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)

While AIDS seizes the headlines, other sexually transmitted diseases (STDs) create devastation of their own. In women STDs can lead to pelvic inflammatory disease, causing lifelong pain, infertility, and ectopic pregnancy, which can kill. Children are born with blinding eye infections. Men are left infertile. People die of advanced stages of syphilis. Furthermore, STDs multiply the transmissibility of HIV, the AIDS virus, as much as ninefold.
 ...
PMID:Population reports. Controlling sexually transmitted diseases. 823 82

A 38-year-old woman, who had a normal delivery at age 29 and a Cesarean section at age 35, underwent laparoscopic adhesiolysis the next year because of pain. Later that year, a laparotomy was performed to remove the left adnex because of a hemorrhagic corpus luteum. During this operation, she underwent sterilization by bipolar coagulation and division of the right tube. 6 months later, her 2-year-old daughter died of hemophilus meningitis. The next year, she was admitted to the hospital several times because of pain in her lower abdomen. She decided to undergo refertilization. The operative technique involved insertion of a Foley catheter into the uterine cavity. Laparoscopic adhesiolysis was performed, and blue dye was flushed through the catheter. The medial end of the right tube was cut off in thin slices until dye passed through the lumen. The lateral part of the tube was then cut, and hemostasis was secured by point monopolar diathermia. The portions of the tube were mobilized slightly and adapted by 2 sutures in the muscularis and 1 in the serosa. Blue dye was flushed through the tube to demonstrate patency. The pelvic cavity was rinsed with Ringer's solution, with about 300 ml left in the abdomen. No antibiotics or steroids were administered. The operation took 90 minutes, and the patient left the hospital the next day. She was able to return to work without using any sick leave. 22 days after the operation, she had a normal menstruation and she achieved an intrauterine pregnancy in the following cycle. A lack of funds in the Norwegian public health service has led to a debate about the necessity of providing the so-called "luxury" procedures of refertilization and infertility surgery. The traditional operative methods are expensive and require between 5 and 7 days of hospitalization. In order to determine whether traditional laparotomy with microsurgical end-to-end anastomosis of the tube or laparoscopic refertilization is more effective, a comparative, randomized study will be necessary.
 ...
PMID:Laparoscopic tubal anastomosis: reversal of sterilization. 825 59

A variety of new data on the biology, pathophysiology and metabolic changes occurring in leiomyomas and in the ectopic endometrium have opened new avenues for research in a neglected area, that of benign proliferations of the female reproductive tract. In addition, the availability of potent inhibitors of ovarian function which, like the super-agonist analogues of GnRH, have no hormonal activity (oestrogenic, progestogenic or androgenic) has allowed for the first time to evaluate the effect of oestrogen deprivation on endometriosis and uterine fibrosis. The results, although impressive, are only temporary: in both cases hypoestrogenism produces an important relief of symptoms, but--once treatment is discontinued--both conditions usually continue to evolve. For this reason, much remains to be done to optimize Gn-RH analogue utilization. In the case of endometriosis, there seem to be three main areas for future research: pain, infertility and the possibility of modifying its natural history. In addition, the role of combined, medico-surgical therapy remains to be established, especially in the case of severe disease. In the treatment of fibrosis, analogues can be utilized as pre-treatment before conservative or demolitive surgery, or as an alternative to hysterectomy. The role of analogues as a pre-surgical adjuvant has probably been overemphasized and it is time to carry out well controlled studies to narrow down indications. At present they include: severe anemia caused by chronic heavy uterine bleeding, and the need to minimize intraoperative blood loss. Much remains to be done before analogues can become a real alternative to surgery. To date no single sequential therapeutic regimen has been identified which is capable of prolonging the beneficial effects of agonists without their well known negative consequences. Temporary results can be obtained interrupting analogue therapy and substituting it with the administration of a progestogen. Finally, analogue administration can be prolonged by associating an oestrogen-progestogen sequential combination as in HRT. In all of these instances, what are urgently needed are well controlled randomized clinical trials.
 ...
PMID:[Directions of future research on GnGH analogs in the treatment of endometriosis and uterine fibromyoma]. 827 76

