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)

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

The complications of sexually transmitted diseases -- epididymitis in men and pelvic inflammatory disease in women -- result in 12,000 cases of infertility a year in France. It is therefore necessary to implement a program for the prevention of sexually transmitted diseases in France. The 1st step in such a program must be a feasibility study to determine the level of participation of general practitioners and the suitability of the questionnaires. The feasibility study was carried out in 2 steps, one in 1984 and a similar one in 1985. In each year, during a 4-week period, 57 participating doctors filled out questionnaires for each patient consulting for leucorrhea or urethral discharge. During the year between the studies, information brochures on sexually transmitted diseases were produced for doctors and the public. In 1984, the physicians noted 154 cases of leucorrhea and urethral discharge; in 1985, they noted 121 cases, an average of 6 cases/1000 patients. Of the 275 cases, 141 were in men, 134 in women. Only 4% of the men and 9% of the women were under 20, indicating that young patients go to a free health clinic rather than to private practitioners. Over 1/2 of the men, but only 1/5 of the women had multiple sexual partners, and 1/2 the patients were consulting for a recurrence. Bacteriological screening showed that the commonest organisms in the male infections were Gonococcus and Chlamydia trachomatis, while in women mycoses were more prevalent. The feasibility study showed that general practitioners cooperated and that the quality of the data was good. The 2nd phase of the study, a community randomized trial, is currently being conducted in 6 French administrative departments, 3 for treatment and 3 to act as controls. In each department 50 physicians are participating. All available information will be disseminated in the 3 treatment departments for 3 months after beginning the experiment.
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PMID:The prevention of sexually transmitted diseases which affect fertility: methodological problems and initial results. 334 19

To increase knowledge of the prevalence of genital chlamydia trachomatis infection and the associated epidemiologic and clinical factors, cultures were obtained from 2320 patients at a Denver clinic for sexually transmitted diseases. Specific subsamples examined included 96 consecutive male clinic attendees with no urethral discharge on examination, 1193 consecutive male attendees with urethral discharge, and 1031 consecutive female attendees. Only 4 (4%) of the men attending the clinic who did not have a discharge on examination were positive for chlamydial infection compared with 275 (23%) of men with a discharge. Of the men with discharge, the isolation rate of chlamydia was 27% among heterosexuals but only 14% among homosexuals and bisexuals. Of the female attendees cultured, 172 (17%) had positive cervical findings. Younger age was associated with chlamydial infection in both men and women even after controlling for sexual activity. In a subgroup of men without gonococci, those who had polymorphonuclear leukocytes on smear had higher isolation rates (33%) than those who did not (3%). Among women, chlamydia rates were significantly lower for whites (13%), married women (7%), and diaphragm users (0%). There was a marginally significant increased rate of chlamydial isolation among oral contraceptive users only for women aged 20 years or below. Significantly fewer (18%) men with profuse discharge were positive for chlamydial infection compared with men with a scant or moderate discharge (27% and 31%, respectively), and those with a purulent discharge were less likely to be positive than men with a clear or white discharge. Stepwise multiple logistic regression suggested the following risk factors for chlamydial infection in men: polymorphonuclear leukocytes, gram-stained smear negative for intracellular diplococci, age under 25 years, history of discharge, discharge for more than 7 days, and no dysuria. Risk factors for women included age less than 25 years, unmarried status, gonorrhea, an abnormal cervix, pelvic inflammatory disease, and no recent antibiotic use.
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PMID:Factors related to genital Chlamydia trachomatis and its diagnosis by culture in a sexually transmitted disease clinic. 339 97

Ten women with acute right upper-quadrant abdominal pain but negative results for biliary investigations had a current or past history of pelvic inflammatory disease. A diagnosis of the Curtis-Fitz-Hugh syndrome was made and was confirmed in five patients by laparoscopy. Neisseria gonorrhoeae was not isolated from the cervical and urethral swabbings of seven patients tested. Chlamydia trachomatis was isolated from the endocervical canal in one of six patients examined. Of sera from nine patients tested by a micro-immunofluorescence test, nine and six samples respectively showed type-specific IgG and IgM antibodies against C trachomatis serotypes D-K. Type-specific IgG and IgA antibodies were also detected in the cervical and urethral discharge of two out of five patients and in the peritoneal aspirate of two. The presence of high titres of IgG or IgM in sera and IgG or IgA in the local discharges of our patients suggests that C trachomatis was probably the cause of the CFH syndrome.
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PMID:Chlamydia and the Curtis-Fitz-Hugh syndrome. 732 53

