Women's health
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Trauma complicates approximately 6-7% of all pregnancies and is associated with significant maternal and fetal morbidity and mortality. While the majority of trauma is minor, it is minor trauma that contributes to the majority of fetal mortality. Since virtually every organ system is affected anatomically and physiologically by pregnancy, it is important for healthcare providers who care for trauma victims to be aware of these changes. ⋯ Diagnostic and radiologic procedures should be used as indicated, with fetal exposure to radiation limited as much as possible. Management of the pregnant trauma victim requires a multidisciplinary approach in order to optimize outcome for mother and fetus. This review discusses the epidemiology, assessment and treatment of pregnant trauma patients and reviews areas where prevention efforts may be focused.
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Abnormal uterine bleeding imposes major medical, social and financial problems for women, their families and the health services. Abnormal uterine bleeding refers to the regularity, frequency, duration and volume of bleeding. ⋯ In Australia, the estimated cost of investigating and managing heavy menstrual bleeding alone is approximately AUS $6 million per annum. This article addresses the common causes of irregular bleeding in pre- and peri-menopausal women and presents an investigational approach.
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Surgical intervention for both emergency and elective surgeries will increase as women live longer and maintain active lifestyles. Older women with operable conditions tolerate elective gynecologic and other nonvascular surgery with acceptable morbidity and mortality. ⋯ With aging and postmenopausal status, changes associated with aging appear to play a greater role than gender in pharmacologic responses. Surgical outcomes should be optimized to maintain and even improve women's quality of life.
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Amplification of the human epidermal growth factor receptor 2 (HER2) gene occurs in 18-23% of invasive breast carcinomas and is associated with a worse prognosis. This novel transforming gene was identified in 1985, and in 1987 HER2 amplification was demonstrated to be central to the aggressive, malignant phenotype of these cancers and a significant predictor of both time to relapse and overall survival. ⋯ In 2005, results from four major trastuzumab adjuvant trials demonstrated a marked reduction in risk of recurrence, and trastuzumab is now an essential component of the adjuvant treatment of HER2-positive early breast cancer. Concerns regarding cardiac safety and mechanisms of resistance to trastuzumab remain important issues and are being addressed in ongoing research efforts.