The practice of speech surrogacy is used for communication across many cultures. Previous work has historically engaged with the study of speech surrogates as part of anthropological or ethnomusicological inquiry; more recently, scholars have explored aspects of the formal relationship between spoken and surrogate linguistic structures. How speech surrogates function as systems of communication is not yet well understood. Based on evidence from an interdisciplinary corpus of documentation, characteristics of culture and discourse, as well as features of linguistic structure, are shown to play a role in fostering communicability in speech surrogates. Cultural constraints are linked to the development of a speech surrogate-mediated discourse within a community of practice, facilitating comprehension of the surrogate system. Moreover, specific structures including formulas, enphrasing, and framing devices are identified as common to various speech surrogate traditions, suggesting a common function as aids to communication. This analysis points to the need to investigate speech surrogates as linguistic systems within a discursive context.
Objective
To conduct a systematic review and meta-analysis to estimate the prevalence of occult uterine malignancy of any subtype specifically at the time of hysterectomy for pelvic organ prolapse (POP).
Methods
We primarily used MEDLINE to access existing literature. The search terms used were “occult malignancy” or “occult uterine pathology” paired with “morcellation” or “hysterectomy.” Our cutoff date for articles was March 25, 2019. We further narrowed articles down based on whether they included data on occult malignancy at time of hysterectomy specifically for POP.
Results
Our search yielded a total of 233 journal articles, of which 53 met the criteria for a full-text review. Eight studies provided specific data on occult uterine malignancy among women undergoing surgery for POP and formed the basis for this meta-analysis. Among the 8 studies examined, the total number of patients combined was 35,880, and there were 144 total occult uterine malignancies. There were 7 case series and 1 population-based study included. The pooled prevalence of occult uterine malignancy at the time of hysterectomy for POP was 0.22% (95% confidence interval, 0.11%–0.35%]. There was very little heterogeneity observed across the 8 studies (I
2 = 12.06%, Q χ2[7] = 7.96, P = 0.336).
Conclusions
The pooled prevalence of occult uterine malignancy, of any subtype, at the time of surgery for POP specifically is 0.22% based on meta-analysis of existing studies. Surgeons can use this statistic as part of the preoperative counseling of patients with POP before hysterectomy.
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