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)

One of the complications of abdominal surgery is the occurrence of intra-abdominal adhesions. The problems related to these adhesions have created a major impact on the health care system, thereby incurring a substantial cost to health care. In the field of gynaecology, adhesion-related problems include infertility, abdominal pain and bowel obstruction.
 ...
PMID:Introduction--prevention of adhesion formation: the journey continues. 1172 66

Ovarian hyperstimulation is a recognized complication of ovulation induction with gonadotrophins. The syndrome is becoming more common as the number of women undergoing in-vitro fertilization increases. It is rarely seen in conjunction with clomiphene citrate usage. This case report is of moderate to severe ovarian hyperstimulation in a patient who was treated with clomiphene citrate because of infertility secondary to anovulation. She presented with amenorrhoea for five weeks, lower abdominal pain and a positive urinary human chorionic gonadotrophin (hCG) test. Pelvic ultrasonography was suggestive of a possible ectopic pregnancy with a differential diagnosis of a ruptured ovarian cyst. Diagnostic laparoscopy was done followed by laparotomy. Oophorectomy was performed because the ovary was thought to be complex with solid areas. However, conservative management with avoidance of laparotomy is the recommendation in confirmed cases of ovarian hyperstimulation but this requires a high level of suspicion in patients who have ovulation induction.
 ...
PMID:Ovarian hyperstimulation syndrome associated with clomiphene citrate. 1176 32

Once the condition of pelvic inflammatory disease (PID) has been diagnosed clinicans should initiate immediate therapy. If antibiotics are withheld until a specific microbiologic diagnosis is obtained, the possibility of laboratory error and of processing delays hinders appropriate therapy. Evolving knowledge of the definition, etiology, and treatment of PID provides additional rationale for immediate antibiotic administration. PID, which refers to the clinical syndrome attributed to the ascending spread of microorganisms from the vaginal and endocervix to the fallopian tubes and contiguous structures, includes the clinical entities of endometritis, salpingitis, and parametritis, and/or peritonitis. Clinical diagnosis usually involves a history of lower abdominal pain, lower abdominal tenderness, cervical motion tenderness, and adnexal tenderness. Many organisms play a role in the pathogenesis of this syndrome, and clinicians should initiate treatment regimens which are active against the broadest range of pathogens. The treatment of choice is not established. No single agent is active against the entire spectrum of pathogens. Several antimicrobial combinations provide broad spectrum activity against the major pathogens in vitro, but many have not been adequatley evaluated for clinical efficacy in PID. Drugs with optimal anaerobic activity are perferred in patients with a pelvic mass or IUD associated PID. In most other women, drugs with optimal activity against N. gonorrhoea and C. trachomatis may be preferred. Due to the severe longterm complications resulting from PID, including infertility and ectopic pregnancy, clinicians should seriously consider hospitalizing women with PID whenever practical. Criteria for hospitalization are outlined.
 ...
PMID:How to treat PID. 1226 36

IUD users are 2-5 times more likely to develop pelvic inflammatory disease (PID) than women who use other methods of contraception. The incidence of PID/100 woman years is 5.2 among IUD users compared with 0.9 among women who use oral contraceptives and 1.4 among users of barrier methods. Virtually all women with tailed IUDs have some bacteria in utero. Increased menstrual flow among IUD users may also contribute to the greater incidence of PID. The highest rate of PID is found in women 15-19 years of age, 1.5% of whom develop PID each year. Each year there are 12 surgical interventions and 6 hysterectomies for every 1000 cases of PID, and about 110,000 women become infertile as a result of this condition. In addition to infertility (which is a sequela in 13% of women after 1 episode of PID, in 35% after 2 episodes, and in 75% after 3 episodes), longterm consequences from PID include pain (17%) and subsequent PID (20-24%). Clinicians are urged to look for specific signs of PID, including cervical infection with a friable mucosa and mucopus, mild abdominal pain, plama cells in the mucopus, uterine tenderness, andexal tenderness, and vaginal discharge with an unpleasant odor. Chylamydia trachomatis is increasing as an etiologic agent, but is likely to produce the mild type of PID that may be unrecognized as such. It is concluded that the IUD should not be used in teenagers or in women who seek pregnancy at a later point.
 ...
PMID:IUD users most likely to develop PID; suffer long-term damage. 1226 10

