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Query: UMLS:C0000737 (
abdominal pain
)
31,184
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Testicular torsion is characterized by the sudden onset of testicular pain associated with
abdominal pain
, nausea and vomiting. Fever is unusual and urinalysis is often normal. Fever, pyuria, dysuria and
urethral discharge
are characteristic of epididymitis. Radionuclide scanning and Doppler ultrasound are helpful in establishing the diagnosis. If the diagnosis is uncertain, the patient should be considered to have testicular torsion until it is proved otherwise. Undiagnosed torsion leads to testicular necrosis.
...
PMID:The acute scrotum. 327 40
Ten women with acute right upper-quadrant
abdominal pain
but negative results for biliary investigations had a current or past history of pelvic inflammatory disease. A diagnosis of the Curtis-Fitz-Hugh syndrome was made and was confirmed in five patients by laparoscopy. Neisseria gonorrhoeae was not isolated from the cervical and urethral swabbings of seven patients tested. Chlamydia trachomatis was isolated from the endocervical canal in one of six patients examined. Of sera from nine patients tested by a micro-immunofluorescence test, nine and six samples respectively showed type-specific IgG and IgM antibodies against C trachomatis serotypes D-K. Type-specific IgG and IgA antibodies were also detected in the cervical and
urethral discharge
of two out of five patients and in the peritoneal aspirate of two. The presence of high titres of IgG or IgM in sera and IgG or IgA in the local discharges of our patients suggests that C trachomatis was probably the cause of the CFH syndrome.
...
PMID:Chlamydia and the Curtis-Fitz-Hugh syndrome. 732 53
Teso District in eastern Uganda with low fertility (crude birth rate in 1969 was 37/1000), and Ankole District in western Uganda with high fertility (55/1000), were selected to study malaria, nutrition, gonorrhea, and syphilis. The gonorrhea methodology for women included genital examination and endocervical smears and cultures. Husbands of gonococcal-negative fertile and infertile women also were examined for the presence of gonorrhea and evidence of infection in the past. Three hundred and forty-three women in Teso and 250 in Ankole underwent medical examination. In the Teso District, 84 (25%) of the women, as compared with 22 (8.9%) in Ankole, complained of lower
abdominal pain
(p 0.001). Seven women in Teso but none in Ankole had signs of bartholinitis. Mucopurulent discharge in the vagina was found in 56 (19%) of the Teso women as compared with 17 (10%) of the Ankole women (p 0.02). 90 (30.5%) of the women in Teso but only 21 (12.5%) women in Ankole had an eroded and/or infected cervix (p 0.001). Evidence of salpingitis was obtained in 56 (19%) of the Teso women as compared with 10 (5.9%) Ankole women (p 0.001). A tender adnexal mass was felt in 23 (7.8%) of the Teso sample but in only one (0.6%) in Ankole. Among the women in Teso, 54 (18.3%) had a positive cervical smear or culture for gonorrhea, but only four (2.4%) in Ankole had similar positive tests (p 0.001). Evidence of pelvic inflammatory disease was present in 17% of the infected Teso women. None of the infected Ankole women, however, had PID. Cervical secretions showed gonococci in only 10% of the infertile women as compared with 23% of the fertile women. However, 24.5% of husbands of the gonococcal-negative infertile women, as compared with 6.7% of husbands of the gonococcal-negative fertile women, were found to have active gonorrhea (p 0.01). In this group 75.5%, and 57.7% of husbands, respectively, had a past history of
urethral discharge
(p 0.05), while 18.4% and 5.8%, respectively, had bilaterally thickened epididymides (p 0.05).
...
PMID:Gonorrhea and female infertility in rural Uganda. 746 80
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.
...
PMID:Management of STDs and cost of treatment in primary health care centres in Pikine, Senegal. 794 56
In 1994 Chlamydia trachomatis specimens from 175 men and 135 women attending a clinic for treatment of sexually transmitted disease were genotyped by polymerase chain reaction-based restriction fragment length polymorphism of the omp1 gene. Information about the patients was collected at their initial visit. The associations between C. trachomatis genotype and patients' self-reported symptoms, clinical signs, and characteristics were studied. Genotypes E, F, and D/D-predominated (men: 71%; women: 60%). Five specimens (1.6%) showed evidence of mixed infections. Among men, complaints of
urethral discharge
and dysuria were most commonly associated with genotypes H and J (100% vs. 59%-68% for the other genotypes; P = .03); in addition, > or = 10 leukocytes per microscopic field were least often observed for genotypes G/Ga (19% vs. 59%-65% for the other genotypes; P = .01). Women's reports of lower
abdominal pain
were more often associated with F, G group genotypes (32%) than with B-complex (6%) or C-complex (13%) genotypes (P = .02). Certain symptoms of genital C. trachomatis infection were related to the infecting genotype. Further work will be necessary and should involve markers of the host immune response.
...
