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

Herpes simplex infections of the perianal skin and anal canal are not uncommon, as evidenced by the present series of 16 cases, but have rarely been reported in the literature of the past. They are caused by the HSV-2 virus, which is also associated with genital lesions. There is abundant evidence that anogenital herpes is a venereal disease. Anal herpes is most commonly transmitted by anal intercourse. When the infection is present inside the anal canal, especially in a primary attack, the pain can be quite dibilitating. The diagnosis can usually be made on clinical grounds by recognizing the typical vesicles or aphthous ulcers, together with inguinal lymphadenopathy. The disease is self-limiting, but may be recurrent. Asymptomatic homosexuals may represent a large reservoir of the disease, which appears to be on the increase in our society. Cytology, immunofluorescence, viral cultures and serologic tests can be used for laboratory confirmation of the diagnosis. Newer methods of treatment with vaccine containing heat-inactivated virus, and use of photoinactivation following topical application of heterotricyclic dyes, show promise.
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PMID:Anal infections caused by herpes simplex virus. 17 17

A 34-year-old woman presented with lower abdominal pain, dysmenorrhea, dyspareunia and vaginal discharge. A total abdominal hysterectomy was done for persistent, severe uterine pain unresponsive to medical management. Histologic examination of the surgical specimen revealed a large condyloma acuminatum of the endocervix and lower uterine segment. This represents a rare manifestation of a very common venereal disease.
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PMID:Giant condyloma acuminatum of the endocervix and lower uterine segment. 49 Apr 92

Different types of mechanical and spermicidal contraceptives are discussed. Condoms prevent the spread of venereal disease and retard premature ejaculation, but sometimes cause allergic reactions and break relatively often. Cervical caps, rings, and diaphragms are manufactured in diffferent sizes and differ in shape to accommodate different anatomical configurations. IUDs also are produced in many different shapes and sizes; some are coated with copper. IUDs accelerate the movement of the ovum through the Fallopian tubes and modify the development of the endometrium. IUD use can cause bleeding, pain, or uterine perforations. Their rate of effectiveness is between .4% and 5.3%, depending on the model; copper IUDs are the most effective. Spermicides are found in the form of cremes, jellies, and soluble suppositories.
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PMID:[Contraceptive aids]. 103 2

Sixty Jordanian women with pelvic inflammatory disease (PID) were studied. Of these, 31 were given oral amoxycillin/clavulanic acid (augmentin) for a mean duration of 8.4 days and 29 were given a standard triple drug regimen of oral ampicillin, intramuscular gentamicin and metronidazole tablets/pessaries for a mean duration of 7.2 days. Bacterial culture (cervical and high vaginal swabs) was positive in every case, most often E. coli but sometimes more than one pathogen was isolated. No gonococci were isolated and tests for chlamydia in 16 patients (8 in each group) were negative, suggesting a dissociation between the etiology of PID and sexually transmitted disease in this Jordanian study. After 3 days of treatment, more patients in group I (augmentin) showed diminution of symptoms of pain and discharge (P less than or equal to 0.05) compared to group II. At the end of treatment, complete cure or satisfactory improvement was recorded in 93.1% and 92.9% of cases in the two groups, corresponding to in vitro bacterial efficacy of 90.4% and 96.5%, respectively. No serious side effects were noted in either regimen. The results of this comparative study suggest that oral amoxycillin/clavulanic acid (augmentin) may be a convenient alternative to the triple drug regimen usually administered for the treatment of pelvic inflammatory disease.
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PMID:Amoxycillin/clavulanic acid (augmentin) compared with triple drug therapy for pelvic inflammatory disease. 134 89

Researchers analyzed 1991 data on 678 12-45 year old women attending either a university-based family planning clinic, 8 Planned Parenthood clinics, or the private practice or health maintenance organization clinic of 8 physicians in southeast Texas to determine the characteristics of these women who accepted Norplant shortly after its approval in the US and their overall attitude towards Norplant. Most acceptors were 25 years old (64.1%) and not married (67.4%). In fact, 45% were 21 years old which was higher than expected. Norplant was 1 of the first contraceptives used by 44% of the women. Further, these women had only recently chosen to prevent unplanned pregnancy. The mean family size was 1.2. 35 of the women did not want any more children. The remaining 67% used Norplant to space births. 32.5% of the women had experienced at least 1 abortion, which was significantly higher than the national adjusted rate. The leading reasons for choosing Norplant included dissatisfaction with previous methods (55.5%), its convenience (38.7%), and confidence in its effectiveness (20.8%). 44% of the women were not concerned about Norplant. The main concerns of the other women were pain during insertion (21.9%), menstrual changes (17.9%), and hormonal effects (16.2%). Further, 11.8% were worried about Norplant's effect on future pregnancies. Most women (61.1%) had previously used oral contraceptives (OCs). 5.3% had used no method in the last 3 months. 42.2% had used condoms either alone or with a spermicide. Yet, 48% of them would now either stop using them or use them sometimes. They constituted 40% of the unmarried women. This resulted in an increased risk of acquiring a sexually transmitted disease or HIV among 25% of the sample. Medicaid patients paid nothing for Norplant or its insertion. Patients who received Norplant via the physician training program paid nothing for Norplant but did for its insertion. Some clinic patients made required copayments of $9-$100. Private practice patients paid $500-$750 for Norplant and its insertion.
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PMID:Characteristics and attitudes of early contraceptive implant acceptors in Texas. 142 82

