151
|
Identification of Predictive Factors in Endometriosis for Improvement in Patient Quality of Life. J Minim Invasive Gynecol 2019; 27:712-720. [PMID: 31146030 DOI: 10.1016/j.jmig.2019.05.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 05/15/2019] [Accepted: 05/18/2019] [Indexed: 12/20/2022]
Abstract
STUDY OBJECTIVE To investigate predictive factors for change in quality of life (QOL) between pre- and postoperative periods in patients with endometriosis. DESIGN A prospective and multicenter cohort study. SETTING Five districts including a tertiary referral center and private and general public hospitals. PATIENTS Nine hundred eighty-one patients aged 15 to 50 years underwent laparoscopic treatment (preferred approach) for endometriosis between January 2004 and December 2012. INTERVENTIONS Laparoscopic treatment for endometriosis. All revised American Fertility Society stages were included. MEASUREMENTS AND MAIN RESULTS QOL was evaluated using the 36-Item Short Form Survey questionnaire. Factors influencing changes for each 36-Item Shorty Form Survey domain score between t0 (before surgery) and 1 year after surgery were predicted on the basis of univariate and multivariable analyses. The effect size (ES) method was used to measure changes in QOL. Univariate analysis revealed that 47% of stage IV endometriosis patients presented an improvement in the postoperative Physical Component Summary (PCS) score (ES ≥ 0.8) versus 26%, 31.3%, and 27.5% of patients with stage I, II, and III, respectively (p <.001). Forty-four percent and 38% of patients with chronic pelvic pain (CPP) presented an improvement in postoperative PCS and Mental Component Summary scores (ES>0.8) versus 23% and 24% of patients without CPP, respectively (p <.001). Multivariable analysis (ES > 0.8 vs ES < 0) revealed that women with CPP were more likely to experience greater improvement in postoperative PCS and Mental Component Summary scores than women without CPP (relative risk [RR] = 2.7; 95% confidence interval [CI], 1.7-4.4; p <.001 and RR = 1.8; 95% CI, 1.2-2.8; p <.01, respectively). Accordingly, fertile patients were more likely to show higher rates of improvement in the postoperative PCS score than infertile patients (RR = 1.8; 95% CI, 1.1-3.1; p <.05). CONCLUSION Patients presenting with severe endometriosis and who experience higher levels of pain are more likely to show improvement in QOL after surgery. CPP is the most significant independent predictive factor for changes in QOL scores.
Collapse
|
152
|
Coloma JL, Martínez‐Zamora M, Collado A, Gràcia M, Rius M, Quintas L, Carmona F. Prevalence of fibromyalgia among women with deep infiltrating endometriosis. Int J Gynaecol Obstet 2019; 146:157-163. [DOI: 10.1002/ijgo.12822] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 01/21/2019] [Accepted: 04/10/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Jose Luis Coloma
- Department of GynecologyInstitut Clínic of Gynecology, Obstetrics and NeonatologyHospital Clínic of Barcelona Barcelona Spain
| | - Maria‐Angeles Martínez‐Zamora
- Department of GynecologyInstitut Clínic of Gynecology, Obstetrics and NeonatologyHospital Clínic of Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- Faculty of MedicineUniversity of Barcelona Barcelona Spain
| | - Antonio Collado
- Service of RheumatologyInstitut Clínic d'Especialitats Mèdiques i QuirúrgiquesHospital Clínic of Barcelona Barcelona Spain
| | - Meritxell Gràcia
- Department of GynecologyInstitut Clínic of Gynecology, Obstetrics and NeonatologyHospital Clínic of Barcelona Barcelona Spain
| | - Mariona Rius
- Department of GynecologyInstitut Clínic of Gynecology, Obstetrics and NeonatologyHospital Clínic of Barcelona Barcelona Spain
| | - Lara Quintas
- Department of GynecologyInstitut Clínic of Gynecology, Obstetrics and NeonatologyHospital Clínic of Barcelona Barcelona Spain
| | - Francisco Carmona
- Department of GynecologyInstitut Clínic of Gynecology, Obstetrics and NeonatologyHospital Clínic of Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- Faculty of MedicineUniversity of Barcelona Barcelona Spain
| |
Collapse
|
153
|
Comptour A, Chauvet P, Canis M, Grémeau AS, Pouly JL, Rabischong B, Pereira B, Bourdel N. Patient Quality of Life and Symptoms after Surgical Treatment for Endometriosis. J Minim Invasive Gynecol 2019; 26:717-726. [DOI: 10.1016/j.jmig.2018.08.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 08/08/2018] [Accepted: 08/11/2018] [Indexed: 12/30/2022]
|
154
|
Abstract
OBJECTIVES To determine if pain catastrophizing is independently associated with pain health-related quality-of-life (HRQoL) in women with endometriosis, independent of potential confounders. MATERIALS AND METHODS Analysis of cross-sectional baseline data from a prospective database at a tertiary referral center for endometriosis/pelvic pain. Referrals to the center were recruited between December 2013 to April 2015, with data collected from online patient questionnaires, physical examination, and review of medical records. The primary outcome was HRQoL as measured by the 11-item pain subscale of the Endometriosis Health Profile-30 questionnaire. The Pain Catastrophizing Scale was the independent variable of interest. Other independent variables (potential confounders) included other psychological measures, pain severity, comorbid pain conditions, and social-behavioral and demographic variables. Multivariable linear regression was used to control for these potential confounders and assess independent associations with the primary outcome. RESULTS In total, 236 women were included (87% consent rate). The mean age was 35.0±7.3 years, and 98 (42%) had stage I to II endometriosis, 110 (47%) had stage III to IV endometriosis, and 28 (11%) were of unknown stage after review of operative records. Regression analysis demonstrated that higher pain catastrophizing (P<0.001), more severe chronic pelvic pain (P<0.001), more severe dysmenorrhea (P<0.001), and abdominal wall pain (positive Carnett test) (P=0.033) were independently associated with worse pain HRQoL. DISCUSSION Higher pain catastrophizing was associated with a reduced pain HRQoL in women with endometriosis at a tertiary referral center, independent of pain severity and other potential confounders.
Collapse
|
155
|
Pinot-Monange A, Moisset X, Chauvet P, Gremeau AS, Comptour A, Canis M, Pereira B, Bourdel N. Repetitive Transcranial Magnetic Stimulation Therapy (rTMS) for Endometriosis Patients with Refractory Pelvic Chronic Pain: A Pilot Study. J Clin Med 2019; 8:jcm8040508. [PMID: 31013910 PMCID: PMC6518231 DOI: 10.3390/jcm8040508] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 03/31/2019] [Accepted: 04/11/2019] [Indexed: 12/12/2022] Open
Abstract
Endometriosis concerns more than 10% of women of reproductive age, frequently leading to chronic pelvic pain. Repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) induces an analgesic effect. This effect on chronic pelvic pain is yet to be evaluated. The objective of this study was to assess the feasibility and effect of rTMS to reduce pain and improve quality of life (QoL) in patients with chronic pelvic pain due to endometriosis. This pilot, open-labelled prospective trial examined treatment by neuronavigated rTMS over M1, one session per day for 5 consecutive days. Each session consisted of 1.500 pulses at 10 Hz. We assessed tolerance, pain change and QoL until 4 weeks post treatment with a primary endpoint at day 8. Twelve women were included. No patients experienced serious adverse effects or a significant increase in pain. Nine women reported improvement on the Patient Global Impression of Change with a reduction in both pain intensity and pain interference (5.1 ± 1.4 vs. 4.1 ± 1.6, p = 0.01 and 6.2 ± 2.1 vs. 4.2 ± 1.5, p = 0.004, respectively). rTMS appears well tolerated and might be of interest for patients suffering from chronic pelvic pain for whom other treatments have failed. A randomized controlled trial is mandatory before proposing such treatment.
Collapse
Affiliation(s)
- Anne Pinot-Monange
- Department of Gynecological Surgery, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France.
| | - Xavier Moisset
- Department of Neurology, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France.
- Neuro-Dol, University of Clermont Auvergne, Inserm U1107, 63000 Clermont-Ferrand, France.
| | - Pauline Chauvet
- Department of Gynecological Surgery, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France.
| | - Anne-Sophie Gremeau
- Department of Gynecological Surgery, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France.
| | - Aurélie Comptour
- Department of Gynecological Surgery, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France.
| | - Michel Canis
- Department of Gynecological Surgery, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France.
| | - Bruno Pereira
- Biostatistics Division (DRCI), CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France.
| | - Nicolas Bourdel
- Department of Gynecological Surgery, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France.
| |
Collapse
|
156
|
Patient-reported outcome measures in benign gynecologic surgery: updates and selected tools. Curr Opin Obstet Gynecol 2019; 31:259-266. [PMID: 30973376 DOI: 10.1097/gco.0000000000000544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Use of patient-reported outcome measures in clinical practice and research is becoming more prevalent and reflects initiatives to center the patient in healthcare delivery and outcomes assessment. The purpose of this review is to provide a summary description of selected, validated tools used to assess outcomes related to several benign gynecologic conditions: abnormal uterine bleeding, fibroids and endometriosis. RECENT FINDINGS Given the availability of several validated instruments to assess patient outcomes in benign gynecology, there is still significant heterogeneity in tools used in trials. SUMMARY Patient outcomes assessment should be an integral part of clinical practice and research in order to treat the whole patient and address any health-related impacts on quality of life. More attention is needed to increase standardization of tools used in research to facilitate assessment of comparative efficacy between treatments.
Collapse
|
157
|
Zhang X, Zhang R, Chen D, Huang R, Tian Y, Zhang P, Zhang J. Association of tea drinking and dysmenorrhoea among reproductive-age women in Shanghai, China (2013-2015): a cross-sectional study. BMJ Open 2019; 9:e026643. [PMID: 30962237 PMCID: PMC6500245 DOI: 10.1136/bmjopen-2018-026643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To investigate the association between tea drinking and dysmenorrhoea among women of reproductive age. DESIGN A cross-sectional study based on Shanghai Birth Cohort Study. SETTING Two preconceptional care clinics in Shanghai, China. PARTICIPANTS 1183 women of reproductive age who sought preconceptional care were recruited from August 2013 to April 2015. PRIMARY AND SECONDARY OUTCOME MEASURES Participants were asked if they had pelvic pain associated with menstrual bleeding during the past 12 months and to further grade the intensity of menstrual cramp as mild, moderate and severe. Multinomial logistic regression was performed to assess the association of tea drinking and dysmenorrhoea. Other information, such as demographic and lifestyle factors, was also collected and assessed in relation to dysmenorrhoea. RESULTS The prevalence of dysmenorrhoea was 57.8%, among whom 10.4% and 3.5% had moderate and severe dysmenorrhoea, respectively. Tea drinking was associated with a lower prevalence of dysmenorrhoea (adjusted OR [aOR]=0.68, 95% CI 0.50 to 0.93 for mild dysmenorrhoea; aOR=0.59 (95% CI 0.32 to 1.04) for moderate-to-severe dysmenorrhoea). Green tea and oolong tea appeared to have most reduction in the prevalence of dysmenorrhoea (for mild dysmenorrhoea: green tea: aOR=0.63 (95% CI 0.44 to 0.90) and oolong tea: aOR=0.60 (95% CI 0.35 to 1.03); for moderate-to-severe dysmenorrhoea: green tea: aOR=0.42 (95% CI 0.20 to 0.85) and oolong tea: aOR=0.34 (95% CI 0.11 to 1.09)). CONCLUSIONS Consumptions of green tea and possibly oolong tea were associated with a lower prevalence of dysmenorrhoea.
