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PloS One 2024The primary challenge encountered by individuals diagnosed with endometriosis is the experience of pain. Emerging research indicates that oxidative stress is implicated... (Meta-Analysis)
Meta-Analysis
Vitamin C and E antioxidant supplementation may significantly reduce pain symptoms in endometriosis: A systematic review and meta-analysis of randomized controlled trials.
BACKGROUND
The primary challenge encountered by individuals diagnosed with endometriosis is the experience of pain. Emerging research indicates that oxidative stress is implicated in the initiation of pain associated with endometriosis. Vitamins C and E are known for their antioxidative properties. The primary objective of this study is to assess the efficacy of antioxidant supplementation, consisting of these vitamins, in the management of pain associated with endometriosis.
METHODS
A comprehensive search was conducted on the ClinicalTrials.gov, Scopus, Europe PMC, and Medline databases up until August 23rd, 2023, utilizing a combination of relevant keywords. This review incorporates literature that examines the relationship between antioxidant supplementation and pain in endometriosis. We employed fixed-effect models to analyze the risk ratio (RR) and present the outcomes together with their corresponding 95% confidence intervals (CI).
RESULTS
A total of five RCTs were incorporated. The results of our meta-analysis indicated that antioxidant supplementation with vitamin C and E combination was associated with higher proportion of endometriosis patients reporting reduced chronic pelvic pain (RR 7.30; 95%CI: 3.27-16.31, p<0.00001, I2 = 0%), alleviations of dysmenorrhea (RR 1.96; 95%CI: 1.25-3.07, p = 0.003, I2 = 39%), and dyspareunia (RR 5.08; 95%CI: 2.10-12.26, p = 0.0003, I2 = 0%) than patients only receiving placebo.
CONCLUSIONS
This study suggests the potential ability of vitamin C and E in alleviating pain symptoms experienced by individuals with endometriosis.
Topics: Female; Humans; Ascorbic Acid; Endometriosis; Antioxidants; Randomized Controlled Trials as Topic; Dietary Supplements; Vitamin E; Dysmenorrhea; Pelvic Pain; Dyspareunia
PubMed: 38820340
DOI: 10.1371/journal.pone.0301867 -
World Journal of Clinical Cases May 2024Uterine fibroids are benign tumors that originate from smooth muscle cells of the uterus. It is the most common gynecological disorder, affecting up to 80% of women of...
BACKGROUND
Uterine fibroids are benign tumors that originate from smooth muscle cells of the uterus. It is the most common gynecological disorder, affecting up to 80% of women of reproductive age. Uterine fibroids can cause various symptoms such as abnormal uterine bleeding, pelvic pain, infertility, and pregnancy complications. The treatment options for uterine fibroids include medical therapy, surgical intervention, and minimally invasive techniques.
AIM
To compare ovarian function of women with uterine fibroids who did or did not undergo uterine artery embolization (UAE).
METHODS
This prospective cohort study enrolled 87 women with symptomatic uterine fibroids who underwent UAE, and 87 women with the same symptoms who did not undergo UAE but received conservative management or other treatments. The two groups were matched for age, body mass index, parity, and baseline characteristics of uterine fibroids. The primary outcome was ovarian function that was evaluated by serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and anti-Müllerian hormone (AMH), as well as ovarian reserve tests, such as antral follicle count (AFC) and ovarian volume (OV). The secondary outcome was fertility that was evaluated based on the menstrual cycle, ovulation, conception, pregnancy, and delivery. The participants were followed-up for 36 months and assessed at 1, 3, 6, 12, 24, and 36 months after treatment.
RESULTS
The study found that the most common minor complication of UAE was postembolization syndrome in 73.6% of women, resolving within a week. No significant differences were observed between the UAE group and the control group in serum levels of reproductive hormones (FSH, LH, E2, AMH) and ovarian reserve indicators (AFC, OV) at any point up to 36 months post-treatment. Additionally, there were no significant differences in conception, pregnancy, or delivery rates, with the average time to conception and gestational age at delivery being similar between the two groups. Birth weights were also comparable. Finally, there was no significant correlation between ovarian function, fertility indicators, and the type or amount of embolic agent used or the change in fibroids post-treatment.
