Examining the associations between self and body compassion and health related quality of life in people diagnosed with endometriosis.

OBJECTIVE: An understanding of the role that self and body compassion may play as protective mechanisms in the context of psychological and physical health conditions is steadily increasing. The availability of research pertaining to their role in mitigating the health-related quality of life (HRQoL) impacts associated with endometriosis is limited. The current study examined the influence of self and body compassion on HRQoL in people diagnosed with endometriosis. METHODS: Individuals aged 18+ years (n = 318), assigned female at birth, with a self-reported diagnosis of symptomatic endometriosis completed an online cross-sectional survey. Participant demographics and endometriosis-related data was collected in addition to self and body compassion and HRQoL. Standard multiple regression analyses (MRA) were conducted to estimate the proportion of variance in HRQoL that can be accounted for by self and body compassion in endometriosis. RESULTS: Self and body compassion were both associated with higher HRQoL across all domains. However, when both self and body compassion were entered into a regression, only body compassion was significantly associated with HRQoL domains of physical wellbeing, bodily pain, vitality, social engagement and general HRQoL; self-compassion explained no unique variance. In the domain of emotional wellbeing, when both self and body compassion were entered into a regression, both were significantly associated, and explained unique variance. CONCLUSIONS: It is suggested that future psychological interventions for individuals living with endometriosis should emphasise building general self-compassionate abilities with a subsequent specific focus on strategies designed to improve body compassion.

Correlates of health-related quality of life: The influence of endometriosis, body image and psychological wellbeing.

OBJECTIVE: The understanding as to how people with endometriosis view and relate to their bodies is limited but important given the physical and psychological symptoms associated with the condition. The current study explored the differences in HRQoL (general, physical, emotional) and body image in an endometriosis and control sample. The current study also examined the influence of disease status (+Endo, -Endo), psychological wellbeing, and body image on HRQoL. METHODS: Data was collected via an international online cross-sectional survey examining HRQoL, body image factors (negative appreciation of body size, lack of body familiarity, general body dissatisfaction), and psychological wellbeing (depression, anxiety, somatic concern) in adults. RESULTS: Participants were grouped by disease status (endometriosis: +Endo n = 318; control: -Endo n = 420). As hypothesised, the +Endo group reported significantly lower HRQoL and poorer body image than those in the -Endo group. Hierarchical multiple regression analyses (MRA) indicated that disease status and somatic concern are significant correlates of general HRQoL, and that disease status and lack of body familiarity are significant correlates of physical and emotional HRQoL. CONCLUSION: Endometriosis has a negative impact on HRQoL and body familiarity, with those diagnosed with the condition reporting significantly lower levels of HRQoL. Assessment and treatment of poor body familiarity in people diagnosed with endometriosis is recommended as part of psychological treatment pathways.

Predictors of self-compassion in endometriosis: the role of psychological health and endometriosis symptom burden.

STUDY QUESTION: What is the relationship between self-compassion, endometriosis-related symptoms and psychological health in women with symptomatic endometriosis? SUMMARY ANSWER: Decreased self-compassion is associated with increased psychological distress, extended diagnostic delay and varies according to individual endometriosis-symptom profile. WHAT IS KNOWN ALREADY: Existing research indicates that endometriosis is associated with reduced psychological health and varied endometriosis-related symptom profiles. Examining the level of self-compassion reported by women with endometriosis is important as greater self-compassion has been found to improve psychological well-being in several chronic health populations. STUDY DESIGN, SIZE, DURATION: This study utilized a cross-sectional survey design to explore the relationship between self-compassion, psychological health and endometriosis-related symptoms (n = 318). PARTICIPANTS/MATERIALS, SETTING, METHODS: Women with a self-reported diagnosis of endometriosis were recruited via online advertising through social media platforms. Demographic and endometriosis-specific information (e.g. disease stage, diagnostic delay, symptom experience) was collected in addition to psychological health and self-compassion. Psychological health was measured by the PROMIS Emotional Distress and Anxiety short forms and the Patient Health Questionnaire (PHQ-15). Self-compassion was measured by the Self-Compassion Scale (26-item). Independent t-tests, bivariate correlations and linear regression analyses explored the relationship between specific endometriosis-related symptoms, psychological health and self-compassion. MAIN RESULTS AND THE ROLE OF CHANCE: Hierarchical multiple regression indicated that psychological symptoms accounted for the greatest variance in levels of self-compassion in the current sample. Depression and anxiety were found to be significant negative predictors of self-compassion. Notable symptoms that were significant in the final model were the presence of dysmenorrhea, lower back pain, dyspareunia, pain after sexual intercourse, fatigue and nausea. LIMITATIONS, REASONS FOR CAUTION: The cross-sectional nature of the findings prevents direct findings of causality. The information pertaining to endometriosis was self-report in nature and was not medically verified. WIDER IMPLICATIONS OF THE FINDINGS: These preliminary findings indicate the importance of clinical interventions aimed at enhancing self-compassion and the importance of individual case conceptualization and treatment planning based on endometriosis-related symptomatic profiles. STUDY FUNDING/COMPETING INTEREST(S): The study was not associated with research funding. Author L.V.N. is a member of the Endometriosis Australia Clinical Advisory Committee. TRIAL REGISTRATION NUMBER: N/A.