Unique endometriosis-specific secretory proteins would be of paramount importance as noninvasive markers for diagnosis and evaluation of therapeutic approaches for endometriosis. Furthermore, identification of endometriosis-specific secretory proteins may be an important step towards understanding the pathophysiology of endometriosis-associated pain and infertility. Therefore this study was designed to assess protein synthesis and secretion by ectopic uterine implants from steroid-treated and reproductively cyclic rats with surgically induced endometriosis. Uteri, ectopic uterine implants, and control tissues were incubated in L-[35S]methionine or D-[6-3H]glucosamine for 0-24 h and 24-48 h. De novo-synthesized proteins released into the culture media were identified using two-dimensional SDS-PAGE, fluorography, and computer-assisted image analysis. Two distinct groups of ectopic uterine implant proteins were identified: ENDO I (M(r) 40,000-50,000; pI 4.0-5.2) and ENDO II (M(r) 28,000-32,000; pI 7.5-9.0) were produced by ectopic uterine implants and not the uteri. A third group of proteins, previously identified in culture media of the uteri from progesterone-treated rats and called PUP-1 (M(r) 70,000; pI 5.7), was synthesized and secreted by ectopic uterine implants 24-48 h later than in parallel uterine cultures. The detection of ectopic uterine implant proteins suggests biochemical characteristics of the ectopic tissue that may be used to develop unique markers for endometriosis. Furthermore, the delayed synthesis and secretion of the uterine protein PUP-1 by the ectopic uterine implants illustrates yet another example of the asynchronous behavior of these two tissues, which may be related to the etiology or pathophysiology of the disease.
 ...
PMID:Polypeptides synthesized and released by rat ectopic uterine implants differ from those of the uterus in culture. 831 87

Female genital mutilation, also misleadingly known as female circumcision, is usually performed on girls ranging in from 1 week to puberty. Immediate physical complications include severe pain, shock, infection, bleeding, acute urinary infection, tetanus, and death. Longterm problems include chronic pain, difficulties with micturition and menstruation, pelvic infection leading to infertility, and prolonged and obstructed labor during childbirth. An estimated 80 million girls and women have undergone female genital mutilation. In Britain alone an estimated 10,000 girls are currently at risk. Religious, cultural, medical, and moral grounds rationalize the custom which is practiced primarily in sub-Saharan Africa, the Arab world, Malaysia, Indonesia, and among migrant populations in Western countries. According to WHO it is correlated with poverty, illiteracy, and the low status of women. Women who escape mutilation are not sought in marriage. WHO, the UN Population Fund, the UN Children's Fund, the International Planned Parenthood Federation, and the UN Convention on the Rights of the Child have issued declarations on the eradication of female genital mutilation. In Britain, local authorities have intervened to prevent parents from mutilating their daughters. In 1984, the Inter-African Committee Against Harmful Traditional Practices Affecting Women and Children was established to work toward eliminating female genital mutilation and other damaging customs. National committees in 26 African countries coordinate projects run by local people using theater, dance, music, and storytelling for communication. In Australia, Canada, Europe, and the US women have organized to prevent the practice among vulnerable migrants and refugees.
 ...
PMID:Female genital mutilation. 840 Sep 25

