Evaluation of bovhyaluronidase azoxymer efficacy in combined treatment of patients with endometriosis based on the results of multicenter prospective non-interventional study (ISLAND)

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (5) ◽  
pp. 392-401
Author(s):  
Maria I. Yarmolinskaya ◽  
Viktor E. Radzinsky ◽  
Mekan R. Orazov ◽  
Irina N. Korotkikh ◽  
Oleg R. Ziganshin ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Pain Intensity ◽  
Pelvic Pain ◽  
Physical Functioning ◽  
Life Quality ◽  
Reproductive Age ◽  
Alternative Methods ◽  
Sf 36 ◽  
Complex Therapy ◽  
Significant Life

Background. Endometriosis is a chronic progressive recurrent disease associated with pelvis pain, menses disorders and infertility. The prevalence of endometriosis (EGE) tends to increase steadily and reaches 15% among women of reproductive age. Endometriosis-associated pain can persist despite surgical and drug treatment of this disease, resulting in a significant decrease in the quality of life of patients. The main causes of EGE-associated pain are local inflammatory, adhesive, neuro- and angiogenic processes. Currently, the search for alternative methods of pathogenesis-based therapy of the disease is one of the priority tasks. Given its anti-inflammatory, enzymatic, antioxidant effects and anti-adhesion mechanism of action, bovhyaluronidase azoximer, an enzyme agent with hyaluronidase activity, is a promising drug in the complex therapy of EGE. Aim. To compare bovhyaluronidase azoxymer efficacy in complex therapy of patients with EGE using dienogest (2 mg) versus monotherapy with this progestogen in real clinical practice. Materials and methods. 149 female patients of reproductive age were enrolled in the study after surgical treatment for EGE. The patients were divided into two groups: the first group (n=94) was treated with complex therapy by dienogest (2 mg) daily within 6 months in combination with suppositories containing bovhyaluronidase azoxymer (3000 IU): 1 suppositorium once within 3 days,10 administrations; and then 1 suppositorium once in 7 days, 17 administrations, within 120 days; the second group (n=55) received monotherapy with dienogest (2 mg) daily up to 6 months. EGE-associated pelvic pain intensity, uterine bleeding severity and life quality were assessed during the study, after 30, 90, 150 and 180 days with regard to the basic values. Results. There was a statistically significant reduction of pain intensity observed in both groups compared to the basic level, using visual analogue scale of pain (VAS), the Biberoglu and Berman scale, but there was a distinct trend towards a more significant decrease in pelvic pain score basing on VAS in patients received complex therapy versus monotherapy with dienogest 2 mg after 30 days of treatment (p=0.051). Life quality assessment of patients in both groups revealed statistically significant increase in scores for all values of the SF-36 life quality scale just after the second follow-up visit. More significant life quality improvement in patients was observed with complex therapy with regard to such descriptors of the SF-36 Questionnaire as Physical functioning, Role-physical functioning, Pain intensity (p0.05). Conclusion. Bovhyaluronidase azoxymer in combination with dienogest (2 mg) improves the overall therapy effectiveness for EGE and is associated with more significant reduction in pelvic pain intensity, inflammatory and adhesive processes in the pelvis, and significant life quality improvement compared to monotherapy with 2 mg dienogest.

scholarly journals FRI0492 СLINICAL AND LABORATORY DATA AND ALGORITHM OF MANAGEMENT OF ADULT PATIENTS WITH OLIGO-ARTICULAR VARIANTS OF JIA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 844.1-845
Author(s):  
M. Dzhus ◽  
M. Kyluk ◽  
O. Ivashkivsky ◽  
T. Karasevska
Keyword(s):  
Mental Health ◽  
Pain Intensity ◽  
Normal Distribution ◽  
Physical Functioning ◽  
General Health ◽  
Laboratory Data ◽  
Well Being ◽  
Adult Patients ◽  
Psychological Status ◽  
Sf 36

