Endometriosis: A Retrospective Analysis of Clinical Data from a Cohort of 4,083 Patients, With Focus on Symptoms.

BACKGROUND: Endometriosis is an estrogen-dependent and chronic inflammatory gynecological disease due to the presence of ectopic endometrial tissue outside the uterine cavity. This disease affects approximately 10% of the female population. In spite of its relatively high prevalence, information about its pathogenesis, diagnosis, and therapy is not complete. PATIENTS AND METHODS: We present a retrospective study performed on 4,083 patients with endometriosis, with a focus on symptoms. The archived data were analyzed investigating the distribution of symptoms among patients, the correlation of symptoms with the occupation of the patients, and finally the correlation with the other anamnestic data. Statistical associations between the data for all cases were then considered separately. RESULTS: Chronic fatigue syndrome and dyspareunia were confirmed as being among the main symptoms of endometriosis, together with bowel disorders. On the other hand, we registered a low occurrence of urinary disorders and even of chronic pelvic pain, which is usually considered among the main symptoms of endometriosis. We found an increase in incidence of symptoms starting from the age group 25-29 years up to 40-44 years and, subsequently, a significant decrease in the group aged 55-59 years. For all the symptoms analyzed, we found a higher incidence in employers, graduates and freelancers. Finally, we found a protective effect of the number of gestations on chronic fatigue syndrome. CONCLUSION: This in-depth study on such a vast cohort of affected patients clarifies some important aspects on the complex symptomatology of this still enigmatic disease. In particular, the study highlights the symptoms most closely related to endometriosis which will help speed up the diagnostic process of patients suffering from this pathology.

Endometriosis: A Retrospective Analysis on Diagnostic Data in a Cohort of 4,401 Patients.

BACKGROUND/AIM: Endometriosis is a gynecological estrogen-dependent inflammatory disease due to ectopic endometrial tissue and often associated with pelvic pain. Despite its high prevalence, there are still uncertainties about its pathogenesis, diagnosis, and therapy. PATIENTS AND METHODS: This study presents a retrospective study conducted on 4,401 endometriosis patients, 584 of which underwent laparoscopic procedures. The archived data about clinical signs, magnetic resonance imaging (MRI) results, topography of the endometriosis lesions (obtained via laparoscopy) associated diseases, sample analysis and histological findings were analyzed. Next, the statistical associations between the information for each case, provided by these diagnostic tools were determined. RESULTS: MRI is the most sensitive and specific diagnostic system for ovarian lesions, but poor in sensitivity and specificity for deep endometriosis lesions and not indicated for peritoneal lesions which remain the exclusive prerogative of laparoscopy. Clinical signs are essential for diagnosing deep lesions. The Ca125 and Ca19.9 markers have a poor reliability and their negativity in symptomatic patients has no clinical value, while in positive cases it could probably be used as a monitoring parameter. CONCLUSION: The results generated will help provide an accurate picture of the topography and distribution of endometriotic lesions. Correlation analyses between the data generated by the clinical-instrumental examinations and those on the site of the disease identified by laparoscopy, allow to define the predictive value of the clinical-instrumental signs in the diagnosis and localization of endometriotic disease.

Seasonal variation of Hedruris dratini (Nematoda) parasitizing Hydromedusa tectifera (Chelidae), with focus on host's torpor state.

BACKGROUND: The aim of this study was to analyze the seasonal distribution of the nematode Hedruris dratini parasitizing the South American Snake-necked turtle Hydromedusa tectifera and the amphipod Hyalella spp. in an urban stream. We focused on understand which strategies parasite population displays to get through the host's hibernation period. RESULTS: The highest prevalence and abundance of H. dratini were found in summer. The parasitic load was lower in winter, however there were no significant differences when it was compared with autumn and spring. Generalized linear model identified the temperature as a determining factor for the presence of parasites in turtles. CONCLUSIONS: Our results indicate that, beside turtles enter in a diapause state, the life cycle of H. dratini never stop throughout the year, being a continuous transmission between both the intermediate and final host throughout the year. Turtles feed and become infected with parasite larvae even in winter although with a lower ingestion rate.

Orthopedic Multidimensional Prognostic Index (Ortho-MPI) in the elderly with hip or neck femur fracture: a pilot study.

The Orthopedic Multidimensional Prognostic Index (Ortho-MPI) was performed and validated in order to ameliorate the decision-making process as regards the elderly with hip or neck femur fractures. A retrospective study was performed. 95 patients 65 years old and over with a diagnosis of hip or femur fracture were enrolled. A standardized comprehensive orthopedic geriatric assessment was performed. It included information on: depressive symptoms, functional and instrumental activities of daily living, cognitive and nutritional status, laboratory tests, risk of pressure sore, comorbidities and comorbidity. The Ortho-MPI was calculated. After six months their initial assessment, patients were recalled in order to know if they live too or not. The survival condition was associated to the prognostic capacity calculated by the Ortho-MPI. Results showed that higher Ortho-MPI Index value was associated with higher six months-later mortality. In an unvaried analysis model the Ortho-MPI index was associated with death event of the elderly patients enrolled (OR=1.05; 95% CI, 1.01-1.10; z=2.27; p=0.023). This association was also validated by considering different ages between participants (OR=1.05; 95% CI, 1.004-1.11; z=2.13; p=0.033). Furthermore, each specific index considered in the total Ortho-MPI was associated with the death event of the elderly patients. In conclusion it was shown that the Ortho-MPI Index could be used to predict outcome in the elderly with hip or femur fracture.

Behavioural addictions in adolescents and young adults: results from a prevalence study.

Our study aims to assess the prevalence of behavioural addictions in an adolescent population, evaluating the effects of gender and age, and to assess the correlations among different behavioural addictions. 2853 high school students were assessed in order to evaluate the prevalence of behavioural addictions such as Pathological Gambling (PG), Compulsive Buying (CB), Exercise Addiction (EA), Internet Addiction (IA), and Work Addiction (WA), in a population of Italian adolescents. The South Oaks Gambling Screen-Revised Adolescent (SOGS-RA), the Compulsive Buying Scale (CBS), the Exercise Addiction Inventory (EAI), the Internet Addiction Test (IAT), and the Work Addiction Risk Test (WART), were compiled anonymously by the students. Overall prevalence was 7.0% for PG, 11.3% for CB, 1.2% for IA, 7.6% for WA, 8.5% for EA. PG and EA were more common among boys, while gender had no effect on the other conditions. CB was more common among younger (<18 years old) students. The scores of all of these scales were significantly correlated. The strong correlation among different addictive behaviours is in line with the hypothesis of a common psychopathological dimension underlying these phenomena. Further studies are needed to assess personality traits and other clinical disorders associated with these problems behaviours.

Comparison of pain perception between open and minimally invasive surgery in total knee arthroplasty.

Total knee arthroplasty (TKA) was a well-established procedure that had shown excellent long-term results in terms of reduced pain and increased mobility. Pain was one of the most important outcome measures that contributed to patient dissatisfaction after TKA. After a computerized search of the Medline and Embase databases, we considered articles from January 1st, 1997 to October 31st, 2009 that underlined the impact on patient pain perception of either standard open total knee arthroplasty or minimally invasive total knee arthroplasty. We included articles that used the visual analog scale (VAS), Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC), Knee Score, Hospital for Special Surgery Score (HSS), Oxford Knee Score (OKS) as postoperative pain indicators, and we included studies with a minimum follow-up period of two months. We excluded studies that monitored only functional postoperative knee activities. It was shown that TKA with the open technique was a better treatment for knees with a positive effect on pain and function than the minimally invasive technique.