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Archive for the ‘Women’s health’ Category

BMJ  2007;335:765-768 (13 October), by:

Patrick Petignat, consultant gynaecological oncologist, Michel Roy, professor and gynaecological oncologist.

  • Cervical cancer is the second most common cancer in women worldwide.
  • Cervical cancer is an important cause of early loss of life as it affects relatively young women. 
  • Cervical biopsy is the most important investigation in diagnosing cervical cancer

Surgery or chemoradiotherapy can cure 80-95% of women with early stage disease (stages I and II) and 60% with stage III disease.

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chlamydia-rapid-test.jpg

A new test for diagnosing Chlamydia trachomatis is quicker and more cost effective than current tests, and has the potential to reduce complications and transmission to sexual partners. 

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BMJ  2007;335:663-666 (29 September).

Managing anovulatory infertility and polycystic ovary syndrome

BY: Adam H Balen, professor of reproductive medicine and surgery, Anthony J Rutherford, consultant in reproductive medicine and surgery.

Summary points

  • Polycystic ovary syndrome is the most common endocrine problem affecting women and the most common cause of anovulatory infertility
  • Oral clomifene citrate remains the first line treatment to induce ovulation
  • Gonadotrophin treatment needs careful monitoring to reduce risk of multiple pregnancy
  • Despite early promise, the role of metformin and insulin lowering agents is unclear in the management of anovulatory polycystic ovary syndrome

Anovulation is the cause of infertility in about a third of couples attending infertility clinics, and polycystic ovary syndrome accounts for 90% of such cases.

The definition of polycystic ovary syndrome recognises obesity as an association and not a diagnostic criterion. Only 40-50% of women with the syndrome are overweight.

Obesity has a profound effect on both natural and assisted conception—it influences the chance of becoming pregnant and the likelihood of a healthy pregnancy. Obesity is associated with increased rates of congenital anomalies (neural tube defects and cardiac defects), miscarriage, gestational diabetes, hypertension, problems during delivery, stillbirth, and maternal mortality.

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endometriosis

Management of endometriosis in general practice: the pathway to diagnosis By: Pugsley, Zoë

BJGP, Volume 57, Number 539, June 2007 , pp. 470-476(7).

Background: The prevalence of endometriosis is estimated to be around 10%. Diagnosis is through visualisation of the lesions, mostly via laparoscopy.

Ultrasound was frequently requested by GPs, but was helpful in diagnosing endometriosis in only 10.6% of women who underwent a scan.

Thirty-nine per cent of women were referred to gynaecologists two or more times BEFORE a positive diagnosis was made.

The median time from first presentation with symptoms to diagnosis was 9.0 years. NINE years

Read more about the MANAGEMENT of ENDOMETRIOSIS here.

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FERTILITY

THE MOST IMPORTANT DETERMINANT OF A COUPLE’S FERTILITY IS THE WOMAN’S AGE.

BMJ 22.9.07 quote of the week.

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BMJ  2007;335:582 (22 September),  

Mammography screening reduces mortality from breast cancer:

Organised mammography screening reduces the number of deaths from breast cancer, a study that was based on more than 300 000 women in Finland has found (International Journal of Cancer doi: 10.1002/ijc.23070). Results from the study, which followed up women from 1992 to 2003, shows that breast cancer mortality fell by 22%.

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Editor’s choice
 

Questioning fondly held assumptions

Jane Smith, deputy editor (BMJ 2007;335 (4 August).

An important part of the BMJ’s business is to question assumptions.

This week illustrate the careful unpicking of evidence.

A US women’s health initiative study showed that HRT did not have the beneficial effects expected on coronary heart disease and indeed showed increased risks of breast cancer, stroke, and venous thromboembolism.

HRT has come full circle, now the indications for use are again hot flushes, night sweats, and vaginal dryness. The hope that HRT could also prevent chronic disease is dead.

If you want to read more JUST CLICK HERE.

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