Collapse
Affiliation(s)
- Xiaoyu Zhang
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Rongrong Zhang
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Department of Obstetrics and Gynecology, Shanghai, China
| | - Dan Chen
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Rong Huang
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| | - Ying Tian
- Shanghai Jiao Tong University, School of Public Health, Shanghai, China
| | - Ping Zhang
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Department of Obstetrics and Gynecology, Shanghai, China
| | - Jun Zhang
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
| |
Collapse
|
158
|
Rationale and design of a multicenter randomized trial to compare the graft patency between no-touch vein harvesting technique and conventional approach in coronary artery bypass graft surgery. Am Heart J 2019; 210:75-80. [PMID: 30743210 DOI: 10.1016/j.ahj.2018.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 11/27/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Vein graft failure is a crucial challenge in coronary artery bypass graft (CABG) surgery. Previous studies have suggested a patency benefit of the No-Touch vein harvesting technique, but only with small sample sizes. MATERIALS AND METHODS This study is a prospective, multicenter randomized clinical trial with a large sample size, aiming to investigate the efficacy of the No-Touch technique compared with the conventional approach. All patients requiring isolated CABG with left internal mammary artery plus at least one saphenous vein graft will be considered for entry into the study. Two thousand cases (1000 in each arm) will be enrolled over 1 to 2 years in 7 hospitals in China. Participants will be randomized in equal proportions between two surgical strategies: the No-Touch or conventional technique. The primary endpoint is graft vessel occlusion at 3 months after CABG surgery by CT coronary angiography. Secondary outcomes are major adverse cardiac or cerebrovascular events at 3 and 12 months post-operation and graft vessel occlusion at 1 year. DISCUSSION This study will define the role of the No-Touch vein harvesting technique in CABG surgery and provide strong evidence to answer whether this technique could reduce vein graft occlusion.
Collapse
|
159
|
Wu X, Zuo W, Liu H, Wang Z, Xu C. Decreased expression of cell polarity protein Scribble correlated with altered subcellular localization of the Crumbs homologue 3 protein in human adenomyotic endometrial cells. J Obstet Gynaecol Res 2019; 45:1148-1159. [PMID: 30912223 DOI: 10.1111/jog.13952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 02/15/2019] [Indexed: 01/10/2023]
Abstract
AIM Previous studies have revealed that loss of cell apical-basal polarity contributed to the early stages of tumorigenesis. Adenomyosis involves a down-growth and aberrant implantation of the endometrial basalis into the myometrium. This study discovered aberrant expression of polarity protein Scribble (Scrib) and Crumbs homologue 3 protein (CRB3) in epithelial cells of diffuse adenomyosis. METHODS This was a case-controlled study, including 39 patients with histologic evidence of adenomyosis, and 48 patients with carcinoma in situ of the uterine cervix without adenomyosis or endometriosis as control. Adenomyotic foci, eutopic endometrium of adenomyotic patients as well as normal endometrium were collected. Reverse Transcription Polymerase Chain Reaction (RT-PCR), Immunoreactivity, confocal microscopy and immune electron microscopy were conducted to evaluate Scribble expression and localization of Scribble and CRB3. RESULTS Scrib was screen out as an abnormally expressed polarity protein in adenomyotic eutopic endometrium (ADM-EU) at messenger RNA (mRNA) level. The ADM-EU and adenomyotic ectopic endometrium showed a significantly decreased expression of Scrib compared with normal endometrium (all P-values <0.05). Scrib decreased significantly in ADM-EU than normal endometrium only in patients at proliferative phase and with severe dysmenorrhea (P-values <0.01, P-values <0.001 respectively). In ADM-EU, Scrib expression significantly lowered in patients with severe dysmenorrhea than mild dysmenorrhea (P-values <0.05). Aberrant redistribution of CRB3 from apical to basal lateral membrane portion was also detected in experiments by confocal microscopy immune electron microscopy (all P-values <0.01). CONCLUSION Basolateral polarity protein Scrib was found decreased significantly in endometrial cells of adenomyosis at mRNA and protein level, compared with normal endometrium. Menstrual phase and severity of dysmenorrhea has an impact on Scrib expression. Scrib decrease was accompanied by aberrant redistribution of CRB3 from apical to basal lateral membrane portion.
Collapse
Affiliation(s)
- Xiaoyi Wu
- Department of Obstetrics and Gynecology of Shanghai Medical School, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Weiwen Zuo
- Department of Obstetrics and Gynecology of Shanghai Medical School, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China
| | - Haiou Liu
- Department of Obstetrics and Gynecology of Shanghai Medical School, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, People's Republic of China
| | - Zehua Wang
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, People's Republic of China
| | - Congjian Xu
- Department of Obstetrics and Gynecology of Shanghai Medical School, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, People's Republic of China
| |
Collapse
|
160
|
Carvalho N, Margatho D, Cursino K, Benetti-Pinto CL, Bahamondes L. Control of endometriosis-associated pain with etonogestrel-releasing contraceptive implant and 52-mg levonorgestrel-releasing intrauterine system: randomized clinical trial. Fertil Steril 2019; 110:1129-1136. [PMID: 30396557 DOI: 10.1016/j.fertnstert.2018.07.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 07/05/2018] [Accepted: 07/06/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To assess the efficacy of an etonogestrel (ENG)-releasing contraceptive implant or the 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS) in the control of endometriosis-associated pelvic pain. DESIGN Noninferiority randomized clinical trial in which women with endometriosis were assigned to use an ENG implant (experimental treatment) or an LNG-IUS (active comparator). Monthly follow-up visits were conducted up to 6 months. SETTING University teaching hospital. PATIENT(S) One hundred three women, with endometriosis-associated chronic pelvic pain, dysmenorrhea, or both for more than 6 months. In cases of deep endometriosis, vaginal ultrasonography and magnetic resonance imaging were used as additional diagnostic tools. INTERVENTION(S) The ENG implant or the LNG-IUS were inserted within the first 5 days of the menstrual cycle. MAIN OUTCOME MEASURE(S) Daily scores of noncyclic pelvic pain and dysmenorrhea were evaluated using a daily visual analogue scale. Health-related quality of life was evaluated using the Endometriosis Health Profile-30 questionnaire at baseline and up to 6 months. Bleeding patterns were assessed daily from a menstrual calendar. RESULT(S) Both contraceptives improved significantly the mean visual analogue scale endometriosis-associated pelvic pain and dysmenorrhea, without significant differences between treatment group profiles. Health-related quality of life improved significantly in all domains of the core and modular segments of the Endometriosis Health Profile-30 questionnaire, with no difference between both treatment groups. The most common bleeding patterns at 180 days of follow-up were amenorrhea and infrequent bleeding and infrequent bleeding and spotting among ENG implant and LNG-IUS users, respectively. CONCLUSION(S) In this noninferiority study both contraceptives improved significantly pelvic pain, dysmenorrhea, and health-related quality of life in endometriosis. CLINICAL TRIAL REGISTRATION NUMBER Clinicaltrials.gov under number NCT02480647.
Collapse
Affiliation(s)
- Nelsilene Carvalho
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Campinas, São Paolo, Brazil
| | - Deborah Margatho
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Campinas, São Paolo, Brazil
| | - Kleber Cursino
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Campinas, São Paolo, Brazil
| | - Cristina L Benetti-Pinto
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Campinas, São Paolo, Brazil
| | - Luis Bahamondes
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Campinas, São Paolo, Brazil.
| |
Collapse
|
161
|
Tao B, Liu K, Wang D, Ding M, Zhao P. Effect of Intravenous Oxycodone Versus Sufentanil on the Incidence of Postoperative Nausea and Vomiting in Patients Undergoing Gynecological Laparoscopic Surgery. J Clin Pharmacol 2019; 59:1144-1150. [PMID: 30875090 DOI: 10.1002/jcph.1408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 02/26/2019] [Indexed: 02/06/2023]
Abstract
More than 30% of patients who undergo surgery will experience postoperative nausea and vomiting (PONV) if no prophylactic treatments are used. Although numerous studies have been performed to investigate the factors related to PONV, the effect of perioperative intravenous oxycodone on the incidence of PONV has not been well investigated. In this study, gynecological patients (grade I-II, aged 18-65 years, scheduled to undergo elective gynecological laparoscopic surgery under general anesthesia) were randomized to the oxycodone group or the sufentanil group. In the oxycodone group, patients received intravenous oxycodone for the induction and maintenance of anesthesia, as well as postoperative analgesia, while sufentanil was used in the sufentanil group. The primary outcome variable was the incidence of PONV. As secondary outcomes, time to first PONV, the rating of the most severe PONV, postoperative pain scores at different time points, hemodynamics, and side effects were evaluated. We found that, compared with sufentanil, oxycodone decreased the incidence of PONV by 13.5% (P = .041). The time to first vomiting was longer in the oxycodone group than in the sufentanil group. Postoperative pain scores at different time points and hemodynamics were comparable between the oxycodone and sufentanil groups. We concluded that the incidence of PONV in gynecological patients who underwent laparoscopic surgery was lower when using intravenous oxycodone for anesthesia induction, anesthesia maintenance, and postoperative analgesia than when using intravenous sufentanil. However, oxycodone and sufentanil provided the same stable hemodynamics during surgery and satisfactory postoperative analgesia.
Collapse
Affiliation(s)
- Bingdong Tao
- Department of Anesthesiology, Shengjing Hospital, China Medical University, Shanghai, China
| | - Kun Liu
- Department of Anesthesiology, Shengjing Hospital, China Medical University, Shanghai, China
| | - Dandan Wang
- Department of Anesthesiology, Shengjing Hospital, China Medical University, Shanghai, China
| | - Mengmeng Ding
- Department of Anesthesiology, Shengjing Hospital, China Medical University, Shanghai, China
| | - Ping Zhao
- Department of Anesthesiology, Shengjing Hospital, China Medical University, Shanghai, China
| |
Collapse
|
162
|
Microablative fractional CO2 laser for the genitourinary syndrome of menopause: up to 12-month results. Menopause 2019; 26:248-255. [DOI: 10.1097/gme.0000000000001206] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
163
|
Bullo S. "I feel like I'm being stabbed by a thousand tiny men": The challenges of communicating endometriosis pain. Health (London) 2019; 24:476-492. [PMID: 30782020 DOI: 10.1177/1363459318817943] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Endometriosis, as a widespread gynecological condition, affects an estimated 1 in 10 women and yet has a worldwide average diagnosis length of 7.5 years. Causing incapacitating pain, among other associated manifestations, the condition severely impacts on women's lives. This article uses online survey data to investigate how pre-diagnosis endometriosis pain is conceptualized and articulated in order to explore communication challenges reported in early consultations that can potentially be seen to play a role in diagnosis delay. The findings of this study indicate that women feel that they do not have the appropriate tools to describe their pain and, in many instances, feel dismissed therefore prolonging diagnosis. The article finds that the majority of the pain descriptors identified use elaborate metaphorical scenarios to convey the intensity of the pain and concludes with some reflections on the issue of metaphorical language in endometriosis pain communication practices while calling for interdisciplinary work in order to devise appropriate tools for endometriosis pain communication.
Collapse
|
164
|
Yu Q, Zhang S, Li H, Wang P, Zvolanek M, Ren X, Dong L, Lang J. Dienogest for Treatment of Endometriosis in Women: A 28-Week, Open-Label, Extension Study. J Womens Health (Larchmt) 2019; 28:170-177. [PMID: 30461337 DOI: 10.1089/jwh.2018.7084] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Qi Yu
- Peking Union Medical College Hospital, Beijing, People's Republic of China
| | - Shulan Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Huajun Li
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China
| | - Ping Wang
- Department of Gynecology, Huaxi Second Hospital, Chengdu, People's Republic of China
| | | | - Xiaowei Ren
- Data Sciences & Analytics, Bayer Healthcare Co. Ltd., Beijing, People's Republic of China
| | - Liying Dong
- Research & Development, Pharmaceuticals, Bayer AG, Berlin, Germany
| | - Jinghe Lang
- Peking Union Medical College Hospital, Beijing, People's Republic of China
| |
Collapse
|
165
|
Bourdel N, Chauvet P, Billone V, Douridas G, Fauconnier A, Gerbaud L, Canis M. Systematic review of quality of life measures in patients with endometriosis. PLoS One 2019; 14:e0208464. [PMID: 30629598 PMCID: PMC6328109 DOI: 10.1371/journal.pone.0208464] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/16/2018] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Endometriosis and quality of life has been the subject of much research, however, there is little consensus on how best to evaluate quality of life in endometriosis, resulting in many and diverse scales being used. In our study, we aim to identify quality of life scales used in endometriosis, to review their strengths and weaknesses and to establish what would define an ideal scale in the evaluation of endometriosis-related quality of life. MATERIALS AND METHODS A search of the MEDLINE and EMBASE databases was carried out for publications in English and French for the period from 1980 to February 2017, using the words 'endometriosis' and 'quality of life'. Publications were selected if they reported on quality of life in patients with endometriosis and specified use of a quality of life scale. A quantitative and a qualitative analysis of each scale was performed in order to establish the strengths and weaknesses for each scale (systematic registration number: PROSPERO 2014: CRD42014014210). RESULTS A total of 1538 articles publications were initially identified. After exclusion of duplicates and application of inclusion criteria, 201 studies were selected for analysis. The SF-36, a generic HRQoL measure, was found to be the most frequently used scale, followed by the EHP-30, a measure specific to endometriosis. Both perform well, when compared with other scales, with scale weaknesses offset by strengths. EHP-5 and EQ-5D also showed to be of good quality. All four were the only scales to report on MCID studied in endometriosis patients. CONCLUSION For clinical practice, routine evaluation of HRQOL in women with endometriosis is essential both for health-care providers and patients. Both SF-36 and EHP-30 perform better overall with regard to their strengths and weaknesses when compared to other scales.