Teso District in eastern Uganda with low fertility (crude birth rate in 1969 was 37/1000), and Ankole District in western Uganda with high fertility (55/1000), were selected to study malaria, nutrition, gonorrhea, and syphilis. The gonorrhea methodology for women included genital examination and endocervical smears and cultures. Husbands of gonococcal-negative fertile and infertile women also were examined for the presence of gonorrhea and evidence of infection in the past. Three hundred and forty-three women in Teso and 250 in Ankole underwent medical examination. In the Teso District, 84 (25%) of the women, as compared with 22 (8.9%) in Ankole, complained of lower abdominal pain (p 0.001). Seven women in Teso but none in Ankole had signs of bartholinitis. Mucopurulent discharge in the vagina was found in 56 (19%) of the Teso women as compared with 17 (10%) of the Ankole women (p 0.02). 90 (30.5%) of the women in Teso but only 21 (12.5%) women in Ankole had an eroded and/or infected cervix (p 0.001). Evidence of salpingitis was obtained in 56 (19%) of the Teso women as compared with 10 (5.9%) Ankole women (p 0.001). A tender adnexal mass was felt in 23 (7.8%) of the Teso sample but in only one (0.6%) in Ankole. Among the women in Teso, 54 (18.3%) had a positive cervical smear or culture for gonorrhea, but only four (2.4%) in Ankole had similar positive tests (p 0.001). Evidence of pelvic inflammatory disease was present in 17% of the infected Teso women. None of the infected Ankole women, however, had PID. Cervical secretions showed gonococci in only 10% of the infertile women as compared with 23% of the fertile women. However, 24.5% of husbands of the gonococcal-negative infertile women, as compared with 6.7% of husbands of the gonococcal-negative fertile women, were found to have active gonorrhea (p 0.01). In this group 75.5%, and 57.7% of husbands, respectively, had a past history of urethral discharge (p 0.05), while 18.4% and 5.8%, respectively, had bilaterally thickened epididymides (p 0.05).
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PMID:Gonorrhea and female infertility in rural Uganda. 746 80

In men urethral discharge is commonly caused by Neisseria gonorrhoeae and Chlamydia trachomatis. Both organisms cause an acute anterior urethritis and infected men usually present with symptoms of urethritis. A proportion of men with urethral infection may remain asymptomatic. Amongst women the common cause of vaginal discharge is vaginitis caused by Trichomonas vaginalis, Candida albicans and anaerobic bacterial infection (bacterial vaginosis). However, cervicitis caused by N. gonorrhoeae and C. trachomatis also causes vaginal discharge. Cervicitis is the more serious cause of vaginal discharge as the aetiologic agents may lead to infection ascending above the internal os of the cervix resulting in pelvic inflammatory disease and other complications.
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PMID:Syndromic management of sexually transmitted diseases. Part 2--The management of genital discharge. 1010 31

This study aimed to describe the quality and costs of sexually transmitted disease (STD) case management in urban pharmacies in The Gambia, and explore pharmacy workers' (PWs) willingness to improve the STD care they provide. PWs from 24 registered pharmacies were interviewed in order to collect information on their knowledge and practices regarding management of STDs. The same pharmacies were visited by a male 'simulated client' (SC) to ascertain how urethral discharge syndrome (UDS) cases were managed in practice. Fifteen (63%) pharmacies were equipped for treatment of UDS, pelvic inflammatory disease (PID) and genital ulcer syndrome (GUS), according to national guidelines. Appropriate syndromic management for UDS was mentioned by 11% of PWs but actually given to 4.4% of the SC visits. None of the PID or GUS cases would be treated correctly. Forty-two per cent of PWs advised on partner notification, 38% on safe sex and 29% on treatment compliance in the SC visits. The reported costs for treatment of UDS, PID and GUS ranged from $2.5-$15.0. The cost of treatment actually purchased by the SC averaged $3.5 (range $1.5-$9.6) for UDS. Excluding the pharmacy sector from interventions will limit the impact of STD control measures. Regular training in syndromic management and rational drug use, with a concise manual for reference are recommended. Strategies to lower the cost of drugs should be explored.
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PMID:Management of sexually transmitted diseases in urban pharmacies in The Gambia. 1139 80

