JAMA : the journal of the American Medical Association
-
Comparative Study Historical Article
Mastoid development in ancient and modern populations. A longitudinal radiological study.
The effect of otitis media on the human mastoid process in a common milieu over a millennium was evaluated by comparing two present and four ancient populations. Temporal bone pneumatization patterns indicate that otitis media and mastoiditis existed in antiquity, and there were more altered pneumatization patterns in skulls from the era following European contact than from eras before European contact. Pneumatization patterns were similar in ancient skulls and in a preponderantly white male population mostly born before antibacterial availability. ⋯ Reasons for differences are explored. It is inferred that upper respiratory tract infections were prevalent in the Upper Missouri River Basin during the past millennium. Furthermore, microbiological agents with virulence similar to today's flora were prevalent in this region more than 1,000 years ago.
-
An estimated 3.5 million women aged 15 to 44 years in the United States underwent hysterectomy (excluding radical procedures) between 1970 and 1978. Data from the National Center for Health Statistics were used to study the influence of age, race, and geographic region on hysterectomy rates, surgical approach, and concurrent oophorectomy. The number and rate of hysterectomies increased between 1970 and 1972 but remained stable thereafter. ⋯ Rates were consistently highest for women in the South and lowest for women in the Northeast. Women undergoing hysterectomy in the Northeast had the lowest percentage performed by a vaginal approach and the highest percentage performed in conjunction with bilateral oophorectomy. Women having a hysterectomy in the West had the highest percentage performed by a vaginal approach.
-
Comparative Study
Mortality from abortion and childbirth. Are the populations comparable?
Critics have challenged previous comparisons of mortality from legal abortion and childbirth for contrasting population groups with different clinical characteristics. They allege that most women dying from abortion were young, white, and healthy, while those dying from childbirth had serious underlying conditions. ⋯ These adjustments for demographic and health differences between the two populations actually widened the difference in the mortality risk between abortion and childbirth. Thus, between 1972 and 1978, women were about seven times more likely to die from childbirth than from legal abortion, with the gap increasing in the more recent years.