Use of the Short-Form McGill Pain Questionnaire as a diagnostic tool in women with chronic pelvic pain.

STUDY OBJECTIVE: To estimate the usefulness of the Short-Form McGill Pain Questionnaire (MPQ) pain descriptors in the diagnostic evaluation of chronic pelvic pain. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: University-based center specializing in chronic pelvic pain. PATIENTS: Three hundred thirty-one consecutively evaluated women with chronic pelvic pain who had data sufficient for evaluation. INTERVENTIONS: The relationships between MPQ pain descriptors and subsequent diagnoses were evaluated using odds ratios, sensitivity, specificity, and positive and negative predictive values. MEASUREMENTS AND MAIN RESULTS: The most common diagnoses were endometriosis, interstitial cystitis and painful bladder syndrome, and irritable bowel syndrome. Seventy-one percent of the patients had more than one diagnosis. Relative risks for pain descriptors as diagnostic tools for specific diagnoses were most significant, with "cramping" for endometriosis (4.0), "cramping" for interstitial cystitis and painful bladder syndrome (2.0), "sickening" for irritable bowel syndrome (1.5), and "aching" for abdominal myofascial pain syndrome (4.27). CONCLUSION: Several of the MPQ descriptors had high negative predictive values but not high positive predictive values, which suggests that they have diagnostic usefulness in excluding but not predicting pelvic pain-related diagnoses. This was especially the case with cramping as an MPQ descriptor in women with endometriosis. However, overall the MPQ descriptors were not robust as diagnostic tools, which suggests that inclusion of the MPQ descriptors in the evaluation of women with chronic pelvic pain is of limited diagnostic value.

Prevalence of metabolic syndrome and related characteristics in obese adolescents with and without polycystic ovary syndrome.

CONTEXT: Adults with polycystic ovary syndrome (PCOS) may be at increased risk for metabolic syndrome (MBS) and related cardiovascular disease. It is not clear whether PCOS diagnosed in adolescence increases the risk of MBS in this age group. OBJECTIVE: The aim was to compare the prevalence and related characteristics of MBS in obese adolescents with and without PCOS. DESIGN: We conducted a cross-sectional study of overweight and obese PCOS adolescents and BMI matched controls. PATIENTS AND PARTICIPANTS: A total of 74 subjects, 43 with PCOS and 31 controls, participated in the study. INTERVENTIONS: Each subject underwent a physical examination and laboratory evaluation for a diagnosis of MBS. Regional fat distribution was determined by computerized tomography scan in the PCOS adolescents. MAIN OUTCOME MEASURES: We measured the prevalence of MBS and its components in adolescent subjects and controls. RESULTS: The PCOS group had larger ovarian volume and higher measures of total testosterone and free androgen index than controls, but there were no differences in waist circumference, fasting glucose, blood pressure, or lipids. PCOS adolescents demonstrated more glucose abnormalities and higher plasminogen activator inhibitor-1. By pediatric criteria, 53% of the PCOS and 55% of the control adolescents had MBS. By adult criteria, 26% of PCOS and 29% of controls met diagnostic criteria for MBS. CONCLUSIONS: Obese adolescent women have a high prevalence of MBS, and PCOS does not add additional risk for MBS. There appears to be an association between MBS and visceral adiposity. PCOS is associated with increased incidence of glucose intolerance and increased plasminogen activator inhibitor-1. Our results reinforce the importance of obesity counseling in adolescents to recognize the possible risk of future cardiovascular disease in these young women.