Pelvic Exam Video Nejm

Pelvic Exam Video NEJM: A Comprehensive Guide for Patients and Professionals

Introduction:

The thought of a pelvic exam can be daunting for many individuals. Understanding the procedure, its purpose, and the potential variations in technique is crucial for both patients seeking informed consent and healthcare professionals striving for best practices. This comprehensive guide delves into the specifics of pelvic exams, referencing relevant information available through the New England Journal of Medicine (NEJM) and other reputable sources. We will explore the procedure's steps, variations, patient preparation, and address common concerns to provide a clear and comprehensive understanding of this vital medical examination. This post aims to demystify the pelvic exam, empowering patients and enriching the knowledge base of medical professionals. We will analyze relevant research, addressing the nuances and ensuring accuracy, making it a valuable resource for both audiences.

I. Understanding the Pelvic Exam: Purpose and Indications

The pelvic exam is a crucial component of women's healthcare, providing valuable insights into reproductive health and overall well-being. It's a physical examination of the external genitalia, vagina, cervix, and (in some cases) rectum and ovaries. While the specific components may vary based on the patient's age, medical history, and presenting complaints, the primary goals typically include:

Screening for abnormalities: Detecting early signs of cervical cancer (Pap smear), STIs, uterine fibroids, ovarian cysts, or other reproductive system issues.
Assessing reproductive health: Evaluating menstrual irregularities, infertility concerns, or pregnancy-related complications.
Diagnosing gynecological problems: Identifying the cause of pelvic pain, abnormal bleeding, or other symptoms related to the reproductive system.
Monitoring chronic conditions: Tracking the progression or response to treatment for conditions like endometriosis or pelvic inflammatory disease.

While the NEJM itself might not feature videos explicitly demonstrating the pelvic exam, the journal often publishes articles on related topics like cervical cancer screening guidelines, the impact of various screening techniques, and advancements in imaging technologies used in diagnosing pelvic conditions. These articles indirectly inform best practices for conducting and interpreting pelvic examinations.


II. The Procedure: A Step-by-Step Guide

The pelvic exam is typically conducted by a healthcare provider (physician, nurse practitioner, or physician assistant) in a private and comfortable setting. While precise steps may vary slightly, the general procedure usually includes:

1. Patient Preparation: The patient is usually asked to undress from the waist down and lie on an examination table, draping for privacy.
2. External Examination: The provider visually inspects the external genitalia for any abnormalities, inflammation, or lesions.
3. Speculum Examination: A speculum, a medical instrument, is gently inserted into the vagina to visualize the cervix and obtain samples for a Pap smear or other tests.
4. Bimanual Examination: The provider inserts one or two fingers into the vagina while placing the other hand on the abdomen. This allows them to palpate the uterus, ovaries, and fallopian tubes for size, shape, and any abnormalities.
5. Rectovaginal Examination (Optional): This step involves inserting a finger into the rectum and vagina simultaneously to assess the rectovaginal septum and identify any abnormalities in the rectum or posterior pelvic structures.

III. Variations in Pelvic Exam Techniques

The technique employed during a pelvic exam may vary depending on the patient's age, medical history, and the reason for the examination. For instance:

Teenage girls: The exam might be modified to be less invasive and to address the specific concerns of adolescent patients.
Postmenopausal women: The focus might shift towards assessing hormonal changes and the risks associated with age-related conditions.
Patients with specific conditions: The exam may be adapted to accommodate patients with disabilities, chronic pain, or other medical conditions that might impact the procedure.

Understanding these variations is crucial for ensuring patient comfort and accurate diagnostic results.


IV. Addressing Patient Concerns and Anxiety

Many patients experience anxiety before a pelvic exam. Open communication between the patient and provider is crucial to address concerns and ensure a comfortable experience. Providers should explain each step of the procedure thoroughly, answer questions honestly, and create a supportive environment. Techniques like deep breathing exercises or mindfulness can help manage anxiety.

V. The Role of Technology and Imaging in Pelvic Exams

While the traditional pelvic exam remains a cornerstone of gynecological care, technology has significantly enhanced diagnostic capabilities. Ultrasound, MRI, and CT scans provide detailed images of the pelvic organs, allowing for earlier and more accurate detection of abnormalities. The NEJM regularly features studies exploring the effectiveness and applications of these imaging modalities in gynecological diagnosis and management.


VI. Conclusion: Empowering Patients and Enhancing Healthcare

The pelvic exam, though sometimes intimidating, is a valuable tool for maintaining women's health. Understanding the procedure, its variations, and its importance in detecting and managing health concerns is crucial for both patients and healthcare providers. Accessing credible resources and open communication are key to minimizing anxiety and ensuring a positive and informative experience.

Article Outline: Pelvic Exam Video NEJM

Name: A Comprehensive Guide to Pelvic Exams: Understanding the Procedure, Addressing Concerns, and Exploring Technological Advancements

Introduction: Defining the pelvic exam and its importance.
Chapter 1: Purpose and indications of pelvic exams. Mentioning relevant NEJM-related research indirectly.
Chapter 2: Step-by-step guide to the pelvic exam procedure.
Chapter 3: Variations in pelvic exam techniques based on patient factors.
Chapter 4: Addressing patient concerns and anxieties related to the exam.
Chapter 5: The role of technology (ultrasound, MRI, CT scans) in enhancing pelvic exam diagnostics. Referencing the role of the NEJM in publishing relevant studies.
Conclusion: Summarizing the importance of the pelvic exam and promoting patient empowerment.


(Detailed explanation of each point in the outline is provided above in the main article.)


