Medscape women's health最新文献_第9页

Innovations in Breast Imaging: How Ultrasound Can Enhance the Early Detection of Breast Cancer. 乳腺成像的创新:超声如何增强乳腺癌的早期检测。

Medscape women's health Pub Date : 1997-07-01

Sabel, Staren

引用次数: 0

Perinatal Thyroid Dysfunction: Prenatal Diagnosis and Treatment. 围产期甲状腺功能障碍:产前诊断与治疗。

Medscape women's health Pub Date : 1997-07-01

Mestman

{"title":"Perinatal Thyroid Dysfunction: Prenatal Diagnosis and Treatment.","authors":"Mestman","doi":"","DOIUrl":"","url":null,"abstract":"Thyroid diseases affect up to 10% of women, but most respond well to treatment. During pregnancy, however, normal metabolic changes may obscure pathology, and improper management may harm the fetus. Tests for levels of thyroid stimulating hormone (TSH), free thyroxine, and free triiodothyronine are essential. Generally, high TSH values suggest primary hypothyroidism, while suppressed levels indicate hyperthyroidism. Hyperthyroidism is commonly manifested by goiter, ophthalmopathy, proximal muscle weakness, tachycardia, and weight loss or inability to gain weight. Among women, the most common etiology of thyroid disease is thyroid autoimmunity (Graves' disease or Hashimoto's thyroiditis); affected women are at an increased risk of postpartum thyroid dysfunction. Women who have Graves' disease diagnosed during pregnancy typically have a history of hyperthyroidism symptoms antedating conception, and occasionally thyroid stimulating immunoglobulins may be elevated enough to induce fetal hyperthyroidism. Women with Hashimoto's thyroiditis typically are euthyroid but may be hypothyroid with diffuse goiter; diagnosis is confirmed by elevated levels of antithyroid peroxidase antibodies or antimicrosomal antibodies. Other forms of thyroid dysfunction include benign or malignant nodules and hyperemesis gravidarum. Hypothyroidism typically is treated with levothyroxine. Hyperthyroidism is treated with antithyroid drugs. The goal is to avoid overdosage of medication, which could cause goiter and/or hypothyroidism in the fetus.","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"2 7","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"1997-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20660560","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 - Progressive Pelvic Pain in a Young Nulliparous Female. 妇科病例挑战-进行性骨盆疼痛在一个年轻的未生育女性。

Medscape women's health Pub Date : 1997-06-01

Hill

引用次数: 0

Cervical Carcinoma in Pregnancy: Assessing the Diagnostic and Therapeutic Options. 妊娠期宫颈癌:评估诊断和治疗方案。

Medscape women's health Pub Date : 1997-06-01

Abu-Rustum, Jones

{"title":"Cervical Carcinoma in Pregnancy: Assessing the Diagnostic and Therapeutic Options.","authors":"Abu-Rustum, Jones","doi":"","DOIUrl":"","url":null,"abstract":"Invasive cervical cancer is an infrequent complication of pregnancy, but it remains a significant cause of morbidity worldwide. When cervical cancer is suspected or diagnosed during pregnancy, the clinician must confront the potential risk to both the mother and the fetus. Due to the relative infrequency of this condition, guidelines for management are not clearly defined. Over the last several years, some investigators have reported on and advocated a more conservative approach to the management of this disease. This report assesses the recent literature on the evaluation and management options of invasive cervical cancer detected during pregnancy. Although delay of therapy may allow for maturation of the fetus, the data are currently insufficient to recommend a prolonged delay in treatment of the pregnant woman for advanced or even stage I disease. However, the available literature regarding a carefully planned, brief delay in therapy is encouraging, and all options should be presented to the patient. Ultimately, the management of invasive cervical cancer during pregnancy requires collaboration on the part of the patient, her family, and the entire multidisciplinary health care team, including the obstetrician, neonatologist, gynecologic oncologist, radiation oncologist, and social and psychiatric support personnel.","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"2 6","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"1997-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20660557","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

Examining the Complex Relationship of Human Papillomavirus to Cervical Dysplasia and Carcinoma. 探讨人乳头瘤病毒与宫颈发育不良和宫颈癌的复杂关系。