CONCLUSION
UAE resulted in significantly positive pregnancy outcomes, no adverse events post-treatment, and is a safe and effective treatment for uterine fibroids that preserves ovarian function and fertility.
PubMed: 38817222
DOI: 10.12998/wjcc.v12.i15.2551 -
Scientific Reports May 2024Pregnancy affects a woman's physiological and psychological state. One of the most important aspects that requires attention is the quality of life of pregnant women....
Pregnancy affects a woman's physiological and psychological state. One of the most important aspects that requires attention is the quality of life of pregnant women. The quality of life of women during this period is influenced by a number of factors, such as back and pelvic pain, physiotherapy and physical activity, and also sexual satisfaction. Eighty-five women aged 21-40 years (30.80 ± 5.05) in pregnancy trimesters participated in the study: 17 women were in the first trimester, 32 women were in the second, and 36 women in the third trimester. The World Health Organisation Quality of Life (WHOQOL-BREF), Oswestry Disability Index (ODI) and the Sexual Satisfaction Scale for Women SSS-W-R15 were used to answer the research hypotheses. Respondents also provided information on questions regarding physiotherapy treatments and physical activity. Quality of life (WHOQOL-BREF) and disability due to back pain (ODI) showed a statistical association and relationship (p-value = 0.045, rho = - 0.22). Quality of life (WHOQOL-BREF) has an association with sexual satisfaction in pregnant women (SSS-W-R15) (p-value = 0.003, rho = 0.32). The trimester of pregnancy has an effect on ODI (p-value = 0.027). A significant effect occurred in a detailed comparison between the first and third trimesters of pregnancy (p-value = 0.026). The trimester also has an impact on quality of life (WHOQOL-BREF) (p-value = 0.002). In a detailed analysis, a significant effect occurred between the first and third trimesters of pregnancy (p-value = 0.001). Moreover, the trimester of pregnancy has an impact on sexual satisfaction (SSS-W-R15) (p-value = 0.027). After detailed statistical analysis, a significant effect occurred between trimesters one and three of pregnancy (p-value = 0.046). On the other hand, the number of days of physical activity performed by pregnant women per month and the type of physical activity had no effect on the ODI (p-value = 0.071). The type of physical activity performed by pregnant women also has no effect on ODI (p-value = 0.023). The number of physiotherapy treatments used has no effect on the ODI (p-value = 0.156). Type of physiotherapy treatment has no effect on ODI (p-value = 0.620). Normal pregnancy quality of life (WHOQOL) is related to ODI and sexual satisfaction (SSS-W-R15), while the trimester of pregnancy also has an impact on quality of life, disability due to back pain and sexual satisfaction.
Topics: Humans; Female; Pregnancy; Quality of Life; Adult; Young Adult; Pregnancy Trimesters; Surveys and Questionnaires; Back Pain; Exercise
PubMed: 38816467
DOI: 10.1038/s41598-024-63355-7 -
Brazilian Journal of Physical Therapy 2024The accurate diagnosis of pelvic floor muscle impairments is essential. The plethora of terms and the lack of evidence to support widely used pelvic floor muscle...
BACKGROUND
The accurate diagnosis of pelvic floor muscle impairments is essential. The plethora of terms and the lack of evidence to support widely used pelvic floor muscle function (PFMF) measurements hinder diagnostic labels.
OBJECTIVE
To structure an examination of PFMF using visual observation and digital palpation and terms consistent with the ICF terminology, and to test its intra and interrater reliability/agreement.
METHODS
A panel of 9 physical therapists applied Delphi method to structure the PFMF exam under ICF terminology and to verify its measurements reproducibility. For reliability and agreement, a convenience sample of women aged 51.2 ± 14.7 years had the sensitivity to pressure, pain, muscle tone, involuntary movement reaction, control of voluntary movement (contraction/relaxation), coordination, strength, and endurance examined by two raters, in the same day for interrater (n = 40), and one week apart, for intrarater reliability (n = 25). Percent agreement, linear weighted kappa, intraclass correlation coefficient, and Bland-Altman's limits of agreement were calculated (alpha = 0.05).