Ectopic pregnancy remains a leading cause of maternal mortality and accounts for a sizeable proportion of infertility and ectopic recurrence. The possibility that a woman is experiencing an ectopic pregnancy must be considered when evaluating a woman, especially a sterilized woman, who has a possible pregnancy, amenorrhea, abdominal pain, or abnormal bleeding; studies have found that one in six pregnancies occurring after tubal sterilization are ectopic. The authors present a clinical study of 82 cases of ectopic pregnancy admitted to the department of Obstetrics and Gynecology of Mahatma Gandhi Institute of Medical Sciences, Sevagram. Cases of ectopic pregnancy represent 0.99% of total obstetric admissions, of whom 69.51% were diagnosed as such on admission. 40.24% of the women were older than 30 years, while 34.14% were elderly beyond third parity. 70.73% of the women presented before missing their second period. Patients presented with multiple complaints, but the most common was abdominal pain reported by 61.70%. 78.04% were admitted with an acute abdomen, but shock was present in only 7.14% of cases. The main surgical treatment modality was salpingectomy among 59.75%. There was no maternal mortality through postoperative morbidity in the form of paralytic ileus, although fever did occur in some women.
 ...
PMID:Clinical study of ectopic pregnancy. 1228 89

The IUD is a highly popular contraceptive method, used by almost 500,000 women in Bangladesh alone. One concern with IUD use, however, is the potential risk of post-insertion pelvic inflammatory disease (PID), a serious disease which can lead to chronic lower abdominal pain, ectopic pregnancy, infertility, and death. An increased risk of PID exists for approximately 1 month after IUD insertion, presumably related to the introduction of bacteria into the uterus during the insertion procedure. Proper processing of IUD instruments and supplies and close attention to aseptic technique can help to reduce the risk of post-insertion PID. Concern over the ability to maintain aseptic technique is particularly high with regard to health care workers who travel between clinics in rural areas. In Bangladesh, providers in rural areas had problems transporting equipment, obtaining fuel and clean water, and finding the time needed to boil and cool instruments. A portable, easy-to-use steam sterilizer has now been developed and made available, allowing health workers to fully sterilize IUD instruments before visiting rural clinics, so that they no longer have to boil the instruments on site. AVSC was one of several organizations which worked with Bangladesh's National Task Force to develop the portable sterilizer for IUD instruments and supplies.
 ...
PMID:Low-tech innovation helps provide safer services. 1229 23

The symptothermal methods include all those that identify the woman's fertile period through the basal body temperature and the periovulatory signs. Research conducted following the discovery over a century ago of the hyperthermic plateau in the later part of the menstrual cycle has confirmed that under normal conditions, and when the daily temperature is taken under comparable conditions, infertility may be assumed when the high temperature plateau is confirmed. A reliable temperature curve requires certain conditions: it should be taken upon awakening with a basal thermometer over a sufficient time to obtain an accurate measure, at almost the same time every day, and the graph paper should be appropriately scaled for recording. Various guidelines of interpretation have been developed throughout the world. Serena considers infertility assured from the 3rd consecutive day of elevated temperature as long as other fertility symptoms have disappeared. Among symptoms of ovulation that are perceptible to the woman are cyclic changes in the quantity and consistency of the cervical mucus, which has the advantage of predating and thus forecasting ovulation and of being less sensitive than the basal temperature to nongenital infections, sleepless nights, or other stresses. Use of mucus changes alone as an indicator of fertility carries the risk that such changes may not be noticed or may be due to an estrogen surge not related to ovulation. Other symptoms that are useful for some women in confirming temperature or mucus changes include 4 different alterations in the cervix, abdominal pain or mittelschmerz, intramenstrual bleeding, feeling of heaviness in the breasts, and variations in mood and libido. Many groups that teach the temperature curve and clyclical symptoms also provide instructions or mathematical rules for determining the number of infertile days at the beginning of the cycle. Some programs state that 6-7 days are usually infertile provided that the menses were preceded by a hyperthermic plateau. Many groups recommend the calculation of Ogino or a variant. The symptothermal method of fertility control combines the basal temperature curve with the other signs of fertility to serve as a basis for modification of sexual behavior to enhance or suppress fertility. Different programs stress different elements or combinations. The efficacy of the symptothermal methods depends on precise recordkeeping and observation and on competent instruction and counseling, as well as the willingness of the couple to modify their sexual behavior. Statistical measures of the method's efficacy are complex and unsatisfactory as they attempt to apply rigid rules to actions and decisions that are in fact filled with nuance.
 ...
PMID:[The sympto-thermal methods]. 1231 2

