Medicine and Health Sciences Commons^™

12-Month Outcomes Of The Us Patient Cohort In The Sonata Pivotal Ide Trial Of Transcervical Ablation Of Uterine Fibroids., Joseph Hudgens, D. Alan Johns, Andrea S. Lukes, David A. Forstein, Dipak Delvadia

Touro College of Osteopathic Medicine (New York) Publications and Research

Objective: The prospective SONATA pivotal Investigational Device Exemption (IDE) trial was performed in the United States (US) and Mexico to examine the safety and effectiveness of transcervical fibroid ablation (TFA) in the treatment of symptomatic uterine fibroids. This is an analysis of 12-month clinical outcomes in the US cohort.

Methods: TFA with the Sonata System was performed on women with symptomatic uterine fibroids. The 12-month co-primary endpoints were reduction in menstrual blood loss and freedom from surgical reintervention. Symptom severity, quality of life, patient satisfaction, safety, and reductions in uterine and fibroid volumes were also evaluated.

Results: One hundred twenty-five …

Pregnancy-Associated Spontaneous Pneumomediastinum: A Contemporary Review, Sonu Sahni, Narcisse Amine

Touro College of Osteopathic Medicine (New York) Publications and Research

Spontaneous pneumomediastinum (SPM), also referred to as mediastinal emphysema, is defined as the presence of free air in the mediastinal cavity without a clear and identifiable cause. Spontaneous pneumomediastinum, in general, is a relatively rare condition, more so in the setting of pregnancy or labor. Clinically, SPM may present as dyspnea, chest pain, and subcutaneous swelling, which may be of serious concern in the setting of pregnancy. A comprehensive literature review revealed that the majority of patients are primiparas, of a younger age, and have term or longer durations of pregnancy. The second stage of labor was found to be …

Clinical Significance Of A False Positive Glucose Challenge Test In Patients With A High Body Mass Index, A Borja, M Moretti, Nisha Lakhi

NYMC Faculty Publications

OBJECTIVE: To determine if there is an increased maternal or neonatal morbidity in overweight and obese patients with a false positive glucose challenge test (GCT). METHODS: Patients with a body mass index (BMI) >/=25.0 at registration were included in this prospective 36-month study. The study cohort consisted of patients with a false positive (FP) GCT, with two comparison cohorts: those with a (1) screen negative (SN) GCT result and (2) true positive (TP) GCT result. Risks were reported as odd ratios with 95% confidence intervals, with a P/=4000 g in the FP cohort, but this fell short of reaching statistical …

Reply To M. Lambertini Et Al, Kutluk Oktay, V Turan, G Bedoschi

NYMC Faculty Publications

No abstract provided.

Double Balloon Cervical Ripening Catheter For Control Of Massive Hemorrhage In A Cervical Ectopic Pregnancy, N Zambrano, J Reilly, M Moretti, Nisha Lakhi

NYMC Faculty Publications

Cervical pregnancy can be complicated by perfuse vaginal bleeding. Mechanical compression directed at tamponing the cervical vessels can control hemostasis. There are several types of balloon catheters that have been described for cervical compression. However use of a double balloon catheter is a novel approach for cervical tamponade, as one balloon is positioned below the external cervical os and the second balloon is situated above in the internal cervical os. This compresses the cervix from internal os to external os between the two balloons, forming a "cervical sandwich." We describe this method of cervical tamponade using a silicone double balloon …

Atypical Hemolytic Uremic Syndrome In First Trimester Pregnancy Successfully Treated With Eculizumab, Gabriela Andries, Michael Karass, Srikanth Yandrapalli, M Karass, Delong Liu, John Nelson, R Pawar, Savneek Chugh

NYMC Faculty Publications

BACKGROUND: Atypical hemolytic uremic syndrome is a rare disorder which is known to cause acute thrombotic microangiopathy during pregnancy with poor maternal and fetal outcomes. Atypical hemolytic uremic syndrome is caused mostly by dysregulation of alternative complement pathway secondary to genetic mutations. Most of the cases reported have been in the post-partum period. We report a rare case of a patient who presents with thrombotic microangiopathy in the first trimester of her eleventh pregnancy and was successfully treated with eculizumab. CASE PRESENTATION: A 30-year-old woman presented at 10 weeks of gestation with hypertension, hemolytic anemia, thrombocytopenia, and acute kidney injury, …

Oocyte Cryopreservation, Esther Gellis

The Science Journal of the Lander College of Arts and Sciences

Anti-mitotic therapies are a form of therapy used to treat cancer patients. The use of these treatments on females can result in fertility complications. Therefore, prior to treatment, women must seek ways to preserve their ability to conceive children after receiving treatment. This study analyzes the outcomes of oocyte cryopreservation and its many variables. Three important variables that can affect the outcome of oocyte cryopreservation are age, cryopreservation method and cryoprotectants. Evidence indicates that human oocyte cryopreservation can enable a woman to preserve her ability to give birth to a healthy child, following anti-mitotic therapies. Hundreds of babies have been …