RESULTS
Four round Delphi discussion structured the PFMF exam, named EFSMAP (Exame das Funções Sensoriais e Motoras do Assoalho Pélvico/Examination of Pelvic Floor Sensory and Motor Functions), set a list of concepts and instructions targeted at reproducibility and established PFMF diagnostic labels. Reliability, except for pain and tone, were moderate to excellent (Kw= 0.67-1.0 and ICC=0.48-0.82). Agreement was substantial for most PFMF features (0.64-1.00), except pain.
CONCLUSIONS
The EFSMAP was successfully developed as a valid and reliable exam to be used in research and clinical practice; it provides labels for the diagnosis of pelvic floor muscle impairments. It might be easily adopted worldwide as it uses ICF terminology.
Topics: Humans; Pelvic Floor; Female; Reproducibility of Results; Middle Aged; Delphi Technique
PubMed: 38815549
DOI: 10.1016/j.bjpt.2024.101067 -
Journal of Obstetrics and Gynaecology :... Dec 2024A biopsychosocial approach to the understanding of pelvic pain is increasingly acknowledged. However, there is a lack of standardised instruments - or their use - to... (Review)
Review
BACKGROUND
A biopsychosocial approach to the understanding of pelvic pain is increasingly acknowledged. However, there is a lack of standardised instruments - or their use - to assess risk factors and their impact on pelvic pain in both clinical and research settings. This review aims to identify validated tools used to assess known contributory factors to pelvic pain, as well as the validated tools to measure the impact of pelvic pain in adolescents and young adults, in order to provide a framework for future standardised, adolescent specific assessment and outcome tools.
METHODS
Literature searches were performed in MEDLINE, PsycInfo and PubMed. Search terms included pelvic pain, dysmenorrhoea, endometriosis, adolescent, pain measurement, quality of life, sleep, mental health, coping strategies and traumatic experience.
RESULTS
We found validated instruments to assess adverse childhood experiences and coping strategies, both known contributing factors to pelvic pain. The impact of pain was measured through validated tools for health-related quality of life, mental health and sleep.
CONCLUSIONS
Pelvic pain evaluation in adolescents should include a multi-factorial assessment of contributing factors, such as childhood adversity and coping strategies, and impacts of pelvic pain on quality of life, mental health and sleep, using validated instruments in this age group. Future research should focus on the development of consensus amongst researchers as well as input from young women to establish a standardised international approach to clinical trials involving the investigation and reporting of pelvic pain in adolescents. This would facilitate comparison between studies and contribute to improved quality of care delivered to patients.
Topics: Humans; Adolescent; Pelvic Pain; Female; Quality of Life; Adaptation, Psychological; Pain Measurement; Risk Factors; Mental Health; Adverse Childhood Experiences; Dysmenorrhea; Young Adult; Sleep
PubMed: 38813795
DOI: 10.1080/01443615.2024.2359126 -
Frontiers in Public Health 2024Anesthesia providers face numerous occupational hazards, including exposure to anesthesia gases, which can lead to fatigue. These professionals face challenges such as...
BACKGROUND
Anesthesia providers face numerous occupational hazards, including exposure to anesthesia gases, which can lead to fatigue. These professionals face challenges such as night shifts, OR stress, limited mobility and sunlight access, high workload, inadequate rest breaks. Health-related sociodemographic variables, such as smoking, sleep patterns, and obesity. Our research aims to explore various risk factors associated with fatigue among operating theatre workers including sleep quality.
METHODS
A cross-sectional study was conducted on 227 of operating room healthcare professionals from five tertiary hospitals in Saudi Arabia, for a period of 6 months, between January 1, 2023 to June 1, 2023. The study used a five-point Likert scale sheet and the FSS "fatigue severity scale" to analyze and measure fatigue and sleep quality. The questionnaire included all socio-demographic variables, work conditions, and fatigue severity scale items.
