Trina Mansour - Academia.edu (original) (raw)
Papers by Trina Mansour
Cervical cancer is a significant women's health problem worldwide. Most cases of cervical can... more Cervical cancer is a significant women's health problem worldwide. Most cases of cervical cancer occur in developing countries that have ineffective screening programs. The incidence and mortality of cervical cancer in the United States have been decreasing in the past 30 years due to widespread screening. In the United States, cervical cancer diagnosis is usually in women who have never received screening or received inadequate screening.[1] Human papillomavirus (HPV) is one of the most common risk factors for cervical cancer. There are over 100 different strains of HPV, and those considered of high risk are involved in the etiology of cancer. Screening guidelines for cervical cancer have been evaluated and adjusted considering the time required for disease progression. Screening methods of cervical cancer include cytology and HPV testing.[2]
The Journal of Maternal-Fetal & Neonatal Medicine, 2019
Journal of perinatology : official journal of the California Perinatal Association, 2017
To assess the accuracy of different sonographic estimated fetal weight (EFW) cutoffs, and combina... more To assess the accuracy of different sonographic estimated fetal weight (EFW) cutoffs, and combinations of EFW and biometric measurements for predicting small for gestational age (SGA) in fetal gastroschisis. Gastroschisis cases from two centers were included. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated for different EFW cutoffs, as well as EFW and biometric measurement combinations. Seventy gastroschisis cases were analyzed. An EFW<10% had 94% sensitivity, 43% specificity, 33% PPV and 96% NPV for SGA at delivery. Using an EFW cutoff of <5% improved the specificity to 63% and PPV to 41%, but decreased the sensitivity to 88%. Combining an abdominal circumference (AC) or femur length (FL) z-score less than -2 with the total EFW improved the specificity and PPV but decreased the sensitivity. A combination of a small AC or FL along with EFW increases the specificity and PPV, but decreases the sensitivity of predicting SGA.
American journal of physiology. Endocrinology and metabolism, Jun 1, 2016
Vitamin D status increases during healthy mammalian pregnancy, but the molecular determinants rem... more Vitamin D status increases during healthy mammalian pregnancy, but the molecular determinants remain uncharacterized. The first objective of this study was to determine the effects of pregnancy, and the second objective was to examine the role of chronic hypoxia on vitamin D status and metabolism in an ovine model. We analyzed the plasma levels of cholecalciferol, 25-OH-D, and 1α,25-(OH)2D in nonpregnant ewes, near-term pregnant ewes, and their fetuses exposed to normoxia (low altitude) or hypoxia (high-altitude) for 100 days. Hypoxic sheep had increased circulating levels of 25-OH-D and 1α,25-(OH)2D compared with normoxic sheep. Hypoxia increases in 25-OH-D were associated with increased expression of renal 25-hydroxylases CYP2R1 and CYP2J. Pregnancy did not increase further the plasma levels of 25-OH-D, but it significantly increased those of the active metabolite, 1α,25-(OH)2D, in both normoxic and hypoxic ewes. Increased bioactivation of vitamin D correlated with increased expre...
![Research paper thumbnail of Accuracy of Sonographic Fetal Biometry Measurements [26M]](https://attachments.academia-assets.com/94417999/thumbnails/1.jpg)
](Obstetrics & Gynecology, 2016
Of the 308 patients who were included in the study, 129 (41.8%) were found have adenomyosis Of th... more Of the 308 patients who were included in the study, 129 (41.8%) were found have adenomyosis Of these 129 patients with adenomyosis, 45 (34.8%) had a preoperative TVUS performed by an expert sonographer. Expert guided TVUS had a 71.43% sensitivity for extensive adenomyosis as diagnosed on pathology using the following sonographic criteria: enlarged uterus, globular shape of uterine body, asymmetry between anterior and posterior myometrium walls, heterogeneity of myometrium with anechoic and hyperechoic areas, microcystic diverticular areas in myometrium, blurred transitional zone between endometrium and myometrium. Routine guided TVUS had a 14.29% sensitivity for diagnosis of adenomyosis using no specific criteria for diagnosis. CONCLUSION: Expert guided TVUS has increased sensitivity when diagnosing adenomyosis compared to routine TVUS. Expert guided TVUS sensitivity is increased further in specimens with extensive disease. A grading system might be evaluated to improve the overall diagnosis of adenomyosis by stratifying its degree of likelihood compared to the extent of the disease.
