1/4. A systematic history for the patient with chronic pelvic pain.Chronic pelvic pain is a source of frustration to both the physician and the patient. physicians have been ill equipped by their training to confront the multifaceted nature of the complaints of patients with chronic pelvic pain. patients have experienced a repetitive dismissal of their complaints by physicians too busy in their practices to address their problems comprehensively. The approach to the patient with chronic pelvic pain must take into account six major sources of the origin of this pain: 1) gynecological, 2) psychological, 3) myofascial, 4) musculoskeletal, 5) urological, and 6) gastrointestinal. Only by addressing and evaluating each of these components by a very careful history and physical examination and by approaching the patient in a comprehensive manner can the source of the pain be determined and appropriate therapy be administered. This article was developed to provide the clinician with a set of tools and a methodology by which the patient with this complaint can be approached.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/4. A young woman with abdominal pain.patients rarely present with solely a physical problem. While psychological overlay and social factors expand the differential diagnosis and modify management, physical dangers should not be forgotten. Disruption of the family unit isolates individuals and requires extra consideration from the caring practitioner, as in the case of Sarah Leigh.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
3/4. Deferred pelvic examinations: a purposeful omission in the care of mentally ill women.In their struggle to meet the multiple psychiatric and rehabilitative needs of the many chronic mentally ill living in the community, community mental health centers and aftercare clinics have overlooked the importance of pelvic examinations for women patients. The author presents a review of the literature focusing on the reasons that such exams are generally deferred and the arguments that support conducting complete physical examinations of women psychiatric patients. She then presents results of a study that indicate the extent to which pelvic examinations are deferred, suggests steps that facilities can take to rectify the problem, and poses questions for further research.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/4. Localized mucosal involvement and severe pulmonary involvement in a young patient with paraneoplastic pemphigus associated with Castleman's tumour.We describe a 19-year-old female patient who developed recurrent ulcerations limited to the orogenital mucosa for the last 3 years. She also developed dyspnoea 5 months after the onset of the orogenital lesions. Castleman's tumour of the retroperitoneum was found incidentally during routine physical examination. The diagnosis of paraneoplastic pemphigus (PNP) was made by pathological and immunological studies. The orogenital ulceration responded well to corticosteroid therapy, but severe bronchiolitis obliterans progressed despite intensive care. The patient eventually died from respiratory failure. This case demonstrates the diversity of clinical features of paraneoplastic pemphigus.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |