-
Turkish Journal of Obstetrics and... Jun 2024Endometriosis is a prevalent condition in women that causes pelvic pain and fertility issues due to the growth of endometrial tissue outside the uterus during menstrual...
Endometriosis is a prevalent condition in women that causes pelvic pain and fertility issues due to the growth of endometrial tissue outside the uterus during menstrual cycles. Steroid hormones play a crucial role in the development and growth of endometriosis lesions; therefore, researchers have investigated several effective drugs that target hormones for treating this disease. One such drug is bazedoxifene, but despite several animal studies, there has yet to be a comprehensive evaluation of their combined results. A systematic search was conducted across several databases (Embase, PubMed, Scopus, and Web of Sciences) to identify studies investigating the effectiveness of bazedoxifene in animal models of endometriosis. Meta-analysis was performed using the size of endometriosis implants before and after drug administration in the case and control groups, along with the p-value of the associations. Begg's and Egger's tests were used to assess publication bias. This study included four eligible studies consisting of 45 endometrial animal models and 35 control subjects. The meta-analysis showed that bazedoxifene significantly reduced the size of endometriosis implants in animal models compared with the control group (odds ratio: 0.122, 95% confidence interval: 0.050-0.298, p<0.001). Detailed investigation determined that there was no significant heterogeneity between the studies (I2=38.81, and p-value of the Q test=0.179). However, according to Egger's test, the study showed publication bias (p=0.035). This study found that bazedoxifene is a promising treatment option for endometriosis in animal models. However, more research on animals and humans is required to confirm these results.
PubMed: 38853494
DOI: 10.4274/tjod.galenos.2024.82610 -
Brazilian Journal of Physical Therapy 2024The Dysmenorrhea Symptom Interference (DSI) scale is a reliable, valid, and responsive tool to assess the interference of menstrual pain in the physical, mental, and...
BACKGROUND
The Dysmenorrhea Symptom Interference (DSI) scale is a reliable, valid, and responsive tool to assess the interference of menstrual pain in the physical, mental, and social activities of women.
OBJECTIVE
To translate and cross-culturally adapt the DSI scale into Brazilian-Portuguese (DSI-BrPt) and investigate the measurement properties of this version in on- and off-menses versions.
METHODS
The original (United States) scale was translated and culturally adapted following existing guidelines. Measurement properties of the DSI-BrPt were investigated in 1387 women with dysmenorrhea. Reliability was analyzed via intraclass correlation coefficients (ICC) and test-retest reliability. Furthermore, structural validity, internal consistency (Cronbach's alpha), cross-cultural validity, construct validity (correlation with WHODAS 2.0 and SPS-6 scores questionnaires), and floor and ceiling effects were determined.
RESULTS
No significant adaptations were needed during the translation process of the DSI-BrPt. The values of Cronbach's α were adequate (α ≥0.87) for the unidimensional scale. The test-retest reliability was considered adequate (ICC >0.78) and there was no systematic error for both on-menses and off-menses versions. Moreover, the DSI had a positive and strong correlation with WHODAS 2.0. There were no floor and ceiling effects neither for the total sample, nor among off-menses, or on-menses women.
CONCLUSION
The DSI-BrPt scale has been translated and cross-culturally adapted successfully. The DSI-BrPt scale presented adequate measurement properties. The scale is valid and reliable, and, therefore, an adequate tool for monitoring dysmenorrhea symptoms in Brazilian women during and between menses.
Topics: Humans; Dysmenorrhea; Brazil; Female; Surveys and Questionnaires; Cross-Cultural Comparison; Reproducibility of Results; Psychometrics
PubMed: 38848625
DOI: 10.1016/j.bjpt.2024.101065 -
Annals of Medicine and Surgery (2012) Jun 2024The presentation of a strangulated obturator hernia is rare, with it accounting for less than 0.04% of all hernias. Delay in presentation and diagnosis results in...
INTRODUCTION
The presentation of a strangulated obturator hernia is rare, with it accounting for less than 0.04% of all hernias. Delay in presentation and diagnosis results in complications like bowel ischemia, necrosis, perforation, and peritonitis, thereby increasing morbidity and mortality.
