Scar endometriosis: a mystery entity

Scar Endometriosis is described as having an active endometrial tissue at the scar area outside the uterine cavity. Corner stone for diagnosis is proper history, clinical examination and suspicion-based imaging. Caesarean scar endometriosis (CSE) usually seen following procedures like caesarean sections, hysterectomies. Time of presentation can be very variable so yet times difficult to suspect. Once suspected Convincing patient that they have active glands other than in uterine cavity is not easy. Hence proper imaging and biopsy is needed to backup for thorough counselling and treatment to improve the quality of life.

Download Full-text

Dental Students’ Oral Health-Related Quality of Life and Temporomandibular Dysfunction-Self-Rating versus Clinical Assessment

Healthcare ◽

10.3390/healthcare9101348 ◽

2021 ◽

Vol 9 (10) ◽

pp. 1348

Author(s):

Dagmar Schnabl ◽

Philipp Sandbichler ◽

Maximilian Neumaier ◽

Johannes Girstmair ◽

Fabian Barbieri ◽

...

Keyword(s):

Quality Of Life ◽

Oral Health ◽

Clinical Examination ◽

Normal Function ◽

Dental Students ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

G 14

The aim of this study was to compare dental students’ self-perception of oral health with the results of a clinical examination of the masticatory system. Seventy-four dental students (38 (51.4%) females and 36 (48.6%) males) completed the Oral Health Impact Profile questionnaire (OHIP-G-14) and underwent a clinical examination according to the Graz Dysfunction Index (GDI). Data were analyzed with descriptive and comparative statistics. Median OHIP-G-14 scores were 3 (IQR 0–6) in the total collective, 4 (1–11) in females, and 2 (0–4) in males (p = 0.072). A score of 0 was found in 29.7% of the sample. The results of the GDI were 50% “normal function”, 43.2% “adaptation”, 5.4% “compensation”, and 1.4% “dysfunction”. The comparison of OHIP-G-14 scores and DGI groups showed a significant difference (p = 0.031). Based on the questionnaire, less than one third of the sample indicated maximum oral health-related quality of life. In contrast, the GDI revealed “normal function” or “adaptation” in 93.2%. Dental students underappreciated their oral health condition. Health assessments should not be solely questionnaire-based, especially in health professionals (-to-be). To establish a valid diagnosis of the state of health, self-assessment must be complemented by an objective clinical examination, e.g., GDI.

Download Full-text

COVID-19 Compromises In The Medical Practice And The Consequential Effect On Endometriosis Patients

10.1101/2021.05.04.21255000 ◽

2021 ◽

Author(s):

Shaked Ashkenazi ◽

Ole Linvaag Huseby ◽

Gard Kroken ◽

Luis Adrian Soto ◽

Marius Pents ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Mental State ◽

Medical Management ◽

Uterine Cavity ◽

Well Being ◽

Reproductive Age ◽

Cross Sectional Survey ◽

Keywords Endometriosis

Background and purpose In response to the ongoing coronavirus disease 2019 (COVID-19) pandemic, self-isolation practices aimed to curb the spread of COVID-19 have severely complicated the medical management of patients suffering from endometriosis and their physical and mental well- being. Endometriosis, the main cause for chronic pelvic pain (CPP), is a highly prevalent disease characterized by the presence of endometrial tissue in locations outside the uterine cavity that affects up to 10% of women in their reproductive age. This study aimed to explore the effects of the global COVID-19 pandemic on patients suffering from endometriosis across multiple countries, and to investigate the different approaches to the medical management of these patients based on their self- reported experiences. Methods A cross-sectional survey, partially based on validated quality of life questionnaires for endometriosis patients, was initially created in English, which was then reviewed by experts. Through the process of assessing face and content validity, the questionnaire was then translated to fifteen different languages following the WHO recommendations for medical translation. After evaluation, the questionnaire was converted into a web form and distributed across different platforms. An analysis of 2964 responses of participants from 59 countries suffering from self-reported endometriosis was then conducted. Results The data shows an association between COVID-19 imposed compromises with the reported worsening of the mental state of the participants, as well as with the aggravation of their symptoms. For the 1174 participants who had their medical appointments cancelled, 43.7% (n=513) reported that their symptoms had been aggravated, and 49.3% (n=579) reported that their mental state had worsened. In comparison, of the 1180 participants who kept their appointments, only 29.4% (n=347) stated that their symptoms had been aggravated, and 27.5% (n=325) stated their mental health had worsened. 610 participants did not have medical appointments scheduled, and these participants follow a similar pattern as the participants who kept their appointments, with 29.0% (n=177) reporting aggravation of symptoms and 28.2% (n=172) reporting that their mental state had worsened. Conclusions These findings suggest that COVID-19 pandemic has had a clinically significant negative effect on the mental and physical well-being of participants suffering from endometriosis based on their self-reported experiences. Thus, they show the importance of further assessment and reevaluation of the current and future management of this condition in medical practices worldwide. Keywords Endometriosis, COVID-19, questionnaire, Quality of life, Mental health, Physical health

