ISSN:1040-872X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The adolescent pregnancy rate has decreased throughout the USA. However, compared with other industrialized countries, US rates remain high. Efforts to decrease the number of teenage pregnancies are centered on sex education, postponing sexual activity, and safe sex practices.

ISSN:1040-872X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

There is an increasing awareness of physical and sexual abuse against women and children. However, standardization of research is needed in order to facilitate comparison among studies on abuse. Most of the research has focused on prevalence, incidence and causes of domestic violence, family violence, and physical and sexual abuse. There is also a need to evaluate the effect of different intervention programmes. It is important that the education system, the health sector and the judicial system are motivated to recognize that they have not only the opportunity, but also the responsibility to take action against physical and sexual abuse. A multidisciplinary and multiagency perspective is needed in approaching this issue. All of us, especially educators and clinicians, are in a position to address abuse, and ultimately to reduce violence in our society. Abuse is everyone's business.

ISSN:1040-872X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Optimal management of HIV infection in pregnancy requires maternal use of potent antiretroviral therapy to prevent disease progression in the mother and vertical transmission to the newborn. Combination antiretroviral therapy substantially reduces the risk of perinatal HIV transmission and appears to be more effective than zidovudine monotherapy. The administration of single dose nevirapine to mother intrapartum and infant postpartum effectively reduces vertical HIV transmission and is less costly and cumbersome than zidovudine regimens. Elective cesarean section reduces vertical transmission of HIV but its benefit is less clear when antiretroviral therapy decreases maternal plasma HIV viral load to low levels at delivery. If possible, HIV-infected mothers should avoid breastfeeding. The present review discusses the importance of early identification of maternal HIV infection, strict adherence to combination antiretroviral regimens to prevent drug resistance, developing a better understanding of antiretroviral pharmacokinetics in pregnancy and short/long term safety of anti-HIV drugs.

ISSN:1040-872X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

This review addresses recent publications that investigate etiology, epidemiology and different modalities in diagnosis and therapy for ectopic pregnancy. A significant proportion of recent work has focused in the development of new diagnostic tools to aid in the early detection of ectopic pregnancy. Diagnostic modalities have included systemic and local markers, vascular endothelial growth factor, vascular cell adhesion molecule-1, urokinase plasminogen activator receptor, cervical fetal fibronectin, and hormonal level determinations. In addition, magnetic resonance imaging, ultrasonography, color flow mapping and endometrial thickness have been evaluated. New studies have investigated controversial issues related to the cost of the medical versus surgical treatment and the use of different medications and techniques for the management of ectopic pregnancy. Most important of all, several lines of investigation have addressed the use of human chorionic gonadotropin, algorithms, and scoring systems as prognostic indicators of successful therapy and to determine the risk of complications. The management of cervical, interstitial and heterotopic pregnancy is evaluated in this review and a summary of recent proposed diagnostic tools and concepts in management is also presented.

ISSN:1040-872X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

This review summarizes the recent literature examining the relationship between endometriosis and infertility. It is clear that the advanced stage of the disease and the mechanical disruption of the pelvic anatomy may cause infertility. The link between early stage endometriosis and infertility remains a source of controversy. Management plans must be individualized contingent upon the stage of disease, the age of the patient and the duration of infertility. The preponderance of data suggests that ablative therapy at the time of laparoscopy is as good as, or superior to expectant or medical therapy. With the exception of IVF/ET, ovarian suppression with GnRH agonists is not warranted in endometriosis-associated infertility. Controlled ovarian hyperstimulation with IUI is appropriate therapy in women with minimal-to-mild and surgically corrected endometriosis.

ISSN:1040-872X    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1040-872X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The present review describes the neuronal innervation of the external urethral and anal sphincters. A knowledge of this innervation helps in understanding the clinical symptoms of urinary and anorectal pathology, and in choosing the appropriate technique of nerve localization or block. An ability to locate the pudendal nerve, on the basis of surgically documented anatomy, has important diagnostic and therapeutic advantages. It can be used to study the integrity of pelvic floor muscles, in biofeedback training, nerve blocks, pudendal canal decompression, chronic stimulation trials to treat urinary or faecal incontinence, and in nerve conduction studies or evoked potential recordings. Furthermore, the superficial location of the sphincteric innervation in the perineum and ischiorectal fossa renders the nerve branches susceptible to injury during operative correction of urinary or faecal incontinence. Supported by a knowledge of anatomy, we can make firm recommendations on which to base safe surgical techniques that avoid damage to urethral and anal sphincteric innervation.

ISSN:1040-872X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Pelvic organ prolapse is a common worldwide problem. Recent advances in our understanding of its pathophysiology, along with progress made in the evaluation and treatment of pelvic support defects, are discussed. Although the pathophysiology of this condition is still not completely understood, genetic factors and environmental factors are involved. Understanding these factors better will help us to approach treatment of pelvic organ prolapse in a more logical manner. Multiple surgical techniques are available for pelvic relaxation, with a wide range of success rates ranging from 77 to 97% for various procedures. New techniques need to be studied further before being incorporated into routine practice. Better standardization of evaluation methods can help in such clinical studies.

ISSN:1040-872X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Despite being described over 80 years ago, interstitial cystitis remains a disease of undetermined aetiology and poor treatment outcomes. Generally agreed diagnostic criteria of this condition, which occurs primarily in females, are frequency, urgency and pain, a low-capacity hypersensitive bladder, and mucosal haemorrhages and tearing on bladder distention. Although current theories of pathophysiology are predominantly conjecture, important elements of the disease process are increased afferent and efferent neuronal activity, an excess of inflammatory mediators, increased epithelial permeability and possibly reduced bladder vascularity. Improved treatment outcome will follow a better understanding of pathophysiology.

ISSN:1040-872X    

出版商:OVID    

年代:2000

数据来源: OVID