Comprehensive therapy
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Comprehensive therapy · Jan 2005
ReviewNewer antidepressants and other nonhormonal agents for the treatment of hot flashes.
The reluctance to use estrogen in breast cancer survivors with hot flashes has extended to its use in healthy women since the 2002 publication of the Women's Health Initiative study. This article reviews the clinical development of nonhormonal agents as alternatives to hormonal therapy for the management of hot flashes.
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Intravenous fluid administration is critical to the care of hospitalized patients. Despite the lack of a clear consensus on fluid administration, one may use the principles in this article to develop an organized framework for patient care.
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Cultural influences are often more important in the elderly and help explain the influence of nonbiological factors underlying pain appraisal, expression, and folk treatments. Five main psychological theories that underlie these cultural influences help direct supportive interventions.
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Comprehensive therapy · Jan 2005
ReviewChronic pelvic pain in women: evaluation and management in primary care.
Chronic pelvic pain (CPP) in women is a common disorder, affecting as many as 15% of adult women, and often provides both a diagnostic and therapeutic challenge. Pain in CPP may originate directly from pelvic organs, or may be referred from more distant tissue sites. A comprehensive medical history and physical examination should include special attention to gynecological, urological, gastrointestinal, psychiatric, myofascial, and neuromuscular systems. ⋯ Laboratory tests, transvaginal ultrasound, and laparoscopy may identify serious disease or provide significant reassurance to patient. Specific surgical procedures for various conditions and pain relief measures are beneficial in selected patients. A sensitive physician who is willing to spend adequate time and coordinate care with specialists can markedly diminish the suffering of these patients.