Download Full-text

Oral health-related quality of life among children undergoing cancer therapy.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e12006 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e12006-e12006 ◽

Cited By ~ 1

Author(s):

Hai Ming Wong ◽

Chun Hung Chu ◽

Godfrey Chi Fung Chan

Keyword(s):

Quality Of Life ◽

Oral Health ◽

Cancer Therapy ◽

Dental Caries ◽

Cancer Patients ◽

Clinical Examination ◽

Health Related Quality ◽

Related Quality ◽

Health Related

e12006 Background: Despite much interest in oral complications in cancer patients and studies reporting their prevalence, aetiology and management, there has been little understanding of how they affect the patients and the family. The aim of this study was, therefore, to assess the impact of oral complications on life quality for children undergoing cancer therapy. Methods: Seventy 6 - 14 years old paediatric patients undergoing cancer therapy in the Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong participated in this study. A clinical examination of the dentition and oral soft tissues was performed using criteria suggested by the World Health Organization. Clinical examination evaluated the status of: i) dental caries (DMFT/dmft Index), ii) periodontal health (CPI Index), iii) infection, such as herpes and candidiasis, iv) thrombocytopathy in the form of oral petechiae and spontaneous gingival bleeding, v) xerostomia, and vi) mucositis (WHO Mucositis Scale). Two questionnaires were filled by the children and their parents: i) the Child Perceptions Questionnaire (CPQ), and ii) a questionnaire contained simple closed questions to collect the information of oral health habits of children and demographic data from the parents. Results: Higher CPQ scores were found in children with mucositis (p < 0.001), dental caries (p < 0.001), children who were born in mainland China (p < 0.05), or parents of lower education or income level (p < 0.05). In multiple regression analyses, mucositis and dental caries were the significant predictors (p < 0.001) of the higher CPQ scores among the various parents and children characteristics collected in this survey. Conclusions: The findings of this study showed that paediatric cancer patients with mucositis and dental caries had poorer oral health-related quality of life.

Download Full-text

Deferring Nail Mycological Sampling during the COVID-19 Pandemic: Recommendations from a Multidisciplinary Panel of Nail Specialists

Skin Appendage Disorders ◽

10.1159/000520628 ◽

2021 ◽

pp. 1-4

Author(s):

Shari R. Lipner ◽

Mahmoud Ghannoum ◽

Molly A. Hinshaw ◽

Phoebe Rich ◽

Beth S. Ruben ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Practice ◽

Clinical Examination ◽

Accurate Diagnosis

Onychomycosis is the most common nail condition seen in clinical practice, with significant impact on quality of life. Clinical examination alone is insufficient for accurate diagnosis, but mycological confirmation can be challenging during the COVID-19 pandemic. In this letter, a multidisciplinary panel of dermatologists, a podiatrist, dermatopathologists, and a mycologist, discuss considerations for mycological sampling during the pandemic.

