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In addition, this system puts inmates in a passive role in terms of medication treatment and does not foster selfsufficiency. These include patientrelated factors, factors related to systems of care (including the medication dispensing systems described above), and medicationrelated factors. It also allows inmates to develop self-sufficiency in managing medications, which may facilitate improved adherence upon release. They may be told that a refill request was made too early or too late, which can result in delays in dispensing medications, and ultimately, treatment interruptions. Diagrams and videos may be more effective than readingintensive material in some cases. Upon release, telephone hotlines may be available to provide follow-up support and linkages to community services. To the extent possible, family and friends should be included in the education process. In 2004, nearly one third of inmates in state facilities and one fourth of inmates in the federal system committed their offenses under the influence of drugs (Mumola and Karberg, 2006). Depression and other psychiatric illnesses are more prevalent among inmates than among the general population (James and Glaze, 2006). Inmates should be educated in advance about potential adverse events and urged to observe and report them. For treating gastrointestinal toxicities, antiemetics and antidiarrheals should be available on an as-needed basis. That can be especially challenging in the correctional environment, particularly in facilities that do not allow inmates to self-administer medications. Make arrangements with prison authorities to provide food when inmates are taking medications that require administration with food. Some antiretroviral medications have clinically significant interactions with other drugs. These interactions may cause failure of either the antiretroviral drug or the other medication, or they may cause additional toxicity. In many correctional systems, inmates must document a physical address at which they intend to reside in order to be released. Many will have difficulty managing even the most basic elements for successful reintegration into their communities. Ideally, the discharge process at the correctional facility will maximize the likelihood that the releasee will have continuous medical care. A short confinement period, for example, can prevent the development of a solid transitional plan. Jail inmates may be released without their medications and have no choice but to call or walk into community health centers or clinics for their medications and ongoing care. For some individuals, interruptions in treatment occur during their time in jail or prison. Based on their individual histories, anticipate circumstances that may result in them breaking parole. For example, if a client confides that he or she has anxiety regarding meeting the parole officer, initiate and practice role plays to better prepare the client for this encounter. It is important that clinic staff and community-based organizations develop the capacity to work with clients in real time as they present for care in order to help them maintain continuity with their medications. Gender Responsive Strategies: Research, Practice, and Guiding Principles for Women Offenders. Preventing death among the recently incarcerated: an argument for naloxone prescription before release. Bridging the Communicable Disease Gap: Identifying, Treating and Counseling High Risk Inmates. S: Subjective A newly diagnosed patient presents to clinic after being referred from a testing center in the community. Although there are some areas of education that should be considered for all patients (see above), patients should not be required to have a high level of understanding in each area. Patients should be given the opportunity to learn as much about an area as they would like, and should be encouraged to gain a working knowledge of the information that is necessary to keep them healthy and safe.
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Despite the subsequent rapid spread of this virus worldwide, traditional public health measures were able to contain and control this outbreak. Acknowledgments We would like thank Yuan Zhang and Raymond Chow, for producing the graphics in this article, and Alice Au Yeung, for her assistance with the manuscript preparation. Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong. Cluster of severe acute respiratory syndrome cases among protected health care workers-Toronto, April 2003. Severe acute respiratory syndrome: radiographic appearances and pattern of progression in 138 patients. Clinical presentations and outcome of severe acute respiratory syndrome in children. In: Program and abstracts of the 43rd Meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy (Chicago). Program and abstracts of the 43rd Meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy (Chicago). Microbiologic characteristics, serologic responses, and clinical manifestations in severe acute respiratory syndrome, Taiwan. Human metapneumovirus detection in patients with severe acute respiratory syndrome. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. Preliminary results on the potential therapeutic benefit of interferon alfacon-1 plus steroids in severe acute respiratory syndrome [abstract K-1315e]. In: Program and abstracts of the meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy (Chicago). Development of a standard treatment protocol for severe acute respiratory syndrome. High dose pulse versus nonpulse corticosteroid regimens in severe acute respiratory syndrome. Management of severe acute respiratory syndrome: the Hong Kong University experience. Coronavirus-positive nasopharyngeal aspirate as predictor for severe acute respiratory syndrome mortality. Mechanisms of action of intravenous immune serum globulin in autoimmune and inflammatory diseases. One by one, the most severe outbreaks in the initial waves of infection are being brought under control. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Brief examples of economic, social, and political repercussions illustrate the wide-ranging impact a new disease can have in a closely interconnected and highly mobile world. Simultaneously, the disease began spreading around the world along international air travel routes as guests at the hotel flew home to Toronto and elsewhere, and as other medical doctors who had treated the earliest cases in Viet Nam and Singapore travelled internationally for medical or other reasons. All of these initial outbreaks were subsequently characterized by chains of secondary transmission outside the health care environment. At present, the outbreaks of greatest concern are concentrated in transportation hubs or spreading in densely populated areas. Further investigations rule out anthrax, pulmonary plague, leptospirosis, and haemorrhagic fever. Epidemiological analysis indicated that the new disease was spreading along the routes of international air travel. After the recommendations, all countries with imported cases, with the exception of provinces in China, were able, through prompt detection of cases, immediate isolation, strict infection control, and vigorous contact tracing, to either prevent further transmission or keep the number of additional cases very low. During the last week of April, the outbreaks in Hanoi, Hong Kong, Singapore, and Toronto showed some signs of peaking. However, new probable cases, including cases in hospital staff, additional deaths, and first cases imported to new areas continued to be reported from several countries. The cumulative total number of cases surpassed 5000 on 28 April, 6000 on 2 May, and 7000 on 8 May, when cases were reported from 30 countries on six continents.
