ABSTRACT
PURPOSE: The Endometriosis Health Profile 5 (EHP-5) is a short version of an endometriosis-specific quality of life questionnaire. The objective of the study was to assess the psychometric validity of its French version. METHODS: A total of 125 patients with histologically proven endometriosis who underwent surgery for painful symptoms and 80 asymptomatic controls completed the EHP-5. Principal components analysis was performed to determine the dimensions of the instrument. Internal consistency was assessed using Cronbach's alpha. Construct validity was assessed by testing the relationship between the EHP-5 and the characteristics of endometriosis. RESULTS: For each item of EHP-5, endometriosis patients scored significantly higher than control women (p > 0.0001). Eleven items of the EHP-5 were unidimensional with excellent internal consistency (Cronbach's alpha = 0.92), and a summary aggregated index was then constructed. The EHP-5 index was sensitive to the presence of endometriosis, the type, location, severity of the disease, and pain or infertility as the main complaint with effect sizes ranging from 0.48 (95 % CI 0.11-0.85) for superficial endometriosis to 2.56 (95 % CI 2.18-2.93) for deeply infiltrating endometriosis. CONCLUSION: The French version of EHP-5 is valid and can be used for reporting patient-orientated outcome in future studies of French-speaking patients with endometriosis.
Subject(s)
Cross-Cultural Comparison , Endometriosis/psychology , Psychometrics/instrumentation , Quality of Life/psychology , Adult , Female , France , Humans , Psychometrics/methods , Reproducibility of Results , Surveys and Questionnaires , TranslatingABSTRACT
OBJECTIVE: To assess the effectiveness and complication rate with Essure microinsert placements for tubal sterilization and the concomitant bipolar intrauterine surgical procedure. DESIGN: Case control study. SETTING: Department of gynecology and obstetrics of a general hospital in France. PATIENT(S): 382 women, including 41 undergoing one or several concomitant uterine procedures with Essure placement, and 341 undergoing Essure placement only (controls). INTERVENTION(S): Essure placement with or without bipolar hysteroscopic procedure for polyp, myoma, or endometrial ablation. MAIN OUTCOME MEASURE(S): Success rate for microinsert placement and complications at 3 months. RESULT(S): Forty-one patients had Essure microinserts placed in combination with a bipolar hysteroscopic procedure: endometrial resection (n=32), fibroma resection (n=4), or polyp ablation (n=5). They were compared with 341 patients who underwent Essure placement only. The success rate for Essure placement was 97.6% in the combination group versus 97.6% in the control group. The complication rate was 4.9% (n=2) in the combination group versus 2.6% (n=9) in the control group. The difference in the success and complication rates was not statistically significant. CONCLUSION(S): Performing intrauterine bipolar resection during hysteroscopy for sterilization is possible without reducing the Essure placement success rate and without increasing morbidity.
Subject(s)
Hysteroscopy , Intrauterine Devices , Sterilization, Tubal/instrumentation , Sterilization, Tubal/methods , Adult , Case-Control Studies , Female , France , Hospitals, General , Humans , Hysteroscopy/adverse effects , Intrauterine Devices/adverse effects , Middle Aged , Prospective Studies , Sterilization, Tubal/adverse effects , Time Factors , Treatment OutcomeABSTRACT
Conservative surgical treatment with wide local excision of lower pole breast carcinoma is a major factor of poor cosmetic results. We propose reconstruction of the inferior part of the breast using a fascio-cutaneous flap during excision of lower pole cancers, particularly in cases of women with small-sized breasts. In 2005, 14 patients were selected to undergo conservative breast surgery with fasciocutaneous flap taken from the fatty area found below the thoraco-mammary fold. This area of tissue was de-epedermized and the rotated to fill the breast defect. Patient were followed to determine carcinologic and cosmetic result as one year. All patients had invasive carcinoma. Mean volume of existed tissue was 43 cm3. Margins were adequate for 12 patients and the final 2 patients in the serie had to undergo mastectomy for involved margins. At one year, cosmetic results were graded as good by both the surgeon and the patients. Mammograms were satisfactory except for one case of partial liposclerosis of the flap. Preliminary results showed feasibility and relevance of this new technique for breast cancer located at the lower pole.
Subject(s)
Breast Neoplasms/surgery , Mammaplasty/methods , Surgical Flaps , Adult , Aged , Aged, 80 and over , Breast/pathology , Breast/surgery , Breast Neoplasms/pathology , Female , Humans , Middle Aged , Suture TechniquesABSTRACT
HIV can be transmitted to foetus during pregnancy, labour, and breastfeeding. An estimated 600,000 newborns acquired HIV each year through mother to fetus transmission. Without preventive interventions, approximately 25% of infants born to HIV positive mothers contract the virus. Elective delivery by caesarean section at 38th weeks, before labor and rupture of membrane, decreased the fetal risk. Anniotomy and long-standing rupture of the membranes should be avoided, as should breastfeeding. As well based on the review of literature the authors provide an overview of vertically acquired of HIV infection, preventive measures and perinatal car are discussed.
