GOUT
Treatment consists of resting the elbow,
applying
ice-packs
,
and taking
analgesic
drugs
(painkillers). Severe or persistent
pain may be relieved by local injections
of a
corticosteroid drug
.
gonadal dysgenesis
Defective development of the
gonads
(the testes and ovaries). Gonadal dysge-
nesis is a feature of
Turner’s syndrome
.
gonadorelin
A medicinal version of gonadotrophin-
releasing hormone (GnRH), w hich is
naturally released by the
hypothalamus
.
GnRH stimulates the nearby pituitary
gland to secrete the two
gonadotrophin
hormones
follicle-stimulating hormone
(FSH) and luteinizing hormone (LH).
Gonadorelin can be given by injec-
tion. It is used to investigate suspected
disease of the hypothalamus.
Gonadorelin analogues are synthe-
sized forms of, and closely resemble,
gonadorelin. They cause the hypotha-
lamus to release less GnRH, and this
effect leads to a reduction in the levels
of FSH and LH. Gonadorelin analogues
are used to counter the effects of natural
hormones
during
gonadorelin
treat-
ment of
infertility.
The drugs are also used
to
treat
endometriosis
and
hormone-
dependent
cancers
including
breast
cancer
and
prostate cancer
.
gonadotrophin hormones
Hormones
that stimulate cell activity in
the
ovaries
and
testes
.
Gonadotrophins
are
essential
for
fertility.
The
most
important are follicle-stimulating hor-
mone (FSH) and luteinizing hormone
(LH), secreted by the
pituitary gland
.
Another gonadotrophin, HCG (see
gon-
adotrophin, human chorionic
) ,
is produced
by the placenta in pregnancy.
Certain gonadotrophins are used as
drugs in the treatment of
infertility
.
gonadotrophin, human
chorionic
A
hormone
produced by the
placenta
in
early
pregnancy
.
Human chorionic gon-
adotrophin (HCG) stimulates the
ovaries
to produce
oestrogen
and
progesterone
,
w hich are necessary for a healthy preg-
nancy. HCG may also be produced in
nonpregnant women by a
choriocarcino-
ma
(a cancerous tumour of the uterus),
and by some testicular tumours
(see
testis, cancer of
)
in men.
HCG is excreted in the urine; the
detection of HCG levels in urine forms
the basis of
pregnancy tests
.
HCG ex-
tracted from
the urine
of pregnant
women is given by injection to treat
certain types of
infertility
.
It may help to
induce
ovulation
in women w ho have
not been ovulating, and, in men, it may
increase
sperm
production. HCG is occa-
sionally given to prevent
miscarriage
in
women whose production of proges-
terone is deficient.
gonads
The sex glands: the testes (see
testis
)
in
men and the
ovaries
(see
ovary
)
in
women. The activities of the gonads,
both male and female, are regulated by
gonadotrophin
hormones
,
w hich
are
released by the pituitary gland.
gonorrhoea
One
of the
most
common
sexually
transmitted infections
.
Gonorrhoea
is
widespread throughout the world.
CAUSES AND INCIDENCE
Gonorrhoea, w hich is caused by the
bacterium N
e i s s e r i a
g o n o r r h o e a e
, is most
often transmitted during sexual activity,
including oral and anal sex. An infected
woman may also transmit the disease to
her baby during
childbirth
.
SYMPTOMS AND SIGNS
Gonorrhoea has an incubation period
of between two and ten days. In men,
symptoms include a discharge from the
urethra
and pain on passing urine. Many
infected women have no symptoms; if
symptoms are present, they usually con-
sist of a vaginal discharge or a burning
sensation on passing urine.
Infection acquired through anal sex
can cause gonococcal
proctitis
(inflam-
mation of the rectum and anus). Oral
sex with an infected person may lead to
gonococcal
pharyngitis
,
w hich
some-
times
causes
a sore
throat. A baby
exposed to the infection during birth
may acquire the eye infection gonoc-
occal
ophthalmia
.
COMPLICATIONS
Untreated gonorrhoea may spread to
other parts of the body. In men, it may
cause
prostatitis
(inflammation of the
prostate) or
epididymo-orchitis
(inflam-
mation of a testis and the chamber
where sperm mature), affecting fertility
In women, it causes
pelvic inflammatory
disease
,
w hich may damage the
fallopian
tubes.This problem increases the risk of
later
ectopic pregnancy
and may lead to
infertility
.
Gonococcal bacteria in
the
bloodstream may result in
septicaemia
or
septic arthritis
.
DIAGNOSIS AND TREATMENT
Tests are performed on a sample of dis-
charge or on swabs taken from the
urethra,
cervix
,
or
rectum
in order to
confirm the diagnosis.
Gonorrhoea is treated with
antibiotic
drugs
.
Treatment is effective but does
not protect against reinfection; in addi-
tion, bacterial resistance to antibiotics is
an increasing problem. The patient’s
recent sexual contacts w ill need to be
tested to establish whether or not they
are also infected (see
contact tracing
) .
Goodpasture’s syndrome
A rare
autoimmune disorder
(in which
the body’s immune system attacks its
own tissues) causing
inflammation
of the
glomeruli (see
glomerulus
)
in the kid-
neys and the alveoli (tiny air sacs) in the
lungs, as well as
anaemia
.
Goodpasture’s
syndrome is a serious disease; unless
treated early it may lead to life-threaten-
ing
bleeding
into
the
lungs
and
progressive
kidney failure
.
It
is
most
common in young men, but can devel-
op at any age and in women.
Goodpasture’s syndrome may respond
to
treatment
with
immunosuppressant
drugs
and
plasmapheresis
(a procedure
for removing unwanted antibodies from
blood plasma). People who have severe
or repeated attacks of the disorder re-
quire
dialysis
(a technique for removing
waste products from the blood) and,
ultimately, a
kidney transplant
.
GORD
The abbreviation for gastro-oesophageal
reflux disease (see
acid reflux
) .
goserelin
A synthetic drug chemically related to
the hypothalamic hormone
gonadorelin.
Goserelin is used to treat
breast cancer
,
prostate cancer
,
fibroids
,
infertility, and
endometriosis
.
Adverse effects of gosere-
lin include loss of bone density after
prolonged application.
gout
A common
metabolic disorder
that causes
attacks of
arthritis
,
usually in a single
joint (often the base of the big toe).
Gout is due to high levels of uric acid
in the blood (see
hyperuricaemia
) ;
the
arthritis is due to the deposition of uric
acid crystals in joint tissue.
The affected joint is red, swollen, and
extremely tender. Attacks last for a few
days and often recur. They are sometimes
accompanied by fever. With recurrent
G
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