During the period 1977-86, 193 women underwent surgery for ectopic pregnancy in the Medway Health District. 1 ectopic pregnancy was found for every 233 deliveries, an incidence of 0.43%, with a rising trend. The most common presenting symptom was abdominal pain (96%) and the most frequent physical finding was abdominal tenderness (91%). Past histories of appendicectomy (24%), infertility (19%), use of IUD (15%), and pelvic infection (13%) were elicited. In 95% of the cases, the pregnancy was tubal. 56% of the patients required blood transfusions and there were no maternal deaths. These findings confirm the rising incidence of ectopic pregnancy. During the study period, the diagnosis and management of ectopic pregnancy have changed significantly. The early use of plasma hCG, ultrasonography, and laparoscopy decreases the morbidity and mortality associated with ectopic pregnancy, allowing conservative tubal surgery when indicated.
 ...
PMID:A ten year survey of 193 ectopic pregnancies. 1231 37

Each year 250 million new cases of sexually transmitted diseases (STDs) have the potential to cause pelvic inflammatory disease, infertility, blindness, and death. Sometimes the onset of these STDs is symptomless, but the following conditions indicate the presence of an STD: genital discharge, sores, wounds, or blisters; swollen glands in the groin; cauliflower-like growths on the genitals; skin rash; lower abdominal pain in females; painful swelling in the testicles; alopecia; discharge from the eyes; and pain during intercourse. The 5 most common STDs which can be cured with antibiotics are chancroid, chlamydial infection, gonorrhea, syphilis, and trichomoniasis. By the end of 1994 in Uganda, 390 primary health units will be available for STD treatment, and most health workers will be trained in STD patient management. Since patients will receive the minimum amount of treatment needed to cure the STD, they will be well advised to use the drugs provided. Notification of all recent sex partners is also essential, and sex partners should be evaluated even if they are asymptomatic. Patients are advised to engage in safe sex behavior, including remaining faithful to a monogamous relationship and using condoms, and to seek medical advice if they develop STD symptoms or are exposed to STD. The AIDS virus is also transmitted through sexual intercourse as well as through blood transfusions, from mother to child, and through the use of contaminated needles. HIV infection progresses from a stage where it cannot be detected to an asymptomatic stage to a symptomatic stage. Chronic diarrhea, fever, and weight loss are the major symptoms. There is no treatment for HIV infection, but zidovudine (AZT) can delay progress of the disease. The most important treatment available is counseling and understanding. The Uganda AIDS Commission works to control the disease through education, treatment of STDs, provision of safe blood for transfusion, monitoring, counseling patients, and promoting research. The primary objective in the care of AIDS patients is to improve the quality of their life as much as possible.
 ...
PMID:Telling signs and symptoms. 1231 60

Patients with sexually transmitted diseases (STDs) in developing countries are often untreated for long periods of time or receive ineffective treatment, producing complications that can lead to infertility, blindness, and even death. In addition, there is growing research evidence that people with bacterial or viral STDs are more likely to acquire--and perhaps transmit--the human immunodeficiency virus (HIV). STD control programs in developing countries must be reorganized to include: 1) good management of patients with STDs and their contacts, 2) case finding for syphilis in the antenatal population, 3) screenings and case findings for gonorrhea in high-risk groups, and 4) systematic prophylaxis for ophthalmia neonatorum in newborns. Since diagnosis before treatment is problematic in rural areas, the World Health Organization recommends simple treatment protocols based on the most common STD symptoms--urethral discharge; gynecological complaints such as vaginal discharge, low abdominal pain, or dysuria; genital ulceration; and inguinal bubo, a swelling of the lymph nodes in the groin. Other components of this approach include standardized treatment, contact tracing and treatment, health education targeted at high-risk groups, follow-up and case referral where necessary, and the collection of simple statistics on treatment efficacy and STD epidemiology. The incidence of STDs in developing countries is steadily increasing as a result of urbanization, increased numbers of young people, and delayed age at marriage. However, this situation can be combatted through application of treatment protocols, technological advances, improvements in the health care delivery system, and awareness on the part of policy makers of the seriousness of the STD problem.
 ...
PMID:Management of sexually transmitted diseases. 1234 18


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>