Etiology and treatment of overactive bladder in women.

Overactive bladder (OAB) is a condition that affects millions of women in the United States (US). Although the etiology is largely unknown, risk factors include Caucasian race, insulin-dependent diabetes mellitus, and history of depression. Patients present with urgency with or without urinary incontinence and often have urinary frequency and nocturia. Most patients can be evaluated in the office setting utilizing simple testing. Current treatments consist of behavioral/lifestyle modification, usually in combination with antimuscarinic drug therapy. Improvements in the adverse effect profiles of antimuscarinic drugs have positively impacted quality of life. When appropriately evaluated, most patients presenting to primary care providers can be effectively treated.

The vulvar dermatoses.

INTRODUCTION: Dermatologic diseases of the vulva may cause dyspareunia. These disorders may be overlooked by gynecologists and urologists because of lack of residency training experience. Dermatologists who are most familiar with these diseases are infrequently trained in vulvovaginal examination. As such, these disorders are often improperly diagnosed and treated. AIM: To describe the presentation and management of the major vulvar dermatoses including irritant and allergic contact dermatitis, lichen sclerosus, lichen simplex chronicus, and lichen planus. MAIN OUTCOME MEASURE: Data from a peer review literature search on the topic of vulvar dermatoses. METHODS: The literature for this review article was obtained through a Medline search. Appropriate dermatology textbooks were utilized for additional information. RESULTS: A comprehensive survey of the vulvar dermatoses. CONCLUSION: Vulvar dermatoses must be considered a part of the differential diagnosis of any woman with a sexual pain disorder. As such, healthcare providers who evaluate and treat women with dyspareunia must become familiar with the most common dermatologic disorders of the vulva.

Domestic violence homicide in Oklahoma: 1998-1999.

BACKGROUND: Domestic violence homicide is a significant public health issue for healthcare providers. The objective of this study was to review all domestic violence homicides in Oklahoma from 1998-1999 in order to identify strategies to prevent domestic violence homicides. METHODS: All domestic violence homicides from the years 1998-1999 were identified and reviewed by the Oklahoma Domestic Violence Fatality Review Board (ODVFRB) through records provided by the Oklahoma State Bureau of Investigation (OSBI) list of homicides resulting from domestic violence. In addition eleven other sources were utilized to compliment the OSBI data. RESULTS: The ODVFRB reviewed 113 domestic violence fatalities in Oklahoma for the years 1998-1999. Of the 113 cases reviewed, 69 (61%) were committed by intimate partners (IP) and 44 (39%) were committed by other family members. Sixty-two percent of perpetrators had a documented history of committing domestic violence. Law enforcement had responded to domestic disturbances before the death event in at least 32% of the fatal cases. Firearms were used in 59% of the homicides. CONCLUSIONS: Through in depth multidisciplinary review of domestic violence homicide cases and subsequent system changes, domestic violence deaths can be prevented.