Article Type
Changed
Fri, 05/13/2022 - 16:35
Dr. Christianson scans the journals, so you don’t have to!

Mindy S. Christianson, MD
One recent meta-analysis in European Radiology compared the treatment success and safety of ultrasound- and MR-guided high-intensity focused ultrasound (HIFU) with surgery for treating symptomatic uterine fibroids. In a meta-analysis of 10 studies involving 4450 patients, Liu et al reported that the decrease in uterine fibroid severity score at 6- and 12-month follow-up was significantly higher in the HIFU group than the surgery group. Additionally, the HIFU group showed a significantly greater increase in quality-of-life (QoL) scores at 6- and 12-month follow-up compared to the surgery group. Other advantages of HIFU compared to surgery included a shorter hospital stay duration and shorter time to return to work. The rate of significant complications was also lower with HIFU. HIFU and surgery demonstrated similar effects regarding the incidence of adverse events, symptom recurrence, re-intervention, and pregnancy.

Chiuve et al published a large cohort study in the Journal of Epidemiology and Community Health that evaluated the association between uterine fibroids and diagnosed depression, anxiety and self-directed violence. Women aged 18-50 years with diagnosed uterine fibroids (n=313,754) were identified in the Optum Clinformatics commercial insurance claims database and matched 1:2 on age and calendar time to women without (n=627,539). After adjusting for confounders, women with uterine fibroids had a higher rate of depression, anxiety and self-directed violence then women not diagnosed with fibroids. Among women with pain symptoms and heavy menstrual bleeding, the hazard ratio comparing women with fibroids to women without was 1.21 for depression, 1.18 for anxiety and 1.68 for self-directed violence. Among women with fibroids, those who underwent hysterectomy had higher rates of depression, anxiety and self-directed violence.

A third study by Wesselink et al in Human Reproduction examined ambient air pollution exposure and the risk of developing uterine fibroids. This was a prospective cohort study of 21,998 premenopausal Black women in 56 US metropolitan areas from 1997 to 2011. During the follow up, 28.4% of participants (n=6238) reported uterine fibroid diagnosis by ultrasound or surgery. Increased ozone concentrations were associated with an increased risk of being diagnosed with uterine fibroids, with a stronger association among women less than 35 years of age and parous women. Other pollutants, specifically particulate matter <2.5 microns and nitrogen dioxide, were not associated with an increased risk of uterine fibroids.

Author and Disclosure Information

Mindy S. Christianson, MD Medical Director, Johns Hopkins Fertility Center
Associate Professor, Division of Reproductive Endocrinology and Infertility
Johns Hopkins University School of Medicine

Publications
Topics
Sections
Author and Disclosure Information

Mindy S. Christianson, MD Medical Director, Johns Hopkins Fertility Center
Associate Professor, Division of Reproductive Endocrinology and Infertility
Johns Hopkins University School of Medicine

Author and Disclosure Information

Mindy S. Christianson, MD Medical Director, Johns Hopkins Fertility Center
Associate Professor, Division of Reproductive Endocrinology and Infertility
Johns Hopkins University School of Medicine

Dr. Christianson scans the journals, so you don’t have to!
Dr. Christianson scans the journals, so you don’t have to!

Mindy S. Christianson, MD
One recent meta-analysis in European Radiology compared the treatment success and safety of ultrasound- and MR-guided high-intensity focused ultrasound (HIFU) with surgery for treating symptomatic uterine fibroids. In a meta-analysis of 10 studies involving 4450 patients, Liu et al reported that the decrease in uterine fibroid severity score at 6- and 12-month follow-up was significantly higher in the HIFU group than the surgery group. Additionally, the HIFU group showed a significantly greater increase in quality-of-life (QoL) scores at 6- and 12-month follow-up compared to the surgery group. Other advantages of HIFU compared to surgery included a shorter hospital stay duration and shorter time to return to work. The rate of significant complications was also lower with HIFU. HIFU and surgery demonstrated similar effects regarding the incidence of adverse events, symptom recurrence, re-intervention, and pregnancy.

