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The incidence of iliac vein thrombosis in pregnancy is quite low; however when it does occur, delay in diagnosis can have significant sequelae. We report a pregnant woman who presented with severe acute abdominal pain secondary to... more
The incidence of iliac vein thrombosis in pregnancy is quite low; however when it does occur, delay in diagnosis can have significant sequelae. We report a pregnant woman who presented with severe acute abdominal pain secondary to isolated iliac vein thrombosis. A primigravida presented at 33 weeks of gestation with acute onset of severe left-sided lower abdominal pain. A magnetic resonance imaging study revealed isolated left iliac vein thrombosis. After treatment with heparin her pain completely resolved. Iliac vein thrombosis may cause acute abdominal pain in pregnant women and should be considered in the differential diagnosis when other common causes of pain have been excluded.
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In an analysis of 6376 singleton births the prevalence of macrosomia was 4.9%; the attending perinatal mortality was 58/1000 compared to 18/1000 in controls. Eighty-three percent perinatal deaths occurred in unbooked patients after... more
In an analysis of 6376 singleton births the prevalence of macrosomia was 4.9%; the attending perinatal mortality was 58/1000 compared to 18/1000 in controls. Eighty-three percent perinatal deaths occurred in unbooked patients after prolonged and neglected labor. Mortality and morbidity were weight related; the macrosomic baby delivered by section or by diabetic mother or that died was significantly heavier. There was strong association between maternal age, parity, diabetes, mild hypertension, previous history of a big baby and macrosomia in this study. Pregnancy was significantly prolonged with higher incidence of emergency sections and primary postpartum hemorrhage in mothers of macrosomic babies. Fetal sex does not appear to be an important factor in macrosomia.
Research Interests: Obstetrics, Incidence Geometry, Nigeria, Medicine, Pregnancy, and 15 moreHumans, Female, Gynecology and Obstetrics, Obstetrics and Gynaecology, Risk factors, Newborn Infant, Adult, Infant Mortality, Risk Factors, Perinatal mortality, Fetus, Cross Sectional Studies, Pregnancy Outcome, Pregnancy complications, and Paediatrics and reproductive medicine
Objective. To describe a case of successful oocyte retrieval, fertilization and clinical pregnancy despite very low β-hCG level, twelve hours after ovulation trigger. Design. Case report. Setting. Academic medical center. Patient. A... more
Objective. To describe a case of successful oocyte retrieval, fertilization and clinical pregnancy despite very low β-hCG level, twelve hours after ovulation trigger. Design. Case report. Setting. Academic medical center. Patient. A 38-year-old patient inadvertently administered 2,000 IU hCG for final oocyte maturation; serum hCG twelve hours later was 16 IU/L. Interventions. Effort to obtain and administer a booster dose of hCG over the next twenty-seven hours failed. Main Outcome. Successful oocyte retrieval. Results. Fourteen oocytes were retrieved of which twelve were in metaphase II and nine fertilized after intracytoplasmic sperm injection (ICSI). Of these, eight embryos survived to day 5 and were subjected to preimplantation genetic screening (PGS) by comparative genomic hybridization (CGH). Results were available the next day, three of the embryos were euploid and one was transferred on day 6. Pregnancy was confirmed twelve days later and currently the patient has an ongoing...
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Research Interests: Infertility, Medicine, Pregnancy, Humans, Fertility and Sterility, and 14 moreFemale, Intracytoplasmic Sperm Injection, Clinical Sciences, Adult, Public health systems and services research, Retrospective Studies, Fertilization in Vitro, Suction, Asymptomatic, Ectopic Pregnancy, Cohort Studies, syringes, Paediatrics and reproductive medicine, and minimally invasive surgical procedures
Research Interests: Genetics, Andrology, Medicine, Embryo, Pregnancy, and 15 moreHumans, In Vitro Fertilisation, Female, Ovulation Induction, Embryo Transfer, Embryonic Development, Adult, Fertilization in Vitro, Miscarriage, Pregnancy Rate, Oocyte, Estradiol, Pregnancy Outcome, embryo implantation, and Paediatrics and reproductive medicine
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Objective To highlight the management of massive ovarian edema in young reproductive-age women. Design A case report of a healthy female with clitoromegaly and elevated androgen levels secondary to massive ovarian edema. Setting... more
Objective To highlight the management of massive ovarian edema in young reproductive-age women. Design A case report of a healthy female with clitoromegaly and elevated androgen levels secondary to massive ovarian edema. Setting Reproductive Endocrinology and Infertility Department of an academic hospital. Patient A healthy 20-year-old woman who presented for routine gynecological care and was found to have a 2-cm clitoromegaly and elevated androgen levels. Interventions The patient underwent a diagnostic laparoscopy and right oophorectomy. Main Outcome Measures Measurement of androgen levels. Results Final pathology showed massive edema of the ovary with no evidence of malignancy or androgen-secreting tumor cells. In addition, resolution of the elevated androgen levels was observed. Conclusions Massive ovarian edema due to asymptomatic subacute torsion should be included in the differential diagnosis of reproductive-age patients who present with ovarian mass and hyperandrogenemia within the tumor range. Although not performed in our case, conservative management that involves detorsion, ovarian biopsy, and oophoropexy to prevent a recurrence should be the treatment of choice.
