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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

Eighty-one women who presented to a genitourinary medicine clinic with mild to moderate acute or chronic abdominal pain were studied in order to compare the clinical features of those who had pelvic inflammatory disease (PID) and those who did not. The diagnosis was made by laparoscopy, and PID was detected in 14%, adhesions in 11% and endometriosis in 16%. Women with PID were clinically indistinguishable from women with other diagnoses or no obvious cause.
Int J STD AIDS
PMID:Abdominal pain in women attending a genitourinary medicine clinic: who has PID? 781 51

We studied the current management of STD-related syndromes by urban health facilities in Pikine (Senegal) in 252 consecutive patients presenting with STD-related complaints, to assess the cost and effectiveness of services and to estimate the potential benefit by introducing management protocols. Most common presenting complaints for women were vaginal discharge and low abdominal pain, reported for 122 (82.9%) and 22 (15.0%) of 147 female patients. Urethral discharge and genital ulceration were reported for 80 (76.2%) and for 17 (16.2%) of 105 male patients. The average cost was 4.01 ECU (1 European Currency Unit = 1.2 US$ = 334 Franc CFA) for male patients (ranging from 0.57 to 25.70 ECU) and 12.75 ECU for female patients (ranging from 0.57 to 37.60 ECU). Only 20 of 80 patients with urethral discharge (25%) received effective treatment. Effectiveness was not related to cost of therapy or qualification of staff. Utilization of management protocols improves the quality and accessibility of care for STD, by potentially doubling effectiveness and reducing the costs for patients to 12% of the current level.
Int J STD AIDS
PMID:Management of STDs and cost of treatment in primary health care centres in Pikine, Senegal. 794 56

Between October 1991 and October 1993, 17 AIDS patients (14 intravenous drug users, 3 sexually acquired) were commenced on percutaneous endoscopic gastrostomy (PEG) feeding in St James's Hospital. Indications were progressive weight loss related to severe anorexia, persistent oesophageal candidiasis (5) and absence of gag reflex (1). Two patients requested PEG tube removal after one week because of crampy abdominal pain without peritonitis. Five patients died from AIDS related infections within 6 weeks of PEG insertion. Ten patients were followed up for > 2 months (mean 5.2 months, range 2.5-15.5 months). In these 10 patients, 1 patient developed a PEG site infection which responded to topical antibiotics. There were no other complications. There was a significant (P < 0.001) increase in energy and protein intake at 2 months. Variant degrees of weight gain occurred in all patients (mean 2.6 kg) (P < 0.01). Small but significant increases in other anthropometric variables occurred. Patients who died within 6 weeks of PEG insertion were older, and had a lower serum albumin than the group who survived > 2 months (P < 0.01). A self-administered questionnaire demonstrated that the majority of patients found PEG feeding acceptable and preferable to nasogastric (NG) feeding.
Int J STD AIDS
PMID:An evaluation of percutaneous endoscopic gastrostomy feeding in AIDS. 873 34

Our objectives were to evaluate tolerance and compliance of post-exposure triple therapy in health-care workers (HCWs) by retrospective observational study. Structured telephone interview of HCWs identified through data from antiretroviral prescribing centres. Twenty HCWs who received triple prophylaxis were identified over one year. Sixteen agreed to participate in the study. All but one source patient had documented HIV infection. Half HCWs were not aware of post-exposure therapy. Most HCWs received a zidovudine, lamivudine and indinavir combination. All completed at least 4 weeks of therapy. Only 50% received their first dosage less than 4 h after exposure. Nearly all experienced adverse events, mostly digestive (nausea and abdominal pain n=15) or psychological (anxiety and depression n=15), none resulting in therapy discontinuation. Most events occurred 2 to 7 days after therapy initiation. Most modified their sexual life with abstinence or condom use. Compliance was excellent. Half HCWs did not miss any tablet, 4 forgot one dosing a month and 4 one dosing a week. Follow up is over 6 months in all but one HCW. No HIV seroconversion has been observed to date. In France, post-exposure triple antiretroviral therapy is widely available 24 h a day in every emergency room but further training and development of HCWs is needed to decrease consulting time and increase referral to specialized physicians. Notable moderate adverse events, both physical and psychological are noted, however, compliance is excellent.
Int J STD AIDS 1998 Oct
PMID:Tolerance, compliance and psychological consequences of post-exposure prophylaxis in health-care workers. 981 9