Background:The oligo-articular JIA is a disease that begins in childhood and can lead to joint damage and disability in adulthood with significant social losses.Objectives:The aim of this study was to evaluate the clinical and laboratory status and to develop an algorithm of managment adult patients with oligo articular variant of JIA, depending on the detection of RF or/and A-CCP, ANA, HLA-B27.Methods:The study included 168 adult patients from different regions of Ukraine who were diagnosed with JIA in childhood between 1984 and 2014 without severe comorbidities. Inclusion criteria were: age 16 to 60 years; duration of the disease > 3 years. Among patients with JIA were identified 64 patients with oligo-articular variant: 44 (26,2%) - with persistant oligo-arthritis, and 20 (11,9%) with extended oligo-arthritis. The disease activity was evaluated by DAS28 and JADAS-10. The questionaries SF-36, HAQ, TAS-20, PHQ-9 were analyzed and remote articular JADI-A and extra-articular JADI-E damages were evaluated. Statistical studies were performed using IBM SPPS Statistics version 25.0.0.0 software, the results were considered to be reliable at 5% critical level (P <0.05). The distribution of quantitative variables was tested by the Shapiro-Wilk test. Quantitative variables with a normal distribution were expressed as mean ± SD, quantitative variables that showed a non-normal distribution were expressed with a median (P25-P75), also performed correlative analysis of the variablesResults:It was found that patients with active JIA in 26.5% have depression according to the PHQ-9, while patients in remission have no signs of depression. Most adult patients with JIA (86.4%) have elevated and high levels of alexithymia. The predictors of JIA remission in adulthood are male sex (OR = 0.453; 95% CI 0.253-3.556); arthritis of more than 3 joints (OR = 0.459; 95% CI 0.347-0.770); wrist arthritis in childhood (OR = 0.082; 95% CI 0.009-0.739) and JADAS-10 in the disease onset (OR = 0.758; 95% CI 0.589-0.896) <6 points, treatment with IB in the history (OR = 0,767; 95% CI 0.054-0.811) and the duration of DMARDS treatment (OR = 0.741; 95% CI 0.636-0.863) > 1.5 years. The negative correlation of JADI-A and the patient’s physical well-being PCS (r = -0.27, p <0.05) and physical functioning (r = -0.24, p < 0.05), pain intensity (r = -0.24, p <0.05), general health (r = -0.24, p <0.05), vital activity (r = -0,19, p <0,05), social functioning (r = -0,27, p <0,05), mental health (r = -0,22, p <0,05) according to SF-36. The severity of extra-articular damages JADI-E correlated with PCS (r = -0.22, p <0.05) and physical functioning (r = -0.28, p<0.05), pain intensity (r = -0.20, p <0.05), general health (r = -0.23, p <0.05), and mental health (r = -0.23, p <0.05), but also had a positive correlation with HAM-A (r = 0.25, p <0.05), depression scale (r = 0.28, p <0.05) and PHQ-9 (r = 0.28, p <0.05). Significantly lower level of physical health was established in patients who requires prosthetics (p <0.001) compared to those who did not need prosthetics.Conclusion:Based on the obtained results, algorithms of management of adult patients with JIA oligoarthritis were developed, depending on the detected articular and extra-articular damages and the need for prosthetics and the psychological status.Disclosure of Interests:None declared

scholarly journals Pain syndromes in endometriosis: an integrated approach to the problem management

2020 ◽  
pp. 271-273
Author(s):  
T.F. Tatarchuk
Keyword(s):  
Quality Of Life ◽  
Oxidative Stress ◽  
Pelvic Pain ◽  
Standard Treatment ◽  
Reproductive Age ◽  
Alternative Methods ◽  
Endometrial Cells ◽  
Group 2 ◽  
Group 1

