Ovarian hyperstimulation syndrome in a spontaneous pregnancy with a complete hydatidiform mole.

OBJECTIVE: To present a case of ovarian hyperstimulation syndrome occurring after evacuation of a spontaneously conceived hydatidiform molar pregnancy. DESIGN: Case report. SETTING: University-affiliated teaching hospital. PATIENT(S): A 19-year-old nulliparous woman who underwent vacuum curettage for a complete hydatidiform molar pregnancy was admitted to our hospital with ovarian hyperstimulation syndrome and large bilateral pleural effusions. INTERVENTION(S): Intravenous fluid, deep vein thrombosis prophylaxis, placement of bilateral chest tubes. MAIN OUTCOME MEASURE(S): Management of ovarian hyperstimulation syndrome. RESULT(S): Ultrasonography and computed tomography showed large multicystic ovaries, marked ascites, and large pleural effusions that required placement of bilateral chest tubes. She had recovered by hospital day 14. CONCLUSION(S): Ovarian hyperstimulation syndrome may develop in women who have undergone treatment for a hydatidiform mole, and serious complications may develop rapidly.

Relationship of obesity to outcome of medical abortion.

OBJECTIVE: The purpose of this study was to compare the outcome of medical abortion for obese women and nonobese women. STUDY DESIGN: We conducted a chart review of women having medical abortions in 2005-2007. Outcomes were classified as surgical intervention, need for additional visits, and complete abortion. The rate of surgical intervention was compared for women with BMI less than 30 to women with BMI greater than 30. RESULTS: Of the 1202 eligible procedures using mifepristone and misoprostol, there were 861 women with BMI less than 30 and 341 women with BMI greater than 30. Women with BMI less than 30, and women with BMI greater than 30 had identical rates of surgical intervention, 5% and 6%, respectively (P = .72). CONCLUSION: In light of the additional risks of surgical abortion to obese women, medical abortion should be considered for these women.

Absorption classification of oral drugs based on molecular surface properties.

The aim of this study was to investigate whether easily calculated and comprehended molecular surface properties can predict drug solubility and permeability with sufficient accuracy to allow theoretical absorption classification of drug molecules. For this purpose, structurally diverse, orally administered model drugs were selected from the World Health Organization (WHO)'s list of essential drugs. The solubility and permeability of the drugs were determined using well-established in vitro methods in highly accurate experimental settings. Descriptors for molecular surface area were generated from low-energy conformations obtained by conformational analysis using molecular mechanics calculations. Correlations between the calculated molecular surface area descriptors, on one hand, and solubility and permeability, on the other, were established with multivariate data analysis (partial least squares projection to latent structures (PLS)) using training and test sets. The obtained models were challenged with external test sets. Both solubility and permeability of the druglike molecules could be predicted with high accuracy from the calculated molecular surface properties alone. The established correlations were used to perform a theoretical biopharmaceutical classification of the WHO-listed drugs into six classes, resulting in a correct prediction for 87% of the essential drugs. An external test set consisting of Food and Drug Administration (FDA) standard compounds for biopharmaceutical classification was predicted with 77% accuracy. We conclude that PLS models of easily comprehended molecular surface properties can be used to rapidly provide absorption profiles of druglike molecules early on in drug discovery.