RESULTS
The major findings revealed a significant correlation between fatigue severity scores and exposure to anesthesia gases. Socio-demographic variables such as smoking have showed major relevance to fatigue in the sample size, as (76.6%) of the participants that answered as regular smokers have showed result of positive correlation to fatigue and with a significant of (0.034). Out of the total sample, 76.1% were exposed to anesthesia gases once daily, showing a positive association with fatigue severity scores. Work-related factors like job experience and position also had a lower association with fatigue severity. (0.031) Univariate logistic regression (0.035).
CONCLUSION
The study found that the work-related conditions like workload on Anesthesia technicians and technologists over 44 h per week and gas exposure is directly linked to fatigue severity and sleep quality so is the socio-demographic considerations. With poor sleep quality in younger staff which is documented in the study result a large-scale prospective analysis to understand the factors affecting OR staff's sleep quality and fatigue severity and what can be done to regulate working hours and break time and incorporate naps in to enhance patient safety and well-being for anesthesia providers in Saudi Arabia.
Topics: Humans; Cross-Sectional Studies; Fatigue; Saudi Arabia; Operating Rooms; Male; Adult; Female; Surveys and Questionnaires; Sleep Quality; Middle Aged; Occupational Exposure; Risk Factors; Health Personnel
PubMed: 38813423
DOI: 10.3389/fpubh.2024.1392950 -
Cureus Apr 2024Endometriosis is a chronic benign inflammatory disease that affects women of reproductive age. The clinical presentations of endometriosis include dysmenorrhea,... (Review)
Review
Endometriosis is a chronic benign inflammatory disease that affects women of reproductive age. The clinical presentations of endometriosis include dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. There is a well-established association between endometriosis and infertility. Therefore, there is a need for an early diagnosis of endometriosis-related infertility. In this study, we aim to identify the role of biomarkers as predictive factors of the presence of the disease and its severity and their correlation with the pregnancy outcome. We performed an electronic database search of all published studies in PubMed and EMBASE from January 2018 to May 2023. Numerous innovative biomarkers identified in cases of endometriosis and infertility have been studied over the past years, including micro-RNAs, BCL6 endometrial expression, cytotoxic T-lymphocyte antigen 4, human leukocyte antigen G, programmed cell death protein 1, programmed cell death ligand 1 immune checkpoint molecules, plasma fibronectin-fibrin complexes, homeobox A10 gene, systemic inflammatory response markers, uterine natural killer cells, and the eutopic endometrium proteome. Considerable research has been done to identify diagnostic biomarkers for the early detection and prevention of endometriosis-associated infertility. However, none of these biomarkers displayed enough diagnostic accuracy to be used in daily clinical practice. Future research is valuable to establish them as reliable diagnostic tools.
PubMed: 38813329
DOI: 10.7759/cureus.59288 -
SAGE Open Medical Case Reports 2024Intrauterine device is a widely used contraceptive method. However, it may translocate to other sites within the pelvic cavity, including the intestines and the bladder....
Intrauterine device is a widely used contraceptive method. However, it may translocate to other sites within the pelvic cavity, including the intestines and the bladder. This contraceptive method has failure rate between 1 and 3 out of 100 women/year. The use of intrauterine device also slightly increases the risk of ectopic pregnancy upon its failure. The combination of intrauterine device translocation and contraceptive failure is rare. We present such a case. A 29-year-old woman (Gravida 4, Para 2) presented with a complaint of abdominal pain and presence of blood spotting over the last 7 h. She tested positive for pregnancy. Upon arrival, her vital signs were normal, but she was moderately obese with a body mass index (BMI) of 38.8 kg/m. She displayed tenderness during abdominal examination and cervical motion tenderness. Her blood test results showed no significant abnormalities. Abdominal ultrasound revealed a translocated part of intrauterine device to the cervix and transvaginal ultrasound confirmed the presence of a hypoechoic complex structure in the left adnexa, measuring 53 mm, alongside free fluid in Morrison's pouch. An emergency laparotomy was performed, revealing a normal uterus and a ruptured left fallopian tube with approximately 800 cc of blood in the abdomen.
