Nationwide Ethnic/Racial Differences in Surgical Treatment of Discoid Meniscus in Children

Background: Discoid meniscus, a congenital meniscus variant, may have greater incidence in Asian populations. No United States population-based studies have examined the discoid meniscus ethnic/racial distribution. Hypothesis/Purpose: In pediatric patients undergoing meniscus surgery, we hypothesize that ethnic/racial variability exists in patients with discoid meniscus and this variability is different than in patients with isolated medial meniscus tears. Methods: The Pediatric Health Information System (PHIS) was queried from 48 hospitals to examine patients 18 years of age and younger between 2015 and 2019, using ICD-10 codes. A cohort of patients treated surgically for discoid meniscus was compared to a cohort of patients treated surgically for medial meniscal tear. These two populations were compared based on age, gender, ethnicity/race, CPT® code, insurance, urban vs rural, and region of country. Univariate testing and multivariable logistic modeling were used to test for associations. Results: A discoid meniscus cohort of 399 children (median age, 13.0 years) was compared to a medial meniscus tear cohort of 3157 children (median age, 16.0 years) (p<0.001) (Table 1). Hispanic/Latino children accounted for 36.8% of the discoid meniscus and 22.7% of the medial meniscus populations (p<0.001). Among pediatric patients that had surgery for discoid meniscus or medial meniscus, Hispanic/Latino children had 2.4 times the odds of surgery for discoid meniscus compared to white patients after adjusting for age and insurance (p<0.001) (Table 2). Asian children also had 2.4 times the odds of surgery for discoid meniscus compared to white patients (p=0.017). Conclusion: This study shows a significant association of ethnicity/race with discoid versus medial meniscus surgical treatment in children. Among pediatric patients that had surgery for discoid or medial meniscus, Hispanic/Latino and Asian patients were significantly more likely to have surgery for discoid meniscus than white patients. Hispanic/Latino children made up a greater percentage of the population having surgery for a discoid meniscus versus medial meniscus. When evaluating pediatric patients, younger age and Asian or Hispanic/Latino ethnicity should increase attention to the possibility of a discoid meniscus. [Table: see text][Table: see text]

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Israeli Arabs develop diverticulitis at a younger age and are more likely to require surgery than Jews

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202015000200004 ◽

2015 ◽

Vol 28 (2) ◽

pp. 102-104

Author(s):

Itai GHERSIN ◽

Nadav SLIJPER ◽

Gideon SROKA ◽

Ibrahim MATTER

Keyword(s):

Surgical Treatment ◽

Racial Differences ◽

Rural Areas ◽

Age Of Onset ◽

Acute Diverticulitis ◽

First Episode ◽

Urban Centers ◽

Younger Age ◽

Israeli Arabs ◽

The Impact

BACKGROUND: Only few studies have examined the impact of racial differences on the age of onset, course and outcomes of diverticulitis. AIM: To provide data about the epidemiology of diverticulitis in northern Israel, and to determine whether ethnicity is a predictor of age of onset, complications, and need for surgery. METHODS: Was conducted a retrospective review of the charts of all patients diagnosed with a first episode of diverticulitis in our hospital between 2005 and 2012. RESULTS: Were found 638 patients with a first episode of acute diverticulitis in the eight year interval. Israeli Arabs developed a first episode of diverticulitis at a younger age compared to Jews (51.2 vs 63.8 years, p<0.01). Arabs living in rural areas developed diverticulitis at a younger age than Arabs living in urban centers (49.4 vs 54.5 years, P=0.03). Jewish and Arabic men developed diverticulitis at younger age compared to their female counterparts (59.9 vs 66.09, p<0.01, and 47.31 vs 56.93, p<0.01, respectively). Arabs were more likely [odds ratio (OR)=1.81 ,95% confidence interval (CI)1.12-2.90, p=0.017] than Jews to require surgical treatment (urgent or elective) for diverticulitis. CONCLUSIONS: Israeli Arabs tend to develop diverticulitis at a younger age and are more likely to require surgical treatment for diverticulitis compared to Jews. Arabs living in rural areas develop diverticulitis at a younger age than Arabs living in urban centers. These findings highlight a need to address the root cause for ethnic differences in onset, course and outcome of acute diverticulitis.

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Racial Differences in Survival after Surgical Treatment for Melanoma

Annals of Surgical Oncology ◽

10.1245/s10434-011-1706-3 ◽

2011 ◽

Vol 18 (10) ◽

pp. 2925-2936 ◽

Cited By ~ 26

Author(s):

Karen Kadela Collins ◽

Ryan C. Fields ◽

Dadrie Baptiste ◽

Ying Liu ◽

Jeffrey Moley ◽

...

Keyword(s):

Surgical Treatment ◽

Racial Differences

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Patient Involvement in Surgery Treatment Decisions for Breast Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2005.06.217 ◽

2005 ◽

Vol 23 (24) ◽

pp. 5526-5533 ◽

Cited By ~ 228

Author(s):

Steven J. Katz ◽

Paula M. Lantz ◽

Nancy K. Janz ◽

Angela Fagerlin ◽

Kendra Schwartz ◽

...

