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)

A case report is presented of the failure of diethylstilbestrol to prevent an ectopic pregnancy. A 29-year-old physician's wife, gravida 4, para 2, abortuses 2, received 25 mg diethylstilbestrol twice daily for 5 days beginning on Day 14 of the menstrual cycle after condom accident during intercourse the prior night. Withdrawal bleeding did not occur. The patient's menstrual period before the condom accident had begun on August 25, 1971. In mid-October she returned to the doctor feeling pregnant. The pregnancy test was positive on October 18, 1971, and physical examination revealed a soft uterus of about 7 weeks' gestation. Because of the fear of congenital defects in the fetus from diethylstilbestrol, suction curettage was carried out on October 27, 1971. On October 31, 1971, the patient experienced great pain in the lower left quadrant. Her abdomen was tender and distended, and pelvic examination revealed a bulging cul-de-sac from which culdocentesis revealed nonclotting blood. Laparotomy revealed a ruptured tubal pregnancy on the left side. A left salpingectomy was carried out which pathologically confirmed a tubal pregnancy. The question of whether diethylstilbestrol prevents implantation in the uterus but not in extrauterine sites is examined. A report by Morris is noted in which the only 3 pregnancies which followed diethylstilbestrol failure were ectopic. It is recommended that others with similar cases report them in order to better understand what occurs.
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PMID:Ectopic pregnancy after postcoital diethylstilbestrol. 111 39

Experience with the LEm IUD in an immediate postpartum program is reported. During a 6-month period in 1973, the LEM device was inserted in 1359 patients immediately after term delivery. The LEM is made of polyethylene, impregnated with 20% barium sulfate. When inserted through a plastic tube it is a 2-dimensional device in the shape of a Gothic X. When the uterus involutes, the LEM becomes 3-dimensional. A double string is attached. At the end of 1 year, the gross pregnancy rate was 6.4%. This rate was greatest in the second 6 months of use. In 19 of the 25 cases of pregnancy the device was in place. In 1 case a stillbirth resulted at term. In 3 others spontaneous abortion had occurred and in 1 other abortion followed removal of the device by a physician. In 1 year, the gross expulsion rate was 20.6% of users, mostly during the first 6 months. Expulsions represented 76.2% of terminations of use. Removals for bleeding or pain were only 2.2%. In 1 case perforation of the uterine wall had occurred. After a Pomeroy procedure was done, this LEM was removed through the cervical os. The LEM IUD appears to be less effective than desired in pregnancy prevention. Design modifications are planned.
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PMID:The LEM device in an immediate postpartum contraception program. 127 54

To study the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on uterine contractility in different parts of the uterus and on the direction and velocity of propagation of the activity, intra-uterine pressure (IUP) was measured simultaneously in 10 dysmenorrheic and 5 eumenorrheic patients with two microtransducer catheters at two locations (30 mm apart) before and after taking nimesulide, a newly developed NSAID. The uterus developed higher pressure cycles in the fundus than in the isthmus, in both eumenorrheic and dysmenorrheic conditions. Nimesulide did not affect either the active pressure (AP) or the direction and velocity of propagation of the activity, though it alleviated pain significantly. In dysmenorrheic patients, resting pressure (RP) is at a high level only in the fundus. The velocity of propagation ranged from 12 to 19 mm/s. The mathematical probability of procervical activity (1.0 if all procervical; 0.0 if all profundal), and thus the transport, was 0.59 in eumenorrheic and 0.68 in dysmenorrheic patients, the average for the whole series being 0.65. The luminal content (menstrual blood) moves in the cervical direction much more slowly than would be expected on the basis of simple calculations of velocity (velocity vector) of propagation.
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PMID:Analysis of uterine contractility after administration of the non-steroidal anti-inflammatory drug nimesulide. 131 39

A 30-year old primigravida with a history of drug addiction came to the Rigshospitalet in Copenhagen, Denmark for prenatal care at 15 weeks gestation. Physicians did an amniocentesis because of family history of trisomy 21. Ultrasound examinations in the 17th and 18th weeks of gestation indicated a living fetus with the placenta on the right lateral wall of the uterus, but there was an insufficient amount of amniotic fluid. Maternal alpha fetoprotein serum levels were extremely high (298 kIU/L). Physicians predicted a poor fetal prognosis and advised the woman to undergo an abortion. On the first day, they inserted 4 vaginal pessaries of 1 mg gemeprost and administered 25-30 mg bupivacain through an epidural catheter to control abdominal pain. 8 hours after first insertion, they began intravenous (IV) administration of oxytocin. Her cervix remain closed and uterine tension did not increase. 2 hours after beginning the oxytocin IV, she suffered from an abrupt severe abdominal pain which was transferred to the right shoulder. Heart rate and blood pressure remained normal. 4 hours later, her body temperature rose, so she received 500 m pivampicillin 3 times/day. She experienced no vaginal bleeding and no uterine contractions. Her cervix had still no opened. On the third day, health workers inserted 5 more pessaries. On the fourth day, they administered 75 ml isotonic saline/hour transcervically, but she still did not abort. Her temperature vacillated even though she received antibiotics and the pain continued despite epidural analgesics. On day 5, health workers administered 3.75 mcg prostaglandin F2 alpha/minute transcervically. After 6 hours of no progress, they performed a laparotomy and observed a macerated, malodorous fetus in the peritoneal cavity which continued 1200 ml of blood. The medial part of the left fallopian tube an the left uterine corner had ruptured. They removed the fetus via wedge resection; it had no malformations. Physicians should consider ectopic pregnancy when attempts at induced abortion do not succeed.
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PMID:Misdiagnosis of interstitial pregnancy followed by uterine cornual rupture during induced midtrimester abortion. 132 30

