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)

This literature review compares the merits and disadvantages of the levonorgestrel-releasing IUD made by Leiras Pharmaceuticals, Turkey, Finland (LNG-IUD-20), with the Nova-T, Copper-T (TCu) and 220C, and Copper-T-38-Ag (TCu-380Ag). This IUD releases 20 mcg levonorgestrel daily from a Silastic sleeve on the vertical shaft containing 52 mg. The plasma level stabilized after a month at about 0.2 ng/ml, about half as high as that seen with Norplant implants. It is identical in size to the Nova-T. The Cu-T IUDs differ with respect to copper wire or sleeves, or silver-cored wire. The chief studies reviewed here were 2 multi-center trails primarily in European countries, and a 2 large multi-center trials in India. Cumulative pregnancy rates were 0.0 to 0.6 per 100 users for the LNG IUD, compared to slightly higher failures for inert or copper IUDs. While removal rates for bleeding, pain and pelvic inflammatory disease were lower for the LNG-IUD-20, removals for oligomenorrhea, amenorrhea and hormonal side effects were higher than for the other IUDS. In the Indian trials, removals for amenorrhea and irregular bleeding were much higher than rates reported in the European studies, resulting in significantly lower continuation rates overall. The results pointed to district benefits for the LNG-IUD-20, such as lower blood loss and anemia, relief of dysmenorrhea and menorrhagia, as well as possible lower risks of ectopic pregnancy in case of failure, less PID (pelvic inflammatory disease), and the claim by the maker that strictly correct placement is not necessary. Disadvantages of the LNG-IUD-20 are more difficult insertion due to the wider diameter; oligomenorrhea, amenorrhea and irregular bleeding; hormonal side effects such as acne, weight gain, nausea, headache and breast tension; and potential risk of functional ovarian cysts. The LNG-IUD-20 is considered comparable to copper IUDs in effectiveness, safety, longevity, and return to fertility after removal. Users should be counseled that the oligomenorrhea or amenorrhea is neither a medical problem or indicative of infertility, is common for the 1st 2 months, is reversible on removal, may signal an improved hemoglobin profile, relief of dysmenorrhea, and may be preferred to heavy bleeding from other IUDS. The program implications of this IUD are potential lower incidence of ectopic pregnancy and PID. The effect of its use on breast feeding, cost-effectiveness compared to Norplant, in-country manufacture, and cultural acceptance need to be determined in specific locales.
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PMID:An evaluation of the levonorgestrel-releasing IUD: its advantages and disadvantages when compared to the copper-releasing IUDs. 177 15

A levonorgestrel-releasing IUD and the Copper T 380Ag IUD were in randomized comparison for seven years in five clinics. In two other clinics the randomized study was truncated at five years, but use of the Copper T continued. No pregnancies occurred to users of either device in years 6 and 7. Cumulative pregnancy rates were 1.1 per 100 at seven years for the steroid-releasing and 1.4 per 100 for the copper-releasing IUDs. Cumulative rates of PID did not differ between devices. Infection rates appeared to be lowest during the sixth and seventh years of the study. Termination attributable to amenorrhea was the principal contributor to differences in cumulative continuation rates between devices. At the five clinics that carried the comparative study to seven years, cumulative continuation rates were 24.9 per 100 for LNg20 IUD users and 29.4 per 100 for TCu 380Ag users. Women who used either method for periods of five to seven years experienced, on average, marked to mild increases in hemoglobin as compared with levels at admission. The Copper T380 family and the LNg20 IUDs represent the most effective reversible contraceptive methods yet studied in long-term randomized trials.
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PMID:Prolonged intrauterine contraception: a seven-year randomized study of the levonorgestrel 20 mcg/day (LNg 20) and the Copper T380 Ag IUDS. 179 62

The control of a cyclical movement of the lower leg with electrical stimulation of the quadriceps muscles is formulated as an optimal control problem. The time integral of knee torque is taken as the optimisation criterion. As an additional condition, every cycle a certain reference maximum angle should be reached. A model study indicates that one stimulation burst per cycle at the maximum recruitment level is a suboptimal solution to this problem. To compensate for the influence of muscle fatigue, the burst time is adaptively adjusted by a discrete time PID-controller on the basis of the performance in the previous cycles. This strategy appeared to be successful in experimental tests. A considerable time difference (about 0.15 s) was found between the end of the stimulation burst and the tracking of the passive state trajectory, which satisfies the maximum angle condition.
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PMID:Control of FES-induced cyclical movements of the lower leg. 181 49

