10: Bacterial Vaginosis w/ Dr. Sara Kim

In this episode Dr. Sara Kim discusses the history, diagnosis, consequences, and treatment of bacterial vaginosis. 

1. ACOG. Vaginisits Practice Bulletin. (2015).

2. Chawla, R. B., Preena; Chadha, Sanjim; Grover, Sujatha; Garg, Suneela. Comparison of Hay's Criteria with Nugent's Scoring System for Diagnosis of Bacterial Vaginosis. Biomed Research International 2013 (2013).

3. Eschenbach, D. A. History and review of bacterial vaginosis. American Journal of Obstetrics and Gynecology 169, 441-445 (1993).

4. Fettweis, J. B., J Paul; Serrano, Myrna; Sheth, Nihar; Girerd, Philippe; Edwards, David; Strauss, Jerome; Jefferson, Kimberly; Buck, Gregory, Vaginal Microbiome Consortium. Differences in vaginal microbiome in African American women versus women of European ancestry. Microbiology 160, 2272-2282 (2014).

5. Greenwood, J. P., MJ. Transfer of Haemophilus vaginalis Gardner and Dukes to a New Genus, Gardnerella: G. vaginalis (Gardner and Dukes). International Journal of Systematic Bacteriology 30, 170-178 (1980).

6. Hillier, S. N., Robert; Eschenbach, David; Krohn, Marijane; Gibbs, Ronald; Martin, David; Cotach, Mary Frances; Edelman, Robert; Pastorek, Joseph; Rao, Vijaya; McNellis, Donald; Regan, Joan; Carey, Christopher; Klebanoff, Mary A. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. New England Journal of Medicine 333, 1737-1742 (1995).

7. Koumans, E. S., Maya; Bruce, Carol; McQuillan, Geraldine; Kendrick, Juliette; Sutton; MAdeline; Markowitz, Lauri. The Prevalence of Bacterial Vaginosis in the United States, 2001-2004; Associations with Symptosm, Sexual Behaviors, and Reproductive Health. Sexually Transmitted Diseaese 34, 864-869 (2007).

8. Lachiewicz, M. M., Laura; Jaiyeoba, Oluwatosin. Pelvic Surgical Site Infection in Gynecologic Surgery. Infectious Diseases in Obstetrics and Gynecology 2015 (2014).

9. Larsson, P.-G. a. C., Bodil. Does pre- and postoperative metronidazole treatment lower vaginal cuff infection rate after abdominal hysterectomy among women with bacterial vaginosis? Infect Dis Obstet Gynecol 10, 133-140 (2002).

10. Lin, L. S., J; Kimber, N; Shott, S; Tangora, J; Aroutcheva, A; Mazees, MB; Wells, A; Cohen, A; Faro, S. The Role of Bacterial Vaginosis in Infection After Major Gynecologic Surgery. Infectious Diseases in Obstetrics and Gynecology 7 (1999).

11. Ling, Z. L., Xia; Chen, Weiguan; Luo, Yueqiu; Yuan, Li; Xia, Yaxian; Nelson, KAren; Shalei, Huang; Zhang, Shaoen; Wang, Yuezhu; Yuan, Jieli; Li, Lanjuan; Xiang, Charlie. The Restoration of the Vaginal Microbiota After Treatment for Bacterial Vaginosis with Metronidazole or Probiotics. Microbial Ecology 65, 773-780 (2013).

12. Menard, J.-P. Antibaterical treatment of bacterial vaginosis: current and emerging therapies. International Journal of Women's Health 3, 295-305 (2011).

13. Muthuamy, S. E., Selvi. Comparison of Amsel's Criteria, Nugent Score and Culture for the Diagnosis of Bacterial Vaginosis. National Journal of Laboratory Medicine 5, 37-40 (2016).

14. Onderdonk, A. D., Mary L; Fichorova, Raina N. The Human Microbiome during Bacterial Vaginosis. Clinical Microbiology Reviews 29, 223-238 (2016).

15. Tebes, C. L., Catherine; Sinnott, John. The effect of treating bacterial vaginosis on preterm labor. Infect Dis Obstet Gynecol 11, 123-129 (2003).

16. Xiao, B. N., Xiaoxi; Wang, Ben; Du, Pengcheng; Na, Risu; Chen, Chen; Liao, Qinping. Predictive value of the composition of the vaginal microbiota in bacterial vaginosis, a dynamic study to identify recurrence-related flora. Scientific Reports Nature 6, doi:10.1038/srep26674 (2015).

