Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-eight patients with 40 varicoceles underwent spermatic venography and 27 varicoceles were treated by transvenous embolization under local anaesthesia as an outpatient procedure. The indications for the procedure were infertility (21), swelling (3), pain and discomfort (9) and asymptomatic varicoceles (5).
 ...
PMID:Non-operative treatment of varicocele. 379 66

We compared menstrual characteristics and constitutional factors in 268 white women with primary infertility due to endometriosis and in 3,794 white women admitted for delivery at seven collaborating hospitals from 1981 to 1983. Adjusting for confounding factors, including location, age, religion, and education, women with short-cycle lengths (less than or equal to 27 days) and longer flow (greater than or equal to one week) had more than double the risk for endometriosis compared with women with longer cycle lengths and shorter duration of flow. There was a trend for increasing risk for endometriosis to be associated with increasing menstrual pain. Adjusting for these menstrual characteristics, we found decreased risk for endometriosis associated with smoking or exercise that was largely confined to women who began either habit at an early age and were heavier smokers or more strenuous exercisers. We conclude that risk for endometriosis may relate to menstrual factors that predispose to greater pelvic contamination with menstrual products and to constitutional factors that influence endogenous hormonal levels.
 ...
PMID:The relation of endometriosis to menstrual characteristics, smoking, and exercise. 395 Nov 17

Discussion focused on the adverse effects associated with IUDs and on the possibilities of developing new forms of IUDs capable of reducing these adverse effects. The most common adverse side effects associated with IUDs are ectopic pregnancy, miscarriage, failure due to expulsion, uterine perforation, infection, pain, bleeding, and subsequent infertility. Many of these problems stem ultimately from improper fitting and insertion procedures. Perforation is usually the direct result of improper insertion techniques and many pelvic infections occur shortly after insertion. The infection is 7.7/100 women years of use during the 1st 15 days following insertion, 2.2 during the 2nd year of use, and 0.7 during the 4th year of use. Hysterographic studies suggest that the improper position of IUDs is responsible for the high incidence of cramping, expulsion, and abnormal bleeding associated with IUD use. The risk of many of these negative effects is reduced with duration of use; however, most IUDs must be replaced every 2-3 years. As devices with longer life spans are perfected, some of the insertion related problems should decrease. Epidemiological research suggests that the long term use of copper IUDs is not carcinogenic; however, the long term use of plastic devices may be associated with an increased risk of actinomyces infection. Infection may also be introduced into the pelvic region via the IUD thread. Efforts are underway to develop IUDs with built in drug release control systems. These devices might reduce the incidence of infection. Efforts are also underway to develop IUDs which might reduce bleeding problems and other IUDs, such as the postpartum Delta T, which might reduce the postpartum expulsion rate.
 ...
PMID:Intrauterine devices: present and future. 611 May 76

The study purpose was to assess the value of laparoscopy in a small community hospital (Northeastern Ohio General Hospital) with 1 operator utilizing the procedure and to examine its complications, failures, and problems. 518 laparoscopies were performed over the August 1972 to November 1975 period. 93% of the procedures (484 patients) were for interval sterilization. 4% (18 patients) were for diagnostic purposes, and 3% (16 patients) were for infertility. The surgical technique utilized throughout most of the study was a single puncture method using the Jacobs-Palmer operating laparoscope. Study results are derived from analysis of 3 different factors. The 1st part of the study was carried out to collect the data on the population in general, and this was acquired from a review of the hospital charts. The 2nd segment was the 3 week and 6 week office follow-up reviews of the patients and their problems. The 3rd part was the longterm follow-up in which patients returned for routine gynecologic care. There were 5 failures of the procedure in this study, or 10/1000. There have been no cases of delayed postoperative bleeding. All bleeding that was identified was seen at the time of the surgery and managed at that point. There were no deaths in this series. The following side effects were found in longterm follow-up. This consisted of 376 patients. 3% (15 patients) had delayed menses after the surgery, which appeared to be associated with longterm use of oral contraceptives, 6% (30 patients) had amenorrhea for more than 75 days postoperatively. 22 patients (5.5%) had hypomenorrhea within the 1st 2 years postoperatively. 5% (25 patients) had a discharge from catgut suture while less than 1% had an umbilical difficulty or discharge from the Dexon suture. 18 patients (3.6%) of the population had postoperative dysuria within the 1st month. Delayed pain, dysmenorrhea, or dysparenuia within the 1st 2 years was detected in 2.5% (12) of the total population but could not be totally explained on a physiologic or anatomic basis. 7 patients (1.2%) had sexual anhedonia. There were 3 hysterectomies carried out subsequent to laparoscopic sterilization. The report of the Complications Committee of the American Association of Gynecologic Laparoscopists is reviewed. In this series the major difficulties or complications encountered in laparoscopy have not been observed. This is due in part to the training of the individual operator but also to a team effort at this hospital.
 ...
PMID:Laparoscopy: a retrospective study with two or more years follow-up of patients in a small community hospital. 621 Jun 47

