Womens Health

Women's Health Newsletters 11/22/98 - 12/20/98

 

 




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***** Woman's Diagnostic Cyber Newsletter *****
              January 31, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. A geriatric medication assessment
2. Obstetric handbook
3. Vulvar intraepithelial neoplasia (VIN) and cancer
4. Dietary fiber does not reduce colon cancer
5. Stomach ulcers and bacterial infection
6. Humor is healthy

Spread the word! Send a copy of this newsletter
to someone you know.

Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. A geriatric medication assessment
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

A frequent, but overlooked health concern for 
elder parents is an adverse reaction or 
interaction among all of the prescription and OTC 
medicines that they may be taking. The average 
older adult is on 7 daily medications. Over 20% of 
hospital admissions over age 65 are due to an 
adverse medication reaction. If you are 
responsible for an older adult and  have noticed 
recent strange behavior such as depression, memory 
loss, confusion and psychotic behavior or sudden 
physical problems, the answer may be in a 
medication problem. At Agenet.com, one of the 
services offered is a medication assessment. 
There is a $45 charge for this but it would seem to 
be well worth it to prevent an unnecessary 
hospitalization for an older loved one. 

Geriatric medication assessment

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Obstetric handbook
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The University of Iowa has a handy set of 
obstetric guidelines online booklet. Women who are 
newly pregnant may like the concise overview of 
topics like: Preconception care, Prenatal care, 
Prenatal patient education, Activity, Habits and 
miscellaneous, Rh screening and Rh(D) 
immunoglobulin, Prenatal diagnosis of congenital 
disorders, Alpha-fetoprotein (AFP), Antenatal 
fetal surveillance, Nausea and vomiting of 
pregnancy, Diabetes in pregnancy, Hypertension in 
pregnancy, preeclampsia, and eclampsia, Early 
antepartum hemorrhage, Late antepartum hemorrhage, 
Intrauterine growth retardation (IUGR), Vaginal 
birth after cesarean section (VBAC), Preterm 
labor, Premature rupture of membranes (PROM), 
Postdate pregnancy, Evaluation of labor, Labor 
dysfunction, Intrapartum monitoring and 
management, Amnioinfusion, Induction of labor, 
Obstetric anesthesia and analgesia, Vaginal 
delivery, Breech delivery, Episiotomy, Shoulder 
dystocia, Group B streptococcal infection, 
Cesarean section, Postpartum care, Postpartum 
hemorrhage, Puerperal fever, 

Obstetric handbook

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Vulvar intraepithelial neoplasia and cancer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Do venereal warts, HPV infections, lead to vulvar 
cancer? Why does the doctor want to do a vulvar 
biopsy? These and other questions about the 
uncommon occurrence of vulvar dysplasia or vulvar 
lesions are discussed at: 

VIN  and vulvar cancer

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4.  Dietary fiber does not reduce colon cancer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

By now you have probably heard the news that high 
fiber in your diet does not reduce the incidence 
of colon cancer. All that Metamucil and bran 
flakes for nothing. You may want to look at a news 
article summary of the New England Journal of 
Medicine article concerning this. This should 
remind us that any data showing a relationship 
between what we eat and medical diseases or 
cancer, needs to be very carefully examined before 
we jump to a cause and effect assumption. 

Fiber does not reduce colon cancer

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Stomach ulcers and bacterial infection
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did you know that stomach ulcers are now thought 
to be caused by a bacterial infection and not by 
just "high" stomach acid levels or type A 
personalities. In fact many ulcers are now curable 
by antibiotics. The American Digestive Health 
Foundation offers a handy fact sheet about ulcers 
and the bacterial infection, H. pylori. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

These days men have to be more careful then ever 
when talking about women.