FAQs:

1. Is a pelvic exam painful? While some discomfort is possible, the exam should not be painful. Communication with the provider is key to minimizing discomfort.
2. How often should I have a pelvic exam? The frequency depends on age, medical history, and risk factors. Your healthcare provider will recommend a schedule appropriate for you.
3. What if I'm a virgin? The exam can be modified to be less invasive and address the specific concerns of virgins.
4. What should I do to prepare for a pelvic exam? Your provider will give you specific instructions, but generally, you should wear loose, comfortable clothing.
5. What if I experience pain during the exam? Communicate immediately with your provider. They can adjust the technique or stop the exam if needed.
6. Can I bring someone with me to the exam? This depends on the clinic's policy; it’s best to confirm beforehand.
7. What are the risks associated with a pelvic exam? The risks are minimal but can include infection (rare) or discomfort.
8. What if the results of my pelvic exam are abnormal? Your provider will explain the results and discuss the appropriate next steps.
9. Are there alternative methods to a traditional pelvic exam? While a traditional exam remains essential, imaging technologies can supplement it.


Related Articles:

1. Cervical Cancer Screening Guidelines: Discusses the latest recommendations for Pap smears and HPV testing.
2. Pelvic Inflammatory Disease (PID): Diagnosis and Management: Explores the causes, symptoms, and treatment of PID.
3. Endometriosis: Understanding Symptoms and Treatment Options: Provides information on the causes, symptoms, and management of endometriosis.
4. Ovarian Cysts: Types, Symptoms, and Treatment: Discusses various types of ovarian cysts and their management.
5. Uterine Fibroids: Diagnosis and Treatment: Covers the causes, symptoms, and treatment options for uterine fibroids.
6. Abnormal Uterine Bleeding: Causes and Treatment: Explores the various reasons for abnormal uterine bleeding.
7. Sexually Transmitted Infections (STIs): Prevention and Treatment: Provides information on common STIs and their management.
8. Infertility: Causes, Diagnosis, and Treatment: Discusses the causes of infertility and the available treatment options.
9. Menopause Management: Strategies for Symptom Relief: Provides strategies for managing menopausal symptoms.