This discussion of acute pelvic inflammatory disease (PID) -- usually a spontaneous infection that occurs among sexually active, menstruating, nonpregnant women -- covers: pathophysiology; microbial etiology (gonorrhea, chlamydia, genital mycoplasmas, and aerobic and anerobic bacteria); epidemiology (number of sexual partners, age, IUDs, previous PID, previous gonorrhea, untreated male sexual contacts, and perihepatitis associated with PID); diagnosis (physical examination, laboratory examination, culdocentesis, examination of the male partner, cultures, and ultrasonography); treatment; and sequelae (recurrent PID, infertility, ectopic pregnancy, and pain). The majority of infections are caused by bacteria and a polymicrobial bacterial infection is common. Neisseria gonorrhea, Chlamydia trachomatis, and a wide variety of aerobic and anerobic bacteria are most frequently isolated from women with PID. Primary PID is usually and acute infection in which organisms ascend into the uterus and fallopian tubes from the cervix. Chronic active infections are unusual except in neglected cases and in Actinomyces infection, but sterile chronic inflammatory adhesions are common residuals of acute infection. Except for women who have an IUD in place or the 15% who have had uterine instrumentation, spontaneous PID is almost totally confined to women who are sexually active. There is a much higher PID rate among younger than older women. Women who use an IUD for contraception are at least 2-4 times more likely to develop PID than nonusers. Women who have had PID are twice as likely to develop the infection as those who have never had it. A history of a prior uncomplicated gonococcal infection is more common among women with PID than among women without disease. Untreated males with urethral N. gonorrhea and possibly with C. trachomatis infection are an important source of infection both for the initial and for recurrent episodes of PID. Abdominal pain is the most common symptom although the pain may be mild or even absent in at least 5% of patients with PID verified by laparoscopy. In patients who have overt PID, it is possible to establish the diagnosis with reasonable certainty by a combination of history, physical examination, Gram stain of cervical secretions, culdocentesis, and examination of the male sexual partner. Adequate treatment of salpingitis includes an assessment of the severity of the infection, administration of appropriate antibiotics, employment of other health measures, close patient follow-up, and treatment of the male sexual patner. 25% of women with 1 episode of salpingitis develop a subsequent episode.
 ...
PMID:Acute pelvic inflammatory disease. 636 7

This paper reviews the clinical recognition, diagnosis, and management of ectopic pregnancy at the Queen of Angels Hospital for the past 15 years. The incidence of ectopic pregnancy to deliveries is 1:195. Pain is the cardinal symptom of ectopic pregnancy, and amenorrhea of some degree was present in all cases. Pelvic inflammatory disease is a factor in the development of tubal pregnancy in some women. A careful history and thorough physical examination are important in making a careful diagnosis. The only laboratory procedures which are of any value are the blood type and the Rh determination. While examination of endometrial tissue obtained by biopsy or curettage has proved useful in ectopic pregnancy diagnosis, it is not totally decisive. Culdocentesis has proved to be the diagnostic procedure of the greatest value in recognizing intraperitoneal hemorrhage and it increases the correct preoperative diagnosis from 65-70% to 95%. Laparoscopy is useful when the physician is in doubt about the nature of the problem and it has produced an increase in the number of ectopic pregnancies diagnosed. Ultrasound is another useful tool in confirming a diagnosis of ectopic pregnancy; its accuracy ranges from 70-92%. A newly developed pregnancy test is more sensitive than conventional pregnancy tests and would be positive for pregnancy. Women who have had a previous ectopic pregnancy have a higher subsequent incidence of persistent infertility, recurrent ectopic pregnancy, and pregnancy wastage; the risk of another ectopic pregnancy increases 30-50 fold. While extopic pregnancy does recur, it is true that about 1/3 of those women do have successful pregnancies. Where previous induced abortion has occurred, there is a 10-fold increased risk of ectopic pregnancy. Women who become pregnant accidentally with an IUD in place have a greater likelihood of experiencing an extrauterine pregnancy. Abdominal pregnancy is often encountered as an aborting ectopic pregnancy during the 1st trimester. In cases such as this, there can be local excision and hemostasis. Idiopathic thrombocytopenic purpura was another encountered complication. Salpingectomy is inappropriate and even dangerous when used with an ectopic pregnancy. Early diagnosis and prompt surgery can help increase the survival rate. However, conservative surgery which preserves the tube is feasible and practical using salpingotomy and partial salpingectomy. Maternal death resulting from ectopic pregnancy is usually the result of sudden massive hemorrhage. The initiation of therapy prior to rupture is helpful. Ectopic pregnancy rate has remained fairly consistent among the white population but has decreased significantly in the nonwhite population. This is likely tied to an improvement in socioeconomic status, better patient education, and a greater awareness of medical needs. To decrease the maternal mortality rate from ectopic pregnancy, obstetricians and gynecologists must be more aggressive in research and treatment of ectopic pregnancy.
 ...
PMID:Ectopic pregnancy: current clinical trends, a fifteen year study. 645 60