Politically Correct Usage When Talking To/About 
Females 
 
She does not: GET PMS
She becomes: HORMONALLY HOMICIDAL
 
She does not have: A KILLER BODY
She is: TERMINALLY ATTRACTIVE
 
She is not: A BAD COOK
She is: MICROWAVE COMPATIBLE
 
She is not: A BAD DRIVER
She is: AUTOMOTIVELY CHALLENGED
 
She is not a: PERFECT 10
She is: NUMERICALLY SUPERIOR

She is not: EASY
She is: HORIZONTALLY ACCESSIBLE
 
She does not: HATE SPORTS ON TV
She is: ATHLETICALLY BIASED
 
She does not have: SEXY LIPS
She is: COLLAGEN DEPENDENT
 
She does not get: DRUNK
She is: ACCIDENTALLY OVER-SERVED
 
You do not ask her: TO DANCE
You request a: PRE-COITAL RHYTHMIC EXPERIENCE
 
She is not: A GOSSIP
She is a: VERBAL TERMINATOR
 
She does not: WORK OUT TOO MUCH
She is an: ABDOMINAL OVERACHIEVER
 
She does not have: A GREAT BUTT
She is: GLUTEUS TO THE MAXIMUS
 
She is not: HOOKED ON SOAP OPERAS
She is: MELODRAMATICALLY FIXATED
 
She is not: COLD OR FRIGID
She is: THERMALLY INCOMPATIBLE
 
She does not: WEAR TOO MUCH MAKE-UP
She is: COSMETICALLY OVERSATURATED
 
She does not have: GREAT CLEAVAGE 
Her breasts are: CENTRALLY LOCATED
 
She will never: GAIN WEIGHT
She will become: A METABOLIC UNDERACHIEVER
 
She is not: A SCREAMER OR MOANER
She is: VOCALLY APPRECIATIVE
 
She does not: SHAVE HER LEGS
She experiences: TEMPORARY STUBBLE REDUCTION
 
She does not have: A HARD BODY
She is: ANATOMICALLY INFLEXIBLE
 
She does not: SUN BATHE
She experiences: SOLAR ENHANCEMENT
 
Her breasts will never: SAG
They will: LOSE THEIR VERTICAL HOLD
 
She does not: SHOP TOO MUCH
She is: OVERLY SUSCEPTIBLE TO MARKETING PLOYS
 
She does not: CUT YOU OFF
She becomes: HORIZONTALLY INACCESSIBLE
 
She does not have: BIG HAIR
She is: OVERLY AEROSOLED
 
She does not: SNORE
She is: NASALLY REPETITIVE
 
She does not: GET DRUNK
She becomes: VERBALLY DYSLEXIC
 
She does not have: BIG HOOTERS
Her: CUPS RUNNETH OVER
 
She is not: TOO SKINNY
She is: SKELETALLY PROMINENT

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you 
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



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***** Woman's Diagnostic Cyber Newsletter *****
                January 24, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. Warning about dietary supplement Blue Nitro/GBL
2. Women supporting health problems
3. Insulin resistance - what does it mean?
4. Preoperative MRI diagnosis of breast cancer
5. Loss of sexual desire
6. Humor is healthy

Spread the word! Send a copy of this newsletter
to someone you know.

Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Warning about dietary supplement Blue Nitro/GBL
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The FDA has issued a warning about a dietary 
supplement sold under the names of Revivarant and 
GBL by companies in Florida and in California 
under the brand names Blue Nitro or Blue Nitro 
Vitality, GH Revitalizer or GHR, Remforce, 
Renewtrient and Gamma G. The drug claims to have 
such effects as building muscle, enhancing sexual 
performance and reducing stress. 

The FDA has linked the substance to one death and 
54 cases of severe reactions including seizures 
and comatose-like states. The main product in 
these is GBL or gamma butyrolactone, and it is 
metabolized to a formerly banned "date-rape" 
drug, GHB, or gamma hydroxybutyrate. 

FDA warning about Blue Nitro/GBL

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Women supporting health problems
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Woman's Diagnostic Cyber has added a feature 
called Healthshare in which women have volunteered 
to offer email support to other women with 
concerning health problems such as chronic pelvic 
pain, depression, endometriosis, fibromyalgia, 
high risk pregnancy, hysterectomy, infertility, 
interstitial cystitis, low carbohydrate diets and 
pregnancy loss. 

More volunteers for these and other health topics 
are still needed. See: 

Healthshare support

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Insulin resistance - what does it mean?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Women with polycystic ovarian disease are often 
aware of an entity called insulin resistance 
syndrome, but who else cares? Any woman who has 
had gestational diabetes, hypertension or is 
moderately overweight should also be concerned 
about this condition. Women with insulin 
resistance are at risk of developing heart disease 
and high blood pressure and ultimately conditions 
that may result in an earlier than normal death. 
Do not wait until you develop Type 2 diabetes, get 
checked now so you can make lifestyle changes to 
prevent it. 