We report our experience with transvaginal sonography (TVS) in 35 nonpregnant adolescent and young teenage females referred for pelvic sonography. We assessed the efficacy of TVS as compared to transabdominal sonography (TAS) in 40 examinations. Of the 40 examinations, there were 5 discrepancies. In 4, abnormalities were detected on TVS not seen on TAS. In one there was a false-positive TAS with bowel recognized as such on TVS. Image quality (clarity, completeness, anatomic detail) was judged better by two reviewers on TVS in 85% of cases but additional useful information given in 58% of patients. TVS provided greater diagnostic confidence in 30% of patients with possible PID by better demonstration of fluid in the endometrial canal, pyosalpinx or tubo-ovarian abscess, or by better characterization of free pelvic fluid. The average scan time required for TVS was 8 minutes. TVS was better tolerated than TAS in the majority of patients. TVS is a relatively easy, rapid imaging technique that is well tolerated. It enhances anatomic detail and helps to elucidate unclear findings on TAS. TVS is also helpful in obese patients and those unable to maintain a full bladder. It should be considered a useful and worthwhile adjunct to TAS in the evaluation of adolescents and teenagers with pelvic diseases.
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PMID:Transvaginal ultrasound in a children's hospital: is it worthwhile? 181 78

The authors report their experience concerning 110 cases of acute salpingitis that were diagnosed and controlled laparoscopically one month after antibiotic treatment had been achieved. During the second look laparoscopy three parameters were appreciated: pelvic adhesions, tubal patency, and residual inflammation. Laparoscopic findings at the time of early second look have shown relationship between the occurrence of tubal sequelae and the seriousness of initial PID: the relation was statistically significant regarding pelvic adhesions and tubal patency. Chlamydia trachomatis infections were associated with a poorer reproductive potential outcome. Second look laparoscopy seems particularly indicated after severe form of PID (pyosalpinx, tubo-ovarian abscess), in the presence of Chlamydia trachomatis, among young nulliparous woman wishing to conceive.
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PMID:[Acute salpingitis. Celioscopy before and after treatment: 110 cases]. 183 69

Twenty-seven patients with diffuse fibrosing alveolitis (DFA), 27 patients with granulomatous lung disease (GLD), 3 patients with homozygous alpha 1-proteinase inhibitor deficiency (alpha 1-PID), and 6 healthy volunteers (C) were studied using thin section high resolution CT (HRCT) at 50% of actual vital capacity (VC), determined and controlled spirometrically during each exposure. A fast contour tracing algorithm was used to isolate the lung parenchyma followed by a quantitative histogram analysis of the frequencies of CT values. Mean CT values enabled us to discriminate significantly between the groups of C and alpha 1-PID. Significant differences were found between the groups of GLD and DFA versus C by applying suitably selected intervals of CT values. Moreover, if the patients were assigned to four different groups according to their lung function results (normal, restrictive, obstructive, restrictive and obstructive), again significant differences existed with respect to defined intervals of CT values. Mean CT values showed a significant negative correlation with lung function tests representative of lung parenchymal disease, i.e., VC, diffusing capacity, and exercise PaO2. Moreover, CT values ranging from -899 to -800 HU correlated positively, whereas CT value frequencies above -699 HU correlated inversely with these same lung function parameters. These results indicated that certain intervals of CT values do reflect functionally different abnormalities of lung parenchyma. It is concluded that an analysis of frequencies of CT values determined by spirometrically standardized HRCT provides objective quantitative data that reflect changes of pulmonary structure corresponding to lung function impairments. Thus, spirometrically standardized HRCT may be helpful for evaluating and staging patients with diffuse pulmonary disease.
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PMID:Standardized quantitative high resolution CT in lung diseases. 188 91