Collapse
Affiliation(s)
- Nicolas Bourdel
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
- Faculty of Medecine, ISIT-University of Auvergne, Clermont-Ferrand, France
| | - Pauline Chauvet
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
- Faculty of Medecine, ISIT-University of Auvergne, Clermont-Ferrand, France
| | - Valentina Billone
- Department of Mother and Child, University Hospital P. Giaccone, Palermo, Italy
| | - Giannis Douridas
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Arnaud Fauconnier
- Department of Gynecology and Obstetrics, Centre Hospitalier Intercommunal de Poissy-Saint-Germain-en-Laye, Poissy, EA 7285 Research Unit ‘Risk and Safety in Clinical Medicine for Women and Perinatal Health’, Versailles-Saint-Quentin University (UVSQ), Montigny-le-Bretonneux, France
| | - Laurent Gerbaud
- Dept of Public Health, PEPRADE, Université Clermont Auvergne, CHU Clermont-Ferrand, France, CNRS, SIGMA Clermont, Institut Pascal, Clermont-Ferrand, France
| | - Michel Canis
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
- Faculty of Medecine, ISIT-University of Auvergne, Clermont-Ferrand, France
| |
Collapse
|
166
|
Bolze PA, Descargues P, Poilblanc M, Cotte E, Sesques A, Paparel P, Charlot M, Hajri T, Rousset P, Golfier F. [Contribution of meb to endometriosis patients' diagnosis and treatment]. ACTA ACUST UNITED AC 2018; 47:3-10. [PMID: 30563784 DOI: 10.1016/j.gofs.2018.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Diagnosis and treatment of endometriosis may be complex and therefore justify the discussion of therapeutic decisions in a multidisciplinary endometriosis board (MEB). The development of endometriosis regional expert centers requires an assessment of the quality and relevance of MEB. METHODS Qualitiative retrospective study on patients whose management was discussed in Centre Hospitalier Lyon-Sud between June 2013 and December 2017. RESULTS Among 376 patients presented in MEB, 309 (80.2%) were painful and 184 (59.5%) had complex endometriosis. A complete clinical evaluation was performed in 120 (38.8%) patients. MRI was performed for 370 (98.4%) patients including 303 (81.9%) with a second reading by an expert radiologist. These second readings allowed a diagnosis correction in 88 (60.7 %) patients with complex endometriosis. MR enterography (27.8 %) and rectal endoscopic sonography (14.4%) were the most frequently used third-line exams to complete the initial imaging of digestive lesion in patients with rectal endometriosis. Surgery was proposed for 199 (52,9%) patients including 108 (58,7%) with complex endometriosis. CONCLUSION One of the major interests of MEB in endometriosis is the second reading of MRI, which, by identifying complex endometriosis initially undiagnosed or underestimated, enabled to better discuss the benefits/risks of therapeutic choices, and to organize complex surgeries when those were retained. The development of MEB in regional expert centers will contribute to optimizing the relevance of care for patients with endometriosis.
Collapse
Affiliation(s)
- P A Bolze
- Service de chirurgie gynécologique et oncologique - obstétrique, hospices civils de Lyon, université Claude-Bernard Lyon 1, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - P Descargues
- Service de chirurgie gynécologique et oncologique - obstétrique, hospices civils de Lyon, université Claude-Bernard Lyon 1, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
| | - M Poilblanc
- Service de chirurgie gynécologique et oncologique - obstétrique, hospices civils de Lyon, université Claude-Bernard Lyon 1, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - E Cotte
- Service de chirurgie digestive, hospices civils de Lyon, université Claude-Bernard Lyon 1, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - A Sesques
- Service de chirurgie gynécologique et oncologique - obstétrique, hospices civils de Lyon, université Claude-Bernard Lyon 1, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Service de médecine de la reproduction, hospices civils de Lyon, université Claude-Bernard Lyon 1, hôpital Femme-Mère-Enfant, 56, boulevard Pinel, 69500 Bron, France
| | - P Paparel
- Service de chirurgie urologique, hospices civils de Lyon, université Claude-Bernard Lyon 1, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - M Charlot
- Service d'imagerie médicale, hospices civils de Lyon, université Claude-Bernard Lyon 1, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - T Hajri
- Service de chirurgie gynécologique et oncologique - obstétrique, hospices civils de Lyon, université Claude-Bernard Lyon 1, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - P Rousset
- Service d'imagerie médicale, hospices civils de Lyon, université Claude-Bernard Lyon 1, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - F Golfier
- Service de chirurgie gynécologique et oncologique - obstétrique, hospices civils de Lyon, université Claude-Bernard Lyon 1, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| |
Collapse
|
167
|
ACOG Committee Opinion No. 760: Dysmenorrhea and Endometriosis in the Adolescent. Obstet Gynecol 2018; 132:e249-e258. [DOI: 10.1097/aog.0000000000002978] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
168
|
Gracia M, Alcalà M, Ferreri J, Rius M, Ros C, Saco MA, Martínez-Zamora MÁ, Carmona F. Ulipristal Acetate Improves Clinical Symptoms in Women with Adenomyosis and Uterine Myomas. J Minim Invasive Gynecol 2018; 25:1274-1280. [DOI: 10.1016/j.jmig.2018.04.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/26/2018] [Accepted: 04/02/2018] [Indexed: 11/30/2022]
|
169
|
Girling JE, Hawthorne SCJ, Marino JL, Nur Azurah AG, Grover SR, Jayasinghe YL. Paternal Understanding of Menstrual Concerns in Young Women. J Pediatr Adolesc Gynecol 2018; 31:459-467. [PMID: 29655581 DOI: 10.1016/j.jpag.2018.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/20/2018] [Accepted: 04/05/2018] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE No studies have specifically considered paternal understanding of menstruation. This study aimed to establish the degree of understanding of fathers of adolescent girls with menstrual symptoms relative to mothers. DESIGN AND SETTING This was a cross-sectional survey-based study. Adolescent patients attending an outpatient gynecology clinic for dysmenorrhea and/or heavy menstrual bleeding and their parents were invited to complete surveys. PARTICIPANTS Sixty surveys were completed (24 of 40 daughters, 20 of 40 mothers, 16 of 40 fathers). INTERVENTIONS AND MAIN OUTCOME MEASURES Surveys aimed to test parents' understanding of menstrual symptoms and potential medications, as well as fathers' concerns with their daughters' health. RESULTS The fathers' knowledge of menstrual symptoms was poorer than mothers, although most knew heavy menstrual bleeding (15/16, 94%) and mood swings (14/16, 87%). Many parents answered "don't know" or did not answer questions about potential consequences of medications, although parents were clearly concerned about side effects. Most fathers (13/16, 81%) were open to discussing menstrual concerns with daughters; however, only 54% (13/24) of daughters were open to such discussions. Of fathers, 81% (13/16) were sympathetic/concerned, 56% (9/16) felt helpless, and 13% (2/16) were frustrated when daughters were in pain. When asked about effects, 88% (14/16) of fathers (79% [15/20] of mothers) were worried about their daughter's welfare and 63% (10/16) (55% [11/20] of mothers) about schooling. CONCLUSION We present, to our knowledge, the first insight into fathers' knowledge of their daughters' menstrual health. Overall, parents have an incomplete picture of menstrual symptoms. Even in this cohort, which could be expected to be well informed because of their daughters' attendance at a tertiary hospital, it is clear that further knowledge would assist them caring for their daughters.
Collapse
Affiliation(s)
- Jane E Girling
- Gynaecology Research Centre, The University of Melbourne Department of Obstetrics and Gynaecology and Royal Women's Hospital, Melbourne, Victoria, Australia.
| | - Samuel C J Hawthorne
- Gynaecology Research Centre, The University of Melbourne Department of Obstetrics and Gynaecology and Royal Women's Hospital, Melbourne, Victoria, Australia; Department of Gynaecology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Jennifer L Marino
- Gynaecology Research Centre, The University of Melbourne Department of Obstetrics and Gynaecology and Royal Women's Hospital, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Abdul G Nur Azurah
- Department of Obstetrics and Gynaecology, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Sonia R Grover
- Department of Gynaecology, Royal Children's Hospital, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia; Department of Obstetrics and Gynaecology, UKM Medical Centre, Kuala Lumpur, Malaysia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Yasmin L Jayasinghe
- Gynaecology Research Centre, The University of Melbourne Department of Obstetrics and Gynaecology and Royal Women's Hospital, Melbourne, Victoria, Australia; Department of Gynaecology, Royal Children's Hospital, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| |
Collapse
|
170
|
Liang Y, Liu D, Yang F, Pan W, Zeng F, Wu J, Xie H, Li J, Yao S. Perineural invasion in endometriotic lesions contributes to endometriosis-associated pain. J Pain Res 2018; 11:1999-2009. [PMID: 30310304 PMCID: PMC6165785 DOI: 10.2147/jpr.s168715] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose Recent studies have shown that abnormal distribution of pelvic nerves contributes to endometriosis-associated pain. However, the relationship between neurogenesis and pain severity in endometriosis still remains uncertain, which makes it an enigma for both gynecologists as well as neuropathologists. In this study, we tried to explore a special phenomenon, perineural invasion (PNI), in deep infiltrating endometriosis (DIE) and investigated the correlation between PNI- and DIE-associated pain. Patients and methods The study was conducted in the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Sun Yat-sen University from June 2012 to January 2015. In total, 64 patients with DIE were enrolled. They received laparoscopically surgical resection of endometriotic lesions. The Kruskal–Wallis and Mann–Whitney tests were used for comparisons of enumeration data. Spearman rank correlation was used for linear analysis. Results Immunohistochemical analysis demonstrated that PNI was commonly found in DIE lesions. Patients were divided into PNI (+) group and PNI (−) group. The visual analog scale scores of dysmenorrhea, dyspareunia, and chronic pelvic pain were higher in PNI (+) group than in PNI (−) group. Also, we found significantly increased density of newly formed nerve fibers as well as microvessels in lesions of PNI (+) group. Further, double immunofluorescence showed a closely spatial nerve–vessel network in the endometriotic lesion of PNI (+) group. More importantly, correlation analysis revealed positive relation between the density of newly formed nerve fibers in the lesion and the density of microvessels in lesions of PNI (+) group. Conclusion This study suggests that PNI in endometriotic lesions plays an important role in endometriosis-associated pain, mainly through a mechanism named “neuroangiogenesis”.
Collapse
Affiliation(s)
- Yanchun Liang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China,
| | - Duo Liu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China,
| | - Fan Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China,
| | - Wenwei Pan
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China,
| | - Feitianzhi Zeng
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China,
| | - Jinjie Wu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Hongyu Xie
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Jiaying Li
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Shuzhong Yao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China,
| |
Collapse
|
171
|
Interrelationships among endometriosis-related pain symptoms and their effects on health-related quality of life: a sectional observational study. Obstet Gynecol Sci 2018; 61:605-614. [PMID: 30254997 PMCID: PMC6137011 DOI: 10.5468/ogs.2018.61.5.605] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 12/18/2017] [Accepted: 01/03/2018] [Indexed: 11/08/2022] Open
Abstract
Objective To assess the correlation between different pain symptoms and different domains of women's health-related quality of life (HRQoL). Methods Seventy-seven women with deep infiltrating endometriosis were successively enrolled between June 2011 and August 2013 while being prepared to undergo laparoscopy due to pain and/or infertility. We quantified the intensities of dysmenorrhea, deep dyspareunia, chronic pelvic pain, and dyschezia (menstrual and non-menstrual) using a 11-point visual analog scale (VAS: 0-10) and the validated full versions of the Short Form 36 (SF36) and Endometriosis Health Profile (EHP30) questionnaires to assess HRQoL. The pain symptoms were considered simultaneously in a hierarchical agglomerative clustering method (exploratory multivariate approach) and the associations among scores were tested by bivariate correlation. Results Dysmenorrhea showed the lowest similarity on to the multivariate cluster analysis and no statistically significant correlation with the other pain symptoms: deep dyspareunia (P=0.244), chronic pelvic pain (P=0.108), menstrual dyschezia (P=0.238), and non-menstrual dyschezia (P=0.380). Dysmenorrhea and chronic pelvic pain were the main symptoms correlated with all domains of the SF36 and the EHP30 (core instrument) questionnaires (P<0.05). Conclusion Dysmenorrhea and chronic pelvic pain were independent factors associated with HRQoL.