Neonatal circumcision continues to be a controversial subject. The American Academy of Pediatrics has revised its earlier policy, stating that newborn circumcision has potential benefits as well as risks and emphasizing the need to explain these issues to parents considering the procedure so that an informed decision can be made. Compared with circumcised males, uncircumcised males are at greater risk for urinary tract infection, sexually transmitted disease, phimosis, paraphimosis, and balanoposthitis. Complications of circumcision include infection, hemorrhage, and meatal stenosis. Analgesia should be prescribed for the substantial pain associated with the procedure. Alternatives to circumcision include retraction of the foreskin with use of local or general anesthesia. Regular foreskin hygiene is important for all males, whether circumcised or not.
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PMID:The circumcision question. 157 30

Over a period of 33 months in a paediatric accident and emergency department, the clinical pattern and possible causes of vulvovaginitis were studied prospectively in 200 girls presenting with genital discharge, irritation, pain, or redness. The major causes were poor hygiene and threadworms. The suspicion of sexual abuse arose in a few girls but no organisms of sexually transmitted disease were found. Urinary symptoms were common but only 20 patients had a significant bacteriuria and 40 had sterile pyuria. Specific skin problems occurred in 28 cases. Simple measures to improve hygiene and treatment of threadworms gave effective relief. Genital irritation caused urinary symptoms with no clinical evidence of infection, and it is advised that antibiotic treatment should await urine culture. Specific skin problems require help from a dermatologist. The possibility of sexual abuse must be considered especially if the vulvovaginitis is persistent or recurrent after adequate treatment.
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PMID:Vulvovaginitis: causes and management. 148 39

A total of 100 heterosexual adults of either sex with frequent episodes of recurrent genital herpes were allocated to treatment with either Genivir (DIP-253) 1% cream or placebo cream. All patients had genital herpes previously verified by a positive viral culture. The study was carried out as a double-blind parallel group trial. Fifty patients were allocated to each of the two treatment groups. The treatment was initiated within 24 hours after the first sign of a recurrence, and at the pretreatment examination all patients had developed typical lesions with blisters and/or sores. At baseline a sample for herpes virus culture and typing was obtained. The creams were applied four times daily for five days. Follow-up examinations were carried out on days 1, 2, 4 and if needed on days 7, 10 and 14. The major factor used for assessment of efficacy was the time to complete healing of all lesions. Duration of pruritus and pain were also recorded. In the group of patients treated with Genivir cream the time to complete healing was 3.3 days and in the placebo group 6.1 days. The difference was statistically significant (P less than 0.001). The mean duration of pain was 1.3 days in the Genivir group and 2.5 days in the placebo group: this difference also reached significance (P less than 0.01). The duration of pruritus was about the same in both groups. The active agent in Genivir, DIP-253, is a heterocyclic aromatic complex with confirmed anti-herpetic activity and with evidence of a local immunomodulatory effect. It was concluded that the efficacy of topical application of DIP-253 may be due to combined antiviral and immunomodulatory activities.
Int J STD AIDS 1990 Jan
PMID:Genivir (DIP-253) 1% cream versus placebo cream in the treatment of recurrent genital herpes: a double-blind study. 209 94

Foreign bodies in the female genital tract are well recognized as a cause of pain, discharge, secretions, and infection. In the small child, the presence of a vaginal discharge is usually associated with either a common object which has been inserted or sexual abuse complicated by a sexually transmitted disease. A 3-year-old child presented with a recurrent labial secretion and drainage due to an unusual foreign body. It was only during a second operation that the possibility of a foreign body was entertained, and diagnostic testing was begun. A third operation permitted removal of the foreign body, a large bone probably of animal origin. The fistula tract was closed after a colostomy was performed. This represents the first reported case of a rectovulvar fistula not of a congenital nature.
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PMID:Rectovulvar fistula in a child secondary to an unusual foreign body. 221 56

In Riyadh, Saudi Arabia, physicians took endocervical swab examples from 325 women and urethral swab samples from 85 men to determine the extent of Chlamydia trachomatis infections and to compare an enzyme immunoassay (EIA) for the detection of C. trachomatis with the standard cell culture. All the men had urethritis. The women included pregnant, postnatal, and nonpregnant women. EIA positive tests were used to indicate C. trachomatis infection. 22.4% of all men had chlamydia infection (17.2% of symptom free men, 26% of men experiencing pain when urinating and/or urethral discharge, and 75% of men with postgonococcal urethritis). 8.6% of all pregnant women had cervical C. trachomatis infection (8.5% of asymptomatic pregnant women and 16.7% of pregnant women with vaginal discharge). 11.4% of all postnatal and nonpregnant women tested positive for C. trachomatis. The rates among these women were 66.7% for those who had pelvic inflammatory disease (PID), 50% for those with a history of abortion. 50% for those with a herpetic lesion, 25% for those using oral contraceptives (OCs), 16.3% for nonpregnant women with pain during urination and/or vaginal discharge, 11.4% for those with no symptoms, 8.1% for those with infertility, 7.7% for postnatal women having pain during urination or vaginal discharge, and 4% for those using IUDs. The EIA's sensitivity rates ranged from 75% for women with infertility to 100% for symptomatic men and those with postgonococcal urethritis, symptomatic pregnant women, symptomatic postpartum women, women with PID, and women using OCs. Specificity rates were higher and ranged 92.9-100%. EIA's high sensitivity and specificity along with its rapid performance make it a valuable diagnostic test in clinics where incidence of C. trachomatis infection tends to be high, e.g., sexually transmitted disease clinics. Clinicians could also use it in low risk settings, but they should be careful when interpreting results.
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PMID:Enzyme immunoassay in the diagnosis of Chlamydia trachomatis infections in diverse patient groups. 267 Nov 55


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