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This chapter discusses the risk factors, clinical signs, evaluation, prevention and screening, and treatment of ovarian cancer and ovarian masses. Ovarian cancer is the leading cause of death from gynecological malignancy and the fourth most common cause of cancer death in women. Advancing age is the greatest risk factor. Use of oral contraceptive pills reduces the risk of ovarian cancer by 30 to 60%. A review of women with ovarian cancer compared with women with breast cancer or no cancer found that most women with ovarian cancer complained of the four following groups of non-specific symptoms in the 1-3 months before diagnosis: abdominal pain (30%), abdominal swelling (16.5%), GI symptoms (8.4%), and pelvic pain (5.4%). Transvaginal sonography (TVS) is the examination of choice to establish the diagnosis. In menstruating women, pregnancy, pregnancy complications and functional cysts are the most common causes of ovarian masses.
Phillippa Miranda, Department of Medicine, Division of Endocrinology and Metabolism, Duke University Medical Center, Durham, NC, USA,
Diana McNeill, Department of Medicine, Division of Endocrinology and Metabolism, Duke University Medical Center, Durham, NC, USA
The incidence and prevalence of diabetes is increasing worldwide. This chapter examines the diagnosis, prevention, and management of diabetes in mid-life women. In mid life, type 2 diabetes is the most common type of diabetes. Diagnostic criteria and classification schemes for diabetes have been proposed and published by the American Diabetes Association (ADA) and World Health Organization (WHO). Risk factors for the development of type 2 diabetes include obesity, physical inactivity, age, and family history of type 2 diabetes. Good glycemic control, through education, self-blood glucose monitoring, diet, and exercise, as well as medications, is important to minimize the increased health risks associated with diabetes. Since the complications of diabetes, including heart attack, stroke, blindness, end-stage renal disease, and lower-extremity amputation, are more prevalent with advancing age and duration of diabetes, mid-life women with diabetes must advocate for their own healthcare management.
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