ABSTRACT
Routine pelvic examinations have been a fundamental part of the annual female examination. The 2014 American College of Physicians (ACP) guideline recommends against routine pelvic examinations in asymptomatic, nonpregnant, average-risk women. Our aim was to evaluate women's attitudes and beliefs about pelvic examinations and how knowledge of the new guidelines contributes to attitudes and beliefs. A descriptive cross-sectional study was performed using a self-administered written survey developed through literature review and pretested and revised on the basis of staff suggestions. Nonpregnant women age≥21years presenting to outpatient clinics at Mayo Clinic in Arizona or Mayo Clinic in Rochester, Minnesota, received the survey. After being asked about pelvic examination practices and beliefs, participants were informed of the ACP guideline, to determine effect on attitudes and beliefs. Demographic characteristics and pertinent medical history questions were collected from participants. In total, 671 women who were predominantly white, married, and educated completed surveys. Participants described pelvic examinations as reassuring, and a majority believed the examinations were useful in detecting ovarian cancer (74.6%), necessary for screening for sexually transmitted infections (STIs) (71.0%), or necessary before initiating contraception (67.0%). After reading the 2014 ACP guideline, significantly fewer women planned to continue yearly pelvic examinations (P<0.001). Despite evidence to the contrary, women believed pelvic examinations were necessary for STI screening, contraception initiation, and ovarian cancer detection. After education on the ACP screening guideline, fewer women planned to continue yearly pelvic examinations.
Subject(s)
Guidelines as Topic , Gynecological Examination , Health Knowledge, Attitudes, Practice , Adult , Contraception/statistics & numerical data , Cross-Sectional Studies , Female , Humans , Mass Screening , Middle Aged , Ovarian Neoplasms/prevention & control , Sexually Transmitted Diseases/prevention & control , Surveys and Questionnaires , United States , Uterine Cervical Neoplasms/prevention & control , Women's HealthABSTRACT
Women who receive transplants require contraception counseling because of the teratogenicity of immunosuppressant medications and the risks posed by pregnancy after transplant. Fortunately, pregnancy can succeed with careful planning and monitoring.
Subject(s)
Family Planning Services , Immunosuppressive Agents , Organ Transplantation , Female , HumansABSTRACT
Hemi paretic ataxia (HA) is a lacunars syndrome that presents with motor deficit and pyramidalism associated to ipsilateral ataxia out of proportion to such deficit. Topography of lesions is wide and acute infarcts have been recognized at the infernal capsule, pons, thalamus, corona radiate and cortex. Symptoms are associated to involvement of pyramidal and corticopontocerebellar tracts. We report a 44-year-old mole presenting with right hemi paresis and severe ataxia. The magnetic resonance imaging showed a sub acute infarction of the left lenticular nucleus and infernal capsule. The patient was treated with physiotherapy, anti platelet agents and statins and was discharged with an evident recovery.
Subject(s)
Ataxia/etiology , Cerebral Infarction/complications , Paresis/drug therapy , Adult , Ataxia/drug therapy , Cerebral Infarction/drug therapy , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Internal Capsule/blood supply , Magnetic Resonance Imaging , Male , Paresis/etiology , Platelet Aggregation Inhibitors/therapeutic use , Severity of Illness IndexABSTRACT
Hemi paretic ataxia (HA) is a lacunars syndrome that presents with motor deficit and pyramidalism associated to ipsilateral ataxia out of proportion to such deficit. Topography of lesions is wide and acute infarcts have been recognized at the infernal capsule, pons, thalamus, corona radiate and cortex. Symptoms are associated to involvement of pyramidal and corticopontocerebellar tracts. We report a 44-year-old mole presenting with right hemi paresis and severe ataxia. The magnetic resonance imaging showed a sub acute infarction of the left lenticular nucleus and infernal capsule. The patient was treated with physiotherapy, anti platelet agents and statins and was discharged with an evident recovery.
Subject(s)
Adult , Humans , Male , Ataxia/etiology , Cerebral Infarction/complications , Paresis/drug therapy , Ataxia/drug therapy , Cerebral Infarction/drug therapy , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Internal Capsule/blood supply , Magnetic Resonance Imaging , Paresis/etiology , Platelet Aggregation Inhibitors/therapeutic use , Severity of Illness IndexABSTRACT
Hemiparetic ataxia (HA) is a lacunar syndrome that presents with motor deficit and pyramidalism associated to ipsilateral ataxia out of proportion to such deficit. Topography of lesions is wide and acute infarcts have been recognized at the internal capsule, pons, thalamus, corona radiata and cortex. Symptoms are associated to in¬volvement of pyramidal and corticopontocerebellar tracts. We report a 44-year-old male presenting with right hemiparesis and severe ataxia. The magnetic resonance imaging showed a subacute infarction of the left lenticular nucleus and internal capsule. The patient was treated with physiotherapy, anti platelet agents and statins and was discharged with an evident recovery(AU)
Hemiparesia ataxia (HA) es un síndrome lacunar que se presenta con déficit motor y piramidalismo asociados a cabo ataxia ipsilateral de la proporción de dicho déficit. La topografía de las lesiones es muy amplia y los infartos agudos han sido reconocidos en la cápsula interna, la protuberancia, el tálamo, corona radiata y la corteza. Los síntomas están asociados a la participación de los tractos piramidal y corticopontocerebellar. Presentamos un varón de 44 años de edad con hemiparesia derecha y ataxia severa. La resonancia magnética mostró un infarto subagudo de la izquierda, núcleo lenticular y la cápsula interna. El paciente fue tratado con fisioterapia, agentes anti plaquetas y las estatinas y fue dado de alta con una recuperación evidente(AU)