This document provides an overview of current issues in perinatology and preterm birth. It discusses definitions and common causes of preterm birth such as spontaneous preterm labor and preterm premature rupture of membranes. Risk factors for preterm birth include multiple gestations, preeclampsia, and maternal medical conditions. Complications of prematurity are also reviewed such as respiratory distress syndrome and intraventricular hemorrhage. Current tocolytic medications for inhibiting preterm labor are described including beta-agonists, calcium channel blockers, nitric oxide donors, and oxytocin receptor antagonists. The efficacy, maternal and fetal effects, dosing, and contraindications of specific medications like ritodrin and nifed
This is a brief discussion on diabetes mellitus as medical emergency that can be encountered in any dental office.
What to do in such conditions is what I've briefly tried to explain over here.
Regards,
Dr. Abhishek Sharma
(M.D.S - 2016 Batch ; Oral & Maxillofacial Surgery)
This document discusses endometrial cancer and its premalignant stage of endometrial hyperplasia. It identifies several risk factors for developing endometrial cancer including nulliparity, obesity, diabetes, and hereditary conditions. Endometrial hyperplasia is caused by prolonged, unopposed estrogen stimulation and can be classified as simple, complex, or atypical depending on its histological features and malignant potential. Management of hyperplasia may involve progestogen therapy or hysterectomy depending on the type of hyperplasia and patient factors. The goal of treatment is to prevent the development of endometrial cancer.
This document provides an overview of current issues in perinatology and preterm birth. It discusses definitions and common causes of preterm birth such as spontaneous preterm labor and preterm premature rupture of membranes. Risk factors for preterm birth include multiple gestations, preeclampsia, and maternal medical conditions. Complications of prematurity are also reviewed such as respiratory distress syndrome and intraventricular hemorrhage. Current tocolytic medications for inhibiting preterm labor are described including beta-agonists, calcium channel blockers, nitric oxide donors, and oxytocin receptor antagonists. The efficacy, maternal and fetal effects, dosing, and contraindications of specific medications like ritodrin and nifed
This is a brief discussion on diabetes mellitus as medical emergency that can be encountered in any dental office.
What to do in such conditions is what I've briefly tried to explain over here.
Regards,
Dr. Abhishek Sharma
(M.D.S - 2016 Batch ; Oral & Maxillofacial Surgery)
This document discusses endometrial cancer and its premalignant stage of endometrial hyperplasia. It identifies several risk factors for developing endometrial cancer including nulliparity, obesity, diabetes, and hereditary conditions. Endometrial hyperplasia is caused by prolonged, unopposed estrogen stimulation and can be classified as simple, complex, or atypical depending on its histological features and malignant potential. Management of hyperplasia may involve progestogen therapy or hysterectomy depending on the type of hyperplasia and patient factors. The goal of treatment is to prevent the development of endometrial cancer.
Endometrial hyperplasia is an increased proliferation of endometrial glands relative to the stroma that can progress to endometrial carcinoma. It occurs most often in peri-menopausal women with elevated estrogen levels and is caused by prolonged, unopposed estrogen stimulation. Endometrial hyperplasia is classified as simple, complex, or atypical depending on architectural and cytological abnormalities. Endometrial carcinoma is the most common cancer of the female reproductive system, occurring most often in post-menopausal women. It is broadly classified into Type I and Type II tumors based on clinical and molecular characteristics and risk factors. Surgery is the primary treatment for early-stage disease while radiation and chemotherapy may be used
The endometrium is the inner lining of the uterus. It consists of epithelial cells, stroma, glands, and connective tissue. The endometrium is built up during the menstrual cycle under the influence of estrogen and progesterone. Endometrial hyperplasia is a non-cancerous thickening of the endometrial lining due to unopposed estrogen stimulation. It can occur due to conditions like estrogen therapy, PCOS, or estrogen-secreting tumors. More severe forms are at greater risk for developing into endometrial cancer.
