Caring for women with diabetes
Posted by: admin on: June 30, 2011
Women present unique disease-management challenges for clinicians whether they suffer from type 1, type 2 or gestational diabetes.
- One-in-three women with diabetes will die from heart disease compared to one in nine women without the condition.
- In fact, women with diabetes generally have shorter life spans than women without the disease, and are more likely than men to lose their eyesight.
- They often face more severe complications from uncontrolled diabetes and might also have other conditions, such as eating disorders or depression that can complicate treatment.
Read the rest of this entry »
FDA Approves Second Folate-Boosted Oral Contraceptive
Posted by: admin on: June 29, 2011
Folate-Boosted Oral Contraceptive is intended to reduce the risk for rare neural tube defects in a pregnancy conceived during its use or shortly thereafter
- The US Food and Drug Administration (FDA) has approved an oral contraceptive Safyral in which 451 μg levomefolate calcium has been added to each tablet of a 21/7 drospirenone 3 mg/estradiol 30 μg regimen (Yasmin; Bayer).
- The new formulation is intended to reduce the risk for rare neural tube defects in a pregnancy conceived during its use or shortly thereafter.
- Combining an oral contraceptive with folate is important, because women may become pregnant during oral contraceptive use or shortly after discontinuation possibly before seeking preconception counseling from their healthcare providers.
- Addition of 451 μg levomefolate to a 24/4 drospirenone 3 mg/estradiol 20 μg oral contraceptive regimen significantly increased red blood cell and plasma folate levels at 24 weeks relative to the regimen alone (420 ± 347 nmol/L vs 34.3 ± 171 nmol/L and 15.8 ± 20.4 nmol/L vs −2.2 ± 14.6 nmol/L, respectively; P < .0001 for both comparisons).
- Adverse events associated with use of folate-boosted oral contraceptives most commonly include premenstrual syndrome, headache/migraine, breast pain/tenderness/discomfort, nausea/vomiting, and abdominal soreness.
- The 21/7 drospirenone 3 mg/estradiol 30 μg/levomefolate 451 μg regimen warns against its use in women smokers older than 35 years due to an increased risk for serious cardiovascular events.
Read More: http://www.medscape.com/viewarticle/734688?src=mp&spon=34
What is a difficult patient, and how doctors may be responsible
Posted by: admin on: June 29, 2011
What, exactly, is a difficult patient?
- Doctors can tell many tales of what they term as a difficult encounter just as many patients can recall doctors whom they would say are difficult to work with as well.
- Patients deemed difficult included those with more than five symptoms, severe symptoms or an underlying mental disorder or were less functional.
- These patients are less likely to fully trust or be satisfied with their physician, and they are more likely to report a worsening of symptoms two weeks after their visit.
- It’s important to note that patients aren’t the only responsibly party to the difficult encounter physicians play a role in this as well
- Researchers found that physicians who were involved in difficult encounters generally tended to have less experience and fewer psychosocial skills.
- When you have someone who has 15 to 20 years of experience, they have learned how to deal with these patients said the researchers
- There will always be patients with multiple medical problems or psychiatric disorders that will make the encounter more challenging.
- But it depends on a physician’s psychosocial experience whether that encounter will traverse into the realm of difficult and that experience comes with time.
- Perhaps more training during residency is needed on how to deal with complex patient interactions so that new doctors would be more comfortable in handling a broader spectrum of patients.
Read More: http://www.kevinmd.com/blog/2011/03/difficult-patient-doctors-responsible.html
Uncertainty in the diagnostic methods of the obstetrician
Posted by: admin on: June 28, 2011
Now that the appropriate technology is available, the obstetrician may virtually eliminate intrapartum stillbirths and reduce morbidity to a minimum.
- Computers were becoming commonplace in academic settings and nuclear energy a reality, doctors should be able to reliably detect fetal distress and act upon it safely, sparing parents the grief of the past.
- Likewise, ultrasounds have allowed us to peer into the womb, and into the bodies of our unborn children, allowing us to anticipate not only the gender of our babies, but also see things as subtle as heart or spine defects.
- Molecular biology has allowed us to go even further, and examine the blueprints of life in utero, allowing parents to prepare for a child with chromosomal issues, or reassuring those with family histories of hereditary disorders.
- Reality, however, has proven otherwise. Despite close and continuous monitoring in labor by the best trained and most capable staff and doctors, babies still die suddenly, or are born with unexpected asphyxia, or unanticipated illness. Read the rest of this entry »
FDA makes more people eligible for gastric-band surgery
Posted by: admin on: June 28, 2011
Food and Drug Administration approved a lower recommended body mass index (BMI) threshold for Lap-Band weight loss surgery, to a BMI of 30 for patients with at least one obesity-related condition.
Lap-Band is a procedure that helps patients lose weight by restricting the amount of food that can be consumed at each meal.
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