Background. Endometriosis affects 10 % of women of reproductive age. Endometriosis is often accompanied by the following symptoms: dyspareunia, pelvic pain, and dysmenorrhea. Pain is a leading symptom of endometriosis and often persists despite treatment. Objective. To elucidate the basics of pathogenesis and treatment of pain in endometriosis. Materials and methods. Analysis of literature data on this topic; own study involving 64 women with endometriosis. Group 1 was given dienogest (2 mg per day) for 3 months, and group 2 was given dienogest in combination with Tivortin (5 intravenous infusions of 100 ml each other day with the switch to Tivortin aspartate (“Yuria-Pharm”) orally). Results and discussion. Pain in endometriosis includes several pathophysiological mechanisms: increased nociception, inflammation, and changes in the recognition of pain in the nervous system. Significant pelvic vascularization promotes the rapid transmission of pain signals from this area to the brain. The severity of pain noted by women poorly correlates with the degree of disease detected during surgery. According to the recommendations of NICE (2017), one or more of the following symptoms are sufficient for suspected endometriosis: chronic pelvic pain (>6 months), dysmenorrhea, which adversely affects quality of life and daily activity, dyspareunia, gastrointestinal disorders and urinary system symptoms associated with menstruation, and infertility in combination with one or more of the above symptoms. Endometriosis requires flexible adaptation of management and the constant choice of treatment tactics depending on the symptoms and life situation of the patient. The basic goals of treatment inlude elimination of symptoms, restoration of quality of life and fertility, prevention of recurrences and repeated surgical intervention. Analgesics, neuromodulators and hormonal agents are used for pharmacological pain management. Additional and alternative methods include reflexology, manual therapy, osteopathy, exercise, dietary changes, and sleep hygiene. Elimination of the oxidation imbalance is one of the methods to treat pain in endometriosis. The uterus is a highly vascularized organ and its cells are constantly affected by high concentrations of oxygen. In settings of hypoxia, steroidogenesis, angiogenesis, inflammation and metabolic transition occur in endometrial cells. In women with endometriosis, there is an increase in markers of oxidative stress in the blood. Intrauterine oxidative stress can be eliminated with the powerful antioxidant L-arginine (Tivortin, “Yuria-Pharm”). In our own study, it was shown that the inclusion of Tivortin into the treatment allowed to decrease the intensity of intermenstrual endometriosis-associated pelvic pain more markedly than the standard treatment. The initial pain level was 61.32±3.2 according to the visual-analog scale in group 1 and 64.2±2.8 in group 2 (Tivortin). A month later, the indicators were 36.5±2.6 and 27.2±2.2, respectively. It should be noted that the effect of Tivortin is stable. In the standard treatment group, the intensity of pain increased again after the end of therapy, and in the Tivortin group remained at a low level. Evaluation of the McGill questionnaire results showed that in Tivortin group pain decreased not only due to the actual strength of the pain, but also due to a decrease in its sensory and emotional characteristics. After treatment, in group 1 the intensity of menstrual bleeding also increased more markedly. Conclusions. 1. The goals of endometriosis treatment are to eliminate symptoms, restore quality of life and fertility, prevent recurrence and repeated surgeries. 2. The effectiveness of L-arginine (Tivortin) in the treatment of endometriosis was ensured by normalizing vascular tone in the pelvic organs, reducing oxidative stress, psychostabilizing effect, increasing the antibacterial activity of neutrophils. 3. The use of Tivortin is a promising area for the treatment of endometriosis and prevention of its recurrence.

scholarly journals Кореляція між показниками пов'язаної зі здоров’ям якості життя і формою еректильної дисфункції у чоловіків молодого та середнього віку

2010 ◽  
Vol 1 (1) ◽  
pp. 41-49
Author(s):  
D. Z. Vorobets ◽  
I. I. Horpynchenko ◽  
Z. D. Vorobets
Keyword(s):  
Erectile Dysfunction ◽  
Endothelial Dysfunction ◽  
Pain Intensity ◽  
Physical Functioning ◽  
Sexual Desire ◽  
Strong Correlation ◽  
General Health ◽  
Premature Ejaculation ◽  
Bodily Pain ◽  
Sf 36

The psychogenic erectile dysfunction (ED) does not show strong correlation between domains of questionnaires SF-36 and IIEF. In conditions of ED caused by endothelial dysfunction the domains of general health, physical functioning, bodily pain and vitality strongly correlates with all domains rates of IIEF questionnaire except overall satisfaction. In conditions of erectile dysfunction caused by chronic pelvis pain the rates of IIEF correlate with domains of physical functioning, pain, vitality from SF-36. In conditions of premature ejaculation and ED accompaniment the rates of general health, pain intensity and vitality become worth and correlate with total score of IIEF, rates of sexual desire end intercourse satisfaction.

scholarly journals Effectiveness of the vitamin drug Doctovit for correction of clinical symptomatology and restoration of life quality in complex therapy of chronic erosive H. pylori-associated gastritis