Application of static fatigue testing to the behavior of absorbable sutures.

Absorbable sutures, since their conception, have become the dominant method for surgical wound closure and are constantly being improved. However, despite their years of service, not all aspects of their performance are fully understood. In particular, suture absorption is usually characterized by immersing the suture in a model in vitro environment under zero stress followed by measurement of the residual tensile strength as a function of immersion time. When in use, absorbable sutures are exposed to mechanical stress, which may affect the absorption rate; however, this phenomenon has not been adequately studied. The present work reports results of static fatigue tests in which the suture material is subjected to a mechanical load while immersed in a controlled environment and the time to fracture is measured as a function of the applied load. This approach is proved a viable method for obtaining a more detailed evaluation of absorbable suture performance.

MR imaging of the wrist: effect on clinical diagnosis and patient care.

PURPOSE: To evaluate the effect of magnetic resonance (MR) imaging of the wrist on clinicians' diagnoses, diagnostic certainty, and patient care. MATERIALS AND METHODS: A controlled observational study was performed. Referring clinicians completed questionnaires about diagnosis and intended management before and after wrist MR imaging. One hundred eighteen consecutive patients referred for MR imaging of the wrist were recruited from the MR imaging units at a regional teaching hospital and a large district general hospital. The main measures were changes in the clinicians' leading and subsidiary diagnoses after MR imaging, their certainty in these diagnoses, and changes in intended patient care. RESULTS: Questionnaires were incorrectly completed for five patients, questionnaires were not returned for three, appointments were canceled for 10, and two could not tolerate the MR examination. Complete follow-up data were available for 98 patients. The clinical diagnosis changed in 55 of 98 patients; in the remaining 43 patients, diagnostic certainty increased in 23. Clinicians reported that MR imaging had substantially improved their understanding of the disease in 67 of 98 patients. The care plan changed in 45 of 98 patients, with a shift away from surgical treatment. Twenty-eight patients were discharged without further investigation. MR imaging was similarly effective in the regional teaching center and the district general hospital. CONCLUSION: MR imaging of the wrist influences clinicians' diagnoses and management plans.

Repellency and efficacy of 65% permethrin and 9.7% fipronil against Ixodes ricinus.

Two topically applied spot-on products--65% permethrin (Defend Exspot Treatment for Dogs, Schering-Plough Animal Health, Union, NJ) and 9.7% fipronil (Frontline Spot On Dog, Merial Limited, Iselin, NJ)--used for canine flea and tick control were evaluated for repellency against Ixodes ricinus, the tick species that is the primary vector of Lyme disease in Europe. Eighteen dogs were randomly assigned to the following treatment groups (n = 6): (1) 65% permethrin, (2) 9.7% fipronil, or (3) untreated control. Dogs were exposed to ticks in individually assigned cages with a carpet that covered =70% of the cage bottom. Dogs in treatment groups 1 and 2 were treated in accordance with label directions for each re-spective product on study day 0. Fifty unfed, male and female adult ticks were placed in the cages 15 to 30 minutes before the dogs. The dogs were placed in the cages for a 2-hour exposure period at 2, 7, 14, 21, 28, 35, and 41 days after treatment. After a 2-hour exposure period, dogs were removed from the cages and live (attached and unattached) and dead ticks were counted on the dogs, on the carpets, and in the cages. Cages were thoroughly cleaned and new carpet was used for each tick exposure period. Treatment of dogs with 65% permethrin reduced tick numbers on dogs by 99.1% at 2 days, 99.0% at 1 week, 95.9% at 2 weeks, 88.5% at 3 weeks, 87.1% at 4 weeks, and 48.0% at 6 weeks after application. In contrast, treatment of dogs with 9.7% fipronil reduced tick numbers on dogs by 61.4% at 2 days, 51.6% at 1 week, 37.0% at 2 weeks, 33.7% at 3 weeks, 10.8% at 4 weeks, and 0% at 6 weeks after application. The efficacy of 65% permethrin was significant (P < or = .05) when compared to the control at all challenges, whereas the efficacy of 9.7% fipronil was not significant as compared to controls at 21, 28, 35, and 41 days after treatment. The 65% permethrin killed significantly more Ixodes ricinus ticks (P < or = .05) than 9.7% fipronil from 2 to 41 days after treatment. The 65% permethrin repelled 1.9-, 2.0-, 3.0-, 43.3-, 3.9-, 8.9-, and 17.3-fold more Ixodes ricinus than did 9.7% fipronil at 2, 7, 14, 21, 28, 35, and 41 days after treatment, respectively, and all differences in repellency were significant (P < or = .05).

The histopathology of de Quervain's disease.