Bonus Episode - Russel Earl Marker

A bonus episode describing the life and contributions of Russel Earl Marker. He led a fascinating life and his work made possible the great advances in the understanding of female fertility that took place in the 1950s. Without his work the history of hormonal contraception would likely look completely different and in this episode we pay tribute to his brilliance and dedication.

Episode 9 - Contraception - Part 4

In this episode we discuss the history, methods, effectiveness, and pitfalls of permanent sterilization. 

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1. Tubal Techniques

2. D. Bartz & J. Greenberg. Sterilization in the United States. Rev Obstet Gyn. 2008; 1(1): 23-32.

3. CREST Study

4. CREST Study: Regret

5. CREST Study: Ectopic

6. Fit to Be Tied: Sterilization and Reproductive Rights in America, 1950-1980

Episode 8: Contraception - Part 3

In this episode we discuss the ancient and modern history of barrier contraceptives and their effect on society. We also review the development of the IUD and its place in the modern contraceptive landscape.

• The story of the condom. F. Kahn et al. Indian Journal of Urology. 29(1):12-15. 2013

• History of Intrauterine Devices. L. Margulies. Bulletin of the NY Academy of Medicine. 51(5). 1975

• Trends in Long-acting Reversible Contraception Use Among U.S. Women Aged 15-44. NCHS 188. 2015

• UN report on contraceptive choices

• Side effects from the copper IUD: do they decrease over time? D. Hubacher et al. Contraception. 2009 May; 79(5):356-362

Episode 7: Contraception - Part 2

In this episode we discuss the menstrual cycle and how a few people figured out how to hack it to provide safe, effective contraception. 

Menstrual Cycle Graphic #1

Menstrual Cycle Graphic #2

Effectiveness of Birth Control Methods

History of the Oral Contraceptive #1

History of the Oral Contraceptive #2

Episode 6: Contraception - Part 1

Contraception is major element in the life of women throughout the world. In this episode we chart its history from ancient Egypt to modern times and discuss its implications at the personal and societal levels. 

Episode 5: Pelvic Inflammatory Disease - Part 3

Pelvic inflammatory disease to PID has been a factor in the lives of women in the western world for at least 500 year. It effects up to 5% of US women at sometime during their life and its effects can be long-lasting and devastating. In this episode, part 3 of 3, we discuss the treatment and prevention of PID along with a detour into antibiotics.

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1. Goupil Bernutz. Clinical Memoirs on the Diseases of Women. 1866

2. Lachlan Aitken. Remarks on Pelvic Peritonitis and Pelvic Cellulitis. Baltimore Medical Journal. 1870. Volume 1

3. David Berry & Alexander Freeland. Manual of Gynecology - Volume 1. 1883

4. Howard Kelly. Operative Gynecology - Volume 2. 1898

5. Sexually Transmitted Diseases Treatment Guidelines. CDC. 2015

6. W. Stamm et al. Prevention of Pelvic Inflammatory Disease by Screening for Cervical Chlamydial Infection. N Engl J Med 1996; 334:1362-1366

7. P. Oakeschott et al. Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial. BMJ 2010; 340

Episode 4: Pelvic Inflammatory Disease - Part 2

Pelvic inflammatory disease to PID has been a factor in the lives of women in the western world for at least 500 year. It effects up to 5% of US women at sometime during their life and its effects can be long-lasting and devastating. In the episode, part 2 of 3, we discuss the diagnosis of PID.

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Diagnosis

1. Howard Kelly. The Diagnosis of Pelvic Inflammatory Diseases. 1894.

2. Westrom L. Objectivized diagnosis of acute pelvic inflammatory disease. AJOG 1969

3. Sellors J, Mahony J, Goldsmith C et al. The accuracy of clinical findings and laparoscopy in pelvic inflammatory disease. Am J Obstet Gynecol 1991; 164: 113–120.