PMID:Chlamydia trachomatis genotypes: correlation with clinical manifestations of infection and patients' characteristics. 950 48
Travel and tourism are associated with an increased risk of sexually transmitted infections (STIs) and unwanted pregnancy. This article offers guidelines for health professionals on pre-travel counseling and outlines steps in the clinical management of returning travelers who have been exposed to STIs or pregnancy. The imperative for controlling STIs is particularly urgent now that an epidemiologic link between STIs and vulnerability to HIV infection has been established. Much can be done before a trip abroad in terms of prevention, including the provision of condoms and leaflets explaining the risks of unprotected sex while on holiday or a business trip. Patients should be questioned about their sexual behaviors before, during, and after travel and those who have taken sexual risks while traveling should be offered screening for STIs. The STI-related conditions addressed in this article include vaginal discharge, lower
abdominal pain
,
urethral discharge
, scrotal pain, genital ulcer disease, inguinal bubo, and genital warts. Recommended treatment regimens for the most prevalent reproductive tract infections are outlined.
...
PMID:The sexual health of travelers. 965 51
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
According to World Health Organization estimates, there are 333 million new cases of sexually transmitted diseases (STDs) each year. The total number of reproductive tract infections (RTIs) is even higher since these infections may have few visible symptoms, especially in women. Left untreated, however, RTIs can lead to infertility. Common symptoms include: unusually thick or foul-smelling vaginal or
urethral discharge
, genital sores, anal sores, genital itching, pain when urinating and during sexual intercourse, painful swelling in the lymph glands or groin, and lower
abdominal pain
. The open sores associated with STDs such as syphilis, chancroid, and genital herpes greatly increase the risk of HIV transmission, as may STDs such as gonorrhea that are associated with urethral or vaginal discharge. To facilitate the prompt diagnosis and treatment of RTIs, this article briefly describes the diagnosis and long-term effects of gonorrhea, syphilis, chancroid, chlamydia, pelvic inflammatory disease, genital herpes, genital warts, candida, and bacterial vaginosis.
...
PMID:Common infections. 1234 38
Cost concerns as well as constraints of time, resources, and access to treatment frustrate and even impede the use of the etiological and clinical approaches to diagnosing and treating sexually transmitted diseases (STDs) in Africa. Syndromic case management, an alternative to these approaches, refers to the ability to identify and treat a syndrome caused by a STD, with minimal or no requirement for laboratory support. A syndrome can be defined as a combination of symptoms or complaints, with signs detected during clinical examination. The most important STD-related syndromes include
urethral discharge
in men, vaginal discharge in women, genital ulcer in men and women, lower
abdominal pain
, inguinal bubo (swelling), balanitis/balanoposthitis in men, and scrotal swelling. The aim of syndromic management is to identify a syndrome and treat it accordingly with combination therapy which will cover the main pathogens that cause it. The World Health Organization (WHO) strongly encourages the adoption of the syndromic management of STDs, and it has developed a series of flow-charts or clinical algorithms for the standardized management of STD cases. These general guidelines need to be adapted for local conditions in order to maximize their specificity and effectiveness. The advantages and disadvantages of syndromic case management, as well as the implementation of the strategy, are considered.
...
PMID:Syndromic case management of STDs in Africa. 1234 89
Chlamydia trachomatis is the leading cause of bacterial sexually transmitted diseases worldwide. Urogenital strains are classified into serotypes and genotypes based on the major outer membrane protein and its gene, ompA, respectively. Studies of the association of serotypes with clinical signs and symptoms have produced conflicting results while no studies have evaluated associations with ompA polymorphisms. We designed a population-based cross-sectional study of 344 men and women with urogenital chlamydial infections (excluding co-pathogen infections) presenting to clinics serving five U.S. cities from 1995 to 1997. Signs, symptoms and sequelae of chlamydial infection (mucopurulent cervicitis, vaginal or
urethral discharge
; dysuria; lower
abdominal pain
; abnormal vaginal bleeding; and pelvic inflammatory disease) were analyzed for associations with serotype and ompA polymorphisms. One hundred and fifty-three (44.5%) of 344 patients had symptoms consistent with urogenital chlamydial infection. Gender, reason for visit and city were significant independent predictors of symptom status. Men were 2.2 times more likely than women to report any symptoms (P=0.03) and 2.8 times more likely to report a
urethral discharge
than women were to report a vaginal discharge in adjusted analyses (P=0.007). Differences in serotype or ompA were not predictive except for an association between serotype F and pelvic inflammatory disease (P=0.046); however, the number of these cases was small. While there was no clinically prognostic value associated with serotype or ompA polymorphism for urogenital chlamydial infections except for serotype F, future studies might utilize multilocus genomic typing to identify chlamydial strains associated with clinical phenotypes.
...
PMID:Population-based genetic epidemiologic analysis of Chlamydia trachomatis serotypes and lack of association between ompA polymorphisms and clinical phenotypes. 1652 8
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