Obstetrics and Gynecology Commons^™

How To Effectively Reduce Costs Associated With Robotic Surgery: Is This Even Possible?, Martin A. Martino Md, Jocelyn Shubella, Wesly Menard, Jeremy Patriarco, Brian Leader, Rachel Miller Pa-C, Megan Allen Rn, M Bijoy Thomas Md, Richard Boulay Md

Department of Obstetrics & Gynecology

No abstract provided.

Benchmarking Quality Metrics For Endometrial Cancer Patients: Robotics Vs. Laparoscopy, Martin A. Martino Md, Jocelyn Shubella, Shamol Williams Msii, Rachel Morcrette Pa-C, Jeremy Patriarco, Hai-Yen Nguyen Md, Amy Hordendorf, M Bijoy Thomas Md, Richard Boulay Md

Department of Obstetrics & Gynecology

No abstract provided.

The Role Of Acidic Fibroblast Growth Factor And Fibroblast Growth Factor Receptor 4 In High Grade Serous Carcinoma, Tarrik Zaid

Dissertations & Theses (Open Access)

Background: High grade serous carcinoma whether ovarian, tubal or primary peritoneal, continues to be the most lethal gynecologic malignancy in the USA. Although combination chemotherapy and aggressive surgical resection has improved survival in the past decade the majority of patients still succumb to chemo-resistant disease recurrence. It has recently been reported that amplification of 5q31-5q35.3 is associated with poor prognosis in patients with high grade serous ovarian carcinoma. Although the amplicon contains over 50 genes, it is notable for the presence of several members of the fibroblast growth factor signaling axis. In particular acidic fibroblast growth factor (FGF1) …

A Cost Analysis Of Postoperative Pain Management In Endometrial Cancer Patients: Robotic Department Of Surgery Vs. Laparoscopy Department Of Surgery, Martin A. Martino Md, Jocelyn Shubella, Rachel Miller Pa-C, Joycelyn C. Schindler Md, Sharon R. Kimmel Phd, Mha, Shamol Williams Msii, Richard Boulay Md, M Bijoy Thomas Md

Department of Obstetrics & Gynecology

No abstract provided.

Surgical Site Infections In Gynecologic Oncology Patients: A Retrospective Study Of Patient Characteristics And Intraoperative Parameters, Christine C. Chen Md, Joanne N. Quiñones Md, Msce, Richard Boulay Md, M Bijoy Thomas Md, Martin Martino Md

Department of Obstetrics & Gynecology

No abstract provided.

The Outcome Of Patients With Platinum-Resistant/Refractory Ovarian Cancer Treated With The Combination Of Pegylated Liposomal Doxorubicin And Gemcitabine, Vijaya Galic Md, Mba, Richard Boulay Md, M Bijoy Thomas Md, Cody Gillenwater, Christine C. Chen Md, Martin Martino Md

Department of Obstetrics & Gynecology

No abstract provided.

Macrosomia Is The Only Reliable Predictor Of Shoulder Dystocia In Babies Weighing 3.5 Kg Or More, Siti Zawiah Omar

Siti Zawiah Omar

Objective: To determine if shoulder dystocia can be predicted in babies born weighing 3.5 kg or more. Study design: A case-control study nested in a perinatal database of 899 mothers and their babies who weighed 3.5 kg or more. All were term pregnancies and delivered vaginally. A case was defined as any baby that encountered shoulder dystocia at delivery. Controls were deliveries over the same period that were not complicated by shoulder dystocia. A logistic regression model was created with macrosomia, parity, previous delivery of more than 3.5 kg, diabetes in pregnancy, prolonged labor, prolonged second stage and instrumental delivery …

Sulforaphane Induces Cell Cycle Arrest By Protecting Rb-E2f-1 Complex In Epithelial Ovarian Cancer Cells, Christopher S. Bryant, Sanjeev Kumar, Sreedhar Chamala, Jay Shah, Jagannath Pal, Mahdi Haider, Shelly Seward, Aamer M. Qazi, Robert Morris, Assaad Semaan, Masood A. Shammas, Christopher Steffes, Ravindra B. Potti, Madhu Prasad, Donald W. Weaver, Ramesh B. Batchu

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Sulforaphane (SFN), an isothiocyanate phytochemical present predominantly in cruciferous vegetables such as brussels sprout and broccoli, is considered a promising chemo-preventive agent against cancer. In-vitro exposure to SFN appears to result in the induction of apoptosis and cell-cycle arrest in a variety of tumor types. However, the molecular mechanisms leading to the inhibition of cell cycle progression by SFN are poorly understood in epithelial ovarian cancer cells (EOC). The aim of this study is to understand the signaling mechanisms through which SFN influences the cell growth and proliferation in EOC.