American Journal of Obstetrics and Gynecology, 2016
OBJECTIVE: Fetal gastroschisis is associated with SGA in up to 25% of cases. Our objective was to... more OBJECTIVE: Fetal gastroschisis is associated with SGA in up to 25% of cases. Our objective was to determine the predictive utility of third trimester biometric measurements for detecting SGA at delivery. STUDY DESIGN: A retrospective review of fetal gastroschisis cases from two institutions (Loma Linda University and Stanford University) was conducted. For the current study, cases with a third trimester ultrasound exam within 2 weeks of delivery were included. Both institutions use a Hadlock formula for the estimation of fetal weight (EFW) including BPD, HC, AC and FL. Maternal demographic data and individual ultrasound parameters were compared between those with and without SGA at delivery (defined as birth weight less than 10% for gestational age). Distribution of normality was evaluated by the Shapiro-Wilk test. Outcomes were evaluated using chi-squared test and Mann-Whitney U-test as appropriate. Logistic regression analysis was used to estimate the probability of SGA using individual parameters and the overall EFW. RESULTS: Of 178 gastroschisis cases, 70 underwent an ultrasound exam within 2 weeks of delivery. Of those 16 pregnancies (22.9%) were complicated by SGA. There was no difference in mean maternal age (20.8 vs. 21.6, p¼0.314), the gestational age of the ultrasound exam (35.0 vs. 35.3, p¼0.690), days between the last ultrasound exam and delivery (6.8 vs. 6.7, p¼0.972), or the gestational age of delivery (36.6 vs. 36.5, p¼0.883) between those with and without SGA. Women with SGA neonates had a lower pre-pregnancy BMI (21.2 vs. 30.6, p¼0.013). There were also statistically significant differences between the total EFW, the BPD, HC, the AC, and FL between those with and without SGA. However, neither the total EFW or individual biometric measurements were found to be predictive of SGA. CONCLUSION: Women with SGA neonates at birth were more likely to have lower BMI prior to pregnancy. However, neither the overall EFW or individual biometric parameters were predictive of SGA at delivery in cases of fetal gastroschisis.
The Journal of Maternal-Fetal & Neonatal Medicine, 2015
To investigate the association between meconium staining and perinatal and neonatal outcomes in p... more To investigate the association between meconium staining and perinatal and neonatal outcomes in pregnancies with gastroschisis. Retrospective analysis of infants with prenatally diagnosed gastroschisis born in two academic medical centers between 2008 and 2013. Neonatal outcomes of deliveries with and without meconium staining were compared. Primary outcome was defined as any of the following: neonatal sepsis, prolonged mechanical ventilation, bowel atresia or death. Secondary outcomes were preterm delivery, preterm-premature rupture of membranes (PPROM) and prolonged hospital length of stay. One hundred and eight infants with gastroschisis were included of which 56 (52%) had meconium staining at delivery. Infants with meconium staining had a lower gestational age at delivery (36.3 (±1.4) versus 37.0 (±1.2) weeks, p = 0.007), and a higher rate of PPROM (25% versus 8%, p = 0.03) than infants without meconium. Meconium staining was not significantly associated with the primary composite outcome or with any of its components. After adjustments, meconium staining remained significantly associated with preterm delivery at &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;36 weeks [odds ratio OR = 4.0, 95% confidence intervals (CI): 1.5-11.4] and PPROM (OR = 3.8, 95%CI: 1.2-14.5). Among infants with gastroschisis, meconium staining was associated with prematurity and PPROM. No significant increase in other adverse neonatal outcomes was seen among infants with meconium staining, suggesting a limited prognostic value of this finding.
