Fear, misinformation, and pharmaceutical messianism in the promotion of compounded bioidentical hormone therapy.

Compounded bioidentical hormone therapy (cBHT) for menopausal symptoms maintains popularity in western countries despite the availability of hormone products in different formulations and dosages produced by pharmaceutical companies with federal oversight. Akin to many populist therapeutic trends in the history of medicine, cBHT advocates tend to capitalize on consumer fears about existing FDA-approved hormone treatments. Unsubstantiated, exaggerated, or outright false claims are commonplace in promoting cBHT. Given these elements, the basic elements of pharmaceutical messianism continue to drive the cBHT movement.

A comparison of preoperative and intraoperative evaluations for patients who undergo site-specific operation for the correction of pelvic organ prolapse.

OBJECTIVE: We compared preoperative and intraoperative assessments of pelvic organ prolapse to ascertain whether differences existed. STUDY DESIGN: This study is a retrospective analysis of information that was collected of 193 women who underwent reconstructive operation for pelvic organ prolapse between January 1994 and April 1999 by the senior author (B. L. S.) in this institution. Support for the urethra, bladder, cervix or vaginal cuff, cul-de-sac, and rectum were assessed with the Baden-Walker halfway system before and during the operations. RESULTS: Preoperative and intraoperative assessments were significantly correlated (Spearman rank order correlation, 0.85-0.94). A comparison of the assessments revealed significantly greater prolapse at the urethra, cervix/cuff, cul-de-sac, and rectum on intraoperative evaluation (P