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Annals of Emergency Medicine Jul 2017
Topics: Anti-Bacterial Agents; Centers for Disease Control and Prevention, U.S.; Chlamydia Infections; Emergency Medicine; Female; Gonorrhea; Humans; Mass Screening; Pelvic Inflammatory Disease; Practice Guidelines as Topic; Sexually Transmitted Diseases; United States
PubMed: 28645411
DOI: 10.1016/j.annemergmed.2017.05.019 -
Korean Journal of Radiology Apr 2021The perihepatic space is frequently involved in a spectrum of diseases, including intrahepatic lesions extending to the liver capsule and disease conditions involving... (Review)
Review
The perihepatic space is frequently involved in a spectrum of diseases, including intrahepatic lesions extending to the liver capsule and disease conditions involving adjacent organs extending to the perihepatic space or spreading thanks to the communication from intraperitoneal or extraperitoneal sites through the hepatic ligaments. Lesions resulting from the dissemination of peritoneal processes may also affect the perihepatic space. Here we discuss how to assess the perihepatic origin of a lesion and describe the magnetic resonance imaging (MRI) features of normal structures and fluids that may be abnormally located in the perihepatic space. We then review and illustrate the MRI findings present in cases of perihepatic infectious, tumor-related, and miscellaneous conditions. Finally, we highlight the value of MRI over computed tomography.
Topics: Abscess; Endometriosis; Female; Hepatitis; Humans; Liver; Magnetic Resonance Imaging; Pelvic Inflammatory Disease; Peritoneal Diseases; Peritoneum; Peritonitis; Tomography, X-Ray Computed
PubMed: 33236541
DOI: 10.3348/kjr.2019.0774 -
Clinical Gastroenterology and... Oct 2020
Topics: Female; Gonorrhea; Hepatitis; Humans; Pelvic Inflammatory Disease; Peritonitis
PubMed: 31408704
DOI: 10.1016/j.cgh.2019.08.008 -
The Journal of the American Osteopathic... Jul 2020
Topics: Female; Gonorrhea; Hepatitis; Humans; Pelvic Inflammatory Disease; Peritonitis
PubMed: 32598463
DOI: No ID Found -
Clinical Infectious Diseases : An... Oct 2019We evaluated the risk of pelvic inflammatory disease (PID), ectopic pregnancy, and infertility in women with a previous Chlamydia trachomatis (CT) diagnosis compared...
BACKGROUND
We evaluated the risk of pelvic inflammatory disease (PID), ectopic pregnancy, and infertility in women with a previous Chlamydia trachomatis (CT) diagnosis compared with women who tested negative for CT and CT untested women, considering both targeted and incidental (ie, prescribed for another indication) use of CT-effective antibiotics.
METHODS
This was a retrospective study of women aged 12-25 years at start of follow-up within the Clinical Practice Research Datalink GOLD database linked to index of multiple deprivation quintiles, 2000-2013. CT test status and antibiotic use were determined in a time-dependent manner. Risk of PID, ectopic pregnancy, or female infertility were evaluated using of Cox proportional hazard models.
RESULTS
We studied 857 324 women, contributing 6 457 060 person-years. Compared with women who tested CT-negative, women who tested CT-positive had an increased risk of PID (adjusted hazard ratio [aHR], 2.36; 95% confidence interval [CI], 2.01-2.79), ectopic pregnancy (aHR, 1.87; 95% CI, 1.38-2.54), and infertility (aHR, 1.85; 95% CI, 1.27-2.68). The PID risk was higher for women with 2 or more positive CT tests than those with 1 positive test. PID risk increased with the number of previous antibiotic prescriptions, regardless of CT test status.
CONCLUSIONS
We showed an association between CT-positive tests and 3 adverse reproductive health outcomes. Moreover, this risk increased with repeat CT infections. CT-effective antibiotic use showed no decreased risks of subsequent PID regardless of CT history. Our results confirm the reproductive health burden of CT, which requires adequate public health interventions.
