Do short-term markers of treatment efficacy predict long-term sequelae of pelvic inflammatory disease?
Objective This study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease, predict sequelae of lack of pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain. Study Design Women with mild-to-modera...
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Published in | American journal of obstetrics and gynecology Vol. 198; no. 1; pp. 30.e1 - 30.e7 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
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Philadelphia, PA
Mosby, Inc
2008
Elsevier |
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Abstract | Objective This study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease, predict sequelae of lack of pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain. Study Design Women with mild-to-moderate pelvic inflammatory disease were assessed after treatment initiation at 5 days for tenderness (n = 713) and at 30 days for tenderness, cervical infections and endometritis (n = 298). Pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain were evaluated after 84 months, on average. Results Pelvic tenderness at 5 and at 30 days significantly elevated the risk for developing chronic pelvic pain; tenderness at 30 days was also significantly associated with recurrent pelvic inflammatory disease. However, pelvic tenderness at 5 and at 30 days was only modestly clinically predictive of chronic pelvic pain or recurrent pelvic inflammatory disease (positive predictive values 22.1-66.9%). No short-term marker significantly influenced the likelihood of achieving a pregnancy. Conclusion Tenderness at 5 or 30 days did not accurately predict the occurrence of pelvic inflammatory disease-related reproductive morbidities. |
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AbstractList | This study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease, predict sequelae of lack of pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain.
Women with mild-to-moderate pelvic inflammatory disease were assessed after treatment initiation at 5 days for tenderness (n = 713) and at 30 days for tenderness, cervical infections and endometritis (n = 298). Pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain were evaluated after 84 months, on average.
Pelvic tenderness at 5 and at 30 days significantly elevated the risk for developing chronic pelvic pain; tenderness at 30 days was also significantly associated with recurrent pelvic inflammatory disease. However, pelvic tenderness at 5 and at 30 days was only modestly clinically predictive of chronic pelvic pain or recurrent pelvic inflammatory disease (positive predictive values 22.1-66.9%). No short-term marker significantly influenced the likelihood of achieving a pregnancy.
Tenderness at 5 or 30 days did not accurately predict the occurrence of pelvic inflammatory disease-related reproductive morbidities. OBJECTIVEThis study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease, predict sequelae of lack of pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain.STUDY DESIGNWomen with mild-to-moderate pelvic inflammatory disease were assessed after treatment initiation at 5 days for tenderness (n = 713) and at 30 days for tenderness, cervical infections and endometritis (n = 298). Pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain were evaluated after 84 months, on average.RESULTSPelvic tenderness at 5 and at 30 days significantly elevated the risk for developing chronic pelvic pain; tenderness at 30 days was also significantly associated with recurrent pelvic inflammatory disease. However, pelvic tenderness at 5 and at 30 days was only modestly clinically predictive of chronic pelvic pain or recurrent pelvic inflammatory disease (positive predictive values 22.1-66.9%). No short-term marker significantly influenced the likelihood of achieving a pregnancy.CONCLUSIONTenderness at 5 or 30 days did not accurately predict the occurrence of pelvic inflammatory disease-related reproductive morbidities. Objective This study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease, predict sequelae of lack of pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain. Study Design Women with mild-to-moderate pelvic inflammatory disease were assessed after treatment initiation at 5 days for tenderness (n = 713) and at 30 days for tenderness, cervical infections and endometritis (n = 298). Pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain were evaluated after 84 months, on average. Results Pelvic tenderness at 5 and at 30 days significantly elevated the risk for developing chronic pelvic pain; tenderness at 30 days was also significantly associated with recurrent pelvic inflammatory disease. However, pelvic tenderness at 5 and at 30 days was only modestly clinically predictive of chronic pelvic pain or recurrent pelvic inflammatory disease (positive predictive values 22.1-66.9%). No short-term marker significantly influenced the likelihood of achieving a pregnancy. Conclusion Tenderness at 5 or 30 days did not accurately predict the occurrence of pelvic inflammatory disease-related reproductive morbidities. |
Author | Bass, Debra C., MS Kip, Kevin E., MPH, PhD Nelson, Deborah B., PhD Trout, Wayne, MD Richter, Holly E., PhD, MD Trautmann, Gail M., MA Soper, David E., MD Peipert, Jeffrey F., MD, MPH Schubeck, Dianne, MD Ness, Roberta B., MD, MPH |
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CitedBy_id | crossref_primary_10_1016_S1283_081X_23_47977_5 crossref_primary_10_1093_infdis_jiab067 crossref_primary_10_1016_j_gofs_2019_03_009 crossref_primary_10_17816_pmj36145_54 crossref_primary_10_2217_17455057_4_4_383 crossref_primary_10_1016_j_ijantimicag_2015_05_004 crossref_primary_10_1016_j_jgyn_2012_09_023 crossref_primary_10_1155_2015_547251 crossref_primary_10_1016_j_medmal_2017_01_007 crossref_primary_10_1097_01_JAA_0000460930_07543_6c |
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Keywords | treatment chronic pain adnexitis chlamydia prediction endometritis infertility recurrent pelvic inflammatory disease Short term Treatment Treatment efficiency Gynecology Prediction Biological marker Salpingitis Predictive factor Long term Obstetrics Female genital diseases Fallopian tube pathology |
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Snippet | Objective This study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease,... This study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease, predict... OBJECTIVEThis study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease,... |
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SubjectTerms | Administration, Oral adnexitis Adolescent Adult Bacterial diseases Bacterial diseases of the genital system Biological and medical sciences Cefoxitin - administration & dosage chlamydia chronic pain Dose-Response Relationship, Drug Doxycycline - administration & dosage Drug Administration Schedule Drug Therapy, Combination endometritis Female Follow-Up Studies Gynecology. Andrology. Obstetrics Human bacterial diseases Humans Infectious diseases infertility Infertility, Female Inflammation Mediators - analysis Infusions, Intravenous Medical sciences Obstetrics and Gynecology Pain Measurement Pelvic Inflammatory Disease - diagnosis Pelvic Inflammatory Disease - drug therapy prediction Predictive Value of Tests Probability Probenecid - administration & dosage Proportional Hazards Models Recurrence recurrent pelvic inflammatory disease Severity of Illness Index Time Factors treatment Treatment Outcome |
Title | Do short-term markers of treatment efficacy predict long-term sequelae of pelvic inflammatory disease? |
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