Chiuve et al published a large cohort study in the Journal of Epidemiology and Community Health that evaluated the association between uterine fibroids and diagnosed depression, anxiety and self-directed violence. Women aged 18-50 years with diagnosed uterine fibroids (n=313,754) were identified in the Optum Clinformatics commercial insurance claims database and matched 1:2 on age and calendar time to women without (n=627,539). After adjusting for confounders, women with uterine fibroids had a higher rate of depression, anxiety and self-directed violence then women not diagnosed with fibroids. Among women with pain symptoms and heavy menstrual bleeding, the hazard ratio comparing women with fibroids to women without was 1.21 for depression, 1.18 for anxiety and 1.68 for self-directed violence. Among women with fibroids, those who underwent hysterectomy had higher rates of depression, anxiety and self-directed violence.

A third study by Wesselink et al in Human Reproduction examined ambient air pollution exposure and the risk of developing uterine fibroids. This was a prospective cohort study of 21,998 premenopausal Black women in 56 US metropolitan areas from 1997 to 2011. During the follow up, 28.4% of participants (n=6238) reported uterine fibroid diagnosis by ultrasound or surgery. Increased ozone concentrations were associated with an increased risk of being diagnosed with uterine fibroids, with a stronger association among women less than 35 years of age and parous women. Other pollutants, specifically particulate matter <2.5 microns and nitrogen dioxide, were not associated with an increased risk of uterine fibroids.

Mindy S. Christianson, MD
One recent meta-analysis in European Radiology compared the treatment success and safety of ultrasound- and MR-guided high-intensity focused ultrasound (HIFU) with surgery for treating symptomatic uterine fibroids. In a meta-analysis of 10 studies involving 4450 patients, Liu et al reported that the decrease in uterine fibroid severity score at 6- and 12-month follow-up was significantly higher in the HIFU group than the surgery group. Additionally, the HIFU group showed a significantly greater increase in quality-of-life (QoL) scores at 6- and 12-month follow-up compared to the surgery group. Other advantages of HIFU compared to surgery included a shorter hospital stay duration and shorter time to return to work. The rate of significant complications was also lower with HIFU. HIFU and surgery demonstrated similar effects regarding the incidence of adverse events, symptom recurrence, re-intervention, and pregnancy.

Chiuve et al published a large cohort study in the Journal of Epidemiology and Community Health that evaluated the association between uterine fibroids and diagnosed depression, anxiety and self-directed violence. Women aged 18-50 years with diagnosed uterine fibroids (n=313,754) were identified in the Optum Clinformatics commercial insurance claims database and matched 1:2 on age and calendar time to women without (n=627,539). After adjusting for confounders, women with uterine fibroids had a higher rate of depression, anxiety and self-directed violence then women not diagnosed with fibroids. Among women with pain symptoms and heavy menstrual bleeding, the hazard ratio comparing women with fibroids to women without was 1.21 for depression, 1.18 for anxiety and 1.68 for self-directed violence. Among women with fibroids, those who underwent hysterectomy had higher rates of depression, anxiety and self-directed violence.

A third study by Wesselink et al in Human Reproduction examined ambient air pollution exposure and the risk of developing uterine fibroids. This was a prospective cohort study of 21,998 premenopausal Black women in 56 US metropolitan areas from 1997 to 2011. During the follow up, 28.4% of participants (n=6238) reported uterine fibroid diagnosis by ultrasound or surgery. Increased ozone concentrations were associated with an increased risk of being diagnosed with uterine fibroids, with a stronger association among women less than 35 years of age and parous women. Other pollutants, specifically particulate matter <2.5 microns and nitrogen dioxide, were not associated with an increased risk of uterine fibroids.

Publications
Publications
Topics
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Article Series
Clinical Edge Journal Scan: Uterine Fibroid September 2021
Gate On Date
Thu, 07/29/2021 - 18:45
Un-Gate On Date
Thu, 07/29/2021 - 18:45
Use ProPublica
CFC Schedule Remove Status
Thu, 07/29/2021 - 18:45
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article