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)

The Multiload IUD with an exposed copper surface area of 250 mm2 (MLCu250) was developed in 1972 and has become one of the most widely used IUDs. Modifications to the MLCu250 include an increase in the area of exposed copper wire to 375 mm2 (the MLCu375) and an increase in the diameter of copper wire from 0.3 to 0.4 mm. The Multiload has been evaluated extensively in noncomparative and comparative clinical trials. In these latter studies the MLCu250 performed better than the Cu-7 and TCu-200, and the MLCu375 performed better than the Fincoid or Nova T and about equally as well as the TCu380. Pooled data from over 26,000 insertions of the MLCu250 gave the following 3-year cumulative event rates (per 100 women): pregnancy, 2.0; expulsion, 3.1; removal for pain/bleeding, 7.1. Comparative studies of the Multiload and other IUDs have shown all IUDs in current use are associated with similar rates of pelvic inflammatory disease. IUDs such as the MLCu375 that have larger copper surface areas appear to be associated with lower ectopic pregnancy rates. Follow-up studies of women who have had their Multiloads removed indicate that use of the device does not impair future fertility or affect pregnancy outcome. All IUD users, regardless of the type of IUD used, are at risk of complications. On balance, the benefits of IUD usage far exceed the associated risks.
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PMID:Fifteen years' experience with the Multiload IUD. 307 Nov 8

The Copper-Fix (Cu-Fix) is a thread-type copper-bearing device designed to overcome the most common IUD-related problems: bleeding and pain. Two distinctive features--virtual absence of a frame and provision of an anchoring system--make this new intrauterine device the first radical departure from current IUD technology. The Cu-Fix 390 was inserted at intervals in 382 women, and 4851 woman-months of experience had been accumulated at 18 months. The device was exceedingly well retained by the uterus (expulsion rate 0.6 at 18 months) and the removal rate for bleeding/pain was low (3.1 at 18 months). Serious complications did not occur; the pregnancy rate amounted to 0.3 at 18 months, with a continuation rate of 87.6%, which includes an 8.1% removal rate for pregnancy wish. Cardinal event rates were not influenced by the age or gravidity status of the recipient.
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PMID:The Copper-Fix (Cu-Fix): a new concept in IUD technology. 307 Nov 9

Appendicitis caused by a misplaced IUD was found in a 29-year-old pregnant woman. The woman had had the device inserted 8 years before. About 5 months after placement and a severe experience of right lower quadrant pain, medical examination revealed that she was pregnant. Abdominal and pelvic X-ray films were thought to be consistent with IUD expulsion, a fairly common occurrence, with an estimated rate of 2-20% within 1 year of placement. Over the next 7 years, the woman continued to experience right lower quadrant pain, but the pain was mild until 20 weeks into her next pregnancy when she was hospitalized with nausea, anorexia, fever, and severe pain. Surgery revealed that her appendix and cecum were bound to an inflamed mass of tissue. During the course of an appendectomy, this tissue mass was found to contain a copper-coated IUD, which was removed by blunt dissection and gentle traction. The IUD had probably partially perforated the uterus on insertion; complete perforation followed in 2-3 months; and copper from the device caused inflammation that eventually involved the appendix. Several months after the appendectomy, it was discovered that the inflammatory mass had been replaced by dense adhesions. This case shows that abdominal and pelvic X-ray examinations may not be sufficient to locate a misplaced IUD in a pregnant woman. If a misplaced device is not clearly visible on X-ray films, further workup may be necessary to avoid the possibility of chronic abdominal pain and complications.
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PMID:IUD appendicitis during pregnancy. 307 60