  pelvic exam video nejm: Canadian Family Medicine Clinical Cards David Keegan MD, 2014-07-21 These are peer-reviewed handy point-of-care tools to support clinical learning in Family Medicine. The content is aligned with SHARC-FM - the Shared Canadian Curriculum in Family Medicine. Objectives and more information is available at sharcfm.com.
  pelvic exam video nejm: Gastrointestinal Motility Satish S.C. Rao, 2012-12-06 Gastrointestinal motility has evolved from an esoteric laboratory tool into a sophisti cated diagnostic technique that is now widely used clinically to guide in management of complex gastrointestinal problems. Today, it is the most rapidly growing subspecialty within gastroenterology. Previously, many of the gastrointestinal motility problems were either ignored or attributed to a disturbance of psyche. But with the growing knowledge and understanding of how a dysfunction of the gastrointestinal muscle and nerves can cause disease, we are at the threshold of a revolution in our approach to the diagnosis and treatment of gastrointestinal motility disorders. The purpose of this book is to serve as a useful, up-to-date reference manual and guide for the diagnostic and therapeutic approach towards common adult and pediatric gastrointestinal motility problems. In order to enhance the understanding of these disor ders, a problem-oriented approach has been chosen, and wherever possible the authors have provided clinical case scenarios to illustrate their message. The emphasis has been on how to diagnose and treat motility disorders rather than to provide an encyclopedic infor mation. The reference list at the end of each chapter should enable the enthusiast to seek further information. Some of the material presented in this book has been derived from the proceedings of the annual University ofIowa College of Medicine GI Motility Symposia.
  pelvic exam video nejm: Vibrant and Healthy Kids National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Committee on Applying Neurobiological and Socio-Behavioral Sciences from Prenatal Through Early Childhood Development: A Health Equity Approach, 2019-12-27 Children are the foundation of the United States, and supporting them is a key component of building a successful future. However, millions of children face health inequities that compromise their development, well-being, and long-term outcomes, despite substantial scientific evidence about how those adversities contribute to poor health. Advancements in neurobiological and socio-behavioral science show that critical biological systems develop in the prenatal through early childhood periods, and neurobiological development is extremely responsive to environmental influences during these stages. Consequently, social, economic, cultural, and environmental factors significantly affect a child's health ecosystem and ability to thrive throughout adulthood. Vibrant and Healthy Kids: Aligning Science, Practice, and Policy to Advance Health Equity builds upon and updates research from Communities in Action: Pathways to Health Equity (2017) and From Neurons to Neighborhoods: The Science of Early Childhood Development (2000). This report provides a brief overview of stressors that affect childhood development and health, a framework for applying current brain and development science to the real world, a roadmap for implementing tailored interventions, and recommendations about improving systems to better align with our understanding of the significant impact of health equity.
  pelvic exam video nejm: The Breast Cancer Wars Barron H. Lerner, 2001-05-31 In this riveting narrative, Barron H. Lerner offers a superb medical and cultural history of our century-long battle with breast cancer. Revisiting the past, Lerner argues, can illuminate and clarify the dilemmas confronted by women with--and at risk for--the disease. Writing with insight and compassion, Lerner tells a compelling story of influential surgeons, anxious patients and committed activists. There are colorful portraits of the leading figures, ranging from the acerbic Dr. William Halsted, who pioneered the disfiguring radical mastectomy at the turn of the century to George Crile, Jr., the Cleveland surgeon who shocked the medical establishment by going public with his doubts about mastectomy, to Rose Kushner, a brash journalist who relentlessly educated American women about breast cancer. Lerner offers a fascinating account of the breast cancer wars: the insistent efforts of physicians to vanquish the enemy; the fights waged by feminists and maverick doctors to combat a paternalistic legacy that discouraged decision-making by patients; and the struggles of statisticians and researchers to generate definitive data in the face of the great risks and uncertainties raised by the disease. As easy as it is to demonize male physicians, the persistence of the radical mastectomy and other invasive treatments has had as much to do with the complicated scientific understandings of breast cancer as with sexism. In Lerner's hands, the fight against breast cancer opens a window on American medical practice over the last century: the pursuit of dramatic cures with sophisticated technologies, the emergence of patients' rights, the ethical and legal challenges raised by informed consent, and the limited ability of scientific knowledge to provide quick solutions for serious illnesses. A searching and profound work on an emotionally charged issue, The Breast Cancer Wars tells a story that remains of vital importance to modern breast cancer patients, their families and the clinicians who strive to treat and prevent this dreaded disease.
  pelvic exam video nejm: Handbook of Sports Medicine and Science Margo Mountjoy, 2014-10-06 This new International Olympic Committee (IOC) handbook covers the science, medicine and psycho-social aspects of females in sports at all levels of competition. Each chapter focuses on the specific issues that female athletes confront both on and off the field, such as bone health, nutritional recommendations, exercise/competition during menstruation and pregnancy, and much more. Fully endorsed by the IOC and drawing upon the experience of an international team of expert contributors, no other publication deals with the topic in such a concise and complete manner. The Female Athlete is recommended for all health care providers for women and girl athletes internationally for all sports and all levels of competition. It is a valuable resource for medical doctors, physical and occupational therapists, nutritionists, and sports scientists as well as coaches, personal trainers and athletes.
  pelvic exam video nejm: Unanticipated Outcomes Jerome Kassirer, 2017-06-01
  pelvic exam video nejm: Handbook of ICU Therapy Ian McConachie, 2006-01-12 Handbook of ICU Therapy provides rapid access to important information on the treatment of the critically ill patient. It comprises a series of 'cutting edge' reviews of the most advanced treatment concepts available in the modern ICU. Whilst assuming a basic knowledge of underlying conditions, it nonetheless outlines key physiological principles where necessary, and critically reviews current literature and best practice. The heart of the book is aimed at providing key practical information on treatment techniques to the busy clinician in an easily accessible style. In addition to conventional drug therapy, ventilator, fluid and physical therapies are also discussed in detail. All of the authors are directly involved in ICU research and practice and are familiar with all of the latest developments in this fast-moving field of medicine.
