RESUMO
The three primary indications for estrogen replacement therapy in postmenopausal women are severe vasomotor symptoms (hot flashes), prevention or treatment of osteoporosis, and atrophy of the genital tract. Estrogen replacement therapy is well established as reducing the morbidity and mortality associated with osteoporosis. The increased incidence of endometrial cancer associated with estrogen use (from 1/1,000 to 4/1,000 per year) must be accepted and viewed in perspective. Many of these estrogen-related cancers are stage I lesions, with a cure rate of 95%. In addition, the risk associated with estrogen replacement therapy can be reduced by coadministration of a progestogen during the last ten days of the cycle.
Assuntos
Estrogênios/uso terapêutico , Osteoporose/tratamento farmacológico , Neoplasias Uterinas/induzido quimicamente , Adulto , Neoplasias da Mama/induzido quimicamente , Estrogênios/efeitos adversos , Feminino , Humanos , Pessoa de Meia-Idade , RiscoRESUMO
It has been the purpose of this presentation to detail a safe technique for performance of laparoscopy. Emphasis has also been placed on potentially serious complications and how they can be avoided. This procedure employs highly technical equipment, and the surgeon should have formal training in the technique. It is essential to have an in-depth knowledge of the use of optics, electrical principles, gas under pressure, and the physiologic changes that occur when carbon dioxide is placed in the abdominal cavity. Above all, the surgeon must adhere rigidly to guidelines for appropriate technique. Deviation will most assuredly result in complications and even death.
Assuntos
Laparoscopia , Anestesia Geral , Vasos Sanguíneos/lesões , Queimaduras por Corrente Elétrica/etiologia , Sistema Digestório/lesões , Embolia Aérea/etiologia , Feminino , Tecnologia de Fibra Óptica , Parada Cardíaca/etiologia , Humanos , Laparoscópios , Laparoscopia/efeitos adversos , Agulhas , Pneumoperitônio ArtificialAssuntos
Efeitos da Radiação , Esterilização Reprodutiva , Castração , Estudos de Avaliação como Assunto , Tubas Uterinas/cirurgia , Feminino , Seguimentos , Humanos , Histerectomia/mortalidade , Legislação Médica , Métodos , Ovário/efeitos da radiação , Esterilização Tubária/efeitos adversos , Estados UnidosRESUMO
PIP: An approach to the management of the climacteric and postmenopausal patient is outlined. Menopause refers to the time at which menstruation ceases; climacteric, the period of transition. Neither is pathological. After the functional life of the ovary terminates when the supply of primary oocytes is exhausted, the feedback mechanism with FSH is disrupted leading to high blood and urinary levels of FSH. Estrogen often continues to be produced for about 10 years postmenopausally. Hormone therapy is indicated to treat vasomotor instability, such as hot flashes, numbness and tingling, vertigo, cold hands and feet, palpitations and headache, dysfunctional uterine bleeding, and senile vaginitis. The psychological changes often noted are functional and not due to estrogen withdrawal. There is currently no proof of the efficacy of long term estrogen replacement as a means of preventing heart diseases or osteoporosis.^ieng
