Abstract:
:Recognizing the enormous impact that quality breast screening mammography can have on reducing breast cancer deaths, we need to determine when women's and physician's perceived restrictions for mammography examination impede the progress of its use for early cancer detection. A uniform system should emphasize valid communication and education between women and their physicians. Women seek to have a voice in their medical treatment. Yet that responsibility has an emotional price. Physicians and patients must decide together on the most appropriate strategies to enhance communication and adopt specific guidelines they will adhere to, to detect and cure early breast cancer. Women must be educated about breast screening mammography, and physicians must increase their efforts to proclaim its importance. Women need be assured the trend is toward using the most modern mammographic techniques. Quality medical care is medicine's purpose and in women's best interest. At present, no other diagnostic method is equivalent to mammography and capable of providing an equivalent impact on improving the detection and cure rate of breast cancer. Despite medical activities designed to reduce uncertainty in medicine, scientific evidence has not provided systematic answers as to the "best" way to approach issues of quality, cost, accessibility, or communication for breast screening mammography. No particular expert opinion or preference prevails for breast screening protocols. What is needed is adoption of a multidisciplinary approach, educating and motivating women and physicians to participate in breast screening activities. With trends directed toward high-volume breast screening operations, low-cost, quality mammography must be available and be impeccably performed. Some activities are natural subjects for financial quantification. It is objectionable to assume, however, that we can accurately place and agree on dollar amounts alone to represent the costs and benefits of screening mammography. The gaps between practices and attitudes about the benefits, risks, and costs of screening mammography suggest that people are not satisfied with the way physicians, women, influential groups, or regulatory agencies are balancing all of the elements. Better communication must exist between physicians and their peer groups involved in performing responsible mammography. Better communication must be achieved between physicians and women to take advantage of the usefulness of quality breast screening mammography. High-quality screening programs must be linked to third-party reimbursement and to legislation, if we are to make a difference. Screening mammography deserves our medical, economic, social, and political attention and action.
journal_name
Obstet Gynecol Clin North Amjournal_title
Obstetrics and gynecology clinics of North Americaauthors
Sierra AE,Potchen EJsubject
Has Abstractpub_date
1990-12-01 00:00:00pages
927-38issue
4eissn
0889-8545issn
1558-0474journal_volume
17pub_type
杂志文章,评审abstract::The use of antiretroviral agents to treat patients infected with HIV has become increasingly complex. Obstetricians caring for the pregnant woman infected with HIV must, no less than the HIV specialist, be familiar with the various medications now available. This article profiles each of the antiretroviral agents curr...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(05)70347-8
更新日期:1997-12-01 00:00:00
abstract::Women with unexplained recurrent pregnancy loss (RPL) represent a highly heterogeneous group of patients. Past studies have investigated systemic endocrine and immunologic mechanisms as potential causes for pregnancy loss in unexplained RPL, while exciting new work has focused on spermatozoal, embryonic, and endometri...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2013.10.008
更新日期:2014-03-01 00:00:00
abstract::The number of women diagnosed with breast cancer continues to increase, but mortality rates have substantially declined. Much of the credit for this decline has been attributed to early detection from mammographic screening. However, there are significant controversies about the effectiveness of all screening tools fo...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2013.05.001
更新日期:2013-09-01 00:00:00
abstract::Several clinical advances in the field of assisted reproductive technology have improved the success rates of IVF. These advances include improvements in ovulation induction protocols, the introduction of recombinant gonadotropins, GnRH agonists, and, most recently, GnRH antagonists. ICSI has proved to be the most suc...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(05)70152-2
更新日期:2000-09-01 00:00:00
abstract::Hepatitis B virus is an important sexually transmitted organism that causes not only disease in sexual partners but important perinatal illness as well. The obstetrician-gynecologist must be aware of the epidemiology and the pathophysiology of HBV infections, as well as strategies for treatment and prevention. Physici...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1989-09-01 00:00:00