Collapse
|
172
|
Fernández-Martínez E, Onieva-Zafra MD, Parra-Fernández ML. Lifestyle and prevalence of dysmenorrhea among Spanish female university students. PLoS One 2018; 13:e0201894. [PMID: 30096156 PMCID: PMC6086430 DOI: 10.1371/journal.pone.0201894] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 07/24/2018] [Indexed: 01/02/2023] Open
Abstract
The aim of this study was to determine the prevalence of primary dysmenorrhea in a sample of Spanish university students, and to describe their menstrual characteristics, lifestyle habits and associated risk factors. This cross-sectional study was conducted with a total of 258 young female university students recruited from the Ciudad Real Faculty of Nursing, with a mean age of 20.63± 3.32 years. An anonymous self-report questionnaire was used to collect data from students. This included sociodemographic characteristics, lifestyle habits, gynecological personal history and the severity of pain using the visual analogue scale. The statistical analysis of the data included calculation of the mean, percentages, chi-square analysis of the data and logistic regression. The prevalence of dysmenorrhea was of 74.8% (n = 193) with a mean pain severity of 6.88 (±1.71). Our results show that 38.3% of students described their menstrual pain as severe and 58% as moderate. The bivariate analysis showed statistically significant differences between students with and without dysmenorrhea: a higher proportion of women with dysmenorrhea had a greater duration of the menstruation flow (p = .003), a longer duration of the menstrual cycle (p = .046), were not using the oral contraceptive pill (p = .026) and had a family history of dysmenorrhea (p = .001). Backward step-wise binary logistic regression analysis using all the significant bivariate variables including lifestyle variables revealed the following risk factors: drinking cola drinks, duration of the menstrual flow, eating meat and having a first-degree relative affected by dysmenorrhea.
Collapse
Affiliation(s)
- Elia Fernández-Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Ciudad Real, Spain
| | - María Dolores Onieva-Zafra
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Ciudad Real, Spain
| | - María Laura Parra-Fernández
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Ciudad Real, Spain
| |
Collapse
|
173
|
Abou-Al-Shaar H, Adogwa O, Mehta AI. Lumbar Spinal Stenosis: Objective Measurement Scales and Ambulatory Status. Asian Spine J 2018; 12:765-774. [PMID: 30060388 PMCID: PMC6068421 DOI: 10.31616/asj.2018.12.4.765] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 07/13/2017] [Accepted: 07/16/2017] [Indexed: 11/23/2022] Open
Abstract
Lumbar spinal stenosis (LSS) is one of the most common affecting the elderly population that may lead to loss of function and the inability to execute basic activities of daily living. While surgical decompression remains the standard of care, choosing an optimal management strategy is usually guided by a set of clinical, radiological, and measurement indices. However, to date, there is a major uncertainty and discrepancy regarding the methodology used. There is also inconsistent adoption of outcome measures across studies, which may result in huge limitations in predicting the efficacy and cost-effectiveness of different treatment paradigms. Herein, we review the various measurement indices used for outcome assessment among patients with LSS, and delineate the major advantages and disadvantages of each index. We call for the development of a single objective outcome measure that encompasses and addresses all issues encountered in this heterogeneous group of patients, including monitoring the patient's progression after treatment.
Collapse
Affiliation(s)
- Hussam Abou-Al-Shaar
- Department of Neurosurgery, Hofstra Northwell School of Medicine, Manhasset, NY, USA
| | - Owoicho Adogwa
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Ankit I. Mehta
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|
174
|
Jensen JT, Schlaff W, Gordon K. Use of combined hormonal contraceptives for the treatment of endometriosis-related pain: a systematic review of the evidence. Fertil Steril 2018; 110:137-152.e1. [DOI: 10.1016/j.fertnstert.2018.03.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 03/08/2018] [Accepted: 03/12/2018] [Indexed: 10/28/2022]
|
175
|
Chauvet P, Guiguet-Auclair C, Comptour A, Denouël A, Gerbaud L, Canis M, Bourdel N. Feelings and expectations in endometriosis: Analysis of open comments from a cohort of endometriosis patients. J Gynecol Obstet Hum Reprod 2018; 47:281-287. [PMID: 29807206 DOI: 10.1016/j.jogoh.2018.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/20/2018] [Accepted: 05/23/2018] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Endometriosis symptoms may have a negative effect on health-related quality of life (HRQoL). Analyses of open comments are known to be a key source of information and support. The authors aimed to analyse open comments associated with a validation scale study, in order to ascertain whether the questionnaires allowed an adequate exploration of patient preoccupations and in so doing define important quality of life themes not assessed in HRQoL scales. MATERIAL AND METHODS Analysis of open comments, following two questionnaires (SF-36 and EHP-30) as part of a national study evaluating the EHP-30, was performed. Questionnaires were distributed online, via a link to the RedCap Internet platform. The association EndoFrance, a support group for endometriosis patients, notified women of the launching of the study. Women were asked to complete the questionnaire and had the opportunity to comment. Comments were gathered, coded systematically, and categorised by theme. RESULTS Of the 1156 women who responded to the questionnaire, 913 (79.0%) declared having a confirmed surgical diagnosis of endometriosis, and 265 comments were analysed. Comments were classified in 20 themes. Correspondence between the themes and items for both questionnaires and the open comments was investigated for all topics, including those non-addressed by the questionnaires. 8 themes are not mentioned in both questionnaires, 9 themes are covered by EHP-30, two by SF-36 and only one by both. CONCLUSION Anonymous data collection and subsequent analysis proves to be an effective and practical way of obtaining patient opinion on their pathology. Analysis of comments may provide additional and useful information to the classical HRQoL Scale.
Collapse
Affiliation(s)
- Pauline Chauvet
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, place Lucie Aubrac, 63100 Clermont-Ferrand, France; Faculty of Medicine, ISIT-University of Auvergne, place Henri Dunant, 63000 Clermont-Ferrand, France
| | - Candy Guiguet-Auclair
- Department of Public Health, PEPRADE, Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, 63000 Clermont-Ferrand, France
| | - Aurélie Comptour
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, place Lucie Aubrac, 63100 Clermont-Ferrand, France
| | - Amélie Denouël
- EndoFrance, 01120 Montluel, France; Research and Innovation Department, Montpellier University Hospital, 34090 Montpellier, France
| | - Laurent Gerbaud
- Department of Public Health, PEPRADE, Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, 63000 Clermont-Ferrand, France
| | - Michel Canis
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, place Lucie Aubrac, 63100 Clermont-Ferrand, France; Faculty of Medicine, ISIT-University of Auvergne, place Henri Dunant, 63000 Clermont-Ferrand, France
| | - Nicolas Bourdel
- Department of Gynaecological Surgery, Clermont-Ferrand University Hospital, place Lucie Aubrac, 63100 Clermont-Ferrand, France; Faculty of Medicine, ISIT-University of Auvergne, place Henri Dunant, 63000 Clermont-Ferrand, France.
| |
Collapse
|
176
|
Munrós J, Martínez-Zamora MA, Tàssies D, Reverter JC, Rius M, Gracia M, Ros C, Carmona F. Total Circulating Microparticle Levels After Laparoscopic Surgical Treatment for Endometrioma: A Pilot, Prospective, Randomized Study Comparing Stripping with CO 2 Laser Vaporization. J Minim Invasive Gynecol 2018; 26:450-455. [PMID: 29803597 DOI: 10.1016/j.jmig.2018.05.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/10/2018] [Accepted: 05/17/2018] [Indexed: 01/17/2023]
Abstract
STUDY OBJECTIVE To evaluate serial generation of microparticles (MPs) after laparoscopic stripping or CO2 laser vaporization in the surgical treatment of patients with ovarian endometrioma (OE). DESIGN A prospective, randomized, blinded, pilot study (Canadian Task Force classification I). SETTING Tertiary care university hospital from December 2014 to July 2016. PATIENTS Thirty women with unilateral OE undergoing laparoscopic surgery. INTERVENTION Patients were randomly selected to undergo either CO2 laser vaporization (L group) or laparoscopic stripping (S group) of OE. MEASUREMENTS AND MAIN RESULTS Blood samples were collected before surgery and at 2 hours, 24 hours, 1 month, and 3 months after surgery. An MP generation curve after OE surgery was created. MP generation was greater in the S group than in the L group at all time points evaluated. The MP generation curve showed a significantly higher area under the curve after excisional surgery (p <.05). CONCLUSION The higher MP levels in the S group suggest an increased inflammation and procoagulant response after this procedure.
Collapse
Affiliation(s)
- Jordina Munrós
- Department of Gynecology, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clinic of Barcelona, Faculty of Medicine, University of Barcelona, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Maria-Angeles Martínez-Zamora
- Department of Gynecology, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clinic of Barcelona, Faculty of Medicine, University of Barcelona, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Dolors Tàssies
- Department of Hemotherapy and Hemostasis, Hospital Clinic of Barcelona, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Juan Carlos Reverter
- Department of Hemotherapy and Hemostasis, Hospital Clinic of Barcelona, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Mariona Rius
- Department of Gynecology, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clinic of Barcelona, Faculty of Medicine, University of Barcelona, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Meritxell Gracia
- Department of Gynecology, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clinic of Barcelona, Faculty of Medicine, University of Barcelona, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Cristina Ros
- Department of Gynecology, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clinic of Barcelona, Faculty of Medicine, University of Barcelona, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Francisco Carmona
- Department of Gynecology, Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clinic of Barcelona, Faculty of Medicine, University of Barcelona, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| |
Collapse
|
177
|
Chyung SYY, Swanson I, Roberts K, Hankinson A. Evidence-Based Survey Design: The Use of Continuous Rating Scales in Surveys. ACTA ACUST UNITED AC 2018. [DOI: 10.1002/pfi.21763] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | | | - Andrea Hankinson
- Public Service Commission, Government of Alberta; 10011 109 St NW Edmonton AB T5J 3S8
| |
Collapse
|
178
|
Gaubeca-Gilarranz A, Fernández-de-Las-Peñas C, Medina-Torres JR, Seoane-Ruiz JM, Company-Palonés A, Cleland JA, Arias-Buría JL. Effectiveness of dry needling of rectus abdominis trigger points for the treatment of primary dysmenorrhoea: a randomised parallel-group trial. Acupunct Med 2018; 36:302-310. [PMID: 29720379 DOI: 10.1136/acupmed-2017-011566] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To compare the effectiveness of trigger point dry needling (TrP-DN) versus placebo needling, relative to an untreated control group, on pain and quality of life in primary dysmenorrhoea. METHODS In this randomised, single blind, parallel-group trial, 56 females with primary dysmenorrhoea were randomly allocated to TrP-DN (n=19), placebo needling (n=18) or no treatment (n=19). Patients in both groups were asked to undertake a stretching exercise of the rectus abdominis daily. The needling group received a single session of TrP-DN to trigger points (TrPs) in the rectus abdominis, and the placebo group received placebo needling. The primary outcome was pain intensity (visual analogue scale). Secondary outcomes were quality of life, use of non-steroidal anti-inflammatory drugs, the number of days with pain, and self-perceived improvement, measured using a Global Rate of Change. Outcomes were assessed at baseline, and 1 and 2 months after the treatment. RESULTS Females receiving TrP-DN exhibited greater decreases (P<0.001) in pain than those receiving placebo (1 month: Δ-19.8 mm, 25.9 to -13.7; 2 months: Δ-26.0 mm, -33.1 to -18.9) or assigned to the untreated control group (1 month: Δ-26.0mm, -32.5 to -19.5; 2 months: Δ-20.1 mm, -26.4 to -13.8). Females in the TrP-DN group also exhibited a greater decrease in the amount of medications (P<0.001). No differences in the number of days with pain or quality of life were found (all P>0.1). CONCLUSIONS This trial suggests that a single session of TrP-DN of the rectus abdominis combined with stretching was more effective than placebo needling and stretching alone at reducing pain and the amount of medication used in primary dysmenorrhoea. TRIAL REGISTRATION NUMBER ACTRN12616000170426 .