Suprofen (Suprol-Cilag S.p.A.), a prostaglandin synthetase inhibitor, was tested in a double-blind crossover design on 28 women whose IUDs caused them pain or increased menstrual bleeding. The subjects had worn either a Gravigard (18 women) or a Copper T (10) for 6 to 10 months. Each subject was observed for the first month, and took either placebo or Suprofen during the next menses, followed by the alternative for the third cycle. They took 20 mg Suprofen 4 times daily, at the first sign of bleeding and or pain, then 3 times daily thereafter, for the duration of symptoms or up to 7 days. Before treatment, 71% had severe bleeding, 18% had moderate bleeding and 11% had slightly increased bleeding. During Suprofen, 43% obtained a strong decrease in menstrual blood loss, 36% had a moderate decrease and 7% had a slight decrease. Placebo decreased bleeding moderately in 2. Pain was moderate to intense in 26 women and slight or none in 2 before treatment. With Suprofen, pain decreased moderately or greatly in 23 and slightly or not at all in 5 women. Placebo improved pain moderately in 1 subject. Reported side effects of the drug were stomach cramps in 1 and nausea and headaches in 2 women. In this study, when the subjects were categorized by degree of symptoms, the prostaglandin antagonist was more effective in those complaining of more severe bleeding and pain.
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PMID:Action of a prostaglandin synthetase inhibitor on IUD associated uterine bleeding. 310 27

An IUD releasing 20 mcg/day of levonorgestrel (LNg20) was compared with a Copper T IUD (TCu 380 Ag) in a randomized trail involving 2244 women 7 centers in the US, Brazil, Egypt, Chile, Singapore, and the Dominican Republic. The cumulative gross pregnancy rate at 2 years was 0.2 for the LNg 20 device and 0.9 for the TCu 380 Ag IUD. There were no ectopic pregnancies in more than 1600 woman-years of use of each device. The removal rates due to oligomenorrhea or amenorrhea were 10.7/100 among LNg 20 acceptors compared with only 0.2/100 among TCu 380 Ag acceptors in the 2-year study peroid. Removal rates for pain and/or bleeding did not differ significantly between devices. Hemoglobin rose an average of 0.5 g/dl in the LNg 20 group and declined an average of 0.2 g/dl in the TCu 380 Ag group. At the end of 2 years, the continuation rates were 59.4/100 among LNg 20 acceptors and 67.5/100 among TCu 380 Ag acceptors. This difference is ascribable to the scanty and infrequent bleeding patterns associated with the former device. It is concluded that both these IUDs provide highly effective intrauterine protection.
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PMID:Two years of intrauterine contraception with levonorgestrel and with copper: a randomized comparison of the TCu 380Ag and levonorgestrel 20 mcg/day devices. 311 85

The use-effectiveness of an intrauterine contraceptive device releasing 20 mcg of levon ISZ orgestrel daily (Lng-IUD), and of a Nova T copper-releasing IUD, were studied in a randomized comparative mulicenter trial. The Lng-IUD was inserted in 1821, and the Nova T in 937 women. The 12-month net pregnancy rate with the Lng-IUD (0.1/100 women) was significantly lower than that with the Nova T (0.9/100). Removal rates for menstrual problems and/or pain were similar for the 2 methods (net rates 7.5 and 8.7 respectively). The 12-moth continuation rates were 82.2 for the Nova T and 79.7 for the Lng-IUD. The reduction of the bleeding led to oligomenorrhea and amenorrhea in users of the Lng-IUD; the removal rate for these reasons was 1.4. The removal rate for hormonal side effects with the Lng-IUD was 2.4. Blood hemoglobin concentrations increased among users of the Lng-IUD and decreased among users of the Nova T. The results show that the Lng-IUD was highly effective contraceptive method which reduced menstrual bleeding. It it a promising alternative for women desiring a highly-effective method for long-term use.
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PMID:Effective contraception with the levonorgestrel-releasing intrauterine device: 12-month report of a European multicenter study. 312 32

