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How is endometriosis-associated chronic pelvic pain treated Empirical sequential treatment with nonsteroidal anti-inflammatory drugs, oral contraceptives administered in monthly or longer cycles, GnRH agonist analogues (nafarelin, goserelin, and leuprolide), progestins (medroxy-progesterone acetate) Irritable bowel syndrome, pelvic congestion syndrome, and interstitial cystitis also respond to GnRH agonists To decrease pain from primary dysmenorrhea Currently, evidence is insufficient to substantiate efficacy of antidepressants for the treatment of chronic pelvic pain However, adding psychotherapy to medical treatment of chronic pelvic pain appears to improve response over that of medical treatment alone and should be considered Excision or destruction of endometriotic tissue, lysis of adhesions, and hysterectomy (in women who have finished childbearing) have been proposed to relieve chronic pelvic pain It is the surgical resection of the superior hypogastric plexus which innervates the cervix, uterus, and proximal fallopian tubes with afferent nociception It may be used to treat centrally located dysmenorrhea but has limited efficacy for chronic pelvic pain or pain that is not central in its location Multimodal therapy (medical therapy, surgical therapy, and behavioral/mental health treatment, along with pain consultation) is superior to treatments that emphasize a single approach

that, if all the time spent debugging and fixing bindings could be harnessed, we would have, as a species, solved global warming and world hunger, and figured out a way of getting your food delivered before the toast gets cold. The source of a binding can be broken down into two things: where the data is coming from and what bit of data you want from there. The where can be one of four different things (table 11.2).

so a simple audio CD application will suf ce Sony s HotBurn provides an easy, failsafe path to audio CD creation The rst screen in HotBurn offers a selection of Wizards, Layout Managers, and some Other Options, as shown in Figure 11 - 5 HotBurn was developed by Asimware Innovations, Inc and is distributed under license by Sony Electronics, Inc

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Table 11.2 Where the data comes from in a Binding Description You use Source when you want to bind to a particular object. Invariably, that object is defined as a resource, so the notation looks like this (from our ListView example):

In what other sources of chronic pelvic pain are GnRH agonists effective When are oral contraceptives indicated for treatment of chronic pelvic pain What is the role of antidepressants in treatment of chronic pelvic pain

You use ElementName when you want to bind to a property on some other element in your UI. For example, if there were a control called someListBox and you wanted a TextBox to be the same color as the list box, you d write this:

Figure 11 - 5

<TextBox Background= "{Binding ElementName=someListBox, Path=Background}" /> RelativeSource RelativeSource is used when you don t know the specific element you want to reference, but you know where that element is relative to where you are now that is, relative to the element that you re currently binding. There are several different modes for RelativeSource that control its behavior.

What are the obstetric and gynecologic differential diagnoses for acute pelvic pain Pelvic inflammatory disease Adnexal cysts/masses/abscesses with bleeding, torsion, or rupture Ectopic pregnancy Spontaneous abortion Endometritis Degeneration, infarction, or torsion of leiomyomas (fibroids) What are non-gynecologic differential diagnoses for acute pelvic pain Appendicitis Diverticulitis Urinary tract infection or obstruction Renal colic Which of these diagnoses are life threatening and must be ruled out quickly Ectopic pregnancy Tubo-ovarian abscess Ruptured ovarian cyst Appendicitis On what additional points should the history taking focus to determine a pelvic etiology The regularity and timing of menstrual periods, possibility of pregnancy, presence of vaginal discharge or bleeding, and a recent history of dyspareunia or dysmenorrhea Ectopic pregnancy: unruptured pregnancy leads to localized unilateral pain because of fallopian tube dilatation If it ruptures, the pain becomes generalized because of peritoneal irritation A pelvic examination may reveal cervical motion tenderness that is exaggerated on the side of the tubal pregnancy Tubo-ovarian abscess: patients present with generalized abdominal pain and rebound tenderness caused by peritoneal inflammation Bilateral, palpable, fixed, and tender masses are commonly found on examination

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