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)

A case of primary ovarian pregnancy involving a Copper 7 (Cu 7) IUD is described, and the pertinent literature is reviewed. A 29-year old white woman, gravida 2, para 2, presented with nausea and fatigue of 1 months' duration and severe bilateral upper abdominal pain with radiation to both shoulders of 1 day's duration. Her menstrual cycles for the previous 4 months had been irregular and her last menstrual period started 35 days prior to admission. She was known to have had a Cu 7 IUD in situ for 26 months. On admission, the patient was in moderate abdominal distress. Direct and rebound tenderness with some voluntary guarding was found in the upper abdomen, with minimal lower abdominal tenderness. Pelvic examination was normal, except for slight tenderness. Pelvic examination was normal, except for slight tenderness in the right adnexal area. No vaginal bleeding was observed. Serum pregnancy test (RIA) was positive. Sonogram of the abdomen showed the IUD in situ, free fluid in the peritoneal cavity, and a mass in the right adnexal area containing fetal parts and a fetal heartbeat. Dilation and curettage after removal of the IUD obtained a minimal amount of tissue. Laparotomy revealed 500-600 ml of blood. The uterus, both fallopian tubes, and the left ovary were normal. A hemorrhagic cystic area at the distal pole of the right ovary was actively bleeding. Wedge resection of the right ovary was performed. The patient recovered well and was discharged from the hospital 4 days after the operation. The hemorrhagic ovarian mass measured 6.0x4.5x3.0 cm. Section demonstrated at 3.0 cm cavity filled with clear fluid. The cavity was lined with a smooth membrane and contained a 1.6 cm embryo. A corpus luteum, 1.5 cm in greatest dimension, was adjacent to the cavity. Microscopic sections showed an edematous stroma and an area of implantation with vascularized chorionic villi adjacent to a corpus luteum. Hemorrhage extended from the area of implantation to the ovarian surface. Sections of the fetus were histologically normal. The diagnosis was ovarian pregnancy. Available data allow an approximation of the proportion of woman years of IUD use that involve the Cu 7 IUD in the US since 1966, which is calculated to be 28%. This calculation agrees with the observed 27% of the cases of ovarian pregnancy with an IUD in situ that involved the Cu 7 IUD reported in the US literature. This comparison suggests that the Cu 7 does not increase or decrease the risk of ovarian pregnancy relative to inert plastic IUDs. Clinicians should be aware of the possibility of ovarian pregnancy in patients who use the IUD.
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PMID:Ovarian pregnancy with a Copper-7 intrauterine device in situ. 682 9

A 21-year old white multiparous woman who had undergone a Copper-7 IUD insertion 6 days before hospital admission for abdominal pain reported she could not locate her IUD string. A slight bleeding from the cervical os was noted upon pelvic examination, and no IUD string was found. Ultrasonic B-mode scanning was performed, but the pathognomonic signs of an IUD (e.g., shadowing or entrance-exit echoes) were not seen. A digital scout view, obtained with a GE CT/T 8000 scanner showed the IUD within the pelvis. Laparoscopy was performed to remove the IUD, and the patient recovered uneventfully. The previous definitive procedure for locating IUD position was hysterosalpingography (HSG) but this technique is now used only when the sonographic and plain radiographic findings are equivocal. CT is a much easier, faster, and less invasive procedure than HSG and just as definitive; it also has the advantage of lower patient irradiation, with about 2 rad (0.02 Gy) skin dose and about 0.2 rad (0.002 Gy) gonadal dose for a single section. Fluoroscopy during HSG may deliver 0.5-1.0 rad/minute (0.005-0.01 Gy/minute) to the gonads. Patient irradiation may be minimized by a digital scout view of the pelvis. It is possible to perform the entire examination with only 1 axial scan, as in this patient, by accurately aligning the scanner.
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PMID:Location of intrauterine devices: evaluation by computed tomography. 719 49