Topics: Adolescent; Adult; Anti-Bacterial Agents; Child; Chlamydia trachomatis; Female; Humans; Infertility, Female; Pelvic Inflammatory Disease; Pregnancy; Primary Health Care; Proportional Hazards Models; Retrospective Studies; Risk Factors; Young Adult
PubMed: 31504315
DOI: 10.1093/cid/ciz429 -
Gynecologie, Obstetrique, Fertilite &... May 2019The objective of this literature review is to update the recommendations for clinical practice about the diagnosis of pelvic inflammatory disease (PID), microbiologic... (Review)
Review
The objective of this literature review is to update the recommendations for clinical practice about the diagnosis of pelvic inflammatory disease (PID), microbiologic diagnosis excluded. An adnexal pain or cervical motion tenderness are the signs that allow a positive diagnosis of PID (LE2). Associated signs (fever, leucorrhoea, metrorrhagia) reinforce clinical diagnosis (LE2). In a woman consulting for symptoms compatible with PID, a pelvic clinical examination is recommended (grade B). In cases of suspected PID, hyperleukocytosis associated with a high C-reactive protein suggests a complicated PID or a differential diagnosis such as acute appendicitis (LE3). The absence of hyperleukocytosis or normal CRP does not rule out the diagnosis of PID (LE1). When PID is suspected, a blood test with a blood count and a CRP test is recommended (grade C). Pelvic ultrasound scan does not contribute to the positive diagnosis of uncomplicated PID because it is insensitive and unspecific (LE3). However, ultrasound scan is recommended to look for signs of complicated PID (polymorphic collection) or differential diagnosis (grade C). Waiting for an ultrasound scan to be performed should not delay the start-up of antibiotic therapy. In case of diagnostic uncertainty, an abdominal-pelvic CT scan with contrast injection is useful for differential diagnosis of urinary, digestive or gynaecological origin (LE2). Laparoscopy is not recommended for the unique purpose of the positive diagnosis of PID (grade B).
Topics: Appendicitis; Blood Cell Count; C-Reactive Protein; Diagnosis, Differential; Female; Humans; Laparoscopy; Leukocytosis; Pelvic Inflammatory Disease; Pelvic Pain; Tomography, X-Ray Computed; Ultrasonography
PubMed: 30878687
DOI: 10.1016/j.gofs.2019.03.010 -
BMJ Case Reports Feb 2019
Topics: Adult; Anti-Bacterial Agents; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Female; Hepatitis; Humans; Liver; Pelvic Inflammatory Disease; Peritonitis; Tomography, X-Ray Computed
PubMed: 30765452
DOI: 10.1136/bcr-2019-229326 -
Pediatrics in Review Aug 2020
Review
Topics: Abdominal Pain; Adolescent; Child; Child, Preschool; Diabetic Ketoacidosis; Diagnosis, Differential; Female; Humans; Migraine Disorders; Pain, Referred; Pediatrics; Pelvic Inflammatory Disease; Peptic Ulcer
PubMed: 32737258
DOI: 10.1542/pir.2019-0221 -
Panminerva Medica Jun 2016Endometriosis remains a very enigmatic and perplexing disease. The exact mechanism by which endometriosis causes infertility is still unclear. In the present paper, we... (Review)
Review
Endometriosis remains a very enigmatic and perplexing disease. The exact mechanism by which endometriosis causes infertility is still unclear. In the present paper, we will review possible mechanisms leading to subfertility or infertility in women with endometriosis and examine them according to location. Endometriosis in the pelvic cavity is a pathology associated with a general inflammatory response and should therefore be considered an inflammatory disease. Inflammatory changes affect the peritoneal fluid and hence the intratubal milieu, since the ampulla (where fertilization takes place) is exposed to peritoneal fluid through the fimbria. Any inflammatory change at this level may therefore impact fertilization and natural conception. The relationship between ovarian endometriomas and infertility may, of course, be explained by the presence of periovarian endometriosis. In the ovary, fibrosis observed in some cortical areas is induced by the inflammatory reaction caused by the presence of endometriomas. The association between fibrosis and a reduced ovarian reserve was demonstrated. Upregulated recruitment and the subsequent demise of early follicles may result in focal exhaustion of primordial follicles. Burn-out of early follicles by a local pelvic inflammatory environment caused by endometriomas may therefore be suggested. However, intraovarian inflammation, subsequent fibrosis and depletion of the ovarian reserve constitute another reason that should also be given due consideration. In addition, surgery should not be ruled out as a possible cause of ovarian reserve depletion. In conclusion, potential mechanisms leading to infertility are numerous, and while some of them remain hypothetical for now, others are supported by clear evidence. These possible mechanisms were reviewed in the present paper.
Topics: Endometriosis; Female; Humans; Infertility, Female; Iron Overload; NF-kappa B; Oocytes; Ovarian Diseases; Oxidative Stress; Pelvic Inflammatory Disease; Prostaglandins
PubMed: 26837776
DOI: No ID Found -
The New England Journal of Medicine Nov 2019
Topics: Abdominal Pain; Cholelithiasis; Female; Hepatitis; Humans; Middle Aged; Pelvic Inflammatory Disease; Peritonitis
PubMed: 31774961
DOI: 10.1056/NEJMicm1813625