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Archive for December, 2010

Academic OB/GYN Podcast Episode 28 – Journals for December 2010

December 30, 2010 7 comments

Journals for 2010 with Nicholas Fogelson and Paul Browne.  Topics include NICHD Strip Classification, Oral vs Intrauterine Progestins for Hyperplasia, Fetal Lung Maturity Outcomes Less than 39 Weeks, Congenital Toxo and more!

Academic OB/GYN Podcast Episode 28 – Journals for December 2010

How to Place Falope Rings

December 19, 2010 2 comments
Categories: Surgery, Surgical Videos

The Downside of Understanding

December 13, 2010 25 comments

As I look back over my 10 year career in obstetrics and gynecology, I am sometimes struck at how many things have been discovered in this time period.  When I started the origin of pre-eclampsia was unknown, and now we know that it likely originates in an overabundance of a molecule called Soluble FMS-Like Tyrosine Kinase, a competitive inhibitor to natural angiogenesis in the placenta.  Ten years ago the origins of cervical dysplasia were still being developed, and now we know that the majority if not the entirety of cervical dysplasia and cancer is due to an infection of Human Papillomavirus,  and for all intents and purposes cervical cancer is actually a sexually transmitted disease.  We have developed this idea even further, allowing us to use HPV virus detection as part of a screening program for cervical dysplasia and cancer, and even to immunize for HPV infection in young women yet to be exposed.

All of these things amaze me.  But to be honest, they also make the practice of obstetrics and gynecology more difficult.   We have advanced our understanding to level that is impossible to explain to patients who lack a strong background in science, forcing us to accept simplistic explanations over explanations of how it really works. Let’s use HPV as an example.

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Categories: Gynecology

Academic OB/GYN Cases: Another Day, Another Dermoid

December 10, 2010 1 comment

First blonde one for me.   Gotta catch ’em all!

An Argument for Coverage of Lactation Consultation

December 8, 2010 8 comments

A while back I published a bit about how to get insurance appeals approved.   So here’s a specific example.  This regards a young woman who delivered her first infant and was having trouble breastfeeding.  After discharge, her physician recommended home lactation consultation services, which her insurer denied as not medically necessary.  The patient’s policy did cover “skilled” medically necessary home health service , but not “custodial” care, defined as care meant for ongoing maintenance or assistance with daily living.

So here’s an answer to that (nonsense).

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