Bladder control problems affect about 17 million people in the United States.
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Exploring Transparency Through Apology and DisclosureOur malpractice lawyer counsels on a complicated case involving a delivery with an unexpected outcome and multiple health care providers involved.
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Performing Nonsurgical Radiofrequency Energy Tissue Micro-Remodeling in Women with SUIFeasibility of Performing Nonsurgical Radiofrequency Energy Tissue Micro-Remodeling in Women with Stress UrinaryIncontinence Using Oral and Local Anesthesia
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TVT – Tension Free Vaginal TapeOBGYN.net Conference CoverageFrom ISGE 2001 Congress - Chicago, Illinois, 2001
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The Global Library of Women's Medicine: www.GLOWM.comCoverage of the 2009 World Congress of Perinatal Medicine
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Place of Laparoscopy in Gynecologic Cancer Who Should Do It?OBGYN.net Conference CoverageINTERNATIONAL FEDERATION of GYNECOLOGY & OBSTETRICS: Washington DC, USA
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Gestational Hypertension: Implications for Pre-eclampsia and EclampsiaExperts discuss potential complications of gestational hypertension, as well as the role of home blood-pressure (BP) monitoring as an adjunct in managing these cases.
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Fifty Shades of ExhaustedSpicing things up in the bedroom can have consequences, and an exhausted on-call Ob/Gyn can attest to that.
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Foreign Residency ExperienceOBGYN.net Conference CoverageFrom American Association of Gynecological LaparoscopistsSan Francisco, California - November 2001
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Genital Wart Management: A Partnership Between Physician and PatientWith its implications of sexual transmission and potential cervical cancer, a diagnosis of genital warts can be emotionally distressing to patients. Because no single treatment serves every patient, the best approach to selecting a therapeutic option considers the extent of the disease, wart location, and the patient's individual needs.
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Is Maternal Mortality Really Rising in the United States? If so, How Can We Prevent It?While unreliable data may call into question the accuracy of CDC statistics, it's likely that maternal mortality rates are rising in the U.S. From obesity to advanced maternal age, an increase in C-sections to unequal access to care, here’s a look at contributing factors and how we can manage them.
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Intercellular communication in the eggOBGYN.net Conference Coveragefrom the 19th Annual Meeting of ESHRE - Madrid, Spain
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Dr. Jordan Phillips on the future of the AAGLDr. Paul Indman: “Jordan, this is a momentous occasion. It’s hard to believe there’s talk of your retirement and, of course, I don’t believe that you’re really retiring.”Dr. Jordan Phillips: “Well, it’s a change of activity. I will retire as of December 31, 2000 from the Board of Trustees. I anticipate continuing some of my other activities; I’m the Managing Editor of the Journal of the AAGL, and I plan to continue that and other things.”Dr. Paul Indman: “I’m sure you’ll be just as involved as ever.”Dr. Jordan Phillips: “Not on a day-by-day basis.”Dr. Paul Indman: “You’ve been characterized as a visionary by everyone who has spoke and certainly I think you are. Today we saw a presentation on space medicine doing laparoscopy in zero gravity. What do you see as the future of endoscopic surgery?”Dr. Jordan Phillips: “Number one, I think endoscopic surgery has proven that it’s a very important part of the armamentarium for surgery. I see that through the last several years the use of endoscopy has gone from just being a diagnostic tool and a sterilizing tool to being a full operating tool. So now we can do full surgeries using the endoscope but it requires one other major ingredient and that’s the skill of the surgeon so you must have a very competent surgeon doing complicated endoscopic procedures.”Dr. Paul Indman: “What is the AAGL doing to improve the skill of surgeons?”Dr. Jordan Phillips: “We continue to do many things. Not only do we have the annual meeting but we also have regional meetings, we have workshops, and we put on live cadaveric surgical anatomy programs. We’re doing a whole series of things besides publishing the Journal with all the recent articles, putting out News Scope, which is a news article, and having bulletins put out. AAGL has been very busy.”Dr. Paul Indman: “I think the AAGL has been responsible for improving the skill of surgeons around the world and certainly it’s probably the number one influence that I’ve seen. What are some of your wildest dreams that we’ll be doing in twenty-five years?”Dr. Jordan Phillips: “It’s come even faster than that and that is the majority of surgeries performed will be actually done through an endoscope. They’ll be very few operations performed in a routine gynecological practice that’s being done by open surgery. Open surgery doing a full open incision is almost obsolete and there are some departments in the world today where 90% of all gynecologic operations are done through an endoscope.”Dr. Paul Indman: “What do you see as the biggest resistance to that in our country?”Dr. Jordan Phillips: “The biggest resistance that we have is the case that we have to continue to train people and to make them better surgeons and smoother; safe surgeons I guess is the best term to use.”Dr. Paul Indman: “One of the problems I hear constantly with surgeons is that insurance companies are reimbursing less and less, they may essentially reimburse for a half an hours worth of work and the surgeons say - I can do this in a half an hour if I make a giant incision but it will take me three or four hours through a laparoscope, I can’t afford to do that. How can we get around that?”Dr. Jordan Phillips: “They’ve been able to prove that by using a laparoscope it’s less cost because they use less equipment, the patient doesn’t stay in the hospital as long, and most endoscopic operations are done in a short stay. That is they go in in the morning and they have the operation then go home in the afternoon so they don’t even stay overnight so the expenses will change because of the decreased hospital costs.”Dr. Paul Indman: “The total cost though but still the surgeon has such a major disincentive for doing