Collapse
Affiliation(s)
| | - César Fernández-de-Las-Peñas
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcon, Spain.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | | | | | | | - Joshua A Cleland
- Department of Physical Therapy, Franklin Pierce University, Manchester, New Hampshire, USA.,Physical Therapist, Rehabilitation Servicesv, Concord Hospital, Concord, New Hampshire, USA.,Faculty, Manual Therapy Fellowship Program, Regis University, Denver, Colorado, USA
| | - Jose L Arias-Buría
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcon, Spain.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| |
Collapse
|
179
|
Karafotias G, Korres G, Teranishi A, Park W, Eid M, Karafotias G, Korres G, Teranishi A, Eid M, Teranishi A, Korres G, Park W, Karafotias G, Eid M. Mid-Air Tactile Stimulation for Pain Distraction. IEEE TRANSACTIONS ON HAPTICS 2018; 11:185-191. [PMID: 29911977 DOI: 10.1109/toh.2017.2781693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Using the human sense of touch, pain control has been studied for decades. With the rise of Virtual Reality (VR) and haptic technologies, creating VR and haptic sensations provide a unique opportunity for pain distraction. In this paper, we present an experimental study to test whether VR and mid-air ultrasound tactile stimulation reduce perceived pain simulated via the cold pressor test, i.e., submerging a human hand in cold water (2 C) for as long as the test subject can. Fifty right-handed subjects participated in the study and three tasks were considered: task 1 involved experiencing the cold pressor test with no distraction (considered as the control task), task 2 involved playing a simple VR game with no tactile feedback, and task 3 utilized the same VR game with tactile feedback; tasks 2 and 3 were assigned in random order after task 1. The tolerance time, perceived pain rating, and quality of experience were evaluated and compared for the three tasks. Results demonstrated that when a VR task involves physical (touch) interaction, tactile stimulation plays a significant role in increasing pain tolerance time. Furthermore, the study demonstrated that for high pain tolerance participants, tactile stimulation is more effective for pain distraction compared to low pain tolerance participants. Although there are no significant differences in perceived pain and quality of experience between VR and VR+Tactile tasks, there are significant differences in tolerance time (Wilcox signed rank test, p 0.05). It is presumed that VR and the tactile stimulation induces positive emotions when utilized (for both valence and arousal).
Collapse
|
180
|
Huchon C, Aubry G, Ploteau S, Fauconnier A. [Specific clinical signs suggestive of endometriosis (excluding adenomyosis) and questionnaires of symptoms, pain and quality of life: CNGOF-HAS Endometriosis Guidelines]. ACTA ACUST UNITED AC 2018. [PMID: 29530559 DOI: 10.1016/j.gofs.2018.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In case of consultation for chronic pelvic pain or suspicion of endometriosis, it is recommended to evaluate the pain (intensity, resonance) and to search out the evocative and localizing symptoms of endometriosis (Grade B). The main symptoms suggestive of endometriosis are: severe dysmenorrhea (NP2), deep dyspareunia (NP2), painful defecation during menstruation (NP2), urinary tract symptoms during menstruation (NP2) and infertility (NP2). In patients with chronic pelvic pain, it is recommended to search deep infiltrating endometriosis in patients with painful defecation during menstruation or severe deep dyspareunia (Grade B). It is recommended to search symptoms suggestive of sensitization in painful patients with endometriosis (Grade B). When suggestive symptoms of endometriosis are present, a directed gynecological examination is recommended, where possible, including examination of the posterior vaginal cul-de-sac (Grade C). In assessing pain intensity or evaluating analgesic effectiveness of a treatment, it is recommended to use a scale to measure the intensity of pain (Grade A). In the management of symptomatic endometriosis, it is recommended to evaluate the quality of life (Grade C).
Collapse
Affiliation(s)
- C Huchon
- Service de gynécologie & obstétrique, CHI Poissy-St-Germain-en-Laye, Université Versailles-Saint-Quentin en Yvelines, 10, rue du champ Gaillard, BP 3082, 78303 Poissy cedex, France.
| | - G Aubry
- Service de gynécologie-obstétrique, CHI Poissy-St-Germain, 10, rue du Champ-Gaillard, 78303 Poissy, France
| | - S Ploteau
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Mère-Enfant, CHU de Nantes, 8, boulevard Jean-Monnet, 44093 Nantes, France
| | - A Fauconnier
- Service de gynécologie & obstétrique, CHI Poissy-St-Germain-en-Laye, Université Versailles-Saint-Quentin en Yvelines, 10, rue du champ Gaillard, BP 3082, 78303 Poissy cedex, France
| |
Collapse
|
181
|
Wattier JM. [Conventional analgesics and non-pharmacological multidisciplinary therapeutic treatment in endometriosis: CNGOF-HAS Endometriosis Guidelines]. ACTA ACUST UNITED AC 2018; 46:248-255. [PMID: 29510963 DOI: 10.1016/j.gofs.2018.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Indexed: 12/24/2022]
Abstract
A major symptom of endometriosis is pelvic pain with a wide range of intensity, rhythm, type, and expression, without clearly established relationship between pain and the disease. Endometriosis-associated pain has physical, psychological/behavioral and social consequences with a significant impact on patient quality-of-life in relation with the biopsychosocial model of chronic pain. Pain assessment in all of its dimensions, as well as assessing the consequences of pain is therefore a crucial part of therapeutic management. Conventional analgesics are commonly used although studies demonstrating their efficacy in the treatment of endometriosis-related pelvic pain are lacking. Non-steroid anti-inflammatory drugs (NSAIDs), known to be effective in dysmenorrhea unrelated to endometriosis, have not been recently re-assessed in patients with endometriosis. Following rigorous assessment, the characterization of neuropathic components of endometriosis-related pelvic pain may lead to treatment with antiepileptic of antidepressant drugs, although gabapentin and amitriptyline have yet to be specifically assessed in the setting of endometriosis-related pain. Other pharmacologically active compounds have been tested to treat endometriosis-related pain but did not demonstrate efficacy with sufficient level of evidence. Diets, dietary supplements and herbal medicine are often proposed and/or used as adjuncts without any conclusive evidence. Although the effects on endometriosis-related pain are methodologically difficult to assess, physical adjunctive therapies such as acupuncture, transcutaneous neurostimulation, osteopathy/chiropractics, physical therapy and physical activity, the long-term therapeutic relationship they establish may potentiate beneficial effects perceived by patients. However, it remains difficult to demonstrate significant effects of cognitive and/or behavioral interventions on endometriosis-related pain. CONCLUSION The complexity of managing endometriosis-related pain requires a holistic approach with sustained attention to the patient. Treatments, either pharmacologic or non-pharmacologic, including adjuvant therapies, associate a technical expertise to which a human approach must be added in order to bring value to these treatments. Multidisciplinary and/or inter disciplinary approaches are therefore essential to the care of patients suffering from endometriosis.
Collapse
Affiliation(s)
- J-M Wattier
- Centre d'étude et traitement de la douleur, hôpital Claude-Huriez, CHRU de Lille, rue Michel-Polonowski, 59000 Lille, France.
| |
Collapse
|
182
|
Chen CX, Draucker CB, Carpenter JS. What women say about their dysmenorrhea: a qualitative thematic analysis. BMC WOMENS HEALTH 2018; 18:47. [PMID: 29499683 PMCID: PMC5833075 DOI: 10.1186/s12905-018-0538-8] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 02/21/2018] [Indexed: 12/28/2022]
Abstract
Background Dysmenorrhea is highly prevalent and is the leading cause of absence from school and work among women of reproductive age. Evidence suggests that dysmenorrhea may also be a risk factor for other chronic pain conditions. Limited research has examined women’s experience with dysmenorrhea using qualitative data. Research is warranted to address issues and needs that are important from women’s own perspectives. Therefore, the purpose of this study was to describe women’s salient thoughts about their experiences of dysmenorrhea. Methods We analyzed data collected from an open-ended question within a cross-sectional survey study conducted in the United States. Using qualitative thematic analysis, free text responses to a question asking women to share their experience with dysmenorrhea were analyzed. Results The sample consisted of 225 women who provided valid responses to the open-ended question. Six themes were identified: (1) The dysmenorrhea symptom experience varied among women; (2) The dysmenorrhea symptom experience varied across time, (3) A variety of factors influenced the dysmenorrhea symptom experience, (4) Dysmenorrhea symptoms could have a negative impact on the women’s daily lives, (5) Dysmenorrhea was not seen as a legitimate health issue by the women, health care providers, or society, and (6) Treatment for women with dysmenorrhea varied in acceptability and effectiveness. Conclusions The findings of this study have important implications for dysmenorrhea symptom assessment and the development of personalized interventions to support dysmenorrhea management.
Collapse
Affiliation(s)
- Chen X Chen
- Indiana University School of Nursing, 600 Barnhill Drive, NU E415, Indianapolis, IN, 46202, USA.
| | - Claire B Draucker
- Indiana University School of Nursing, 600 Barnhill Drive, NU E415, Indianapolis, IN, 46202, USA
| | - Janet S Carpenter
- Indiana University School of Nursing, 600 Barnhill Drive, NU E415, Indianapolis, IN, 46202, USA
| |
Collapse
|
183
|
Signorile PG, Viceconte R, Baldi A. Novel dietary supplement association reduces symptoms in endometriosis patients. J Cell Physiol 2018; 233:5920-5925. [PMID: 29243819 DOI: 10.1002/jcp.26401] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/11/2017] [Indexed: 12/22/2022]
Abstract
Endometriosis is characterized by disabling symptoms that afflict young women with severe physical discomfort, difficulty in relationship life, and infertility; however, the currently available therapeutic strategies are unsatisfactory. Goal of this research was to identify a new combination of natural active ingredients that, administered as dietary supplements, could have the effect of reducing inflammatory response in endometriosis patients, decreasing the symptoms the disease produces and its harmful effects on affected organs. A cohort of endometriosis patient was treated for 3 months with a composition including quercitin, curcumin, parthenium, nicotinamide, 5-methyltetrahydrofolate, and omega 3/6. Using a VAS scale, we demonstrated a significant reduction of the symptoms in endometriosis patients treated with the dietary composition respect to the controls. Moreover, we demonstrated also a significant reduction in the serum levels of PGE2 and CA-125. Further study are required to compare the effect of this combination of molecules with standard therapies and to evaluate if the use of these dietary supplements in combination with standard therapies may lead to the improvement of the regular medical treatment for endometriosis.
Collapse
Affiliation(s)
| | | | - Alfonso Baldi
- Italian Endometriosis Foundation, Formello, Rome, Italy.,Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli,", Caserta, Italy
| |
Collapse
|
184
|
Munrós J, Tàssies D, Reverter JC, Martin L, Pérez A, Carmona F, Martínez-Zamora MÁ. Circulating Neutrophil Extracellular Traps Are Elevated in Patients With Deep Infiltrating Endometriosis. Reprod Sci 2018; 26:70-76. [PMID: 29448896 DOI: 10.1177/1933719118757682] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Neutrophil extracellular traps (NETs) have been described to be related to the pathogenesis of inflammatory and autoimmune conditions. Endometriosis is currently considered a chronic inflammatory condition. Therefore, we performed a preliminary case-control study to compare the circulating plasma NET levels in patients with surgically confirmed endometriosis (E group, n = 82) and those of patients without surgical findings of endometriosis (C group, n = 35). Venous blood samples were obtained at the time of surgery. Circulating plasma NET levels were assessed as histone-DNA complexes (ie, nucleosomes) by a quantitative sandwich enzyme-linked immunosorbent assay. The results were expressed in arbitrary units. Circulating plasma NET levels were significantly higher in the E group compared with the C group (median [25th; 75th percentiles]): E group: 0.734 [0.484; 1.363]; C group: 0.541 [0.411; 0.653]; P = .005). The subanalysis of E group patients with deep infiltrating endometriosis (DIE group) or without DIE (non-DIE group) showed that plasma NET levels were higher in the DIE group ( P = .02). No differences were observed in NET levels among patients with and without severe pelvic pain or in patients with and without infertility, regardless of the presence of endometriotic lesions. Therefore, our study shows significantly higher NET levels in patients with endometriosis, which seem to be attributed to increased levels in the subgroup of patients with DIE, suggesting that the presence of elevated circulating plasma NET levels may reflect an inflammatory status in this gynecological condition. Further research is warranted to confirm our findings and to assess the exact role of NETs in the pathophysiological mechanisms of endometriosis.
