The risks of lowering the cesarean-delivery rate

Article Abstract:

Obstetricians should focus on lowering the cesarean rate only in women in their first pregnancy. The cesarean delivery rate in the US in 1995 was 21% of all pregnancies, a figure that Healthy People 2000 wants to reduce to 15%. However, two strategies for achieving this goal include a trial of labor in women with a previous cesarean and extracting the baby through the vagina with forceps or a vacuum. The first strategy can result in uterine rupture and the second may damage the baby. Obstetricians should reconsider this goal, especially since it appears to be driven by economic considerations.

Methods, Prevention, Childbirth, Delivery (Childbirth), Cesarean section

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Appropriate use of Artificial Nutrition and Hydration: Fundamental Principles and Recommendations

Article Abstract:

The ethical principles that have guided the appropriate use of Artificial Nutrition and Hydration (ANH) during the past 20 years from 2005 are examined and steps are recommended to promote clinical practices that are more consistent with these principles. ANH improves the survival rate among patients receiving chemotherapy and also improves survival among patients who are in a permanent vegetative state.

Health aspects, Ethical aspects, New England, Persistent vegetative state, Artificial nutrition

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Risks of testosterone-replacement therapy and recommendations for monitoring

Article Abstract:

The adverse effects of testosterone replacement therapy are reviewed. Topics include coronary artery disease, lipid profiles, polycythemia, benign prostatic hyperplasia, prostate cancer, prostate-specific antigen (PSA), hepatic effects, sleep apnea, and other minor adverse effects. Testosterone replacement therapy is used to treat men who have low blood levels of testosterone, the male sex hormone.

Care and treatment, Complications and side effects, Hormone therapy, Testosterone, Hypogonadism, Hormone replacement therapy

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