CASE PRESENTATION
The authors report the case of an 85-year-old multiparous woman who presented with a 3-day history of abdominal pain and vomiting. Upon examination, she exhibited hypotension, altered sensorium, and a distended abdomen with visible peristalsis. An abdominal pelvic computed tomography scan confirmed the diagnosis of 'intestinal obstruction secondary to an incarcerated obturator hernia'. Subsequently, a lower midline laparotomy was performed, successfully reducing the bowel and repairing the hernial orifice. The patient was discharged on the fourth postoperative day, and there has been no hernia recurrence as of her 3-month follow-up.
DISCUSSION
The presentation of a strangulated obturator hernia can be elusive. During clinical examination, both the Howship-Romberg sign and the Hannington-Kiffs sign tests may be negative. Laparoscopic obturator hernia repair has been shown to reduce hospital stay and morbidity. A midline laparotomy has the advantage of easy manual reduction, minimizing bowel trauma, accurately accessing the bowel, and facilitating bowel resection.
CONCLUSION
Obturator hernias constitute rare subtypes of abdominal hernias. They typically occur in older women, and patients often present with poor functional status and multiple comorbidities. The clinical diagnostic tests are uncertain, even in patients with a high index of suspicion. Timely diagnosis and appropriate surgical management are crucial for a favorable outcome.
PubMed: 38846839
DOI: 10.1097/MS9.0000000000002073 -
Cureus May 2024Ascites can manifest as a result of many conditions, with cirrhosis being the most common cause in the United States. Here, we present a case of lymphocytic ascites, a...
Ascites can manifest as a result of many conditions, with cirrhosis being the most common cause in the United States. Here, we present a case of lymphocytic ascites, a less common variant that occurred due to infection with Chlamydia trachomatis. This was a 37-year-old female with a history of substance and sexual abuse who presented with the chief complaints of abdominal pain, abdominal distension, and weight gain. She was febrile on admission with a distended, tender abdomen. The more common cardiac, renal, and hepatic causes were ruled out with extensive workup. Diagnosis and therapeutic paracentesis were done with fluid analysis significant for lymphocyte predominance and absence of malignant cells. Multi-modal imaging had ruled out suspicious malignant masses but CT abdomen/pelvis did show complex large volume ascites. Urine chlamydia and gonorrhea polymerase chain reaction (PCR) had resulted positive for chlamydia, leading us to start Doxycycline. Other infectious workups were negative, but ascitic fluid chlamydia NAAT was positive. Though initially worsening, the patient started showing significant clinical improvement after starting doxycycline, with the resolution of ascites and associated symptoms. This case report intends to bring to attention the importance of testing for chlamydia infection in cases of lymphocytic ascites, especially in sexually active females.
PubMed: 38846180
DOI: 10.7759/cureus.59760 -
Medecine Tropicale Et Sante... Mar 2024Accidental ingestion of a foreign body into the gastrointestinal tract is not uncommon, however the development of hepatic abscesses secondary to digestive perforation...
Accidental ingestion of a foreign body into the gastrointestinal tract is not uncommon, however the development of hepatic abscesses secondary to digestive perforation by a foreign body is rare. We report the case of pyogenic hepatic abscesses secondary to gastric perforation by a fishbone complicated by acute peritonitis. A 53-year-old patient was admitted to our hospital with the main complaints: diffuse abdominal pain with vomiting in a context of fever and physical asthenia. A painful febrile hepatomegaly with jaundice was objectified, as well as a non-specific biological inflammatory syndrome. An initial abdominopelvic CT scan revealed multifocal liver abscesses. Faced with the initial therapeutic failure associating parenteral antibiotic therapy and abscess drainage, a second abdominal CT scan identified a foreign body straddling the antropyloric wall and segment I of the liver.A xypho-pelvic midline laparotomy was performed with nearly 200 cc of peritoneal fluid coming out. A fishbone approximately 5 cm long was extracted by laparotomy, followed by gastric closure with omentum, peritoneal cleansing and drainage. Symptomatic adjuvant treatment was initiated, including a proton pump inhibitor (Pantoprazole). He also benefited from transfusion support in the face of anemia. Antibiotic therapy was continued for a total of 2 weeks after surgery. The evolution was favorable with follow-up imaging at 3 months, showing complete resorption of the hepatic abscesses.