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However, little evidence has demonstrated improved overall survival from surgical staging (Lagasse, Creasman, Shingleton, Ford, & Blessing, 1980). Studies comparing clinical staging to surgical staging have shown a tendency to overestimate the extent of disease during surgery. These same studies have not been found to change patient survival, and the future of surgical staging in cervical cancer remains investigational (Creasman, 1995; Pecorelli & Odocino, 2003). Physical examination is the first piece of evidence for staging (Creasman, 1995; Greene et al. As these tests become more available, they may become an official part of staging. The initial treatment depends on the extent of disease at diagnosis and individual variables. Both surgery and primary radiation with concomitant chemotherapy have been proven equally effective in treating early cervical cancer. More advanced cases usually are treated with combination radiotherapy and chemotherapy. Chemotherapy is used as a radiosensitizer when radiation therapy is employed and also for metastatic and recurrent disease (Schneider & Kohler, 2007). For this reason, any woman diagnosed with cervical cancer should see at least one gynecologic oncologist to ensure proper treatment (Malzoni, Tinelli, Cosentino, Perone, & Vicario, 2007). Advantages and disadvantages of each modality must be evaluated based on patient-specific criteria. When surgery is part of the plan of care, the type of hysterectomy that is performed depends on the extent of the lesion. Except for these early lesions, the standard of care for surgical management of cervical cancer is a radical hysterectomy. A radical hysterectomy differs from a simple hysterectomy because the connective tissue surrounding the uterus and cervix and upper vagina are removed and surgery includes a full pelvic lymphadenectomy. This is necessary because of the typical pattern of metastasis in cervical cancer. Left untreated, cancer cells from the cervix will migrate out to the pelvic sidewalls. Piver, Rutledge, and Smith (1974) described five classes of radical hysterectomy based on how much tissue is dissected and excised during surgery. The uterine artery is ligated where it crosses over the ureter; the uterosacral and cardinal ligaments are divided midway toward their attachment to sacrum and the pelvic sidewall (also known as a modified radical hysterectomy). The uterine artery is ligated at its origin from the superior vesical or internal iliac artery; uterosacral and cardinal ligaments are resected at their attachments to the sacrum and pelvic sidewall; and the upper one-half of the vagina is resected. The ureter is dissected completely from the vesicouterine ligament, the superior vesical artery is sacrificed, and threefourths of the vagina is resected. This is not as common as the other procedures because patients with disease requiring this level of dissection should be treated with radiation. Radical hysterectomy is a technically challenging surgery and should only be performed by an experienced gynecologic oncologist (Malzoni et al. Aside from general surgery risks, such as hemorrhage, infection, thromboembolic events, wound breakdown, ileus, and bowel obstructions, radical hysterectomy has specific morbidities. Bladder dysfunction following radical hysterectomy is the most common complication, and it may be prolonged. About 75% will have return to normal bladder function within one to two weeks following surgery and most will be back to normal by three weeks. Sexual dysfunction also is common after radical hysterectomy because part of the length of the vagina is removed. During treatment, cystitis and diarrhea are common side effects of radiation on the bladder and bowel. Acute inflammation can become chronic, which may lead to morbidities such as colitis, proctitis, and enteritis.
