Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242172 (pelvic inflammatory disease)
 3,755 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sexually transmitted diseases (STDs) are common and happen more frequently in younger patients. These adolescents have unique risks of acquiring infection because of developing psychosocial skills, biological factors and sociocultural barriers. The clinician must be adept at identifying and modifying these risks through knowledge of the adolescent stages of development and biology, with good history and examination skills that make teens comfortable during their evaluation, and with patient education and treatment. Whereas patient compliance and partner notification can be problematic in any population, teenagers may be more prone not to follow through on these issues. While compliance may notbe as important as previously thought, there is a dearth of studies of patient compliance and STD treatment in adolescents. Guidelines for the treatment of STDs were published by the Centers for Disease Control and Prevention (CDC) in 1998 and the Medical Society for the Study of Venereal Diseases in 1999. Most of the data obtained to formulate these guidelines were not necessarily adolescent specific and few studies, if any, have included adolescent patients since the CDC document was published. In the treatment of chlamydia, it appears that even with relative noncompliance with the 7-day regimen of doxycycline, it is as effective as single dose azithromycin. This has implications in cost control, important for centres with limited funds for treatment. While fluoroquinolone-resistant gonorrhoea has been reported for some time, the number of reports in the US is increasing, with a recent report of decreased susceptibility to azithromycin. As many studies have shown efficacy with single agent therapy with azithromycin in combined gonococcal and chlamydial infection, one must view these new resistance data with concern and give serious consideration to dual agent treatment, especially in the locale of the practitioner. Also, fluoroquinolone use is not advised in patients under the age of 18 years at present because of concerns of adverse effects on cartilage. While not much has changed from the 1998 guidelines for most of the other STDs, there seems to be a general trend in treating pelvic inflammatory disease (PID) on an outpatient basis if good follow-up is assured, even in the adolescent population. There is still debate on whether anaerobe coverage is needed in PID without tubo-ovarian abscess or other complications. One other update includes the use of daily metronidazole gel instead of twice daily usage in the treatment of bacterial vaginosis. With the lack of studies specific to adolescents, it is left up to the clinician to tailor the treatment of adolescents on the basis of current guidelines and patient preferences.
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PMID:Drug treatment of nonviral sexually transmitted diseases: specific issues in adolescents. 1151 80

Recent research reported that bacterial vaginosis (BV) might enhance the acquisition and transmission of HIV. BV is also associated with an increased risk of pelvic inflammatory disease, a disease also associated with intrauterine device (IUD) insertion. To measure the magnitude of this problem, we conducted a prevalence survey of BV and sexually transmitted diseases (STDs; defined as current infections with Neisseria gonorrhoeae, Chlamydia trachomatis, and/or Trichomonas vaginalis) among all patients attending a family planning clinic in Manado from May to July 1999. BV was diagnosed by Gram stain using Nugent's criteria and vaginal trichomoniasis by wet mount or culture. Cervical infections with C. trachomatis and N. gonorrhoeae were diagnosed by DNA probe. Of 357 patients, 116 (32.5%) had BV, 83 (23.3%) had trichomoniasis, 9 (2.5%) had chlamydia, and 8 (2.2%) had gonorrhea. The prevalence of STD was similar among users of all types of contraception. However, BV was more common among IUD users (47.2%) than among non-IUD users (29.9%). This association persisted after controlling for age, education, ever had douching, and any STD (odds ratio 2.0, 95% CI 1.1-3.8). BV was also associated with STD (41.3% in women with STD vs. 29.4% in women without). This association remained significant after adjusting for age, education, ever had douching, and IUD use (odds ratio 1.7, 95% CI 1.1-2.9). Because we found that BV was associated with IUDs and that other studies reported that both BV and IUDs were associated with pelvic inflammatory disease, a Gram stain evaluation of BV may be considered prior to IUD insertion
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PMID:High rate of bacterial vaginosis among women with intrauterine devices in Manado, Indonesia. 1170 96

We assessed the association between the causative agents of vaginal discharge and pelvic inflammatory disease (PID) among women attending a rural sexually transmitted disease clinic in South Africa; the role played by coinfection with human immunodeficiency virus type 1 (HIV-1) was studied. Vaginal and cervical specimens were obtained to detect Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, and bacterial vaginosis. HIV-1 infection was established by use of serum antibody tests. A total of 696 women with vaginal discharge were recruited, 119 of whom had clinical PID. Patients with trichomoniasis had a significantly higher risk of PID than did women without trichomoniasis (P=.03). PID was not associated with any of the other pathogens. When the patients were stratified according to HIV-1 status, the risk of PID in HIV-1-infected patients with T. vaginalis increased significantly (P=.002); no association was found in patients without HIV-1. T. vaginalis infection of the lower genital tract is associated with a clinical diagnosis of PID in HIV-1-infected women.
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PMID:Trichomonas vaginalis is associated with pelvic inflammatory disease in women infected with human immunodeficiency virus. 1179 80

Wet preparation has limited sensitivity for diagnosis of Trichomonas vaginalis (TV) infection. An observational study of 337 women was conducted to evaluate a new polymerase chain reaction (PCR) test for TV. The sensitivities of wet preparation and TV culture were 52% (95% confidence interval [CI], 41-62) and 78% (95% CI, 69-86), respectively. TV PCR had a sensitivity of 84% (95% CI, 75-90) and a specificity of 94% (95% CI, 90-97). Metronidazole was provided to 67 (69%) of 97 women with TV because of TV on wet preparation, exposure to TV, or a diagnosis of bacterial vaginosis or pelvic inflammatory disease; however, if TV PCR had been used for diagnosis, 81 (84%) of 97 women with TV would have been treated (P=.02). TV is significantly undertreated using standard algorithms for metronidazole therapy. Given the association of trichomoniasis with perinatal morbidity and HIV transmission, women in high-risk groups may benefit from TV PCR.
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PMID:Trichomonas vaginalis polymerase chain reaction compared with standard diagnostic and therapeutic protocols for detection and treatment of vaginal trichomoniasis. 1217 32

