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1/19. 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.
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ranking = 1
keywords = gynecologic
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2/19. women's health in northeast thailand: working at the interface between the local and the global.

    An important first step in translating global statements about women's right to health into action programs is an assessment of the interface between local health culture and public health/medical practice. In this paper, we present the findings of an ongoing research project focusing on women's sexual and reproductive health in Northeast thailand. The project is a prototype illustrating how formative research may be used to guide intervention development as well as midcourse correction. Examples are provided which clearly illustrate why cultural understandings of gynecological health are important to consider before introducing women's health programs. One case featured describes how an iatrogenic fear of cervical cancer has emerged from public health messages and screening programs. A hybrid model of cancer has evolved from preexisting local ideas, resulting in an exaggerated sense of risk wherein women fear that a wide range of common problems may potentially transform into this fatal disease. We argue that public health needs to be held accountable for what transpires when health messages are introduced into a community. Monitoring of community response is necessary. In the second half of the paper we describe efforts to increase community understanding of women's health problems, create gender and culturally sensitive health care services, and enhance the technical and communication skills of health staff.
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ranking = 1
keywords = gynecologic
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3/19. Value of the erythrocyte sedimentation rate in gynecologic infections.

    The ESR remains a valuable test in gynecology, specifically when obtained sequentially in cases of pelvic infection. It is nonspecific but has much merit in assessing prognosis and therapeutic measures. In conjunction with laparoscopy and diagnostic ultrasound it plays an important part in the evaluation of abdominal and pelvic infections.
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ranking = 4
keywords = gynecologic
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4/19. True ectopic ovary: a case and review.

    INTRODUCTION: Ectopic ovarian tissue is a rare gynecologic problem. The nomenclature and classification systems are unclear and still debated. CASE REPORT: Herein we provide a case report and review the literature to help clarify the classification system of ectopic ovarian tissue.
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ranking = 1
keywords = gynecologic
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5/19. Gastrointestinal stromal tumor mimicking gynecological disease.

    gastrointestinal stromal tumors (GISTs) are common mesenchymal tumors of the digestive tract. These tumors occasionally present a pelvic mass and leading to the misdiagnosis of gynecologic diseases. Two patients with GIST in the small intestine giving an impression of an ovarian fibroma and a uterine leiomyoma respectively were diagnosed correctly at the surgery. In the patients with a pelvic mass, especially if unusual symptoms and laboratory data being not compatible with gynecological disease, the possibility of diseases other than a gynecologic disease has to be considered.
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ranking = 7
keywords = gynecologic
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6/19. Detached ciliary tufts mistaken for peritoneal parasites: a warning.

    Detached ciliary tufts of columnar epithelial cells from the female genital tract may be mistakenly identified as protozoa when examined in wet mounts of fluid specimens in the laboratory because of their appearance and motility, although they are generally identified correctly in fixed specimens prepared for cytologic examination. A case of such mistaken identity in specimens from a gynecologic patient was documented, and the literature on ciliary tufts was reviewed. Infectious disease and gynecology consultants should be alert to the potential confusion arising from the presence of ciliary tufts in body fluids.
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ranking = 1
keywords = gynecologic
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7/19. Surgical control of pelvic hemorrhage: bilateral hypogastric artery ligation and method of ovarian artery ligation.

    Hypogastric artery ligation and internal iliac artery ligation are the same procedure. It has been several years since extensive work on this procedure has been reported in the literature. Since this has proved to be a potentially life-saving technique in serious obstetric and pelvic hemorrhage, it is somewhat surprising to find that the procedure is poorly understood. We have reviewed this procedure in depth, emphasizing important aspects and restating indications for its use. We have also included a case presentation in which we recently performed bilateral ligation of the hypogastric arteries and the ovarian arteries to control intractable hemorrhage. Although ovarian artery ligation is often mentioned as an adjunct in controlling pelvic hemorrhage, we believe the technique has never been described in the English language. We present a surgical technique for ligating the ovarian arteries, believing that teaching both bilateral hypogastric artery ligation and ovarian artery ligation should be an integral part of obstetric and gynecologic training.
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ranking = 1
keywords = gynecologic
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8/19. A technique for surgical correction of fallopian tube prolapse.

    prolapse of the fallopian tube is a rare complication of gynecologic surgery. Five cases were operated upon in the authors' hospital within the past year. A summary of these cases is given. One of the cases, which required a second operative procedure, is discussed. The surgical technique for complete excision of the prolapsed fallopian tube via the vagina is described.
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ranking = 1
keywords = gynecologic
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9/19. Intraoperative ultrasound for gynecologic procedures.

    Recent technological advances in portable dynamic imaging equipment allow for the performance of intraoperative ultrasound examinations during certain gynecologic procedures. Reported is the authors' technique for such an examination and outlined are specific vaginal and abdominal gynecologic procedures wherein adjunctive ultrasound may facilitate performance of the operative procedure, enhance safety, and decrease the possibility of complications.
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ranking = 6
keywords = gynecologic
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10/19. diagnosis and surgical treatment of colonic endometriosis.

    endometriosis is sufficiently common that it should always be considered in the differential diagnosis of colon lesions of women of childbearing age. Seven selected cases illustrate problems in diagnosis and management of endometriosis of the colon. Characteristic of colon endometriosis are large bowel symptoms frequently associated with gynecologic complaints, usual sigmoid and rectosigmoid location, extramucosal radiologic appearance, and difficult diagnosis by endoscopic biopsy. Suspicion of malignancy and presence of a symptomatic colon lesion are indications for bowel resection, which is an effective form of therapy.
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ranking = 1
keywords = gynecologic
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