Key points VULVAR PREMALIGNANT AND MALIGNANT DISEASE Squamous cell carcinomas constitute 90% of primary vulvar malignancies. More than 80% of patients are older than 50 years at the time of diagnosis. Cancer of the vulva accounts for approximately 4% of…
Key points Human papillomavirus (HPV) infection is the cause of virtually all cases of cervical dysplasia/cancer and many cases of vaginal and vulvar dysplasia The majority of HPV infections regress spontaneously, but if the infection persists, dysplasia and cancer may…
Key points Electromagnetic radiation is a form of energy that has no mass or charge and travels at the speed of light. The inverse square law states that the energy measured from a radiation source is inversely proportional to the…
Key points The immune system consists of the innate and adaptive immune systems. The innate system is present at birth and consists of natural barriers, natural killer (NK) cells, macrophages, and the complement system. The adaptive immune system adapts to…
Key points The mean amount of menstrual blood loss in one cycle is approximately 35 mL but may be as much as 60 mL, with an average loss of 13 mg of iron. Heavy menstrual bleeding occurs in 9% to…
Key points Postoperative febrile morbidity is related to infection in approximately 20% of cases and noninfectious causes in 80% of cases. Infection in older adults will not always present with classic findings. The amount of temperature elevation may not reflect…
Key points Optimal preparation for an operation facilitates a successful result and protects the patient and physician. The most significant risk factors for postoperative morbidity are preoperative conditions. They may affect the operation, anesthesia, and postoperative course and may preclude…
Key points The Centers for Disease Control and Prevention regularly revises its treatment protocols for sexually transmitted infections (STIs). This information may be accessed online at www .cdc.gov/publications . Pediculosis pubis, an infestation by the crab louse Phthirus pubis, is…
Key points Estimates of fecal incontinence range from 11% to 20% of community-dwelling women older than 64 years. More than 30% of women reporting urinary incontinence also report fecal incontinence, known as dual incontinence. The internal anal sphincter, under autonomic…
Key points Continence is determined by the balance between forces that maintain urethral closure and those that affect detrusor function. Parasympathetic nervous system activity via the neurotransmitter acetylcholine stimulates receptors in the bladder wall to activate detrusor contraction. Sympathetic nervous…