Results

SFN at concentrations of 5 - 20 …

Ethnic Disparities In Cervical Cancer Survival Among Texas Women, Ann L. Coker, Christopher P. Desimone, Katherine S. Eggleston, Arica L. White, Melanie Williams

CRVAW Faculty Journal Articles

Objective: The aim of this work was to determine whether minority women are more likely to die of cervical cancer. A population-based cohort study was performed using Texas Cancer Registry (TCR) data from 1998 to 2002.

Methods: A total of 5,166 women with cervical cancer were identified during 1998–2002 through the TCR. Measures of socioeconomic status (SES) and urbanization were created using census block group-level data. Multilevel logistic regression was used to calculate the odds of dying from cervical cancer by race, and Cox proportional hazards modeling was used for cervical cancer-specific survival analysis.

Results: After adjusting for age, SES, …

Addressing Cervical Cancer In Central Appalachia, Baretta R. Casey, Richard A. Crosby, Wallace Bates, Tonya D. Godsey, Mark B. Dignan

Center of Excellence in Rural Health Presentations

Rural women, particularly those residing in Appalachia, have some of the nation’s highest cervical cancer mortality rates. With support from federal and private grants, the University of Kentucky Center for Excellence in Rural Health-Hazard is attempting to address this issue. Eastern Kentucky-based researchers are surveying 18- to 26-year-old female community health center patients and college students about their risk factors for the disease, and then offering them free Gardasil, a vaccine against the virus that causes most cervical cancer cases.

The 50-G Glucose Challenge Test And Pregnancy Outcome In A Multiethnic Asian Population At High Risk For Gestational Diabetes, Siti Zawiah Omar

Siti Zawiah Omar

Objective: To evaluate the 50-g glucose challenge test (GCT) on pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes (GDM). Methods: GCT was positive if the 1-hour plasma glucose level was >= 7.2 mmol/L. GDM was diagonsed by a 75-g glucose tolerance test using WHO (1999) criteria. Of the 1368 women enrolled in the study, 892 were GCT negative, 308 were GCT false-positive status was associated with preterm birth (adjusted odds ration [AOR] 2.1; 95% CI, 3.3-7.5), cesarean delivery (AOR 2.5; 95% CI, 1.6-3.2), postpartum hemorrhage (AOR 2.1; 95% CI, 1.2-3.7), and neonatal macrosomia (AOR 2.5; …

Breast Cancer Screening In Women Exposed In Utero To Diethylstilbestrol, Elizabeth A. Camp, Ann L. Coker, Stanley J. Robboy, Kenneth L. Noller, Karen J. Goodman, Linda T. Titus-Ernstoff, Elizabeth E. Hatch, Arthur L. Herbst, Rebecca Troisi, Raymond H. Kaufman, Ervin Adam

CRVAW Faculty Journal Articles

Purpose: To determine if women exposed in utero to diethylstilbestrol (DES) are more likely than unexposed women to receive recommended or additional breast cancer screening examinations.

Methods: 1994 Diethylstilbestrol-Adenosis (DESAD) cohort data are used to assess the degree of recommended compliance of breast cancer screenings found in 3140 DES-exposed and 826 unexposed women. Participants were enrolled at four sites: Houston, Boston, Rochester, and Los Angeles. Logistic regression modeling was used to analyze mailed questionnaire data that included reported frequency over the preceding 5 years (1990–1994) of breast-self examinations (BSEs), clinical breast examinations (CBEs), and mammograms.

Results: DES-exposed women exceeded annual …

Ritonavir Blocks Akt Signaling, Activates Apoptosis And Inhibits Migration And Invasion In Ovarian Cancer Cells, Sanjeev Kumar, Christopher S. Bryant, Sreedhar Chamala, Aamer Qazi, Shelly Seward, Jagannath Pal, Christopher P. Steffes, Donald W. Weaver, Robert Morris, John M. Malone, Masood A. Shammas, Madhu Prasad, Ramesh B. Batchu

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Ovarian cancer is the leading cause of mortality from gynecological malignancies, often undetectable in early stages. The difficulty of detecting the disease in its early stages and the propensity of ovarian cancer cells to develop resistance to known chemotherapeutic treatments dramatically decreases the 5-year survival rate. Chemotherapy with paclitaxel after surgery increases median survival only by 2 to 3 years in stage IV disease highlights the need for more effective drugs. The human immunodeficiency virus (HIV) infection is characterized by increased risk of several solid tumors due to its inherent nature of weakening of immune system. Recent observations …

Medical Hope, Legal Pitfalls: Potential Legal Issues In The Emerging Field Of Oncofertility, Gregory Dolin, Dorothy E. Roberts, Lina M. Rodriguez, Teresa K. Woodruff

All Faculty Scholarship

The article will begin its discussion by identifying the values at stake in the field of oncofertility. These values include the constitutional protection of the rights of women and minors to bear children and to use reproduction-assisting technologies, as well as the feminist critique of gendered expectations that may pressure women to use these technologies.

