Pain Levels of Women Diagnosed with Endometriosis: Is There a Difference in Younger Women?

STUDY OBJECTIVE: Early diagnosis and treatment of endometriosis affecting adolescent women are important in preventing chronic pain. Our aim was to analyze the clinical characteristics and severity of symptoms in adolescent patients with endometriosis compared with older patients. METHODS: This single-center retrospective cohort study in a tertiary referral hospital analyzed women whose first consultation at the certified endometriosis center of Bern University Hospital between January 2017 and December 2020 resulted in the clinical diagnosis of endometriosis. Patients, divided into 2 groups by age, reported visual analog scale (VAS) scores for noncyclic pelvic pain, dysmenorrhea, dyschezia, dysuria, and dyspareunia. The symptom types and severity in the 2 groups were compared. The young patients with endometriosis were analyzed in greater detail, comparing VAS scores and types of endometriosis. RESULTS: From a total of 826 patients, 144 (17.4%) patients 24 years old or younger and 682 (82.6%) patients over 24 years old were compared. The younger patients reported significantly higher pain scores for dysmenorrhea (VAS 7.3 vs 6.6; P = .015), dyspareunia (VAS 4.6 vs 3.4; P = .001), and noncyclic pelvic pain (VAS 4.3 vs 3.7; P = .032) compared with the older patient collective. Similar results were found when excluding patients with hormonal treatment. CONCLUSION: Young patients with clinically diagnosed endometriosis have significantly higher dysmenorrhea and dyspareunia pain levels than older patients. By acknowledging and understanding this, early diagnosis and adequate treatment can be promoted. Dyspareunia in adolescents in particular merits clinical attention.

4X reduction extreme ultraviolet interferometric lithography.

We report the initial results from a 4X reduction interferometric lithography technique using extreme ultraviolet (EUV) radiation from a new undulator on the Aladdin storage ring at the Synchrotron Radiation Center of the University of Wisconsin-Madison. We have extended traditional interferometric lithography by using 2(nd) diffraction orders instead of 1(st) orders. This change considerably simplifies mask fabrication by reducing the requirements for mask resolution. Interferometric fringes reduced by 4X (from 70 nm half-period grating to 17.5 nm) have been recorded in a 50 nm thick hydrogen silsesquioxane photoresist using 13.4 nm wavelength EUV radiation.

Potential energy curves of diatomic molecular ions from high-resolution photoelectron spectroscopy. I. The first six electronic states of Ar2+.

High-resolution photoelectron spectroscopic data have been used to determine the potential energy curves of the first six electronic states of Ar2+. The potential energy functions properly include the effects of the long-range interactions and of the spin-orbit interaction and are of spectroscopic accuracy (1-2 cm(-1)) over a wide range of internuclear distances. The total number of adjustable parameters could be reduced to only 12 by truncating the long-range interaction series after the R(-6) term and assuming an R-independent spin-orbit coupling constant. This assumption was verified to be valid to an accuracy of +/-2 cm(-1) over the range of internuclear distances between 3.0 and 4.6 A. The interaction potential proposed by Siska [P. E. Siska, J. Chem. Phys. 85, 7497 (1986)] was generalized to a form that is expected to be sufficiently flexible to describe chemical bonding in other diatomic molecular ions. The potential energy curves are more accurate than the best available ab initio curves by two orders of magnitude and provide quantitative information on dissociation energies and equilibrium internuclear distances. The local maximum between the two potential wells of the I(1/2g) state was determined to lie 62 cm(-1) below the Ar(1S0)+Ar(+)(2P(3/2)) dissociation limit, and the II(1/2g) state is found to be significantly more bound (De=177 cm(-1)) than previously assumed.

High-resolution millimeter wave spectroscopy and multichannel quantum defect theory of the hyperfine structure in high Rydberg states of molecular hydrogen H2.

