Background
Understanding the impact of race/ethnicity on the prevalence and presentation of endometriosis may help improve patient care.
Objective
To review systematically the evidence for the influence of race/ethnicity on the prevalence of endometriosis.
Search strategy
CENTRAL, MEDLINE, PubMed, Embase, LILACS, SCIELO, and CINAHL databases, as well as the grey literature, were searched from date of inception until September 2017.
Selection criteria
Randomised control trials and observational studies reporting on prevalence and/or clinical presentation of endometriosis.
Data collection and analysis
Twenty studies were included in the review and 18 studies were used to calculate odds ratio (OR) with 95% confidence interval (CI) through a random effects model. Methodological quality was assessed using the Newcastle‐Ottawa risk of bias scale (NOS).
Main results
Compared with White women, Black woman were less likely to be diagnosed with endometriosis (OR 0.49, 95% CI 0.29–0.83), whereas Asian women were more likely to have this diagnosis (OR 1.63, 95% CI 1.03–2.58). Compared with White women, there was a statistically significant difference in likelihood of endometriosis diagnosis in Hispanic women (OR 0.46, 95% CI 0.14–1.50). Significant heterogeneity (I2 > 50%) was present in the analysis for all racial/ethnic groups but was partially reduced in subgroup analysis by clinical presentation, particularly when endometriosis was diagnosed as self‐reported,
Conclusions
Prevalence of endometriosis appears to be influenced by race/ethnicity. Most notably, Black women appear less likely to be diagnosed with endometriosis compared with White women. There is scarce literature exploring the influence of race/ethnicity on symptomatology, as well as treatment access, preference, and response.
Tweetable abstract
Prevalence of endometriosis may be influenced by race/ethnicity, but there is limited quality literature exploring this topic.
Our findings indicate muscle activation is not dependent on anatomical orientation but perhaps on its role in maintaining knee joint stability in the frontal and transverse loading planes. This is useful for delineating the roles of biarticular knee joint muscles and could have implications in robotics, musculoskeletal modeling, sports sciences, and rehabilitation.
Background: Understanding the impact of race/ethnicity on the prevalence and presentation of endometriosis may help improve patient care. Objective: To systematically review the evidence for the influence of race/ethnicity on the prevalence of endometriosis.
Sex-related differences in neuromuscular activation have been previously identified and are thought to be an underlying contributor to the ACL injury mechanism. During dynamic tasks evaluating the role of muscle action as it relates to joint stability is difficult since individual muscle contributions to force generation are confounded by biomechanical factors of movement. The purpose of this study was to examine sex-related differences in knee muscle action during a weight-bearing isometric exercise and identify the stabilising role of these muscles. Healthy young adults stood with their dominant leg in a boot fixed to a force platform. A force matching protocol required participants to modulate normalised ground reaction forces in various combinations of anterior-posterior, medial-lateral loads while maintaining a constant joint position. Normalised electromyographic data of eight muscles crossing the knee joint were displayed in polar plots. Patterns were quantified with an orientation analysis and mean activation magnitudes were computed. Females demonstrated symmetrical activation patterns with significantly greater activation in the rectus femoris (p ¼ 0.037), lateral gastrocnemius (p ¼ 0.012), and tensor fascia lata (p ¼ 0.005) compared to males. High between-subject reliability (ICC ¼ 0.772-0.977) was observed across groups suggesting we have identified fundamental sex-related differences in knee joint stabilisation strategies. ß
Background
Patient specific three-dimensional (3D) models can be derived from two-dimensional medical images, such as magnetic resonance (MR) images. 3D models have been shown to improve anatomical comprehension by providing more accurate assessments of anatomical volumes and better perspectives of structural orientations relative to adjacent structures. The clinical benefit of using patient specific 3D printed models have been highlighted in the fields of orthopaedics, cardiothoracics, and neurosurgery for the purpose of pre-surgical planning. However, reports on the clinical use of 3D printed models in the field of gynecology are limited.
Main text
This article aims to provide a brief overview of the principles of 3D printing and the steps required to derive patient-specific, anatomically accurate 3D printed models of gynecologic anatomy from MR images. Examples of 3D printed models for uterine fibroids and endometriosis are presented as well as a discussion on the barriers to clinical uptake and the future directions for 3D printing in the field of gynecological surgery.
Conclusion
Successful gynecologic surgery requires a thorough understanding of the patient’s anatomy and burden of disease. Future use of patient specific 3D printed models is encouraged so the clinical benefit can be better understood and evidence to support their use in standard of care can be provided.
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