Prenatal Diagnosis, 2015
Objectives Neonates with gastroschisis are often small for gestational age (SGA) based on populat... more Objectives Neonates with gastroschisis are often small for gestational age (SGA) based on population nomograms. Our objective was to evaluate the effect of SGA on perinatal and neonatal outcomes in cases of gastroschisis. Methods This is a retrospective study of neonates with prenatally diagnosed gastroschisis from two academic centers between 2008 and 13. Perinatal and neonatal outcomes of neonates with SGA at birth were compared with appropriate-for-gestational-age (AGA) neonates. The primary composite outcome was defined as any of the following: neonatal sepsis, short bowel syndrome at discharge, prolonged mechanical ventilation (upper quartile for the cohort), bowel atresia or death. Results We identified 112 cases of gastroschisis, 25 of whom (22%) were SGA at birth. There were no differences in adverse peripartum outcomes between SGA and AGA infants. No difference was found in the primary composite neonatal outcome (52% vs 36%, p = 0.21), but SGA infants were more likely to have prolonged mechanical ventilation (44% vs 22%, p = 0.04) and prolonged length of stay (LOS) (52% vs 22%, p = 0.007). After adjusting for GA at delivery, SGA remained associated with prolonged LOS (OR = 4.3, CI: 1.6-11.8). Conclusion Among infants with gastroschisis, SGA at birth is associated with a fourfold increase in odds for prolonged LOS, independent of GA.
Cancer Letters, 2014
We have identified a new variant of human Stat5a, found at higher ratios to full-length Stat5a in... more We have identified a new variant of human Stat5a, found at higher ratios to full-length Stat5a in invasive ductal carcinoma versus contiguous normal tissue. The variant, missing exon 5, inhibits p21 and Bax production and increases cell number. After prolactin stimulation, only full-length Stat5a interacts with the vitamin D and retinoid X receptors, whereas only D5 Stat5a interacts with activating protein 1-2 and specificity protein 1. Prolactin also oppositely regulates interaction of the two Stat5a forms with b-catenin. We propose that a change in splicing leading to upregulation of this new isoform is a pathogenic aspect of invasive ductal carcinoma.
Current Opinion in Obstetrics & Gynecology
Cervical cancer is a significant women's health problem worldwide. Most cases of cervical can... more Cervical cancer is a significant women's health problem worldwide. Most cases of cervical cancer occur in developing countries that have ineffective screening programs. The incidence and mortality of cervical cancer in the United States have been decreasing in the past 30 years due to widespread screening. In the United States, cervical cancer diagnosis is usually in women who have never received screening or received inadequate screening.[1] Human papillomavirus (HPV) is one of the most common risk factors for cervical cancer. There are over 100 different strains of HPV, and those considered of high risk are involved in the etiology of cancer. Screening guidelines for cervical cancer have been evaluated and adjusted considering the time required for disease progression. Screening methods of cervical cancer include cytology and HPV testing.[2]
The Journal of Maternal-Fetal & Neonatal Medicine, 2019
Journal of perinatology : official journal of the California Perinatal Association, 2017
To assess the accuracy of different sonographic estimated fetal weight (EFW) cutoffs, and combina... more To assess the accuracy of different sonographic estimated fetal weight (EFW) cutoffs, and combinations of EFW and biometric measurements for predicting small for gestational age (SGA) in fetal gastroschisis. Gastroschisis cases from two centers were included. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated for different EFW cutoffs, as well as EFW and biometric measurement combinations. Seventy gastroschisis cases were analyzed. An EFW<10% had 94% sensitivity, 43% specificity, 33% PPV and 96% NPV for SGA at delivery. Using an EFW cutoff of <5% improved the specificity to 63% and PPV to 41%, but decreased the sensitivity to 88%. Combining an abdominal circumference (AC) or femur length (FL) z-score less than -2 with the total EFW improved the specificity and PPV but decreased the sensitivity. A combination of a small AC or FL along with EFW increases the specificity and PPV, but decreases the sensitivity of predicting SGA.