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The following include general principles and 1 Centers for Diseases Control and Prevention. All live vaccinesd,e Effectiveness of any inactivated vaccine depends on degree of immune suppression. For patients in whom initiation of immunosuppressive medication is planned, vaccinations should be administered prior to immunosuppression when feasision and should not be given within 2 weeks before initiation. Inactivated vaccines and Immune immune response to inactivated vaccines generally is not affected by circulating antibody. Safety is not a concern, nor is risk of graft rejection or exacerbation of immune-mediated are very unlikely to respond (although also unlikely to be harmed), such as those receiving intensive chemotherapy and those who have received anti-B-lymphocyte antibody therapy within 6 months. Additional vaccines not given universally are indicated for children with certain conditions. If chemotherapy is ongoing or other immunosuppressive therapy is escalated, cella) to guide management. Inactivated vaccine administration can be deferred temporarily until corticosteroids are discontinued if the hiatus is expected to be brief and adherence to return appointment is likely. Children who are receiving only maintenance physiologic doses of corticosteroids can receive live-virus vaccines. Low or moderate doses of systemic corticosteroids given daily or on alternate days. Children who have a disease (eg, systemic lupus erythematosus) that, in itself, is considered to suppress the immune response and/or are receiving immunosuppressant medication other than corticosteroids and who are receiving systemic or locally administered corticosteroids. Vaccination status should be assessed pretreatment, and recommended vaccines should be administered with timing as for planned corticosteroid use (see Timing of Vaccines). Counsel household members regarding risk of infection and ensure vaccination (see Household Members of Immunosuppressed Patients, p 82) Consider serologic testing for Histoplasma species, Toxoplasma species, and other intracellular pathogens depending on risk of past exposure Perform serologic testing for hepatitis B virus Consider testing for varicella-zoster virus and Epstein-Barr virus food safety ( Household members of these patients should be counseled about risks of infection and should have vaccination status made current. All infants, children, adolescents, and adults with asplenia, regardless of the reason for the asplenic state, have an increased risk of fulminant septicemia, especially associated with encapsulated bacteria, which is associated with a high mortality rate. Fulminant septicemia, however, has been reported in adults as long as 25 years after splenectomy. Those with functional or anatomic asplenia also are at increased risk of fatal malaria and severe babesiosis. A second dose should be administered 5 years later (see Pneumococcal Infections, p 626). When splenectomy is planned for a patient 2 type b (Hib) immunization should be initiated at 2 months of age, as recommended for otherwise healthy young children on the annual immunization schedule. Previously unimmunized children with asplenia younger than 5 years should receive Hib vaccine according to the catch-up schedule. Management options include postponement of splenectomy for as long as possible in people with congenital hemolytic anemia, preservation of accessory spleens, performance of partial splenectomy for benign tumors of the spleen, conservative (nonoperative) management of splenic trauma, or when feasible, repair rather than removal. Antimicrobial Agents Daily antimicrobial prophylaxis against pneumococcal infections is recommended for many children with asplenia, regardless of immunization status. In general, antimicrobial prophylaxis (in addition to immunization) should be considered for all children with asplenia younger than 5 years of age and for at least 1 year after splenectomy at any age. The appropriate duration of prophylaxis for children with asplenia attributable to other causes is unknown. Some experts continue prophylaxis throughout childhood and into adulthood for particularly high-risk patients with asplenia. For children with anaphylactic allergy to penicillin, erythromycin can be given (250 mg, twice daily). When antimicrobial prophylaxis is used, these limitations must be stressed to parents and patients, who should be made aware that all febrile illnesses potentially are serious in children with asplenia and that immediate medical attention should be sought because the initial signs and symptoms of fulminant septicemia can be subtle. Likewise, medical attention should be sought for asplenic patients who suffer animal bites. In some clinical situations, other antimicrobial agents, such as aminoglycosides, may be indicated. Risk of Some physicians recommend empiric parenteral antimicrobial therapy in the immediate post-traumatic period. In the case of pertussis immunization during infancy, vaccine administration could coincide with or hasten the recognition of a disorder associated with seizures, such as infantile spasms or severe myoclonic epilepsy of infancy, which could cause confusion about the role of pertussis immunization.
