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37

Androgen levels predict risk of type 2 diabetes in women with PCOS

A new way of assessing the risk of developing type 2 diabetes for women with polycystic ovary syndrome (PCOS) has been developed by the University of Birmingham. PCOS is a common condition affecting around 1 in 5 women during their life. The condition causes non-dangerous cysts to develop on the ovaries which can affect fertility. The condition tends to also be characterised by having higher levels of male hormones than normal. These androgen hormones, such as androstenedione and testosterone, are also present in healthy women but at lower levels.  
diabetes.co.uk
almost 8 years ago
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39

Sterilisation

Sterilisation Can be controversial in some cultures Should only be undertaken in stable relationships where the couple is certain they do not want any more children   Epidemiology Rates falling in developed countries UK is unusual as the number of men receiving the operation is greater than the number of women 18% of men between 18-69 have had a vasectomy  
almostadoctor.com - free medical student revision notes
almost 8 years ago
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38

Ectopic Pregnancy

 Definition Implantation of conceptious outside uterine cavity When Women in reproductive age present with pelvic pain and positive pregnancy test à Ectopic pregnancy until proven otherwise   Incidence 20:1000 pregnancies Increasing from 11:1000 pregnancies  
almostadoctor.com - free medical student revision notes
almost 8 years ago
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55

Retroverted Uterus

The normal position of the uterus is anteverted. In this position, the uterus is concave on the side of the bladder, and bends round to sit just above and behind the bladder.   In a retroverted uterus, the uterus instead bends ‘backwards’ so that the concave side is posterior. About 20-30% of women have a retroverted uterus.   Clinical features  
almostadoctor.com - free medical student revision notes
almost 8 years ago
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67

Chromosomal Abnormalities

Chromosomal Abnormalities Chromosomal abnormalities are a very common cause of spontaneous miscarriage. Most commonly a child with a chromosomal abnormality will not survive to birth. However, there are many cases where the child will survive, although often they have severe disability in life. The normal rate of miscarriage in the general population is 15%. Miscarriage does not become statistically significant unless one particular woman has >3 instances.  
almostadoctor.com - free medical student revision notes
almost 8 years ago
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43

Anxiety and Generalised Anxiety Disorder (GAD)

Generalised Anxiety Disorder (GAD) Epidemiology Very common. Prevalence: Men – 2-4% Women 3-4.5% Accounts for 1/3 of all psychiatric diagnosis Accounts for 10% of all GP consultations Closely related to depression – and many patients move between the two states. Often patients satisfy the criteria for both anxiety and depression  
almostadoctor.com - free medical student revision notes
almost 8 years ago
Www.bmj
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48

A patient with rheumatoid arthritis, cryoglobulinaemia, and an “accidental” finding

A 60 year old woman, originally from Greece, was admitted after burning herself while trying to warm her legs on an electric heater. She had rheumatoid arthritis treated with methotrexate and adalimumab.  
bmj.com
over 7 years ago
Www.bmj
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55

Dermatitis herpetiformis

A 28 year old woman presented with a raised, red and intensely itchy rash on the extensor surface of her elbows and buttocks, in groups of small blisters. There was no history of trauma, atopy, or recent illness. She had no gastrointestinal symptoms or change in bowel habit and had not lost weight. No major medical or surgical history was noted and she was not taking drugs on a regular basis. Owing to the appearance and location of the rash, together with pruritus, dermatitis herpetiformis was suspected.  
bmj.com
over 7 years ago
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102

Medical Student Podcast 002

Prescribing Safety Assessment (0:40), Foundation Programme applications (1:44), Clare Gerada talks about the importance of values (3:40), Patrick the robot buttocks (7:32), are women ruining medicine? (9:05)  
Audioboo
over 7 years ago
Www.bmj
2
16

A woman with a sore spot on her leg

A 41 year old civil servant, with a background of poorly controlled Crohn’s disease, presented to her general practitioner with a skin lesion on her left shin that had been there for eight weeks (fig 1⇓).  
bmj.com
over 7 years ago
Static.www.bmj
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15

Interpreting raised serum prolactin results

A 29 year old woman working in a solicitor’s office presented with secondary amenorrhoea and was found to have a serum prolactin concentration of 2940 mIU/L (upper reference limit <600) and thyroid stimulating hormone (TSH) concentration of 5.2 mIU/L (reference range 0.27-4.2 mIU/L). She had a history of depression and had previously been treated for anxiety and hyperthyroidism. There was no history of acne or hirsutism, and, until eight months before presentation, her periods had been regular. Her body mass index (BMI) was 18 compared with 19.8 the previous year.  
bmj.com
over 7 years ago
Www.bmj
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75

