Акушерство и гинекология

[Наталья П.]

Онлайн книги по акушерству и гинекологии
[Ссылки доступны только зарегистрированным пользователям ]

[E.E. Studentsov]

Obstetrical & Gynecological Survey
Volume 60(7), July 2005, pp 415-416
A Testimony: The Wisdom of Drs. Eastman and Novak
[Soundings]
Barron, Bruce A. MD, PhD, MPH

Department of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
Address correspondence to: Bruce Barron, MD, PhD, MPH, Adjunct Professor, Department of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill, CB# 7445, Rosenau Hall, Chapel Hill, NC 27599-7445. E-mail: [Ссылки доступны только зарегистрированным пользователям ].
The collapse of the former Soviet Union, FSU, led to the beginning acceptance of entrepreneurial activities and the exploration of the characteristics and potential of a free market economy in the region. The recognition of the enormous human and material resources in the area resulted in an influx of foreigners from Western Europe and the United States. A vast array of bankers, builders, chemists, IT consultants, mechanical engineers, managing directors and the like together with their families descended on the capitals of the newly independent countries of the FSU.

Since the 1960s, Pepsico had been active in the former Soviet Union as a result of Nikita Khrushchev’s taste for Pepsi Cola. Kentucky Fried Chicken and Pizza Hut restaurants dotted the landscape of Moscow, Kiev, St. Petersburg, and most other large cities. The executives at Pepsi knew from experience that health care was a significant issue for these new émigrés to the FSU. They undertook to find an institution with which to joint venture in the development of a system to deliver American-style medical care to these workers and their families.

After a wide-ranging search, Pepsi selected the Presbyterian Hospital in the City of New York as a partner for this endeavor. As president of Columbia Presbyterian Health Services, the for-profit arm of the Presbyterian Hospital, I directed the hospital’s participation in this joint venture. In this role, I had the occasion to visit Russia on many occasions. This gave me the opportunity to visit the major hospitals and medical teaching institutions in Moscow. In order to validate my role in dealing with the medical authorities, during the course of my visits, I asked to stand for examination for a Russian medical license and certification in obstetrics and gynecology. All these activities provided me with the opportunity to examine first-hand the Russian medical system in Moscow.

The differences between medicine in the West and the FSU are striking to the most casual observer. Medical students enter their training after completing what would be considered the equivalent of one year of university education. Medical education is primarily the didactic presentation of material and involves very little direct patient contact. The curriculum includes many subjects common to those of medical schools in the West. However, there are many major discrepancies between the two educational systems. The Russian medical student has extensive exposure to areas that we consider folk or alternative medicine and far less time is devoted to the more rigorous, scientifically based aspects of the basic sciences and clinical medicine. Perhaps most importantly, fewer than 10% of Russian physicians are able to read English. This means that they are unable to access a vast portion of the body of medical literature. The majority of Russian physicians are generalists with little time spent in training beyond the six- or seven-year medical school program. Specialists practice in the hospitals, all of which are essentially government-run establishments. In Moscow, there are several Kremlin hospitals. These are far and away the best equipped and have the most highly trained staff, many of whom have had some training in the West.

The failings of the Russian medical system are revealed in the health indices of the general population. The effects of the use of alcohol and tobacco, air, water, and soil pollution, violence, and other factors have resulted in a net decrease in the population with deaths exceeding births, life expectancy decreasing in almost every cohort. Although it is difficult to validate the accuracy or precision of health statistics in the FSU, among women in the reproductive ages, there is substantial data that indicates that the incidence of both elective and spontaneous abortion, infertility, fetal alcohol syndrome, sexually transmitted diseases, prematurity, and maternal and infant mortality are extraordinarily high compared to the comparable data for Western Europe and North America. The reported incidence of cardiovascular and neoplastic disease in this cohort are higher by an order of magnitude, as are the correlated death rates. In fact, in many areas the death rates exceed birth rates resulting in a net decrease in the population. There is a large swath of Western Russia where the effects on the indices of health and mortality reflect the long-term effects of the disaster at the nuclear reactor at Chernobyl.

