Behçet's disease in obstetrics and gynecology

Beh?et's disease is a multisystemic disease of unknown origin characterized by a recurrent bipolar aphtosis (oral and genital) associated with vascular, digestive or articular symptoms. Gynecologists can be faced to this disease at any time of the life of their patients, including during the pregnancy. Given that the first demonstrations of the disease can be genital, they are in the front line to evoke this diagnosis. They thus have to know the main characteristics of the disease to make the diagnosis and to organize a multidisciplinary management. During pregnancy, the treatment of the disease is to be adapted to avoid teratogenic drugs, and adapt the doses of the treatment.     

Is there gender bias toward male residents in an obstetrics and gynecology training program?

OBJECTIVE: To assess whether male obstetric and gynecologic residents experience gender bias in training for vaginal deliveries. STUDY DESIGN: We compared male and female resident training experiences in vaginal deliveries in a community hospital. Three analyses were performed: (1) total number of deliveries performed by male and female residents, (2) percentage of deliveries that male and female residents performed with female attendings, and (3) percentage of attending deliveries performed by male residents. The main outcome measure was whether male residents had limited training opportunities with female attendings as compared to female residents. RESULTS: There was no difference between male and female residents with regard to total deliveries performed per rotation. Male residents were as likely as female residents to participate in vaginal deliveries by a female attending. Conversely, female attendings were as likely as male attendings to have a male resident attend their patients' deliveries. CONCLUSION: There was no evidence of gender bias regarding male resident training opportunities in vaginal deliveries in an obstetric and gynecologic training program.     

Anti-TNFα therapy and its implication in gynecology and obstetrics

Anti-TNFα treatments have modified the medical care, the course and the quality of life of the patients with autoimmune rheumatic, cutaneous or bowel inflammatory diseases. On the other hand, these treatments may have potential severe side effects during pregnancy (congenital malformations, fetal infections). Actually, many pregnancies have been reported during anti-TNFα exposures, with good maternal and neonatal outcomes. The introduction or the discontinuation of these treatments will always have to be discussed with the specialist of the chronic disease and, ideally, during a preconceptional counselling. In gynecology, anti-TNFα drugs may offer a new safe and effective approach to treating patients with recurrent miscarriages or unexplained or failed in vitro fertilization cycles. On the other hand, these treatments significantly increase the risk for serious infections or viral reactivations and may promote gynaecological malignancies. An adapted gynaecological survey is necessary.     

Is there a sea change ahead for obstetrics and gynecology?

A number of beneficial sociocultural reforms have occurred throughout our society, including a new work/family balance. This change, and a number of others, are challenging the dynamic balance within our specialty. We must advocate for appropriate social, political, and economic interventions that will realistically mesh with the health care needs of our nation, while preserving that which is best about the culture of American medicine.     

Medical informatics in obstetrics and gynecology - the actual challenge?

There is common agreement about the importance of information management systems in obstetrics and gynecology. Those systems are necessary tools for medical quality management and are essential for the actual preparation for the age of the "diagnosis related groups" that will be introduced in Germany next year. Nevertheless there are only small scientifically activities to improve information management systems and to evaluate their performance. Great efforts are necessary to develop new features and not to loose the conflict between the needs of the physicians and their patients and the needs and demands of hospital administrative authorities.     

What influences medical students to pursue careers in obstetrics and gynecology?

OBJECTIVES: The purpose of this study was to identify factors that influence medical students to choose of obstetrics/gynecology as a career specialty. STUDY DESIGN: A Web-based survey of medical students was conducted that included demographics, desire to enter the obstetrics and gynecology specialty, factors that influence selection of the obstetrics and gynecology specialty, perceptions about the obstetrics and gynecology specialty, and incidents of encouragement and discouragement toward entering the obstetrics and gynecology specialty. Analysis included parametric and nonparametric testing. RESULTS: Fifty-one percent of the students (n=205) returned the survey: 131 women (64%) and 72 men (35%); 2 respondents did not specify gender. Various factors influenced a medical student to pursue a career in obstetrics and gynecology, which revealed some specific areas of significant difference between genders, particularly in relation to lifestyle issues and practice trends. CONCLUSIONS: This study amplifies the importance of understanding the role of student gender when exploring the obstetrics and gynecology specialty as a career choice. Appreciating factors that influence decisions to enter the obstetrics and gynecology specialty provides opportunities to impact the experiences and decisions of students toward considering the obstetrics and gynecology specialty as a career choice.     