abstract::The colposcope, basically binoculars on a stand, is used for the evaluation of the genital tract. Its optics, although complicated in theory, are easy to use in practice. Certain adjustments are necessary for stereoscopic viewing. Other adjustments adapt the optics for high viewing and either adapt the optics for high...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1993-03-01 00:00:00
abstract::The discovery that insulin resistance has a key role in the pathophysiology of PCOS has led to a novel and promising form of therapy in the form of the insulin-sensitizing drugs. Although no extremely large trials using these drugs for this indication have been performed, more than 18 trials have specifically examined...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(05)70191-1
更新日期:2001-03-01 00:00:00
abstract::Ultimately, the timely diagnosis of ovarian cancer will rely on clinical judgment and careful analysis of presenting symptoms within the context of a thoughtful dialogue between the patient and her physician. Symptoms most typical of ovarian cancer include bloating, abdominal or pelvic pain, and difficulty eating. In ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章
doi:10.1016/j.ogc.2012.02.007
更新日期:2012-06-01 00:00:00
abstract::The information available concerning the effects of chemotherapy administered during pregnancy is limited and consists of case reports and small series. A registry has been established at the National Cancer Institute, but there are currently only several hundred cases of neonates exposed to chemotherapy registered. A...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(05)70324-7
更新日期:1997-09-01 00:00:00
abstract::The key to the differential diagnosis of these related conditions is knowledge of the natural history of each disease process; an awareness of how this usually translates in each instance into clinical and laboratory parameters; an appreciation for the wide spectrum of findings for each of these conditions, which are ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1991-06-01 00:00:00
abstract::The fluorinated quinolones are synthetic derivatives of nalidixic acid. They are well absorbed when administered orally and have an extended duration of action. They are of primary value in treating gonorrhea and complicated urinary tract infections in nonpregnant women. ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1992-09-01 00:00:00
abstract::Ovarian remnant syndrome has become increasingly recognized as a cause of pelvic pain after extirpative surgery. Surgical removal of the ovarian remnant is the optimal treatment. Laparoscopy is safe and effective in managing ovarian remnant syndrome when performed by an experienced laparoscopist. ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2004.05.012
更新日期:2004-09-01 00:00:00
abstract::Dyspepsia with or without nausea is common during pregnancy. Known ulcer disease, gastritis, and GERD may improve during pregnancy. Many women have a stoic and long-suffering posture during pregnancy owing to an unrealistic expectation concerning the teratogenicity of commonly used drugs. It is appropriate in medicine...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(05)70204-7
更新日期:2001-06-01 00:00:00
abstract::As women's doctors, we have a commitment and responsibility to promote effective cancer screening for cervical cancer and breast cancer. At present, the screening tests for ovarian cancer cannot be applied to the mass population. For an individual patient, however, the role of sonography, tumor markers, and physical e...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1993-06-01 00:00:00
abstract::Amniotic fluid embolism remains one of the most devastating conditions in obstetric practice with an incidence of approximately 1 in 40,000 deliveries and a reported mortality rate ranging from 20% to 60%. The pathophysiology involves an abnormal maternal response to fetal tissue exposure associated with breaches of t...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2016.07.001
更新日期:2016-12-01 00:00:00
abstract::Abnormal uterine bleeding in the reproductive age, that is, dysfunctional uterine bleeding, is a very common symptom encountered in office gynecology. The judicious use of hysteroscopy to manage this medical entity adds a new dimension in handling this often perplexing problem. This article focuses mainly on abnormal ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章
doi:
更新日期:1988-03-01 00:00:00
abstract::Significant gender differences exist in the prevalence of substance use disorders in the United States. There is a trend among boys and girls aged 12 to 17 years toward comparable rates of use and initiation for alcohol, cocaine, heroin, and tobacco. If this trend continues, over time there may be a narrowing of the m...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(03)00072-x
更新日期:2003-09-01 00:00:00