Medscape women's health Pub Date : 1997-06-01

Montero, Larkin, Houston, Toney

{"title":"Examining the Complex Relationship of Human Papillomavirus to Cervical Dysplasia and Carcinoma.","authors":"Montero, Larkin, Houston, Toney","doi":"","DOIUrl":"","url":null,"abstract":"Human papillomavirus (HPV) infection is quite common in women and is clearly the major risk factor for cervical intraepithelial neoplasia and invasive cervical cancer. HPV DNA has been detected in 80% to 90% of CIN 3 lesions and invasive cervical cancers. While the most common presentation is warts, or condylomata, many infections are detected only by Pap smear cytologic evidence. We still do not have a clear understanding of HPV latency, reactivation, subclinical infection without apparent disease, and the triggers or cofactors required for malignant transformation. More than 70 different strains of HPV have been identified, and specific subtypes have been associated with a greater risk of progression to dysplasia and cervical cancer. A better knowledge of the oncogenic mechanisms of HPV and improved diagnostic testing is critical to guide future therapeutic and preventive investigations. The Pap smear is used for initial screening; cytologic results suspicious for premalignancy or malignancy are subsequently evaluated by colposcopy and biopsy of suspicious lesions. Cervical cancer has been designated an AIDS-defining illness; in HIV-infected patients, the prevalence of HPV is 5 times that of the general population. Because the disease presents at a later stage in HIV-infected patients and is less responsive to treatment, close attention to timely Pap smears and appropriate follow-up is important in this population. Presently, early detection and aggressive treatment and follow-up of premalignant lesions offer the best approach to the prevention of cervical cancer.","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"2 6","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"1997-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20660555","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

Identifying Ultrasound Markers for Down Syndrome. 识别唐氏综合症的超声标记。

Medscape women's health Pub Date : 1997-06-01

Martin, Gardner, Rappaport

{"title":"Identifying Ultrasound Markers for Down Syndrome.","authors":"Martin, Gardner, Rappaport","doi":"","DOIUrl":"","url":null,"abstract":"Although the incidence of Down syndrome increases with advancing maternal age, the use of maternal age alone as a screening tool results in the identification of only about one third of the cases of fetal Down syndrome. Screening tools for Down syndrome (trisomy 21) have become more sensitive and specific during the last few years. The use of biochemical markers for the screening of patients with fetuses having chromosomal anomalies has become more widespread in the obstetric community. The triple-screen test uses maternal age plus serum alpha-fetoprotein, unconjugated estriol, and human chorionic gonadotropin levels to calculate a risk for fetal Down syndrome. Because as many as 11% to 35% of fetuses with chromosomal defects have anatomical characteristics that can be visualized on a detailed ultrasound evaluation, researchers are studying the usefulness of this imaging technique as a screening tool for Down syndrome. Ultrasound findings associated with trisomy 21 may be divided into 2 groups. The first group comprises the common major malformations associated with Down syndrome, such as duodenal atresia and cardiac disease. The second group comprises the ultrasound screening indicators, that is, anatomical malformations highly specific to Down syndrome. This group includes brachycephaly, mild ventriculomegaly, macroglossia, abnormal facies, nuchal edema, echogenic or hyperechoic bowel, pyelectasis, and shortening of the limbs. Although the diagnosis of chromosomal anomalies remains dependent on karyotyping, the use of ultrasound may limit the number of invasive procedures and allow for more accurate genetic counseling of the mother at risk for delivering an infant with Down syndrome.","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"2 6","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"1997-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20660556","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

Diagnosing and Managing Breast Disease During Pregnancy and Lactation. 妊娠和哺乳期乳腺疾病的诊断和管理。