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Clinicopathologic features of a systemic Coronavirus-associated disease resembling feline infectious peritonitis in the domestic (Mustela putorius). Identification of group 1 Coronavirus antigen in multisystemic granulomatous lesions in ferrets (mustela putorius furo). Signalment: 12-week-old male Sprague-Dawley rat, Rattus norvegicus (09-1220); 12-week-old female Sprague-Dawley rat, Rattus norvegicus (09-1215). History: these two rats were part of a larger study investigating the prevalence of lung lesions in Sprague-Dawley and athymic nude rats between 3 and 24 weeks of age, housed in either barrier or isolator facilities. The two rats submitted were both housed in a barrier facility from birth and were sacrificed at 12 weeks of age to look for gross and microscopic evidence of lung pathology. Gross Pathology: No gross lesions were observed at routine post mortem examination; however, after 10% formalin infusion via the trachea and a minimum of 24 hours immersion fixation, multifocal (4-20), 0. Aerobic and anaerobic culture of lung tissue did not culture any bacteria or fungi. Lung, rat: Multifocally, pulmonary arterioles are surrounded by moderate numbers of lymphocytes and histiocytes. The majority of cells are pleomorphic lymphocytes and large foamy macrophages with fewer neutrophils and occasional plasma cells and eosinophils (mixed inflammatory cell interstitial pneumonia). In some slides the pleura is multifocally mildly expanded by a similar cellular infiltrate (pleuritis). The perivascular lymphatics are occasionally moderately ectatic (perivascular oedema). Extensive serological testing, bacterial culture and protozoal identification testing failed to identify a causative agent. Electron microscopy failed to demonstrate the presence of viral-particles, although structures interpreted as bacterial bacilli were observed in the majority of rats with lung lesions. Conference Comment: this case provides a detailed look at the rapid evolution of this mild but historically important pulmonary condition in rats. The contributor adequately outlined the historical aspects surrounding this lesion, and describes the current consensus identifying Pneumocystis carinii as the inciting agent. In humans the organism is hypothesized to be continually present within the lungs from the first few years of life, often in the absence of overt pathology. Histopathology of naturally transmitted "rat respiratory virus": progression of lesions and p r o p o s e d d i a g n o s t i c c r i t e r i a. Pneumocystis carinii causes a distinctive interstitial pneumonia in immunocompetent laboratory rats that had been attributed to "rat respiratory virus. Pneumocystis carinii infection causes lung lesions historically attributed to rat respiratory virus. Pneumocystis infection in an immunocompetent host can promote collateral sensitization to respiratory antigens. History: Euthanized because of a large subcutaneous mass and abdominal distension. Gross Pathology: A 15 mm diameter abscess is present in the subcutaneous layer of the dorsal left abdominal wall. This abscess extended into the abdomen and is contiguous with the left uterine horn. It is filled with thick yellow material, a swab of which is taken for bacterial culture. Laboratory Results: Bacteriology: Aerobic: Pasteurella pneumotropica present; Strict Anaerobe: Peptostreptococcus anaerobius present. Histopathologic Description: the left uterine horn has severe necrosuppurative inflammation in the lumen and extending through the muscularis. The uterus also has a neoplastic cell population in the endometrium, myometrium and surrounding soft tissue. In some areas the neoplasm has sheets of oval to round cells with a moderate amount of amphophilic cytoplasm and eccentric nuclei. Similar neoplastic cells efface the pancreas and are present in the mesometrium, ovary, gall bladder, in abdominal lymph nodes and the spleen.