Studies of the preparation of adult patients for surgery are reviewed. While many show that preparation reduces stress, the studies are criticized for methodological and conceptual inadequacies. In particular, studies often fail to measure a range of stress responses, and also fail to provide measures over a sufficient time span to fully assess the effect of preparation on stress responses which are known to have differing rates of responsiveness. The experimental study was specifically designed to overcome these problems. Eighty patients undergoing a minor gynecological operation (laparoscopy for sterilization or infertility investigation) were allocated to one of three groups: routine care only (Control 1); routine care plus a minimally informative preparatory booklet (Control 2); or routine care plus a maximally informative preparatory booklet (Experimental group). Patients in the special preparation condition showed lower stress responses on measures of preoperative anxiety. At both one- and six-week follow ups they showed reduced state anxiety and elevated postdischarge vigor scores. They also showed less pain after surgery and recovered faster in hospital and in the first six days after going home. They returned to normal activities faster than patients in the two control groups. There were no differences on measures of postoperative symptoms, medication use, or reported time to return to normal health. The results are discussed in terms of previous studies of psychological preparation, and current concepts of stress. Suggestions for the design of preparatory interventions are made which match the type and timing of the intervention to the target stress response.
 ...
PMID:Psychological preparation as a method of reducing the stress of surgery. 649 Dec 64

Details of medical history, symptomatology, operative findings and certain other special features are reported for patients with external endometriosis treated operatively during the period 1969-76. The incidence of endometriosis in this survey was 19% of all gynecological laparotomies. The mean age of the patients at the time of the operation was 36.7 years. The most common sites of endometriosis were the retrocervix and the ovaries. Of the patients, 559 (70%) had complained of dysmenorrhea; the pain generally began before the bleeding. Also typical was the exacerbation of the pain with increasing age. Twenty-seven per cent of the patients also complained of infertility. Surgery was performed because of acute abdominal symptoms in 6% of cases. The incidence of endometriosis in postmenopausal women was 2.5% and that in young women, 1%. Endometriosis recurred in 15% of the cases during the follow-up period. Gestagen therapy after the operation had no effect on the recurrence rate.
 ...
PMID:External endometriosis in 801 operated patients. 652 4

Pelvic inflammatory disease (PID) is a serious health problem that affects the reproductive capacity and the sexual activities of women. Approximately 50,000 cases are reported annually resulting in severe pain, reduced fertility and costly health care. Diagnosis of PID requires a complex analysis of the history, a thorough physical examination and diagnostic testing. Goals of care include accurate diagnosis with particular emphasis on differential diagnosis, antibiotic therapy, close follow-up and counseling. Antibiotic therapy is directed against the pathogenic organism, either gonococcal or nongonococcal. Careful counseling and follow-up aids successful treatment and decreases the likelihood of infertility.
 ...
PMID:Pelvic inflammatory disease: a review of therapy. 663 86

One hundred thirty-seven premenopausal women with premenstrual tension underwent laparoscopy for bleeding, pain and/or infertility. Endometriosis was the associated gynecologic disease observed most frequently (66 patients). Other associated disorders were primary dysmenorrhea (31), poststerilization syndrome (24), chronic pelvic inflammatory disease (8) and leiomyoma uteri (8). Screening for prolactin and thyroid-stimulating hormone in patients with galactorrhea (74) revealed one patient with pituitary microadenoma and two with primary hypothyroidism. The midluteal progesterone levels were significantly decreased, whereas the midluteal estradiol 17 beta levels were significantly elevated. Because of the frequent association of premenstrual tension with other gynecologic diseases, screening for premenstrual tension in all premenopausal women is recommended.
 ...
PMID:The ubiquitousness of premenstrual tension in gynecologic practice. 668 65


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>