Menopause.

In brief Women experience many changes during menopause and the climacteric. Physical changes can affect nearly every organ system; social and psychological changes can cause fear and anxiety. However, by exercising, a woman can improve her quality of life and mitigate the negative effects of these changes.

Syncope.

In brief Syncopal episodes are usually benign, but some causes can be life-threatening. The differential diagnosis is extensive and includes vasovagal reaction, decreased intravascular volume, metabolic disorders, cardiac disorders, medication use and abuse, Valsalva maneuver, and intracranial conditions. A detailed account of the event and a medical history direct the workup.

Feasibility of prehospital r-TPA therapy in chest pain patients.

Study Objective: The purpose of this study was to determine the number of eligible prehospital thrombolytic candidates and to estimate the potential time saved if field thrombolysis had been initiated in a series of prehospital chest pain patients.

Design And Setting: Prehospital 12-lead ECGs were obtained by paramedics during initial evaluation of chest pain patients and stored in the computerized ECG. Prehospital 12-lead ECGs, prehospital charts, and hospital charts then were reviewed retrospectively for final hospital diagnosis, prehospital and emergency department times, and historical exclusion criteria for prehospital treatment with recombinant tissue-type plasminogen activator (r-TPA).

Prehospital bicarbonate use in cardiac arrest: a 3-year experience.

The American Heart Association no longer recommends the routine use of sodium bicarbonate in cardiac arrests. Reasons cited include the lack of documented effect on clinical outcome and potential adverse effects of metabolic alkalosis and hypernatremia. We reviewed 36 months of experience with 619 nontrauma adult, prehospital cardiac arrest patients to identify 273 successful resuscitations who had emergency department blood gases and electrolytes performed.