Academic OB/GYN Podcast Episode 15 – Green and Grey Journals January 2010
In this episode I discuss several articles from the January Issue of the Green an Grey journals, and a few articles from the Lancet to boot! We discuss the prospective outcomes in thrombophilia, Metformin and Glyburide in GDM, Miso vs Pit for PPH, interstitial pregnancy, and SFlt-1 and PLGF for detection of pre-eclampsia. Thanks for listening!
Academic OB/GYN Episode 15 – Green and Grey Journal January 2010
HIPAA, Medical Case Reports, and Unbalanced Benefit in News Reporting
On January 12, 2010, a magnitude 7.0 earthquake rocked the island country of Haiti, destroying much of the capital Port Au Prince and leading to the deaths of as many as 200,000 people. Since this time, thousands of images of the resulting carnage have been published in both traditional media and on internet sites.
Recently there has been some discussion about the appropriateness of some of these images, particularly those that depict individual humans in despair or even in death. Some have argued that such images should not be published without the express consent of the person depicted, or with the consent of the next-of-kin in cases of the dead. Media, for the most part, has held that in cases of extreme human events the benefit of publicizing the truth outweighs whatever emotional harm might come to an individual through publication of their plight. They argue that the many outweigh the few, in this case.
Academic OB/GYN Cases – DVT in Pregnancy
A 25 year old 12 week pregnant woman presents with increasing pain in her left leg…
Academic OB/GYN Cases – Huge Prolapsed Fibroid
I recently was consulted to see a patient in the cardiac intensive care unit who had recently had a large anterior wall myocardial infarction, for the complaint of vaginal bleeding. She had had the heart attack two days previous, and was now on several cardiac meds and IV heparin. Her resultant ejection fraction was only 30%.
After admission to the hospital, she felt something come out of her vagina and she started having heavy vaginal bleeding. On exam she had a very large pedunculated fibroid.
Click the jump to see what we saw..
D and C Workshop
This is a rerecording of a recent workshop on D and C procedure that I did with my residents. Enjoy!
If you would like to use this prezi for your residents, let me know and I can send you the file. All I ask is a mention of the blog in your presentation!
Enjoy!
Blog and podcast on hiatus for a bit
Hello Friends/Tweeps/Readers/Listeners
Due to a death in the family I have not had much time recently to work on the blog and podcast. I have not forgotten you all and all the support you have given, and am committed to making 2010 the biggest year yet for Academic OB/GYN! But for the moment, it is on break. I hope to get back to it in the next 3-4 weeks.
Be well,
Nicholas Fogelson, MD
An Obstetrical Analysis of “The Christmas Miracle”
Dr Onyeije
By Nicholas Fogelson, M.D. and Chukwuma Onyeije, M.D.
Early reports described the story of Tracy Hermanstorfer as a “Christmas Miracle”. It has also been described as inspiring, heartwarming, and “wonderfully appropriate for the season.” Others have referred to her saga as a nightmare with a happy ending.
On Christmas Eve 2009, Ms. Hermanstorfer was admitted to Memorial Hospital in Colorado Spring, Colorado after her water broke. Ms. Hermanstorfer suffered a cardiac arrest during labor with her child Colton. After immediate resuscitative efforts failed, nearby Maternal Fetal Medicine physician (Dr Stephanie Martin) performed an emergency cesarean section. In the minutes following the delivery, Ms Hermanstorfer regained circulation and breathing, and is now doing well. Her infant also went on to survive and is apparently well.
Ortho Evra and Venous Thromboembolism Risk – Why You Need to Read More Than Abstracts
When Ortho Evra, the contraceptive patch came on the market, physicians were happy that women had a new and novel contraceptive method that significantly expanded options over what was already available. Since that time, hundreds of thousands of women worldwide have safely used Ortho Evra for birth control.
As the transdermal patch was a new delivery method for birth control, several new pharmacokinetic studies were done postmarketing, in addition to those done prior to FDA approval. One of these studies demonstrated that patients using Ortho Evra had on average 60% higher estrogen blood levels than patients on oral contraceptives, despite lower peak levels (1). Given that estrogen somewhat increases the risk of venous thromboembolism(VTE), this data raised the concern that Ortho Evra might confer a greater attributable risk than traditional oral contraceptives.
A bit about Receiver Operator Curves and Cesarean Delivery
In a few posts I have mentioned Reciever Operator Curves (ROC), and a few folks have asked what I mean, so I want to explain it. This is an extremely important concept in medicine, and in decision making in general. Unfortunately, it is also quite complex. So complex in fact, that it is possible to explain an ROC in very high end mathematical speaking, such that few would understand (and yes, it can get over my head as well.) To see this kind of explanation, check out the Wikipedia entry on the ROC. But I want to try to make it a little simpler.
Academic OB/GYN Podcast Episode 14 – Cardiovascular Disease Markers in Women
In this episode I interview Dr Paul Ridker from Brigham and Women’s hospital about the JUPITER trial, a randomized trial of statins for prevention of cardiac events in people with elevated C-Reactive Protein who do not have hyperlipedemia. Dr Ridker is hugely published as was on Time Magazine’s list of 100 Most Influential People. We discuss not only his work, but academic medicine in general. It was a great discussion that I hope you enjoy!
Academic OB/GYN Episode 14 – Cardiovascular Disease Markers in Women
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