Page 7 – Womens Health Polylang

This review focuses on the interrelationships between common psychiatric illnesses and the course of pregnancy, postpartum, and breastfeeding. Within the life cycle context, the impact of childbearing on existing disorders or vulnerabilities in the female patient is of primary interest, as well as episodes that are etiologically related to childbearing. Treatment considerations for psychiatric disorders during childbearing invoke special modifications of the risk-benefit decision-making process. Mental health is fundamental to health. For the pregnant woman, the capacity to function optimally, enjoy relationships, manage the pregnancy, and prepare for the infant’s birth is critical. Perinatal health can be conceptualized within a model that integrates the complex social, psychological, behavioral, environmental, and biologic forces that shape pregnancy. Unipolar and bipolar mood disorders, which are common in pregnant and postpartum women, deserve the attention of obstetric providers. Procedures to identify those at risk should begin in pregnancy if not in the preconceptional period.

Urodynamic Assessment: Patient Evaluation & Equipment

February 9, 2009

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An overall perspective of the urodynamic assessment and have a basic understanding of the principles involved and what to be done looking for with different patient populations. It gives an overview of the procedures to assist healthcare providers in conducting urodynamic assessment. Obtaining a good medical history, concentrating on urologic complaints, is critical to do before embarking on urodynamic assessment. Urodynamics encompasses all the diagnostic modalities used in the evaluation of bladder and urethral function. It describes a number of complimentary tests of varying degrees of complexity that can be performed individually or in combination depending on the clinical circumstances. It has improved our ability to select therapy that addresses the underlying pathophysiology in a rational way. Advances in urodynamics and video-urodynamics has improved our understanding of the normal and abnormal functions of the bladder and sphincter.

The Ethical Concept of the Fetus as a Patient

March 12, 2009

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Ethics is an essential dimension of obstetrical practice. In this paper, authors have developed a framework for clinical judgment and decision-making about the ethical dimensions of the obstetrician-patient relationship. Authors emphasize a preventive ethics approach that appreciates the potential for ethical conflict and adopts ethically justified strategies to prevent those conflicts from occurring. First defined are ethics, medical ethics, and the fundamental ethical principles of medical ethics, beneficence and respect for autonomy. Authors then show how these two principles should interact in obstetric judgment and practice, with emphasis on the core concept of the fetus as a patient.

Cervical Cancer: Early Detection and Prevention

June 24, 2009

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Worldwide, cervical cancer is the second most common malignancy in women and a major cause of morbidity and mortality. Cervical cancer is gender-specific disease that disproportionately affects women in the lowest socioeconomic classes throughout the world. In 2004, the 57th World Health Assembly adopted World Health Organization’s global reproductive health strategy, which identified five priority areas including “combating sexually transmitted infections”; the strategy also specifically addressed cervical cancer prevention. Screening programs have successfully reduced disease rates in developed countries that support cytology-based services; these services are too complex for most developing countries to implement. Many important advances have also taken place in the diagnosis and treatment of cervical cancer. This review also defines the strategies for diagnosis and management of abnormal cervical cytology and histology. These strategies reflect new information concerning the natural history of cervical carcinogenesis and the performance of screening and diagnostic tests. The most important component in the management of cervical cancer will always be primary prevention.

Toxic Shock Syndrome

September 23, 2009

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Toxic shock syndrome (TSS) was first described in children in 1978 but was quickly identified as an illness occurring primarily in menstruating women 12-24 years of age. During the 1979-1981 epidemic, tampon users were demonstrated to be 18 times more likely to develop menstrual TSS than non-users. Recent focus has shifted in conjunction with wound infections, postpartum endometritis and vaginitis; the predominance of cases continues to be related to menstruation. The purpose of this document is to understand the pathogenesis of toxic shock syndrome (TSS), clinical picture, early diagnosis and the latest advances in treatment. Of the approximately 30 million menstruating women in USA, it is estimated that 70% use tampons and over 50% of those use super-absorbent types. Almost 1,000,000 women are at theoretic risk. The incidence in menstruating women is now 6-7: 100,000 annually. The incidence on non-menstrual disease has shown only a slight increase in the past 10 years.

