American family physician
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Chronic pelvic pain in women may involve more than the gynecologic organ systems. Urologic, gastrointestinal, musculoskeletal and psychiatric disease processes may be contributing factors, the majority of which can be treated medically. A thorough history and physical examination are often all that is necessary to initiate effective treatment. A multidisciplinary approach to management will recognize the interactive process of the biopsychosocial model that may act to produce chronic pelvic pain.
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Although thrombolytic therapy is used in a variety of settings, it has gained the most prominence in the treatment of myocardial infarction. The effectiveness of thrombolytic agents in reducing mortality in patients who present with myocardial infarction has been clearly demonstrated by large-scale studies. ⋯ It is now recommended that all patients who have appropriate electrocardiographic changes and present within 12 hours of the onset of acute myocardial infarction be considered for thrombolytic therapy. Factors such as age and history of previous myocardial infarction are no longer viewed as barriers to treatment.