2019 ◽  
Vol 44 (3) ◽  
pp. 62-69
Author(s):  
N.B. Gubergrits ◽  
L.S. Babinets ◽  
I.M. Halabitska
Keyword(s):  
Clinical Symptoms ◽  
Life Quality ◽  
Complex Treatment ◽  
Erosive Gastritis ◽  
Clinical Symptomatology ◽  
Sf 36 ◽  
Complex Therapy ◽  
Significant Regression ◽  
H Pylori ◽  
Psychological Parameters

Inclusion of the vitamin drug Doctovitin the complex treatment of patients with chronic erosive gastritis contributed to a statistically significant regression of clinical symptoms (p<0.05). This led to significant improvement of physical and psychological parameters of life quality: according to the SF-36 questionnaire scale — at the average of 4.9%, GSRS questionnairescale — by 17.2% (p<0.05), which proved the effectiveness and reasonability of using the vitamin drug in complex treatment and rehabilitation of patients with chronic erosive gastritis. It is expedient to prescribe 2 tablets of the vitamin complex Doctovit per day after eating during 2 months for the correction of polynutrient disorders in complex treatment of chronic erosive gastritis.

scholarly journals СLINICAL AND LABORATORY DATA AND ALGORITHM OF MANAGEMENT OF ADULT PATIENTS WITH POLYARTICULAR VARIANT OF JUVENILE IDIOPATHIC ARTHRITIS

2019 ◽  
Vol 15 (3-4) ◽  
pp. 24-31
Author(s):  
M.B. Dzhus ◽  
G.V. Mostbauer ◽  
T.A. Karasevska ◽  
M.I. Shevchuk ◽  
M.S. Kulik
Keyword(s):  
Mental Health ◽  
Juvenile Idiopathic Arthritis ◽  
Pain Intensity ◽  
Physical Functioning ◽  
General Health ◽  
Joint Damage ◽  
Well Being ◽  
Adult Patients ◽  
Psychological Status ◽  
Sf 36

Relevance. The polyarticular variant of juvenile idiopathic arthritis (JIA) is a disease that begins in childhood and leads to joint damage and disability in adulthood with significant social losses. At 18, patients go under the supervision of adult rheumatologists, often accompanied by loss of control of the disease due to insufficient compliance from both the patient and the physician. Today, there is no documented process for the transfer of patients from childhood to adulthood in Ukraine. Therefore, creating an algorithm for managing such patients is an urgent task.The polyarticular variant of JIA is a disease that begins in childhood and leads to joint damage and disability in adulthood with significant social losses.  Objective of this study was to evaluate the clinical and laboratory status and to develop an algorithm for managing adult patients with polyarticular variant of JIA, depending on the detection of RF or/and A-CCP.  Materials and methods. The study included 168 adult patients from different regions of Ukraine who were diagnosed with JIA in childhood between 1984 and 2014 without severe comorbidities.  Inclusion criteria were: 16 to 60 years old;  duration of the disease more than 3 years;  the presence of documentary evidence of childhood diagnosis of JIA (ambulatory card, hospital records). Among patients with JIA were identified 53 patients with polyarticular variant, of whom 42 or 25% - with RF (-) polyarthritis and 11 or 6.5% - with RF (+) polyarthritis. The disease activity was evaluated by DAS28 and JADAS-10. The questionaries SF-36, HAQ, TAS-20, PHQ-9 were analyzed and remote articular JADI-A and extra-articular JADI-E damages were evaluated. Statistical studies were performed using IBM SPPS Statistics version 25.0.0.0 software, the results were considered to be reliable at 5% critical level (P <0.05).  Results. The negative correlation of JADI-A and the patient's physical well-being PCS (r = -0.27, p <0.05) and physical functioning (r = -0.24, p <  0.05), pain intensity (r = -0.24, p <0.05), general health (r = -0.24, p <0.05), vital activity (r = -0,  19, p <0,05), social functioning (r = -0,27, p <0,05), mental health (r = -0,22, p <0,05) according to SF-36. The severity of extra-articular damages JADI-E correlated with PCS (r = -0.22, p <0.05) and physical functioning (r = -0.28, g  <0.05), pain intensity (r = -0.20, p <0.05), general health (r = -0.23, p <0.05), and mental health (r =  -0.23, p <0.05), but also had a positive rcorrelation with HAM-A (r = 0.25, p <0.05), depression scale (r = 0.28, p <0,  05) and PHQ-9 (r = 0.28, p <0.05).  Significantly lower level of physical health was established in patients who requires prosthetics (p <0.001) compared to those who did not need prosthetics.  Conclusion. Based on the results obtained, algorithms for managing adult patients with JIA positive for RF or / and A-CCP were developed, depending on the detected articular and extra-articular damages and the need for prosthetics and the psychological status.