abstract::This article discusses pathophysiology, diagnosis, and treatment of high-grade cervical dysplasia. ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2008.09.008
更新日期:2008-12-01 00:00:00
abstract::Hematologic disorders in pregnancy are relatively common and encompass a wide spectrum of clinical conditions. The treatment and obstetric management of the majority of these diseases are well established, although controversy exists in areas such as sickle cell disease and ITP. Once the diagnosis of a specific disord...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1992-12-01 00:00:00
abstract::This article gives an overview of various clinical research designs such as randomization, cohort studies, and case-control studies. It also describes several biases that may occur in design studies and relevant statistics relating to surgeons using lasers. ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章
doi:
更新日期:1991-09-01 00:00:00
abstract::The frequency of early term birth varies depending on patient, provider, and system characteristics. Early term deliveries are associated with suboptimal neonatal outcomes without evidence of maternal benefit. Some early term births are either unavoidable or absolutely indicated for maternal and/or fetal benefit in th...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2011.12.002
更新日期:2012-03-01 00:00:00
abstract::Gonorrhea is the most common sexually transmitted disease in the United States. This article discusses the epidemiology, pathogenesis of Neisseria gonorrhoeae, diagnosis, clinical manifestations, and treatment of this important disease. ...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1989-09-01 00:00:00
abstract::The surgical procedures used for the treatment of chronic pelvic pain, their indications, and success rates are reviewed. A thorough preoperative evaluation is presented that will enable the physician to detect patients at high risk for surgical failure and those who will be more appropriately managed with nonsurgical...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1993-12-01 00:00:00
abstract::With the highest rates of unintended pregnancy and abortion in the developed world, the United States has plenty of room for improving the distribution of existing contraceptive options and an imperative for developing new methods. This article surveys new and future contraceptive methods. It does not contain a compre...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2007.01.006
更新日期:2007-03-01 00:00:00
abstract::Contemporary management of HIV in pregnancy remains a moving target. With the development of newer antiretroviral agents with lower side-effect profiles and laboratory methods for detection and monitoring of HIV, considerable progress has been made. This review examines key concepts in the pathophysiology of HIV and p...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2014.08.003
更新日期:2014-12-01 00:00:00
abstract::The normal vaginal, or resident, flora is complex and easily includes over a dozen different organisms, many of them potential pathogens. The quantitative nature of the vaginal flora also is a factor in development of symptoms. This complex milieu is further varied by nature's changes over the years from birth to meno...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1989-06-01 00:00:00
abstract::The incidence of malignant melanoma is rising, and this may be the most frequently encountered malignancy during pregnancy. Because effective treatment of advanced or metastatic disease remains elusive, the key to adequate therapy is surveillance for early disease with prompt diagnostic work-up and treatment. Review o...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8545(05)70014-0
更新日期:1998-06-01 00:00:00
abstract::If the contraindications to hysteroscopy are observed, complications should be small. The risks of fluid overload, especially in operative cases, is the most common critical problem, so that accurate recording of fluid use and collection are essential. The inexperienced, unsupervised surgeon is most likely to encounte...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1995-09-01 00:00:00
abstract::This article reviews the key concepts regarding the counseling and management of cervical dysplasia and invasive cervical cancer diagnosed during pregnancy. Emphasis is placed on balancing the maternal and fetal well-being in collaboration with appropriate multidisciplinary teams. Information regarding appropriate dia...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.ogc.2005.08.007
更新日期:2005-12-01 00:00:00
abstract::Recent guidelines from multiple organizations stress screening initiation no earlier than the age of 21 years and increased screening intervals for women aged 21 to 29 years. Primary prevention with human papillomavirus vaccination has the potential to significantly affect the development of high-grade cervical lesion...
journal_title:Obstetrics and gynecology clinics of North America
pub_type: 杂志文章
doi:10.1016/j.ogc.2013.02.007
更新日期:2013-06-01 00:00:00