Part III will focus on the medical options of oncofertility. It will also discuss some conditions that may lead otherwise fertile and young patients to lose their ability to bear children as a side-effect of necessary medical treatment. The article will then proceed to discuss …

A Placebo-Controlled Trial Of Oral Pyridoxine In Hyperemesis Gravidarum, Siti Zawiah Omar

Siti Zawiah Omar

Objective: To evaluate oral pyridoxine in conjunction with standard therapy in women hospitalized for hyperemesis gravidarum (HG). Methods: Patients with HG were randomized at hospitalization to 20 mg oral pyridoxine thrice daily or to placebo. Intravenous rehydration, metoclopramide and oral thiamine were also administered. Metoclopramide and thiamine were continued for 2 weeks after discharge. Rehospitalization for HG in the 2-week study period was ascertained, vomiting was recorded by diary, and nausea was evaluated with a 10-point visual analogue scale (VAS) at enrolment, after hospital discharge and on week 1 and 2 reviews. Results: Ninety-two women were included in the analysis. …

Sensitization Of Ovarian Cancer Cells To Cisplatin By Genistein: The Role Of Nf-Kappab, Leigh A. Solomon, Shadan Ali, Sanjeev Banerjee, Adnan R. Munkarah, Robert T. Morris, Fazlul H. Sarkar

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Platinum-resistance (PR) continues to be a major problem in the management of epithelial ovarian cancer (EOC). Response to various chemotherapeutic agents is poor in patients deemed PR. Genistein, a soy isoflavone has been shown to enhance the effect of chemotherapy in prostate and pancreatic cancer cells in vitro and in vivo by reversing chemo-resistance phenotype. The goal of this study was to investigate the effects of combination therapy with genistein and cisplatin as well as other cytotoxic conventional chemotherapeutic agents in platinum-sensitive (PS) and resistant EOC cells.

Methods

The PS human ovarian cancer cell line A2780 and its …

Understanding Barriers For Adherence To Follow-Up Care For Abnormal Pap Tests, Katherine S. Eggleston, Ann L. Coker, Irene Prabhu Das, Suzanne T. Cordray, Kathryn J. Luchok

CRVAW Faculty Journal Articles

Objective: Approximately 4000 women annually will die from preventable and treatable cervical cancer. Failure to adhere to follow-up recommendations after an abnormal Pap test can lead to development of cervical cancer. This paper summarizes the body of literature on adherence to follow-up after an abnormal Pap test in order to facilitate development of interventions

to decrease morbidity and mortality due to cervical cancer.

Methods: We conducted a comprehensive search of published literature addressing risk factors for adherence or interventions to improve adherence following an abnormal Pap test as the outcome. We included peer-reviewed original research conducted in the …

Let-7 Expression Defines Two Differentiation Stages Of Cancer, Scott Shell, Sun-Mi Park, Amir Reza Radjabi, Robert Schickel, Emily Kistner, David Jewell

Dartmouth Scholarship

The early phases of carcinogenesis resemble embryonic development, often involving the reexpression of embryonic mesenchymal genes. The NCI60 panel of human tumor cell lines can genetically be subdivided into two superclusters (SCs) that correspond to CD95 Type I and II cells. SC1 cells are characterized by a mesenchymal and SC2 cells by an epithelial gene signature, suggesting that SC1 cells represent less differentiated, advanced stages of cancer. miRNAs are small 20- to 22-nucleotide-long noncoding RNAs that inhibit gene expression at the posttranscriptional level. By performing miRNA expression analysis on 10 Type I and 10 Type II cells, we have determined …

Labour And Perinatal Outcome In Women At Term With One Previous Lower-Segment Caesarean: A Review Of 1000 Consecutive Cases, Siti Zawiah Omar

