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Query: UMLS:C0001577 (adnexitis)
 232 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ultrasonography (US) is suitable for diagnosing schistosomiasis-related organic pathology and is particularly useful to assess its evolution after therapy and/or interruption of exposure to the Schistosoma parasites. Evolution of pathology after treatment: Regression of hepatic abnormalities in Schistosma mansoni-infected children and adolescents has been observed already from 7 months post-therapy on. This does, however, not occur in all cases: individual differences are great ranging from spontaneous regression of pathology without treatment to persistence of pathology lasting for years after therapy even without re-infection. Intensity and duration of exposure, different parasite strains, patients' age and genetic background all influence the evolution of pathology. In communities at continuous exposure to S. mansoni infection, repeated re-treatment is required to control hepatosplenic morbidity. In Schistosoma japonicum infection, changes around the portal tree may regress, but characteristic diffuse abnormalities described as 'network pattern' abnormalities do not resolve. In Schistosoma haematobium infection bladder abnormalities and urinary tract obstruction frequently resolve after treatment. Clinically relevant pathology may resurge from 1 year after therapy on if exposure continues. Subjects with more advanced pathology before therapy, appear to be at higher risk of pathology re-appearance. Evolution of pathology after interruption of exposure to schistosomiasis: Knowledge on the evolution of pathology induced by S. mansoni is limited to some reports in emigrants and to the experience of ultrasonographists working in areas, where transmission has been partially interrupted. Due to the longevity of the parasite, infection may last for many years. Even after elimination of the parasites severe pathology may persist for long. In S. haematobium infection spontaneous healing after interruption of re-exposure may occur, but cases have been reported where urogenital lesions led to complications many years after exposure. Contrary to hepatosplenic and urinary pathology, knowlegde on the evolution of other organic abnormalities is very limited: studies on the evolution of biliary abnormalities or intestinal pathology have not been published. Genital pathology may be induced by all Schistosoma spp. Post-therapy evolution of genital schistosomiasis is largely ignored. In some European travellers partial regression of prostatic fibrosis has been described. Schistosomal adnexitis leading to infertility and/or ectopic pregnancy has been reported occurring many years after interruption of exposure. Ultrasonography (US) has never been used to study the influence of schistosomiasis on pregnancy. Concluding, current knowlegde on the evolution of pathology after treatment and/or interruption of exposure is still fragmentary. Frequently, fibrosis reverses after therapy, but advanced pathology may persist for long. Therefore, the possibility of severe clinical complications has to be taken into account, even if the infection is inactive since many years. In interventions aimed at controlling schistosomiasis-related morbidity, evolution of pathology must be monitored by US in representative patient cohorts. Further systematic US-studies are needed not only on the evolution of hepatosplenic and urinary pathology but also on that of intestinal, biliary and genital pathology induced by schistosomiasis, as well as on the influence of schistosomiasis on the outcome of pregnancy.
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PMID:Evolution of schistosomiasis-induced pathology after therapy and interruption of exposure to schistosomes: a review of ultrasonographic studies. 1099 27

The author reviews problems concerning infertility in developed countries. Topics covered include natural fertility, "demographic and social trends in family planning such as increasing maternal age at first childbirth, the increase of age-specific infertility rates through known ([adnexitis]), unknown (the environment) or debatable (induced abortion, certain contraceptive methods) causes, and the availability of highly developed techniques to assist conception. The actual prevalence of infertility is poorly documented and is either derived from demographic surveys or from hospital populations. To record the true prevalence of infertility, population-based surveys including infertility specialist confirmation of the etiology are needed. One survey of this type indicates a lifetime prevalence of 17% of couples." (SUMMARY IN ENG)
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PMID:[Fecundity, fertility, and sterility: assessment and controversy]. 1228 23

Endometriosis is certainly responsible for many instances of infertility, although its physiopathological mechanism is not very clear. Tubal endometriosis can lead to occlusion of the tubes, ovarian endometriosis can cause adhesions, and peritoneal endometriosis can cause adnexitis. Sterility caused by endometriosis is often secondary, while amenorrhea, menstrual fever, and pain are always present. Clinical medical examinations should be completed by hysterography and celioscopy. Endometriosis can be treated with hormonotherapy: lynestrenol and norethindrone atrophy the endometrium, block ovulation, and cause persistent amenorrhea. Surgical treatment has benefited enormously from the recent progress in microsurgery; it is now possible not only to resect the unwanted tissue, but to reconstitute the healthy one. It would be now reasonable to expect a pregnancy in about 50% of treated cases.
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PMID:[Endometriosis and infertility]. 1233 3

The term male adnexitis summarizes acute and chronic infections of the male urogenital tract. Chronic infections and inflammatory conditions are difficult to diagnose and the therapy has not been standardized. Therapy and management of complications has been clearly defined for acute urogenital infections. To date, antibiotic treatment in chronic infections and inflammatory conditions is only indicated when pathogenic bacteria can be retrieved from urogenital secretions.The usefulness of treatment with anti-inflammatory drugs is still debatable. One of the major concerns is the effect of urogenital infection on the fertility of the male. Although associations between urogenital infections and infertility have been shown for some entities, a general negative outcome of infectious events on male fertility appears to be unlikely.
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PMID:[Male adnexitis]. 1885 68

Trichomonas vaginalis is the most common non-viral sexually transmitted pathogen. The infection is prevalent in reproductive age women and is associated with vaginitis, endometritis, adnexitis, pyosalpinx, infertility, preterm birth, low birth weight, bacterial vaginosis, and increased risk of cervical cancer, HPV, and HIV infection. In men, its complications include urethritis, prostatitis, epididymitis, and infertility through inflammatory damage or interference with the sperm function. The infection is often asymptomatic and recurrent despite the presence of specific antibodies, suggesting the importance of the innate immune defense. T. vaginalis adhesion proteins, cysteine proteases, and the major parasite lipophosphoglycan (LPG) play distinct roles in the pathogenesis and evasion of host immunity. LPG plays a key role in the parasite adherence and signaling to human vaginal and cervical epithelial cells, which is at least in part mediated by galectins. The epithelial cells respond to T. vaginalis infection and purified LPG by selective upregulation of proinflammatory mediators. At the same time, T. vaginalis triggers an immunosuppressive response in monocytes, macrophages, and dendritic cells. The molecular mechanisms underlying reproductive complications and epidemiologic risks associated with T. vaginalis infection remain to be elucidated.
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PMID:Impact of T. vaginalis infection on innate immune responses and reproductive outcome. 1985 Mar 56


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