Insulin resistance syndrome

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Preoperative MRI diagnosis of breast cancer
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
An interesting abstract in the Journal of Clinical 
Oncology recently reported that MRI has a much 
better rate of diagnosing the extent of a breast 
cancer preoperatively compared with mammography 
(98% v 55%). Mammography is good at screening for 
possible cancer but it is poor for determining the 
total size of a breast lesion. MRI is more 
expensive than mammography but once it is known 
that there is a breast cancer present this should 
help the surgeon tremendously to know the lesion 
size before hand to plan the necessary surgery. 

MRI diagnosis of breast cancer extent

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Loss of sexual desire
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Loss or lowering of sexual desire is a frequent 
question asked by women who want to know what 
possible causes could explain those feelings. A 
unique site called sexhealth.org has a nice, 
concise discussion of the different causes of loss 
of sexual desire including: stress and fatigue, 
anxiety, estrangement from partner, misdirected 
sexual desire, loss of erotic associations, 
physiological causes, and medications. They will 
also happen to sell you devices to stimulate your 
sexual practices if you are interested. 

Loss of sexual desire

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Face Lift

A middle aged woman has a heart attack.  While on 
the operating table she has a near death 
experience.  She sees God, and asks if this is it. 

God says no, that she has another 30-40 years to 
live.  She recovers, and decides to stay in the 
hospital and have a face lift, liposuction, tummy 
tuck, hair dyed, etc.  She figures since she's got 
another 30 or 40 years she might as well make the 
most of it. 

She walks out of the hospital after the last 
operation and immediately gets hit by an 
ambulance. 

She arrives in front of God and asks, "I thought 
you said I had another 30 or 40 years?" To which 
God replies, 
"To tell you the truth, I didn't recognize you." 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you 
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



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***** Woman's Diagnostic Cyber Newsletter *****
                January 17, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. Cesarean section rate goals questioned
2. Hospital report cards - cardiology
3. PMS and Premenstrual Dysphoric Disorder
4. Sexual abuse medical manifestations
5. Hysteroscopy for submucous fibroid resection
6. Humor is healthy

Spread the word! Send a copy of this newsletter
to someone you know.

Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. Cesarean section rate goals questioned
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
A recent editorial in the New England Journal of 
Medicine has called into question the Healthy 
People 2000 goal of reducing the cesarean-delivery 
rate to 15 percent. While the C/S rate went from 
5% in 1970 to a peak of 25% in 1988, the authors 
point out that just trying to reduce the current 
C/S rate of 21% to 15% (that is the rate of C/S 
for women who have never had a C/S before) for the 
sake of a numerical goal may be hazardous for 
mothers and infants. They point out a small but 
real increase in rupture of the uterus from VBAC 
(vaginal birth after a previous Cesarean section) 
attempts, and a small but real increase of baby 
injuries from a higher incidence of vacuum 
assisted vaginal deliveries which may be done in 
an attempt to reduce C/S rates. The bottom line is 
that doctors cannot afford to let goals outside of 
the "do what's best for this mother and infant" 
govern medical decisions. Similarly, women should 
not try to influence decisions based on the 
outside goals of avoiding C/S because "doctors are 
doing them unnecessarily" or even the opposite 
extreme of pushing for a C/S to avoid pain or a 
fear that is not medically probable. Let's stick 
with what's best on an individual basis.

News summary at:

News summary - cesarean section rates

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. Hospital report cards - cardiology
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

How does your hospital rate on taking care of 
heart attacks or performing coronary bypass. A 
very interesting site produced by Specialty Care 
Network reports the Medicare Provider Analysis 
from HCFA as to Medicare data from billing 
documents. I know this will be an extremely 
controversial report among physicians and 
hospitals because it is sometimes like comparing 
apples and oranges. Different hospitals have
different levels of risk category patients. 
Nevertheless, you may want to see how your 
regional hospital stacks up nationally on 
different cardiology, orthopedic, neurological and 
respiratory diagnoses and procedures. They will be 
adding obstetrics statistics later this year and I 
cannot wait -- or can I? 