A 68-year-old female who had undergone total hysterectomy for carcinosarcoma five months previously was noted to have a solitary nodular shadow in the right lung on chest X-ray. Percutaneous needle biopsy of the lung was performed via the right anterior chest wall, and the histologic findings showed metastasis from carcinosarcoma of uterus. Two months after needle biopsy, a chest wall mass appeared of the site of puncture of the lung needle biopsy. The mass was resected to relieve the chest wall pain and the specimen showed carcinosarcoma of uterus histologically. We consider that tumor cells were implanted to the chest wall along the needle tract after percutaneous needle biopsy of the lung. The postoperative chest computed tomogram showed the route of tumor implantation from the metastasis of right lung into the right chest wall. Dissemination and chest wall implantation of malignant cells after percutaneous lung needle biopsy have been rarely reported. However there are no reports of tumor implantation of sarcoma. The possibility of implantation of tumor cells along the needle tract after percutaneous lung needle biopsy should be carefully considered in cases of carcinosarcoma.
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PMID:[A case of pulmonary metastasis from carcinosarcoma of uterus with subcutaneous implantation of tumor cells along the needle tract after percutaneous needle biopsy of lung]. 140 12

Tetridamine (2-methyl-3-methylamino-4,5,6,7-tetrahydroindazole) is a well known analgesic and anti-inflammatory drug. Here the activity and the tolerability of a new 0.134% tetridamine formulation in rats and women, are reported. Anti-inflammatory and analgesic tests were performed in Sprague-Dawley rats with carrageenin oedema; topical application of 0.134% tetridamine solution showed a marked reduction of paw swelling (-54.4%) and pain sensibility (-81.0%). A 28 days vaginal tolerability study performed on Sprague-Dawley rats with tetridamine lavage (0.2 ml/rat/day) showed, in comparison with control group, no changes in haematology, coagulation, clinical biochemistry and in histological examinations of uterus and vagina. Clinical studies (4 open and 1 double-blind) were performed on 93 women suffering from vulvovaginitis and cervicitis by treatment of 0.134% tetridamine vaginal lavage, two times daily, for 7 days. Tetridamine lavage reduced or eliminated all inflammation symptoms like burning, leucorrhea, etc. and resulted very well tolerated. From these pharmacotoxicological and clinical results we can conclude that tetridamine vaginal lavage is a new formulation with high activity and good tolerability.
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PMID:Activity and tolerability of tetridamine vaginal lavage in rats and women. 141 90

Chronic pelvic pain in women is associated with radiological evidence of pelvic venous dilatation and reduced flow, termed 'pelvic congestion'. The aim of this study was to elucidate a possible role in this condition for vasoactive intestinal peptide and calcitonin gene-related peptide, both localized in perivascular nerves in the ovaries and uterus. Healthy volunteers and women with chronic pelvic pain and venous congestion received intravenous infusions of vasoactive intestinal peptide (n = 15), calcitonin gene-related peptide (n = 15) or a bland infusate (n = 7). Changes in the uterovaginal and skin blood flow were assessed by continuous measurement of vaginal, axillary, cheek and hand temperature. During calcitonin gene-related peptide infusion median hand temperature changes were +0.97 degrees C in women with pelvic pain and -0.03 degrees C in healthy volunteers (p < 0.05). There were no differences between groups in hand and cheek temperature responses to vasoactive intestinal peptide infusion. Vasoactive intestinal peptide and calcitonin gene-related peptide appeared to dilate the uterovaginal vasculature in healthy subjects but not in those with pelvic pain. Vasoactive intestinal peptide and calcitonin gene-related peptide did not provoke pain in healthy subjects but in those with pelvic pain, symptoms were significantly exacerbated during calcitonin gene-related peptide infusion but not by vasoactive intestinal peptide. Changes in plasma follicle stimulating hormone, luteinizing hormone and oestradiol during either infusion were not significant. These findings indicate greater sensitivity to calcitonin gene-related peptide in women with pelvic pain and suggest a possible underlying neurovascular disorder.
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PMID:Suprasensitivity to calcitonin gene-related peptide but not vasoactive intestinal peptide in women with chronic pelvic pain. 142 2

Transcervical tubal cannulation using tactile guidance has a similar rate of successful cannulation compared with that with US guidance (78% versus 73%) but takes less time to perform (2.3 +/- 1.8 minutes versus 8.7 +/- 6.2 minutes, mean +/- SD) and is associated with less pain and bleeding. This appears to be because of the design of the Labotect tubal cannulation set that uses a special speculum and tenaculum to straighten the uterus before insertion of the guide cannula and a less traumatic ball-tipped guide catheter.
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PMID:Transcervical tubal cannulation: a comparison of two techniques. 142 62

Endometriosis is defined as the presence of endometrial tissue outside the cavity of the uterus. The urinary tract is rarely affected, only 1 to 11%. Bladder is the most frequent urinary localization while the ureteral involvement is rare. We report a case of intrinsic ureteral endometriosis in a woman with left hydronephrosis, lumbar pain and septic fever. Instrumental and laboratory investigations can hardly lead to a reliable diagnosis of ureteral endometriosis. A final diagnosis is feasible only by histologic examination, which obviously implies surgery.
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PMID:[Intrinsic endometriosis of the ureter. Clinical case]. 146 62

A patient is described in whom breakthrough of pain occurred from uterine rupture during effective extradural analgesia, demonstrating the hypothesis of the "extradural sieve". Subsequent abolition of this pain by addition of fentanyl to bupivacaine 0.25% raises the question whether or not this combination should be avoided in women with a scarred uterus undergoing "trial of labour".
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PMID:Abolition of the extradural sieve by addition of fentanyl to extradural bupivacaine. 794 84


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