Biopsychosocial correlates of persistent postsurgical pain in women with endometriosis

ObjectiveTo examine pain and biopsychosocial correlates over time for women with persistent postsurgical pain after surgery for endometriosis.MethodsCrossâ sectional study of women who underwent any endometriosis surgery between 2003 and 2006. Following surgery, patients completed validated questionnaires (Shortâ Form McGill Pain Questionnaire, 12â item Shortâ Form Health Survey, Beck Depression Inventory, Coping Strategies Questionnaire catastrophizing subscale). The primary outcome was pelvic pain intensity, measured by the McGill total pain score. Bivariate comparisons between each potential predictor and pain intensity were performed using the Ï 2 and t tests, 1â way analysis of variance, and simple linear regression.ResultsIn total, 79 completed the questionnaires and were included in the present analysis. The McGill affective pain score was negatively correlated with age (βâ coefficient â 0.12, P = 0.002) and positively correlated with catastrophization (βâ coefficient 0.66, P = 0.01). Women with a history of dyspareunia scored significantly higher on the McGill total pain score (P < 0.001); there was no association between pain intensity and endometriosis severity.ConclusionYounger age and catastrophization are correlated with persistent pain following surgery for endometriosis. The severity of endometriosis does not predict persistent pain. Further evaluation of psychosocial factors may identify patients who are least likely to benefit from surgeries for endometriosisâ associated pelvic pain.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135478/1/ijgo169.pd

Biopsychosocial Correlates of Persistent Post-surgical Pain in Women with Endometriosis

Background: • Endometriosis is a benign gynecologic condition associated with pain and infertility, affecting up to 30% of women • Treatment of endometriosis often includes a combination of medical and surgical management • Short term improvement of pain is more likely with surgical treatment of lesions than diagnostic laparoscopy alone • Recently, psychological factors such as catastrophization and depression have been associated with poor pain outcomes • Long term predictors of pain outcome for endometriosis have not been well described. Objective: • To determine long-term pain outcomes for women undergoing endometriosis surgery based on their demographic, procedural, and pyschometric elements

Individual Differences in Correspondence Bias: Measurement, Consequences, and Correction of Biased Interpersonal Attributions

Across consequential attributions of attitudes, ability, emotions, and morality, people make correspondent inferences. People infer stable personality characteristics from others’ behavior, even when that behavior is caused by situational factors. We examined the structure of correspondent inferences and report the development and validation of an instrument measuring individual differences in this correspondence bias (a Neglect of External Demands scale, or “NED”). The NED is internally consistent and distinct from scales and measures of intelligence, cognitive ability, cognitive reflection, general decision making ability, preference for control, and attributional style. Individual differences in correspondence bias predict blaming people for harmful accidents, believing coerced confessions, correcting for job and task difficulty when making performance evaluations and incentive-compatible personnel selections, and separating market and fund performance when making incentive-compatible investments. Fortunately, the tendency to commit correspondence bias can be reduced. Making situational information easier to process debiases those most prone to correspondence bias

Short-term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve: a pilot randomized controlled trial

OBJECTIVE: To examine the short-term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve when ovarian preservation is planned in view of determining the feasibility of conducting the study on a larger scale. DESIGN: Pilot randomized controlled trial. SETTING: Tertiary care, academic medical center. PATIENT(S): Thirty premenopausal women aged 18 to 45 years undergoing laparoscopic hysterectomy with ovarian preservation for benign indications from April 2012 to September 2012. INTERVENTION(S): Bilateral salpingectomy (n = 15) versus no salpingectomy (n = 15) at the time of laparoscopic hysterectomy with ovarian preservation. MAIN OUTCOME MEASURE(S): Antimüllerian hormone (AMH) measured preoperatively, at 4 to 6 weeks postoperatively, and at 3 months postoperatively, with operative time and estimated blood loss abstracted from the medical records. RESULT(S): The mean AMH levels were not statistically significantly different at baseline (2.26 vs. 2.25 ng/ml), 4 to 6 weeks postoperatively (1.03 vs. 1.25 ng/ml), or 3 months postoperatively (1.86 vs. 1.82 ng/ml) among women with salpingectomy versus no salpingectomy, respectively. There was also no statistically significant temporal change in the mean AMH level from baseline to 3 months postoperatively (-0.07 vs. -0.08 ng/ml) between the two groups. No difference in operative time (116 vs. 115 minutes) or estimated blood loss (70 vs. 91 mL) was observed. CONCLUSION(S): Salpingectomy at the time of laparoscopic hysterectomy with ovarian preservation is a safe procedure that does not appear to have any short-term deleterious effects on ovarian reserve, as measured by AMH level. Conducting a trial of this nature that is adequately powered with long-term follow-up evaluation would be feasible and is required to definitively confirm these results

Preferred physical characteristics of lidocaine thin film for women with vestibulodynia

