A focus on the distinctions and current evidence of endometriosis in adolescents

Endometriosis (EM) occurring in adolescents presents distinct clinical and histologic characteristics compared to the disease in women. Because the symptoms of EM are nonspecific, often overlapping with those experienced in a range of gynecological and gastrointestinal conditions, the process of reaching a diagnosis of EM is often delayed. The diagnosis of EM is suspected depending on the history and the symptoms and signs, is corroborated by physical examination and imaging techniques, and is finally proved by histological examination of specimens collected during laparoscopy. Currently, there is insufficient evidence to make strong recommendations for management in adolescents who may have EM. This short report reviews some peculiarities of EM in adolescents and provides an update of recent knowledge of the diagnosis and treatment of EM. We hope that the present contribution may help to bring more attention to the clinical diagnosis of EM and consequently aid in decreasing diagnostic delay.     

The ‘Variant Normal’ Electrocardiogram of the Professional Football Player

The ECGs of highly trained athletes reveal variants that may incorrectly be called abnormal.     

Is the Gambling Motives Questionnaire really three-dimensional? A proposition of a four-dimensional Gambling Motives Questionnaire – Revised

The aim of the present study was to improve the weaknesses of the three-dimensional Gambling Motives Questionnaire and to examine the psychometric properties and factor structure of the Gambling Motives Questionnaire-Revised. The Gambling Motives Questionnaire was administered to a sample of 418 gamblers (92% men, mean age 19.5 years). Participants completed the Gambling Motives Questionnaire and an additional item tapping boredom, as well as a variety of measures of gambling behavior and gambling problems as criterion measures. Results showed that the Gambling Motives Questionnaire-Revised is better represented as a four-factor structure tapping the following four gambling motives factors; enhancement, coping, social, and self-gratification, Δχ² Δ(df) = 24.76 (3), p < 0.001. Removing two problematic items from the Gambling Motives Questionnaire and adding an extra item tapping boredom also improved the fit of the Gambling Motives Questionnaire-Revised. The subscales enhancement, social, and coping were all significant predictors of variety of gambling behaviors (p < 0.05), whereas enhancement, coping, and self-gratification predicted frequency of gambling behaviors (p < 0.01). Coping and self-gratification predicted loss of control (p < 0.01), whereas self-gratification predicted gambling problems (p < 0.001). The Gambling Motives Questionnaire – Revised, consisting of the four dimensions enhancement motives, social motives, coping motives and self-gratification motives, is a reliable and valid instrument to measuring gambling motives.     

Perceived safety and controllability of events: Markers of risk for marijuana use in young adults?

Drawing on constructs from the trauma literature, the current study evaluated perceptions of safety and controllability of events as potential markers of risk for marijuana use. In addition, we characterized these perceptions in relation to individual level substance abuse risk factors (marijuana expectancies, impulsivity, depression, and anxiety), gender, and race. Data were collected via web survey from college students at two northeastern universities (n = 228, 82.0% female). Controllability of events (CE) was rated significantly higher by Blacks than Whites. Safety/vulnerability (SV) and CE were associated with impulsivity, depression, and anxiety. CE was also associated with marijuana expectancies. Logistic regression analyses revealed a modest but significant association between SV and lifetime use even after adjusting for race, gender, age, and individual level substance abuse risk factors (odds ratio = 1.10, 95% confidence intervals:1.02–1.18). No association between SV and past 3 month frequency of use or between CE and either marijuana outcome was found. Findings support a link between perceptions of safety and ever using marijuana. They further demonstrate overlap of both perceived safety and controllability of events with substance use related risk factors, and suggest that they differ by race. Additional studies that assess substance use more broadly and query trauma history, using larger, more diverse samples, are needed to more fully grasp the relevance of these constructs to substance use, including their potential as targets for substance abuse prevention efforts.     

Long-term clinical outcomes of cochlear implantation in children with symptomatic epilepsy

ObjectivesTo describe long-term clinical outcomes of cochlear implantation in deaf children with symptomatic epilepsy.Materials and methodsA retrospective data analysis review of patients implanted at the Cochlear Implant Center of the University of Parma, Italy, was performed, searching for implanted children with a confirmed diagnosis of symptomatic epilepsy. Clinical data, imaging findings, pre- and post-operative epilepsy pattern and EEG traces were analyzed; communicative skills were assessed using the Profile of Actual Linguistic Skills.ResultsSearch retrieved two patients affected by profound bilateral sensorineural hearing loss and symptomatic epilepsy (associated respectively with methylmalonic acidemia and cerebral palsy). After careful parental counselling both patients were offered and underwent cochlear implantation. Activation and use of cochlear implant did not determine substantial changes of pre-existing seizure pattern and EEG traces. Both patients showed substantial development of their communicative abilities.ConclusionsCochlear implantation in children with symptomatic epilepsy did not determine variations in seizure pattern or EEG traces. Both patients experienced substantial benefit from cochlear implantation.