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)

Most adolescent gynecological problems are related to sexual activity or the development or failure of hypothalamic-pituitary-ovarian-uterine activity. The 1st years of menstruation are usually anovulatory resulting in variable periods of amenorrhea which corrects itself in time. In profuse menstrual loss, endocrine, metabolic, and hemorrhagic disorders must be exlcuded before treatment with progesterone for endometrial hyperplasia. Primary amenorrhea requires detailed examination before diagnosis. Secondary amenorrhea is commonly caused by a disturbance of the hypothalamic-pituitary-ovarian axis due to an emotional disturbance. If pregnancy is eliminated, examination and reassurance are sufficient treatment. Most dysmenorrhea may be treated with mild analgesics and reassurance; in severe cases ovulation may be inhibited by estrogen treatment. Dilation of the cervix should never be attempted. In complaints of vaginal discharge, examination should be made for trichomonas, monilia, gonorrhea, or a forgotten tampon. Requests for contraception should be taken seriously regardless of age. The combined contraceptive pill or Gravigard or copper 7 IUD is the method of choice. Lower abdominal pain caused by pelvic inflammatory disease should be treated early to prevent tubal occlusion after salpingitis. Evidence of higher cervical cancer incidence among women who were sexually active in adolescence suggests routine cervical cytology should be performed. Treatment of adolescents should dispel ignorance and embarrassment with patience and skill.
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PMID:Aspects of student health. Adolescent gynaecology. 83 29

Although sexually transmitted diseases are a major public health problem at the international level, the relationship between contraception and pelvic infection is seldom examined. Numerous STDs are more difficult to diagnose, more frequent, and more serious in women than in men. Differential diagnosis between pelvic infection and other intraabdominal syndromes has been a concern for practitioners for years, and many pelvic infections are probably never diagnosed. Lower abdominal pain and sensitivity as well as fever, leucocytosis, accelerated sedimentation rate, inflammatory annexial mass evident on sonography, and microorganisms in the pouch of Douglass and presence of leucocytes in the peritoneal fluid are diagnostic criteria. Apart from errors in treatment resulting from errors in diagnosis, pelvic infections are often inadequately treated, especially in the initial phase before symptoms are confirmed. The exact incidence of pelvic infections in the US is unknown, but pelvic inflammatory disease (PID) accounted for over 200,000 hospitalizations per year between 1970-75. PID carries grave risks of subsequent ectopic pregnancy, chronic pelvic pain, and infertility which is more likely as the number of acute episodes increases. The female genital tract has diverse microenvironments propitious for growth of microorganisms of different types, aerobic and anaerobic. Each anatomic site has specific features conditioning bacterial growth. Histological modifications during the menstrual cycle and pregnancy affect the microbial flora. Except in the case of gonorrhea, it is not known how many female lower genital tract infections spread to the upper tract. Since 1970, several studies have domonstrated a growing diversity of cervical and vaginal flora in asymptomatic subjects. The principal risk factors for PID have been well described in the literature. All contraceptive methods except the IUD provide some degree of protection against PID. Even among IUD users the risk of PID is probably not greater than among women with a comparable risk of exposure to STDs. The protective effect of condoms has been recognized since the era of Casanova, but it is difficult to quantify. Studies describing the protective effects of spermicides used one against pelvic infection are very rare, and protective effects have usually been demonstrated only in vitro. Surfactants such as nonoxynol probably have viricidal properties against herpes simplex. Condoms and diaphragms have been seen to exercise a protective effect independent of spermicide, with relative risks of .6 and .4 compared to nonouse of contraception. There is as yet no consensus on changes in risk of PID during oral contraceptive (OC) use, but several studies have shown OCs to have a protective effect. Risks of PID in IUD users apparently stem from contamination during insertion or of the thread during prolonged use, but both possibilities remain controversial. The use of women not using contraception as controls in studies of relative risks of PId may not be appropriate because their sexual behavior and risks of exposure to STDs may differ. At the moment of ovulation, when the mucus is most receptive, IUDs do not place any barrier in the way of ascension of sperm and bacteria to the upper genital tract.
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PMID:[Contraception and pelvic infection in women]. 1234 Dec 41

Lower abdominal pain of acute onset in young women with a negative pregnancy test is a frequent reason for referral to the general surgical team and the differential diagnoses include acute appendicitis, complicated ovarian cysts and pelvic inflammatory disease. Intestinal and mesenteric cystic disease is a rare entity and less than half of cases present acutely. We present a case of a 25-year-old woman who underwent diagnostic laparoscopy for acute lower abdominal pain and was diagnosed with a ruptured, infected mesenteric cyst.
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PMID:A ruptured infected mesenteric cyst diagnosed on laparoscopy for suspected appendicitis. 2471 57