Women's health
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Hypertensive disorders are the most common medical complication of pregnancy, with an incidence of 5-10%, and a common cause of maternal mortality in the USA. Incidence of pre-eclampsia has increased by 25% in the past two decades. ⋯ The increased understanding of the pathophysiology of hypertension in pregnancy, as well as advances in medical therapy to minimize risks of fetal toxicity and teratogenicity, will improve our ability to prevent and treat hypertension in pregnancy. Fetal programming and fetal origins of adult disease theories extrapolate the benefit of such therapy to future generations.
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The two major consequences of endometriosis are pain and infertility. Despite numerous studies and proposed guidelines, some aspects of the treatment for these complications are still under debate or lack convincing evidence that favors one approach over the other. Future studies will hopefully present new evidence in regard to the optimal treatment for each indication and suggest innovative pharmacotherapy following improved understanding of the pathophysiology of endometriosis. Until then, individualization of the treatment according to the specific indication, taking into consideration the benefits versus the risks for the patient and the tolerability profile, remains the most appropriate approach.
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Gerson Weiss speaks to Natasha Leeson, Assistant Commissioning Editor Gerson Weiss obtained his MD degree from New York University (NY, USA). After an internship in internal medicine at Baltimore City Hospital (MD, USA), he completed residency in obstetrics and gynecology at New York University. Further training in reproductive endocrinology was obtained as a postdoctoral research fellow in physiology at the University of Pittsburgh (PA, USA), in the laboratory of Dr Ernst Knobil. ⋯ Dr Weiss is a past President of the Society for Gynecologic Investigation. He currently serves on the NIH's Advisory Committee on Research on Women's Health. Dr Weiss conducts an active clinical practice both in gynecology and reproductive endocrinology and infertility at his institution.
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The purpose of this paper is to examine how well research findings on dyspareunia (intercourse pain) fit the fear-avoidance (FA) model on pain. ⋯ The results demonstrate the relevance of the FA model in sexual pain. They also imply that treatment methods for fear and avoidance in other pain conditions offer new avenues for treating sexual pain problems in the clinic. Future studies should focus on expanding how the mechanisms in the FA model contribute to sexual pain, as well as how treatments based on the model may be applied clinically.