Medscape women's health最新文献_第7页

Managing clinical complexities of long-term contraception. 管理长期避孕的临床复杂性。

Medscape women's health Pub Date : 1998-01-01

L Borgatta

{"title":"Managing clinical complexities of long-term contraception.","authors":"L Borgatta","doi":"","DOIUrl":"","url":null,"abstract":"The 3 methods of long-term contraception (LTC) approved for use in the US are intrauterine devices (IUDs), levonorgestrel subdermal implants, and sustained-release medroxyprogesterone acetate injections. Women who use reversible LTC are likely to receive care from clinicians who did not prescribe the method of contraception originally. Fortunately, most concerns arising from the use of reversible LTC can be managed by clinicians regardless of their specialty. Problems associated with an IUD can include a missing string, partial expulsion of the device, change in menstrual pattern, vaginal discharge, or infection. Headaches, weight gain, dermatologic problems, changes in hair growth, and irregularities in menses are among the problems that clinicians may confront while caring for a woman who has had subdermal hormone implants or has been taking depot injections. Besides the problems caused by or complicating specific methods of LTC, a woman may seek clinical care for a variety of general concerns. These include a desire to terminate LTC in order to become pregnant, and physical changes that are suspected to indicate pregnancy or contraceptive failure. In addition, general health conditions such as concurrent medications, hypertension, and endocrine disorders may need special consideration in a woman using LTC. There are few medical indications for discontinuing or changing LTC, even when intercurrent illnesses arise.","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"3 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20647278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gynecology case challenge: vaginal bleeding in a woman taking an injectable contraceptive. 妇科病例挑战:服用注射避孕药的妇女阴道出血。

Medscape women's health Pub Date : 1998-01-01

D A Hill

引用次数: 0

Perspective on women's health: editors' 1997-1998 year in review. 妇女健康展望:1997-1998年编辑回顾。

Medscape women's health Pub Date : 1998-01-01

K M Freund, J G Pastorek

{"title":"Perspective on women's health: editors' 1997-1998 year in review.","authors":"K M Freund, J G Pastorek","doi":"","DOIUrl":"","url":null,"abstract":"Heart disease, breast cancer, and hormone therapy were top clinical concerns in women's health in 1997. One of the major reports on heart disease confirmed that women are no different from men in terms of early infarct-related artery patency rates, reocclusion after thrombolytic therapy, and ventricular functional response to injury/reperfusion; nevertheless, women have 3 times the mortality of men in the first 30 days after an acute myocardial infarction. Research brought only modest gains in the understanding of breast cancer etiology in 1997, but engendered major debate on whether women younger than 50 years should have mammograms every 1 to 2 years. A National Institutes of Health consensus conference said no, but the National Cancer Institute's National Cancer Advisory Board said yes. Evidence of estrogen benefits and risks mounted: One report added to the data suggesting that estrogen may retard age-related memory loss, while another study reported that the risk of breast cancer significantly increased with long-term use of estrogens. The interest in selective estrogen receptor modulators (SERMs), also called \"designer estrogens,\" grew. Efforts to develop pharmacologic treatment for obesity suffered a setback in 1997 when a team reported that 1 in 3 patients who used d-fenfluramine developed abnormal valvular thickening, with the most severe cases needing valve replacement. One of the most promising events in colorectal cancer, the third most common cancer in women, was the set of screening guidelines issued by the Agency for Health Care Policy and Research. The year ended with major ethical debates about multiple gestation and cloning.","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"3 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20647153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recognizing and treating syphilis in pregnancy. 妊娠期梅毒的识别与治疗。

Medscape women's health Pub Date : 1998-01-01

J A Larkin, L Lit, J Toney, J A Haley

{"title":"Recognizing and treating syphilis in pregnancy.","authors":"J A Larkin, L Lit, J Toney, J A Haley","doi":"","DOIUrl":"","url":null,"abstract":"The number of primary and secondary syphilis cases in young women rose dramatically in the late 1980s and early 1990s, due to illicit drug use and the exchange of drugs for sex. Of infants born to mothers with primary or secondary syphilis, up to 50% will be premature, stillborn, or die in the neonatal period; further, most of these children are born with congenital disease that may not be apparent for years. While appropriate treatment of the pregnant female can prevent congenital syphilis, the major deterrent has been the inability to effectively identify these women and get them to undergo treatment. In determining a penicillin regimen, the clinician must consider the stage of maternal infection, the length of fetal exposure, and physiologic changes in pregnancy that can affect the pharmacokinetics of antibiotics. Treatment decisions may be further complicated in patients who are allergic to penicillin or infected with HIV. The pathogenesis of congenital syphilis is not completely understood, but placental invasion is the presumed major route. All women should be screened for syphilis with a nontreponemal test (eg, rapid plasma reagin [RPR] or venereal disease research laboratory [VDRL] test) in the first trimester. Those at high risk should be retested at 28 weeks and near delivery. Even with appropriate treatment of syphilis during pregnancy, fetal infection may still occur in up to 14% of cases. Treating syphilis during pregnancy can be difficult due to physiologic changes that can alter drug levels and the risk that drugs will induce uterine contractions or compromise the health of the fetus. While there are added risks and potential complications, treatment regimens parallel those in nonpregnant women.","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"3 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20647282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinician's Photo Guide To Recognizing and Treating Skin Diseases in Women: Part 2. Pregnancy-Related Dermatoses. 临床医生的照片指南识别和治疗皮肤病的妇女:第2部分。与怀孕有关的皮肤病。