Progestagen-releasing IUDs were developed to diminish the problems of bleeding and pain with inert and copper-containing IUDs. The intrauterine release of the progestagen causes endometrial atrophy, resulting in impairment of nidation, and interferes with transport of the ovum and the spermatozoa. 2 available types, Progestasert, Biograviplan (Alza Corporation, California; Grunenthal) and Levonorgestrel Nova-T (Leiras Pharmaceuticals, Finland), have been sufficiently tested in multinational trials. Compared with Progestasert, LNG Nova-T showed lower pregnancy rates (Pearl Index 0.30), less risk for ectopic pregnancy, and a longer effective lifetime (7 years). With both IUDs, the amount and duration of menstrual blood loss is decreased. Amenorrhea is a frequently occurring side effect of LNG Nova-T, caused by endometrial atrophy. Intermenstrual blood loss and spotting incidences are not uniformly reduced and are still a frequent reason for removal. Preinsertion counseling may improve the acceptance of these nonhealth threatening side effects. With both IUDs, a decrease in menstrual cramps during periods is perceived and a low incidence of PID is found. Basically, the progestagen-releasing IUD can be recommended to all women who wish an IUD for contraception and to women with contraindications for OCs, especially to those with menorrhagia, anemia, or risk for anemia. (author's)
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PMID:Intrauterine steroid contraceptives. 313 66

For a study on the side effects of the Copper 7 Minigravigard IUD, physicians at the Family Planning Center in Siriraj Hospital in Bangkok, Thailand inserted this IUD in 99 nulliparous women between 17-32 years old after performing a pelvic examination and a Papanicolaou smear between February 1983-January 1986. The women returned for reexaminations on the 3rd, 6th, and 12th months following insertion. After the 1st year, they returned annually. 2% of the women experienced enough post insertion pain that they required a mild analgesic. 17% experienced no pain. 5 women became pregnant and the IUD was subsequently removed. 4 woman delivered full term, health infants, while the 5th experienced a spontaneous abortion 1 week after removal of the IUD. The 1 year pregnancy rate stood at 3% which was higher than the 1.7% rate for a study of the Copper T 200. The expulsion rate stood at 6% during the 1st year, while it climbed to 8% in the 2 remaining years. Due to excessive bleeding and/or pain, physicians had to remove 4.5%, 7.6%, 8%, and 9.1% of the IUDs at 3, 6, 12, and 24 and 36 months respectively. In the study of the Copper T 200, the removal rate was higher (10.7%). No cases of pelvic inflammatory disease occurred. At the end of 2 and 3 years, 30.8% and 18.2% of the women still had the IUD. This 3 year study showed the advantages of the Copper-7 Minigravigard IUD to be simple insertion with minimal pain.
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PMID:A three-year study of the copper-7 minigravigard intrauterine contraceptive device in nulliparous women. 317 48

This study presents the one-year experience with a new copper-releasing intrauterine contraceptive device, the Fincoid IUD. Between November 1984 and August 1985, 650 Fincoid devices were inserted in parous women to test the efficacy and clinical performance of the devices. After one year, 16 pregnancies had occurred (2.8 net cumulative rate); 26 devices had been partially or totally expelled (4.4); 27 devices had been removed for bleeding and/or pain (4.7); and 16 devices had been removed for other medical reasons (2.8). The continuation rate at the end of the first year was 84.3, indicating a good clinical performance.
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PMID:One-year results with the Fincoid IUD--a Hungarian experience with the short model. 321 71

A new IUD, the copper T 380A; soon will be marketed in the US. According to early clinical trials, the T 380A had a lower pregnancy rate than copper-bearing IUDs with less copper but was removed more often because of bleeding and pain. Removals were less frequent among older women. The gross cumulative pregnancy rate with the copper T 380A in 1 published study of 1051 women was 2.8/100 women at the end of 4 years. Women under age 20 had a pregnancy rate of 3.7/100, those 20-24 a rate of 3.2, and those 25 and older a rate of 1.9. More recently, large multicenter trials have reported pregnancy rates lower than with most other IUDs. Pelvic inflammatory disease (PID) occurs more often in women who use IUDs. Other IUD risks include uterine perforation during insertion, septic abortion if pregnancy does not occur, and and increased incidence of ectopic pregnancy compared to the incidence with oral contraceptive use. Copper released from IUDs may inhibit metabolism of prostaglandins by the uterus and decrease the length of the luteal phase of the menstrual cycle. The copper T 380A appears to be somewhat more effective than earlier IUDs but may cause more bleeding and pain. Its effects when used for longer than 4 years are unknown.
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PMID:New copper IUD. 327 26


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