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

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.
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PMID:The need for a chlamydial culture service. 48 48

A 34-year-old woman presented with lower abdominal pain, dysmenorrhea, dyspareunia and vaginal discharge. A total abdominal hysterectomy was done for persistent, severe uterine pain unresponsive to medical management. Histologic examination of the surgical specimen revealed a large condyloma acuminatum of the endocervix and lower uterine segment. This represents a rare manifestation of a very common venereal disease.
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PMID:Giant condyloma acuminatum of the endocervix and lower uterine segment. 49 Apr 92

The microbiological and epidemiological correlates of vaginal colonisation by Mobiluncus species were examined among randomly selected women attending a sexually transmitted disease (STD) clinic. Women positive for Trichomonas vaginalis were excluded. Mobiluncus spp. were detected by Gram stained vaginal smear in 21% of 633 STD clinic patients, including 53% of those with and 4% of those without bacterial vaginosis (BV), as diagnosed by clinical criteria. Gardnerella vaginalis and Mycoplasma hominis detected by vaginal culture and Mobiluncus detected by vaginal Gram stain were each independently associated with BV after adjusting by logistic regression for the presence of sexually transmitted disease pathogens, gravidity, parity and number of lifetime sexual partners (p less than 0.001 for each organism). Bacterial vaginosis was negatively correlated with isolation of lactobacilli, yeast and herpes simplex virus. After adjusting for presence or absence of BV, women with Mobiluncus were more likely to harbour G vaginalis (odds ratio 5.6, 95% confidence interval 1.6-19.5), M hominis (OR 3.7, 95% CI 2.0-7.0) and Neisseria gonorrhoeae (OR 2.9, 95% CI 1.4-6.0) and less likely to harbour vaginal yeast (OR 0.4, 95% CI 0.2-1.0); were more likely to be black (OR 2.7, 95% CI 1.5-4.6), and to have been pregnant (OR 1.8, 95% CI 1.1-3.1); but after the adjustment for BV, vaginal colonisation by Mobiluncus was not associated with symptoms of odour, abdominal pain, menstrual irregularities, or with adnexal tenderness. In summary, Mobiluncus, Gardnerella vaginalis and Mycoplasma hominis were independently associated with a clinical diagnosis of bacterial vaginosis, and Mobiluncus was further associated with the presence of BV-associated microorganisms (M hominis and G vaginalis), N gonorrhoeae, black race, and gravidity.
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PMID:Microbiological, epidemiological and clinical correlates of vaginal colonisation by Mobiluncus species. 191 72

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).
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PMID:Pelvic inflammatory disease: guidelines for prevention and management. 203 5

The protozoon Blastocystis hominis may cause episodes of diarrhoea with abdominal pain, tenesmus, fever and eosinophilia. We have observed 5 cases of blastocystosis in male subjects with symptomatic HIV infection. All patients had a complete response to metronidazole. This report confirms that Blastocystis hominis may be responsible for HIV-related diarrhoea.
Int J STD AIDS 1990 Mar
PMID:Blastocystosis: a new disease in the acquired immunodeficiency syndrome? 209 90

Two hundred women attending the sexually transmitted disease (STD) clinic at Middle Road Hospital were investigated. Chlamydia trachomatis was isolated from 32% of women who were contacts of men with nongonococcal urethritis, 15% of contacts of gonococcal urethritis, 27% of contacts of unspecified STD, and 13% of women without any history of STD in their sex partners. Overall, Chlamydia trachomatis was isolated from 17% of 200 women, Neisseria gonorrhoeae from 13% of 199 women, Candida albicans from 34% and Trichomonas vaginalis from 6% of 197 women. Three per cent of the patients had positive VDRL results. A history of bilateral lower abdominal pain and the presence of cervicitis were significantly associated with chlamydial infection. Forty one per cent of the 34 chlamydia-positive women were asymptomatic. The results of this study show that C. trachomatis infection is more common than infection with N. gonorrhoeae in women who attend STD clinics. The need for routine screening and treatment on the basis of epidemiological and clinical markers of infection has to be carefully examined.
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PMID:Endocervical chlamydial infection in women attending a sexually transmitted disease clinic in Singapore. 260 75