Endometrial hyperplasia is an overgrowth of the endometrial glands that can progress to endometrial cancer. It is caused by unopposed estrogen stimulation and is classified based on architectural patterns and presence of atypia. Treatment involves hysterectomy or progestin therapy depending on risk of cancer and fertility desires. Progestin therapy is effective at regressing hyperplasia, especially without atypia, but requires long-term treatment and monitoring to prevent recurrence. Hysterectomy is recommended for complex or atypical hyperplasia or if progestin therapy fails. Bilateral salpingo-oophorectomy may be performed for postmenopausal women but risks are low.
PCOS is a common hormonal disorder characterized by oligomenorrhea and hyperandrogenism. It can cause long term health risks like diabetes, cardiovascular disease, and endometrial cancer. Management involves lifestyle changes like weight loss through diet and exercise to improve symptoms. Medications may be used to treat irregular periods, hirsutism, and help with ovulation induction and fertility. Screening for metabolic complications is recommended due to increased risk.
Endometrial polyps are benign growths that occur in the endometrium. They are common in women over 40 and can cause abnormal bleeding. On pathology, they appear as irregular glandular growths with thick-walled blood vessels and fibrotic stroma. While most are non-cancerous, polyps are associated with a slightly increased risk of endometrial cancer and need to be evaluated. Treatment involves surgical removal, such as with a hysteroscopic polypectomy.
This document discusses proliferative lesions of the endometrium including endometrial polyps, hyperplasia, and carcinomas. It provides details on the morphology, pathogenesis, risk factors, classification and clinical presentation of each condition. Endometrial polyps are benign overgrowths that can cause bleeding. Hyperplasia is an exaggerated response to estrogen and is classified based on architectural and cytological features. Endometrial carcinoma is the most common cancer of the female genital tract and arises through estrogen exposure or endometrial atrophy. Uterine fibroids are also discussed.
The revised 2014 WHO classification of endometrial hyperplasia is recommended, distinguishing between hyperplasia without atypia and atypical hyperplasia. Diagnosis is typically via endometrial biopsy. For hyperplasia without atypia, initial treatment involves counseling and observation, with progestogen therapy or a levonorgestrel intrauterine device recommended if regression does not occur. For atypical hyperplasia or failure of medical treatment, total hysterectomy is usually recommended. Special considerations apply to fertility-preserving treatment and management in breast cancer patients on tamoxifen.
Adneksiyal kitlelere yaklaşım dr aydın köşüşAydın Köşüş
Adneksiyal kitlelerde izlenecek yöntem nasıl olmalıdır? Laparoskopinin yönetimde yeri nedir? Her adneksiyal kitleye cerrahi gerekir mi? Çocuklardaki adneksiyal kitlelerde yönetim nasıl olmalıdır?
DR.BAHRİ YILDIZ ADNEKSİAL KİTLELERE YAKLAŞIM VE O-RADS SİSTEMİ.pptxuzmdrbahriyildiz
Ovarian-Adnexal Reporting and Data System Ultrasound (O-RADS US),ULTRASONOGRAPHY,ADNEXİAL MASS,GYNECOLOGY,PELVİC ULTRASONOGRAPHY,BAHRİ YILDIZ ,ULTRASOUND,PELVİS,ADNEXİA,O-RADS,İOTA,MERSİN TIP FAKÜLTESİ,MERSİN MEDİCİNE,ONCOLOGY ULTRASOUND,İOVA ,MORPHOLOGİC İNDEX,ŞIRNAK ,UZM.DR.BAHRİ YILDIZ,TEMEL ULTRASONOGRAFİ,PRNİNCİPL OF ULTRASOUND,KADIN DOĞUM ASİSTANLARI,
Servikal İntraepitelyal Neoplazilerde (CIN) Yönetim nasıl olmalıdır?