Topics: Humans; Middle Aged; Peritonitis; Male; Liver Abscess, Pyogenic; Foreign Bodies; Acute Disease; Senegal; Stomach
PubMed: 38846121
DOI: 10.48327/mtsi.v4i1.2024.390 -
BMJ Open Jun 2024Primary dysmenorrhoea occurs in up to 50% of menstruating females. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used therapeutic remedies for...
Self-reported gastrointestinal adverse effects of non-steroidal anti-inflammatory drugs in female students with dysmenorrhoea at Makerere University: prevalence, discontinuation and associated factors. a cross sectional study.
BACKGROUND
Primary dysmenorrhoea occurs in up to 50% of menstruating females. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used therapeutic remedies for dysmenorrhoea in Uganda. However, NSAIDs are associated with a 3-5 fold increase in the risk of gastrointestinal (GI) adverse drug effects.
OBJECTIVES
We aimed to determine the prevalence and associated factors of self-reported NSAID-related GI adverse effects in female students who use NSAIDs in managing dysmenorrhoea-associated pain at Makerere University.
DESIGN
A cross-sectional study.
SETTING
Makerere University's main campus, situated North of Kampala, Uganda.
PARTICIPANTS
314 female students pursuing an undergraduate programme at Makerere University and residing in different halls of residence and hostels.
OUTCOMES
Social demographic data, menstrual history and treatment data.
RESULTS
Overall, 314 valid responses were received from female students with a median age of 22 years (IQR: 18-29 years). The median age at menarche was 13 years (IQR: 9-18 years). 41% (n=129/314) of the respondents had used medication for dysmenorrhoea and 32% (n=41/129) of whom reported NSAID-associated GI adverse effects with nausea being the most frequently reported (44%, n=18/41)Factors independently associated with GI adverse effects were: age at menarche (p=0.026), duration of menstruation (p=0.030) and use of ibuprofen (p=0.005). Females taking ibuprofen for dysmenorrhoea were about four times as likely to have NSAID-associated GI adverse effects (adjusted OR 3.87, 95% CI 1.51 to 9.91) than those who did not receive ibuprofen. Logistic regression was used to determine factors associated with self-reported adverse effects of NSAIDs among the female students. A p<0.05 was considered statistically significant.
CONCLUSION
We found a considerably high prevalence of NSAID-related GI adverse effects driven by factors such as age at menarche and ibuprofen use.
Topics: Humans; Female; Dysmenorrhea; Anti-Inflammatory Agents, Non-Steroidal; Cross-Sectional Studies; Young Adult; Students; Adolescent; Universities; Adult; Prevalence; Uganda; Self Report; Gastrointestinal Diseases; Ibuprofen; Logistic Models
PubMed: 38844394
DOI: 10.1136/bmjopen-2023-079660 -
Heliyon Jun 2024Chronic pelvic pain (CPP) is a debilitating problem in women with clear evidence of myofascial dysfunction. It seems that Myofascial trigger points (MTrPs) contribute to...
Chronic pelvic pain (CPP) is a debilitating problem in women with clear evidence of myofascial dysfunction. It seems that Myofascial trigger points (MTrPs) contribute to the development of central sensitization (CS). This study aimed to investigate the effect of dry needling on pain and CS in women with CPP. Thirty-six women with CPP participated in this randomized controlled clinical trial and randomly assigned into three groups: dry needling group (DNG), placebo needling group (PNG) and control group (CG). The DNG received five sessions of DN using the "static needling", the PNG received non-penetrating method, and the CG did not receive any intervention. Assessment of outcomes including central sensitization inventory (CSI), short-form McGill pain questionnaire (SF-MPQ), electroencephalography (EEG), conditioned pain modulation (CPM), salivary cortisol concentration, 7-item general anxiety disorder scale (GAD-7), pain catastrophizing scale (PCS), and SF-36 questionnaire was performed pre-intervention, post-intervention, and three months post-intervention by a blind examiner. The result showed a significant group-by-time interaction for CSI, SF-MPQ, and PCS. There was a significant decrease in CSI score in post-intervention and three-months post-intervention compare to pre-intervention in the DNG and PNG. SF-MPQ-PPI score in DNG significantly decreased post-intervention. PCS-Total score decreased significantly post-intervention in DNG and PNG. No significant group-by-time interactions were observed for other variables. EEG results showed regional changes in the activity of frequency bands in both eye closed and eye open conditions. It seems that DN can affect central pain processing by removing the source of peripheral nociception. Trial registration: Iranian Registry of Clinical Trials (IRCT20211114053057N1, registered on: December 03, 2021. https://irct.behdasht.gov.ir/search/result?query=IRCT20211114053057N1).