Adolescents remain a group at particular risk for STD acquisition due to a combination of biological and psychosocial factors. Access to care can be an obstacle to seeking appropriate screening and treatment for many adolescents; undetected infection may lead to unwanted sequelae, including pelvic inflammatory disease, chronic abdominal pain, tubal scarring, and increased risk of ectopic pregnancy. With respect to gonorrhea, chlamydia, syphilis, and chancroid, the hope is that improved detection will decrease sequelae by prompting earlier recognition and treatment. In all cases of suspected sexual abuse cultures remain of utmost importance because of the negative consequences associated with a possible false-positive test result. Urine screening in certain settings, such as school-based health centers and juvenile detention centers, remains positive; however, adolescents with a positive test may still require further evaluation to identify HPV and abnormal Pap smear findings, syphilis, and other STDs currently not recognizable with a simple urine screen.
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PMID:Sexually transmitted diseases: testing and treating. 1037 Jul 7

To design and apply a multi-method promotional package for enhancing awareness and knowledge on STD and AIDS among ITI trainees, and evaluate its impact, an intervention study, using pre and post assessment of the subjects for comparison was carried out. The study was carried out in the Industrial Training Institute (ITI), in a resettlement colony of Delhi. Urethral/vaginal discharge, genital ulcer and pain on micturition were identified as symptoms of STD by a significantly higher number of respondents in the post package sample. A sizable number of subjects included inguinal swelling and lower abdominal pain also as STD symptoms. The IEC intervention showed a significant improvement in knowledge about all four major routes of transmission of HIV/AIDS. Using condoms and avoiding sex with Commercial Sex Workers were reported as measures to prevent STD/AIDS by a significantly higher number of subjects after the intervention. A sizable number of subjects also included other measures (using safe blood/not sharing needles etc.) as well. There was a significant decline in the subjects preferring self treatment or treatment from a chemist shop in case one suffered with an STD. A significant increase was observed in those preferring treatment from govt. facilities or private allopathic doctors. However, the intervention did not seem to result in preference for alternative systems of medicine. The study demonstrated that exposure to intensive promotional intervention, even for a brief period can significantly raise awareness and knowledge of young people even on sensitive topics like STD and AIDS.
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PMID:Impact of a multi-method promotional package on awareness and knowledge about STD and AIDS among the trainees of an industrial training institute in a resettlement colony of Delhi, India. 1093 96

The objective of the study was to determine the clinical manifestations and diagnostic criteria used to diagnose presumptive pelvic inflammatory disease (PID) at the Sydney Sexual Health Centre (SSHC). The study was a retrospective, case-note review of all women diagnosed with presumptive PID between April 1991 and December 1997. Seven hundred and thirteen women were included. The commonest recorded symptoms were vaginal discharge (68%), lower abdominal pain (65%) and dyspareunia (57%), while adnexal tenderness (83%), cervical motion tenderness (75%) and cervicitis (56%) were the most frequently recorded examination findings. Sixty-two per cent were prescribed doxycycline and metronidazole. The recording of signs and symptoms in women with presumptive PID was poor and only 22% met the current Centers for Disease Control (CDC) diagnostic criteria. It is likely that PID is over diagnosed in this group of women. This may lead to under diagnosis of other conditions causing pelvic pain and may be detrimental to reproductive health.
Int J STD AIDS 2000 Aug
PMID:Diagnosing PID--getting the balance right. 1099 Mar 40

Inflammatory pseudohepatic tumours are unusual tumour-like conditions which can easily be mistaken for malignant lesions or liver abscesses. Patients usually present with fever, abdominal pain and loss of weight. The aetiology is unclear but the predominant inflammatory pattern of pathology and the associated systemic reactions suggest an underlying infectious agent. In the majority, microorganisms are not detected. As even routine imaging procedures usually fail to distinguish hepatic pseudotumours from liver neoplasms, biopsy is the definitive means of diagnosis. Until now, no case of pseudohepatic tumour has been reported as being associated with secondary syphilis. We believe secondary syphilis is the cause of this pseudohepatic tumour in our HIV-positive male.
Int J STD AIDS 2006 Feb
PMID:Pseudohepatic tumour associated with secondary syphilis in an HIV-positive male. 1646 82


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