- Email: [email protected]
Is Chronic Pelvic Pain (CPP) Linked to a Pro-Inflammatory Diet or Vitamin D Deficiency?
Abstracts / Journal of Minimally Invasive Gynecology 21 (2014) S191–S227
S195
2
District of Columbia; Department of Surgery, Howard University Hospital, Washington, District of Columbia
ing from isthmus weighted 8,100 grams, measured 330 x 290 x 250 mm. The endometrium of 0.2-mm. Both ovaries and Fallopian tubes were normal. Measurements and Main Results: The histology showed proliferation of giant smooth muscle cells with less than 2 mitosis/10 fields. There was no post-operative bleeding. Her post-surgical course was uneventful with negative tumour markers. She was discharged from the hospital on the sixth postoperative day. Conclusion: The treatment of fast growth and large uterine myomas is resection through classical hysterectomy. 613 Is Chronic Pelvic Pain (CPP) Linked to a Pro-Inflammatory Diet or Vitamin D Deficiency? Jarnagin BK, Rowland GL. Center for Pelvic Health, Franklin, Tennessee Study Objective: To review CPP as a complex, multi-system disorder, develop a possible link between CPP and diet, based on current research which determines a pro-inflammatory diet is responsible for inflammatory conditions occurring in endometriosis patients. Correlate musculoskeletal inflammation in patients with vitamin D deficiencies as a suspected cause of CPP conditions. Design: Comprehensive review with inclusion of two recent research articles on inflammatory conditions related to diet, which provides credible evidence to support the link to pelvic pain conditions, as well as studies on various populations with vitamin D deficiencies who experienced increased chronic musculoskeletal pain. Measurements and Main Results: Pro-inflammatory products are responsible for inflammation and pain through recent research on mice with induced endometriosis. A rapid peritoneal inflammatory response was discovered in diabetic induced mouse models injected with zymosan and dextran sulfate sodium, which occurs from pro-inflammatory diets. Vitamin D deficiencies affect darker skinned populations studied, found at increased risk for decreased vitamin D absorption and musculoskeletal pain, as well as various higher risk populations, ie, elderly, handicapped, obese and chronic disease patients. Conclusion: A pro-inflammatory diet or vitamin D deficiency may play a significant role in CPP. Dietary modifications are needed to reduce inflammation in the body. Pharmacological treatment modalities should also be incorporated with surgical intervention as a last resort. Daily supplementation and routine monitoring of vitamin D is needed to achieve normal levels. If practices around the country implement these changes, subsequent decreases of CPP cases should be seen in the future clinical setting. Future studies are needed to address diet and vitamin D in the patient with chronic pelvic pain.
Study Objective: The purpose of this study is to identify the prevalence of ultrasound-confirmed uterine leiomyoma in a large population of adolescent women in the United States (aged 13 – 21). Design: Retrospective observational study that based on data from collected from a national database, collected over a period of five years. Setting: Data is from the State Emergency Department Databases (SEDD), which captures emergency visits at hospital-affiliated emergency departments (EDs) that do not result in hospitalization. Patients: Adolescent women, aged 13-21, who presented to a hospitalbased emergency room and underwent pelvic ultrasound at the time of their visit. Intervention: Retrospective analysis of a national database. Measurements and Main Results: Analyses was performed on women aged 13-21 years old that underwent pelvic ultrasound during their visit in the states of Maryland and California. Outcome measures include International Classification of Diseases, 9th revision (ICD-9) code of leiomyoma of the uterus, demographic information, presenting complaint, and other morbidities. Conclusion: We present an initial inquiry into the prevalence of ultrasoundconfirmed leiomyoma in an adolescent population, hitherto unexplored in the larger discourse of uterine leiomyoma. 615
Poster Session: Reproductive Issues
Myometrial Abscess: A Complication of Myomectomy of a Large Cervical Myoma Abdelaziz A, Joseph S, Ashraf M, Abuzeid M. Department of Reproductive Endocrinology, Hurley Medical Center, Michigan State University, Flint, Michigan Study Objective: We describe a patient with history of two early miscarriages who presented With menorrhagia and recurrence of multiple fibroids. Laparotomy and Myomectomy were performed and was complicated by myometrial abscess. The diagnosis and management of such a rare complication is described. Design: A case report study. Setting: University affiliated Hospital. Patients: 39-year-old African American female gravida 3, para 1, with a history of two early miscarriages who presented with menorrhagia and recurrence of multiple fibroids. Trans-vaginal 2D US revealed an enlarged uterus with at least 6 uterine fibroids, the largest being 9 cm in diameter Laprotomy and myomectomy was done. Four weeks later the patient presented with a complaint of pelvic pain, nausea, vomiting, Trans-vaginal 2D US revealed a slightly enlarged uterus due to possible infected hematoma in the posterior wall of the lower uterine segment.
