Obstetrics and gynecology clinics of North America
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Abnormal and irregular bleeding are extremely common in the adolescent period and can be looked upon as a part of normal reproductive development. It is essential to have a firm grasp on the normal, physiologic development of the menstrual cycle. ⋯ It is important to recognize the distinct needs, goals, and developmental stages of adolescent patients. No single therapy or approach is universal in the diagnosis and treatment, but must be tailored to the needs of the individual adolescent and her situation.
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Obstet. Gynecol. Clin. North Am. · Mar 2003
ReviewNoninvasive diagnosis of endometriosis: the role of imaging and markers.
Endometriosis is defined by the presence of endometrial tissue outside the uterus. Clinical and basic research in endometriosis has been hampered severely by the lack of accurate noninvasive diagnostic techniques. ⋯ Endometriosis research has entered the postgenomic era, and powerful genomic and proteomic technology is being applied in the search for novel diagnostic and therapeutic approaches. This article explores the recent advances in imaging techniques and the development of diagnostic molecular markers of endometriosis.
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The primary care physician usually is the first person to see patients complaining of breast pain or nipple discharge. The diagnosis of lactational mastitis is evident because of the history The major consideration is prompt and effective treatment and close follow-up evaluation. ⋯ Any diagnosis of mastitis in a patient who is not lactating should be viewed with suspicion. Although several benign and non-life-threatening conditions have been discussed herein, inflammatory breast cancer must always be considered.
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The treatment of cancer pain is improving, but pain remains a significant problem. Although better analgesics with greater efficacy and fewer side effects are needed, the most significant problem regarding the appropriate management of cancer pain remains a lack of knowledge among physicians treating cancer patients. Cancer management should be undertaken within a palliative care model, in which autonomy and respect for individuals and their families guides all aspects of care.
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Urinary tract infections are relatively common in pregnancy and may result in significant morbidity for the pregnant woman and fetus. The authors recommend that all pregnant women be screened for the presence of bacteriuria at their first prenatal visit. ⋯ Women with acute pyelonephritis may sustain significant complications, such as preterm labor, transient renal failure, ARDS, sepsis and shock, and hematologic abnormalities. Pregnant women with urinary tract infections should be followed up closely after treatment because as many as one third will experience a recurrence.