Quality of life of patients with Sjogren’s disease with ongoing therapy with diseasemodifying antirheumatic drugs

2020 ◽  
pp. 33-38
Author(s):  
E. Yu. Gan ◽  
L. P. Evstigneeva
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Life Quality ◽  
Well Being ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Sf 36 ◽  
Disease Modifying ◽  
Sjögren’S Disease

Purpose of the study. Assessing the association between the life quality of patients with Sjogren’s Disease and ongoing therapy with various disease-modifying antirheumatic drugs.Material and methods. The study was conducted on the basis of the regional rheumatology center of the consultative diagnostic clinic of the Sverdlovsk Regional Clinical Hospital No. 1. This work is based on the results of a simultaneous study of 74 patients with primary Sjogren’s Disease (SD), distributed in three comparison groups receiving various disease-modifying antirheumatic drugs chlorambucil, methotrexate and hydroxychloroquine. The diagnosis of SD was carried out according to European-American criteria AECGC (2002) [18]. In order to analyze the quality of life of patients with SD, the 36-Item Short Form Health Survey (SF‑36) was used. Statistical data processing was carried out using Statistica 7.0 program.Results. Assessment of the quality of life of patients with SD, which is an integrative criterion of human health and well-being, revealed the absence of statistically significant differences (p > 0.05) on eight scales and two health components of the SF‑36 questionnaire in the analyzed groups that differ in the treatment of disease-modifying antirheumatic drugs chlorambucil, methotrexate and hydroxychloroquine.Conclusions. The obtained data indicate an equivalent quality of life in SD patients treated with different disease-modifying antirheumatic drugs methotrexate, chlorambucil and hydroxychloroquine, and therefore hydroxychloroquine can be considered as an alternative basic therapy in patients with SD with certain limitations and contraindications methotrexate and chlorambucil.

Clinical and anamnestic characteristics of patients with adenomyosis, accompanied by pelvic pain syndrome

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 77-80
Author(s):  
M R Orazov ◽  
V E Radzinsky ◽  
M B Khamoshina ◽  
A O Dukhin ◽  
L R Toktar ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Pelvic Pain Syndrome ◽  
Common Disease ◽  
Contributing Factors ◽  
High Prevalence ◽  
Inflammatory Processes ◽  
History Of

Pelvic pain syndrome associated with adenomyosis is a common disease in women of reproductive age. Frequency of detection in the population varies from 10 to 53%. The aim - to study the clinical and anamnestic risk factors of pelvic pain, with adenomiose. Materials and methods. The study included 120 (n=120) patients with diffuse adenomyosis with pain and painless form of the disease who underwent examination and treatment in the gynecological Department of the Central clinical hospital №6 of Russian Railways in Moscow. Each patient was provided with an individual card, which was encrypted 171 sign. The studied parameters reflected the passport and anthropometric data, information about education, social status, presence of occupational hazards, complaints, illness. Results. Burdened gynecological and somatic histories, manifested a low health index, a more pronounced hereditary a family history of neoplastic diseases are contributing factors, and high prevalence of postponed surgeries, chronic, long-term ongoing inflammatory processes of the pelvic organs to create a favorable background for the further progression of chronic pelvic pain syndrome in adenomiose.

scholarly journals POS0101 ADVERSE HEALTH-RELATED QUALITY OF LIFE OUTCOME DESPITE ADEQUATE CLINICAL RESPONSE TO TREATMENT IN SYSTEMIC LUPUS ERYTHEMATOSUS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 260.2-261
Author(s):  
A. Gomez ◽  
J. Lindblom ◽  
V. Qiu ◽  
A. Cederlund ◽  
A. Borg ◽  
...  
Keyword(s):  
Clinical Response ◽  
Physical Functioning ◽  
Lupus Erythematosus ◽  
Response To Treatment ◽  
Black African ◽  
Link Type ◽  
Severe Fatigue ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

