Surgical outcomes for robotic-assisted laparoscopic myomectomy compared to abdominal myomectomy

A retrospective cohort of 100 robotic-assisted laparoscopic myomectomy (RM) patients and 48 laparotomic myomectomy (LM) patients at Henry Ford Hospital in Detroit, MI, USA was examined to compare surgical outcomes of RM with LM. Details of age, race, body mass index (BMI), procedure duration, estimated blood loss (EBL), length of stay (LOS), diameter of the largest leiomyoma and number of leiomyomata removed were collected. Procedure duration was significantly longer among RM patients (median: 194 min vs. 127.5 min; Wilcoxon rank sum (WRS) P < 0.001). EBL and LOS were both significantly greater among LM patients (EBL medians 200 vs. 100 ml, WRS P < 0.001; LOS medians 3 vs. 1, WRS P < 0.01). Among the RM patients, 39.4% had a LOS of at least 2 days compared to 89.4% among LM patients. Leiomyomata characteristics did not affect the observed associations. RM could enable widespread use of a minimally invasive approach for leiomyoma treatment.     

Prenatal exposure to household pets influences fetal immunoglobulin E production

Background Early life pet exposure may protect against allergic sensitization during childhood. Few studies have evaluated the effect of prenatal pet exposure on potential neonatal markers of allergic risk. Objective The aim of this study was to investigate whether maternal exposure to pets affects cord blood IgE levels in a population‐based, general risk, ethnically mixed birth cohort. Methods Pet keeping during pregnancy was ascertained from women residing in a defined area of Wayne County Michigan and recruited from five staff model obstetric clinics. Maternal venous blood was analysed for total and allergen‐specific IgE along with cord blood total IgE from 1049 infants. Results Compared with infants from households with no cats or dogs kept indoors during pregnancy, infants whose homes had either cats or dogs had significantly reduced mean cord IgE levels [0.34 IU/mL (95% CI 0.30–0.38) vs. 0.24 IU/mL (0.20–0.27), P=0.025]. Similar effects were apparent in cat‐only households [0.21 IU/mL (0.16–0.27), P=0.020] and dog‐only households [0.24 IU/mL (0.19–0.29), P=0.045]. There was no effect on results when excluding mothers who reported avoiding pets due to allergy‐related concerns. Conclusion Mothers with either cats or dogs in their home during pregnancy deliver children with lower cord blood IgE levels compared with mothers who do not live with these pets, supporting the hypothesis that pet exposure influences immune development in a manner that is protective for atopy and is operant even before birth.     

Variation of dust endotoxin concentrations by location and time within homes of young children

Ownby DR, Peterson EL, Williams LK, Zoratti EM, Wegienka GR, Woodcroft KJ, Joseph CLM, Johnson CC. Variation of dust endotoxin concentrations by location and time within homes of young children.
Pediatr Allergy Immunol 2010: 21: 533–540.
© 2010 John Wiley & Sons A/S Endotoxin may affect the development of allergic disease in childhood but little is known about endotoxin variation within homes. We sought to determine endotoxin concentration agreement within homes when five locations were each sampled twice 5 months apart. Endotoxin was measured using the recombinant Limulus factor C assay in dust samples from 585 homes of children enrolled in a prospective study and again in 335 homes 5 months later. The five locations sampled in each home were the child’s bedroom floor, child’s bed, mother’s bedroom floor, mother’s bed and living room floor. Concentrations of 4 allergens (Can f 1, Fel d 1, Der f 1 and Bla g 2) were also measured from the child’s bedroom floor. In pair‐wise comparisons, endotoxin concentrations in all locations within each home were significantly different from all other locations (p < 0.001) except for the child’s and mother’s bedroom floors (p = 0.272). Spearman correlations between endotoxin concentrations from the different locations were all statistically significant (p < 0.05) but of modest magnitude (r = 0.24–0.54). Similarly, correlations at each site over the 5 month observation interval were statistically significant but modest (r = 0.17–0.44). Pets and season of the year did not affect correlations, although correlations were lower if the floor was not carpeted. Endotoxin concentrations at all locations were minimally correlated with allergen concentrations in both negative and positive directions (r = ?0.12 to 0.12). We conclude that a single measurement of endotoxin from a home dust sample provides an imprecise estimate of dust endotoxin concentrations in other locations within the home and over a relatively short observation interval.