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Approximately 400 cases of quinolone use in human pregnancy have not been associated with arthropathy or birth defects. Cardiovascular defects noted in one strain of rats and cleft palate in mice, not teratogenic in rabbits or monkeys. Two human studies, each with >100 firsttrimester exposures, did not indicate increase in defects, but one study found an increase in spontaneous abortion. Limited experience reported (19 cases); no anomalies noted but red-brown skin discoloration reported in several infants exposed throughout pregnancy. Not teratogenic in animals at exposures expected from treatment of oral or vaginal Candida. Limited human experience does not suggest teratogenicity; might displace bound bilirubin in the neonate, increasing the risk for kernicterus. Report exposures during pregnancy to Antiretroviral Pregnancy Registry:. Entecavir C Animal data do not suggest teratogenicity at human doses; no experience in human pregnancy. No evidence of teratogenicity in 320 cases of human use for treatment of tuberculosis. Increased rate of defects (omphalocele, exencephaly, cleft palate) in rats, mice, and rabbits with high doses; not seen with usual human doses. Report exposures during pregnancy to the Famvir Pregnancy Registry (1-888-669-6682). Single dose may be used for treatment of vaginal Candida though topical therapy preferred. Can be used for invasive fungal infections after the first trimester; amphotericin B preferred in first trimester if similar efficacy expected. Fluconazole C Abnormal ossification, structural defects in rats, mice at high doses. Case reports of rare pattern of craniofacial, skeletal and other abnormalities in five infants born to four women with prolonged exposure during pregnancy; no increase in defects seen in several series after single-dose treatment. No reports of use in first trimester of human pregnancy; might be metabolized to 5-fluorouracil, which is teratogenic in animals and possibly in humans. Caused complete litter destruction or growth retardation in rats, depending on when administered. No teratogenicity in rats and rabbits; eight case reports of human use, only two in first trimester Serious bacterial infections Because of limited experience, other treatment modalities such as cryotherapy or trichloracetic acid recommended for wart treatment during pregnancy Vol. Live vaccines, including intranasal influenza vaccine, are contraindicated in pregnancy. Recommended use during pregnancy All pregnant women should receive injectable influenza vaccine because of the increased risk of complications of influenza during pregnancy. Not indicated; treatment of hepatitis C should be delayed until after delivery Interferons: alfa, beta, gamma C Abortifacient at high doses in monkeys, mice; not teratogenic in monkeys, mice, rats, or rabbits. Approximately 30 cases of use of interferon-alfa in pregnancy reported; 14 in first trimester without increase in anomalies; possible increased risk for intrauterine growth retardation. Possible increased risk for hepatotoxicity during pregnancy; prophylactic pyridoxine, 50 mg/day, should be administered to prevent neurotoxicity. Case reports of craniofacial, skeletal abnormalities in humans with prolonged fluconazole exposure during pregnancy; no increase in defect rate noted among 156 infants born after first-trimester itraconazole exposure. Isoniazid C Active tuberculosis; prophylaxis for exposure or skin-test conversion Itraconazole C Only for documented systemic fungal disease, not prophylaxis. Kanamycin D Drug-resistant tuberculosis Ketoconazole C Teratogenic in rats, increased fetal death in mice, rabbits. None Inhibits androgen and corticosteroid synthesis; might affect fetal male genital development; case reports of craniofacial, skeletal abnormalities in humans with prolonged fluconazole exposure during pregnancy. No evidence of teratogenicity with >1900 first-trimester exposures reported to Antiretroviral Pregnancy Registry. Prevents birth defects of valproic acid, methotrexate, phenytoin, aminopterin in animal models. No increase in birth defects among infants born to 89 women with first-trimester exposure. Animal data and human data do not suggest an increased risk of birth defects, but miscarriage and stillbirth might be increased.
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Clinical presentation and history also have been expanded, and new recommendations have been included for poliovirus vaccination among travelers who are residing for 4 or more consecutive weeks in countries with ongoing poliovirus transmission and are leaving those countries to go to polio-free countries. The recent recognition of invasive disease in sub-Saharan Africa caused by certain serovars of nontyphoidal Salmonella that are highly lethal and distinct genetically from their serovar counterparts causing pediatric disease in industrialized countries has been added to the chapter. Antibiotic treatment options, including emerging resistance to azithromycin, have been added to the chapter. New data on methods of reducing skin and soft tissue infection recurrences attributable to Staphylococcus aureus have been added to the chapter. A smart phone app has been developed to guide management of pregnant women and their infants regarding testing for group B streptococcal infection. The treatment of choice for trichuriasis now is albendazole, because mebendazole no longer is available in the United States. Cutaneous infections following cosmetic surgery increasingly are recognized among the diseases caused by the risk of nontuberculous mycobacterial disease has been added. Antibiotic treatment recommendations for Vibrio cholerae infections are provided in a new table. Antimicrobial Agents and Related chapter has been updated to include data recently incorporated into package inserts for this class of drug. A table with the relative susceptibilities of different fungal species has been added to the chapter. The rapidly expanding repertoire of antiviral agents to treat hepatitis C virus infection has been added to the table. The table of has been updated to match those infectious agents listed at