Collapse
Affiliation(s)
- Jordina Munrós
- 1 Department of Gynaecology, Institut Clínic of Gynaecology, Obstetrics and Neonatology, Hospital Clínic of Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, Villarroel, 170, Barcelona, Spain
| | - Dolors Tàssies
- 2 Department of Hemotherapy and Hemostasis, Hospital Clínic of Barcelona, Villarroel, 170, Barcelona, Spain
| | - Joan Carles Reverter
- 2 Department of Hemotherapy and Hemostasis, Hospital Clínic of Barcelona, Villarroel, 170, Barcelona, Spain
| | - Lidia Martin
- 2 Department of Hemotherapy and Hemostasis, Hospital Clínic of Barcelona, Villarroel, 170, Barcelona, Spain
| | - Amelia Pérez
- 1 Department of Gynaecology, Institut Clínic of Gynaecology, Obstetrics and Neonatology, Hospital Clínic of Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, Villarroel, 170, Barcelona, Spain
| | - Francisco Carmona
- 1 Department of Gynaecology, Institut Clínic of Gynaecology, Obstetrics and Neonatology, Hospital Clínic of Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, Villarroel, 170, Barcelona, Spain
| | - María Ángeles Martínez-Zamora
- 1 Department of Gynaecology, Institut Clínic of Gynaecology, Obstetrics and Neonatology, Hospital Clínic of Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, Villarroel, 170, Barcelona, Spain
| |
Collapse
|
185
|
Pelvic Pain and Quality of Life Before and After Laparoscopic Bowel Resection for Rectosigmoid Endometriosis: A Prospective, Observational Study. Dis Colon Rectum 2018; 61:221-229. [PMID: 29337778 DOI: 10.1097/dcr.0000000000000970] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Surgery for rectosigmoid endometriosis carries a substantial risk of short- and long-term complications, which has to be counterbalanced against the potential effect of the procedure. Prospective data are scarce in the field of deep infiltrating endometriosis surgery. OBJECTIVE The study aimed to assess pelvic pain and quality of life before and after laparoscopic bowel resection for rectosigmoid endometriosis. DESIGN The study involved prospectively collected data regarding pelvic pain and quality of life before and after surgery. SETTINGS It was conducted at a tertiary endometriosis referral unit at Aarhus University Hospital. PATIENTS A total of 175 women were included. INTERVENTION Patients underwent laparoscopic bowel resection for endometriosis. MAIN OUTCOME MEASURES Questionnaires for pain (Numerical Rating Scale) and quality of life (RAND Short Form-36) were answered before and 1 year after surgery. Data on analgesic and hormone treatment were collected. Preoperative and postoperative pelvic pain and quality-of-life scores were compared, and risk factors for improvement/worsening were identified. RESULTS A total of 97.1% of the women completed the 1-year follow up. A significant decrease (p = 0.0001) was observed on all pelvic pain parameters. Most profound was the decrease in dyschezia. A significant improvement on all quality-of-life scores was observed (p = 0.0001). A surgical complication did not have a negative impact on outcome 1 year after surgery. The postoperative outcome was not related to the type of surgery. LIMITATIONS This is an observational study without a control group. Risk factor data should be interpreted with caution, because the study was relatively underpowered for some of the rare outcomes. CONCLUSIONS A significant and clinically relevant improvement in pelvic pain and quality of life 1 year after laparoscopic bowel resection for endometriosis was found. We strongly recommend surgery for rectosigmoid endometriosis that is unresponsive to conservative treatment. See Video Abstract at http://links.lww.com/DCR/A472.
Collapse
|
186
|
Cozzolino M, Magro-Malosso ER, Tofani L, Coccia ME. Evaluation of sexual function in women with deep infiltrating endometriosis. SEXUAL & REPRODUCTIVE HEALTHCARE 2018; 16:6-9. [PMID: 29804777 DOI: 10.1016/j.srhc.2017.12.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 12/19/2017] [Accepted: 12/31/2017] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The influence of deep infiltrating endometriosis (DIE) on sexual function has been poorly studied. The aim of this study was to evaluate the impact of DIE on sexual function by administering questionnaires to women. METHODS Women with a clinical and ultrasound diagnosis of DIE and histological confirmation of endometriosis were included in the study. In interview, women were asked to rate five pain symptoms, dysmenorrhea, dyspareunia, dyschezia, dysuria and Cronic Pelvic Pain (CPP), on a visual analogue scale (VAS), and sexual function was assessed using the Female Sexual Function Index (FSFI). RESULTS A total of 170 women with DIE were identified. A VAS score of 7 or more was taken to indicate that a symptom was 'severe'. Dysmenorrhea was reported to be severe by 66.5% of the sample, dyspareunia by 41.8%, dyschezia by 32.4% and dysuria by 6.5%. Mean FSFI scores did not differ significantly between women with and without endometriosis lesions at particular sites, except for rectovaginal nodules, which were found to be associated with more impaired sexual activity and sexual function. CONCLUSIONS Women with DIE had significant impairment of sexual activity when a partial or total infiltration of the rectovaginal septum occurred. Particular attention should be given to women with this kind of lesion.
Collapse
Affiliation(s)
- Mauro Cozzolino
- Department of Biomedical, Experimental and Clinical Sciences - Division of Obstetrics and Gynecology, University of Florence, Italy; Instituto Valenciano de Infertilidad - IVI Madrid, Madrid, Spain.
| | - Elena Rita Magro-Malosso
- Department of Biomedical, Experimental and Clinical Sciences - Division of Obstetrics and Gynecology, University of Florence, Italy
| | - Lorenzo Tofani
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Italy
| | - Maria Elisabetta Coccia
- Department of Biomedical, Experimental and Clinical Sciences - Division of Obstetrics and Gynecology, University of Florence, Italy
| |
Collapse
|
187
|
Suther KR, Hopp E, Smevik B, Fiane AE, Lindberg HL, Larsen S, de Lange C. Can visual analogue scale be used in radiologic subjective image quality assessment? Pediatr Radiol 2018; 48:1567-1575. [PMID: 29974179 PMCID: PMC6153875 DOI: 10.1007/s00247-018-4187-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/14/2018] [Accepted: 06/13/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Assessment of qualitative or subjective image quality in radiology is traditionally performed using a fixed-point scale even though reproducibility has proved challenging. OBJECTIVE Image quality of 3-T coronary magnetic resonance (MR) angiography was evaluated using three scoring methods, hypothesizing that a continuous scoring scale like visual analogue scale would improve the assessment. MATERIALS AND METHODS Adolescents corrected for transposition of the great arteries with arterial switch operation, ages 9-15 years (n=12), and healthy, age-matched controls (n=12), were examined with 3-D steady-state free precession magnetic resonance imaging. Image quality of the coronary artery origin was evaluated by using a fixed-point scale (1-4), visual analogue scale of 10 cm and a visual analogue scale with reference points (figurative visual analogue scale). Satisfactory image quality was set to a fixed-point scale 3=visual analogue scale/figurative visual analogue scale 6.6 cm. Statistical analysis was performed using Cohen kappa coefficient and agreement index. RESULTS The mean interobserver scores for the fixed-point scale, visual analogue scale and figurative visual analogue scale were, respectively, in the left main stem 2.8, 5.7, 7.0; left anterior descending artery 2.8, 4.7, 6.6; circumflex artery 2.5, 4.5, 6.2, and right coronary artery 3.2, 6.3, 7.7. Scoring with a fixed-point scale gave an intraobserver κ of 0.52-0.77 while interobserver κ was lacking. For visual analogue scale and figurative visual analogue scale, intraobserver agreement indices were, respectively, 0.08-0.58 and 0.43-0.71 and interobserver agreement indices were up to 0.5 and 0.65, respectively. CONCLUSION Qualitative image quality evaluation with coronary 3-D steady-state free precession MR angiography, using a visual analogue scale with reference points, had better reproducibility compared to a fixed-point scale and visual analogue scale. Image quality, being a continuum, may be better determined by this method.
Collapse
Affiliation(s)
- Kathrine Rydén Suther
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, P.O. Box 4950, Nydalen, 0424, Oslo, Norway.
| | - Einar Hopp
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, P.O. Box 4950, Nydalen, 0424, Oslo, Norway
| | - Bjarne Smevik
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, P.O. Box 4950, Nydalen, 0424, Oslo, Norway
| | - Arnt Eltvedt Fiane
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Harald Lauritz Lindberg
- Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Stig Larsen
- Faculty of Veterinary Medicine, Centre for Epidemiology and Biostatistics, Norwegian University of Life Sciences, Oslo, Norway
| | - Charlotte de Lange
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, P.O. Box 4950, Nydalen, 0424, Oslo, Norway
| |
Collapse
|
188
|
Sharma S, Palanchoke J, Reed D, Haxby Abbott J. Translation, cross-cultural adaptation and psychometric properties of the Nepali versions of numerical pain rating scale and global rating of change. Health Qual Life Outcomes 2017; 15:236. [PMID: 29202878 PMCID: PMC5715544 DOI: 10.1186/s12955-017-0812-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/23/2017] [Indexed: 11/24/2022] Open
Abstract
Background Pain intensity and patients’ impression of global improvement are widely used patient-reported outcome measures (PROMs) in clinical practice and research. They are commonly assessed using the Numerical Pain Rating Scale (NPRS) and Global Rating of Change (GROC) questionnaires. The GROC is essential as an anchor for evaluating the psychometric properties of PROMs. Both of these PROMs are translated to many languages and have shown excellent psychometric properties. Their availability in Nepali would facilitate pain research and cross-cultural comparison of research findings. Therefore, the objectives of this study were to translate and cross-culturally adapt the NPRS and GROC into Nepali and to assess the psychometric properties of the Nepali version of the NPRS (NPRS-NP). Methods After translating and cross-culturally adapting the NPRS and GROC into Nepali using recommended guidelines, NPRS-NP was administered to 104 individuals with musculoskeletal pain twice. The Nepali version of the GROC (GROC-NP) was administered at the follow-up for anchor-based assessment. (1) Test-retest reliability and minimum detectable change (MDC) among the stable group, (2) construct validity (by single sample t-test within the improved group and independent sample t-test between groups), and (3) concurrent validity were assessed. Receiver operating characteristic (ROC) curves were plotted to determine the responsiveness of the NPRS-NP using the area under the curve (AUC), and minimum important changes (MIC) for small, medium and large improvements. Results Significant cultural adaptations were required to obtain relevant Nepali versions of both the NPRS and GROC. The NPRS-NP showed excellent test-retest reliability and a MDC of 1.13 points. NPRS-NP demonstrated a good construct validity by significant within-group difference in mean of NPRS score- t(63)= 7.57, P < 0.001 and statistically significant difference of mean score- t(98)= -4.24, P < .001 between the stable and improved groups. It demonstrated moderate concurrent correlation with the GROC-NP; r = 0.43, P < 0.01. Responsiveness of the NPRS-NP was shown at three levels with AUC = 0.68–0.82, and MIC = 1.17–1.33. Conclusions The NPRS and GROC were successfully translated and culturally adapted into Nepali. The NPRS-NP demonstrated good reliability, validity and responsiveness in assessing musculoskeletal pain intensity in a Nepali population. Electronic supplementary material The online version of this article (10.1186/s12955-017-0812-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Saurab Sharma
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal. .,Centre for Musculoskeletal Outcomes Research, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
| | | | | | - J Haxby Abbott
- Centre for Musculoskeletal Outcomes Research, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| |
Collapse
|
189
|
Sharma S, Palanchoke J, Reed D, Haxby Abbott J. Translation, cross-cultural adaptation and psychometric properties of the Nepali versions of numerical pain rating scale and global rating of change. Health Qual Life Outcomes 2017; 15:236. [PMID: 29202878 DOI: 10.1186/s12955-017-0812-8.pmid:29202878;pmcid:pmc5715544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/23/2017] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Pain intensity and patients' impression of global improvement are widely used patient-reported outcome measures (PROMs) in clinical practice and research. They are commonly assessed using the Numerical Pain Rating Scale (NPRS) and Global Rating of Change (GROC) questionnaires. The GROC is essential as an anchor for evaluating the psychometric properties of PROMs. Both of these PROMs are translated to many languages and have shown excellent psychometric properties. Their availability in Nepali would facilitate pain research and cross-cultural comparison of research findings. Therefore, the objectives of this study were to translate and cross-culturally adapt the NPRS and GROC into Nepali and to assess the psychometric properties of the Nepali version of the NPRS (NPRS-NP). METHODS After translating and cross-culturally adapting the NPRS and GROC into Nepali using recommended guidelines, NPRS-NP was administered to 104 individuals with musculoskeletal pain twice. The Nepali version of the GROC (GROC-NP) was administered at the follow-up for anchor-based assessment. (1) Test-retest reliability and minimum detectable change (MDC) among the stable group, (2) construct validity (by single sample t-test within the improved group and independent sample t-test between groups), and (3) concurrent validity were assessed. Receiver operating characteristic (ROC) curves were plotted to determine the responsiveness of the NPRS-NP using the area under the curve (AUC), and minimum important changes (MIC) for small, medium and large improvements. RESULTS Significant cultural adaptations were required to obtain relevant Nepali versions of both the NPRS and GROC. The NPRS-NP showed excellent test-retest reliability and a MDC of 1.13 points. NPRS-NP demonstrated a good construct validity by significant within-group difference in mean of NPRS score- t(63)= 7.57, P < 0.001 and statistically significant difference of mean score- t(98)= -4.24, P < .001 between the stable and improved groups. It demonstrated moderate concurrent correlation with the GROC-NP; r = 0.43, P < 0.01. Responsiveness of the NPRS-NP was shown at three levels with AUC = 0.68-0.82, and MIC = 1.17-1.33. CONCLUSIONS The NPRS and GROC were successfully translated and culturally adapted into Nepali. The NPRS-NP demonstrated good reliability, validity and responsiveness in assessing musculoskeletal pain intensity in a Nepali population.
