Minimally invasive surgery when treating endometriosis has a positive effect on health and on quality of work life of affected women

STUDY QUESTION What is the effect of the minimally invasive surgical treatment of endometriosis on health and on quality of work life (e.g. working performance) of affected women? SUMMARY ANSWER Absence from work, performance loss and the general negative impact of endometriosis on the job are reduced significantly by the laparoscopic surgery. WHAT IS KNOWN ALREADY The benefits of surgery overall and of the laparoscopic method in particular for treating endometriosis have been described before. However, previous studies focus on medical benchmarks without including the patient's perspective in a quantitative manner. STUDY DESIGN, SIZE, DURATION A retrospective questionnaire-based survey covering 211 women with endometriosis and a history of specific laparoscopic surgery in a Swiss university hospital, tertiary care center. Data were returned anonymously and were collected from the beginning of 2012 until March 2013. PARTICIPANTS/MATERIALS, SETTING, METHODS Women diagnosed with endometriosis and with at least one specific laparoscopic surgery in the past were enrolled in the study. The study investigated the effect of the minimally invasive surgery on health and on quality of work life of affected women. Questions used were obtained from the World Endometriosis Research Foundation (WERF) Global Study on Women's Health (GSWH) instrument. The questionnaire was shortened and adapted for the purpose of the present study. MAIN RESULTS AND THE ROLE OF CHANCE Of the 587 women invited to participate in the study, 232 (232/587 = 40%) returned the questionnaires. Twenty-one questionnaires were excluded due to incomplete data and 211 sets (211/587 = 36%) were included in the study. Our data show that 62% (n = 130) of the study population declared endometriosis as influencing the job during the period prior to surgery, compared with 28% after surgery (P < 0.001). The mean (maximal) absence from work due to endometriosis was reduced from 2.0 (4.9) to 0.5 (1.4) hours per week (P < 0.001). The mean (maximal) loss in working performance after the surgery averaged out at 5.7% (12.6%) compared with 17.5% (30.5%) before this treatment (P < 0.001). LIMITATIONS, REASONS FOR CAUTION The mediocre response rate of the study weakens the representativeness of the investigated population. Considering the anonymous setting a non-responder investigation was not performed. A bias due to selection, information and negativity effects within a retrospective survey cannot be excluded, although study-sensitive questions were provided in multiple ways. The absence of a control group (sham group; e.g. patients undergoing specific diagnostic laparoscopy without treatment) is a further limitation of the study. WIDER IMPLICATIONS OF THE FINDINGS Our study shows that indicated minimally invasive surgery has a clear positive effect on the wellbeing and working performance of women suffering from moderate to severe endometriosis. Furthermore, national net savings in indirect costs with the present number of surgeries is estimated to be €10.7 million per year. In an idealized setting (i.e. without any diagnosis delay) this figure could be more than doubled. STUDY FUNDING/COMPETING INTEREST(S) The study was performed on behalf of the University Hospital of Bern (Inselspital) as one of the leading Swiss tertiary care centers. The authors do not declare any competing interest

R-044. Limiting the number of embryos transferred does not significantly influence the outcome of conventional IVF treatment

SEB 1104 TECHNICAL DRG.- 14 D SEP (2

Electromagnetic transitions of the helium atom in superstrong magnetic fields

We investigate the electromagnetic transition probabilities for the helium atom embedded in a superstrong magnetic field taking into account the finite nuclear mass. We address the regime \gamma=100-10000 a.u. studying several excited states for each symmetry, i.e. for the magnetic quantum numbers 0,-1,-2,-3, positive and negative z parity and singlet and triplet symmetry. The oscillator strengths as a function of the magnetic field, and in particular the influence of the finite nuclear mass on the oscillator strengths are shown and analyzed.Comment: 10 pages, 8 figure

Allele-specific long-distance regulation dictates IL-32 isoform switching and mediates susceptibility to HIV-1

