Journal of Minimally Invasive Gynecology, Jun 1, 2006
To determine the prevalence and type of microscopic findings on laparoscopically resected uterosa... more To determine the prevalence and type of microscopic findings on laparoscopically resected uterosacral ligaments in women with chronic pelvic pain and no visible pelvic disease. The effect of this procedure on the patients' level of pain also was assessed as a secondary objective. Prospective follow-up (Canadian Task Force classification II-2). University-affiliated hospital. Twenty-seven premenopausal women undergoing diagnostic laparoscopy for chronic pelvic pain had a normal pelvis on visual inspection. All patients underwent resection and histologic evaluation of the uterosacral ligaments. Pain relief was evaluated by use of a questionnaire administered before and at 3, 6, and 12 months after surgery. Microscopic examination identified endometriosis in 2 (7.4%), endosalpingiosis in 3 (11.1%), and inflammation in 14 (51.9%) patients. Laparoscopic uterosacral ligament resection was associated with a reduction in dysmenorrhea (p < or = .001), with 14 (52%) patients reporting improved or resolved symptoms. There was a statistically significant decrease in dyspareunia (p < or = .01) and in the severity of noncyclical pain (p < or = .002). Thirty-five percent of patients no longer required medication for pain control (p < or = .005). The number of days needed off work also decreased. Despite normal laparoscopic appearance, microscopic endometriosis, endosalpingiosis, and inflammatory changes were found in uterosacral ligaments in 17 (63%) women with chronic pelvic pain. Laparoscopic resection of uterosacral ligaments improved dysmenorrhea, dyspareunia, and noncyclical pain and decreased the number of days lost from work, as well as the proportion of patients who required medication for pain control.
Case Reports in Obstetrics and Gynecology, Dec 31, 2018
Ovarian pregnancy is a rare subtype of ectopic pregnancy with an increased incidence after assist... more Ovarian pregnancy is a rare subtype of ectopic pregnancy with an increased incidence after assisted conception. We present a 31-year-old gestational carrier who presented with suprapubic and pelvic pain at 6 weeks and 2 days' gestation. An ultrasound scan demonstrated an empty uterus and a complex mass in the left adnexa. Operative laparoscopy was performed and an ovarian pregnancy was found and treated. We believe this to be the first report of ovarian pregnancy after IVF in a gestational carrier. Appropriate counselling of surrogate mothers is of utmost importance as the risk of ectopic pregnancy is increased by using assisted reproduction technology. Although ovarian pregnancy still remains a rare event, the possibility of this condition should always be considered.
Ovarian pregnancy is a rare subtype of ectopic pregnancy with an increased incidence after assist... more Ovarian pregnancy is a rare subtype of ectopic pregnancy with an increased incidence after assisted conception. We present a 31-year-old gestational carrier who presented with suprapubic and pelvic pain at 6 weeks and 2 days' gestation. An ultrasound scan demonstrated an empty uterus and a complex mass in the left adnexa. Operative laparoscopy was performed and an ovarian pregnancy was found and treated. We believe this to be the first report of ovarian pregnancy after IVF in a gestational carrier. Appropriate counselling of surrogate mothers is of utmost importance as the risk of ectopic pregnancy is increased by using assisted reproduction technology. Although ovarian pregnancy still remains a rare event, the possibility of this condition should always be considered.
Background. Discussion of the incidence of molar pregnancy and ectopic pregnancy. Role of salping... more Background. Discussion of the incidence of molar pregnancy and ectopic pregnancy. Role of salpingostomy and special considerations for postoperative care. Case. The patient is a 29-year-old G7P4 who presented with vaginal bleeding in the first trimester and was initially thought to have a spontaneous abortion. Ultrasound was performed due to ongoing symptoms and an adnexal mass was noted. She underwent uncomplicated salpingostomy and was later found to have a partial molar ectopic pregnancy. Conclusion. This case illustrates the rare occurrence of a molar ectopic pregnancy. There was no indication of molar pregnancy preoperatively and this case highlights the importance of submitting and reviewing pathological specimens.
Canadian Journal of Infection Control, Jun 1, 2019
Background: Rates of performed caesarean sections have increased globally [1]. Surgical site infe... more Background: Rates of performed caesarean sections have increased globally [1]. Surgical site infections (SSIs) following a caesarean section pose a threat to the safety of the patient. This study intended to determine the current SSI rate after caesarean sections at one community hospital. The rate of incidence of these infections was compared to benchmark rates from various studies, including a report from the American National Healthcare Safety Network (NHSN). This comparative study provides objective evidence of performance in relation to SSIs. Method: The primary data collection method included a form completed by the obstetrician-gynecologists of the individual patients at the six-week post-partum follow-up visit. Demographic data was collected retrospectively through analysis of medical records. Patients who underwent a caesarean section in the seven-month data collection period (between November 2015 and May 2016) were asked to participate, and consent was obtained. Results: A total of 118 caesarean sections were reviewed and seven SSIs diagnosed. A crude SSI rate was calculated at 5.9%. For further insight, NHSN risk-adjusted SSI rates were calculated. The NHSN risk-adjusted SSI rate was determined at 6.1% for those patients presenting with a risk index level of 0 and at 5.9% for those with a risk index level of 1. Both NHSN risk index levels of 2 and 3 were identified to have an adjusted SSI rate of 0.0%. Conclusion: This study, while limited in scope, does add to the collective literature on SSI rates following caesarean sections. Most significantly, it provides a methodology for other centres interested in determining their own infection rates and could lead to improved practices and better patient outcomes.