Diagnosis and management of subclinical hypothyroidism in pregnancy

In prospective studies, the prevalence of undiagnosed subclinical hypothyroidism in pregnant women ranges from 3% to 15%. Subclinical hypothyroidism is associated with multiple adverse outcomes in the mother and fetus, including spontaneous abortion, pre-eclampsia, gestational hypertension, gestational diabetes, preterm delivery, and decreased IQ in the offspring. Only two prospective studies have evaluated the impact of levothyroxine therapy in pregnant women with subclinical hypothyroidism, and the results were mixed. Subclinical hypothyroidism is defined as raised thyrotropin combined with a normal serum free thyroxine level. The normal range of thyrotropin varies according to geographic region and ethnic background. In the absence of local normative data, the recommended upper limit of thyrotropin in the first trimester of pregnancy is 2.5 mIU/L, and 3.0 mIU/L in the second and third trimester. The thyroid gland needs to produce 50% more thyroid hormone during pregnancy to maintain a euthyroid state. Consequently, most women on levothyroxine therapy before pregnancy require an increase in dose when pregnant to maintain euthyroidism. Ongoing prospective trials that are evaluating the impact of levothyroxine therapy on adverse outcomes in the mother and fetus in women with subclinical hypothyroidism will provide crucial data on the role of thyroid hormone replacement in pregnancy.  
bmj.com
over 7 years ago
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27

Risk models for pregnant women with congenital heart disease

Stream Risk models for pregnant women with congenital heart disease by BMJ talk medicine from desktop or your mobile device  
SoundCloud
over 7 years ago
Www.bmj
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46

Airway obstruction after the development of Hashimoto’s thyroiditis

A 67 year old white woman presented to her family doctor in January 2013 with a small asymptomatic thyroid swelling. Her serum thyroid stimulating hormone (TSH) concentration was high (37 mIU/L; reference range 0.5-4.5) and serum free thyroxine was low (5.4 pmol/L; 10-21), consistent with a hypothyroid state. However, she had no clinical features of hypothyroidism. Ultrasonography of the neck showed diffuse hypoechoic enlargement of the thyroid gland, with no retrosternal extension. Her serum anti-thyroid peroxidase (anti-TPO) value was also high (>600 kU/L; <35 kU/L). These features were suggestive of autoimmune (Hashimoto’s) thyroiditis. She was advised to take thyroxine tablets (100 µg) daily, and after two months her neck swelling reduced in size and her serum TSH concentration normalised (1.2 mU/L).  
bmj.com
almost 7 years ago
Foo20151013 2023 37skir?1444774198
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Biohacking - The Brighter Side of Health

2014 is already more than a month old (if you can believe it) and with each passing day, the world we live in is speeding towards breakthroughs in every sphere of life. We're running full tilt, wanting to be bigger and better than we were the day or the hour before. Every passing day reinvents the 'cutting edge' of technology, including medical progress and advancement. Gone are the medieval days when doctors were considered all knowing deities, while medicine consisted of leeches being used to drain 'bad blood'. Nowadays, health isn't just about waiting around until you pick up an infection, then going to your local GP to get treated; in today's world it's all about sustaining your wellbeing. And for that, the new kid on the block is biohacking. Biohacking is the art and science of maximizing your biological potential. As a hacker aims to gain complete control of the system he's trying to infiltrate, be it social or technological; similarly a biohacker aims to obtain full control of his own biology. Simply put, a biohacker looks for techniques to improve himself and his way of life. Before you let your imagination run away with you and start thinking of genetic experiments gone wrong, let me assure you that a biohack is really just about any activity you can do to increase your capabilities or advance your wellbeing. Exercising daily can be a biohack. So can doing the crossword or solving math sums, if it raises your IQ by a few points or improves your general knowledge. What characterizes biohacking is the end goal and the consequent modification of activities to achieve that goal. So what kind of goals would a biohacker have? World domination? Not quite. Adding more productive hours to the day and more productivity to those hours? Check. Eliminating stress and it's causes from their lives? Check. Improving mood, memory and recall, and general happiness? You bet. So the question arises; aren't we all biohackers of sorts? After all, the above mentioned objectives are what everyone aspires to achieve in their lives at one point or the other. unfortunately for all the lazy people out there (including yours truly), biohacking involves being just a tad bit more pro active than just scribbling down a list of such goals as New Year resolutions! There are two main approaches to selecting a biohack that works for you- the biggest aim and the biggest gain. The biggest aim would be targeting those capabilities, an improvement in which would greatly benefit you. This could be as specific as improving your public speaking skills or as general as working upon your diet so you feel more fit and alert. In today's competitive, cut throat world, even the slightest edge can ensure that you reach the finish line first. The biggest gain would be to choose a technique that is low cost- in other words, one that is beneficial yet doesn't burn a hole through your pocket! It isn't possible to give a detailed description of all the methods pioneering biohackers have initiated, but here are some general areas that you can try to upgrade in your life: Hack your diet- They say you are what you eat. Your energy levels are related to what you eat, when you take your meals, the quantity you consume etc. your mood and mental wellbeing is greatly affected by your diet. I could go on and on, but this point is self expanatory. You need to hack your diet! Eat healthier and live longer. Hack your brain- Our minds are capable of incredible things when they're trained to function productively. Had this not been the case, you and I would still be sitting in our respective caves, shivering and waiting for someone to think long enough to discover fire. You don't have to be a neuroscientist to improve your mental performance-studies show that simply knowing you have the power to improve your intelligence is the first step to doing it. Hack your abilities- Your mindset often determines your capacity to rise to a challenge and your ability to achieve. For instance, if you're told that you can't achieve a certain goal because you're a woman, or because you're black or you're too fat or too short, well obviously you're bound to restrict yourself in a mental prison of your own shortcomings. But it's a brave new world so push yourself further. Try something new, be that tacking on an extra lap to your daily exercise routine or squeezing out the extra time to do some volunteer work. Your talents should keep growing right along with you. Hack your age- You might not be able to do much about those birthday candles that just keep adding up...but you can certainly hack how 'old' you feel. Instead of buying in on the notion that you decline as you grow older, look around you. Even simple things such as breathing and stamina building exercises can change the way you age. We have a responsibility to ourselves and to those around us to live our lives to the fullest. So maximise your potential, push against your boundaries, build the learning curve as you go along. After all, health isn't just the absence of disease but complete physical, mental and social wellbeing and biohacking seems to be Yellow Brick Road leading right to it!  
Huda Qadir
almost 8 years ago
Foo20151013 2023 bpq0mk?1444774302
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445