614 Prevalence of Uterine Leiomyoma in an Adolescent Population Nwachuku N,1 Smith KS,1 Obirieze AC,2 Pew K.1 1Department of Obstetrics and Gynecology, Howard University Hospital, Washington,
Intervention: The patient was admitted to the hospital and she was started on I.V. antibiotics (Cefotetan and Clindamycin) after a blood culture was
S195
2
District of Columbia; Department of Surgery, Howard University Hospital, Washington, District of Columbia
ing from isthmus weighted 8,100 grams, measured 330 x 290 x 250 mm. The endometrium of 0.2-mm. Both ovaries and Fallopian tubes were normal. Measurements and Main Results: The histology showed proliferation of giant smooth muscle cells with less than 2 mitosis/10 fields. There was no post-operative bleeding. Her post-surgical course was uneventful with negative tumour markers. She was discharged from the hospital on the sixth postoperative day. Conclusion: The treatment of fast growth and large uterine myomas is resection through classical hysterectomy. 613 Is Chronic Pelvic Pain (CPP) Linked to a Pro-Inflammatory Diet or Vitamin D Deficiency? Jarnagin BK, Rowland GL. Center for Pelvic Health, Franklin, Tennessee Study Objective: To review CPP as a complex, multi-system disorder, develop a possible link between CPP and diet, based on current research which determines a pro-inflammatory diet is responsible for inflammatory conditions occurring in endometriosis patients. Correlate musculoskeletal inflammation in patients with vitamin D deficiencies as a suspected cause of CPP conditions. Design: Comprehensive review with inclusion of two recent research articles on inflammatory conditions related to diet, which provides credible evidence to support the link to pelvic pain conditions, as well as studies on various populations with vitamin D deficiencies who experienced increased chronic musculoskeletal pain. Measurements and Main Results: Pro-inflammatory products are responsible for inflammation and pain through recent research on mice with induced endometriosis. A rapid peritoneal inflammatory response was discovered in diabetic induced mouse models injected with zymosan and dextran sulfate sodium, which occurs from pro-inflammatory diets. Vitamin D deficiencies affect darker skinned populations studied, found at increased risk for decreased vitamin D absorption and musculoskeletal pain, as well as various higher risk populations, ie, elderly, handicapped, obese and chronic disease patients. Conclusion: A pro-inflammatory diet or vitamin D deficiency may play a significant role in CPP. Dietary modifications are needed to reduce inflammation in the body. Pharmacological treatment modalities should also be incorporated with surgical intervention as a last resort. Daily supplementation and routine monitoring of vitamin D is needed to achieve normal levels. If practices around the country implement these changes, subsequent decreases of CPP cases should be seen in the future clinical setting. Future studies are needed to address diet and vitamin D in the patient with chronic pelvic pain.
Study Objective: The purpose of this study is to identify the prevalence of ultrasound-confirmed uterine leiomyoma in a large population of adolescent women in the United States (aged 13 – 21). Design: Retrospective observational study that based on data from collected from a national database, collected over a period of five years. Setting: Data is from the State Emergency Department Databases (SEDD), which captures emergency visits at hospital-affiliated emergency departments (EDs) that do not result in hospitalization. Patients: Adolescent women, aged 13-21, who presented to a hospitalbased emergency room and underwent pelvic ultrasound at the time of their visit. Intervention: Retrospective analysis of a national database. Measurements and Main Results: Analyses was performed on women aged 13-21 years old that underwent pelvic ultrasound during their visit in the states of Maryland and California. Outcome measures include International Classification of Diseases, 9th revision (ICD-9) code of leiomyoma of the uterus, demographic information, presenting complaint, and other morbidities. Conclusion: We present an initial inquiry into the prevalence of ultrasoundconfirmed leiomyoma in an adolescent population, hitherto unexplored in the larger discourse of uterine leiomyoma. 615
Poster Session: Reproductive Issues
Myometrial Abscess: A Complication of Myomectomy of a Large Cervical Myoma Abdelaziz A, Joseph S, Ashraf M, Abuzeid M. Department of Reproductive Endocrinology, Hurley Medical Center, Michigan State University, Flint, Michigan Study Objective: We describe a patient with history of two early miscarriages who presented With menorrhagia and recurrence of multiple fibroids. Laparotomy and Myomectomy were performed and was complicated by myometrial abscess. The diagnosis and management of such a rare complication is described. Design: A case report study. Setting: University affiliated Hospital. Patients: 39-year-old African American female gravida 3, para 1, with a history of two early miscarriages who presented with menorrhagia and recurrence of multiple fibroids. Trans-vaginal 2D US revealed an enlarged uterus with at least 6 uterine fibroids, the largest being 9 cm in diameter Laprotomy and myomectomy was done. Four weeks later the patient presented with a complaint of pelvic pain, nausea, vomiting, Trans-vaginal 2D US revealed a slightly enlarged uterus due to possible infected hematoma in the posterior wall of the lower uterine segment.
614 Prevalence of Uterine Leiomyoma in an Adolescent Population Nwachuku N,1 Smith KS,1 Obirieze AC,2 Pew K.1 1Department of Obstetrics and Gynecology, Howard University Hospital, Washington,
Intervention: The patient was admitted to the hospital and she was started on I.V. antibiotics (Cefotetan and Clindamycin) after a blood culture was