The histopathological appearances of the tendon sheath and synovium from 23 patients treated surgically for de Quervain's disease are described and compared with 24 controls. The condition was not characterized by inflammation, but by thickening of the tendon sheath and most notably by the accumulation of mucopolysaccharide, an indicator of myxoid degeneration. These changes are pathognomonic of the condition and are not seen in control tendon sheaths. The term 'stenosing tenovaginitis' is a misnomer and we believe that de Quervain's disease is a result of intrinsic, degenerative mechanisms rather than extrinsic, inflammatory ones.

Injuries to the hand in rugby union football.

Hand injuries are a common consequence of playing rugby. A prospective study of all rugby injuries referred to a hand clinic over the course of one season was carried out. 72 patients with such injuries were seen. There were 46 fractures and 26 soft tissue injuries. A substantial number were caused deliberately by opponents. One-third of the injuries were thought to be preventable.

Saliva-activated transmission (SAT) of Thogoto virus: dynamics of SAT factor activity in the salivary glands of Rhipicephalus appendiculatus, Amblyomma variegatum, and Boophilus microplus ticks.

Thogoto (THO) virus is transmitted from infected to uninfected ticks when co-feeding on uninfected guinea-pigs, even though the guinea-pigs do not develop a detectable viraemia. This form of non-viraemic transmission is potentiated by a factor(s) secreted by the saliva of ticks and hence has been termed saliva-activated transmission (SAT). The synthesis of the SAT factor by the salivary glands of three ixodid tick species was determined by placing uninfected nymphal ticks on guinea-pigs that were subsequently inoculated with a mixture of THO virus and salivary gland extract (SGE) derived from one of the tick species. SAT factor activity was measured by determining the number of nymphs that acquired THO virus. For the three-host ixodid species, Rhipicephalus appendiculatus and Amblyomma variegatum, maximum enhancement of THO virus transmission was observed when salivary glands were derived from uninfected female ticks that had fed for a period of 6 or 8 days, respectively. In contrast, when salivary glands were derived form uninfected female Boophilus microplus, a one-host ixodid tick species, enhancement of THO virus transmission was observed throughout the tick feeding period. Thus, the natural feeding behaviour of ticks appears to be an important factor in determining the relative importance of these vectors in mediating SAT.

The Herbert screw for delayed and non-union of scaphoid fractures: a review of fifty cases.

The results of treatment using the Herbert screw in 50 consecutive patients with delayed or established non-union of the scaphoid are reported. 14% of these fractures failed to unite after operation and a further 20% required prolonged protection, uniting within six months. There were significant technical problems in 28% of operations. A bone graft was only used when there was significant collapse of the scaphoid (52%) and the cases without graft did just as well. Overall, the results do not support the view that this method of treatment is a significant advance over Russe grafting in terms of union rates, but confirm that it produces similar results without the need for prolonged immobilisation and without the need for bone grafting in almost half the cases, although there can be significant technical problems with the procedure.

Hypoplastic scaphoid--an unusual cause of carpal tunnel syndrome.

A case of median nerve compression within the carpal tunnel, secondary to hypoplasia of the carpal scaphoid and dysplasia of the distal radius, is described in a 15-year-old boy with Spondylo-epiphyseal dysplasia tarda. Hypoplastic carpal bones and a dysplastic distal radius may be a feature of Spondylo-epiphyseal dysplasias, but carpal tunnel syndrome has not been previously reported either in this condition or in association with hypoplasia of the scaphoid.

Habitual anterior subluxation of the head of the ulna treated by Baldwin's operation. A case report.

A case of habitual anterior subluxation of the ulna at the inferior radio-ulnar joint is reported. The subluxation presented with signs and symptoms of both ulnar amd median neuritis. There was no past history of trauma. Baldwin's procedure was carried out, stabilising the distal radio-ulnar joint and relieving all symptoms of nerve compression. The use of Baldwin's procedure to correct this condition has not previously been described.

Osteochondral fractures of the lateral femoral condyle: a result of indirect violence to the knee.

Twenty patients with an average age of eighteen and a half years sustained osteochondral fractures of the lateral femoral condyle as the result of a sudden twist and valgus strain to the straight or almost straight knee. All the patients felt sudden pain at the moment of injury, all had a haemarthrosis, and yet the fracture escaped early diagnosis in one-third of the cases. Internal fixation of the fragment with early mobilisation is recommended if the diagnosis is made within two weeks of injury, and excision of the fragment if it is only later identified.

Arsenic resistance in species of multi-host ticks in the Republic of South Africa and Swaziland.

A survey was made in the Republic of South Africa and Swaziland to determine the incidence of arsenic resistance in multi-host ixodid ticks. Arsenic resistant strains were found in the following species:- Rihipicephalus appendiculatus, Rhipicephalus evertsi, Rhipicephalus capensis, Amblyomma hebraeum and a species of Hyalomma, tentatively identified as Hyalomma rufipes. Strains of Haemaphysalis Leachi, Haemaphysalis silacea and Ixodes pilosus were also tested.