In a study to evaluate the epidemiological status of Chlamydia trachomatis (C. trachomatis) infections in the OB/GYN field, we performed an indirect enzyme immune assay, measuring serum specific IgG and IgA. 1) Among 1,812 cases (0-68 years old), antibody positive rates for IgG and IgA were 29.7% and 11.2%, respectively. The first peak was observed in an age group under 1 year old, representing birth canal infections and the second one in a 20-24 age group showed a certain relation to STD. 2) The C. trachomatis IgG and IgA antibody positive rates in the antigen positive group (139 cases) were significantly higher (p less than 0.01) than in the antigen negative group (792 cases). 3) In the antigen positive group (139 cases), the positive IgG rate was high (78.8-90.9%) but it did not show any clear differences among the following groups: PID, cervicitis, pregnancy and infertility. However, the positive IgA rate in peritoneal antigen positive PID showed a significantly higher positive rate (100%) than other groups such as cervicitis (39.4%), pregnancy (37.8%) and infertility (45.5%). 4) Following oral administration of antibiotics, the C. trachomatis antigen became negative in almost all cases, while IgG decreased or became negative only in cases of initial infection. IgA decreased or became negative in the following cases: initial infection, low titer cases before treatment, cases treated many times and comparatively young patients with acute infections. Consequently, the immunoassay of C. trachomatis serum antibody appeared to be valuable for epidemiological surveys, for defermining the status of the infection and the effect of treatment.
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PMID:[Significance of the detection of serum specific IgA and IgG antibodies to Chlamydia trachomatis in the epidemiological survey, diagnosis and therapeutic effect on chlamydial infection in women]. 189 Mar 54

We describe the first successful outcome of a case of combined tubal and intrauterine quadruplet pregnancy in the literature. The patient's risk factors for combined pregnancy included a history of PID as well as the use of hMG therapy. A laparoscopic salpingectomy was performed, followed by a multifetal pregnancy reduction procedure. Two healthy infants were delivered at 37 weeks of gestation.
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PMID:Combined intrafallopian/intrauterine reduction of a quintuplet gestation. 190 33

Twenty-three patients with bicytopenia or pancytopenia were retrospectively studied. The patients with underlying disorders, blast count of more than 5% on bone marrow (BM) aspirate, blast count of more than 1% on peripheral blood or ringed sideroblast count of more than 15% on BM aspirate were excluded. According to Yoshida's criteria, 23 patients were classified into 6 subtypes [AA (aplastic anemia)1: typical AA, AA2: atypical AA, MDS (myelodysplastic syndrome)3: typical RA (refractory anemia, MDS4-6: atypical RA], and AA1 7 cases; AA2 2 cases; MDS3 5 cases; MDS4 1 case; MDS5 2 cases; MDS6 6 cases. To clarify the clinical features of atypical RA group (MDS4-6), we investigated ferrokinetics, RBC life span, karyotype, serum Epo (erythropoietin) concentration, response to therapy and prognosis. Results were as follows: 1) all three RA patients who were younger than 30 years old were included in atypical RA group, 2) in ferrokinetics study PID (plasma iron disappearance time) values of MDS4 and MDS6 patients ranged between those of AA1 and those of MDS3 patients (5 of 7 patients), 3) two cases who developed leukemia belonged to typical RA group, 4) patients with atypical RA showed response to therapy and their prognosis were better than those with typical RA. These observations suggest that atypical RA have different clinical features from typical RA.
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PMID:[Clinical features of atypical refractory anemia (RA)]. 194 25

Some authors have suggested that use of IUDs (intrauterine contraceptive devices) in nulliparous women should be contraindicated because of the risk for PID (pelvic inflammatory disease); others have found nulliparous women to be suitable candidates for IUD use. Clinical studies of copper IUDs in which parous and nulliparous women have been compared with regard to risk of PID often point to young age as a risk factor, regardless of parity. Vital statistics of PID rates also show this trend. An overall PID rate of 1.49/100 woman-years (WY) was calculated from data contained in 28 of the clinical studies reviewed in this paper. These studies included 25,674 women, of whom 42.5% were nulliparous. Studies of fertility following use of copper IUDs indicate that fertility is not impaired by their use.
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PMID:Copper IUDs, PID, and fertility in nulliparous women. 195 Jul 20


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