HPV virüsü tipi takipte önemli midir? CIN1, CIN2 ve CIN3 te tedavi yöntemi ne olmalıdır?
Pelvic organ prolapse occurs when one or more pelvic organs, such as the bladder, uterus, or rectum, descend from their normal positions due to weakness or damage in the muscles and tissues that support these organs. The document discusses the anatomy of pelvic floor support, factors that can contribute to prolapse, and how different types of prolapse such as cystocele, rectocele, and enterocele are evaluated and treated. Conservative treatments focus on lifestyle changes while surgical repairs aim to reconstruct the weakened pelvic floor tissues and fascia.
This document discusses the evaluation and management of genital prolapse. It begins by describing normal uterine and vaginal support structures. It then discusses the pathophysiology of pelvic organ prolapse, including neuromuscular dysfunction and weakness of supporting ligaments. Evaluation involves history, physical exam including staging systems, and sometimes additional tests. Treatment options include conservative approaches like pessaries or intravaginal devices, as well as surgical options.
Complications of mesh and should we use it ? - www.jinekoklojivegebelik.comjinekolojivegebelik.com
The document discusses the use of mesh in pelvic organ prolapse (POP) surgery, comparing synthetic and biological meshes. It summarizes various studies that have found complication rates ranging from 0-39% for synthetic meshes and 0-64% for biological meshes. While mesh may be preferable for recurrent or complex cases, there is no strong evidence currently to support its routine use in POP surgery. Further research through RCTs and pooled audits is still needed.
The document discusses several potential postpartum complications including postpartum hemorrhage, infection, urinary incontinence, prolapse, and mental health issues. Postpartum hemorrhage is the leading cause of maternal mortality and can be life-threatening, with causes such as uterine atony, lacerations, and retained placenta. Other complications include infection, urinary incontinence, structural issues like prolapse, and mental health issues such as postpartum depression. Prevention, early assessment, and treatment are emphasized to manage complications.
This document provides an overview of abdominal anatomy terminology and structures. It discusses the internal coverings of the abdomen including the peritoneum and mesenteries. It then covers the blood supply and innervation of the foregut, midgut, and hindgut. Finally, it discusses some common congenital abnormalities that can occur in embryonic development of the gastrointestinal tract.
Gebelik Kolestazı -Cholestasis of Pregnancy - www.jinekolojivegebelik.comjinekolojivegebelik.com
1. Intrahepatic cholestasis of pregnancy is characterized by pruritus and jaundice in the last trimester of pregnancy, and can recur in subsequent pregnancies.
2. Laboratory findings include elevated serum bile acids and liver enzymes. The condition can cause complications like preterm birth and fetal distress.
3. Treatment focuses on relieving pruritus through medications like cholestyramine, antihistamines, phenobarbital, and ursodeoxycholic acid. Delivery may be indicated if symptoms are severe or fetal well-being is compromised.
PCOS was first described in 1935 and affects 5-10% of women of reproductive age, making it the most common endocrine disorder. It is characterized by hyperandrogenism, chronic anovulation, and polycystic ovaries. Patients often see multiple medical practitioners before receiving a correct diagnosis of PCOS due to its variable signs and symptoms. Women with PCOS are also at higher risk of developing diabetes, cardiovascular disease, and other metabolic complications. Lifestyle interventions including diet and exercise can help manage symptoms and reduce health risks associated with PCOS.
Case 1 involves a 17-year-old female with primary amenorrhea who has normal development and health history. Her physical exam and labs are normal except she is underweight. She likely has hypothalamic amenorrhea due to inadequate calorie and fat intake and should be evaluated for an eating disorder.
Case 2 is a 24-year-old woman with secondary amenorrhea and irregular periods. She is overweight with signs of PCOS like acne and hirsutism. Her labs show elevated testosterone and cystic ovaries on ultrasound consistent with a diagnosis of PCOS.
