American family physician
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Hair loss is a common problem that may affect both males and females in all age groups. Although androgenetic alopecia (common baldness) is the most frequently occurring type of hair loss, hair loss can result from a variety of local and systemic conditions. ⋯ Treatment is focused on removing the cause of secondary hair loss, patient education and specific interventions for individual types of alopecia. All treatment strategies should address the significant cosmetic and psychologic impact of hair loss.
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Near-drowning and drowning are major causes of neurologic injury and death in young persons. Most victims aspirate water, and pulmonary edema develops in many of these cases. Prolonged submersion causes cerebral asphyxia and adversely affects the brain within five minutes. ⋯ Prehospital advanced cardiac life support with tracheal intubation is indicated in patients with severe injuries. On arrival at the hospital, ventilation with continuous positive airway pressure or positive end-expiratory pressure enhances pulmonary function. Many water submersion accidents are avoidable; close supervision of infants and toddlers, installation of a fence around home swimming pools, and abstinence from alcohol during participation in water sports are some practical precautions.
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The process of identifying and evaluating the common causes of vaginal bleeding during pregnancy changes as the pregnancy progresses to term. The most common identifiable causes of vaginal bleeding during early pregnancy include spontaneous abortion and ectopic pregnancy. Pelvic ultrasound and quantitative beta-human chorionic gonadotropin measurements are used in the evaluation of early-stage bleeding in pregnancy. ⋯ Patients with placental abruption may present with abdominal pain and bleeding. As pregnancy progresses to term, bloody show must be considered as a common source of bleeding. Vaginal and cervical lesions can cause vaginal bleeding in any stage of pregnancy.
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American family physician · Feb 1995
Review Comparative StudyPreventing cervical cancer: the role of the Bethesda system.
The Papanicolaou smear is a well-established component of preventive health protocols for women. The purpose of this screening tool is to detect precursor lesions of invasive cervical carcinoma; however, the natural progression of these lesions is unclear, and it currently is not possible to determine which of the many dysplastic findings have carcinogenic potential. ⋯ The Bethesda system of cytopathologic reporting (introduced in 1988 and revised in 1991) is designed to improve communication between pathologists and clinicians. Compared with other taxonomies, the Bethesda system allows for distinction between changes associated with inflammation and infection and those reflecting squamous cell atypia and dysplasia.