Genital diseases in the mature woman

Vulvovaginal conditions are common in mature women. This reflects age-related changes in immunity and skin barrier function of vulvovaginal tissues. Vaginal atrophy is commonly complicated by dryness and inflammation, which makes postmenopausal atrophic vaginitis a virtually ubiquitous condition. The differential of vaginitis includes inflammatory, infectious, and malignant diseases, plus drug hypersensitivity. Atrophic vaginitis is treated with estrogen replacement therapy. Vulvovaginal malignant melanoma occurs predominantly in postmenopausal women and carries a poor prognosis. Similarly, the incidence of vulvovaginal malignancies, such as squamous cell carcinoma and extramammary Paget disease, rises exponentially after 65 years of age. Early diagnosis of these malignancies is of utmost importance. Lichen sclerosus et atrophicus and vulvovaginal candidosis are among the most common postmenopausal vulvovaginal conditions. Lichen sclerosus et atrophicus is associated with significant morbidity, and its management can be challenging. The incidence of vulvovaginal candidosis increases in patients on estrogen replacement therapy.

Primary care management of women with persistent vaginal discharge

Vaginal discharge is a common complaint managed by NPs in ambulatory settings. This article reviews noninfectious etiologies of vaginal discharge with diagnostic criteria and recommended treatment to aid the NP in correctly managing these patients.

Functional outcomes by age for inpatient cancer rehabilitation: a retrospective chart review

Cancer-related impairments result in disabilities similar to those typically encountered in inpatient rehabilitation settings; however, the use of rehabilitation services by cancer survivors is low. This is particularly important for older adults as they are at higher risk for cancer. This retrospective study collected data from medical records from 215 charts of patients admitted to an inpatient physical rehabilitation hospital, within a 5-year period, with a primary diagnosis of cancer. Mean age was 61 years (SD = 15.7) for 109 (51%) females and 106 (49%) males. Regardless of age, patients achieved significant functional improvement, as shown by their FIM scores (t = 23.06, p < .0001), from admission to discharge. The results have several important implications related to cancer survivorship among older adults. With a push toward aging in place, maintaining optimal physical functioning is crucial. Physical rehabilitation benefited the functional outcomes of this group of cancer survivors regardless of age.