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Illustration of a young man with diabetic arterial disease experiencing pain while walking variable distances (left). Pain is usually distal in the ankle or foot, because smaller, distal vessels are most commonly affected in diabetic arterial disease (Buerger's Disease). This condition is much more common among heavy smokers (right).
Illustration of knee problems of a young athlete. In a young person's knee, there are metabolically active distal femoral and proximal tibial physeal plates between the metaphyseal and periarticular epiphyseal regions. A supraphysiologic stress applied to the knee may be concentrated at the physeal plates, leading to a growth plate fracture.
Illustration of a Papanicolaou (Pap) smear. Shown are a cervical scrape smear (top), a cervical swab smear (bottom left), and an endocervical aspirator (bottom right). A Pap smear is used to detect cervical intraepithelial neoplasia (dysplasia), cervical cancer, vaginal neoplastic cells, condyloma (human papilloma virus, or HPV), trichomoniasis, and herpes.
Illustration of a colposcopy used to visualize an abnormal cervix (top) and an normal one (bottom). This procedure can identify abnormal areas not grossly apparent, so that suspicious areas can be evaluated earlier, diethylstilbestrol (DES)-exposed patients can be evaluated more fully, and directed biopsies can be performed.
Illustration of an ultrasonogram (ultrasound) of a pregnant woman. This procedure may detect an ectopic (tubal) pregnancy, fetal anomalies, fetal age, multiple gestations, fetal distress, and fetal position (vertex, breech or transverse). Other uses include the evaluation of ovarian tumors, uterine fibroids, pelvic pain, endometriosis, and pelvic infections.
Illustration of pelvic inflammatory disease (PID). PID occurs when pathogenic organisms migrate upward from the urethra and cervix into the upper genital tract. PID can lead to infertility, ectopic pregnancy, and chronic pain. Doctors often prescribe at least two broad-spectrum antibiotics for PID, because it is hard to identify the organisms responsible.
Illustration of endometriosis, a condition in which endometrial-like tissue is found outside the uterus. This may create growths leading to severe pain and infertility. Treatments include hormones (danazol, cyclic progestins) to suppress ovarian function; and surgery to remove extensive endometrial implants, adhesions, and endometriomas.
Conceptual illustration of dysmenorrhea (menstrual pain). Primary dysmenorrhea occurs when prostaglandins synthesized in the uterine wall build up just before menstruation and produce strong contractions leading to pain, cramping, and discomfort. Secondary dysmenorrhea may be caused by endometriosis, pelvic infections, and fibroids.
Illustration of a normal human menstrual cycle. Shown are: 1) the ovarian cycle (top), from left to right: maturation of the follicle, ovulation, and the corpus luteum; 2) the uterine cycle (middle), from left to right: day 1 to 28; and 3) the hormone levels (bottom) of estrogen (top line) and progesterone (bottom line).