Case 3 is a 29-year-old with secondary amenorrhea and a history of spontaneous abortion and D&
1. The document discusses various causes of amenorrhea including hypothalamic, pituitary, ovarian, and outflow tract issues.
2. Evaluation involves assessing secondary sex characteristics, symptoms, family history, and targeted medical tests.
3. Treatment focuses on identifying and managing underlying disorders, hormone replacement, and addressing risks like osteoporosis or infertility.
This document provides an overview of polycystic ovarian syndrome (PCOS), including its pathogenesis, diagnosis, and management. PCOS is characterized by hyperandrogenism, oligoovulation or anovulation, and polycystic ovaries. It affects 4-12% of women and is associated with insulin resistance and related metabolic complications. Diagnosis requires two of the three above criteria in the absence of other disorders. Management involves lifestyle changes, medications to regulate cycles and reduce hair growth, and long-term strategies to address insulin resistance and related risks like cardiovascular disease.
This document discusses different types of amenorrhea (primary and secondary) and provides information on their causes and evaluations. Primary amenorrhea is defined as the absence of menstruation by age 16 with normal development or by age 14 without development. Secondary amenorrhea is the absence of menses for 6 months in a previously menstruating female. Causes of primary amenorrhea include hypogonadism, gonadal dysgenesis, and hypogonadotropic hypogonadism. Causes of secondary amenorrhea include pregnancy, CNS disorders, pituitary disorders, ovarian disorders, uterine abnormalities, and systemic disorders/medications. Evaluations for amenorrhea involve pregnancy testing, physical exams, and laboratory tests
This document provides definitions and discusses the evaluation and treatment of amenorrhea and polycystic ovarian syndrome (PCOS). It defines types of amenorrhea and normal menstrual cycles. Evaluation includes pregnancy tests, hormone levels, and progestational challenges. Treatment depends on the underlying cause and may include birth control pills, progesterone, clomiphene, or metformin. PCOS is characterized by irregular periods and elevated androgens. Treatment focuses on weight loss, birth control pills, and improving insulin resistance.
53. Atipisiz Endometrial hiperplazi Atipisiz endometrial hiperplazi 3 ay progestin tedavisi (3.- 6. aylarda endometrial biopsi ) (Ek jinekolojik endikasyon varsa) Histerektomi Persistan atipisiz end hiperplazi Endometrial biopsi takipleri ile progestin tedavisine devam (Hasta histerektomiyi kabul etmez ise) Kanama devam ediyorsa Jinekolojik endikasyon Histerektomi Kanser korkusu
54. Atipili Endometrial hiperplazi Atipili endometrial hiperplazi Cerrahi uygun değilse Histerektomi End ca H/S biopsiler ile ekarte edildikten sonra Megestrol acetate (80-160 mg x 1) (3 ay sonra endometrial biopsi) Regresyon var ise tedaviye endometrial biopsi takipleri ile devam Persistan atipili endometrial hiperplazi
71. Siklik östrojen/progestin tedavisi İlk 3-6 ay kanama düzensizlikleri 3-6 aydan sonra devam eden kanama Konservatif yaklaşım Hastaya güven telkini TVUSG ile endometrial değerlendirme Endometrial biopsi Endometrial proliferasyon Progestin uygulama zamanının uzatılması (?) Tanısal değil SIS / Histeroskopi Endometrial hiperplazi veya kanser Polip, submukoz myom Uygun tedavi Uygun yaklaşım ve tedavi Normal Tedavi şeklinin gözden geçirilmesi
72. Devamlı kombine östrojen/progestin tedavisi İlk 6 ay kanama ya da lekelenme 6 aydan uzun süren düzensiz kanama Konservatif yaklaşım Hastaya güven telkini TVUSG ile endometrial değerlendirme Endometrial biopsi Endometrial atrofi -Tanısal değil SIS / Histeroskopi Polip Submukoz myom Normal Uygun tedavi Hasta ile tedavinin devamını görüş