Biological Reasons For The Neurotoxic Effects Of Mdma (‘Ecstasy’) On The Developing Fetus, Leah Schneeweiss

The Science Journal of the Lander College of Arts and Sciences

MDMA (3, 4-methylenedioxymethamphetamine) is an illicit, recreational drug known by many individuals as ‘Ecstasy.’ MDMA has gained popularity over the past decade and has become a drug of choice at dance parties and clubs because of the stimulating and hallucinogenic effects that it has on the central nervous system. Scientists have determined that MDMA causes neurotoxic damage to adults by harming the serotonergic system in the adult brain. Researchers discovered that embryos exposed to MDMA while in utero also suffer neurotoxic deficits, although not due to impairments in the embryos’ serotonergic systems. These deficits arise because of the cortisol increase …

Short-Term Effects On The Fetus And Long-Term Outcome On Children Exposed To Maternal Chemotherapy, Yocheved Kramer

The Science Journal of the Lander College of Arts and Sciences

Ethical questions with regard to treatment arise when pregnant women are diagnosed with cancer. Does the health of the mother or the health of the fetus take priority? However, research suggests that concern over transplacental transfer should not deter those seeking treatments since avoidance of favorable transfer drugs can allow chemotherapy to be a viable option if properly administered. Doctors highly contraindicate the use of chemotherapeutic drugs in the first trimester due to high risks such as teratogenesis and fetal death. However, they reassure that treatment can be given in the final two trimesters. It presents minimal consequences as long …

Eating Disorders: The Hidden Hormonal Effect On Fertility, Esther Tessler-Karfunkel

The Science Journal of the Lander College of Arts and Sciences

Women who have a history of eating disorders, specifically anorexia nervosa, are more prone to suffer from infertility. There are several hormones which are the driving force in this system and are therefore responsible for this. Fortunately, there are treatments which can help women with a history of eating disorders to reproduce. Using information found on Pubmed and Touro College’s database, this paper will discuss why the body cannot reproduce when it is lacking proper nutrition, as well as the various dynamics in the human reproductive system which are compromised when the body is not properly nourished.

Delayed Versus Early Umbilical Cord Clamping, Bracha Yaffa Sachs

The Science Journal of the Lander College of Arts and Sciences

Immediate cord clamping is a part of the active management of the third stage of labor. Active management is standard birth protocol because it significantly reduces the risk of maternal postpartum hemorrhaging. However, since recent evidence advocates delayed cord clamping, various medical practitioners and health organizations would like to incorporate delayed cord clamping in place of immediate cord clamping as a part of standard birth protocol. Proposed benefits include a serious decline in the prevalence of anemia, especially, in countries where anemia is endemic, as well as a decrease in the risk of intraventricular hemorrhage and late onset sepsis. Although …

The Effects Of Smoking On Pregnant Women, Meir Cohen

The Science Journal of the Lander College of Arts and Sciences

Smoking during pregnancy is accepted as the most significant avoidable risk factor for an unsuccessful pregnancy result. Smoking is linked with fetal growth restriction, and increasing evidence also suggests that smoking can cause stillbirth, preterm birth, placental abruption, and possibly sudden infant death syndrome. Smoking during pregnancy is also associated with enhanced risks of spontaneous abortions, ectopic pregnancies, and placenta previa, and it might increase risks of behavioral disorders in childhood. Studies have shown with randomized controlled trials, that smoking intervention during pregnancy has had limited success. Smoking during pregnancy continues to be an important risk factor for maternal and …

Folic Acid And Neural Tube Defects, Rachel Leah Feinstein

The Science Journal of the Lander College of Arts and Sciences

The following is an excerpt of this article: Neural tube defects (NTD) are the most common types of birth defects. Research shows that folic acid taken periconceptionally greatly reduces the risk of having a NTD affected child. This paper will explain the role that folate plays in the metabolism, specifically in synthesizing methionine. It will bring evidence to show that methionine is crucial for normal neural tube development. In addition, it will explore the genetic factor involved in folate metabolism and possible folate deficiency.

Pregnancy Associated Breast Cancer: An Analysis Of Fetal Treatment Risk, Melissa Barnett

The Science Journal of the Lander College of Arts and Sciences

There are several viable treatment options for patients with PABC considered un-harmful to fetal development. Trastusumab, or Herceptin, targets HER2 protein and successfully combats aggressive breast cancer. In standard doses, it appears to be safe to the fetus even when administered during the first trimester. A likely side effect of Herceptin is anhydramnios, which can be monitored for throughout the stages of a pregnancy (Shrim et al. 2008). Anthracyclines, commonly used in chemotherapy, appear to be non-toxic, and have been used to successfully cure PABC patients in their second and third trimester. However, first trimester spontaneous abortions are documented to …