Evaluating self-esteem modifications after a Life Skills-Based Education intervention.

BACKGROUND: A satisfactory level of self-esteem has been recognized as crucial factor contributing to healthy lifestyle, especially among children and adolescents. We performed an analysis of the impact of Life-Skills Based Education (LSBE) in a cohort of pupils in a Primary School of Sondrio (Northern Italy) and we made a comparison with a control group in a Primary school of the same province where no intervention was performed. METHODS: Changes in levels of self-esteem were assessed through Italian version of the Multidimensional Self-concept Test of Bruce Bracken - T.M.A. For research purpose we used four of the six scales of the Italian version of the Multidimensional Self-esteem Test - T.M.A. RESULTS: The questionnaire was handed out to a total of 318 pupils: 132 students had received a LSBE intervention and 186 had not received any intervention. Median and interquartile range are in the normal range, both for the intervention and control groups. The four subscales showed an improving trend from the beginning (T1) to the end (T2) of the school year, both for the intervention and control groups. Regarding the intervention group, we found statistically significant changes in the subscales of quality of interpersonal relationships (P=0.003) and emotional competencies (P=0.02); regarding the control group, we found statistically significant changes in all the subscales analyzed. Considering the variable "sex", we found a statistically significant improvement only for male students and for the subscale "quality of interpersonal relationships" (P=0.007). CONCLUSIONS: The population trend observed suggests an improvement in competencies and levels of self-esteem in the cohort subjected to a LSBE intervention. Data analysis revealed significant differences in the subscales of quality of interpersonal relationships and emotional competencies, suggesting that LSBE interventions have an higher impact on males than on females. A longer follow-up could be useful in order to provide more reliable and significant data about LSBE programs' real efficacy.

Tuberculosis outbreak in a primary school, Milan, Italy.

Investigation of an outbreak of tuberculosis (TB) in a primary school in Milan, Italy, found 15 schoolchildren had active TB disease and 173 had latent TB infection. TB was also identified in 2 homeless men near the school. Diagnostic delay, particularly in the index case-patient, contributed to the transmission of infection.

Rate of severe ovarian damage following surgery for endometriomas.

BACKGROUND: There is growing and consistent evidence showing that ovarian reserve is affected following surgical excision of ovarian endometriomas. Of particular concern is the risk of severe ovarian damage leading to unresponsiveness to ovarian hyperstimulation. In this study, we aimed to determine the rate of this complication. METHODS: Ninety-three women underwent surgery for monolateral endometriomas were recruited. Patients who underwent IVF were selected and, in all cases, follicular growth was monitored by serial transvaginal ultrasonography. The main outcome measure was the rate of ovaries remaining silent when stimulated after surgery for endometriomas. RESULTS: Absence of follicular growth was observed in 12 operated ovaries although this event never occurred in the contralateral gonad (P < 0.001). The frequency (95% confidence interval) of severe ovarian damage following surgery was 13% (7-21%). CONCLUSIONS: Severe ovarian damage, occurring in gonads operated on for ovarian endometriomas, is not a rare event.

The impact of IVF procedures on endometriosis recurrence.

OBJECTIVE: In infertile women with endometriosis requiring an in vitro fertilization (IVF) procedure, the potential risk of an IVF-related progression of the disease remains a matter of debate. Thus, since available data on this issue are scanty and controversial, an observational study has been herein conducted in order to clarify this issue. STUDY DESIGN: We recruited 233 women with endometriosis who underwent IVF cycles in our unit. Patients were contacted to assess whether they experienced recurrences of the disease after IVF. The main outcome was to evaluate the impact of the number of IVF cycles and the responsiveness to ovarian hyperstimulation on the likelihood of recurrence. Clinical characteristics of women who did and did not have a recurrence were compared. RESULTS: One hundred and eighty-nine women were included, 41 of whom (22%) had a diagnosis of endometriosis recurrence. The 36 months cumulative recurrence rate was 20%. The number of IVF cycles and the responsiveness to ovarian hyperstimulation were not associated with the risk of disease recurrence. The adjusted OR for recurrences according to the number of started cycles was 0.92 (95% CI: 0.77-1.10) per cycle (p=0.35). The adjusted OR for recurrences in women with intact versus compromised ovarian reserve was 0.80 (95% CI: 0.40-1.58) (p=0.52). CONCLUSIONS: IVF procedures do not seem to influence the likelihood of endometriosis recurrence.

Is the dimension of ovarian endometriomas significantly modified by IVF-ICSI cycles?

Information regarding the growth and development of endometriomas during IVF-intracytoplasmic sperm injection (ICSI) cycles is lacking. In this study, the aim was to estimate the influence of IVF-ICSI on the dimension of these cysts and to assess whether this treatment contributes to the manifestation of new endometriomas in patients already affected. Women were eligible if they had been diagnosed with ovarian endometrioma(s). Recruited patients who failed to become pregnant were scanned again 3-6 months later to evaluate the modification of the dimension of the cysts and/or the manifestation of new endometriomas. Forty-eight women completed the study protocol. The median (interquartile range) values for the volume of the cysts before and after the IVF-ICSI cycle were 3.9 (2.9-7.9) ml and 4.9 (2.4-9.9) ml, respectively (Wilcoxon rank test for paired data, not significant). The development of a new endometrioma was documented in one case (2.1%, 95% confidence interval 0.1-11.1%). Fear about the growth of ovarian endometriomas in women who have to undergo IVF-ICSI is not justified.