  pelvic exam video nejm: Orthogeriatrics Paolo Falaschi, 2021 This new open access edition supported by the Fragility Fracture Network aims at giving the widest possible dissemination on fragility fracture (especially hip fracture) management and notably in countries where this expertise is sorely needed. It has been extensively revised and updated by the experts of this network to provide a unique and reliable content in one single volume. Throughout the book, attention is given to the difficult question of how to provide best practice in countries where the discipline of geriatric medicine is not well established and resources for secondary prevention are scarce. The revised and updated chapters on the epidemiology of hip fractures, osteoporosis, sarcopenia, surgery, anaesthesia, medical management of frailty, peri-operative complications, rehabilitation and nursing are supplemented by six new chapters. These include an overview of the multidisciplinary approach to fragility fractures and new contributions on pre-hospital care, treatment in the emergency room, falls prevention, nutrition and systems for audit. The reader will have an exhaustive overview and will gain essential, practical knowledge on how best to manage fractures in elderly patients and how to develop clinical systems that do so reliably.
  pelvic exam video nejm: Pocket Primary Care Meghan M. Kiefer, 2014-03-06 Support your clinical decision making and prepare for everyday challenges in the primary care setting with Pocket Primary Care, a brand new, pocket-sized loose-leaf resource that offers the most current, evidence-based approaches to delivering quality care in the outpatient setting. Representing the efforts of a dedicated team of primary care and specialist physicians at the Massachusetts General Hospital, this practical resource provides the key clinical data you need to manage your patients effectively and quickly. Gain insights into the most up-to-date evidence-based practices, accepted best practices, and expert opinions of physicians at Massachusetts General Hospital, including appropriate workups and when to refer. Quickly find the the information you need through tabs that make it easy to locate topics of interest. Customize the book to meet your specific needs by inserting your own notes into the 6-ring binder's front and back pockets, leaving out pages you don't need, or adding others to it. Get instant access to key clinical information on the most common issues seen in practice, including preventive medicine, cardiology, dermatology, endocrinology, GI, hematology, infectious disease, musculoskeletal complaints, neurology, ophthalmology, ENT, psychiatry, pulmonary, nephrology, women's health, men's health, and geriatrics.
  pelvic exam video nejm: Learning Clinical Reasoning Jerome P. Kassirer, John B. Wong, Richard I. Kopelman, 2010 Employs a case-based approach to teach the basics of clinical reasoning, discusses steps in the clinical reasoning process, inductive and deductive strategies, data collection and its flaws, and assessing the reliability of clinical evidence.
  pelvic exam video nejm: Handbook of Clinical Obstetrics E. Albert Reece, MD, PhD, MBA, John C. Hobbins, 2008-04-15 The second edition of this quick reference handbook for obstetricians and gynecologists and primary care physicians is designed to complement the parent textbook Clinical Obstetrics: The Fetus & Mother The third edition of Clinical Obstetrics: The Fetus & Mother is unique in that it gives in-depth attention to the two patients – fetus and mother, with special coverage of each patient. Clinical Obstetrics thoroughly reviews the biology, pathology, and clinical management of disorders affecting both the fetus and the mother. Clinical Obstetrics: The Fetus & Mother - Handbook provides the practising physician with succinct, clinically focused information in an easily retrievable format that facilitates diagnosis, evaluation, and treatment. When you need fast answers to specific questions, you can turn with confidence to this streamlined, updated reference.
  pelvic exam video nejm: Clinical Management of Male Infertility Giorgio Cavallini, Giovanni Beretta, 2014-10-20 This book provides andrologists and other practitioners with reliable, up-to-date information on all aspects of male infertility and is designed to assist in the clinical management of patients. Clear guidance is offered on classification of infertility, sperm analysis interpretation and diagnosis. The full range of types and causes of male infertility are then discussed in depth. Particular attention is devoted to poorly understood conditions such as unexplained couple infertility and idiopathic male infertility, but the roles of diverse disorders, health and lifestyle factors and environmental pollution are also fully explored. Research considered stimulating for the reader is highlighted, reflecting the fascinating and controversial nature of the field. International treatment guidelines are presented and the role of diet and dietary supplements is discussed in view of their increasing importance. Clinicians will find that the book’s straightforward approach ensures that it can be easily and rapidly consulted.
  pelvic exam video nejm: Bladder Pain Syndrome Jørgen Nordling, Jean Jacques Wyndaele, Joop P. van de Merwe, Pierre Bouchelouche, Mauro Cervigni, Magnus Fall, 2012-11-14 Bladder Pain Syndrome: A Guide for Clinicians provides a comprehensive update in the pathophysiology, epidemiology, terminology, evaluation and treatment of patients with pelvic pain perceived to be related to the urinary bladder. The volume covers the tremendous evolution during the last decade in our understanding of pain syndromes and their diagnosis and treatment. It is now clear that Bladder Pain Syndrome belongs to the family of pain syndromes, and therefore treatment has moved from the treatment of the bladder to the treatment of a pain syndrome with the special problems this presents when the pain syndrome involves urinary symptoms. Interstitial Cystitis was poorly defined and the interpretation and patient selection differed enormously around the world in many ways, making exchange of information unreliable and confusing. Bladder Pain Syndrome is clearly defined and the result is a much better patient selection. This volume provides state of the art background for making a correct evaluation and diagnosis of patients with pelvic pain and voiding problems resulting in a more focused treatment to the benefit of the patients. The volume also covers the close relationship between different pain syndromes including those outside the pelvis. Bladder Pain Syndrome: A Guide for Clinicians will be of great utility to urologists, gynecologists and all health professionals dealing with patients with pelvic pain.