We integrated data obtained from HIV-1 genome-wide association studies with T cell-derived epigenome data and found that the noncoding intergenic variant rs4349147, which is statistically associated with HIV-1 acquisition, is located in a CD4+ T cell-specific deoxyribonuclease I hypersensitive region, suggesting regulatory potential for this variant. Deletion of the rs4349147 element in Jurkat cells strongly reduced expression of interleukin-32 (IL-32), approximately 10-kb upstream, and chromosome conformation capture assays identified a chromatin loop between rs4349147 and the IL-32 promoter validating its function as a long-distance enhancer. We generated single rs4349147-A or rs4349147-G allele clones and demonstrated that IL-32 enhancer activity and interaction with the IL-32 promoter are strongly allele dependent; rs4349147 -/A cells display reduced IL-32 expression and altered chromatin conformation as compared to rs4349147 G/- cells. Moreover, RNA sequencing demonstrated that rs4349147 G/- cells express a lower relative ratio of IL-32α to non-a isoforms than rs4349147 -/A cells and display increased expression of lymphocyte activation factors rendering them more prone to infection with HIV-1. In agreement, in primary CD4+ T cells, both treatment with recombinant IL-32γ (rIL-32γ) but not rIL-32α, and exogenous lentiviral overexpression of IL-32γ or IL-32β but not IL-32α resulted in a proinflammatory T cell cytokine environment concomitant with increased susceptibility to HIV infection. Our data demonstrate that rs4349147-G promotes transcription of non-IL-32α isoforms, generating a proinflammatory e

Rotating spin-1 bosons in the lowest Landau level

We present results for the ground states of a system of spin-1 bosons in a rotating trap. We focus on the dilute, weakly interacting regime, and restrict the bosons to the quantum states in the lowest Landau level (LLL) in the plane (disc), sphere or torus geometries. We map out parts of the zero temperature phase diagram, using both exact quantum ground states and LLL mean field configurations. For the case of a spin-independent interaction we present exact quantum ground states at angular momentum $L\leq N$. For general values of the interaction parameters, we present mean field studies of general ground states at slow rotation and of lattices of vortices and skyrmions at higher rotation rates. Finally, we discuss quantum Hall liquid states at ultra-high rotation.Comment: 24 pages, 14 figures, RevTe

Universal Behavior of Charged Particle Production in Heavy Ion Collisions

The PHOBOS experiment at RHIC has measured the multiplicity of primary charged particles as a function of centrality and pseudorapidity in Au+Au collisions at sqrt(s_NN) = 19.6, 130 and 200 GeV. Two kinds of universal behavior are observed in charged particle production in heavy ion collisions. The first is that forward particle production, over a range of energies, follows a universal limiting curve with a non-trivial centrality dependence. The second arises from comparisons with pp/pbar-p and e+e- data. N_tot/(N_part/2) in nuclear collisions at high energy scales with sqrt(s) in a similar way as N_tot in e+e- collisions and has a very weak centrality dependence. This feature may be related to a reduction in the leading particle effect due to the multiple collisions suffered per participant in heavy ion collisions.Comment: 4 Pages, 5 Figures, contributed to the Proceedings of Quark Matter 2002, Nantes, France, 18-24 July 200

Global Observations from PHOBOS

Particle production in Au+Au collisions has been measured in the PHOBOS experiment at RHIC for a range of collision energies. Three empirical observations have emerged from this dataset which require theoretical examination. First, there is clear evidence of limiting fragmentation. Namely, particle production in central Au+Au collisions, when expressed as $dN/d\eta'$ ($\eta' \equiv \eta-y_{beam}$), becomes energy independent at high energy for a broad region of $\eta'$ around $\eta'=0$. This energy-independent region grows with energy, allowing only a limited region (if any) of longitudinal boost-invariance. Second, there is a striking similarity between particle production in e+e- and Au+Au collisions (scaled by the number of participating nucleon pairs). Both the total number of produced particles and the longitudinal distribution of produced particles are approximately the same in e+e- and in scaled Au+Au. This observation was not predicted and has not been explained. Finally, particle production has been found to scale approximately with the number of participating nucleon pairs for $N_{part}>65$. This scaling occurs both for the total multiplicity and for high \pT particles (3 <\pT< 4.5 GeV/c).Comment: QM2002 plenary talk, 10 pages, 11 figure