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Research Interests: Medicine, Pregnancy, Humans, Female, Gynecology and Obstetrics, and 11 moreObstetrics and Gynaecology, Young Adult, Newborn Infant, Cesarean Section, Combination drug therapy, Prenatal Care, Oligohydramnios, Adrenal cortex hormones, Paediatrics and reproductive medicine, Scimitar syndrome, and Infant Premature
Research Interests: Surgery, Medicine, Humans, Deep Vein Thrombosis, African American, and 12 moreBack Pain, Female, Cytomegalovirus, Hiv Infection, Human immunodeficiency virus, Adult, Disease Progression, Cytomegalovirus Infections, Cystoscopy, Lower Extremity, Paediatrics and reproductive medicine, and HIV infections
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To determine if maternal major depression (MD), antidepressant use, or paternal MD are associated with pregnancy outcomes after non-IVF fertility treatments. Cohort study. Clinics. Participants in two randomized trials: PPCOS II... more
To determine if maternal major depression (MD), antidepressant use, or paternal MD are associated with pregnancy outcomes after non-IVF fertility treatments. Cohort study. Clinics. Participants in two randomized trials: PPCOS II (clomiphene citrate versus letrozole for polycystic ovary syndrome), and AMIGOS (gonadotropins versus clomiphene citrate versus letrozole for unexplained infertility). Female and male partners completed the Patient Health Questionnaire (PHQ-9). Female medication use was collected. PHQ-9 score ≥10 was used to define currently active MD. Primary outcome: live birth. pregnancy, first-trimester miscarriage. Poisson regression models were used to determine relative risks after adjusting for age, race, income, months trying to conceive, smoking, and study (PPCOS II versus AMIGOS). Data for 1,650 women and 1,608 men were included. Among women not using an antidepressant, the presence of currently active MD was not associated with poorer fertility outcomes (live bir...
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Research Interests: Obstetrics, Cryopreservation, Medicine, Pregnancy, Humans, and 15 moreIn Vitro Fertilisation, Female, Embryo Transfer, Clinical Sciences, Gynecology, Estrogens, Adult, Retrospective Studies, Fertilization in Vitro, Risk Factors, Pregnancy Outcome, Cohort Studies, Pre Eclampsia, Paediatrics and reproductive medicine, and ovarian hyperstimulation syndrome
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A problem in developmental toxicology is the massive loss of life from fertilization through gastrulation, and the surprising lack of knowledge of causes of miscarriage. Half to two-thirds of embryos are lost, and environmental and... more
A problem in developmental toxicology is the massive loss of life from fertilization through gastrulation, and the surprising lack of knowledge of causes of miscarriage. Half to two-thirds of embryos are lost, and environmental and genetic causes are nearly equal. Simply put, it can be inferred that this is a dif
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Laparoscopic surgery has several proven advantages over open surgery. However, the role of laparoscopy in adhesion development and applicability of adhesion barrier is unclear. Adhesions occur in majority of women undergoing major... more
Laparoscopic surgery has several proven advantages over open surgery. However, the role of laparoscopy in adhesion development and applicability of adhesion barrier is unclear. Adhesions occur in majority of women undergoing major laparoscopic gynecologic surgery and its sequel, are associated with significant morbidity, economic, and medico-legal consequences. Microsurgical principles and technique alone are insufficient to prevent adhesion formation. However, several biases limit the ability to compare different types of adhesion prevention products for efficacy. It is hoped that better understanding of pathways and demonstration of the mechanisms involved in adhesions formation may help in future research into this field.
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Research Interests: Chemistry, Biology, Cell Biology, Oxidative Stress, Apoptosis, and 15 moreMedicine, Humans, Reactive Oxygen Species, Nitric oxide, Fertility and Sterility, Female, Cellular Respiration, Clinical Sciences, Nitric Oxide Synthase, Anaerobic Exercise, Public health systems and services research, Peritoneum, Postoperative Complications, fibroblasts, and Paediatrics and reproductive medicine
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Objective: To investigate the role of oxidative stress in the development of cisplatin resistance in epithelial ovarian cancer (EOC). Methods: Two parent EOC cell lines (MDAH-2774 and SKOV-3) and their chemoresistant counterparts were... more
Objective: To investigate the role of oxidative stress in the development of cisplatin resistance in epithelial ovarian cancer (EOC). Methods: Two parent EOC cell lines (MDAH-2774 and SKOV-3) and their chemoresistant counterparts were used. Total RNA was extracted and subjected to real-time RT-PCR to evaluate the expression of inducible nitric oxide synthase (iNOS) and glutathione reductase (GSR) in all cells. Nitrate/nitrite levels and GSR activity were also measured using colorimetric and ELISA assays respectively. Cell proliferation was assessed using Ki-67 immunostaining in all cells. Unpaired t-tests were used for statistical analysis at p-value <0.05 for significance. Results: Both EOC cisplatin sensitive cells manifested significant increase in the expression and activity of GSR as compared to their resistant counterparts (p<0.05). On the other hand, EOC sensitive cells manifested a decrease in iNOS expression as compared to their resistant counterparts (p<0.05). Nitrate/nitrite levels were significantly decreased in EOC sensitive cells as compared to their resistant counterparts (p<0.05). Ki-67 immunofluorescence staining revealed increased proliferation in cisplatin resistant cells compared to controls for the MDAH-277a and SKOV-3 cell lines. Conclusion: Our data suggests that the development of cisplatin resistance heighten the prooxidant state in EOC leading to a further increase in cell proliferation. Citation Format: Jimmy Belotte, Nicole Fletcher, Awoniyi Awonuga, Mitchell Alexis, Husam Abu-soud, Michael Diamond, Mohammed Saed, Ghassan Saed. The role of oxidative stress in the development of cisplatin resistance in epithelial ovarian cancer. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr B49.