  pelvic exam video nejm: Gerontology Nursing Case Studies Donna J. Bowles, MSN, EdD, RN, CNE, 2015-04-08 Praise for the first edition: “This is an excellent teaching guide and resource manual for instructors, gerontological nursing students, and practicing nurses and social workers who wish to learn more about geriatric concerns and care. It will be kept by nursing students long after they graduate as a guide to resources that will be valuable throughout their nursing careers. As a home care nurse working mainly with the geriatric community, I found the resources helpful in my practice. As an instructor, I found the book to be a very useful guide for teaching geriatrics.” Score: 90, 4 Stars —Doody’s Medical Reviews “[This] is a unique volume that effectively addresses the lack of gerontology case studies for use with undergraduate nursing students. Case studies are a pedagogically powerful approach to active learning that offer opportunities to apply content to clinical practice.” —The Gerontologist “The case narrative approach of this book promotes active learning that is more meaningful to students (and practicing nurses) and more likely to increase the transfer of evidence into practice. An excellent resource for faculty (staff educators) to facilitate critical learning skills.” —Liz Capezuti, PhD, RN, FAAN Dr. John W. Rowe Professor in Successful Aging Co-Director, Hartford Institute for Geriatric Nursing New York University College of Nursing Vivid case examples help guide nurses in developing appropriate interventions that include complementary and alternative health therapies and provide a basis for evaluating outcomes. Exercises interspersed throughout each case study include numerous open-ended and multiple-choice questions to facilitate learning and critical thinking. The text is unique in that some of the presented cases focus on psychosocial issues such as gambling addiction, hoarding behavior, emergency preparedness, and long-distance caregiving. Cases also depict geriatric clients who are living healthy, productive lives to counter myths and negative attitudes about older adults. Scenarios demonstrating ethical dilemmas prepare students to appropriately respond to “gray area” situations. The text is geared for AACN and NLN accreditation and is organized according to the needs of actual clinical settings. With cases that take place in the home and community or within primary, acute, and long-term care facilities, this book will be useful for courses specific to gerontology nursing or across any nursing curriculum. New to the Second Edition: A completely new section of Aging Issues Affecting the Family New cases addressing health care disparities, aging in place, and prevention of catheter-associated urinary tract infection Additional contemporary case studies The addition of Quality for Safety in Nursing Education (QSEN) initiatives A greater focus on prioritization and delegation of client’s needs infused throughout exercises
  pelvic exam video nejm: OSCEs for the Final FFICM Raj Nichani, Brendan McGrath, 2016-07-28 Comprehensive coverage of key topics for the FFICM OSCE examination, based on actual exam questions and modelled to the curriculum.
  pelvic exam video nejm: Tumor Board Review Robert F. Todd, Kathleen A. Cooney, MD, 2011-10-19 Tumor Board Reviews provides comprehensive coverage of all topics in oncology. Each of the 32 chapters focuses on a specific major disease. A brief overview of epidemiology and risk factors is followed by a sequence of specific presentations organized by tumors stage or disease classification. Each discussion features a case presentation that mimics the format of a tumor board presentation and thus illustrates key diagnostic and management decisions. There is also a discussion of the evidence that supports the clinical management decisions taken in the case, based on current expert panel guidelines. Algorithms and decision tree graphics are used extensively to provide visual support of the decision process. The combination of case presentations and evidence-based management discussions make this volume a unique tool for keeping current with clinical guidelines and provides the reader with a clear understanding of applications of new information for use in daily practice.
  pelvic exam video nejm: Evidence-Based Geriatric Nursing Protocols for Best Practice Marie Boltz, PhD, RN, GNP-BC, FGSA, FAAN, Elizabeth Capezuti, PhD, RN, FAAN, Terry T. Fulmer, PhD, RN, FAAN, DeAnne Zwicker, DrNP, APRN, BC, 2016-03-28 This new edition of one of the premier references for geriatric nurses in hospital, long-term, and community settings delivers current guidelines, real-life case studies, and evidence-based protocols developed by master educators and practitioners. With a focus on improving quality of care, cost-effectiveness, and outcome, the fifth edition is updated to provide the most current information about care of common clinical conditions and issues in older patients. Several new expert contributors present current guidelines about hip fractures, frailty, perioperative and postoperative care, palliative care, and senior-friendly emergency departments. Additionally, chapters have been reorganized to enhance logical flow of content and easy information retrieval. Protocols, systematically tested by more than 300 participating NICHE (Nurses Improving Care for Health system Elders) hospitals‚ are organized in a consistent format and include an overview, evidence-based assessment and intervention strategies, and an illustrative case study with discussion. Additionally, protocols are embedded within chapter text, providing the context and detailed evidence for each. Chapter objectives, annotated references,and evidence ratings for each protocol are provided along with resources for additional study. New to the Fifth Edition: Reorganized to enhance logical flow of information and ease of use Updated and revised Includes new contributions from expert educators and practitioners Provides new chapters on perioperative and postoperative care, general surgical care, care of hip fracture, palliative care, and the senior-friendly emergency department Key Features: Includes PowerPoints and a test bank for instructors Delivers evidence-based, current guidelines and protocols for care of common clinical conditions in the older person Illustrates the application of clinical protocols to real-life practice through case studies and discussion Edited by nationally known geriatric leaders who are endorsed by the Hartford Institute for Geriatric Nursing and NICHE Written for nursing students, nurse leaders, and practitioners at all levels, including those in specialty roles
  pelvic exam video nejm: Lung Ultrasound in the Critically Ill Daniel A. Lichtenstein, 2015-09-29 Written by a pioneer in critical care ultrasound, this book discusses the basic technique and “signatures” of lung ultrasound and explains its main clinical applications. The tools and clinical uses of the BLUE protocol, which allows diagnosis of most cases of acute respiratory failure, are first described in detail. Careful attention is then devoted to protocols derived from the BLUE protocol – the FALLS protocol for diagnosis and management of acute circulatory failure, the Pink protocol for use in ARDS, and the SESAME protocol for use in cardiac arrest – and to the LUCI-FLR program, a means of answering clinical questions while reducing radiation exposure. Finally, the book discusses all the possible settings in which lung ultrasound can be used, discipline by discipline and condition by condition. Lung Ultrasound in the Critically Ill comprehensively explains how ultrasound can become the stethoscope of modern medicine. It is a superb complement to the author’s previous book, Whole Body Ultrasonography in the Critically Ill.