Collapse
Affiliation(s)
- Saurab Sharma
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.
- Centre for Musculoskeletal Outcomes Research, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
| | | | | | - J Haxby Abbott
- Centre for Musculoskeletal Outcomes Research, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| |
Collapse
|
190
|
Alborzi S, Hosseini-Nohadani A, Poordast T, Shomali Z. Surgical outcomes of laparoscopic endometriosis surgery: a 6 year experience. Curr Med Res Opin 2017; 33:2229-2234. [PMID: 28760003 DOI: 10.1080/03007995.2017.1362377] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim of the present study was to review 6 year experience on the surgical outcomes of laparoscopic endometriosis surgery. METHODS A cohort study was performed in Shiraz University of Medical Sciences using data from medical records of 1315 cases of patients with endometriosis undergoing laparoscopic surgery with follow-up of 6 to 72 months. RESULTS This study concerned a cohort of 1315 patients diagnosed with endometriosis operated between April 2010 and April 2016, 1086 (82.5%) of whom were in stage III and IV; 968 (73.61%) had endometrioma (regardless of having deep infiltrative endometriosis [DIE] or peritoneal involvement) and 347 (26.39%) of patients had either DIE or peritoneal involvement without endometrioma. Regarding the patients, unilateral endometrioma was statistically significant in the left ovary (p = .002). One hundred and thirty-three (10.7%) rectal wall, 7 (0.32%) sigmoid colon, 4 (0.18%) vagina, 125 (5.6%) ureter and 33 (1.52) bladder involvements were detected. Prior to operation, the pain VAS score was 8.23 ± 2.03, which decreased to 4.46 ± 2.47 in 93.07% of patients. Fifty-three patients (6.56%) needed reoperation. Sixty-six (33.1%) infertile women had spontaneous pregnancy and 15 (25%) became pregnant using intrauterine insemination (IUI) or assisted reproductive technique (ART) post-operatively. CONCLUSION Surgical treatment of endometriosis seems to be an effective treatment. DIE can be present in the absence of endometrioma. The rate of left endometrioma is higher due to the pressure effect of the sigmoid colon. Nonetheless, if an expert surgeon performs this procedure, not only the rate of post-operative complications, but also the possibility of recurrence would decrease.
Collapse
Affiliation(s)
- S Alborzi
- a Department of Obstetrics and Gynecology , Shiraz University of Medical Sciences , Shiraz , Iran
| | - A Hosseini-Nohadani
- a Department of Obstetrics and Gynecology , Shiraz University of Medical Sciences , Shiraz , Iran
| | - T Poordast
- a Department of Obstetrics and Gynecology , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Z Shomali
- a Department of Obstetrics and Gynecology , Shiraz University of Medical Sciences , Shiraz , Iran
| |
Collapse
|
191
|
Guiu Hernandez E, Gozdzikowska K, Apperley O, Huckabee ML. Effect of topical nasal anesthetic on swallowing in healthy adults: A double-blind, high-resolution manometry study. Laryngoscope 2017; 128:1335-1339. [PMID: 29152749 DOI: 10.1002/lary.26996] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 10/10/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Topical nasal anesthetic (TNA) is used when evaluating pharyngeal swallowing with high-resolution manometry (HRM). It is unclear if desensitizing the nasal mucosa improves procedure tolerability or affects pharyngeal pressure. This study evaluated the effects of TNA on comfort and pharyngeal pressure using HRM. METHODS A double-blinded study was conducted with 20 healthy participants ( x¯ = 27 years). Participants performed five saliva and five 10-mL swallows during two exams with ManoScan HRM ESO catheter (Medtronic, Minneapolis, MN) randomized under placebo (nonanesthetic lubricant) and anesthetized (0.4 mL of 2% viscous lidocaine hydrochloride) conditions. Comfort was rated using a 100-mm visual analog scale (VAS). Pharyngeal HRM amplitude and timing were analyzed. RESULTS VAS ratings were similar under placebo (mean = 38.4, standard deviation [SD] = 19.92) and TNA conditions (mean = 33.78, SD = 18.9), with no significant differences between placebo and anesthetized conditions (t[19] = 1.23, P = 0.23) or tolerability at first and second procedure (t[19] = 1.38, P = 0.18). Lower maximum and mean pharyngeal pressure were found for the TNA condition when compared to placebo (dry: maximum [-15.45 mmHg, standard error (SE) = 5.06 mmHg, P = 0.021]; mean [-5.22 mmHg, SE = 1.58 mmHg, P = 0.005]), and (liquid: maximum [-14.79 mmHg, SE = 5.01 mmHg, P = 0.010]; mean [-2.79 mmHg, SE = 1.99 mmHg, P = 0.008]). CONCLUSION This double-blind, randomized study is the first to investigate effects of TNA on tolerability and pharyngeal pressure using HRM. Results indicate TNA offered no significant difference in procedure comfort while affecting the magnitude of pharyngeal swallowing. LEVEL OF EVIDENCE 4. Laryngoscope, 128:1335-1339, 2018.
Collapse
Affiliation(s)
- Esther Guiu Hernandez
- Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand.,The University of Canterbury Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
| | - Kristin Gozdzikowska
- Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand.,The University of Canterbury Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
| | - Olivia Apperley
- Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand.,Oral Health Centre, Christchurch Hospital, Christchurch, New Zealand
| | - Maggie-Lee Huckabee
- Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand.,The University of Canterbury Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
| |
Collapse
|
192
|
Passavanti MB, Pota V, Sansone P, Aurilio C, De Nardis L, Pace MC. Chronic Pelvic Pain: Assessment, Evaluation, and Objectivation. PAIN RESEARCH AND TREATMENT 2017; 2017:9472925. [PMID: 29359045 PMCID: PMC5735788 DOI: 10.1155/2017/9472925] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/06/2017] [Accepted: 10/15/2017] [Indexed: 12/20/2022]
Abstract
Chronic Pelvic Pain (CPP) and Chronic Pelvic Pain Syndrome (CPPS) have a significant impact on men and women of reproductive and nonreproductive age, with a considerable burden on overall quality of life (QoL) and on psychological, functional, and behavioural status. Moreover, diagnostic and therapeutic difficulties are remarkable features in many patients. Therefore evaluation, assessment and objectivation tools are often necessary to properly address each patient and consequently his/her clinical needs. Here we review the different tools for pain assessment, evaluation, and objectivation; specific features regarding CPP/CPPS will be highlighted. Also, recent findings disclosed with neuroimaging investigations will be reviewed as they provide new insights into CPP/CPPS pathophysiology and may serve as a tool for CPP assessment and objectivation.
Collapse
Affiliation(s)
- Maria Beatrice Passavanti
- Department of Woman, Child, General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| | - Vincenzo Pota
- Department of Woman, Child, General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| | - Pasquale Sansone
- Department of Woman, Child, General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| | - Caterina Aurilio
- Department of Woman, Child, General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| | - Lorenzo De Nardis
- Department of Woman, Child, General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| | - Maria Caterina Pace
- Department of Woman, Child, General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| |
Collapse
|
193
|
Fauconnier A, Staraci S, Daraï E, Descamps P, Nisolle M, Panel P, Roman H, Boulkedid R. A self-administered questionnaire to measure the painful symptoms of endometriosis: Results of a modified DELPHI survey of patients and physicians. J Gynecol Obstet Hum Reprod 2017; 47:69-79. [PMID: 29133195 DOI: 10.1016/j.jogoh.2017.11.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 11/03/2017] [Accepted: 11/06/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE To develop a questionnaire based on patients' verbal descriptors, to measure the painful symptoms of endometriosis. METHODS We performed a two-round modified DELPHI procedure mixing endometriosis patients and physicians to select a set of statements to describe the painful symptoms of endometriosis. Each panelist rated each statement based on diagnosis validity and clarity. The clinicians were experts in endometriosis management selected from various geographic regions in France. Patients were women with surgically confirmed endometriosis who volunteered from a patient association and from the recruitment of the participating physicians. The first round questions were derived from words and phrases in narratives of pain by endometriosis patients. RESULTS Overall, 76 experts were invited, and of these 56 (74%), comprising 33 patients and 23 gynecologists, responded to the first round questionnaire, and 40 (71.4%) to the second round. Among the 48 statements assessed in the first-round questionnaire, 11 were selected after completion of the two round DELPHI procedure. After discussion and rewording of some items, a total of 21 questions were selected during a final face-to-face meeting. The content of the final questionnaire is organized according to four dimensions: (i) spontaneous pelvic pain and dysmenorrhea, (ii) dyspareunia, (iii) painful bowel symptoms, (iv) and other symptoms. We also provide an English (UK) version produced using several steps of translation and back-translation. CONCLUSIONS The questionnaire has content validity to measure the subjective experiences of patients with painful endometriosis and can provide a solid basis on which to develop an efficient patient-centered outcome to measure the painful symptoms in therapeutic or in diagnostic studies of endometriosis.