Balanced Scorecard--a business tool for profit calculations--usable in gynecology and obstetrics?

The balanced scorecard (BSC) is an instrument of business administration using score numbers, that not only includes financial aspects but also levels of communication, motivation and customer relations. Thus it seems usable in service oriented companies including hospitals. The next years will have to show, whether the results rectify the immense expenses necessary with the implementation of the BSC.     

Scientific publications in obstetrics and gynecology journals from China, 2000–2009

Objective

To analyze the output of scientific publications in obstetrics and gynecology journals from 3 principal regions of China: mainland China, Taiwan, and Hong Kong.

Methods

Information on article numbers, impact factors, citation reports, and publication in high-impact obstetrics and gynecology journals by Chinese authors between January 1, 2000, and December 31, 2009, was extracted from PubMed and WoS databases. Comparisons of quantity and quality were done by Kruskal–Wallis and rank-sum tests.

Results

There were 3044 articles from mainland China (n = 1042), Taiwan (n = 1304), and Hong Kong (n = 698). The cumulative impact factors and citations of articles from Taiwan were highest among the 3 regions. In terms of average impact factor and number of citations per article, Hong Kong exceeded mainland China and Taiwan. Fertility and Sterility, Human Reproduction and Gynecologic Oncology were among the most popular obstetrics and gynecology journals used by authors in the 3 regions.

Conclusion

The annual number of articles published in obstetrics and gynecology journals from the 3 regions of China increased during the past decade, especially for mainland China. However, the quality of articles from mainland China arouses attention because the average citation of articles from Hong Kong and Taiwan was higher than that of articles from the mainland.     

Gender stereotypes in gynecology and obstetrics: obstacles for young male physicians?

Up to the mid 1990s, a 'feminization' of medicine took place that was especially pronounced in the field of gynecology. The present paper looks into the reasons for this change based on the literature and results from a study conducted by the author. In 2001, two thirds of the new qualifications in gynecology/obstetrics were awarded to women. The feminist movement has led to the emancipation of women and the assertion that women should be treated by female doctors only. Parallel to this development, gender roles also underwent a change: nowadays, the ideal woman or man is 'androgynous'. Young physicians are both highly instrumental and highly expressive. The increasing similarities between the sexes exert an influence on lifestyle and biographical planning. An increasing number of young physicians no longer prioritize their profession. Male physicians with high expressiveness are often family oriented and consciously refrain from choosing to specialize in gynecology/obstetrics because of the long hours and heavy workload. On the other hand, quite a few women physicians are more instrumental and prioritize their professional commitment. If more male physicians are not attracted into gynecology/obstetrics over the next few years, a process of 'horizontal segregation' could occur, with women physicians accomplishing the patient-focused work while their male colleagues take over the surgery and scientific part of the specialty. It is the very differences between the sexes, however, and the exchange between them, which allow a medical discipline to thrive.     

Biopsychosocial obstetrics and gynaecology – a perspective from Australia

Prior to and throughout the twentieth century, biomedical understandings of health predominated. Australian obstetrician and gynaecologist, Professor Derek Llewellyn-Jones responded to frustrations with the limitations of this narrow approach from both within and beyond the medical profession. His pioneering research, education and writings re-conceptualised the discipline as encompassing the social and psychological contexts and profoundly influenced women’s own understanding of their health and the practice of obstetrics and gynaecology. The biopsychosocial model has replaced biological determinism and is now pervasive in education and clinical practice in many parts of the world. Widespread acceptance of the model has until now been associated with under-recognition of the importance of biology. Recent findings from epigenetics and neuroscience are enabling integration of body, mind and society and enhanced understanding and practice of psychosomatic obstetrics and gynaecology.