Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three case histories of patients who were treated for gonococcal perihepatitis (Fitz-Hugh-Curtis syndrome) are reviewed. The incidence rate of this disease process is believed to be increasing, and a surgical consultation is often asked for in the evaluation of these individuals. The diagnosis of FHCS requires a high index of suspicion. However, if a patient has signs and symptoms of acute cholecystitis plus the recent onset of a purulent genitourinary infection, the diagnosis of FHCS is suggested. Confirmation of this diagnosis is obtained with the culturing of N. gonorrheae from urethral or cervical secretions. The clinical presentation may vary from a moderately symptomatic to an acutely ill individual. Most commonly there is an abrupt onset of sharp right upper quadrant pain. The finding of any degree of lower abdominal or pelvic tenderness in addition to the upper abdominal pain, should make one highly suspicious of pelvic inflammatory disease and concommitant FHCS. Although no deaths have been reported from this syndrome, it is important to make a prompt clinical diagnosis and commence appropriate antibiotic therapy. The currently recommended therapeutic regimen is procaine penicillin, 1,200,000 U, twice a day for 10 days.
 ...
PMID:Gonococcal perihepatitis (the Fitz-Hugh-Curtis syndrome): a diagnostic dilemma. 45 27

The potential sequelae of Chlamydia trachomatis--nonspecific urethritis and post gonococcal urethritis in men and nonspecific genital infection in women--suggest a need for a chlamydial diagnostic service in clinics that treat sexually transmitted diseases. In this prospective study, over 2000 endocervical samples were obtained over an 18-month period from women presenting to a sexually transmitted diseases clinic. The isolation rate for chlamydia averaged 23.6%/month. There was no significant difference in presenting symptoms such as vaginal discharge, dysuria, pruritus, and abdominal pain between patients with chlamydial infection alone, those with gonorrhea alone, and women with no sexually transmitted disease. 178 (31%) of patients with chlamydia were sexual contacts of patients with nonspecific urethritis and 122 (22%) were contacts of men with gonorrhea. In the absence of a chlamydial service laboratory, only contacts of patients with nonspecific urethritis are likely to receive treatment, leaving 2/3 of chlamydia-positive women untreated. In 1976, an estimated 18,300 women were seen in British clinics with undiagnosed, untreated chlamydial infection. Given the magnitude and severity of this problem, a chlamydial diagnostic service should become a mandatory clinic component.
 ...
PMID:The need for a chlamydial culture service. 48 48

The efficacy of intravenous cephalothin was studied prospectively in 20 patients with acute pelvic inflammatory disease, all of whom presented with lower abdominal pain, cervical and adnexal tenderness, fever, and leukocytosis. Blood, cervical, and cul-de-sac cultures were obtained on admission. The latter was transported anaerobically and inoculated in routine and prereduced medium. Transgrow medium with trimethoprim was used for endocervical cultures. Neisseria gonorrhoeae was isolated from the endocervix in 15 patients and from the cul-de-sac in four patients. All received intravenous cephalothin, 2 gm every four hours for seven days. Clinical improvement was observed in 48 to 78 hours. The cervical cultures were negative for N. gonorrhoeae after 48 hours, at the completion of treatment, and two weeks post-treatment. The drug was well tolerated. It was concluded that cephalothin intravenously is an acceptable alternative antibiotic for the treatment of gonococcal pelvic infection.
 ...
PMID:Parenteral cephalothin therapy for pelvic gonococcal infections. 63 81

The purpose of a physician's screening for gonorrhea is the provision of comprehensive health care to patients who seek his care. Among sexually active young patients, gonorrhea is probably far more common than many other diseases a physician "screens" for during a routine physical examination. Since gonorrhea culture tests are too costly in time and money to be offered to every patient, guidelines can be used to select patients for screening who are most likely to have gonorrhea. The gonorrhea culture test should be carried out in the same spirit as a cervical cytology test, as a potential health benefit and without stigma.However, even more important than gonorrhea screening, from the standpoint of the patient, is (1) increased use of culture for diagnostic problem solving, particularly in women with dysuria, abnormal vaginal discharge, abnormal menstrual bleeding or lower abdominal pain, and (2) location and treatment of sex partners.
 ...
PMID:Screening and the detection of gonorrhea. 81 97