Health care report cards

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. PMS and Premenstrual Dysphoric Disorder
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Is it stress, is it PMS? How do you diagnose it? 
This  news article looks at the terminology, the 
cause, the differential diagnosis and common 
treatments for PMS. 

PMS diagnosis and treatment

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Sexual abuse medical manifestations
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Whether a past history of having been sexually 
abused or raped has affected you personally or 
not, it is extremely likely that some of your good 
friends have at some time been sexually abused. It 
should surprise no one that the more severe the 
abuse, the more severe the medical and mental 
health problems are in later life. The article 
below discusses this. Skim the abstract for the 
article from the Archives of Family Medicine, but 
read the introduction after the abstract for an 
excellent summary of this major healthcare 
problem. 

Survivor's of sexual abuse quality of life

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Hysteroscopy for submucous fibroid resection
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

At a site called laparoscopy.com, you may want to 
see some still pictures showing the inside of the 
uterus with a submucous fibroid and how it is 
resected with a loop cautery resectoscope. You 
have to go to the main page and then choose 
"pictures" and then select "gynecology". I like 
non-frame based sites better because we can give 
you a direct page reference, but these 
hysteroscopic pictures may help explain if you 
have abnormal bleeding problems and the doctor 
thinks you might have a fibroid in the endometrial 
cavity that is causing the bleeding. 

Submucous fibroid resection

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
To: All Hospital Staff
From: Administration/Grounds keeping
Subject: New Cost Cutting Measures

In order to remain competitive during the 
commercialization of medicine era, the following 
measures will be taken: 

Effective immediately, this hospital will no 
longer provide security. Each charge nurse will be 
issued a .38 caliber revolver and 12 rounds of 
ammunition. An additional 12 rounds will be stored 
in pharmacy. 

In addition to routine nursing duties, Charge 
Nurses will rotate the patrolling of the hospital 
grounds. A bicycle and helmet will be provided for 
patrolling the parking areas. 
 
In light of the similarity of monitoring 
equipment, ICU will now take over the security 
surveillance duties. The ward clerk will be 
responsible for watching cardiac monitors and 
security monitors as well as regular duties. 

Food service will be discontinued. Patients 
wishing to be fed will need to let their families 
know to bring something or may make arrangements 
with Subway or Pizza Hut to deliver. 

Housekeeping and Physical Therapy will be 
combined. Mops will be issued to those patients 
who are ambulatory, thus providing range of motion 
exercises as well as a clean environment.  
Families and ambulatory patients may also sign up 
to clean the rooms of non-ambulatory patients for 
special discounts on their final bill. Time cards 
will be provided. 

Hospital administration is assuming the 
grounds keeping duties. If an administrator cannot 
be reached by calling his/her office, it is 
suggested that you walk outside and listen for the 
sound of a lawn mower, weed-whacker, etc. 

Maintenance is being eliminated. The hospital has 
subscribed to the Time-Life "How to..." series of 
maintenance books. These can be checked out from 
administration, and a toolbox will be standard 
equipment on all nursing units. We will be 
receiving the series at a rate of one volume every 
other month. We already have the volume on "Basic 
Wiring", but if a non-electrical problem occurs, 
please try to handle it as best you can until the 
appropriate volume arrives. 

Cutbacks in phlebotomy staff will be accommodated 
by only performing blood-related tests on patients 
who are already bleeding. 

Physicians will be informed that they may order no 
more than two X-rays per patient stay. This is due 
to the turnaround time required by Photomat. 

Two prints will be provided for the price of one, 
and physicians are being advised to clip coupons 
from the Sunday paper if they want extra sets. 

In addition to the current recycling programs, a 
bin for collection of unused fruit and bread will 
soon be provided on each floor. Families, 
patients, and the few remaining employees are 
asked to contribute discarded produce. Pharmacy 
will utilize this for antibiotic production. These 
will be available for purchase and, 
coincidentally, will soon be the only antibiotics 
on our HMO's formulary. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you 
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



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***** Woman's Diagnostic Cyber Newsletter *****
              January 10, 1999
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. Inflammatory breast cancer
3. Timing advice for contraceptives
4. Epidural anesthesia for labor
5. Physician directories
6. Humor is healthy

Spread the word! Send a copy of this newsletter
to someone you know.

