Objective: To estimate the effects of race and preoperative uterine anatomy on complication rates after myomectomy.
Methods: A total of 239 abdominal myomectomies were performed at Duke University Medical Center from July 1992 through June 1998. Charts were abstracted using standardized forms. We assessed patient characteristics, surgical indications, preoperative hematocrit, and operative findings. Outcomes were defined as any complication, including transfusion.
Results: The population (n = 225) was 53% black and 47% white. The mean body mass index was 26. Fourteen percent had comorbidities. Twenty percent required transfusion. Black women were found to be more likely to have uteri with more than four leiomyomata and less likely to have only one leiomyoma (P =.001). Black women were 2.48 times more likely to have a complication (P <.006). Race was no longer a significant predictor for complications (odds ratio [OR] 1.36, 95% confidence interval [CI] 0.56, 3.15) after adjustment for uterine size (OR 1.86, 95% CI 1.3, 2.67), number of leiomyomata (OR 1.83, 95% CI 1.1, 3.14), and comorbidities (OR 2.77, 95% CI 1.1, 7.69). A similar pattern was seen for blood transfusion.
Conclusion: Black women undergoing myomectomy are more than twice as likely to have in-hospital complication or blood transfusion than white women. This is largely attributable to differences in uterine size and leiomyoma number. Research is needed to explore why black women are more likely to have larger and more numerous leiomyomata at the time of presentation for surgery.
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http://dx.doi.org/10.1016/s0029-7844(03)00015-2 | DOI Listing |
Am J Respir Crit Care Med
January 2025
Indiana University School of Medicine, Pediatric Pulmonary Medicine, Indianapolis, Indiana, United States.
PLoS One
January 2025
Department of Pharmacotherapy, University of Utah, Salt Lake City, Utah, United States of America.
Background: Venous thromboembolism (VTE) and atrial fibrillation (AF) disproportionately affect older adults, who are at increased risk of bleeding from treatment with anticoagulant therapy. The impact of bleeding on older adults' quality of life (QoL) is poorly understood due to the lack of a validated measure of their experience. This study's purpose is to describe the first evidence-based steps in developing a new condition-specific patient-reported outcome measure (PROM) for the effect of anticoagulant-related bleeding on older adults' QoL.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota.
Importance: There is a clear benefit to body armor against firearms; however, it remains unclear how these vests may influence day-to-day patient encounters when worn by emergency medical services (EMS).
Objective: To determine the association of ballistic vests worn by EMS clinicians with workplace violence (WPV) and disparities in care among racial and/or ethnic minority patients.
Design, Setting, And Participants: Prospective cohort study of a volunteer-based sample of EMS clinicians at a large, multistate EMS agency encompassing 15 ground sites across the Midwest from April 1, 2023, to March 31, 2024.
Tob Induc Dis
January 2025
Institute of Medical Science, University of Toronto, Toronto, Canada.
Introduction: There is substantial interest in the association of vaping e-cigarettes with the risk of cancer. We analyzed this risk in different populations by updating the Kings College London (KCL) review to include the period between July 2021 and December 2023.
Methods: We searched six databases and included peer-reviewed human, animal, and cell/ original studies examining the association between e-cigarettes and cancer risk, but we excluded qualitative studies.
JVS Vasc Insights
October 2024
Division of Vascular Surgery, University of Pittsburgh.
Objective: Antithrombotic therapy improves endovascular intervention outcomes for peripheral artery disease. However, there are limited data guiding the choice and duration of these adjuvant therapies. Thus, we explored current antithrombotic prescribing preferences among vascular interventionalists, hypothesizing that there are varied and inconsistent treatment practices among providers.
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