A randomized clinical trial to compare two different approaches in women with chronic pelvic pain

Article Abstract:

Chronic pelvic pain is treated by a variety of approaches, including drug therapy with hormones and nonsteroidal anti-inflammatory drugs; surgery, for intractable pain; and psychological or psychiatric counselling. Since chronic pelvic pain may be caused by several factors, a single method of managing pain may not be effective. The standard procedure for treating chronic pelvic pain consisted of eliminating organic, or physical causes, followed by routine laparoscopy (exploratory surgery of the abdomen), and psychosocial care. An alternative method of managing chronic pelvic pain incorporates a multidisciplinary approach, which consists of physical and behavioral therapies. This integrated approach focuses on bodily, psychological, dietary, environmental, and physiotherapeutic factors, and does not involve routine laparoscopy, which is an invasive procedure. The effectiveness of standard treatment was compared with that of the alternative integrated approach to managing chronic pelvic pain. Clinical characteristics and severity of pain were similar for all patients. Twenty-seven percent of patients reported pain after sexual intercourse. Adverse sexual experiences, such as sexual abuse or rape in childhood, had occurred in 20 percent of patients. Follow-up at one year after the start of treatment showed that the integrated approach to managing chronic pelvic pain was more effective than the standard procedure. Laparoscopy did not play a major role in alleviating pain. These results show that an integrated approach which immediately focuses on various factors that may contribute to the development of chronic pelvic pain is effective in reducing chronic pelvic pain. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Causes of, Pain, Laparoscopy, Pelvic pain

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Primary neoplasms of the hollow organs of the gastrointestinal tract: staging and follow-up

Article Abstract:

Cancers of the gastrointestinal tract are among the more aggressive and malignant of cancers. Despite early enthusiasm for the use of computed tomography (CT) in the diagnosis, staging, and monitoring of gastrointestinal cancers, CT has, by and large, not lived up to expectations and interest has waned. The only exception is cancer of the esophagus, in which CT scanning is quite accurate with both sensitivity and specificity greater than 90 percent. The usefulness of both CT and magnetic resonance imaging (MRI) seems to be limited for stomach and colorectal cancers. However, ultrasonic imaging shows promise in these areas. Neither CT nor MRI is capable of demonstrating the extent of local spread of rectal cancer, but endoscopic ultrasonography seems to be capable of revealing the depth of tumor invasion in the rectal wall. Ultrasound imaging is also superior to CT in the detection of cancer spread to lymph nodes, but unfortunately the technique still misses too many positive lymph nodes to eliminate the requirement for surgical staging. It is advantageous, of course, to have an imaging technique to detect tumor recurrence during follow-up of treated cancer patients. However, both CT and MRI suffer from the failure to distinguish between old scar tissue and the development a recurrent tumor. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Usage, Tumor staging, Cancer staging, Medical imaging equipment, Diagnosis, Ultrasonic, Diagnostic ultrasonography

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