Note: Some of the long URLs may not wrap as a
hyperlink and you may need to cut and paste.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1.  Inflammatory breast cancer and weight
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Many breast cancers found by routine screening 
mammograms are discovered early and are very 
curable. Cancers associated with postmenopausal 
estrogen therapy are usually well-differentiated 
and, again, very curable. One breast cancer type 
is one of the most aggressive and has a low cure 
rate, tends to occur in younger women. It is 
called inflammatory cancer because its 
presentation is sudden, just like a postpartum 
breast infection. Doctors even fear it worse than 
the other types. This article below in the Journal 
of Clinical Oncology looked at whether weight is a 
risk factor for inflammatory cancer. They found 
that women with a body-mass index over 26.65 kg/m2 
had a 2.45 times risk of this uncommon, but deadly 
form of breast cancer. 

Inflammatory breast cancer and weight

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Timing advice for contraceptives
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

On what day should you start a new pill 
prescription? Do you have to wait 6 weeks after 
delivery to take a DepoProvera shot? Is a break 
from the pills needed every several years? Much of 
the older advice about contraception has changed. 
See the discussion at our news article:

Contraceptive timing advice

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Labor epidural doesn't increase C-sections
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

A recent report in the Journal of the American 
Medical Association (JAMA) looked at high quality 
scientific studies in the literature and their 
effect on the length of labor and the incidence of 
C-section compared with just injections of narcotic 
pain meds. They found the C-section rates were not 
statistically increased (8.2% vs 5.6%) but the 
length of labor was slightly increased by about 
one hour (56 minutes). One the positive side, 
there was a much lower pain score if the woman had 
an epidural. 

Meta-analysis of epidural effect on C-section

A recent single institution study at Louisville, 
KY as reported in Am J Obstet Gynecol 1998; 
179:1527-33 also has confirmed no difference in 
C-section rates (8.8% vs 7.1%) 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Physician directories
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Billed as the largest medical professional 
directory on the Web, you can look up over 400,000 
physicians by locale at Doctors On Call (DOC): 

Doctor directory

You can then look up whether that doctor is Board 
Certified in a specialty from the American Board 
of Medical Specialists. You have to have the exact 
name spelling. 

ABMS Board Certification

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
From: [email protected] (Dorothy Mckay)
Subject: Sex and a government study

Government scientists have just completed the most 
comprehensive study of sex ever done in this 
country. They found some interesting things: 

1. Men finished the questions first and fell 
asleep after the survey. 

2. 97% of all sex involves at least one member of 
the British Royal Family. 

3. A variety of positions are important to men -- 
short stop, quarterback, tight end. 

4. Most Americans still practice monotony. 

5. 45% of women have multiple organisms.

6. 65% of men identified the "G" spot as the place 
where the goalpost stands. 

7. An astonishing 25% of men have never slept with 
Madonna. 

8. The number one fantasy of teenage boys -- a 
partner. 

9. 10% of men are important. 

10. Most women thought sperm banks charged a 
substantial penalty for early withdrawal. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you 
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



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***** Woman's Diagnostic Cyber Newsletter *****
                January 3, 1998
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This week from Woman's Diagnostic Cyber
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. Gyn symptoms
2. FDA risk categories for drugs in pregnancy
3. Designer estrogens available
4. Fosamax not ideal for osteoporosis prevention
5. Average ages - menarche, menopause
6. Humor is healthy

Spread the word! Send a copy of this newsletter
to someone you know.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1.  Gyn symptoms
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

At the Gynecologic Health Center Guide of the 
Women's Health Interactive site, there is a good 
listing of some common gynecologic symptoms such 
as: Pain, Abnormal Bleeding, Irritation, 
Infertility, Fever and Discharge and a brief list 
of some of the causes of those symptoms. 

Gyn symptoms

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. FDA risk categories for drugs in pregnancy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Harbor General UCLA Medical Center has posted the  
different FDA categories of risk for drugs in 
pregnancy and lactation. 