During the past 4 years, 16 patients have been seen who developed a unilateral tubo-ovarian abscess while wearing, or soon after removal of, an IUD. None of the patients had gonorrhea. There appears to be a prodromal syndrome before abscess formation of 2 to 5 weeks during which the patient complains of vague lower abdominal pain, pelvic tenderness, and dyspareunia. A few patients had a rapid onset of symptoms. The device should be removed when prodromal symptoms arise and the patient should be treated with antibiotics. Should a tubo-ovarian abscess develop, surgical intervention is necessary.
 ...
PMID:The intrauterine device and tubo-ovarian abscess. 116 62

The US guidelines for prevention and management of the difficult to diagnose symptomatic pelvic inflammatory disease (PID), which affects approximately 1 million every year, include microbial etiology and pathogenesis, the magnitude of the problem in terms of epidemiology and financial impact, risk assessment, prevention, diagnosis, treatment, and surveillance. The etiology of PID reveals multiple organisms, though mostly C. trachomatis and N. gonorrhoea. PID includes acute, silent, and atypical. C. trachomatis has been isolated in 20-40% of PID cases, while N. gonorrhoea in 27-80% of cervical cases. Other anaerobic bacteria isolated, which comprise 25-50% of acute cases, are Gardnerella vaginalis, Streptococcus species, Escherichia coli, and Hemophilus influenzae. PID results when organisms from the endocervix spread to the endometrium and fallopian tube mucosa. Contributing factors are IUD user's hormonal changes during menses (within 7 days of onset of menses), retrograde menses, and virulent characteristics of acute chlamydial and gonococcal PID. The estimated cost of PID for 1990 was $4.2 billion for 25 million in outpatient care and 275,000 hospitalized. Sexual practice related to the risk of PID are having sex with someone with STD, a young age at first intercourse, multiple sex partners, a high frequency of sexual intercourse and new partners within 30 days. Barrier methods (mechanical or chemical) decrease risk. Inconsistent risk is associated with oral contraceptive use and douching, but IUD's have an increased risk of adverse consequences and further transmission. Recommended action is community health promotion of education, as well as prompt and available clinical service, partner notification, training of health care providers, and routine screening. Individuals must self protect. Clinical diagnosis is difficult and imprecise. Minimum criteria for clinical diagnosis are lower abdominal pain, bilateral adnexal tenderness, cervical motion tenderness. Severe cases require oral temperature 38.3 Centigrade, abnormal cervical or vaginal discharge, elevated erythrocyte sedimentation rate and/or C-reactive protein, culture for N. gonorrhoea and non-cervical tests for C. trachomatis, and optionally endometrial biopsy, tubo-ovarian sonography, and laparoscopy. Failure to meet these criteria should not be withholding therapy. Sensitivity to the emotional needs and careful follow-up are necessary. Inpatient treatment recommendations are broad spectrum regimens such as: Cefoxitin plus doxycycline; for outpatients, cefoxitin plus doxycycline or tetracycline (erthyromycin may be substituted).
 ...
PMID:Pelvic inflammatory disease: guidelines for prevention and management. 203 5

One hundred women attending a sexually transmitted diseases clinic in Harare were examined for presenting features and genital infections. The most common presenting symptoms were of discharge, lower abdominal pain and dysuria, and on examination signs of discharge, inflammation, haemorrhage or ulcers/erosions were noticeable in all women. Fourteen women had genital warts. Pathogens were detected in 95% of patients. Gonococcal infection occurred in 19 women, with 60% of the strains isolated being penicillinase producing. Yeasts were detected in specimens from 25 women while chlamydial infection appeared to be rare, evidence of infection being detected in only eight women. Sera from 44 women were positive by the RPR test and sera from 33 women were positive by TPHA. Gardnerella vaginalis was isolated from 48 women, Group B streptococci from 37 women, and Trichomonas vaginalis from 32 women.
 ...
PMID:Genital infections in women attending a genito-urinary clinic in Harare, Zimbabwe. 219 16