In view of the state of medicine and medical care in Russia, as a part of our program to establish a good working relationship with the Russian physicians, we established libraries of journals, that had been donated by physicians at the Columbia Presbyterian Medical Center in New York, at the major teaching institutions in Moscow. Although there were few journals in their libraries, it became clear that the Russian physicians, generalists and obstetrician–gynecologists alike, had their favorites and the Obstetrical and Gynecological Survey topped their list. When questioned about this, they told me that the Survey was written in a manner that was manageable for someone with limited facility with the language and was a way for them to get an overview of the important findings in obstetrics and gynecology. It is of some historical interest that 60 years after Dr. Eastman and Dr. Novak established the Obstetrical and Gynecological Survey, it still provides a useful window into the discipline for another cohort of physicians caring for women.

[Ссылки доступны только зарегистрированным пользователям ]

[yananshs]

Pruritic Urticarial Papules and Plaques of Pregnancy
[Ссылки доступны только зарегистрированным пользователям ]

Intrahepatic Cholestasis of Pregnancy
[Ссылки доступны только зарегистрированным пользователям ]
[Ссылки доступны только зарегистрированным пользователям ]
[Ссылки доступны только зарегистрированным пользователям ]
[Ссылки доступны только зарегистрированным пользователям ]
[Ссылки доступны только зарегистрированным пользователям ]
[Ссылки доступны только зарегистрированным пользователям ]
[Ссылки доступны только зарегистрированным пользователям ]

[yananshs]

Pruritus in Pregnancy
[Ссылки доступны только зарегистрированным пользователям ]

[Наталья П.]

Просьба оценить, насколько ценна информация (и о чем она?)
[Ссылки доступны только зарегистрированным пользователям ].

[Наталья П.]

[Ссылки доступны только зарегистрированным пользователям ]

Proceedings of a Workshop on
COMPARATIVE PLACENTOLOGY21st –
24th April 2005
Victoria, Canada

[yananshs]

Maternal and neonatal infections
Guidelines, reviews, position statements, recommendations, standards
[Ссылки доступны только зарегистрированным пользователям ]

[dr.Agapov]

Atlas de ginecologia
[Ссылки доступны только зарегистрированным пользователям ]
Атлас по гинекологии на испанском языке.Анатомия,схемы менструального цикла,подборка фотографий вульвитов,злокачественных образований и.т.д.

"Acetic Acid Test" Picture Atlas
[Ссылки доступны только зарегистрированным пользователям ]
Online atlas,по скринингу рака шейки матки от normal cervix до infiltrating cancer

Atlas de imagenes de Ginecologia y Obstetricia
[Ссылки доступны только зарегистрированным пользователям ]
Хороший гинекологический атлас от S.E.G.O.,но на испанском языке

[Chebotnikova T.]

Сообщение от dr.Agapov

Atlas de ginecologia
[Ссылки доступны только зарегистрированным пользователям ]
Атлас по гинекологии на испанском языке.Анатомия,схемы менструального цикла,подборка фотографий вульвитов,злокачественных образований и.т.д.

...ссылка работает

[dr.Agapov]

Сообщение от Chebotnikova T.

нужная ссылка, но не работает

Видно,что то у них с сервером.Неделю назад проверял все ссылки - все работало.
Можно еще зайти по адресу
[Ссылки доступны только зарегистрированным пользователям ]
(но сейчас тоже не работает)

[dr.Agapov]

Colposcopy Atlas

[Ссылки доступны только зарегистрированным пользователям ]
от Louisiana State University Medical Center
Правда для атласа картинок маловато

[Наталья П.]

[Ссылки доступны только зарегистрированным пользователям ]
Библиотека ВОЗ по репродуктивному здоровью
на английском и испанском
Welcome to The WHO Reproductive Health Library (RHL)

Кто хочет бесплатно получать диски с последующими выпусками библиотеки RHL, может подписаться на сайте или по адресу [Ссылки доступны только зарегистрированным пользователям ]
указав следующие данные
name
address (maling address where RHL should be sent)
street
p/o/ box
city
post code
country
e-mail

[Наталья П.]