Category A: Controlled human studies show no fetal risk 

Category B: Animal studies indicate no fetal risk, but no human studies OR adverse effects in animals, but not in well- controlled human studies 

Category C: No adequate human or animal studies.OR adverse fetal effects in animal studies, but no available human data. 

Category D: Evidence of fetal risk, but benefits outweigh risks. 

Category X: Evidence of fetal risk. Risks outweigh any benefits

You will need to know the generic name of the drug 
to look it up. 

Drug risk categories for pregnancy and lactation

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3. Designer estrogens available	
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
You may have heard about a new group of possible 
estrogen therapy replacement medications that will 
help prevent osteoporosis in the menopause without 
any breast stimulation that is feared as leading 
to breast cancer. But do these compounds prevent 
heart disease and lower cholesterol as well as 
estrogen. Tamoxifen which is a treatment and 
preventative for breast cancer was the first of 
these designer estrogens available. Another one, 
raloxifene (Evista) has been approved for over a 
year. See a discussion and comparison at: 

Estrogen substitute update

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4. Fosamax not ideal for osteoporosis prevention
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
As per the preceding discussion, a recent 
randomized clinical trial of alendronate (not a 
selective estrogen category drug), shows that 
Fosamax is not as good at preventing osteoporosis 
as it is in preventing fractures once osteoporosis 
has been diagnosed. This report from the Journal 
of the American Medical Association (JAMA) 
summarizes the latest study quite well. 

Alendronate (Fosamax) clinical trial

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
5. Average ages - menarche, menopause
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
In a study which consisted of 18,997 women from 13 
centers in 11 countries interviewed between 1979 
and 1988, we have learned a typical woman reached 
menarche at age 14 years and delivered her first 
live child 8 years later, at age 22. She was 50 
years old at natural menopause and had had 36 
years of reproductive life. The median (most 
commonly occurring) ages at menarche varied across 
centers from 13 to 16 years. The median age at 
natural menopause ranged between 49 and 52 years. 
This was reported in the American Journal of 
Epidemiology: 

Average age of menarche and menopause

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6. Humor is healthy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
From: "Joe Lex"  [email protected]
Subject: Fractured Foreignisms

A New York magazine recently ran a contest for 
people with silver tongues and a command of 
foreign languages. The rules were to take any 
well-known phrase in a foreign language, change 
just a single letter, and then provide a 
definition for the new expression. Here are some 
of the winners: 

HARLEZ VOUS FRANCAIS?: Can you drive a French motorcycle?

IDIOS AMIGOS: We're wild and crazy guys.

COGITO, EGGO SUM: I think. Therefore, I am a waffle.

RIGOR MORRIS: The cat is dead.

REPONDEZ S'IL VOUS PLAID: Honk if you are Scottish.

QUE SERA SERF: Life is feudal.

LE ROI EST MORT. JIVE LE ROI: The king is dead. No kidding.

POSH MORTEM: Death styles of the rich and famous.

VENI, VIPI, VICI: I came. I am a very important person. I conquered.

PRO BOZO PUBLICO: Support your local clown.

MONAGE A TROIS: I am three years old.

FELIX NAVIDAD: Our cat has a boat.

HASTE CUISINE: Fast French food.

VENI, VIDI, VICE: I came, I saw, I partied.

QUIP PRO QUO: A fast retort.

ALOHA OY: Love, greetings and farewell from such a pain you should never
know.

MAZEL TON: Tons of good luck.

APRES MOE LE DELUGE: Curly and Larry got wet.

PORTE-KOCHERE: Sacramental wine.

ICH LIBERICH: I'm really crazy about having dough.

FUI GENERIS: What's mine is mine.

EX POST FUCTO: Lost in the mail

VISA LA FRANCE: Don't leave your chateau without it.

CA VA SANS DIRT: And that's not gossip.

BUN JOUR: The daily special at the bakery.

BAN JOUR: The daily special of the League of Decency.

BEN JOUR: Charlton Heston's cousin.

BIN JOUR: A special at the thrift shop.

BONE JOUR: A special at the meat market.

AH, MON CHAR: What you say after you burn up the wife you don't want anymore

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
That's it for this time. We will bring you 
accurate women's health answers again soon.
Rick
Frederick R. Jelovsek MD 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



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