PubMed: 38841514
DOI: 10.1016/j.heliyon.2024.e31699 -
Open Medicine (Warsaw, Poland) 2024The objective of this study was to evaluate the efficacy and factors of myofascial release therapy combined with electrical and magnetic stimulation in the treatment of...
The objective of this study was to evaluate the efficacy and factors of myofascial release therapy combined with electrical and magnetic stimulation in the treatment of chronic pelvic pain syndrome (CPPS). A total of 79 female patients diagnosed with CPPS from January 2021 to December 2022 were prospectively analyzed. Every patient received 3 weeks of treatment which included myofascial release therapy combined with electrical and magnetic stimulation. The visual analog score (VAS) of pelvic floor muscle (PFM) trigger points (TrPs) and the changes in pelvic floor surface electromyography before and after treatment were compared. Multiple linear regression was used to analyze the influencing factors of each outcome index. There were significant differences in VASs of muscle TrPs before and after treatment ( < 0.05). For the surface electromyography of PFMs, the differences in pre-baseline rest, post-baseline rest, isometric contractions for muscle endurance evaluation, and coefficient of variation were statistically significant ( < 0.05). Linear regression analysis showed that disease course ( ), dyspareunia ( ), and urinary incontinence ( ) were influencing factors for the decline of pre-baseline rest (5 = 1.067, = 0.089), post-baseline rest (1 = 0.055, 5 = 0.99, = 0.119), VASs of ischial spine (5 = 0.916, = 0.102), obturator internus (5 = 0.796, 6 = -0.703, = 0.245), and pubococcygeus (5 = 0.885, = 0.149) after treatment in the CPPS group. This study confirmed that individualized myofascial release therapy combined with electrical and magnetic stimulation has significant efficacy for patients with CPPS. At the same time, it is more effective for CPPS patients with longer course of disease, dyspareunia, and without urinary incontinence.
PubMed: 38841178
DOI: 10.1515/med-2024-0936 -
Frontiers in Surgery 2024Enhanced recovery after surgery (ERAS) is an evidence-based, multi-modal approach to decrease surgical stress, expedite recovery, and improve postoperative outcomes....
INTRODUCTION
Enhanced recovery after surgery (ERAS) is an evidence-based, multi-modal approach to decrease surgical stress, expedite recovery, and improve postoperative outcomes. ERAS is increasingly being utilized in pediatric surgery. Its applicability to pediatric patients undergoing abdominal tumor resections remains unknown.
METHODS AND ANALYSIS
A group of key stakeholders adopted ERAS principles and developed a protocol suitable for the variable complexity of pediatric abdominal solid tumor resections. A multi-center, prospective, propensity-matched case control study was then developed to evaluate the feasibility of the protocol. A pilot-phase was utilized prior to enrollment of all patients older than one month of age undergoing any abdominal, retroperitoneal, or pelvic tumor resections. The primary outcome was 90-day complications per patient. Additional secondary outcomes included: ERAS protocol adherence, length of stay, time to administration of adjuvant chemotherapy, readmissions, reoperations, emergency room visits, pain scores, opioid usage, and differences in Quality of Recovery 9 scores.
ETHICS AND DISSEMINATION
Institutional review board approval was obtained at all participating centers. Informed consent was obtained from each participating patient. The results of this study will be presented at pertinent society meetings and published in peer-reviewed journals. We expect the results will inform peri-operative care for pediatric surgical oncology patients and provide guidance on initiation of ERAS programs. We anticipate this study will take four years to meet accrual targets and complete follow-up.
TRIAL REGISTRATION NUMBER
NCT04344899.
PubMed: 38840973
DOI: 10.3389/fsurg.2024.1393857