  pelvic exam video nejm: The Testicular Descent in Human K.J. Barteczko, M.I. Jacob, 2012-12-06 The testicular descent (descensus testis) is described in a complete series of human material from stage 14 CC to the adult state by using own phases. Central points of interest in this work are answers to questions which have been discussed controversially by generations of scientists and which are wrong or inadequately documented in most textbooks of embryology: Does an inner gonadal descent exist? What about origin, role and fate of gubernaculum H., processus vaginalis peritonei and gonadal ligaments? How do the annexes of testis come into their final position? The results are based on serial sections, scanning electron microscopy, three-dimensional reconstructions, microdissection and immunohistochemistry.
  pelvic exam video nejm: Handbook of Stress Medicine John R. Hubbard, 1997-10-24 Psychological stress is often overlooked by medical doctors as a major factor in physiologically based illness; however, clinical studies show that stress has a vital impact on both the mental and physical well-being of patients. Handbook of Stress Medicine: An Organ System Approach focuses on the relationship between stress and the physiology and pathology of the major organ systems of the body. It suggests that understanding how stress impacts on illnesses can help hold down medical costs through more accurate diagnoses and promote improved preventative care. Section I offers a general background on stress as it relates to medicine and the difficulties in conducting stress-related research. The primary focus of the text, how stress effects specific organ systems, is examined using scientific and clinical data in Section II. The third section addresses the impact of stress on important medical problems of current interest, such as AIDS, cancer, and substance abuse. It also discusses anxiety disorders. The next section covers topics related to stress, such as stress measurement, stress in the workplace, and the psychodynamics of stress. The final section explores the major pharmacological and non-pharmacological approaches to the treatment of stress and anxiety disorders. This book will assist physicians, psychologists, nurses, physical therapists, and other health care professionals recognize possible stress-related problems, educate their patients, and develop therapeutic strategies for reducing stress and stress-related illnesses.
  pelvic exam video nejm: Challenging Cases in Rheumatology and Diseases of the Immune System Massoud Mahmoudi, 2012-11-14 Challenging Cases in Rheumatology and Diseases of the Immune System is the latest title in a growing collection of thought-provoking case-based titles from Massoud Mahmoudi, D.O., Ph.D. Like his three preceding titles, Challenging Cases in Allergy and Immunology (2009), Challenging Cases in Allergic and Immunologic Diseases of the Skin (2010), and Challenging Cases in Pulmonology (2011), this easy-to-read title presents the topic in a challenging and enjoyable case-based format. Developed by 30 distinguished contributors, the book consists of six parts and 16 chapters, with each chapter presenting two cases. The style of this title follows the previous books: each topic begins with an abstract, followed by a case presentation, working diagnosis, data, final diagnosis, and discussion. In addition, to enhance a review of the subject and stimulate critical thinking, there are 5 to 10 multiple choice questions and answers in each chapter. Challenging Cases in Rheumatology and Diseases of the Immune System is an indispensable resource for all clinicians who care for patients with rheumatic and immunologic disorders.
  pelvic exam video nejm: MDCT: A Practical Approach S. Saini, G.D. Rubin, M.K. Kalra, 2007-03-14 This book describes current examination techniques and advanced clinical applications of state-of-the-art multidetector computed tomography (MDCT) scanners. There are contributions from several distinguished radiologists and clinicians. Each chapter is written from a practical perspective, so that radiologists, residents, medical physicists, and radiology technologists can obtain relevant information about MDCT applications.
  pelvic exam video nejm: Textbook of Family Medicine Robert E. Rakel, David Rakel, 2011 Offers guidance on the principles of family medicine, primary care in the community, and various aspects of clinical practice. Suitable for both residents and practicing physicians, this title includes evidence-based, practical information to optimize your patient care and prepare you for the ABFM exam.
  pelvic exam video nejm: The Best Intentions Committee on Unintended Pregnancy, Institute of Medicine, 1995-06-16 Experts estimate that nearly 60 percent of all U.S. pregnancies--and 81 percent of pregnancies among adolescents--are unintended. Yet the topic of preventing these unintended pregnancies has long been treated gingerly because of personal sensitivities and public controversies, especially the angry debate over abortion. Additionally, child welfare advocates long have overlooked the connection between pregnancy planning and the improved well-being of families and communities that results when children are wanted. Now, current issues--health care and welfare reform, and the new international focus on population--are drawing attention to the consequences of unintended pregnancy. In this climate The Best Intentions offers a timely exploration of family planning issues from a distinguished panel of experts. This committee sheds much-needed light on the questions and controversies surrounding unintended pregnancy. The book offers specific recommendations to put the United States on par with other developed nations in terms of contraceptive attitudes and policies, and it considers the effectiveness of over 20 pregnancy prevention programs. The Best Intentions explores problematic definitions--unintended versus unwanted versus mistimed--and presents data on pregnancy rates and trends. The book also summarizes the health and social consequences of unintended pregnancies, for both men and women, and for the children they bear. Why does unintended pregnancy occur? In discussions of reasons behind the rates, the book examines Americans' ambivalence about sexuality and the many other social, cultural, religious, and economic factors that affect our approach to contraception. The committee explores the complicated web of peer pressure, life aspirations, and notions of romance that shape an individual's decisions about sex, contraception, and pregnancy. And the book looks at such practical issues as the attitudes of doctors toward birth control and the place of contraception in both health insurance and managed care. The Best Intentions offers frank discussion, synthesis of data, and policy recommendations on one of today's most sensitive social topics. This book will be important to policymakers, health and social service personnel, foundation executives, opinion leaders, researchers, and concerned individuals. May