Medscape women's health Pub Date : 1997-05-01

Scott-Conner

{"title":"Diagnosing and Managing Breast Disease During Pregnancy and Lactation.","authors":"Scott-Conner","doi":"","DOIUrl":"","url":null,"abstract":"Although carcinoma of the breast complicates 1:3000 deliveries in the US, most breast conditions unique to pregnancy and lactation are benign--for example, lactating adenoma, galactocele, gigantomastia, and benign bloody nipple discharge. Nevertheless, malignancy must be excluded by a thorough work-up, including breast biopsy if indicated; \"watchful waiting\" when a breast mass is discovered is no more appropriate than in a nonpregnant patient. During lactation, the major problems encountered often are part of a spectrum of inflammatory and infectious complications. Nasopharyngeal organisms from the infant are usually the source of breast infections in lactating women. Keeping the breast empty of milk promotes healing by helping to drain the culture medium that is facilitating growth of organisms. Hence, the earlier recommendations that breast-feeding cease during mastitis have been superseded by the knowledge that breast-feeding is generally not harmful to the infant and may speed resolution of the infectious process. The diagnosis and management of pregnancy-associated breast cancer (PABC) is reviewed. Pregnancy-associated masses are usually discovered by patient self-examination, and the clinician should proceed to fine-needle aspiration or biopsy, rather than mammography, which has poor sensitivity during pregnancy and lactation because of increased breast density. Management of a new breast mass in pregnancy should maximize diagnostic accuracy and minimize the chances of missing PABC, yet avoid harm to the fetus or interruption of lactation.","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"2 5","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"1997-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20660578","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

Genital Herpes: Treatment Guidelines. 生殖器疱疹:治疗指南。

Medscape women's health Pub Date : 1997-05-01

Woolley

引用次数: 0

Breast Cancer Imaging: Can Tc-99m Sestamibi Scintimammography Fit In? 乳腺癌成像:Tc-99m Sestamibi胶片摄影是否适用?

Medscape women's health Pub Date : 1997-04-01

Iraniha, Khalkhali, Cutrone, Diggles, Klein

{"title":"Breast Cancer Imaging: Can Tc-99m Sestamibi Scintimammography Fit In?","authors":"Iraniha, Khalkhali, Cutrone, Diggles, Klein","doi":"","DOIUrl":"","url":null,"abstract":"Mammography and physical examination are currently the most frequently used screening tests for breast cancer. Considering the 85% sensitivity associated with combined mammography and physical examination and a low positive predictive value of 20% to 30% for the diagnosis of breast carcinoma, there is a critical need for a more accurate noninvasive imaging test to improve the sensitivity and specificity of mammography. This study evaluates the role of Tc-99m sestamibi scintimammography as a complementary procedure to conventional mammography for the detection of breast carcinoma. A sample of 157 women (mean age 47.9 years +/- 10.2 years) with 164 lesions appropriate for histologic and cytologic analysis on the basis of suspicious findings on a mammogram and/or physical examination underwent scintimammography. Subsequently, excisional biopsy and/or fine-needle aspiration were performed. There were 52 primary cancers (8 different histopathologic types) and 112 benign breast lesions (6 different histopathologic types). The sensitivity of Tc-99m sestamibi scintimammography for detecting primary breast cancer was 92.3%, and its specificity was 87.5%. Percent-positive and -negative predictive values associated with Tc-99m sestamibi scintimammography in this cohort were 77.4% and 96.0%, respectively.","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"2 4","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"1997-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20660576","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

NIH Consensus Statement on Breast Cancer Screening for Women in Their 40s: How Will It Affect Patient Care? 美国国立卫生研究院关于40多岁女性乳腺癌筛查的共识声明:它将如何影响患者护理?

Medscape women's health Pub Date : 1997-04-01

Huey

{"title":"NIH Consensus Statement on Breast Cancer Screening for Women in Their 40s: How Will It Affect Patient Care?","authors":"Huey","doi":"","DOIUrl":"","url":null,"abstract":"It is generally accepted that breast cancer screening mammograms in women 50 years of age and older has saved lives. It also is generally accepted that the incidence of breast cancer in women younger than 40 is too small to warrant subjecting young women to the risks associated with mammograms. But whether women in the transition years from 40 to 49 should have routine screening mammograms has been debated for 2 decades. On January 23, the NIH Consensus Statement on Screening Mammograms for Women Ages 40 to 49 lit a powder keg when, after 2-and-a-half days of hearings and study, it announced \"The data do not support a universal recommendation that all women in their 40s should undergo screening mammography.\" Many experts have challenged the conclusion and advocated screening mammograms every 1 to 2 years starting at age 40. To sort out the impact of the NIH statement and determine where clinicians and consumers stand, Medscape launched its first on-line survey on January 30. Most Medscape responders agree that screening mammograms every 1 to 2 years should begin at age 40 and fear that third-party health care payers will use the conclusion of the NIH consensus panel to deny reimbursement for screening mammograms in women younger than 50 years of age.","PeriodicalId":79687,"journal":{"name":"Medscape women's health","volume":"2 4","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"1997-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20660575","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