Download Full-text

Surgical Palliative Care

10.1093/med/9780190858360.001.0001 ◽

2019 ◽

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Supportive Care ◽

Terminal Illness ◽

Terminally Ill ◽

Surgical Care ◽

Serious Illness ◽

Moral Framework ◽

Time Of Presentation

Surgical Palliative Care is a synoptic presentation about the treatment of suffering and the promotion of quality of life for seriously or terminally ill patients under surgical care. The contributors include surgeons of different specialties who are leaders in the new specialty of surgical palliative care. Surgical palliative care encompasses supportive care for patients and families with serious illness that includes disease-directed treatment and supportive care for patients and families with terminal illness not seeking disease-directed treatment. The book commences with chapters covering the historical, conceptual and moral framework for surgical palliative care followed by chapters that follow the trajectory of the patient/family encounter with surgical care, from the time of presentation and proceeding to intraoperative and post-operative periods. The unique problems of several surgical subspecialties such as trauma and burns, thoracic surgery, and the transplantation are addressed in individual chapters.

Download Full-text

Biomarkers of endometriosis: How far have we come and where are we going?

Slovenian Medical Journal ◽

10.6016/zdravvestn.3056 ◽

2021 ◽

pp. 1-10

Author(s):

Vid Janša ◽

Joško Osredkar ◽

Eda Vrtačnik Bokal ◽

Tea Lanišnik Rižner ◽

Helena Ban Frangež

Keyword(s):

Quality Of Life ◽

Biomarker Discovery ◽

Uterine Cavity ◽

Final Diagnosis ◽

Non Invasive ◽

Research Priority ◽

Diagnostic Characteristics ◽

Diagnostic Approaches ◽

Gynaecological Disease

Endometriosis is a common gynaecological disease that is characterized by endometrium-like tissue outside the uterine cavity. Endometriosis significantly compromises the quality of life of women and is a major cause of infertility. The gold standard for diagnosis of endometriosis is visual inspection by laparoscopy, which significantly prolongs the time to final diagnosis. This lack of non-invasive diagnostic approaches is why the discovery of biomarkers for endometriosis has been defined as a research priority. In this report, we describe hypothesis-driven and hypothesis-generating approaches for biomarker discovery, along with some important potential biomarkers of endometriosis and their diagnostic characteristics, sensitivities, and specificities. Finally, we present our perspective on the discovery of biomarkers for endometriosis, and discuss some results from our previous and more recent studies. Future studies must focus on improving patient quality of life rather than on discovering significant differences, and therefore close collaboration between clinicians and pre-clinical researchers is essential.

Download Full-text

Dose Effect of Local Betamethasone Injection in Low Back Pain

Revista de Chimie ◽

10.37358/rc.18.9.6538 ◽

2018 ◽

Vol 69 (9) ◽

pp. 2382-2384

Author(s):

Abu Awwad Ahmed ◽

Radu Prejbeanu ◽

Dinu Vermesan ◽

Bogdan Deleanu ◽

Marius Ionitescu ◽

...

Keyword(s):

Quality Of Life ◽

Low Back Pain ◽

Back Pain ◽

Clinical Examination ◽

Trigger Point ◽

Dose Effect ◽

Lumbar Region ◽

Low Back ◽

Point Injection

The purpose of the study is to show the effects and evolution of patients with back pain treated with a different dose of betamethasone, analyzing both their evolution in terms of pain perception and lifestyle. In this study, 43 patients diagnosed with back pain in the lumbar region were included over a 12-month period. Patients were divided into two categories, depending on the dose of betamethasone administered. At 1 month control after the last injection, the first group of patients, a total of 22, given the local injection of betamethasone, trigger point injection, administering the usual dose: 1 ampoule of betamethasone 1 mL + 1 ampoule 1% xyline, at the clinical examination, they claimed that pain was reduced by about 70%, sustaining the improvement of the quality of life. The same group of patients, called for the final evaluation, at 3 month, claimed the pain was reduced by about 95%, as compared to the initial pain before starting the treatment. In the second category, where 21 patients were treated by local injections, trigger point injection, administering the modified dose of betamethasone: � ampoule of betanethasone 0.5 mL + 1 ampule 1% xyline, at 1 month control after the last injection, at the clinical examination they claimed thtat the pain was reduced with just 40%, sustaining an average quality of life. Even if a low dose of betamethasone shows significantly less systemic effects, a higher dose is required in the treatment of low back pain to have the desired effect and to significantly improve the quality of life of the patient.

