Management of the Abnormal Pap Smear

of high-grade squamous intraepithelial lesions (HGSIL) or invasive cancer; therefore, persistent inflammation is an indication for colposcopy.

6. Atrophy with inflammation is common in post-menopausal women or in those with estrogen-deficiency states. Atrophy should be treated with vaginal estrogen for 4-6 weeks, then repeat Pap smear.

7. Hyperkeratosis and parakeratosis. Parakeratosis is defined as dense nuclei within a keratin layer. When no nuclei are present, the cells are designated hyperkeratotic. Parakeratosis and hyperkeratosis occur as a reaction to physical, chemical, or inflammatory trauma, and it may clinically appear as leukoplakia. Benign-appearing parakeratosis or hyperkeratosis requires only a repeat Pap test in 6 months. When this finding persists, colposcopy is indicated.

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Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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