We reviewed a number of eight patients treated in for severe perineal and/or abdominal wall exten... more We reviewed a number of eight patients treated in for severe perineal and/or abdominal wall extensive infections. Regardless of the origin of infection, all patients presented clinical signs of severe sepsis or septic shock. Successful treatment is conditioned by appropriate intensive care, associated with aggressive surgery. The comparison of our results with previous studies shows that changing the treatment attitude would lead to drastic improvement in mortality.
We reviewed a number of eight patients treated in for severe perineal and/or abdominal wall exten... more We reviewed a number of eight patients treated in for severe perineal and/or abdominal wall extensive infections. Regardless of the origin of infection, all patients presented clinical signs of severe sepsis or septic shock. Successful treatment is conditioned by appropriate intensive care, associated with aggressive surgery. The comparison of our results with previous studies shows that changing the treatment attitude would lead to drastic improvement in mortality.
International Journal of Radiation Oncology*Biology*Physics, 2007
Purpose: To determine the feasibility of adjuvant paclitaxel and carboplatin chemotherapy interpo... more Purpose: To determine the feasibility of adjuvant paclitaxel and carboplatin chemotherapy interposed with involved field radiotherapy for women with advanced endometrial cancer. Methods and Materials: This was a prospective cohort study of women with Stage III and IV endometrial cancer. Adjuvant therapy consisted of 4 cycles of paclitaxel (175 mg/m 2 ) and carboplatin (350 mg/m 2 ) every 3 weeks, followed sequentially by external beam radiotherapy (RT) to the pelvis (45 Gy), followed by an additional two cycles of chemotherapy. Para-aortic RT and/or HDR vault brachytherapy (BT) were added at the discretion of the treating physician.
STUDY OBJECTIVE: To determine the prevalence and type of microscopic findings on laparoscopically... more STUDY OBJECTIVE: To determine the prevalence and type of microscopic findings on laparoscopically resected uterosacral ligaments in women with chronic pelvic pain and no visible pelvic disease. The effect of this procedure on the patients' level of pain also was assessed as a secondary objective.
Journal of Minimally Invasive Gynecology, Jun 1, 2006
To determine the prevalence and type of microscopic findings on laparoscopically resected uterosa... more To determine the prevalence and type of microscopic findings on laparoscopically resected uterosacral ligaments in women with chronic pelvic pain and no visible pelvic disease. The effect of this procedure on the patients' level of pain also was assessed as a secondary objective. Prospective follow-up (Canadian Task Force classification II-2). University-affiliated hospital. Twenty-seven premenopausal women undergoing diagnostic laparoscopy for chronic pelvic pain had a normal pelvis on visual inspection. All patients underwent resection and histologic evaluation of the uterosacral ligaments. Pain relief was evaluated by use of a questionnaire administered before and at 3, 6, and 12 months after surgery. Microscopic examination identified endometriosis in 2 (7.4%), endosalpingiosis in 3 (11.1%), and inflammation in 14 (51.9%) patients. Laparoscopic uterosacral ligament resection was associated with a reduction in dysmenorrhea (p < or = .001), with 14 (52%) patients reporting improved or resolved symptoms. There was a statistically significant decrease in dyspareunia (p < or = .01) and in the severity of noncyclical pain (p < or = .002). Thirty-five percent of patients no longer required medication for pain control (p < or = .005). The number of days needed off work also decreased. Despite normal laparoscopic appearance, microscopic endometriosis, endosalpingiosis, and inflammatory changes were found in uterosacral ligaments in 17 (63%) women with chronic pelvic pain. Laparoscopic resection of uterosacral ligaments improved dysmenorrhea, dyspareunia, and noncyclical pain and decreased the number of days lost from work, as well as the proportion of patients who required medication for pain control.
Case Reports in Obstetrics and Gynecology, Dec 31, 2018
Ovarian pregnancy is a rare subtype of ectopic pregnancy with an increased incidence after assist... more Ovarian pregnancy is a rare subtype of ectopic pregnancy with an increased incidence after assisted conception. We present a 31-year-old gestational carrier who presented with suprapubic and pelvic pain at 6 weeks and 2 days' gestation. An ultrasound scan demonstrated an empty uterus and a complex mass in the left adnexa. Operative laparoscopy was performed and an ovarian pregnancy was found and treated. We believe this to be the first report of ovarian pregnancy after IVF in a gestational carrier. Appropriate counselling of surrogate mothers is of utmost importance as the risk of ectopic pregnancy is increased by using assisted reproduction technology. Although ovarian pregnancy still remains a rare event, the possibility of this condition should always be considered.