Many studies published on intrauterine devices (IUDs) during the last six years have consistently reported findings in favor of IUD use. Notable among these findings are: IUDs are not abortifacients; newly developed IUDs are highly effective and the efficacy is long-lasting; IUDs can be safely used by most lactating women, with lower removal rates attributable to bleeding and/or pain; and immediate postplacental IUD insertion reduces the risk of expulsion usually associated with postpartum insertion. Most importantly, in apparent contrast to results often reported in the late 1960s through the early 1980s, recent findings show that IUDs per se, especially the medicated ones, are not associated with an increased risk of pelvic inflammatory disease (PID), nor are they associated with an increased risk of ectopic pregnancy or subsequent infertility. There are still issues concerning IUD use that are controversial in spite of numerous studies. Should some of the contraindications currently listed for IUD use be modified according to the newer findings? Is the risk of uterine perforation increased when the IUD is inserted in lactating women? Do IUD tails increase the risk of PID? Does oral use of antibiotics at IUD insertion help prevent postinsertion PID? There are also issues that have not been sufficiently addressed and more information from empirical studies is needed. These include: the effect of the insertor's skill on IUD performance; IUD use in nulliparous as well as in older women; the relationship between IUD use and chlamydia infection; and long-term IUD use and safety, including actinomycosis, etc. Answers are also needed by administrators facing difficult programmatic decisions. For instance, should programs involving massive IUD removal be implemented as many IUD-wearing women are approaching or passing menopause? Similarly, are large programs to remove less-effective devices and replace them with newer and more effective IUDs advisable? This article reviews the state-of-the-art findings from recent IUD studies on the above issues.
 ...
PMID:What we have learned from recent IUD studies: a researcher's perspective. 840 15

The objective of this study was to evaluate the safety and hemostatic properties of the argon beam coagulator (ABC) at laparoscopy. The study is composed of two parts: laparoscopic results in five anesthetized animals and a preliminary clinical trial in 35 volunteers undergoing laparoscopy. Animals were evaluated during a laparoscopic cholecystectomy training course. Private patients undergoing operative laparoscopy voluntarily consented to a hospital Investigational Review Board-approved protocol to evaluate the ABC. The pigs were 3-month-old, healthy females. The patients were healthy volunteers undergoing laparoscopy for pain, infertility or cholecystectomy. Both pigs and human volunteers underwent operative laparoscopic use of the ABC for hemostasis and selected tissue electrocoagulation using a prototype 10-mm laparoscopic probe. The safety of the ABC was evaluated in the pigs by continuously monitoring heart rate, oxygen saturation and end-tidal CO2. Patients had similar clinical monitoring during operative laparoscopy, with observation of tissue effects of the ABC for hemostasis and tissue electrocoagulation. Laparoscopic use of the ABC in animals and patients produced no observable anesthetic changes, with both pigs and patients recovering normally. The ABC allowed smokeless, hemostatic tissue electrocoagulation, with a rapid non-touching technique easy to apply laparoscopically. We conclude that the ABC can safely be used laparoscopically with excellent hemostasis and effective controlled tissue electrocoagulation. The lack of smoke and the non-touching technique for delivery allow rapid laparoscopic application. The prototype 10-mm delivery probe is cumbersome, and the argon gas flow rate of 4 L/min with firing requires constant venting of the peritoneum with close monitoring of intraperitoneal pressures.
 ...
PMID:Laparoscopic evaluation of the argon beam coagulator. Initial report. 844 2

We studied the relationship between varicocele size and response to surgery in 86 men with a unilateral left varicocele who reported either infertility (83), pain (1) or pain and testicular atrophy (2). Varicoceles were graded according to size: grade 1--small (22 patients), grade 2--medium (44) and grade 3--large (20). Sperm count, per cent motility, per cent tapered forms and fertility index (sperm count times per cent motility) were measured preoperatively and postoperatively. Preoperatively, men with grade 3 varicocele had lower sperm counts and poorer fertility indexes compared to men with grades 1 and 2 varicocele. Sperm concentration improved significantly in men with grade 2 (33 +/- 5 million per cc preoperatively to 41 +/- 6 million postoperatively, p < 0.04) and grade 3 (18 +/- 5 million preoperatively to 32 +/- 7 million postoperatively) varicocele after microsurgical ligation of the varicocele. Motility improved significantly in men with grade 3 varicocele. Decrease in per cent tapered forms was significant in all groups. A comparison of per cent change in fertility index among the groups revealed that men with grade 3 varicocele improved to a greater degree (128%) than men with grade 1 (27%) or grade 2 (21%) varicocele. Pregnancy rates 2 years postoperatively were 40% for grade 1, 46% for grade 2 and 37% for grade 3 varicocele patients. The difference in pregnancy rates among the groups was not statistically significant. In conclusion, infertile men with a large varicocele have poorer preoperative semen quality but repair of the large varicocele in those men results in greater improvement than repair of a small or medium sized varicocele.
 ...
PMID:Relationship between varicocele size and response to varicocelectomy. 845 40