Siti Zawiah Omar

Objective: To compare the outcome in 1000 women at term with one lower transverse Caesarean that was suitable for a trial of labour. Methods: One thousand consecutive women with one previous scar suitable for a trial of labour delivering in our centre from June 2002 to December 2005 were identified from the labour ward register. Data were retrieved from patients' charts, and neonatal admissions were determined. Results: In the study, 76.8% of women underwent a trial of labour, with a 71.2% vaginal birth rate. Hospital stay was shorter with a trial of labour. The three perinatal deaths (0.4%; P = …

Comparative Predictive Value Of Three Prognostic Markers--S-Phase Fraction, Pcna And Mitotic Count On Axillary Lymph Node Metastasis In Carcinoma Breast, Shahid Pervez, Muhammad Nadeem Khan, Muhammad Israr Nasir

Department of Pathology and Laboratory Medicine

Background: Axillary lymph node metastasis is the single most important prognostic factor in carcinoma of the breast. Therefore, prognostic markers that may reliably predict probability of lymph node (LN) metastases are of great value. This study was conducted to compare the predictive value of two novel prognostic / proliferative markers i.e. S-phase fraction (SPF) and proliferating cell nuclear antigen (PCNA) in parallel with mitotic index.

Methods: Data of consecutive cases of infiltrating ductal carcinoma (IDC) breast diagnosed from July 2003 to July 2004 at the section of the Histopathology, The Aga Khan University Hospital, Karachi, were reviewed. A total of …

Frequency And Characteristics Of Breast Lymphomas Presenting To A Tertiary Care Hospital, Pakistan, Nausheen Yaqoob, Shahid Pervez, Naila Kayani, Rashida Ahmed, Zubair Ahmed, Sheema Hasan

Department of Pathology and Laboratory Medicine

Objective: To assess the relative frequency of (primary and secondary) mammary lymphomas presenting to a tertiary care hospital, Pakistan and its categorization according to WHO classification of lymphoid neoplasms.

Methods: All NHLs (nodal and extra nodal) diagnosed in the section of histopathology during 1992-2004 were retrieved and reviewed. All patients (n=30) diagnosed with lymphomatous involvement of the breast were selected. Distinction between primary and secondary breast lymphomas was not made owing to lack of availability of clinical information.

Results: A total of 5637 breast malignancies were diagnosed in our department during the study period of 10 years and the total …

Maternal And Fetal Complications Of Antiphospholipid Syndrome: A Case Report With Long-Term Follow-Up, Tahira Naru, Mohammad Khurshid, Zafar Nazir

Department of Obstetrics & Gynaecology

We report a case of a 26- year old woman having antiphospholipid syndrome in pregnancy with long-term follow up. She presented with recurrent miscarriages, venous thrombosis, avascular necrosis of femoral head, mid-cerebral artery infarction and skin ulcers. Antiphospholipid syndrome is a recognized disorder of pregnancy. Diagnosis requires a high index of suspicion when evaluating women with recurrent pregnancy losses and vascular thrombosis. A low dose aspirin combined with heparin can reduce morbidity and improves the pregnancy outcome.

Cervical Cancer Survival By Socioeconomic Status, Race/Ethnicity, And Place Of Residence In Texas, 1995–2001, Katherine S. Eggleston, Ann L. Coker, Melanie Williams, Guillermo Tortolero-Luna, Jeanne B. Martin, Susan R. Tortolero

CRVAW Faculty Journal Articles

Objective: The current study explored whether socioeconomic status (SES), race/ethnicity, and rural residence may be linked to poorer cervical cancer survival by stage at diagnosis.

Methods: Data from 7,237 cervical cancer cases reported to the Texas Cancer Registry from 1995–2001 were used to address the association by stage at diagnosis and cause of death. Zip code-level census data were used to classify residence and to develop a composite variable for SES. Multilevel Cox proportional hazards modeling was used to estimate hazard ratios

(HR) and 95% confidence intervals (CI).

Results: Late stage at diagnosis was a strong predictor …

Breast Cancer Risk Factor Knowledge Among Nurses In Teaching Hospitals Of Karachi, Pakistan: A Cross-Sectional Study, Faiza Ahmed, Sadia Mahmud, Juanita Hatcher, Shaista M. Khan

Community Health Sciences

Background: Breast cancer is the most common cancer among women in both the developed and the developing world. The incidence of breast cancer in Karachi, Pakistan is 69.1 per 100,000 with breast cancer presentation in stages III and IV being common (>or= 50%). The most pragmatic solution to early detection lies in breast cancer education of women. Nurses constitute a special group having characteristics most suited for disseminating breast cancer information to the women. We assessed the level of knowledge of breast cancer risk factors among registered female nurses in teaching hospitals of Karachi. We also identified whether selected …

Breast Diseases: A Histopathological Analysis Of 3279 Cases At A Tertiary Care Center In Pakistan, M. S. Siddiqui, Naila Kayani, Shahid Pervez, S. A. Aziz, S. Muzaffar, Z. Setna, M. Israr, S. H. Hasan, M. S. Gill

Department of Pathology and Laboratory Medicine

Objective: To know the frequency of breast diseases in Pakistani females.