the time of publication of the 2015 Red Book. To accomplish these goals, physicians must make timely immunization a high priority in the care of infants, children, adolescents, and adults. The global eradication of smallpox in 1977, elimination of poliomyelitis disease from the Americas in 1991, elimination of year-round ongoing measles transmission in the United States in 2000 and in the Americas in 2002, and elimination of rubella and congenital rubella syndrome from the United States in 2004 serve as models were achieved by combining a comprehensive immunization program providing consistent, high levels of vaccine coverage with intensive surveillance and effective public health disease-control measures. The resurgence of pertussis and measles in the United States, however, illustrates how precarious the substantial gains to date can be without vigilant Worldwide eradication of polio, measles, and rubella remains possible through implementation of proven prevention strategies, but diligence must prevail until eradication is achieved, or success itself is imperiled. Discoveries in immunology, molecular biology, and medical genetics have resulted in burgeoning vaccine research. The advent of populationbased postlicensure studies of new vaccines facilitates detection of rare adverse events temporally associated with immunization that were undetected during large prelicensure clinical trials. Sources of Vaccine Information In addition to the Red Book, which is published every 3 years, physicians have evidencePediatrics. The Recommended Immunization Schedule for Persons Age 0 Through 18 Years for the United States is published annually in February (http:/ /redbook. For additional sources of information on international travel, see International Travel (p 101). Annual course offerings include the Immunization Update, Vaccines Epidemiology and Prevention of Vaccine-Preventable Diseases. Appendix I (p 975) provides a list of reliable immunization information resources, including facts conNational Network for Immunization Information ( Information can be obtained from state and local health departments about current epidemiology of diseases; immunization recommendations; legal from the World Health Organization ( The schedulers are based on the recommended immunization schedules for children, adolescents, and adults. Common Misconceptions/ Myths About Immunizationsa,b Claims Natural methods of enhancing immunity are better than vaccinations. Epidemiology-often used to establish vaccine safety-is not science but number crunching. Prior to the use of vaccinations, these In the 19th and 20th centuries, some infectious diseases diseases had begun to decline because began to be better controlled because of improveof improved nutrition and hygiene. However, vaccine-preventable diseases decreased dramatically after the vaccines for those diseases were licensed and were given to large numbers of children.
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A 10-year follow-up after Kegel pelvic floor muscle exercises for genuine stress incontinence. Randomized, double-blind, placebocontrolled crossover trials of venlafaxine for hot flashes after breast cancer. Current status and future prospects for the treatment of chemotherapy-induced peripheral neurotoxicity. Peripheral neuropathy for Taxol and cisplatin combination chemotherapy: Clinical and electrophysiological studies. Feasibility and acceptability of restorative yoga for treatment of hot flushes: A pilot trial. Menopausal hormone therapy after breast cancer: A meta-analysis and critical appraisal of the evidence. Oxcarbazine (Trileptal) monotherapy dramatically improves quality of life in two patients with postherpetic neuralgia refractory to carbamazepine and gabapentin. Effect of dietary phytoestrogens on hot flushes: Can soy-based proteins substitute for traditional estrogen replacement therapy? Distal symmetric polyneuropathy: A definition for clinical research: Report of the American Academy of Neurology, the American Association of Electrodiagnostic Medicine and the American Academy of Physical Medicine and Rehabilitation. Textbook of lymphology for physicians and lymphedema therapists [English printing of German 5th ed. Behavioral treatment of menopausal hot flushes: Evaluation by ambulatory monitoring. Treating hot flashes in breast cancer survivors: A review of alternative treatments to hormone replacement therapy. Eight for 2008: Eight things you should know about osteoporosis and fracture risk. Diagnosis, management, and evaluation of chemotherapy-induced peripheral neuropathy. Executive summary: the state of science on nursing approaches to managing late and long-term sequelae of cancer and cancer treatment. The diagnosis and treatment of peripheral lymphedema: Consensus document of the International Society of Lymphology. Randomized trial of black cohosh for treatment of hot flashes among women with a history of breast cancer. Venlafaxine in management of hot flashes in survivors of breast cancer: A randomized controlled trial. Effects of dietary calcium compared with calcium supplements on estrogen metabolism and bone mineral density. National Institutes of Health state-of-the-science conference statement: Management of menopause-related symptoms. Position statement of the National Lymphedema Network-Topic: Lymphedema risk reduction practices. Nonhormonal therapies for menopausal hot flashes: Systematic review and metanalysis. Treatment of menopause-associated vasomotor symptoms: Position statement of the North American Menopause Society. Neuroprotective effect of vitamin E supplementation in patient treated with cisplatin chemotherapy. Gabapentin for hot flashes in 420 women with breast cancer: A randomized double-blind placebo-controlled trial. Pilot study using gabapentin for tamoxifen-induced hot flashes in women with breast cancer. Hot flashes-a review of literature on alternative and complementary treatment approaches. Inguinofemoral dissection for carcinoma of the vulva: Effect of modifications of extent and technique on morbidity and survival. Aetiology and prevalence of lower limb lymphoedema following treatment for gynaecological cancer.