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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: maxstax@webtv.net (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" joelex@home.com
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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