Obstetrics-Gynecology & Women's Health

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Drilling Down

Propelled by degrees in mathematics, accounting and quantitative analysis, "which was like computers way back then," Horace Clark has engineered the information technology for companies of major interest to financial investors throughout his life.

A major clinical study, the Diabetes Prevention Program (DPP), has shown that regular exercise and a nutritious diet leading to weight loss can prevent type 2 diabetes among people at high risk for the disease.

Winning women over

Irene Brewster*, a 31-year-old mother of two who was in her 31st week of pregnancy, woke up one morning and noticed that her calf was abnormally swollen. After a call to her obstetrician, who was out of town, Brewster rounded up her children and drove to the hospital.

People always experience a certain amount of anxiety when adopting a new technology. When implementing that change costs tens of millions of dollars, however, it could become downright nerve-wracking.

Cases of uterine sarcoma in women receiving tamoxifen citrate (Nolvadex, AstraZeneca) have prompted a "Dear Health Professional" letter, black-box warnings on labeling, and publication of a letter to the editor in the New England Journal of Medicine from FDA officials.

Hereditary

Genetic researchers promise countless improvements in the delivery of care due the development of new information and clues to genetic mutations.

The ruckus over designer babies, human cloning and genetic discrimination has colored much of the debate and perception of genetic services, but the discipline is gaining momentum as research propels new tests to determine the susceptibility to more common diseases, as well as a slew of rare ones.

Medications currently available to treat osteoporosis slow the rate of bone loss primarily by reducing bone resorption. The purported advantage of the anabolic agent teriparatide is that it actually promotes new bone growth. Clinical trials have shown the drug to be effective for vertebral fracture prevention in postmenopausal women at high risk. Additional evidence is accumulating to support teriparatide's use in other populations (including men) with osteoporosis. This injectable is likely to receive FDA approval in the second half of this year.

Emerging data are continually refining our understanding of the risks and benefits of hormone replacement therapy (HRT) in postmenopausal women. This review assesses the current state of evidence on these various risks and benefits, concluding with an outline of what's established and where varying degrees of uncertainty remain. Algorithms for use of HRT for several established indications are featured.

Perhaps the greatest criticism leveled at America's healthcare system is the fact that millions of people have no healthcare insurance at all. Our physicians are among the best trained in the world, and the equipment and technology they work with is state of the art. But those things are meaningless to patients who fall between the cracks of the system and can't access that care.

The Numbers Lie

Current estimates indicate that overactive bladder is a widespread disorder. Yet, these figures only capture people willing to admit to symptoms.

Reducing the amount of fat in the blood is the key weapon against heart disease, and the battle plan recently changed.

The World Health Organization projects that in less than 20 years, depression will be the leading cause of disability in women worldwide.