Health Care: Who Should Pay For What?

December 7, 2009

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Today, maternal, newborn and child health are no longer discussed in purely technical terms, but as part of a broader agenda of universal access. We must spare no effort to find financing solutions which work for rich and poor countries alike because a population’s good health is one of a country’s most precious assets. As the reform of health care systems progresses, countries are searching for a balance between the financial benefits of a competitive health care market, and the need for fairness in sharing the burden of treatment costs. Differences between countries mean that no single model of health care financing will apply everywhere; principles must be adapted to the specific local context. The key to moving towards universal access and financial protection is the organization of financing. Current government expenditure and international flows cannot guarantee universal access and financial protection, because they are insufficient and because they are too unpredictable. Better health through better use of resources.

Depression During Pregnancy

June 28, 2011

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Even though pregnancy is a period of emotional well-being, in some women, when pregnant, experience their first depressive episode, whereas others, with a history of depression, are at risk for its recurrence, suggesting that pregnant women show the same risk for depression as other women of child-bearing age. The purpose of this document is to address the maternal and neonatal risks of both depression and antidepressant medication exposure. It focuses on periconceptional and antenatal management. For the pregnant woman, the capacity to function optimally, enjoy relationships, manage pregnancy, and prepare for the infant’s birth is critical. Perinatal health can be conceptualized within a model that integrates the complex social, psychological, behavioral, environmental and biologic forces that shape pregnancy. Antenatal depression affects the health and well-being of the mother, baby, and family. Early identification and management of depressive symptoms in pregnant women may improve their sense of well-being.

Human Trafficking and Exploitation

September 19, 2014

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Today, some label human trafficking as a form of “modern day slavery,” and frequently, human trafficking has been linked to sex work and prostitution, although there are other forms of trafficking, such as forced labor and domestic work. Human trafficking can involve women, men, and children. Human trafficking is one of the worst abuses of human rights. Because the roots of human trafficking are multifaceted, no one solution exists to eliminate this problem. Unfortunately, as the problem grows, healthcare practitioners will be confronted with the issue in their patient populations. Practitioners should be committed to the collaboration amongst disciplines to address poverty, racism, discrimination, and oppression in order to reduce the vulnerable positions of human trafficking victims and their families. Because of the social justice component in the codes of ethics of professionals such as physicians, nurses, social workers, psychologists, and counselors, all practitioners can play a key role in the individual, community, and systemic levels to help address this gross abuse of power. One way to begin is to educate oneself and one’s respective disciplines about the global nature of human trafficking and the complex dynamics of the problem. This information is presented with the intention of educating health care providers on the long-term medical needs of survivors and on how they can establish a healthcare clinic in their communities. We encourage healthcare providers across the globe to evaluate local trafficking populations care needs and attempt to provide trauma-informed care to these patients. For individuals who are interested in creating such services in their community, a list of steps to guide this process are provided.

Urodynamic Assessment: Techniques

February 9, 2009

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Addressing the various technical aspects, controversies and techniques for performing cystometry. Cystometry (CMG) has been described as the reflex hammer of the urodynamicist. It is not only the method by which the pressure/volume relationship of the bladder is measured, but it is also an interactive process that permits examination of motor and sensory function. The International Continence Society (ICS) had defined certain terms that are used in the reporting of cystometric results.

Cervical Carcinomas: Diagnosis and Management

June 24, 2009

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Globally, cervical cancer is a major health problem, with a yearly incidence of 371,000 cases and an annual death rate of 190,000. 78% of cases occur in developing countries where cervical cancer is the second most frequent cause of cancer-related death in women. Invasive cervical carcinoma, once the most common reproductive-tract cancer in the United States, has recently fallen to the rank of third most common. The purpose of this document is to describe staging criteria and treatment for cervical carcinoma. For practical purposes, it will focus on the squamous and adenocarcinoma histologies only. In addition, new evidence has documented conclusively that survival rates for women with cervical cancer improve when radiotherapy is combined with cisplatin-based chemotherapy in advanced cases.