Download Full-text

Caesarean Scar Endometriosis May Require Abdominoplasty

Clinical Medicine Insights Case Reports ◽

10.1177/11795476211027666 ◽

2021 ◽

Vol 14 ◽

pp. 117954762110276

Author(s):

Barczyński Bartłomiej ◽

Sobstyl Małgorzata ◽

Frąszczak Karolina ◽

Sobstyl Anna

Keyword(s):

Surgical Treatment ◽

Abdominal Wall ◽

Abdominal Wall Defect ◽

Uterine Cavity ◽

Tumour Resection ◽

Wall Defect ◽

Scar Endometriosis ◽

Caesarean Scar ◽

Hernia Prevention

Endometriosis is defined as an ectopic presence of endometrium-like tissue outside uterine cavity, which most commonly involves intraperitoneal organs. However, one of the less frequent forms of the disease is abdominal wall endometriosis usually developing in surgical scars following obstetric and gynaecological surgeries involving uterine cavity entering, that is, caesarean section, myomectomy or hysterectomy. In this case report we present a case of a patient with extensive caesarean scar endometriosis, who required complex surgical management. Successful surgical treatment involved not only radical tumour resection and application of mesh in postoperative hernia prevention but also adequate wound closure ensuring satisfactory cosmetic results, which was most challenging. The abdominal wall defect could not be sutured by traditional technique, thus polypropylene mesh was used and partial abdominoplasty was performed. The wound healed without complication and 24-month follow-up showed no evidence of local recurrence and satisfactory cosmetic result. In case of extensive endometrial abdominal wall tumours surgical treatment may involve application of advanced plastic surgery techniques, like abdominoplasty or skin/musculocutaneous flaps transposition.

Download Full-text

Relationship between clinical examination, Quality of Life, disability and depression in CMT patients: Italian Multicenter study

Neurological Sciences ◽

10.1007/s10072-008-0928-z ◽

2008 ◽

Vol 29 (3) ◽

pp. 157-162 ◽

Cited By ~ 14

Author(s):

L. Padua ◽

I. Aprile ◽

T. Cavallaro ◽

I. Commodari ◽

D. Pareyson ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Examination ◽

Multicenter Study ◽

Examination Quality

Download Full-text

Physiotherapy in Urinary Dysfunction Post-Surgery for Endometriosis: Case Report

EMJ Reproductive Health ◽

10.33590/emjreprohealth/19-00133 ◽

2021 ◽

Author(s):

Natália Mainardi Simas ◽

Domingos Mantelli Borges Filho ◽

Erica M. C. Mantelli Borges ◽

Carla Maria de Abreu Pereira ◽

Vera Lúcia dos Santos Alves

Keyword(s):

Quality Of Life ◽

Uterine Cavity ◽

Sao Paulo ◽

Urinary Dysfunction ◽

São Paulo ◽

Post Surgery ◽

Inflammatory Processes ◽

Short Time ◽

Therapy Service

Endometriosis is characterised by the presence of endometrial tissue outside the uterine cavity that responds to oestrogen and stimulates local inflammatory processes, adhesions, pelvic pain, and infertility. The treatment of endometriosis includes the use of medications and videolaparoscopy for excision of adhesions or lesions. Some complications are associated with the videolaparoscopy, such as vascular, intestinal, urinary, neurological, and more rarely, vulvar oedema, which makes the rehabilitation difficult in the immediate postoperative period. In relation to the urinary dysfunction and to the vulvar oedema, physiotherapy has resources with demonstrated efficacy in the treatment of such complications after videolaparoscopy; they can rehabilitate the patient and improve their quality of life in a short time. In this study, the authors report the case of a patient treated by the Physical Therapy Service of the Santa Casa de Misericórdia Hospital of São Paulo, São Paulo, Brazil, with urinary retention and vulvar oedema after videolaparoscopy for endometriosis, which showed improvement in vulvar oedema with the application of physiotherapy.

Download Full-text