RESUMO
All patients should be screened for a history of sexual abuse and victimization. Survivors of acute sexual assault have physical, psychological, and legal needs. The goal is to minimize additional trauma while simultaneously ensuring quality care and maximizing efforts to collect evidence. A pertinent history, physical examination, and treatment plan should be completed. Chain of custody needs to be maintained. The patient should be discharged with family or friends with appropriate follow-up.
Assuntos
Delitos Sexuais , Feminino , Humanos , Incidência , Delitos Sexuais/psicologia , Delitos Sexuais/estatística & dados numéricosRESUMO
OBJECTIVE: To report an unusual presentation of a patient with unicornuate uterus and a noncommunicating functional rudimentary horn and discuss related patient management issues. SETTING: University hospital. PATIENT: A 27-year-old woman who presented with cyclic abdominal pain after a postpartum tubal ligation. INTERVENTION: Diagnostic studies followed by a laparotomy and resection of the rudimentary horn. RESULTS: Resolution of patient's symptoms. CONCLUSIONS: Patients with a unicornuate uterus and a rudimentary horn recognized for the first time during a tubal ligation require individualized management depending in part on the precise nature of the horn.
Assuntos
Ductos Paramesonéfricos/anormalidades , Útero/anormalidades , Adulto , Feminino , Humanos , Dor/etiologia , Esterilização Tubária/efeitos adversosRESUMO
Hypnosis has many applications in the field of reproductive health care. This paper describes its use in the treatment of sexual dysfunction, urinary incontinence, chronic pelvic pain, hyperemesis gravidarum, and pain relief in labor and delivery. Four case reports are used for illustration. Misconceptions about the risks and benefits of hypnosis are discussed. Information about training for clinicians in hypnosis is described.
Assuntos
Ginecologia , Hipnose/métodos , Obstetrícia , Técnicas Reprodutivas , Adolescente , Adulto , Feminino , Humanos , MasculinoRESUMO
Human immunodeficiency virus type 1 (HIV-1) infection is highly specific for its human host. To study HIV-1 infection of the human nervous system, we have established a small animal model in which second-trimester (11 to 17.5 weeks) human fetal brain or neural retina is transplanted to the anterior chamber of the eye of immunosuppressed adult rats. The human xenografts vascularized, formed a blood-brain barrier, and differentiated, forming neurons and glia. The xenografts were infected with cell-free HIV-1 or with HIV-1-infected human monocytes. Analysis by polymerase chain reaction revealed HIV-1 sequences in DNA from xenograft tissue exposed to HIV-1 virions, and in situ hybridization demonstrated HIV-1 mRNA localized in macrophages and multinucleated giant cells. Pathological damage was observed only in neural xenografts containing HIV-1-infected human monocytes, supporting the hypothesis that these cells mediate neurotoxicity. This small animal model allows the study of direct and indirect effects of HIV-1 infection on developing human fetal neural tissues, and it should prove useful in evaluating antiviral therapies, which must ultimately target HIV-1 infection of the brain.
Assuntos
Complexo AIDS Demência/microbiologia , Infecções por HIV/patologia , Animais , Câmara Anterior , Sequência de Bases , Encéfalo/embriologia , DNA Viral/análise , Feto , Genes Virais , HIV-1/genética , Dados de Sequência Molecular , Hibridização de Ácido Nucleico , Oligodesoxirribonucleotídeos/química , Reação em Cadeia da Polimerase , Ratos , Retina , Transplante Heterólogo , Proteínas Estruturais Virais/genéticaRESUMO
A preliminary trial of oral delta-9-tetrahydrocannabinol (THC) demonstrated an analgesic effect of the drug in patients experiencing cancer pain. Placebo and 5, 10, 15, and 20 mg THC were administered double blind to ten patients. Pain relief significantly superior to placebo was demonstrated at high dose levels (15 and 20 mg). At these levels, substantial sedation and mental clouding were reported.