Collapse
Affiliation(s)
- A Fauconnier
- Department of gynecology and obstetrics, centre hospitalier intercommunal de Poissy-Saint-Germain, university of Versailles Saint-Quentin (UVSQ), 10, rue du Champ-Gaillard, 78103 Poissy, France; Research unit EA7285, risk and safety in clinical medicine for women and perinatal health, Versailles St-Quentin University, 78180 Montigny-le-Bretonneux, France.
| | - S Staraci
- Research unit EA7285, risk and safety in clinical medicine for women and perinatal health, Versailles St-Quentin University, 78180 Montigny-le-Bretonneux, France
| | - E Daraï
- Department of gynecology and obstetrics, hôpital Tenon, 75970 Paris, France
| | - P Descamps
- Department of gynecology and obstetrics, Angers university hospital, 49033 Angers, France
| | - M Nisolle
- Department of gynecology and obstretrics, La Citadelle regional hospital centre, Liège, Belgium
| | - P Panel
- Department of gynecology and obstetrics, André-Mignot hospital centre, 78157 Versailles, France
| | - H Roman
- Department of gynecology and obstetrics, Rouen university hospital centre, 76031 Rouen, France
| | - R Boulkedid
- Clinical epidemiology unit, Robert-Debré hospital, AP-HP, 75019 Paris, France; UMR-S 1123 and CIC-EC 1426, ECEVE, Paris Diderot university, Sorbonne Paris Cité, 75010 Paris, France
| |
Collapse
|
194
|
Lang J, Yu Q, Zhang S, Li H, Gude K, von Ludwig C, Ren X, Dong L. Dienogest for Treatment of Endometriosis in Chinese Women: A Placebo-Controlled, Randomized, Double-Blind Phase 3 Study. J Womens Health (Larchmt) 2017; 27:148-155. [PMID: 29083258 DOI: 10.1089/jwh.2017.6399] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Dienogest is a progestin with demonstrated efficacy in the treatment of endometriosis in European women. The objective of this study was to evaluate the efficacy and safety of dienogest in Chinese women. PATIENTS AND METHODS This 24-week, randomized, double-blind, placebo-controlled multicenter (n = 23) study evaluated the efficacy and safety of 2 mg dienogest once daily in 255 Chinese women aged 18-45 years with laparoscopically diagnosed endometriosis and an endometriosis-associated pelvic pain (EAPP) score ≥30 mm on a 0-100 mm visual analog scale. The primary efficacy variable was absolute change in EAPP from baseline to week 24. Secondary efficacy variables included proportions of responders and intake of supportive analgesic medication. Safety variables included adverse events (AEs), laboratory parameters, and bleeding patterns. Bone mineral density (BMD) was evaluated in a subset of 140 women. RESULTS After 24 weeks of treatment, the difference between treatment arms for mean reduction in EAPP was statistically significant in favor of dienogest (-24.54 mm; 95% CI -29.93 to -19.15; p < 0.0001). Secondary efficacy analyses supported the significant superiority of dienogest over placebo. Dienogest was well tolerated, with few AEs associated with therapy. Dienogest had no effect on BMD levels after 24 weeks of treatment. CONCLUSIONS Dienogest 2 mg once daily for 24 weeks was superior to placebo in reducing EAPP and was safe and well tolerated in Chinese women with endometriosis. The results are consistent with studies previously conducted in European women.
Collapse
Affiliation(s)
- Jinghe Lang
- 1 Department of Obstetrics and Gynecology, Peking Union Medical College Hospital , Beijing, China
| | - Qi Yu
- 1 Department of Obstetrics and Gynecology, Peking Union Medical College Hospital , Beijing, China
| | - Shulan Zhang
- 2 Department of Gynecology and Obstetrics, China Medical University Shengjing Hospital , Shenyang, China
| | - Huajun Li
- 3 Department of Obstetrics and Gynecology, China-Japan Friendship Hospital , Beijing, China
| | - Kerstin Gude
- 4 Medical Affairs Women's Healthcare , Gynecological Therapy, Bayer AG, Berlin, Germany
| | - Christiane von Ludwig
- 4 Medical Affairs Women's Healthcare , Gynecological Therapy, Bayer AG, Berlin, Germany
| | - Xiaowei Ren
- 5 Data Sciences & Analytics, Bayer Healthcare Co. Ltd. , Beijing, China
| | - Liying Dong
- 6 Clinical Development Gynecological Therapies , Division of Pharmaceuticals, Bayer AG, Berlin, Germany
| |
Collapse
|
195
|
Yong PJ. Deep Dyspareunia in Endometriosis: A Proposed Framework Based on Pain Mechanisms and Genito-Pelvic Pain Penetration Disorder. Sex Med Rev 2017; 5:495-507. [DOI: 10.1016/j.sxmr.2017.06.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/19/2017] [Accepted: 06/24/2017] [Indexed: 12/30/2022]
|
196
|
Becker CM, Gattrell WT, Gude K, Singh SS. Reevaluating response and failure of medical treatment of endometriosis: a systematic review. Fertil Steril 2017; 108:125-136. [PMID: 28668150 PMCID: PMC5494290 DOI: 10.1016/j.fertnstert.2017.05.004] [Citation(s) in RCA: 157] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 05/04/2017] [Accepted: 05/04/2017] [Indexed: 11/17/2022]
Abstract
Objective To assess patient response rates to medical therapies used to treat endometriosis-associated pain. Design A systematic review with the use of Medline and Embase. Setting Not applicable. Patient(s) Women receiving medical therapy to treat endometriosis. Interventions(s) None. Main Outcome Measure(s) The proportions of patients who: experienced no reduction in endometriosis-associated pain symptoms; had pain symptoms remaining at the end of the treatment period; had pain recurrence after treatment cessation; experienced an increase or no change in disease score during the study; were satisfied with treatment; and discontinued therapy owing to adverse events or lack of efficacy. The change in pain symptom severity experienced during and after treatment, as measured on the visual analog scale, was also assessed. Result(s) In total, 58 articles describing 125 treatment arms met the inclusion criteria. Data for the response of endometriosis-associated pain symptoms to treatment were presented in only 29 articles. The median proportions of women with no reduction in pain were 11%–19%; at the end of treatment, 5%–59% had pain remaining; and after follow-up, 17%–34% had experienced recurrence of pain symptoms after treatment cessation. After median study durations of 2–24 months, the median discontinuation rates due to adverse events or lack of efficacy were 5%–16%. Conclusion(s) Few studies of medical therapies for endometriosis report outcomes that are relevant to patients, and many women gain only limited or intermittent benefit from treatment.
Collapse
Affiliation(s)
- Christian M Becker
- Endometriosis Care Centre, Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom.
| | - William T Gattrell
- Research Evaluation Unit, Oxford Pharmagenesis, Oxford, United Kingdom; Department of Mechanical Engineering and Mathematical Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Kerstin Gude
- Medical Affairs Women's Healthcare, Bayer, Berlin, Germany
| | - Sukhbir S Singh
- Department of Obstetrics and Gynaecology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| |
Collapse
|
197
|
IVF oocyte retrieval: prospective evaluation of the type of anesthesia on live birth rate, pain, and patient satisfaction. J Assist Reprod Genet 2017; 34:1523-1528. [PMID: 28755151 DOI: 10.1007/s10815-017-1002-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 07/21/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Does the type of anesthesia (paracervical block (PCB) or general anesthesia (GA)) impact live birth rate, pain, and patient satisfaction? METHODS A non-randomized prospective cohort study was conducted in women treated for IVF. Two groups of patients were prospectively included: the PCB group (n = 234) and the GA group (n = 247). The type of anesthesia was determined by the patients. The primary endpoint was cumulative live birth rate by OR. Secondary endpoints were self-assessment of the patients' peri-operative abdominal and vaginal pain vs the doctors' evaluations during PCB, post-operative abdominal and vaginal pain level, and patient satisfaction in both groups. Pain levels were assessed with a numerical rating scale (NRS). RESULTS The live birth rate was similar in both groups (19.8% in the GA group vs 20.9% in the PCB group, P = 0.764). During oocyte retrieval in the PCB group, the physicians significantly under-estimated the vaginal pain experienced by the patients (3.04 ± 0.173 for patients vs 2.59 ± 0.113 for surgeons, P = 0.014). Post-operative vaginal and abdominal pain were significantly greater in the PCB group compared to the GA group (2.26 ± 0.159 vs 1.66 ± 0.123, respectively, P = 0.005, and 3.80 ± 0.165 vs 3.00 ± 0.148, respectively, P < 0.001). Patients were more significantly satisfied with GA than with PBC (P < 0.001). CONCLUSION Because the LBR was similar in both groups and patient satisfaction was high, the choice of anesthesia should be decided by the patients.
Collapse
|
198
|
Chae MO, Jeon HO, Kim A. [A Structural Model for Premenstrual Coping in University Students: Based on Biopsychosocial Model]. J Korean Acad Nurs 2017; 47:257-266. [PMID: 28470162 DOI: 10.4040/jkan.2017.47.2.257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 03/03/2017] [Accepted: 03/06/2017] [Indexed: 11/09/2022]
Abstract
PURPOSE The aims of this study were to construct a hypothetical structural model which explains premenstrual coping in university students and to test the fitness with collected data. METHODS Participants were 206 unmarried women university students from 3 universities in A and B cities. Data were collected from March 29 until April 30, 2016 using self-report structured questionnaires and were analyzed using IBM SPSS 23.0 and AMOS 18.0. RESULTS Physiological factor was identified as a significant predictor of premenstrual syndrome (t=6.45, p<.001). This model explained 22.1% of the variance in premenstrual syndrome. Psychological factors (t=-2.49, p=.013) and premenstrual syndrome (t=8.17, p<.001) were identified as significant predictors of premenstrual coping. Also this model explained 30.9% of the variance in premenstrual coping in university students. A physiological factors directly influenced premenstrual syndrome (β=.41, p=.012). Premenstrual syndrome (β=.55, p=.005) and physiological factor (β=.23, p=.015) had significant total effects on premenstrual coping. Physiological factor did not have a direct influence on premenstrual coping, but indirectly affected it (β=.22, p=.007). Psychological factors did not have an indirect or total effect on premenstrual coping, but directly affected it (β=-.17, p=.036). CONCLUSION These findings suggest that strategies to control physiological factors such as menstrual pain should be helpful to improve premenstrual syndrome symptoms. When developing a program to improve premenstrual coping ability and quality of menstrual related health, it is important to consider psychological factors including perceived stress and menstrual attitude and premenstrual syndrome.
Collapse
Affiliation(s)
- Myung Ock Chae
- Department of Nursing, College of Health Sciences, Cheongju University, Cheongju, Korea
| | - Hae Ok Jeon
- Department of Nursing, College of Health Sciences, Cheongju University, Cheongju, Korea
| | - Ahrin Kim
- Department of Nursing, College of Health Sciences, Cheongju University, Cheongju, Korea.
| |
Collapse
|
199
|
Mendes da Silva D, Gross LA, Neto EDPG, Lessey BA, Savaris RF. The Use of Resveratrol as an Adjuvant Treatment of Pain in Endometriosis: A Randomized Clinical Trial. J Endocr Soc 2017; 1:359-369. [PMID: 29264492 PMCID: PMC5686687 DOI: 10.1210/js.2017-00053] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 03/10/2017] [Indexed: 01/19/2023] Open
Abstract
Context: Resveratrol has been used for the treatment of endometriosis. Objective: To compare resveratrol (40 mg/d) with monophasic contraceptive pill (COC) to COC with placebo for the reduction of pain scores. Design: A randomized clinical trial. Setting: University Hospital. Patients: Women (ages 20 to 50) with laparoscopic diagnosis of endometriosis were eligible for the study. Exclusion criteria: pregnancy, allergy to resveratrol, or contraindications to COC, use of agonists of gonadotropin release hormone or danazol in the last month, or had used depot medroxyprogesterone acetate or Mirena®. Intervention: Subjects were randomized using a computer-generated randomization list to receive COC for 42 days to be taken with identical capsules containing 40 mg of resveratrol or placebo in coded bottles (1:1 ratio). Allocation was concealed in coded, sequenced, opaque-sealed envelopes. Main Outcome: Median pain scores measured with a visual analog scale on day 42. Results: Between 18 June and 6 November 2015, 44 subjects were enrolled. Mean [95% confidence interval (CI)] pain scores on day 0 were 5.4 (4.2 to 6.6) in the placebo group and 5.7 (4.8 to 6.6) in resveratrol groups. After treatment, pain values were [3.9 (2.2 to 5); n = 22] and [3.2 (2.1 to 4.3); n = 22] in the placebo and resveratrol groups, respectively (P = 0.7; Mann-Whitney U test). Median (95% CI) difference between groups was 0.75 (–1.6 to 2.3). Conclusion: Resveratrol is not superior to placebo for treatment of pain in endometriosis.
Collapse
Affiliation(s)
- Daniel Mendes da Silva
- Postgraduate Program in Health Science: Gynecology and Obstetrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil, 90035-903
| | - Luiza Azevedo Gross
- Department of Obstetrics and Gynecology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil, 90035-903
| | | | - Bruce A Lessey
- Department of Obstetrics and Gynecology, Greenville Health System, Greenville, South Carolina
| | - Ricardo Francalacci Savaris
- Postgraduate Program in Health Science: Gynecology and Obstetrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil, 90035-903.,Department of Obstetrics and Gynecology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil, 90035-903
| |
Collapse
|
200
|
Psychometric properties of the French version of the Endometriosis Health Profile-30, a health-related quality of life instrument. J Gynecol Obstet Hum Reprod 2017; 46:235-242. [DOI: 10.1016/j.jogoh.2017.02.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/24/2017] [Accepted: 02/01/2017] [Indexed: 11/20/2022]
|