Uterine perforation is known to be associated with IUD use. Usually the perforation occurs upon insertion, but the IUD can become embedded in the uterus and later be forced through the wall by uterine contractions. On occasion, IUDs have been noted in abdominal viscera, most often the sigmoid colon. Recently, a 20-year-old black woman was encountered whose Copper-7 IUD had perforated her appendix and had caused chronic appendicitis during pregnancy. The woman had had 3 live-born children and 1 spontaneous abortion. The Copper-7 had been inserted 6 months previously without apparent difficulty. At 21 weeks' gestation, the patient developed right lower abdominal pain radiating to the right buttock. She had no other gastrointestinal complaints, was afebrile, and exhibited no abnormal physical findings to explain her symptoms. Urine cultures were negative. 12 weeks later, the patient developed nausea, vomiting, anorexia, and constipation. She was again afebrile. After spontaneous labor at 40 weeks, the patient was delivered of a normal male infant. Following spontaneous expulsion of the placenta, the uterus was manually explored, and no IUD was found. The patient desired postpartum tubal ligation. An x-ray film of the abdomen revealed a Copper-7 IUD in the right lower quadrant at the level of the iliac crest. During the operation, it was noted that the IUD had apparently perforated the uterus 1 centimeter below the right uterotubal junction. The strings were in the myometrium, but the body of the IUD had passed transversely through the lumen of the appendix and remained embedded in it. The IUD may have induced inflammation in an otherwise normal appendix, and this seems most likely particularly because copper-containing IUDs are prone to cause irritation and adhesion formation.
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PMID:Appendiceal perforation by Copper-7 intrauterine contraceptive device. 729 85

Copper is an essential micronutrient and a potential toxic metal. The USEPA current maximum contaminant level goal (MCLG, a nonenforceable aspirational health goal) and the required treatment technique action level, both set at 1.3 mg/liter of copper are not adequately protective for infants and children under 10 years of age. Infants and children up to 10 years of age have increased susceptibility to copper toxicity. The two main reasons for the high sensitivity in this population subgroup are the presence of a normally high concentration of copper in the liver during early life and the lack of a fully developed homeostatic mechanism of copper in children under 10 years of age. This sensitive group of infants and children represents approximately 17% of the total U.S. population. The adverse health effects caused by drinking water contaminated with copper are abdominal pain, nausea, vomiting, diarrhea, headache, and dizziness. The proposed drinking water guideline of 0.3 mg/liter for copper was derived by the application of the risk assessment procedures approved by the USEPA. Drinking water containing 0.3 mg/liter of copper will provide approximately 26% of the nutritional requirement of copper. This proposed drinking water guideline (0.3 mg/liter) for copper will adequately protect health of infants, children, and adults.
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PMID:Need to revise the national drinking water regulation for copper. 866 36

Between April 1988 and June 1991, health workers in Nigeria followed 300 women aged 20-40 who had had a copper releasing IUD inserted during menstruation at the family planning clinic of the University College Hospital in Ibadan. The double blind clinical trial compared the effectiveness and side effects of three copper releasing IUDs: Copper T380A, Multiload 375, and Multiload 250. 75.7% had used no contraception before admission to the study. Pelvic inflammatory disease (PID) occurred more often in the MLCU 250 group than the other two groups. Only two women were hospitalized for PID. These two women used the TCU 380A or MLCU 250. Many IUD users experienced abdominal pain during menstruation and TCU 380A users had the highest rate (27% vs. 21-24%). Heavy bleeding during menstruation was more common in TCU 380A and MLCU 375 users (5% and 4%, respectively, vs. 2%). Pelvic pain/cramps were present in 1-3% of women, but did not contribute to removal. The only case of uterine perforation was in a user of the TCU 380A. None of the MLCU 375 users experienced IUD expulsion, while two TCU 380A users experienced total expulsion and two and one MLCU 250 users experienced total and partial expulsion, respectively. PID was related to IUD removal at 6 months (3.1% vs. 0; p 0.05). The pregnancy rate at 6 months was 1.1% for the TCU 380A group and 0 for the other groups. At 12 months, it was 1.1% for the TCU 380A group and the MLCU 375 group and 0 for MLCU 250. The net 6-month IUD cumulative termination rate was highest in the TCU 380A group (11.1% vs. 3-7%; p 0.05). These differences were no longer significant at 12 months. The net 6- and 12-month IUD continuation rate was 97% and 92% for MLCU 375 compared to 88.9% for TCU 380A and 93% for MLCU 250 and 85.8% for TCU 380A and 87% for MLCU 250, respectively. These findings suggest that these three IUD devices could be used in the hospital's family planning clinic.
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PMID:Performances of copper T 380A and multiload copper 375/250 intrauterine contraceptive devices in a comparative clinical trial. 749 2

A 12-month comparative study conducted at a medical center in Burla, India, failed to detect significant differences in side effects between 60 women who had a Copper-T 200 IUD inserted after induced abortion and 100 women with interval IUD insertion. Most insertions involved women in the 21-30 year age group. Menorrhagia was reported by 8% of women in the postabortion insertion group and 8.5% of those in the interval insertion group after 1 month and by 5% and 10%, respectively, after 3 months; its incidence was negligible thereafter. Dysmenorrhea was experienced by 20% of postabortion insertion cases and 7% of interval cases at 1 month and by 15% and 7%, respectively, at 3 months, at which point it, too, decreased. Women with postabortion IUD insertion reported more lower abdominal pain and back ache in the first 3 months, presumably because of the operative trauma and chance of pelvic inflammation. Expulsion occurred in 2 women in the postabortion insertion group and in 1 woman in the interval group. The single pregnancy reported during the study period involved a woman from the postabortion insertion group (1.6%). The removal rate was 8.3% in the postabortion group and 11% in the interval group; requests were due to a desire for pregnancy or discomfort with menstruation disturbances. These findings refute the commonly held belief that postabortal IUD insertion is associated with an increased risk of infection, spontaneous expulsion, and unacceptable menstrual disturbances.
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PMID:Study of side-effects of Cu-T as intra-uterine contraceptive device in post medical termination of pregnancy and interval cases. 905 9