Background:Despite improvements in medical care that have contributed to prolonged life expectancy for people living with systemic lupus erythematosus (SLE) over the past decades, they still suffer from substantial diminutions of health-related quality of life (HRQoL) compared with the general population and with other chronic diseases.Some studies have demonstrated that conventional synthetic and biological disease-modifying agents contribute to improvements in SLE patients’ HRQoL, and responders to treatment have been shown to report greater improvements than non-responders. Although these observations are clinically relevant, improvement following a therapeutic intervention does not necessarily signify that the individual has achieved a satisfactory health state perception. In rheumatoid arthritis, significant pain and severe fatigue persist in a substantial proportion of patients who achieve a good clinical response to treatment or remission. This paradoxical observation has not been thoroughly explored in SLE.Objectives:To determine the prevalence of adverse HRQoL outcomes in patients with SLE who achieved an adequate clinical response after a 52-week long period on standard therapy plus belimumab or placebo, within the frame of two phase III clinical trials. We further aimed to compare frequencies of adverse HRQoL outcomes across different age categories and ethnic groups, and sought to identify contributing factors.Methods:We included patients who met the primary endpoint of the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials (N=760/1684), i.e. attainment of the SLE Responder Index 4 at week 52. Accordingly, evaluation of adverse HRQoL outcomes was based on patient reports at week 52 from treatment initiation, using the Medical Outcomes Study Short Form 36 (SF-36) health survey and the Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-Fatigue) scale. Adverse HRQoL outcomes were defined as (i) SF-36 scale scores ≤ the 5th percentile derived from age- and sex-matched US population-based norms from the SF-36 health survey user manual; and (ii) FACIT-Fatigue scores <30.Pearson’s chi-square or Fisher’s exact tests were used to investigate associations between dichotomous variables. Comparisons of continuous data between SLE patients and age- and sex-matched norms were performed using the Wilcoxon signed-rank test. Multivariable logistic regression models were created in order to assess independence and priority of potential factors associated with adverse HRQoL outcomes.Results:We found clinically important diminutions of HRQoL in SLE patients compared with matched norms and high frequencies of adverse HRQoL outcomes, the highest in SF-36 general health (29.1%), followed by FACIT-Fatigue (25.8%) and SF-36 physical functioning (25.4%). Overall, frequencies were higher with increasing age. Black/African American and White/Caucasian patients reported higher frequencies than Asians and Indigenous Americans, while Hispanics experienced adverse HRQoL less frequently than non-Hispanics. Increasing organ damage was associated with adverse physical but not mental HRQoL outcomes; disease activity showed no impact. In multivariable logistic regression analysis, addition of belimumab to standard therapy was associated with lower frequencies of adverse SF-36 physical functioning (OR: 0.59; 95% CI: 0.39–0.91; P=0.016) and FACIT-F (OR: 0.53; 95% CI: 0.34–0.81; P=0.004).Conclusion:Substantial proportions of SLE patients reported adverse HRQoL outcomes despite adequate clinical response to treatment, especially in physical aspects. Particularly high proportions were seen within Black/African American and White/Caucasian patients. Add-on belimumab may be protective against adverse physical functioning and severe fatigue. Our results corroborate that HRQoL diminutions constitute a substantial burden in patients with SLE, and highlight the limitations of current therapeutic strategies.Acknowledgements:The authors would like to thank GlaxoSmithKline (Uxbridge, UK) for sharing the data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials with the Clinical Study Data Request (CSDR) consortium, Dimitris Ladakis, Joaquin Matilla and Martin Pehr for contributing to the management of data, as well as all participating patients.Disclosure of Interests:Alvaro Gomez: None declared, Julius Lindblom: None declared, Victor Qiu: None declared, Arvid Cederlund: None declared, Alexander Borg: None declared, Sharzad Emamikia: None declared, Yvonne Enman: None declared, Jon Lampa: None declared, Ioannis Parodis Grant/research support from: Research funding and/or honoraria from Amgen, Elli Lilly and Company, Gilead Sciences, GlaxoSmithKline and Novartis.

scholarly journals Evaluation of the Diagnostic Accuracy of the Interview and Physical Examination in the Diagnosis of Endometriosis as the Cause of Chronic Pelvic Pain