  pelvic exam video nejm: Radiology Fundamentals Harjit Singh, Janet Neutze, 2011-12-02 Radiology Fundamentals is a concise introduction to the dynamic field of radiology for medical students, non-radiology house staff, physician assistants, nurse practitioners, radiology assistants, and other allied health professionals. The goal of the book is to provide readers with general examples and brief discussions of basic radiographic principles and to serve as a curriculum guide, supplementing a radiology education and providing a solid foundation for further learning. Introductory chapters provide readers with the fundamental scientific concepts underlying the medical use of imaging modalities and technology, including ultrasound, computed tomography, magnetic resonance imaging, and nuclear medicine. The main scope of the book is to present concise chapters organized by anatomic region and radiology sub-specialty that highlight the radiologist’s role in diagnosing and treating common diseases, disorders, and conditions. Highly illustrated with images and diagrams, each chapter in Radiology Fundamentals begins with learning objectives to aid readers in recognizing important points and connecting the basic radiology concepts that run throughout the text. It is the editors’ hope that this valuable, up-to-date resource will foster and further stimulate self-directed radiology learning—the process at the heart of medical education.
  pelvic exam video nejm: Dictionary of Abbreviations in Medical Sciences Rolf Heister, 2012-12-06 Not everyone is a friend of the manifold abbreviations that have by now beCome a part of the scientific language of medicine. In order to avoid misunderstanding these abbreviations, it is wise to refer to a reliable dic tionary, such as this one prepared by Heister. The abbreviation ED means, for instance, effective dose to the pharmacologist. However, it might also stand for emetic dose. Radiologists use the same abbreviation for erythema dose, and ED could also mean ethyl dichlorarsine. A com mon meaning of ECU is European currency unit, a meaning that might not be very often in scientific medical publications. ECU, however, also means environmental control unit or European Chiropractic Union. Hopefully, those making inventions and discoveries will make use of Heister's dictionary before creating new abbreviations when preparing manuscripts for scientific publications. It is a very worthwhile goal not to use the same abbreviation for several different terms, especially if it is already widely accepted to mean only one of them. It may be impossible, however, to achieve this goal in different scientific disciplines. Therefore, although it is wise for the abbreviations used in a publication to be defined, it is also very helpful for readers and writers to use a dictionary such as this one. The author deserves our warmest thanks since we know that compiling such a comprehensive dictionary is based upon incredibly hard effort.
  pelvic exam video nejm: Textbook of Assisted Reproduction Gautam Nand Allahbadia, Baris Ata, Steven R. Lindheim, Bryan J. Woodward, Bala Bhagavath, 2020-08-05 Groundbreaking, comprehensive, and developed by a panel of leading international experts in the field, Textbook of Assisted Reproduction provides a multidisciplinary overview of the diagnosis and management of infertility, which affects 15% of all couples around the world. The book aims to cover all aspects of assisted reproduction. Particular attention is given to topics such as the assessment of infertile couples; assisted reproductive techniques (ARTs) including ovulation induction, intra uterine insemination (IUI), in vitro fertilization (IVF) and intracytoplasmic sperm injection (clinical and laboratory aspects); reproductive genetics; and obstetric and perinatal outcomes.
  pelvic exam video nejm: Essentials of Clinical Radiation Oncology Matthew C. Ward, MD, Rahul D. Tendulkar, MD, Gregory M. M. Videtic, MD, CM, FRCPC, 2017-12-28 Essentials of Clinical Radiation Oncology is a comprehensive, user-friendly clinical review that summarizes up-to-date cancer care in an easy-to-read format. Each chapter is structured for straightforward navigability and information retention beginning with a “quick-hit” summary that contains an overview of each disease, its natural history, and general treatment options. Following each quick-hit are high-yield summaries covering epidemiology, risk factors, anatomy, pathology, genetics, screening, clinical presentation, workup, prognostic factors, staging, treatment paradigms, and medical management for each malignancy. Each treatment paradigm section describes the current standard of care for radiation therapy including indications, dose constraints, and side effects. Chapters conclude with an evidence-based question and answer section which summarizes practice-changing data to answer key information associated with radiation treatment outcomes. Flow diagrams and tables consolidate information throughout the book that all radiation oncologists and related practitioners will find extremely useful when approaching treatment planning and clinical care. Essentials of Clinical Radiation Oncology has been designed to replicate a house manual created and used by residents in training and is a one-stop resource for practicing radiation oncologists, related practitioners, and radiation oncology residents entering the field. Key Features: Offers digestible information as a learning guide for general practice Examines essential clinical questions which are answered with evidence-based data from important clinical studies Places clinical trials and data into historical context and points out relevance in current practice Provides quick reference tables on treatment options and patient selection, workup, and prognostic factors by disease site
  pelvic exam video nejm: Ultrasonography in Gynecology Botros R. M. B. Rizk, Elizabeth E. Puscheck, 2014-10-16 Ultrasonography is a cornerstone in the evaluation of gynecologic disease. This authoritative new book looks at the techniques of ultrasonography in both office and hospital settings, offering guidance on the optimal use of equipment and covering the full range of benign and malignant gynecologic disease as well as infertility. Ultrasonography in Gynecology offers extensive coverage of the diagnostic potential of ultrasound in gynecologic disease, from the moment the patient walks into the physician's office. All the different approaches in the ultrasonographic evaluation of disease – including 3D ultrasonography, 3D sonohysterography, Doppler imaging and pelvic floor imaging – are extensively covered, with color images throughout. Written and edited by leaders in the field of ultrasonography who have actively participated in national and international teaching courses, Ultrasonography in Gynecology is a must for all gynecologists dealing with infertility, endometriosis, uterine fibroids, gynecologic cancers, and many more gynecologic conditions.
  pelvic exam video nejm: Guide for Aviation Medical Examiners , 1992
  pelvic exam video nejm: Trauma Eric Legome, Lee W. Shockley, 2011-06-16 Trauma: A Comprehensive Emergency Medicine Approach is a fully illustrated, interdisciplinary overview of trauma. Using both evidence-based approaches and a practical understanding of the emergency department, it gives a broad and in-depth review of trauma care. The entire spectrum of trauma presentations is reviewed from minor soft-tissue injuries through to major life-threatening conditions. Written by over 50 expert contributors, it gives concrete and practical recommendations for evaluation, treatment, consultation and disposition decisions on both common and unusual conditions. Extensive use of photographs, illustrations and key information boxes is used to make the material accessible. Additional sections provide an overview of multiple other issues relating to emergency management of trauma including administrative, nursing, research and legal matters. This book provides an essential reference for anyone who is called upon to provide acute trauma care in the emergency department.
