| The baseline time span for this database
is 1994-2004 (sixth bimonthly, 11-year period). The resulting database contained
4,686 (11 years)
and 954 (2 years - January 1, 2004-December 31, 2004) papers;
14,330 authors; 80 countries; 737 journals; and 2,985 institutions. Read the methodology used to create this
special topic.
Uterine fibroids (also called leiomyomas or leiomyomata) are
monoclonal, benign, smooth muscle tumors of the myometrium, the
muscular portion of the uterus. They are the most common female
genitourinary system tumor. Although 40 percent of all women in the
United States have symptomatic uterine fibroids, some studies indicate
that as many as 70 percent of all women of reproductive age have these
growths, and 80 percent of black women have uterine fibroids. Despite
the availability of new treatments, they have been and remain the most
common reason for hysterectomy.
Uterine fibroids cause significant morbidity, especially in
premenopausal women. Among the symptoms are excessive menstrual
bleeding, both in terms of volume and length of menstrual periods or
bleeding between menses, resulting in anemia and fatigue; in some
cases, large fibroids may cause pressure on the urinary bladder,
resulting in frequent urination, or pressure on the rectum; and large
fibroids may make a woman look pregnant. Fibroids also have an adverse
affect on fertility, causing infertility or pregnancy loss. The
traditional treatment of hysterectomy renders women infertile, so
there has been a quest for better means of treating this condition.
Special Topics has analyzed the literature published about uterine
fibroids within the last 10 years (1994 to 2004) and the last two
years (2003 and 2004). The 20 most-cited papers in both these groups
indicate a possible change in emphasis in treatments for uterine
fibroids. The most-cited paper in the 10-year period is a survey of
data on hysterectomy in the United States from 1988-1990. The #3 paper
in this group is also on hysterectomy: a long-term health study of the
effects of hysterectomy. The second most-cited paper in the group,
however, is one of the seminal papers on a new, noninvasive treatment
for uterine fibroids, uterine artery embolization (UAE), which uses
synthetic microparticles to selectively block the uterine artery so
that blood flow to the fibroids will be cut off, without affecting the
normal supply of blood to healthy uterine tissue. During the 10-year
period, among papers on treatment of the condition, there were the two
papers on hysterectomy, plus seven papers on use of UAE in clinical
trials, one on the use of mifepristone (RU-486), one on endometrial
resection (surgery to remove the endometrium), and one on myomectomy
(surgical removal of the fibroid itself) versus hysterectomy.
The more recent highly cited papers only include one on
hysterectomy, and that one compares it with UAE. There are five papers
on UAE, two on a newer technique that uses magnetic resonance
imaging-guided ultrasound to destroy fibroids, and one on mifepristone
treatment.
The etiology of these tumors remains unknown, and both sets of
papers also include articles that focus on the possible genetic and
biochemical mechanisms related to fibroid formation. The older group
of papers, however, includes only one on gene expression, two on
biochemistry of the tumors, three on hormone effects, one on
pathogenesis, and one on toxicology. On the two-year list, there are
more gene-expression papers (six), and more papers focusing on
biochemistry, signal transduction, and cellular receptors (four in
total). An interesting paper on epidemiology, focusing on the
incidence of fibroids in black and white women, is the sixth
most-cited in the two-year group.
Researchers in the field expect that the area that will be of the
most interest to clinicians in the near future will be the maintenance
of fertility after uterine fibroid treatment.
Methodology
To construct this database,
papers were extracted based on title- and author-supplied keywords for
uterine fibroids. The keywords used were as follows:
fibroid*
-or-
myoma*
-or-
leiomyoma*
-or-
leiomyomata*
-or-
benign gynecological tumor*
The baseline time span for this database
is 1994-2004 (sixth bimonthly, 11-year period). The resulting database contained
4,686 (11 years)
and 954 (2 years - January 1, 2004-December 31, 2004) papers;
14,330 authors; 80 countries; 737 journals; and 2,985 institutions.
Rankings
Once the database was in place,
it was used to generate the lists of top 20 papers (two, and ten years
periods), authors, journals,
institutions, and nations, covering a time span of 1994-2004 (sixth
bimonthly, 11-year period).
The top 20 papers are ranked
according to total cites. Rankings for author, journal, institution,
and country are listed in three ways: according to total cites, total
papers, and total cites/paper. The paper thresholds and corresponding
percentages used to determine
scientist, institution, country, and journal rankings according to
total cites/paper, and total papers respectively are as follows:
| Entity: |
Scientists |
Institutions |
Countries |
Journals |
| Thresholds: |
8 |
26 |
7 |
12 |
| Percentage: |
1% |
1% |
50% |
10% |
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