American journal of physiology. Endocrinology and metabolism, Jun 1, 2016
Vitamin D status increases during healthy mammalian pregnancy, but the molecular determinants rem... more Vitamin D status increases during healthy mammalian pregnancy, but the molecular determinants remain uncharacterized. The first objective of this study was to determine the effects of pregnancy, and the second objective was to examine the role of chronic hypoxia on vitamin D status and metabolism in an ovine model. We analyzed the plasma levels of cholecalciferol, 25-OH-D, and 1α,25-(OH)2D in nonpregnant ewes, near-term pregnant ewes, and their fetuses exposed to normoxia (low altitude) or hypoxia (high-altitude) for 100 days. Hypoxic sheep had increased circulating levels of 25-OH-D and 1α,25-(OH)2D compared with normoxic sheep. Hypoxia increases in 25-OH-D were associated with increased expression of renal 25-hydroxylases CYP2R1 and CYP2J. Pregnancy did not increase further the plasma levels of 25-OH-D, but it significantly increased those of the active metabolite, 1α,25-(OH)2D, in both normoxic and hypoxic ewes. Increased bioactivation of vitamin D correlated with increased expre...
Obstetrics & Gynecology, 2016
Of the 308 patients who were included in the study, 129 (41.8%) were found have adenomyosis Of th... more Of the 308 patients who were included in the study, 129 (41.8%) were found have adenomyosis Of these 129 patients with adenomyosis, 45 (34.8%) had a preoperative TVUS performed by an expert sonographer. Expert guided TVUS had a 71.43% sensitivity for extensive adenomyosis as diagnosed on pathology using the following sonographic criteria: enlarged uterus, globular shape of uterine body, asymmetry between anterior and posterior myometrium walls, heterogeneity of myometrium with anechoic and hyperechoic areas, microcystic diverticular areas in myometrium, blurred transitional zone between endometrium and myometrium. Routine guided TVUS had a 14.29% sensitivity for diagnosis of adenomyosis using no specific criteria for diagnosis. CONCLUSION: Expert guided TVUS has increased sensitivity when diagnosing adenomyosis compared to routine TVUS. Expert guided TVUS sensitivity is increased further in specimens with extensive disease. A grading system might be evaluated to improve the overall diagnosis of adenomyosis by stratifying its degree of likelihood compared to the extent of the disease.
American Journal of Obstetrics and Gynecology, 2016
OBJECTIVE: Fetal gastroschisis is associated with SGA in up to 25% of cases. Our objective was to... more OBJECTIVE: Fetal gastroschisis is associated with SGA in up to 25% of cases. Our objective was to determine the predictive utility of third trimester biometric measurements for detecting SGA at delivery. STUDY DESIGN: A retrospective review of fetal gastroschisis cases from two institutions (Loma Linda University and Stanford University) was conducted. For the current study, cases with a third trimester ultrasound exam within 2 weeks of delivery were included. Both institutions use a Hadlock formula for the estimation of fetal weight (EFW) including BPD, HC, AC and FL. Maternal demographic data and individual ultrasound parameters were compared between those with and without SGA at delivery (defined as birth weight less than 10% for gestational age). Distribution of normality was evaluated by the Shapiro-Wilk test. Outcomes were evaluated using chi-squared test and Mann-Whitney U-test as appropriate. Logistic regression analysis was used to estimate the probability of SGA using individual parameters and the overall EFW. RESULTS: Of 178 gastroschisis cases, 70 underwent an ultrasound exam within 2 weeks of delivery. Of those 16 pregnancies (22.9%) were complicated by SGA. There was no difference in mean maternal age (20.8 vs. 21.6, p¼0.314), the gestational age of the ultrasound exam (35.0 vs. 35.3, p¼0.690), days between the last ultrasound exam and delivery (6.8 vs. 6.7, p¼0.972), or the gestational age of delivery (36.6 vs. 36.5, p¼0.883) between those with and without SGA. Women with SGA neonates had a lower pre-pregnancy BMI (21.2 vs. 30.6, p¼0.013). There were also statistically significant differences between the total EFW, the BPD, HC, the AC, and FL between those with and without SGA. However, neither the total EFW or individual biometric measurements were found to be predictive of SGA. CONCLUSION: Women with SGA neonates at birth were more likely to have lower BMI prior to pregnancy. However, neither the overall EFW or individual biometric parameters were predictive of SGA at delivery in cases of fetal gastroschisis.
