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