This article, intended for use by practitioners in India, summarizes the US Centers for Disease Control's recommendations for the management of sexually transmitted diseases (STDs). The STDs presented are chancroid, genital herpes, granuloma inguinale, lymphogranuloma venereum, syphilis, urethritis, chlamydia, gonococcal infection, bacterial vaginosis, trichomoniasis, vulvovaginal candidiasis, pelvic inflammatory disease, epididymitis, human papillomavirus infection, warts, hepatitis B, and ectoparasitic infections. For each STD, information is provided on treatment, follow up, and special circumstances such as pregnancy and concomitant HIV infection.
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PMID:1998 management recommendations for sexually transmitted diseases. 1229 52

According to World Health Organization estimates, there are 333 million new cases of sexually transmitted diseases (STDs) each year. The total number of reproductive tract infections (RTIs) is even higher since these infections may have few visible symptoms, especially in women. Left untreated, however, RTIs can lead to infertility. Common symptoms include: unusually thick or foul-smelling vaginal or urethral discharge, genital sores, anal sores, genital itching, pain when urinating and during sexual intercourse, painful swelling in the lymph glands or groin, and lower abdominal pain. The open sores associated with STDs such as syphilis, chancroid, and genital herpes greatly increase the risk of HIV transmission, as may STDs such as gonorrhea that are associated with urethral or vaginal discharge. To facilitate the prompt diagnosis and treatment of RTIs, this article briefly describes the diagnosis and long-term effects of gonorrhea, syphilis, chancroid, chlamydia, pelvic inflammatory disease, genital herpes, genital warts, candida, and bacterial vaginosis.
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PMID:Common infections. 1234 38

Five hundred and twenty consecutive women newly attending a genitourinary medicine clinic who participated in a study of sexual behaviour were also tested for type-specific antibody to herpes simplex virus type 2; 135 (26%) were seropositive, of whom only 29 (21.5%) had had clinical evidence of genital herpes. Seropositive women were much more likely to have a past history of genital herpes (odds ratio [OR] 173). They were also more likely to be black non-UK born (OR 14), aged 30 years or over (OR 6), to have had 6-20 sexual partners (OR 3-4), especially from abroad (OR 12), to be unemployed (OR 6) or blue collar workers (OR 4), to have smoked cigarettes (OR 2) and to have practised peno-anal penetration (OR 5). Disease predictors included a past history of pelvic inflammatory disease (OR 63) and bacterial vaginosis (OR 3). Unexpected predictors were only one sexual partner (OR 5) and no non-regular partners (OR 5). Commencing intercourse before 16 years of age showed a protective effect (OR 0.2) and so did use of oral contraception (OR 0.5). Our findings show that infection with HSV-2 is associated with a wider range of morbidity and also emphasize the role of male sexual partner selection in the transmission of infection.
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PMID:Predictors of seropositivity to herpes simplex virus type 2 in women. 1259 Jul 90

Sexually transmitted diseases (STDs) are a major health problem for adolescents. Health care providers for adolescents play a critical role in preventing and treating STDs. In May 2002, the Centers for Disease Control and Prevention published the Sexually Transmitted Diseases Treatment Guidelines 2002. These evidence-based guidelines are based on a systematic literature review focusing on information that had become available since the 1998 Guidelines for Treatment of STDs. This article reviews the new STD treatment guidelines for gonorrhea, chlamydia, bacterial vaginosis, trichomonas, vulvovaginal candidiasis, pelvic inflammatory disease, genital warts, herpes simplex virus infection, syphilis, and scabies. Although these guidelines emphasize treatment, prevention strategies and diagnostic recommendations also are discussed.
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PMID:Sexually transmitted diseases treatment guidelines. 1289 Oct 51

This study aimed to assess the prevalence of bacterial vaginosis (BV) and other cervicovaginal infections, as well as the incidence of complications among new users of IUD, 1 and 6 months after its insertion, in the City of Campinas, Brazil. A total of 223 women who had a TCu-380A IUD inserted from May through November 2001, were included in the study. After the IUD insertion all women were scheduled to two additional visits: after 1 month and after 6 months, when they were interviewed and a pelvic examination was performed, along with a collection of specimens from the vagina and the endocervix for laboratory testing. The Nugent's criterion was used for the BV diagnosis. They were also evaluated with regard to presence of complications possibly related to IUD insertion and use, i.e., abnormal bleeding, dysmenorrhea, expulsion and pelvic inflammatory disease. The prevalence of cervicovaginal infections was 29.1%, BV being the most frequent (19.7%). Dysmenorrhea was more frequent among women with BV than among women without BV (p = 0.03). A trend of abnormal bleeding being more frequent among women with BV was also found. In conclusion, BV after 1 month of IUD insertion was not associated with IUD complications, with the exception of dysmenorrhea.
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PMID:Follow-up of users of intrauterine device with and without bacterial vaginosis and other cervicovaginal infections. 1295 22

Bacterial vaginosis (BV) is the most frequently found condition of the female genital tract. It increases a woman's risk of acquiring HIV, is associated with increased complications in pregnancy, and may be involved in the pathogenesis of pelvic inflammatory disease. Yet there are many unanswered questions about its aetiology, making management of recurrent infection difficult and often idiosyncratic. This paper discusses the current knowledge and possible management of recurrent BV.
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PMID:Managing recurrent bacterial vaginosis. 1475 28


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