Keyword(s):

Breast Cancer ◽

Decision Making ◽

African American ◽

Surgical Treatment ◽

Los Angeles ◽

African American Women ◽

Racial Differences ◽

Patient Involvement ◽

White Women ◽

Treatment Decisions

Purpose High rates of mastectomy and marked regional variations have motivated lingering concerns about overtreatment and failure to involve women in treatment decisions. We examined the relationship between patient involvement in decision making and type of surgical treatment for women with breast cancer. Methods All women with ductal carcinoma-in-situ and a 20% random sample of women with invasive breast cancer aged 79 years and younger who were diagnosed in 2002 and reported to the Detroit and Los Angeles Surveillance, Epidemiology, and End Results registries were identified and surveyed shortly after receipt of surgical treatment (response rate, 77.4%; n = 1,844). Results Mean age was 60.1 years; 70.2% of the women were white, 18.0% were African American, and 11.8% were from other ethnic groups. Overall, 30.2% of women received mastectomy as initial treatment. Most women reported that they made the surgical decision (41.0%) or that the decision was shared (37.1%); 21.9% of patients reported that their surgeon made the decision with or without their input. Among white women, only 5.3% of patients whose surgeon made the decision received mastectomy compared with 16.8% of women who shared the decision and 27.0% of women who made the decision (P < .001, adjusted for clinical factors, predisposing factors, and number of surgeons visited). However, this association was not observed for African American women (Wald test 10.0, P = .041). Conclusion Most women reported that they made or shared the decision about surgical treatment. More patient involvement in decision making was associated with greater use of mastectomy. Racial differences in the association of involvement with receipt of treatment suggest that the decision-making process varies by racial groups.

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THE UTILITY OF STABILITY AND TEAR LOCATION IN A CLASSIFICATION SYSTEM FOR DISCOID MENISCUS SURGICAL PLANNING

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00168 ◽

2019 ◽

Vol 7 (3_suppl) ◽

pp. 2325967119S0016

Author(s):

Brian W. Yang ◽

Catherine Logan ◽

Kathryn Williams ◽

Frances Tepolt ◽

Nikolaos Paschos ◽

...

Keyword(s):

Logistic Regression ◽

Surgical Treatment ◽

Treatment Planning ◽

Classification System ◽

Regression Models ◽

Univariate Analysis ◽

Classification Systems ◽

Discoid Meniscus ◽

Logistic Regression Models ◽

Clinical Records

Background Discoid meniscus (DM) is a congenital variant that typically affects the lateral meniscus of the knee. Despite the presence of multiple classification systems for DM, no system has demonstrated utility in treatment planning. We performed a retrospective review of discoid menisci that underwent surgical intervention at our institution to assess for discoid meniscus characteristics associated with surgical treatment with or without repair. Next, we propose a new method of classifying lateral discoid meniscus and demonstrate its efficacy in predicting surgical treatment. Methods We searched the orthopedic database at our institution for patients who underwent surgical treatment for lateral discoid meniscus between 1991 and 2017. Clinical records were reviewed to determine the type of DM surgery performed (surgery with or without repair) as well as DM morphology, stability, tear presence, tear location, and tear type. Univariate associations between DM characteristics and surgery type were calculated and multivariable logistic regression models of surgery type were created. Based on the univariate analysis and logistic regression models, we propose a new classification system for discoid meniscus. Results There were 434 knees with discoid lateral menisci that received surgical treatment at our institution between 1991 and 2017. In univariate analysis, unstable menisci (93%, p<0.001) and menisci with a tear including the periphery (75%, p<0.001) were more likely to receive surgery with repair. By itself, instability demonstrated 89% sensitivity and 94% specificity in predicting surgery with repair. The main effects logistic regression model including stability and tear showed that that the odds of unstable lateral discoid menisci receiving surgery with repair was 133.1 times higher than stable menisci (p<0.001) while lateral discoid menisci that had a tear including the periphery had 6.54 times higher odds of receiving repair than those that had a tear in the central portion only (p<0.001). Conclusions/Significance Lateral discoid menisci stability and tear location were associated with surgical treatment type in both univariate analysis and logistic regression models (Table 1). Based on our results and clinical relevance, we propose a classification system for DM with utility in surgical treatment planning. Menisci are classified by stability (Stable (S0), Unstable (S1)), morphology (Incomplete (M0), Complete (M1)), and Tear (No tear (T0), Central tear (T1), or Peripheral tear (T2)) (Figure 1). Tables and Figures [Table: see text][Figure: see text]

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Human Stapes Crura: Normal Ultrastructure. Scanning Electron Microscopic Findings

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100116267 ◽

1975 ◽

Vol 33 ◽

pp. 528-529

Author(s):

M.D. Graham

Keyword(s):

Electron Microscope ◽

Surgical Treatment ◽

Scanning Electron Microscope ◽

Osmic Acid ◽

Human Cadaver ◽

Electron Microscopic ◽

Scanning Electron Microscopic ◽

Normal Human ◽

Microscopic Findings ◽

Scanning Electron

The recent development of the scanning electron microscope has added great impetus to the study of ultrastructural details of normal human ossicles. A thorough description of the ultrastructure of the human ossicles is required in order to determine changes associated with disease processes following medical or surgical treatment.Human stapes crura were obtained at the time of surgery for clinical otosclerosis and from human cadaver material. The specimens to be examined by the scanning electron microscope were fixed immediately in the operating room in a cold phosphate buffered 2% gluteraldehyde solution, washed with Ringers, post fixed in cold 1% osmic acid and dehydrated in graded alcohol. Specimens were transferred from alcohol to a series of increasing concentrations of ethyl alcohol and amyl acetate. The tissue was then critical point dried, secured to aluminum stubs and coated with gold, approximately 150A thick on a rotating stage in a vacuum evaporator. The specimens were then studied with the Kent-Cambridge S4-10 Scanning Electron Microscope at an accelerating voltage of 20KV.

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