Clinical Exam Still Matters

After I retired from my academic position at the University of Miami, I started working as an intermittent ob & gyn in various cultural settings in the US and abroad. In 2006 I practiced in a hospital in New Zealand. I saw many interesting cases during my six months at Whangarei Hospital. One stands out in particular. This was a middle aged native Mauri woman who had been seeing her family doctor for several years because she was gaining too much weight, her abdomen was getting bigger, and she was constipated. Each time the family doctor saw her, he did not examine her but patted her on the back and encouraged her to eat less, eat more fruit and vegetables and be more active so that she would lose weight. When much later he finally examined her, he noticed a large tumor in her abdomen and referred her to the hospital. To make a long story short, we operated on her and removed a large ovarian cyst weighing more than 18 kilograms (about 40 pounds). This cyst fortunately turned out to be benign and the woman did well. The operation itself was something else as we needed an extra assistant to hold the tumor in her arms while we removed it without breaking it. Even though this large tumor was certainly not a record, we ended up publishing the case in a New Zealaned medical journal for family practice (see reference below), not so much for the nature of the tumor itself as for pointing out to family doctors (all doctors, in fact) that examining patients before giving them advice is most important. Alison Gale, Tommy Cobb, Robert Norelli, William LeMaire. Increasing Abdominal Girth. The Importance of Clinical Examination. New Zealand Family Physician. 2006; 33 (4): 250-252  
DR William LeMaire
over 7 years ago
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138

New App Helps People Connect With Those Suffering From Dementia

Frieda Rozbruch was always a smart, capable, self-reliant woman. She survived the Holocaust, spoke seven languages and cooked up nine-course meals for th...  
huffingtonpost.com
almost 7 years ago
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Informed consent? How do primary care professionals prepare women for cervical smears: A qualitative study

Cervical screening is a procedure that is mainly carried out in primary care, predominantly by general practitioners (GPs) and practice nurses (PNs). Much has been published about the effects on women of receiving an abnormal smear result but little has been done to investigate the preparation of women by primary care professionals for this.  
sciencedirect.com
over 6 years ago
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Ethical issues and addiction. - PubMed - NCBI

The epidemic of substance abuse continues to pose a significant challenge to clinicians nationwide. Although there is a tendency to simply associate drug abuse with poverty, the problem affects every social stratum gender and race; and pregnant women are no exception. Caring for pregnant, substance-using women and their infants presents complex legal and ethical issues. Debate is ongoing about whether criminal penalties should be imposed on women based solely on their use of alcohol and other drugs during pregnancy. Furthermore, controversies persist about the rights and wishes of pregnant women versus the interests of their fetuses. For health professionals, conflict arises when the pregnant woman chooses behaviors that have the potential to harm the developing fetus. The ethical dilemma arises from competing autonomy-based and beneficence-based obligations to the maternal-fetal dyad. This chapter explores the ethics-based conflicts in the delivery of health care to drug abusing pregnant women.  
ncbi.nlm.nih.gov
over 6 years ago
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The day I removed a toy dinosaur from a woman's vagina

At first I thought my patient had a bad case of thrush. How wrong I was  
theguardian.com
over 6 years ago