PubMed · 16648397
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
John T Queenan. 2006. Worldwide involvement.. https://doi.org/10.1097/01.aog.0000217581.02925.58
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Hepatitis B and hepatitis C may be transmitted form patients to health care workers and from health care workers to patients. To reduce the risk, all obstetrician-gynecologists who provide clinical care should receive hepatitis B virus vaccine. Obstetrician-gynecologists who are hepatitis B surface antigen positive and e antigen positive should not perform exposure prone procedures until they have sought counsel from an expert review panel. Because the risk of hepatitis C virus transmission is lower than that of hepatitis B virus transmission, routine testing of health care workers is not recommended, and hepatitis C virus-positive health care workers are not required to restrict professional activities.
OBJECTIVE: The purpose of this study was to test the hypothesis that the percentage of subspecialists in obstetrics and gynecology who made payments on professional liability claims was less than the percentage of general obstetrician-gynecologists who made payments. METHODS: Professional liability payment data from the Massachusetts Board of Registration in Medicine was used. RESULTS: During the 10 years preceding August 2005, 38.6% of obstetrician-gynecologists and 32.2% of gynecologists made at least 1 professional liability payment. During the same time period, the percentage of subspecialists who made a payment was significantly less than obstetrician-gynecologists: gynecologic oncologists 10.0% (P = .012), maternal-fetal medicine 3.7% (P = .002), and reproductive endocrinologists 11.9% (P = .016). Using aggregate payment data for the period 1994-2003, the average payment per claim for specialists in maternal-fetal medicine ($1,950,000) and gynecologic oncology ($1,014,006) were above the average payment per claim for obstetrician-gynecologists ($447,983) or gynecologists ($400,338). Reproductive endocrinologists had an average payment per claim of $454,047. CONCLUSION: All specialists in the field of obstetrics and gynecology have major professional liability risks. Among subspecialists in obstetrics and gynecology, the favorable trend toward fewer physicians making payments is counterbalanced by greater payments per lost claim. LEVEL OF EVIDENCE: II-2.
PURPOSE OF REVIEW: The success in the use of the tension-free midurethral sling procedures (tension-free vaginal tape, suprapubic arch, transobturator tape) has dramatically altered the approach to the surgical management of stress urinary incontinence in women and marked a resurgence in the use of mesh. We will analyze the characteristics of synthetic meshes and explain the rationale for using monofilament materials with larger pore sizes. Thus, the purpose of this review is to introduce the surgeon to a variety of commercially available mesh materials and the characteristics that make mesh suitable for use as sling grafts. RECENT FINDINGS: Type I macroporous mesh materials appear most suitable for transvaginal implantation. Utilization of these materials in a minimally invasive retropubic or transobturator approach, promising early and intermediate follow-up data has been achieved. The outcome of these procedures in women with urethral hypermobility and genuine stress incontinence seems clear. No controlled data, however, exist to define the role of these procedures in difficult cases of stress incontinence. Newer generations of minimally invasive slings may offer treatment alternatives in these difficult cases. SUMMARY: Minimally invasive slings using Type I mesh materials are safe and effective. 'Hybrid' type slings may offer alternatives in difficult cases of stress urinary incontinence.