The relationship of Chlamydia trachomatis inclusion-forming units in quantitative culture to clinical manifestations and inflammation in urogenital disease was assessed in 1179 patients attending a sexually transmitted diseases clinic. In women, greater inclusion-forming unit counts were associated with cervical mucopus (3000 vs. 450 ifu), amount and character of cervical discharge, > or =30 polymorphonuclear cells (PMNL) per high-power field (hpf) on Gram stain (2050 vs. 320 ifu), and diagnoses of mucopurulent cervicitis (MPC; 2550 vs. 300 ifu) and pelvic inflammatory disease (PID; 3000 vs. 578 ifu). In men, greater inclusion-forming unit counts were associated with urethral discharge (85 vs. 44 ifu), amount and character of discharge, and > or =10 PMNL/hpf (95 vs. 50 ifu). These associations persisted on multivariate analysis. Thus, chlamydial replication is associated with MPC and PID in women, urethritis in men, and inflammation in both. Since infections with high inclusion counts may be the most transmissible, identification and treatment of patients with these chlamydia-associated syndromes is important in control programs.
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PMID:Quantitative culture of Chlamydia trachomatis: relationship of inclusion-forming units produced in culture to clinical manifestations and acute inflammation in urogenital disease. 1167 29

The laboratory of reproductive tract infections (RTIs) is a new entity within the Laboratory Sciences Division of the ICDDR,B. The objectives of the laboratory are to conduct epidemiologic research in RTIs, including sexually transmitted diseases (STDs), to provide technical support to protocols developed in other scientific divisions of the center, to provide training in diagnostic procedures, and to give diagnostic support to patient care. The RTI laboratory has an extremely important role in the national STD control program. Research priorities are to monitor the susceptibility patterns of Neisseria gonorrhoeae and Haemophilus ducreyi, to study the prevalence and etiology of RTIs/STDs among people with high-risk behaviors, and to study the etiology of syndromes such as pelvic inflammatory disease, urethral discharge, and genital ulceration. The laboratory also plans to develop new diagnostic methods and conduct research upon the resistance and virulence mechanisms of STD pathogens.
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PMID:The laboratory of reproductive tract infections. 1229 69

The real prevalence of pelvic inflammatory disease (PID) is unknown since many women are either asymptomatic or have atypical symptoms. It is often difficult to detect, manage, and prevent PID. Since PID has obstetric, gynecologic, and contraceptive-related causes, its prevalence is quite high. About 70% of PID hospital admissions in sub-Saharan Africa are a result of reproductive tract infections (RTIs) while this figure is 34% in Asia and 31% in developed countries. Only 10-20% of lower RTIs ascend into the upper genital tract and an even smaller percentage of women with PID develop chronic sequelae. Still, just 1 episode carries an increased risk of a tubal infertility, ectopic pregnancy, chronic pelvic pain, considerable pain during coitus, a new episode, and menstrual irregularities. Neisseria gonorrhoea and Chlamydia trachomatis are the most common causative organisms of PID. In Africa, the risk factors for PID are the same as they are for sexually transmitted diseases (STDs): multiple sex partners, young age at first intercourse, high frequency of coitus, and a high rate of acquiring new partners. The largest percentage of women with RTIs are monogamous women who are infected and constantly reinfected by their promiscuous husbands. The primary means to prevent PID are promotion of safer sexual behavior and condom usage. Secondary measures include accessible, acceptable, and effective STD services and education and counseling during case management. WHO suggests that STD treatment become part of the primary health care system. It has developed flow charts on syndromic diagnosis for urethral discharge in men and genital ulcer disease in women. Health workers should assume increased PID risk if the partner has had a history of urethral discharge and/or treatment for gonorrhea or nongonococcal urethritis. Partner notification is also needed for case management, but stigmatization in some countries poses a problem. WHO also recommends use of drugs which have a 95% STD cure rate.
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PMID:Pelvic inflammatory disease. 1234 39


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