that and I’m wondering how we can change that?”Dr. Jordan Phillips: “We tried to educate the insurance companies that we’re actually saving the insurance company money on their hospital bills and frankly we are. We have tried and we’ve convinced some of the insurance companies to actually have part compensation. If you do a hysterectomy through a laparoscope or do a hysterectomy through an open incision or vaginal they should have equal compensation, whichever method or approach you use.”Dr. Paul Indman: “Let’s get back to you, Jordan, because this is obviously a very important meeting. This is your last meeting where I guess your Chairing the Board.”Dr. Jordan Phillips: “That’s correct.”Dr. Paul Indman: “What do you think you will be doing next, personally?”Dr. Jordan Phillips: “Oh, we’re quite busy. My wife and I have a project in China called Medical Books for China International where we collect unwanted medical books that we send to China. We’ve now completed 60 shipments of 20 tons in each shipment so we’ve sent over 1,000 tons of medical books, journals, audio tapes, and video tapes to China that have been distributed to over 1,000 medical libraries. This takes a lot of organization, and it’s all handled through our own office. We’ve become the focal point for many institutions, many book dealers, and many book distributors to actually have them send their surplus books to us. Now it adds up to actually over 3 million books in all specialties not only in eye, ear, nose, throat, cardiology, chest, GI, GU, orthopedics, all specialties including nursing, veterinary medicine, basic science, medical law, and all of the various paramedical activities in books. So we’ve actually filled the shelves of many libraries in China, which were empty when we started.”Dr. Paul Indman: “So you’ll be working on that a lot?”Dr. Jordan Phillips: “Not a lot, we have it well organized. We have a staff that does it but it does require attention that we go to China. The Chinese distribute the books, we don’t distribute the books, and we’re planning for next June to have a World Congress in China on medical libraryship on the technical aspects of doing a medical library. There’s a lot to it where it’s changed with the use of computers and all the various new modalities that are available, and we’re going to introduce this to China. All of the Chinese major medical schools, and there are 127 medical schools in China, will come to this meeting. My wife, Mary Zoe Phillips, is actually Secretary General of this entire meeting. We did one ten years ago but now it’s ten years later.”Dr. Paul Indman: “What other visions for the future do you have, Jordan?”Dr. Jordan Phillips: “What other visions for myself?”Dr. Paul Indman: “For yourself and AAGL.”Dr. Jordan Phillips: “The AAGL will continue; it will continue its impact, continue its growth, and continue to be innovative. When you have these very dynamic young people who are push, push, push, I think that this is what’s going to happen. I have complete faith in the future.”Dr. Paul Indman: “You certainly need to be congratulated on such a wonderful organization and it’s a true family.” Dr. Jordan Phillips: “Yes, it really is a family and that’s what we started. In fact, we started right from the beginning and I didn’t call them board dinners, I called them family dinners and that’s just what it is. We got involved with the people, their children, their wives, and families and many other things. I can tell you one of the greatest joys I’ve had has been writing letters of recommendation for some of our people to become advanced in their academic activity. To write letters to become professors or associate professors, it’s a joy for me to do that.”Dr. Paul Indman: “The AAGL has been a family to me, thank you so much, Jordan.”Dr. Jordan Phillips: “You’re welcome, Paul Indman, it’s been a pleasure to see you. Thank you.”
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The Meaning of the 9th World Congress of ISUOG to ArgentinaOBGYN.net Conference CoverageFrom 9th World Congress On Ultrasound in Obstetrics & Gynecology, November, 1999 - Buenos Aires, Argentina
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Ferring SymposiumOBGYN.net Conference CoverageFrom the ESHRE 2001 Conference - Lausanne, Switzerland
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Diagnosis and management of fetal megavesica during the first half of pregnancyFetal megavesica is a rare syndrome caused by morphological or functional obstruction of the fetal urethra. It is the textbook example of a single cause producing a sequence of changes in fetal development.
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Update on Retropubic Incontinence SurgeryA 27-year study of 1300 women undergoing retropubic cystourethropexy using either the modified Marshall-Marchetti-Krantz procedure or the modified Pereyra procedure compares long-term results when the type of surgery is selected on the basis of patient criteria.
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Fetal HiccupsThe patient was a 38 year old G4 P3, 20w4d. I was doing an anatomic survey today. While I was looking at a long axis view of the fetal heart with color Doppler, the baby developed hiccups, and with each contraction of the fetal thorax (which was quite obvious) I could see an explosion of blue color representing blood going through the foramen ovale from right to left.
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Chronic Pelvic Pain: Which Approach? Surgical Versus MedicalChronic pelvic pain is generally used to describe a condition of pelvic discomfort not solely associated with menstruation, of more than 6 month's duration, and of a severity sufficient to cause disability in some form.
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Chinese ringThe IUCD is the stainless steel 'Chinese ring' widely used in China for the last 20 years. We see quite a lot of these rings in Hong Kong from women who recently arrived from China and wanted to have them removed.
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Prenatal TestingOBGYN.net Conference CoverageINTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY:Zagreb, Croatia
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Fetal Cardiac AnomaliesCC 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.
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Fertility Care and Severe Polycystic Ovarian Syndrome (PCOS)In women with severe clomiphene-resistant PCOS, we proposed thatthe insulin-lowering agent troglitazone (Rezulin®) could have a positive impact on the ovarian microenvironment by supporting normal follicular growth, ovulation, and successful pregnancy.