4. Paavonen, J et al. Comparison of endometrial biopsy and peritoneal fluid cytologic testing with laparoscopy in the diagnosis of acute pelvic inflammatory disease. AJOG. 151 (5):645-650. 1985

5. Kiviat, N et al. Endometrial Histopathology in Patients with Culture-proved Upper Genital Tract Infection and Laparoscopically Diagnosed Acute Salpingitis. AJOSP. 1990. 14(2)

6. B. Cacciatore et al. Transvaginal Sonographic Findings in Ambulatory Patients with suspected pelvic inflammatory disease. 1992. 80(6)

7. Tukeva TA, Aronen HJ, Karjalainen PT, Molander P, Paavonen T, Paavonen J. MR imaging in pelvic inflammatory disease: comparison with laparoscopy and US. Radiology 1999;210:209-16

8. J. Moss et al. Serum CA-125 in the diagnosis of acute pelvic inflammatory disease. Int Journal Gyn & Obstetrics. 1994. 44(1)

9. L Westrom et al. Diagnosis of pelvic inflammatory disease: time for a rethink. Sex Transm Infect 2003:79

10. CDC Statement

Episode 3 - Pelvic Inflammatory Disease - Part 1

Pelvic inflammatory disease to PID has been a factor in the lives of women in the western world for at least 500 year. It effects up to 5% of US women at sometime during their life and its effects can be long-lasting and devastating. In the episode, part 1 of 2, we delve into the history, prevalence, causes, and consequences of PID.

History

1. John Hirth. Syphilis – Its early history and Treatment until Penicillin and the Debate on its Origins. Journal of Military and Veterans' Health. 20(4). 2012

2. Goupil Bernutz. Clinical Memoirs on the Diseases of Women. 1866

3. Matthew Mann. A System of Gynecology - Vol. 1. 1887

Prevalence

1. L. Westrom. Incidence, prevalence, and trends of acute pelvic inflammatory disease and its consequences in industrialized countries. 138:880. 1980

2. Pelvic Inflammatory Disease Statistics. CDC. 2015

Definition

1. Howard Kelly. The Diagnosis of Pelvic Inflammatory Diseases. 1894.

2. Pelvic Inflammatory Disease (PID) - CDC Fact Sheet. CDC. 2015

3. R. Brunham, S. Gottlieb. Pelvic Inflammatory Disease. NEJM 372:2309-2048. 2015.

Causes

1. Pelvic Inflammatory Disease (PID) - CDC Fact Sheet. CDC. 2015

2. R. Brunham, S. Gottlieb. Pelvic Inflammatory Disease. NEJM 372:2309-2048. 2015.

3. JA McGregor, et al. Bacterial vaginosis is associated with prematurity and vaginal fluid mucinase and sialidase: results of a controlled trial of topical clindamycin cream. AJOG. 170(4):1048-59. 1994

4. DL Draper, et al. Levels of vaginal secretory leukocyte protease inhibitor are decreased in women with lower reproductive tract infections. AJOG. 183(5):1243-8. 2000

5. I Simms, et al. Associations between Mycoplasma genitalium, Chlamydia trachoma's and pelvic inflammatory disease. J Clin Pathology. 56(8):616-618. 2003.

6. CR Cohen, et al. Detection of Mycoplasma genitalium in women with laparoscopically diagnosed acute salpingitis. Sex Transm Infect. 81:463-466. 2005

Consequences

1. L Westrom. Effect of acute pelvic inflammatory disease on fertility. AJOG. 121(5):707-713. 1975

2. RB Ness, et al. Effectiveness of treatment strategies of some women with pelvic inflammatory disease: a randomized trial. Obstet Gynecol. 106(3):573-80. 2005.

Cost

1. Rein DB, et al. Direct medical cost of pelvic inflammatory disease and its sequelae: decreasing, but still substantial. Obstet Gynecol. 95(3):397-402. 2000.

Episode 2 - Opioids and Physicians

Opioid addiction has a profound impact on many aspects of society. In this episode we examine the ways that doctors and other practitioners contribute to the epidemic and how we can be part of the solution.

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Links

1. Opioid Abuse in Chronic Pain — Misconceptions and Mitigation Strategies

2. CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016

3. Abuse-Deterrent Formulations and the Prescription Opioid Abuse Epidemic in the United StatesLessons Learned From OxyContin

4. Impact of a Mandatory Prescription Drug Monitoring Program on Prescription of Opioid Analgesics by Dentists

5. A Joint Statement From 21 Health Organizations and the Drug Enforcement Administration. Promoting pain relief and preventing abuse of pain medications: A critical balancing act.

6. Primary Care Physicians’ Knowledge And Attitudes Regarding Prescription Opioid Abuse and Diversion

Episode 1 - Opioids and Pregnancy

Opioid Addiction has a profound impact on many aspects of society, including pregnancy. In this episode we delve into the history, pharmacology, effects, and treatment of opioid abuse with special consideration to its effects on pregnancy.