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I was chatting with one of my co-workers about my struggles with pruning in my cherry tree, and she went and looked at the local nursery the following weekend and came home with a 40 lb bag of cherries. I was SO excited! (more…)Fertility preservation strategies: options in women with early stage cancers.
The option to preserve fertility in women with early stage cancers is relatively new and consequently many women need information and advice on this topic. Concerns about current fertility preservation techniques are often reported. Most options are still considered experimental, but some are undergoing clinical development. The traditional approaches, including ovarian stimulation for oocyte cryopreservation, are undergoing limited clinical evaluation, and are unlikely to become standard of care in the future. One long-acting method, long-acting gonadotropin-releasing hormone agonists, is undergoing clinical trials. Sperm cryopreservation is no longer experimental, and cryobanking of oocytes by ovarian transposition or ovarian tissue cryopreservation is being evaluated. There are many options for the female partner to preserve fertility during cancer treatment. Thus, the decision to forgo cancer treatment and allow infertility to develop is a very individual decision. The decision process should be individualized and should include a discussion with the woman’s physician or a physician or counsellor familiar with fertility preservation. Such a discussion should include a discussion about the pros and cons of all options. Clinical practice guidelines will help to guide women and their physicians through the decision-making process.Trends in the management of stable angina.
We examined Medicare claims for outpatients in the United States from 1990 through 1993, with or without coronary revascularization procedures. The number of coronary revascularizations remained virtually stable from 1990 to 1993, with an increase in the range of years of indications for revascularization. Revascularization for unstable angina and the management of unstable angina increased, with 31% of all coronary revascularizations performed on patients with unstable angina. In 1993, there were 234,000 outpatient hospitalizations for acute myocardial infarction (AMI), including 18% with unstable angina. Twenty-five percent of the patients hospitalized with AMI underwent coronary revascularization. The most common revascularization procedures were percutaneous transluminal coronary angioplasty (PTCA) (67%), coronary artery bypass surgery (CABG) (19%), and repeat CABG (9%). Medicare payments for