Presented are two cases from Bangladesh in which an intrauterine device (IUD) transmigrated from the uterine to the pelvic cavity. In the first case, a 19-year-old woman with 2 children had a Copper T-380A IUD inserted by a paramedic in 1988. About 4 days later, she developed lower abdominal pain and vaginal bleeding. An attempt to remove the IUD by dilatation and curettage was unsuccessful and the patient was lost to follow up. In 1995, after she had delivered 3 more children, this patient presented with burning micturition, dysuria, and increased frequency. A plain film revealed a T-shaped radio-opaque shadow in the pelvis. A T-shaped vesical calculus was removed through suprapubic cystolithotomy. In the second case, a 28-year-old woman had a Copper T-380A IUD inserted in 1991. One month later, she developed increased frequency of micturition and could not locate the device's nylon string. A plain film and ultrasonogram of the pelvis indicated the IUD had perforated the uterus and migrated to the bladder. The device was removed through suprapubic cystolithotomy. In both cases, the postoperative recovery was uneventful.
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PMID:Vesical calculus around an intra-uterine contraceptive device. 912 6

A female sterilization regimen involving transcervical insertion of pellets containing 252 mg of quinacrine and 55.5 mg of ibuprofen in the proliferative phase of 2 consecutive menstrual cycles was found to be safe, acceptable, and effective. Subjects included 200 healthy volunteers (mean age, 33.2 years) who presented to a family planning clinic in Central Java Province, Indonesia, seeking sterilization. The insertion procedure (Kimia Farma) is similar to that for the Copper-T IUD. Only 3 women declined the second insertion. One month after insertion, side effects included lower abdominal pain (58.0%), fever (13.5%), and leukorrhea; however, these rates decreased to 0.5%, 2.0%, and 2.0%, respectively, 1 year after the second insertion and to 0.5%, 0.0%, and 1.6%, respectively, after 2 years. During the 2-year study period, 4 women became pregnant 4, 5, 14, and 18 months after the second insertion. The cumulative pregnancy rate was 1.0% 0-12 months after insertion and 2.0% in the second year. One of these women selected pregnancy termination; no malformations were noted in the 3 infants delivered. Quinacrine sterilization has the potential to meet the unmet need for female sterilization in developing countries without access to trained personnel and sophisticated surgical equipment.
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PMID:Quinacrine pellet nonsurgical female sterilization in Wonosobo, Indonesia. 913 Sep 11

An 18-year-old white woman had nausea, vomiting, weight loss, and a diagnosis of anorexia nervosa. Copper-colored skin was noted on physical examination, and serum chemistry values were normal. Subsequent fever, disorientation, and confusion led to the discovery of Addison's disease, which responded well to corticosteroid replacement therapy. Addisonian and anorexic patients exhibit clinical similarities, including nausea, vomiting, weight loss, abdominal pain, cold intolerance, hypothermia, and orthostasis. Other commonalities include prolongation of electrocardiographic PR and QT intervals and generalized slowing on electroencephalogram. Important differences include a brown color to the skin in Addison's disease instead of a yellowish color in anorexia. Addisonian patients also display hypocortisolism, hypoglycemia, and hyperkalemia, in contrast to the hypercortisolism, hyperglycemia, and hypokalemia seen in anorexia.
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PMID:Prompt differentiation of Addison's disease from anorexia nervosa during weight loss and vomiting. 949 78

Although allergic reactions to copper are rare, skin disorders may appear or worsen during the perimenstrual period. This paper presents the case of a 41-year-old user of a copper-containing IUD who presented with a history of recurrent, self-healing skin eruption associated with abdominal pain. The eruption followed a cyclical pattern, appearing 3-7 days before menses and improving spontaneously with the onset of bleeding. Patch testing revealed a positive reaction to copper sulfate and nickel sulfate. After the IUD was removed, abdominal symptoms subsided at the next cycle and progressive resolution of the dermatitis was observed.
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PMID:Perimenstrual dermatitis secondary to a copper-containing intrauterine contraceptive device. 966 54


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