Induced abortion is one of the most frequent surgical procedures in the UK. Even though it is considered safe, it sometimes has complications and long-term sequelae. Pelvic inflammatory disease (PID) is the most prevalent complication and can lead to chronic pelvic pain, pain during intercourse, infertility, and a higher risk of ectopic pregnancy. Chlamydia trachomatis is perhaps the leading etiologic agent for PID among women who have undergone induced abortion and who develop PID. Gonorrhea is another major etiologic agent for PID. Strategies used to try to reduce pelvic infection revolve around administration of antibiotic prophylaxis based on demographic features and on the presence of certain organisms in the genital tract that may increase their risk (e.g., C. trachomatis and Neisseria gonorrhoeae) and universal antibiotic prophylaxis for all women undergoing abortion. Most of the literature suggests that antibiotic prophylaxis does provide some protection against PID but does not clearly indicate who should be screened and for which pathogens and who should be treated and with which antibiotics. Demographic features useful for identifying who should receive antibiotic prophylaxis are: a history of PID, single status, nulliparity, and youth (especially reliable for chlamydial infection). Screening for bacterial vaginosis involves diagnosis based on 3 of 4 criteria: characteristic vaginal discharge, positive amine test, raised vaginal pH, and the presence of clue cells on microscopy of wet or stained preparations of vaginal discharge. Since C. trachomatis is the most important pathogen, drugs sensitive to it should be administered: tetracyclines and erythromycin. Screening women seeking abortion for sexually transmitted diseases (STDs) provides an opportunity to educate them about STDs and treatment compliance and to contact their partners for investigation, treatment, and contact-tracing to reduce the STD-infected pool in the community.
 ...
PMID:Preventing pelvic infection after abortion. 854 9

The aim of this study is to obtain an actual survey of diagnostic and therapeutic procedures of endometriosis (EMT) in gynaecological practice in West Germany. A questionnaire was sent to 6,700 gynaecologist; 1,364 responded. Approximately 5% of all the patients in daily practice have symptoms related to EMT. Most of the patients are in their twenties. The common clinical symptoms of EMT are dysmenorrhoea (91.8%), infertility (79.7%), pelvic pain (70.9%), menstrual irregularity (46.3%), dyspareunia (21.8%) and painful defaecation (12.8%). The diagnostic standard is laparoscopy, but there are many doctors diagnosing EMT also by means of gynaecological examination (23.8%) or ultrasound (21.3%) - especially in young patients. Hormones are the first choice of therapy. Progestins and danazol are preferred. GnRH-analogues are only used by a smaller proportion of gynaecologists - particularly in infertile patients. Surgical procedures with or without hormonal suppression are another line of therapy adapted by 70.9% of the gynaecologists, which are often preferred in infertile patients. Psychological problems in EMT are caused by the uncertainties between EMT and infertility and by the difficulties between physiological menstrual discomfort and pain caused by EMT. 68.5% of the gynaecologists suggest that more information beyond diagnosis and therapy should be given to the patients. Promotion of self-supporting groups should be encouraged by the doctors.
 ...
PMID:[Endometriosis--diagnosis and therapy. Results of a current survey of 6,700 gynecologists]. 858 85


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