Ovarian pregnancy is a rare subtype of ectopic pregnancy with an increased incidence after assist... more Ovarian pregnancy is a rare subtype of ectopic pregnancy with an increased incidence after assisted conception. We present a 31-year-old gestational carrier who presented with suprapubic and pelvic pain at 6 weeks and 2 days' gestation. An ultrasound scan demonstrated an empty uterus and a complex mass in the left adnexa. Operative laparoscopy was performed and an ovarian pregnancy was found and treated. We believe this to be the first report of ovarian pregnancy after IVF in a gestational carrier. Appropriate counselling of surrogate mothers is of utmost importance as the risk of ectopic pregnancy is increased by using assisted reproduction technology. Although ovarian pregnancy still remains a rare event, the possibility of this condition should always be considered.
Background. Discussion of the incidence of molar pregnancy and ectopic pregnancy. Role of salping... more Background. Discussion of the incidence of molar pregnancy and ectopic pregnancy. Role of salpingostomy and special considerations for postoperative care. Case. The patient is a 29-year-old G7P4 who presented with vaginal bleeding in the first trimester and was initially thought to have a spontaneous abortion. Ultrasound was performed due to ongoing symptoms and an adnexal mass was noted. She underwent uncomplicated salpingostomy and was later found to have a partial molar ectopic pregnancy. Conclusion. This case illustrates the rare occurrence of a molar ectopic pregnancy. There was no indication of molar pregnancy preoperatively and this case highlights the importance of submitting and reviewing pathological specimens.
Canadian Journal of Infection Control, Jun 1, 2019
Background: Rates of performed caesarean sections have increased globally [1]. Surgical site infe... more Background: Rates of performed caesarean sections have increased globally [1]. Surgical site infections (SSIs) following a caesarean section pose a threat to the safety of the patient. This study intended to determine the current SSI rate after caesarean sections at one community hospital. The rate of incidence of these infections was compared to benchmark rates from various studies, including a report from the American National Healthcare Safety Network (NHSN). This comparative study provides objective evidence of performance in relation to SSIs. Method: The primary data collection method included a form completed by the obstetrician-gynecologists of the individual patients at the six-week post-partum follow-up visit. Demographic data was collected retrospectively through analysis of medical records. Patients who underwent a caesarean section in the seven-month data collection period (between November 2015 and May 2016) were asked to participate, and consent was obtained. Results: A total of 118 caesarean sections were reviewed and seven SSIs diagnosed. A crude SSI rate was calculated at 5.9%. For further insight, NHSN risk-adjusted SSI rates were calculated. The NHSN risk-adjusted SSI rate was determined at 6.1% for those patients presenting with a risk index level of 0 and at 5.9% for those with a risk index level of 1. Both NHSN risk index levels of 2 and 3 were identified to have an adjusted SSI rate of 0.0%. Conclusion: This study, while limited in scope, does add to the collective literature on SSI rates following caesarean sections. Most significantly, it provides a methodology for other centres interested in determining their own infection rates and could lead to improved practices and better patient outcomes.
We reviewed a number of eight patients treated in for severe perineal and/or abdominal wall exten... more We reviewed a number of eight patients treated in for severe perineal and/or abdominal wall extensive infections. Regardless of the origin of infection, all patients presented clinical signs of severe sepsis or septic shock. Successful treatment is conditioned by appropriate intensive care, associated with aggressive surgery. The comparison of our results with previous studies shows that changing the treatment attitude would lead to drastic improvement in mortality.
We reviewed a number of eight patients treated in for severe perineal and/or abdominal wall exten... more We reviewed a number of eight patients treated in for severe perineal and/or abdominal wall extensive infections. Regardless of the origin of infection, all patients presented clinical signs of severe sepsis or septic shock. Successful treatment is conditioned by appropriate intensive care, associated with aggressive surgery. The comparison of our results with previous studies shows that changing the treatment attitude would lead to drastic improvement in mortality.
International Journal of Radiation Oncology*Biology*Physics, 2007
Purpose: To determine the feasibility of adjuvant paclitaxel and carboplatin chemotherapy interpo... more Purpose: To determine the feasibility of adjuvant paclitaxel and carboplatin chemotherapy interposed with involved field radiotherapy for women with advanced endometrial cancer. Methods and Materials: This was a prospective cohort study of women with Stage III and IV endometrial cancer. Adjuvant therapy consisted of 4 cycles of paclitaxel (175 mg/m 2 ) and carboplatin (350 mg/m 2 ) every 3 weeks, followed sequentially by external beam radiotherapy (RT) to the pelvis (45 Gy), followed by an additional two cycles of chemotherapy. Para-aortic RT and/or HDR vault brachytherapy (BT) were added at the discretion of the treating physician.
STUDY OBJECTIVE: To determine the prevalence and type of microscopic findings on laparoscopically... more STUDY OBJECTIVE: To determine the prevalence and type of microscopic findings on laparoscopically resected uterosacral ligaments in women with chronic pelvic pain and no visible pelvic disease. The effect of this procedure on the patients' level of pain also was assessed as a secondary objective.
Uploads
Papers by Patricia Nascu