PubMed: 38812838
DOI: 10.1177/2050313X241258840 -
Turkish Journal of Medical Sciences 2024To investigate the roles of vascular endothelial growth inhibitor (VEGI) and hypoxia-inducible factor-1α (HIF-1α) in the treatment of refractory interstitial...
BACKGROUND/AIM
To investigate the roles of vascular endothelial growth inhibitor (VEGI) and hypoxia-inducible factor-1α (HIF-1α) in the treatment of refractory interstitial cystitis/bladder pain syndrome (IC/BPS) with hyperbaric oxygen (HBO).
MATERIALS AND METHODS
A total of 38 patients were included. They were assessed before and 6 months after HBO treatment. Three-day voiding diaries were recorded, and O'leary-Sant scores, visual analog scale (VAS) scores, quality of life (QoL) scores, pelvic pain, and urgency/frequency (PUF) scores were evaluated. Bladder capacity was assessed by cystoscopy. Bladder mucosa was collected for Western blot, qRT-PCR, and immunofluorescence staining to compare the expression of VEGI and HIF-1α before and after treatment.
RESULTS
Compared with before treatment, patients showed significant improvements in 24-h voiding frequency (15.32 ± 5.38 times), nocturia (3.71 ± 1.80 times), O'leary-Sant score (20.45 ± 5.62 points), VAS score (41.76 ± 17.88 points), QoL score (3.03 ± 1.44 points), and PUF score (19.95 ± 6.46 points) after treatment (p < 0.05). There was no significant difference in bladder capacity before and after treatment (p ≥ 0.05). The expression levels of VEGI and HIF-1α protein and mRNA were significantly decreased 6 months after treatment compared with before treatment. Immunofluorescence staining results showed that the double positive expression of VEGI and HIF-1α protein in bladder tissue of IC/BPS patients after HBO treatment quantitatively decreased significantly.
CONCLUSION
This study identified a possible mechanism by which VEGI and HIF-1α expression decreased after HBO treatment due to hypoxia reversal, which improved symptoms in IC/BPS patients.
Topics: Humans; Hyperbaric Oxygenation; Hypoxia-Inducible Factor 1, alpha Subunit; Female; Middle Aged; Male; Cystitis, Interstitial; Adult; Quality of Life; Urinary Bladder; Aged; Treatment Outcome
PubMed: 38812622
DOI: 10.55730/1300-0144.5762 -
World Journal of Psychiatry May 2024Rectus abdominis separation (DRA) affects pelvic stability and body image. No studies have explored the effects of manual massage on early postpartum DRA and postpartum...
BACKGROUND
Rectus abdominis separation (DRA) affects pelvic stability and body image. No studies have explored the effects of manual massage on early postpartum DRA and postpartum depression.
AIM
To analyze the curative effect of massage on early postpartum DRA and its impact on postpartum depression and thus its ability promote the overall psychosomatic rehabilitation of postpartum women.
METHODS
Data were retrospectively collected on 70 primiparous women with postpartum DRA who underwent rehabilitation at the Postpartum Rehabilitation Center of Huzhou Maternal and Child Health Hospital from October 2022 to September 2023. The patients were divided into the Group S (35 cases, biomimetic electrical stimulation treatment) and Group L (35 cases, biomimetic electrical stimulation combined with manual massage treatment). Baseline data, the edinburgh postpartum depression scale (EPDS) score, and the visual analog scale (VAS) scores for rectus abdominis distance, waist circumference, and lower back pain before and after treatment were compared.
RESULTS
No significant differences were found in the baseline data, rectus abdominis distance, waist circumference, and VAS and EPDS scores between the two groups before treatment ( > 0.05). After treatment, the distance between rectus abdominis and waist circumference in Group L were significantly smaller than those in Group S ( < 0.05). Furthermore, lower back pain (VAS score) and the EPDS score in Group L were significantly lower than those in Group S ( < 0.05).
CONCLUSION
Manual massage can significantly reduce early postpartum DRA, waist circumference, and back pain and improve the patient's mental state and postpartum depression.
PubMed: 38808091
DOI: 10.5498/wjp.v14.i5.678