One hundred and sixty-five women admitted to a gynaecology unit with lower abdominal pain were screened for infection with Neisseria gonorrhoeae and Chlamydia trachomatis by members of a department of genitourinary medicine. C. trachomatis alone was detected in 21 patients. N. gonorrhoeae alone was isolated from five patients, and dual infection was present in six patients, giving a total of 32 (19%) patients in whom a sexually transmitted disease (STD) was diagnosed. The combination of an endocervical swab placed in Amies transport medium for gonococcal isolation and an endocervical slide for immunofluorescent detection of chlamydiae proved to be a simple and accurate method of screening for STD. As a result of contact tracing, 16 sexual partners of women in whom STD was detected were examined. Three cases of gonococcal and nine cases of non-gonococcal urethritis were diagnosed. None of the sexual partners had symptoms suggestive of genitourinary infection.
 ...
PMID:Infection with Chlamydia trachomatis and Neisseria gonorrhoeae in women with lower abdominal pain admitted to a gynaecology unit. 275 62

The prevalence of symptoms of reproductive tract infections (RTIs) among users of various contraceptive methods and nonusers was investigated in a population-based study conducted in rural Bangladesh. Overall, 22% of the 2929 women surveyed reported symptoms of RTI. Of the 472 symptomatic women examined, 68% had clinical or laboratory evidence of infection. The symptom most commonly reported (97%) was abnormal discharge. Among the 2726 women who could be classified as users of a single method, the percentage of women reporting symptoms varied by contraceptive method. IUD users and tubectomized women were 4 times more likely than nonusers to report abnormal discharge of lower abdominal pain, while users of hormonal methods were 1.6 times more likely to report these symptoms. Among women who had a confirmed RTI, 24% were tubectomized and 22% were IUD users compared to rates of 5.6% in users of hormonal contraception and 3.5% among nonusers. This suggests that tubectomized women and IUD users are 7 times more likely to have a confirmed RTI than nonusers. Multivariate analysis indicated that current birth control method, materials used during menses, prior contraceptive method use, and duration of current method use were the only factors significantly associated with the increased risk of infection. IUD users and tubectomized women were most likely to have lower tract infection, both when considered as all types of vaginitis and when limited to infections such as gonococcal and chlamydial cervicitis that can ascend into the upper tract. A major limitation of this study is that, for cultural reasons, only symptomatic women could be referred for examination. In addition, 24% of the symptomatic women refused examination. These findings suggest that family planning services in Bangladesh are associated with mild and reversible, yet relatively common, RTI. While this morbidity is outweighed by the benefits of family planning, clinics should make an effort to provide accurate diagnosis and treatment of RTIs and to discuss method-associated side effects.
 ...
PMID:Reproductive tract infections in a family planning population in rural Bangladesh. 278 22

We compared the clinical and epidemiological characteristics of 89 women with pelvic inflammatory disease (PID) seen at a clinic for sexually transmitted diseases during 1982 and 1983. Patients were classified into four groups by having endocervical cultures positive for Neisseria gonorrhoeae only (24), Chlamydia trachomatis only (16), both organisms (14), or neither organism (35). More women with cultures positive for N gonorrhoeae were black (p less than 0.005), had a sexual partner with gonorrhoea (p less than 0.005), and had a purulent vaginal discharge (p less than 0.05). No other significant differences were found between groups regarding age, exposure to a sexual partner with non-gonococcal urethritis, history of trichomoniasis, parity, use of antibiotics, contraceptive history, duration of abdominal pain, relation of pain to the phase of the menstrual cycle, abdominal rebound tenderness, reproductive tract signs, or febrility. In women presenting to outpatient clinics, PID tends to be mild and the diagnosis unreliable. Though C trachomatis is emerging as an important aetiological agent, we found no clinical indicators that could distinguish chlamydial from gonococcal PID.
 ...
PMID:Comparison of clinical and epidemiological characteristics of pelvic inflammatory disease classified by endocervical cultures of Neisseria gonorrhoeae and Chlamydia trachomatis. 308 8


1 2 3 4 Next >>