Журнал "Оценка медицинских технологий"
полный текст pdf
[Ссылки доступны только зарегистрированным пользователям ]

Health Technol Assess. 2006 Dec;10(50):iii, ix-x, 1-78.

Amniocentesis results: investigation of anxiety. The ARIA trial.

Hewison J, Nixon J, Fountain J, Cocks K, Jones C, Mason G, Morley S, Thornton J.

Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, UK.

OBJECTIVES: The Amniocentesis Results: Investigation of Anxiety (ARIA) trial tested two hypotheses: first, that giving amniocentesis results out on a fixed date alters maternal anxiety during the waiting period, compared with a policy of telling parents that the result will be issued 'when available' (i.e. a variable date), and secondly, that issuing early results from a rapid molecular test alters maternal anxiety during the waiting period, compared with not receiving any results prior to the karyotype. The effects of the two interventions on anxiety 1 month after receiving karyotype results were also examined.
DESIGN: A multi-centre, randomised, controlled, open fixed sample, 2 x 2 factorial design trial, with equal randomisation.
SETTING: Twelve hospitals in England offering amniocentesis as a diagnostic test for Down's syndrome.
PARTICIPANTS: A total of 226 women who had had an amniocentesis were randomised between June 2002 and July 2004. Eight women with abnormal results or test failure were excluded post-randomisation.
INTERVENTIONS: Issuing karyotype results on a prespecified fixed date, rather than issuing them as soon as they became available and issuing karyotype results alone, or subsequent to issuing results from a rapid molecular test for the most common chromosomal abnormalities.
MAIN OUTCOME MEASURES: Average anxiety during the waiting period, calculated using daily scores from the short version of the Spielberger State-Trait Anxiety Inventory (STAI). Recalled anxiety, measured 1 month after receiving karyotype results, using a rating scale. Anxiety at the 1-month follow-up, measured using the short-form STAI.
RESULTS: There was no evidence that giving out karyotype results on a fixed or on a variable date altered maternal anxiety during the waiting period. However, the analysis only had sufficient power to detect a moderate to large effect. Issuing early results from a partial, but rapid, test reduced maternal anxiety during the waiting period, compared with receiving only the full karyotype results. This was a moderate to large effect. In addition, group differences in recalled anxiety reflected fairly closely the differences in anxiety women had experienced while waiting for results. One month after receiving normal karyotype results, anxiety was low in all groups, but women who had been given rapid test results were more anxious than those who had not. This was a small to moderate effect.
CONCLUSIONS: Since there are no clear advantages in anxiety terms of issuing karyotype results as soon as they become available, or on a fixed date, women could be given a choice between them. Rapid testing was a beneficial addition to karyotyping, at least in the short term. This does not necessarily imply that early results would be preferred to comprehensive ones if women had to choose between them. There should be further research, including more qualitative studies, into the causes, characteristics and consequences of anxiety associated with prenatal testing. The effects of different testing regimes on short- and long-term anxiety, on the preferences of women and on the relationship between anxiety and preference should be investigated. More research is needed on the ways in which information might be used to minimise anxiety in different testing regimes. Further research is also required into the policy implications of incorporating individual preferences for different testing regimes into prenatal testing programmes.

[nick_og]

Дорогие коллеги.
Хочу поделиться недавно найденным мною ресурсом (хотя вероятно часть из вас уже давно им пользуется). Очень милый и интересный сайтик с разными ревью, рекомендациями и статьями по акушерству, гинеколоии и сексуальным растройствам. Буду рад если кому-нибудь этот ресурс будет полезен . А вот и ссылочка: [Ссылки доступны только зарегистрированным пользователям ]
С уважением Д-р Оганесян

[Slepuha]

Уважаемый доктор Оганесян!
Спасибо за ссылку. Очень ценная. Выручила меня.