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.
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PMID:Infection with Chlamydia trachomatis and Neisseria gonorrhoeae in women with lower abdominal pain admitted to a gynaecology unit. 275 62

Pelvic inflammations account for approximately 1/4 of the economic resources expended for maternity care in Chile. The use of IUDs has replaced abortion as the primary cause of pelvic inflammation. Sexually transmitted diseases are increasing but have not yet become a major cause of pelvic inflammations. A retrospective study was conducted of women hospitalized for pelvic inflammations in the septic unit of a hospital in Santiago, Chile, in 1980-83. Among the 313 women admitted with a diagnosis of pelvic inflammation, ages ranged from 17 to 57 and averaged 30.4 years. 11.1% were nulligestes, 25.2% were primiparas, 55.5% were multiparas, and 7.9% were grand multiparas. 45 of the 313 reported an induced abortion prior to the pelvic complication. 126 women (40.2%) reported use of an IUD. 36 women had postpartum infections, and no risk factor was identified for the remainder. The major clinical symptoms were abdominal pain in 67.7%, fever in 48.5%, metrorrhagia in 14.0%, and palpable mass on gynecological examination in 52.3%. Sonography was performed in 92 cases and laparoscopy in 20. Use of laparoscopy increased greatly after the study period and has proven to be extremely valuable in diagnosis. 121 of the 313 patients were treated medically and 192 were treated medically and surgically. The average hospital stay was 8.8 days, with a maximum of 80 days and a minimum of 1 day. The admission diagnosis was incorrect in 138 cases and correct in 175. A purulent acute appendicitis was discovered in 1 patient with a presumed tubo-ovarian abscess. The mortality rate was 1.2%.
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PMID:[Pelvic inflammations]. 297 91

In Nairobi, Kenya, researchers enrolled 35 women at 7-9 days postpartum who delivered vaginally and had clinical endometritis (purulent lochia, fever, uterine tenderness, or uterine subinvolution) and 30 puerperal women without endometritis in a case control study. The study aimed to examine the association between clinical criteria and microbial and histological findings in diagnosing postpartum endometritis and the role of various microorganisms in the etiology of this infection. Cases were significantly more likely to have foul lochia (51.1% vs. 20%; p = .005) and abdominal pain (77.1% vs. 46.7%; p = .02). Laboratory personnel were able to isolate both Neisseria gonorrhoeae and Chlamydia trachomatis significantly more often from the cervices and the endometria of the patients than from the controls. Each of these 2 microorganisms were also isolated more often from the endometria of patients than of controls (3 patients vs. 0 patients for both N. gonorrhoeae and C. trachomatis), but the difference was not significant. The researchers could not determine the etiology of postpartum endometritis in the remaining two-thirds of cases. Isolation rates for Mycoplasma hominis and Ureaplasma urealyticum from the cervices and endometria were essentially the same in both patients and controls. Moderate or severe plasma cell infiltration occurred in 24% of cases and 4.5% of controls (p = .06). No correlation between histology and microbiology existed, however. These findings suggest that controlling maternal sexually transmitted disease would reduce postpartum pelvic infections and secondary infertility.
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PMID:Microbial aetiology and diagnostic criteria of postpartum endometritis in Nairobi, Kenya. 313 52

Diagnosis of the cause of lower abdominal pain in women may be difficult because appendicitis and pelvic inflammatory disease often present similarly. In a prospective study of 118 women, we found that several criteria are useful in establishing this differential. These include (1) duration of symptoms, (2) the presence of nausea, vomiting or both, (3) a history of venereal disease, (4) cervical motion tenderness, (5) adnexal tenderness, and (6) isolated peritoneal signs in the right lower quadrant. Although no single finding can define the diagnosis, the history and physical findings reported herein provide a number of criteria which, when taken together, will usually allow a confident diagnosis of either appendicitis or pelvic inflammatory disease to be made. Attention to these items can improve precision in diagnosis and lessen the incidence of unnecessary laparotomy, which carries a well-documented complication rate of 10 to 20 percent.
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PMID:Differential diagnosis of appendicitis and pelvic inflammatory disease. A prospective analysis. 316 Feb 52


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