Experimental and theoretical methodologies have been developed to determine the hyperfine structure of molecular ions from detailed studies of the Rydberg spectrum and have been tested on molecular hydrogen. The hyperfine structure in l=0-3 Rydberg states of H2 located below the X 2Sigmag+(v+=0,N+=1) ground state of ortho H2+ has been measured in the range of principal quantum number n=50-65 at sub-MHz resolution by millimeter wave spectroscopy following laser excitation to np and nd Rydberg states using a variety of single-photon and multiphoton excitation sequences. The np1(1), nd1(1), and the nf1(0-3) Rydberg states were found to be metastable and to have lifetimes of more than 5 micros beyond n=50. Members of other series, such as the nd1(2), nd1(3), and the np1(0) series, were found to have lifetimes of more than 1 mus. Local perturbations induced by low-n Rydberg states belonging to series converging on rovibrationally excited levels of H2+ reduce the lifetimes in narrow ranges of n values. The hyperfine structure is strongly dependent on the value of the orbital angular momentum l. In the penetrating s and p states at n approximately 50 the exchange interaction dominates over the hyperfine interaction and the levels can be labeled by the total electron spin angular momentum quantum number S (S=0 or 1). In the less penetrating d and f Rydberg states, the hyperfine interaction between the core nuclear and electron spins is larger than the exchange interaction and the Rydberg states are of mixed singlet and triplet character. A procedure based on the Stark effect and on the systematic analysis of selection rules and combination differences was developed to determine the orbital and the total angular momentum quantum numbers l and F and to construct an energy map of p and f Rydberg levels between n=54 and 64 with relative positions of an accuracy of better than 1 MHz. Multichannel quantum defect theory (MQDT) was extended to treat the hyperfine structure in molecular Rydberg states and was used to analyze the observed hyperfine structure of the p and f Rydberg states of H2. The frame transformation between the Born-Oppenheimer channels described by the angular momentum coupling scheme (abetaJ) and the asymptotic channels described by the (e[bbetaS+]) coupling scheme was derived and enables an elegant treatment of all intermediate coupling cases. Purely ab initio quantum defect theory reproduced the experimentally determined positions to within 40 MHz for the p levels and 13 MHz for the f levels. By slight adjustments of the quantum defect functions and their energy dependences and by consideration of the p-f interaction, of the singlet-triplet splittings of the f levels, and of the departure of the ionic levels from pure coupling case (bbetaS+), the agreement between theory and experiment could be improved to 600 kHz. By comparing the results of MQDT calculations of the hyperfine structure of f Rydberg levels with those of coupled equations calculations, the frame transformation approximation of MQDT was shown to be accurate to within 300 kHz. The extrapolated ionic hyperfine structure of the X 2Sigmag+(v+=0,N+=1) ionic level corresponds to the ab initio prediciton of Babb and Dalgarno [Phys. Rev. A 46, R5317 (1992)] within the experimental error.

The effects of total intravenous anesthesia using propofol, ketamine, and vecuronium on cardiovascular response and wake up time.

Total intravenous anesthesia (TIVA) can be an effective alternative to inhalational anesthesia. Various techniques of TIVA have been associated with significant cardiovascular alterations and prolonged wake up times. The purpose of this study was to determine if TIVA utilizing propofol, ketamine, and vecuronium would provide stable hemodynamics in normotensive ASA physical status I and II patients and allow rapid awakening upon completion of surgery. Anesthesia was induced with propofol 1.0 mg/kg intravenously (IV), followed immediately by ketamine 1.0 mg/kg IV and vecuronium 0.1 mg/kg IV. Anesthesia was maintained by constant infusion of propofol 100-200 micrograms/kg/min and ketamine 17-34 micrograms/kg/min. This combination maintained hemodynamic stability and provided a rapid wake up time in 80% of the 40 subjects. The remaining 20% experienced significant tachycardia and hypertension or premature ventricular contractions. The mean wake up time was 9.7 minutes from time of neuromuscular blocking reversal to time of extubation. TIVA can be accomplished with propofol, ketamine, and vecuronium; however, 20% of patients experienced side effects, which make this method less attractive compared to alternative anesthetic techniques.

[Lymph scintigraphy in edema of the extremities]. / Lymphszintigraphie bei Extremitätenödemen.

The method presented here for scintigraphic measurement of lymphatic drainage can be carried out easily and entails little stress for the patient. It is very suitable for routine use in many patients. Since consistency with clinical findings is very good this is an inexpensive method for clarification of lymph drainage disturbances.