The Journal of Maternal-Fetal & Neonatal Medicine, 2015
To investigate the association between meconium staining and perinatal and neonatal outcomes in p... more To investigate the association between meconium staining and perinatal and neonatal outcomes in pregnancies with gastroschisis. Retrospective analysis of infants with prenatally diagnosed gastroschisis born in two academic medical centers between 2008 and 2013. Neonatal outcomes of deliveries with and without meconium staining were compared. Primary outcome was defined as any of the following: neonatal sepsis, prolonged mechanical ventilation, bowel atresia or death. Secondary outcomes were preterm delivery, preterm-premature rupture of membranes (PPROM) and prolonged hospital length of stay. One hundred and eight infants with gastroschisis were included of which 56 (52%) had meconium staining at delivery. Infants with meconium staining had a lower gestational age at delivery (36.3 (±1.4) versus 37.0 (±1.2) weeks, p = 0.007), and a higher rate of PPROM (25% versus 8%, p = 0.03) than infants without meconium. Meconium staining was not significantly associated with the primary composite outcome or with any of its components. After adjustments, meconium staining remained significantly associated with preterm delivery at &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;36 weeks [odds ratio OR = 4.0, 95% confidence intervals (CI): 1.5-11.4] and PPROM (OR = 3.8, 95%CI: 1.2-14.5). Among infants with gastroschisis, meconium staining was associated with prematurity and PPROM. No significant increase in other adverse neonatal outcomes was seen among infants with meconium staining, suggesting a limited prognostic value of this finding.
Prenatal Diagnosis, 2015
Objectives Neonates with gastroschisis are often small for gestational age (SGA) based on populat... more Objectives Neonates with gastroschisis are often small for gestational age (SGA) based on population nomograms. Our objective was to evaluate the effect of SGA on perinatal and neonatal outcomes in cases of gastroschisis. Methods This is a retrospective study of neonates with prenatally diagnosed gastroschisis from two academic centers between 2008 and 13. Perinatal and neonatal outcomes of neonates with SGA at birth were compared with appropriate-for-gestational-age (AGA) neonates. The primary composite outcome was defined as any of the following: neonatal sepsis, short bowel syndrome at discharge, prolonged mechanical ventilation (upper quartile for the cohort), bowel atresia or death. Results We identified 112 cases of gastroschisis, 25 of whom (22%) were SGA at birth. There were no differences in adverse peripartum outcomes between SGA and AGA infants. No difference was found in the primary composite neonatal outcome (52% vs 36%, p = 0.21), but SGA infants were more likely to have prolonged mechanical ventilation (44% vs 22%, p = 0.04) and prolonged length of stay (LOS) (52% vs 22%, p = 0.007). After adjusting for GA at delivery, SGA remained associated with prolonged LOS (OR = 4.3, CI: 1.6-11.8). Conclusion Among infants with gastroschisis, SGA at birth is associated with a fourfold increase in odds for prolonged LOS, independent of GA.
Cancer Letters, 2014
We have identified a new variant of human Stat5a, found at higher ratios to full-length Stat5a in... more We have identified a new variant of human Stat5a, found at higher ratios to full-length Stat5a in invasive ductal carcinoma versus contiguous normal tissue. The variant, missing exon 5, inhibits p21 and Bax production and increases cell number. After prolactin stimulation, only full-length Stat5a interacts with the vitamin D and retinoid X receptors, whereas only D5 Stat5a interacts with activating protein 1-2 and specificity protein 1. Prolactin also oppositely regulates interaction of the two Stat5a forms with b-catenin. We propose that a change in splicing leading to upregulation of this new isoform is a pathogenic aspect of invasive ductal carcinoma.
Current Opinion in Obstetrics & Gynecology