扩展绝经评定量表 II: 回顾性数据分析。
- 作者列表："Honermann L","Knabben L","Weidlinger S","Bitterlich N","Stute P
:Objective: This study aims to discuss a statistically reasonable inclusion of additional questions in the Menopause Rating Scale II (MRS II) for daily use in clinical practice.Methods: Retrospective data analysis was performed (cantonal ethics committee No. 2016-01179). The MRS II was extended with the parameters 'changes in weight', 'headaches', 'skin changes', 'changes in hair growth', 'hair loss', and whether therapy was desired. Data from 419 women seeking medical advice in our menopause center were collected between April 2009 and April 2017. Cronbach's alpha was used to measure internal consistency of the extended questionnaire.Results: For the conventional MRS II (N = 340 of 419, 81.1%), the internal consistency measured with Cronbach's alpha increased from 0.805 to 0.820 considering 'changes in weight' (N = 237, 56.6%), to 0.815 considering 'headaches' (N = 247, 58.9%), and to 0.815 considering 'skin changes' (N = 236, 56.3%) if these additional parameters were added separately. Cronbach's alpha increased from 0.805 to 0.835 (N = 224, 53.5%) if these parameters were added at once. Desire for therapy varied between 42.1% for 'changes in hair growth' (N = 38, 9.1%) and 60.6% for 'hair loss' (N = 33, 7.9%).Conclusion: We suggest including the items 'changes in weight', 'headaches', and 'skin changes' in the MRS II as our results show even higher internal consistency with these symptoms and as the wish for therapy was high.
: 目的: 本研究旨在讨论在临床实践中日常使用的绝经评定量表 II (MRS II) 中统计合理地纳入额外问题。方法: 采用回顾性资料分析方法 (州伦理委员会编号。2016-01179)。MRS II 随参数 “体重变化” 、 “头痛” 、 “皮肤变化” 、 “头发生长变化” 、 “脱发” 以及是否需要治疗而延长。2009 年 4 月至 2017 年 4 月期间，收集了在我们更年期中心寻求医疗建议的 419 名妇女的数据。使用 Cronbach's alpha 测量扩展问卷的内部一致性。结果: 对于常规 MRS II (n = 340 的 419，81.1%),用 Cronbach' s alpha 测量的内部一致性从 0.805 增加到 0.820 考虑 '权重变化' (n = 237，56.6%)，到 0.815 考虑 'headaches' (n = 247，58.9%),和 0.815 考虑到 '皮肤改变' (n = 236，56.3%)，如果这些额外的参数被单独添加。如果一次添加这些参数，Cronbach's α 从 0.805 增加到 0.835 (n = 224，53.5%)。对治疗的渴望在 “头发生长变化” 的 42.1% (n = 9.1%) 和 “脱发” 的 60.6% (n = 7.9%) 之间变化。结论: 我们建议包括 “体重变化” 、 “头痛” 、和 MRS II 中的 “皮肤改变”，因为我们的结果显示与这些症状的内部一致性更高，并且治疗的愿望很高。
METHODS:BACKGROUND:Ultrasound has been demonstrated to accurately diagnose rectal deep endometriosis (DE) and pouch of Douglas (POD) obliteration. The role of ultrasound in the assessment of patients who have undergone surgery for rectal DE and POD obliteration has not been evaluated. AIM:To describe the transvaginal ultrasound (TVS) findings of patients who have undergone rectal surgery for DE. MATERIALS AND METHODS:An observational cross-sectional study at a tertiary care centre in Sydney, Australia between January and April 2017. Patients previously treated for rectal DE (low anterior resection vs rectal shaving/disc excision) were recruited and asked to complete a questionnaire on their current symptoms. On TVS, POD state and rectal DE were assessed. Correlating recurrence of POD obliteration and/or rectal DE to surgery type and symptoms was done. RESULTS:Fifty-six patients were contacted; 22/56 (39.3%) attended for the study visit. Average interval of surgery to study visit was 52.8 ± 24.6 months. Surgery type breakdown was as follows: low anterior resection (56%) and rectal shaving/disc excision (44%). The prevalence of POD obliteration was 16/22 (72.7%) intraoperatively and 8/22 (36.4%) at study visit, as per the sliding sign. Nine patients (39.1%) had evidence on TVS of recurrent rectal DE. Recurrence of POD obliteration and rectal DE was not associated with surgery type or symptomatology. CONCLUSION:Despite surgery for rectal DE, many patients have a negative sliding sign on TVS, representing POD obliteration, and rectal DE. Our numbers are too small to correlate with the surgery type or their current symptoms.
METHODS::Minimally invasive surgery for complex endometriosis requires preoperative planning that intimately connects the gynecologic surgeon to the radiologist. Understanding the surgeon's perspective to endometriosis treatment facilitates a productive relationship that ultimately benefits the patient. We examine minimally invasive surgery for endometriosis and the key radiologic information which enable the surgeon to successfully negotiate patient counseling, preoperative planning, and an interdisciplinary approach to surgery.
METHODS:STUDY OBJECTIVE:Prior research collectively shows that endometriosis is inversely related to women's adiposity. The aim of this study was to assess whether this inverse relationship holds true by disease severity and typology. DESIGN:Cross sectional study among women with no prior diagnosis of endometriosis. SETTING:Fourteen clinical centers in Salt Lake City, Utah and San Francisco, California. PATIENTS:Four hundred and ninety five women, ages 18-44 years, were enrolled in the operative cohort of the Endometriosis, Natural History, Diagnosis, and Outcomes (ENDO) Study. INTERVENTIONS:Gynecologic laparoscopy/laparotomy, regardless of clinical indication. MEASUREMENTS AND MAIN RESULTS:Participants underwent anthropometric assessments, body composition, and body fat distribution ratios before surgery. Surgeons completed a standardized operative report immediately after surgery to capture revised ASRM staging (I to IV) and typology of disease (superficial [SE], ovarian endometrioma [OE], and deep infiltrating endometriosis [DIE]). Linear mixed models, taking into account within-clinical-center correlation were used to generate least square means (95% confidence intervals) to assess differences in adiposity measures by endometriosis stage (no endometriosis, I-IV) and typology (no endometriosis, SE, DIE, OE, OE + DIE) adjusting for age, race/ethnicity, and parity. While the majority of confidence intervals were wide and overlapping, three general impressions emerged: 1) women with versus without incident endometriosis had the lowest anthropometric/body composition indicators; 2) women with stage I or IV had lower indicators compared to women with stage II or III; and 3) women with OE and/or DIE tended to have the lowest indicators, while women with SE had the highest indicators. CONCLUSION:Our research highlights that the relationship between women's adiposity and endometriosis severity and typology may be more complicated than prior research indicates.