Medscape women's health Pub Date : 1997-12-01

Goh

{"title":"Clinician's Photo Guide To Recognizing and Treating Skin Diseases in Women: Part 2. Pregnancy-Related Dermatoses.","authors":"Goh","doi":"","DOIUrl":"","url":null,"abstract":"This report identifies 4 pregnancy-induced dermatoses: (1) pemphigoid gestationis, (2) polymorphic eruption of pregnancy, (3) prurigo of pregnancy, and (4) pruritic folliculitis of pregnancy. According to 1 study of 3192 pregnancies, 0.06% of the women had pemphigoid gestationis (PG), 0.5% had polymorphic eruption of pregnancy (PEP), 0.2% had prurigo of pregnancy (PP), and 0.03% had pruritic folliculitis of pregnancy (PFP). Some reports have suggested an increased risk of fetal morbidity and mortality, as well as an increased risk of premature births, among women with PG. The incidence of fetal morbidity and mortality for the other dermatoses of pregnancy appears to be similar to that in normal pregnancies. Among the drugs used in dermatology, isotretinoin and antineoplastic agents, such as methotrexate, are 2 types that present high risk during pregnancy. Antipruritic medications, such as trimeprazine and doxepin, and some nonsteroidal anti-inflammatory agents, such as indomethacin, also should be avoided during pregnancy and lactation. Analgesics, including acetaminophen, are associated with minimal risk to the fetus or infant. Use of topical corticosteroids is associated with a low risk during pregnancy. Fortunately, many dermatologic disorders allow deferral of treatment or alternate therapeutic methods during pregnancy.","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"2 12","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"1997-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20660849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cervical Cancer Prevention: Toward Cost-Effective Screening. 子宫颈癌预防:迈向具有成本效益的筛查。

Medscape women's health Pub Date : 1997-12-01

McMeekin, McGonigle, Vasilev

{"title":"Cervical Cancer Prevention: Toward Cost-Effective Screening.","authors":"McMeekin, McGonigle, Vasilev","doi":"","DOIUrl":"","url":null,"abstract":"The decrease in the incidence of invasive cervical cancer has been credited to the widespread use of Papanicolaou (Pap) smear screening. Although relatively inexpensive to perform, Pap smears, if positive, often result in further diagnostic work-up (eg, colposcopy, biopsy, endocervical curettage) and associated patient anxiety. Unfortunately, false positives are frequent with Pap smears, and even screened populations of patients continue to have a significant incidence of cervical cancer. Presumably, expanding screening programs to unscreened populations or screening selected, at-risk populations more frequently could further reduce the incidence of invasive cervical cancer. Yet, few rigorous, prospective studies exist to allow for the formulation of cost-effective guidelines that optimize screening resources. To determine just how much screening is cost-effective, the medical community will have to answer several questions regarding the definition of cost-effectiveness itself, the optimal age to begin screening, whether abnormal Pap smears can be better stratified according to risk, the limitations of Pap smear screening, and whether advances in technology can help increase the positive predictive value of current screening strategies.","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"2 12","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"1997-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20660846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinician's Photo Guide To Recognizing and Treating Skin Diseases in Women: Part 1. Dermatoses Not Linked to Pregnancy. 临床医生的照片指南识别和治疗皮肤病的妇女:第1部分。与怀孕无关的皮肤病。

Medscape women's health Pub Date : 1997-12-01

Goh

引用次数: 0

Periareolar Breast Abscess: Redefining the Disease and Its Treatment. 乳晕周围乳房脓肿:重新定义疾病及其治疗。

Medscape women's health Pub Date : 1997-12-01

Finck, Meguid, Numann, Oler

引用次数: 0

A 35-Year-Old Asymptomatic Woman With ASCUS on Pap Report. 一名35岁无症状ASCUS女性巴氏涂片报告。

Medscape women's health Pub Date : 1997-12-01

Dembitzer