2021 ◽  
Vol 18 (12) ◽  
pp. 6606
Author(s):  
Jolanta Nawrocka-Rutkowska ◽  
Iwona Szydłowska ◽  
Aleksandra Rył ◽  
Sylwester Ciećwież ◽  
Magdalena Ptak ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Pelvic Pain ◽  
Predictive Value ◽  
Chronic Pelvic Pain ◽  
Reproductive Age ◽  
Pelvic Surgery ◽  
History Of Surgery ◽  
Previous Surgery ◽  
History Of

Background: Chronic pelvic pain affects approximately 15% of reproductive age women. It is mainly caused by adhesions (20–40%). Despite CPP being the main symptom of endometriosis, the disease is confirmed by laparoscopy only in 12–18% of cases. The aim of this study was to evaluate the results of laparoscopy in women with CCP and to assess the sensitivity and specificity of elements of an interview and clinical examination. Materials and methods: The study included 148 women with CPP. Each patient underwent laparoscopy. In laparoscopy, the presence of endometriosis and/or peritoneal adhesions was confirmed. Then, the sensitivity and specificity and the positive and negative predictive value of endometriosis symptoms or abnormalities in the gynecological examination were statistically calculated. Results: After previous surgery, adhesions were found in almost half (47%) of patients. In patients without a history of surgery, adhesions were diagnosed in 6.34% of patients. Endometriosis without coexisting adhesions was more often diagnosed in women without previous surgery (34.9%), compared to 10.58% in the group with a history of surgery (p < 0.05). Conclusions: Intraperitoneal adhesions are most common in women after pelvic surgery and with chronic ailments. The best results for sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of endometriosis are found in women with irregular menstruations during which the pain increases. Laparoscopy still remains the primary diagnostic and therapeutic method for these women.

scholarly journals Limited predictive value of illness perceptions for short-term poor recovery in musculoskeletal pain. A multi-center longitudinal study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
E. J. de Raaij ◽  
H. Wittink ◽  
J. F. Maissan ◽  
P. Westers ◽  
R. W. J. G. Ostelo
Keyword(s):  
Prognostic Factors ◽  
Pain Intensity ◽  
Musculoskeletal Pain ◽  
Physical Functioning ◽  
Predictive Value ◽  
Illness Perceptions ◽  
Illness Perception ◽  
Added Value ◽  
Poor Recovery ◽  
Significant Difference

Abstract Background Musculoskeletal pain (MSP) is recognized worldwide as a major cause of increased years lived with disability. In addition to known generic prognostic factors, illness perceptions (IPs) may have predictive value for poor recovery in MSP. We were interested in the added predictive value of baseline IPs, over and above the known generic prognostic factors, on clinical recovery from MSP. Also, it is hypothesized there may be overlap between IPs and domains covered by the Four-Dimensional Symptom Questionnaire (4DSQ), measuring distress, depression, anxiety and somatization. The aim of this study is twofold; 1) to assess the added predictive value of IPs for poor recovery and 2) to assess differences in predictive value for poor recovery between the Brief Illness Perception Questionnaire - Dutch Language Version (Brief IPQ-DLV) and the 4DSQ. Methods An eligible sample of 251 patients with musculoskeletal pain attending outpatient physical therapy were included in a multi-center longitudinal cohort study. Pain intensity, physical functioning and Global Perceived Effect were the primary outcomes. Hierarchical logistic regression models were used to assess the added value of baseline IPs for predicting poor recovery. To investigate the performance of the models, the levels of calibration (Hosmer-Lemeshov test) and discrimination (Area under the Curve (AUC)) were assessed. Results Baseline ‘Treatment Control’ added little predictive value for poor recovery in pain intensity [Odds Ratio (OR) 0.80 (Confidence Interval (CI) 0.66–0.97), increase in AUC 2%] and global perceived effect [OR 0.78 (CI 0.65–0.93), increase in AUC 3%]. Baseline ‘Timeline’ added little predictive value for poor recovery in physical functioning [OR 1.16 (CI 1.03–1.30), increase in AUC 2%]. There was a non-significant difference between AUCs in predictive value for poor recovery between the Brief IPQ-DLV and the 4DSQ. Conclusions Based on the findings of this explorative study, assessing baseline IPs, over and above the known generic prognostic factors, does not result in a substantial improvement in the prediction of poor recovery. Also, no recommendations can be given for preferring either the 4DSQ or the Brief IPQ-DLV to assess psychological factors.

Sign in / Sign up

Export Citation Format

Share Document