Methods: A retrospective analysis of 3279 breast specimens received over a period of 4 years (1 993-1996) at the department of pathology, the Aga Khan University Hospital.

Results: Out of a total of 3279 breast specimens, common breast lesions included infiltrating duct carcinoma 37%, followed by fibro adenoma 16.95%, fibrocystic change13.96%, mastitis 6.83% and duct ectasia 5.33%. Majority of the cases of infiltrating duct carcinoma were encountered in the 5th and 6th decades of life. Tumour size was 2 or >2 cms. in 93% of cases and 40% of …

Epidermal Growth Factor Receptor (Egfr) As A Prognostic Marker: An Immunohistochemical Study On 315 Consecutive Breast Carcinoma Patients, S. A. Aziz, Shahid Pervez, N. Kayani, M. H. Rahbar, S. Khan

Department of Pathology and Laboratory Medicine

Objective: To assess the independent and interdependent prognostic value of epidermal growth factor receptor (EGFR) in carcinoma of breast in female population. The Type I family of growth factor receptors includes epidermal growth factor receptor (EGFR also known as EGFRI).

Methods: The expression of EGFR protein was analysed immunohistochemically on 315 tumour specimens of infiltrating ductal carcinoma of breast. These patients also had axillary lymph nodes sampling.

Results: Overexpression and/or amplification of EGFR was observed in 70 (22.00%) tumours. Eleven (16%) were grade I, 43 (61%) grade II and 16 (23%) grade Ill tumours. Axillary lymph node metastasis had significant …

Intimate Partner Violence And Cervical Neoplasia, Ann L. Coker, Maureen Sanderson, Mary Kay Fadden, Lucia Pirisi

CRVAW Faculty Journal Articles

Intimate partner violence (IPV) is associated with a range of adverse physical health outcomes, including chronic and infectious diseases. An emerging literature suggests that partner violence and specifically sexual violence may be associated with an increased risk of cervical neoplasia. To assess the risk of preinvasive and invasive cervical cancer in a cross-sectional study of women screened for IPV by type, frequency and duration, 1152 women ages 18–65 were recruited from family practice clinics in 1997–1998. They were screened for IPV during a brief in-clinic interview, and health history and current status were assessed in a follow-up interview. Of 1152 …

Diagnostic Evaluation Of Fine Needle Aspiration Cytology In The Management Of Palpable Breast Lesions, S. H. Shah, Naila Kayani, S. H. Hasan, I. N. Soomro, Shahid Pervez, A. S. Hussainy

Department of Pathology and Laboratory Medicine

A total of 113 fine needle aspirates of the breast masses were evaluated in which the subsequent biopsy or mastectomy specimen were also available for histological examination. The age ranged from 16 to 80 years with a mean of 42 years. In benign conditions the mean age was 34.7 years while in malignant cases it was 48 years. The cytological diagnoses were compared with the histological results which revealed that the specificity and sensitivity of fine needle aspiration cytology in the palpable breast lesions was 86.1% and 89.2% respectively with a positive predictive value of 93% and efficiency of 88.2%. …

Knowledge, Sources Used And Factors Considered In The Surgical Treatment Decisions Of Women With Breast Cancer, Debra J. Bisel

Masters Theses

The purpose of this replication study was to examine how women with breast cancer reached their decision for surgical treatment (Ward, Heidrich and Wolberg 1989). Twenty-one women who met the surgical criteria, i.e. option for Breast Conserving surgery or Modified Radical Mastectomy, completed four surveys 1 to 7 days post operatively. The women were divided into two groups, 13 who had Breast Conserving surgery and 8 who had Modified Radical Mastectomy. The surveys assessed demographic characteristics of the groups, the level of knowledge regarding breast cancer, factors considered important in reaching the decision for surgery and the sources of information …

Aggressive Angiomyxoma Of Vulva, Farrukh Aijaz, Shahid Pervez, Shehnaz Wasti, Sheema H. Hassan

Department of Pathology and Laboratory Medicine

No abstract provided.