Biomedical subjects
R Lichtman
Publications and source records attributed to R Lichtman.
The impact of the care-by-parent unit on the education of medical students.
Explore the source record for details and available documents.
Five years of experience with public relations at the local level.
Explore the source record for details and available documents.
More voices for educational innovation.
Explore the source record for details and available documents.
Perimenopausal hormone replacement therapy. Review of the literature.
Hormonal replacement therapy--usually involving estrogen with or without an added progestin--has been proposed as a treatment for a variety of changes associated with the perimenopausal years, including hot flushes, vaginal and urinary tract atrophy, sexual problems, aging skin, and a number of affective symptoms. It has also been studied as a preventive measure against osteoporosis and cardiovascular disease, with some researchers claiming a protective effect against breast cancer, although others cite it as a risk factor for breast cancer. This article reviews the literature in each of these areas, suggesting an individualized approach to hormone replacement therapy, determined by patient and practitioner, based on symptomatology and risk factors. Alternative therapies are briefly outlined.
Entry-level degrees for midwifery practice.
The Governing Board of the ACNM Division of Accreditation (DOA) has been charged by the ACNM Board of Directors to consider requiring an entry-level degree for nurse-midwifery practice. This decision has far-reaching implications and must be considered with utmost care. The decision will not be based on the issue of clinical competence but rather, the political statement to be made through the imposition of a degree requirement. The author urges the DOA's Governing Board to consider the implications of its action on a variety of audiences, including potential students, potential consumers, other health professionals, current and future employers, our international colleagues, health insurers and managed care organizations, and policymakers and lawmakers.
Perimenopausal and postmenopausal hormone replacement therapy. Part 1. An update of the literature on benefits and risks.
As life expectancy increases and members of the postwar generation settle into their fifth decade of life, hormone replacement therapy--estrogen or an estrogen-progestin combination--has become a major research interest. An extensive, but often confusing and even contradictory, literature exists on the uses of hormone replacement for the treatment and prevention of a multitude of difficulties that may be associated with the perimenopausal and postmenopausal periods. These include hot flushes, vaginal changes, urinary tract changes, changes in sexuality, affective or emotional symptoms, changes in the oral mucosa and skin, loss of memory and Alzheimer's disease, bone loss and osteoporosis, and cardiovascular disease. This article reviews the literature in each of these areas. It also reviews studies relating to possible side effects of hormone therapy, including endometrial cancer, gall bladder disease, and breast cancer. The article outlines principles for practitioners to follow in assisting women to make informed and individualized decisions about this therapy. Part II of this article, which will appear in the May/June 1996 issue of the Journal of Nurse-Midwifery, will cover specific therapeutic regimens and their management, as well as alternative therapies and preventive measures.
Perimenopausal and postmenopausal hormone replacement therapy. Part 2. Hormonal regimens and complementary and alternative therapies.
As midwives increasingly provide care to women throughout the lifecycle, they need to become familiar with a variety of treatments for perimenopausal and postmenopausal problems and preventive measures for the potentially disabling conditions that can accompany aging. This article reviews various regimens of hormone replacement therapy. It discusses types of estrogen and progestin, appropriate dosages, routes of administration, and duration of therapy. It offers guidelines for initiation, contraindications, and required follow-up. It addresses the management of side effects and problems. The article briefly reviews a variety of complementary and alternative therapies including various self-help measures, such as nutrition and exercise, and selected herbal treatments. Part 1 of this article, which appeared in the January/February 1996 issue of JNM, reviewed the literature on recommended therapeutic and preventive indications for hormone replacement therapy, providing guidelines for the provision of informed consent.
[Perimenopausal hormone replacement therapy--review of the literature].
Explore the source record for details and available documents.