Managing women with a previous diagnosis of endometriosis

2006 ◽  
Vol 12 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Christine Bain
Keyword(s):  
Decision Making ◽  
Hormone Replacement Therapy ◽  
Surgical Treatment ◽  
Clinical Decision Making ◽  
Hormone Replacement ◽  
Management Strategies ◽  
Clinical Decision ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Previous Diagnosis

Endometriosis is an estrogen-dependent condition that primarily inflicts women of reproductive age. There are several gradations of the disease and its extent does not always signify its symptomatic presentation. In those women who have long suffered from endometriosis, previous treatments and their assumed success influence clinical decision making on the use of hormone replacement therapy after menopause. This review considers the management strategies for those women who have become prematurely menopausal after extensive surgical treatment for endometriosis.

scholarly journals Changes of lipids exchange in the postmenopausal women

2003 ◽  
Vol 52 (2) ◽  
pp. 116-121
Author(s):  
Е. Y. Maichuck ◽  
S. V. Yureneva ◽  
O. А. Vasilevitskaya
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Hormone Replacement Therapy ◽  
Ovarian Function ◽  
Hormone Replacement ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Lipids And Lipoproteins ◽  
Timely Administration

The results of large studies have shown that women with the onset of menopause significantly increase the risk of developing cardiovascular disease. This is associated with the loss of the cardioprotective effect of estrogens and the formation of the so-called menopausal metabolic syndrome, which includes changes in the metabolism of lipids and lipoproteins, insulin and carbohydrates, as well as hemostasis and fibrinolysis. Simultaneous shutdown of ovarian function in women of reproductive age after total oophorectomy causes the early development of delayed climacteric disorders, including cardiovascular diseases. Timely administration of hormone replacement therapy can prevent the development of adverse metabolic changes and reduce cardiovascular risk.

scholarly journals The biceps challenge - an experimental approach to the anterior shoulder pain, indicating a new treatment logarithm

2019 ◽  
Author(s):  
Kristian Sørland Humborstad ◽  
Jonn Terje Geitung
Keyword(s):  
Decision Making ◽  
Experimental Study ◽  
Surgical Treatment ◽  
Shoulder Pain ◽  
Structural Changes ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
7 Tesla ◽  
Antiinflammatory Drugs ◽  
Anterior Shoulder Pain

Abstract Abstract Background The biceps muscle’s long head (LHB) with its tendon and origin represents the most important cause of anterior shoulder pain. Conservative treatments (non-steroid antiinflammatory drugs, injections with steroids and physiotherapy) will normally be the first line of treatment. Long-standing pain will usually lead to surgical treatment with either tenodesis or tenotomy as alternative procedures. The main aim of our investigation was to find structural changes that may change the surgical treatment logarithm in these patients. Secondary aims were 1) to see if experimental settings would better visualize such changes on MRI, and correlate this to histological examinations. 2) to see if visualized changes to histology and MRI would have significant correlations to clinical findings and surgical practice. Methods The patients were evaluated at 1) the first outpatient contacts with the orthopedic surgeon, 2) pre-operative 1.5-Tesla MRI, 3) per-op findings with arthroscopy, 4) experimental 7-Tesla MRI, and 5) histology with standard H+E-staining. Findings Our experimental study showed that all the degenerative changes in the LHB-tendon were in the intraarticular part of the tendon, not in the intertubercular sulcus part (shown clearly at the experimental work). None of the preoperative 1.5 Tesla MRI helped us in the clinical decision-making. We did also construct a grading system of peroperative evaluation of the LHB-tendon degeneration that will be useful in clinical decision-making. Interpretation Our experimental study showed a pathological-anatomical correlate to the anterior shoulder pain. In our opinion, it is important to remove the degenerated intraarticular part of the tendon, this in order to avoid postoperative inflammation, pain and prolonged sick leave. A subpectoral biceps tenodesis with removal of the proximal part of the tendon is accordingly the treatment of choice in these patients.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

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