  pelvic exam video nejm: Pharmacy OSCEs Beti Wyn Evans, Laura Kravitz, Nina Walker, Kelly Lefteri, 2013 Pharmacy OSCEs is the only pharmacy-specific OSCE revision guide. With over 70 practice scenarios, this book will support you throughout your training and ensure your best performance on the day of the exam.
  pelvic exam video nejm: Pancreatic Tumors in Children G. Bennett Humphrey, Gerald B. Grindey, Louis P. Dehner, Ronald T. Acton, Theodore J. Pysher, 2011-10-26 Where do you begin to look for a recent, authoritative article on the diagnosis or management of a particular malignancy? The few general oncology textbooks are generally out of date. Single papers in specialized journals are informative but seldom comprehensive; these are more often preliminary reports on a very limited number of patients. Certain general journals frequently publish good in-depth reviews of cancer topics, and pub lished symposium lectures are often the best overviews available. Unfortu nately, these reviews and supplements appear sporadically, and the reader can never be sure when a topic of special interest will be covered. Cancer Treatment and Research is a series of authoritative volumes which aim to meet this need. It is an attempt to establish a critical mass of oncology literature covering virtually all oncology topics, revised frequently to keep the coverage up-to-date, easily available on a single library shelf or by a single personal subscription. We have approached the problem in the following fashion. First, by dividing the oncology literature into specific subdivisions such as lung can cer, genitourinary cancer, pediatric oncology, etc. Second, by asking eminent authorities in each of these areas to edit a volume on the specific topic on an annual or biannual basis. Each topic and tumor type is covered in a volume appearing frequently and predictably, discussing current diagnosis, staging, markers, all forms of treatment modalities, basic biology, and more.
  pelvic exam video nejm: Thyroid Ultrasound and Ultrasound-Guided FNA Biopsy H. Jack Baskin, Sr., 2013-04-17 Over the past two decades ultrasound has undergone numerous advances in technology such as gray-scale imaging, real-time sonography, high resolution 7.5-10 MHz transducers, and color-flow Doppler. This makes ultrasound unsurpassed in its ability to provide very accurate images of the thyroid gland quickly, inexpensively, and safely. However, in spite of these advances, ultrasound remains drastically underutilized by endocrinologists. In part, this is due to a lack of understanding of the ways in which ultrasound can aid in the diagnosis of various thyroid conditions and to a lack of experience in the ultrasound technique by the clinician. Thyroid Ultrasound and Ultrasound-Guided FNA Biopsy presents a `hands-on' approach to using ultrasound in the clinical evaluation and management of thyroid disease. It is written specifically for the clinician and discusses the subtleties one needs to be aware of in using this technique. Particular attention is paid to using ultrasound in conjunction with FNA biopsy. New technology such as three-dimensional ultrasound, color-flow Doppler, and percutaneous injection of cysts and nodules are discussed and demonstrated. Numerous ultrasound examples are used to show the interactions between ultrasound and tissue characteristics and explain their clinical significance. Also presented is the work of several groups of investigators worldwide who have explored new applications of ultrasound, that has led to novel techniques that are proving clinically useful.
  pelvic exam video nejm: Clinical PET-CT in Radiology Paul Shreve, David W. Townsend, 2010-12-14 This book is specifically designed to meet the needs of practicing radiologists by offering a practical, unified approach to PET-CT. It details how to effectively apply PET-CT in patient management. Written by radiologists who fully appreciate and understand both PET and CT, the book details an integrated understanding of PET-CT as a combined modality. Clinical topics include PET-CT of thoracic malignancies, melanoma, and breast cancer. In addition, the book reinforces fundamental concepts, such as the role of imaging diagnosis in disease management.
  pelvic exam video nejm: Anterior knee pain and patellar instability Vicente Sanchis-Alfonso, 2006-03-14 Clinically oriented and richly illustrated, this book provides complete guidance on the surgical and non-surgical management of the anterior knee pain syndrome and is aimed at orthopedic surgeons, sports medicine practitioners, knee specialists and physical therapists.
  pelvic exam video nejm: Bone Densitometry in Growing Patients Aenor Sawyer, 2007-11-06 Bone Densitometry in Growing Patients: Guidelines for Clinical Practice, edited by Drs. Sawyer, Bachrach, and Fung, is a milestone book for all health prof- sionals concerned with bone health in growing patients. The book introduces and emphasizes the importance of attending to issues of bone health and development in childhood and adolescence as a way of maintaining such health and decreasing the epidemic of osteoporosis that we are now seeing in older adults. In doing so, the book offers a much-needed first set of standards of bone densitometry in growing patients. Given the numerous reports of serious interpretation errors in densitometry results in children, the development of this body of work is truly important. It is in this context that Bone Densitometry in Growing Patients: Guidelines for Clinical Practice presents the current evidence, including an assessment of the strengths and weaknesses in the data on assessing bone density in childhood and adolescence. In short, the editors and authors have done an outstanding job of or- nizing not only the key topics in this broad clinical discussion, but also, and most importantly, the evidence within these areas.
  pelvic exam video nejm: Neuroscience Dale Purves, 2004-01-01 Neuroscience is a comprehensive textbook created primarily for medical and premedical students; it emphasises the structure of the nervous system, the correlation of structure and function, and the structure/function relationships particularly pertinent to the practice of medicine. Although not primarily about pathology, the book includes the basis of a variety of neurological disorders. It could serve equally well as a text for undergraduate neuroscience courses in which many of the students are premeds. Being both comprehensive and authoritative, it is also appropriate for graduate and professional use. The new edition offers a host of new features including a new art program and the completely revised Sylvius for Neuroscience: Visual Glossary of Human Neuroanatomy, an interactive CD-ROM reference guide to the human nervous system. Major changes to the new edition also include: additional neuroanatomical content, including two appendices-(1) The Brainstem and Cranial Nerves and (2) Vascular Supply, the Meninges, and the Ventricular System; and updated and new boxes on neurological and psychiatric diseases.
  pelvic exam video nejm: Abdominal Trauma Frank William Blaisdell, Donald D. Trunkey, 1982
  pelvic exam video nejm: Unlearn Your Pain Howard Schubiner, Michael Betzold, 2019