Guidelines and Expert Consensus Documents summarize and evaluate all currently available evidence on a particular issue with the aim of assisting physicians in selecting the best management strategies for a typical patient, suffering from a given condition, taking into account the impact on outcome, as well as the risk/benefit ratio of particular diagnostic or therapeutic means. Guidelines ar…
Obstetrics and gynecology (OB-GYN) morbidity and mortality conferences allow for review of cases with poor or avoidable outcomes. Little data exist on standardized formats for presentation and evaluation. We designed a multidisciplinary morbidity and mortality conference. We formally evaluated resident performance using the milestones format, and evaluated resident understanding of case concep…
To assess whether postpartum hemorrhage can be predicted in women with gestational hypertension or mild preeclampsia at term. Design. A cohort study in which we used data from our multicentre randomized controlled trial (HYPITAT trial). Setting. The study was conducted in 38 hospitals in the Netherlands between 2005 and 2008.
The maternal mortality ratio of Uganda is still high and the leading causes of maternal mortality are postpartum haemorrhage (PPH), severe pre-eclampsia and eclampsia. Criteria-based audit (CBA) is a way of improving quality of care that has not been commonly used in low income countries. This study aimed at finding out the quality of care provided to patients with these conditions and to find …
There are many potential mechanisms of action for the intrauterine device (IUD), which vary by type of IUD (inert, copper, or hormonal). This paper reviews the evidence for each potential mechanism of action. On the basis of available data for fertilization rates and clinical pregnancy rates, the relative contribution of mechanisms acting before or after fertilization were quantitatively estima…
Three intrauterine devices (IUDs) are available in the United States: the copper T 380A and two levonorgestrel-releasing IUDs, one that releases 20 mcg of levonorgestrel per 24 hours, and one that releases 14 mcg per 24 hours. All are safe and effective methods of contraception that work predominantly by prefertilization mechanisms. The copper T 380A IUD may be placed in nonpregnant women at an…
There are at least 1.5 million transgendera individuals (0.5% by a household population based survey) in the United States.1 Although transgender individuals are often closeted, marginalized, and maligned there is growing social, political, and medical awareness. In June 2014, actress Laverne Cox became the first openly transgender person to be on the cover of Time Magazine
Prenatal exposures have known adverse effects on maternal and neonatal outcomes. Professional societies recommend routine screening for environmental, occupational, and dietary exposures to reduce exposures and their associated sequelae.
Heart failure is the most common cardiovascular reason for hospital admission for people older than 60 years of age. Few areas in medicine have progressed as remarkably as heart failure treatment over the past three decades. However, progress has been consistent only for chronic heart failure with reduced ejection fraction. In acutely decompensated heart failure and heart failure with preser…
Neurologists and stroke physicians will be familiar with atrial fibrillation as a major cause of ischaemic stroke, and the role of anticoagulation in preventing cardioembolic stroke. However, making decisions about anticoagulation for individual patients remains a difficult area of clinical practice, balancing the serious risk of ischaemic stroke against that of major bleeding, particularly in…