Ask any third-year medical student how hormonal contraception prevents pregnancy, and they’ll probably tell you it prevents ovulation. What they won’t tell you is that this effect is variable and dose-dependent, and if we depended on it alone, hormonal contraception would be much less effective.
That’s because of the very important, and in my opinion, much under-appreciated effect of hormonal contraception on cervical mucus.
A Cervical Mucus Primer
Fertile cervical mucus— which forms under the influence of rising estrogen levels in the first half of the menstrual cycle and is maximal around ovulation –- is thin, watery, clear and easy for sperm to traverse.
Non-fertile mucus — which forms after ovulation and also in pregnancy under the influence of progesterone –- is the exact opposite: Thick,tacky, non-distensible and impossible for sperm to penetrate. (It’s not called the mucus plug for nothing.) Read more »
*This blog post was originally published at tbtam*
How fast does sudden cardiac arrest cause unconsciousness? In just seconds.
Here’s a video of Salamanca soccer player Miguel Garcia’s episode. At the start of the video, Mr. Garcia can be seen in the background of the image kneeling behind the players in the foreground. Watch carefully as he stands after tying his shoes.
Although it is difficult to see, it appears an automatic external defibrillator arrives in about two minutes, though given the fact his shirt is still on as he’s taken from the field, we note the device is on his gurney as he’s hurried to a nearby ambulance. Reportedly, he survived this sudden cardiac arrest event:
This was NOT a heart attack, but rather a loss of cardiac function caused by a rapid, often disorganized heart rhythm disorder. Compare the relatively long time to resuscitation using an external automatic defibrillator verses the very rapid response afforded to Belgian soccer player Anthony Van Loo, whose internal defibrillator was already installed before he played as primary prevention of sudden death from right ventricular dysplasia.
-WesMusings of a cardiologist and cardiac electrophysiologist.
A new iPhone/iPad game called “Prognosis: Your Diagnosis” looks like a decent attempt at making clinical case studies into a fun activity. Though it’s not clear how accurate and educational the game really is, the interface and goofy screenshots can certainly provide the foundation on which to deliver great content.
Hospitals have recently been stepping up their infection control procedures, in the wake of news about iatrogenic infections afflicting patients when they are admitted. Doctors are increasingly wearing a variety of protective garb — gowns, gloves, and masks — while seeing patients.
In an interesting New York Times column, Pauline Chen wonders how this affects the doctor-patient relationship. She cites a study from the Annals of Family Medicine, which concluded that,
fear of contagion among physicians, studies have shown, can compromise the quality of care delivered. When compared with patients not in isolation, those individuals on contact precautions have fewer interactions with clinicians, more delays in care, decreased satisfaction and greater incidences of depression and anxiety. These differences translate into more noninfectious complications like falls and pressure ulcers and an increase of as much at 100 percent in the overall incidence of adverse events.
Hospitals are in a no-win situation here. On one hand, they have to do all they can to minimize the risk of healthcare-acquired infections, but on the other, doctors need to strive for a closer bond with patients — which protective garb sometimes can impede. Read more »
*This blog post was originally published at KevinMD.com*
On location at the American Heart Association’s “Scientific Sessions” meeting in Chicago, Andrew Schorr discusses lowering your risk of heart disease and how weight affects your risk:
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Ask any third-year medical student how hormonal contraception prevents pregnancy, and they’ll probably tell you it prevents ovulation. What they won’t tell you is that this effect is variable and dose-dependent, and if we depended on it alone, hormonal contraception would be much less effective.