Introduction Vestibulodynia (VBD) is the most common cause of sexual pain in the United States, affecting up to 15% of reproductive-aged women during their lifetime with limited treatment options. The purpose of this study was to describe ideal physical characteristics of a vulvar film designed for insertional sexual pain in sexually active women with VBD. Methods Twenty women were recruited to participant in one of six, semi-structured 60-minute focus group discussions regarding treatment options for VBD. Heterosexual women, aged 18–51 years old with a diagnosis of vulvodynia, vestibulodynia or insertional dyspareunia fit the inclusion criteria. Those who reported no episodes of vaginal intercourse in the prior 18 months were excluded. A new vulvar film technology loaded with 50 mg of 5% lidocaine was introduced to the group. Participants took part in focus groups on a rolling basis depending on availability. Focus group discussions were audio-recorded and transcribed verbatim. Two study investigators coded the transcripts using inductive coding and merged their respective projects to resolve disagreements. We analyzed data related to each code to develop code clusters and higher-level primary topics regarding device preferences. Data related to each of these primary topics was analyzed to assess the range of participant attitudes and preferences and to identify patterns within each primary topic.ResultsOne hundred and sixteen women were recruited, and twenty women were enrolled. The mean age for the participants was 33.3 years. Most women were educated with at least some college (93%), White (78.6%), married (75%), and had income greater than $100,000 (50%). Analysis of the focus group discussions identified five common topics addressed by participants: desired loaded medication, film size, film shape, film flexibility, and ease and accuracy of use. Concerns across topics included comfort, sexual spontaneity, and efficacy. Interest in loading the device with other acceptable medications or combination with lidocaine was independently noted in 2/6 (33%) of the focus groups.DiscussionMucoadhesive vulvar thin films may be an acceptable drug delivery system for insertional sexual pain for women with VBD

OPPERA Study Identifies an Association Between the Use of Hormonal Contraceptives and Orofacial Pain and Headaches

Introduction: • Hormone therapy has been described as a risk factor for chronic pain conditions such as low back pain and temporomandibular disorders (TMD)• Hormonal contraception (HC) may affect pain by altering the function of the endogenous opioid system and augmenting serotonin metabolism • HC has been shown to increase experimental heat and ischemic pain sensitivity in women with TMD and migraine headaches • Women using HC also demonstrate decreased pressure pain and tactile thresholds of the temporalis and masseter muscles compared to healthy women not using HC • An association between the use of HC and painful conditions such as migraine headaches and TMD has been described in previous studies although the nature of this association remains unclear • This analysis sought to determine the relationship between HC use and painful symptoms (particularly headaches and orofacial pain

Preferred physical characteristics of lidocaine thin film for women with vestibulodynia

IntroductionVestibulodynia (VBD) is the most common cause of sexual pain in the United States, affecting up to 15% of reproductive-aged women during their lifetime with limited treatment options. The purpose of this study was to describe ideal physical characteristics of a vulvar film designed for insertional sexual pain in sexually active women with VBD.MethodsTwenty women were recruited to participant in one of six, semi-structured 60-minute focus group discussions regarding treatment options for VBD. Heterosexual women, aged 18–51 years old with a diagnosis of vulvodynia, vestibulodynia or insertional dyspareunia fit the inclusion criteria. Those who reported no episodes of vaginal intercourse in the prior 18 months were excluded. A new vulvar film technology loaded with 50 mg of 5% lidocaine was introduced to the group. Participants took part in focus groups on a rolling basis depending on availability. Focus group discussions were audio-recorded and transcribed verbatim. Two study investigators coded the transcripts using inductive coding and merged their respective projects to resolve disagreements. We analyzed data related to each code to develop code clusters and higher-level primary topics regarding device preferences. Data related to each of these primary topics was analyzed to assess the range of participant attitudes and preferences and to identify patterns within each primary topic.ResultsOne hundred and sixteen women were recruited, and twenty women were enrolled. The mean age for the participants was 33.3 years. Most women were educated with at least some college (93%), White (78.6%), married (75%), and had income greater than $100,000 (50%). Analysis of the focus group discussions identified five common topics addressed by participants: desired loaded medication, film size, film shape, film flexibility, and ease and accuracy of use. Concerns across topics included comfort, sexual spontaneity, and efficacy. Interest in loading the device with other acceptable medications or combination with lidocaine was independently noted in 2/6 (33%) of the focus groups.DiscussionMucoadhesive vulvar thin films may be an acceptable drug delivery system for insertional sexual pain for women with VBD

Putative Risk Factors for Dysmenorrhea from the OPPERA Study

Introduction: Dysmenorrhea is the most common gynecological problem among menstruating women, affecting up to 90% of females during their reproductive years 1,2 • Risk factors for dysmenorrhea are not well described, however it has been associated with young age, early menarche (<12 years) and nulliparity3 • The aims of this investigation are to identify putative risk factors for dysmenorrhea and investigate differences in the severity of menstrual pain among different demographic group

Association Between Gynecological Characteristics and Temporomandibular Disorders: Insights from the OPPERA Study

• Several chronic pain conditions, such as temporomandibular disorders (TMD), are more common in women than in men although the biological mechanisms responsible for this gender disparity are poorly understood • Observational studies suggest that TMD pain is greatest during the late luteal phase of the menstrual cycle and during menses when estrogen levels quickly decline • Also, women with TMD who use hormonal contraception report greater levels of daily pain compared to women not taking hormonal contraception • The aim of this study is to evaluate gynecological characteristics that are putative risk factors for TMD: parity, use of hormonal contraception, and self-reported pain levels and psychological symptoms over the course of the menstrual cycl

Nancy Grace Roman Space Telescope Coronagraph Instrument Observation Calibration Plan

NASA's next flagship mission, the Nancy Grace Roman Space Telescope, is a 2.4-meter observatory set to launch no later than May 2027. Roman features two instruments: the Wide Field Imager and the Coronagraph Instrument. Roman's Coronagraph is a Technology Demonstration that will push the current capabilities of direct imaging to smaller contrast ratios ($\sim$10$^{-9}$) and inner-working angles (3~$\lambda$/D). In order to achieve this high precision, Roman Coronagraph data must be calibrated to remove as many potential sources of error as possible. Here we present a detailed overview of the Nancy Grace Roman Space Telescope Coronagraph Instrument Observation Calibration Plan including identifying potential sources of error and how they will be mitigated via on-sky calibrations.Comment: Posting for public information on the current status of the Roman Coronagraph Observation Calibration Plan; latest updates as of July 29, 202