Medicine and Health Sciences Commons^™

Contemporary Analysis Of Reexcision And Conversion To Mastectomy Rates And Associated Healthcare Costs For Women Undergoing Breast-Conserving Surgery, Youngran Kim, Cecilia Ganduglia-Cazaban, Nina Tamirisa, Anthony Lucci, Trudy Millard Krause

Journal Articles

PURPOSE: This study was designed to provide a comprehensive and up-to-date understanding of population-level reoperation rates and incremental healthcare costs associated with reoperation for patients who underwent breast-conserving surgery (BCS).

METHODS: This is a retrospective cohort study using Merative™ MarketScan

RESULTS: The commercial cohort included 17,129 women with a median age of 55 (interquartile range [IQR] 49-59) years, and the Medicare cohort included 6977 women with a median age of 73 (IQR 69-78) years. Overall reoperation rates were 21.1% (95% confidence interval [CI] 20.5-21.8%) for the commercial cohort and 14.9% (95% CI 14.1-15.7%) for the Medicare cohort. In both cohorts, …

Ectopic Pregnancy Located At Pelvic Wall And Liver: Two Uncommon Case Reports From Vietnam And Mini-Review Literature, Thanh Hai Pham, Van Hoang Bui, Van Hung Nguyen, Phuc Nhon Nguyen

Journal Articles

INTRODUCTION AND IMPORTANCE: Abdominal ectopic pregnancy (AEP) located at hepatic region and pelvic-wall ectopic pregnancy (EP) are rare entities, that provoking a potentially life-threatening condition. Due to insufficient data, a proper management of non-specific types remains a challenge for all gynecologists worldwide.

CASE PRESENTATION: Two child-bearing age women were hospitalized due to delayed menstruation and a urine pregnancy test was positive without a determination of intrauterine pregnancy. The first EP case was located at the pelvic wall which identified incidentally during laparoscopy for a presumed tubal ectopic pregnancy on ultrasonography throughout. The second EP case was found at the hepatic …

When Intervention Becomes Imperative: A Case Report Of Spontaneous Vulvar Edema During Pregnancy, Vo Anh Vinh Trang, Thao-Ngan Nguyen Pham, Bao Huy Le, Thien Tan Tri Tai Truyen, Hoang Kim Tu Trinh, Kieu-Minh Le, Huu Doan Pham, Ngoc Minh Tam Nguyen, Quoc Kha Tran, Phuc Cam Hoang Nguyen, Vinh Hung Tran

Journal Articles

Spontaneous idiopathic vulvar edema during the second trimester is a rare condition. The approach to managing this condition involves relieving symptoms, identifying underlying causes, and implementing appropriate treatment. Managing such cases during pregnancy is challenging because of concerns for potential adverse fetal outcomes. Conservative management expects the condition to be relieved spontaneously postpartum, whereas invasive treatment offers a more rapid resolution. Treatment choices are controversial because each method has its pros and cons and influences the delivery process to a certain extent. Surgical drainage becomes a viable option when patients are not responsive to medications. We report a case of …

Hypertension In Pregnancy Among Immigrant And Swedish Women: A Cohort Study Of All Pregnant Women In Sweden, Per Wändell, Casey Crump, Xinjun Li, Nouha Saleh Stattin, Axel C Carlsson, Jan Sundquist, Kristina Sundquist

Journal Articles

BACKGROUND: Little is known about risks of hypertensive disorders of pregnancy in both first- and second-generation immigrant women in Europe and other Western countries; such knowledge may help elucidate the influence of genetic versus social factors on such risks. We aimed to study both first- and second-generation immigrant women for the presence of all types of hypertension (preexisting hypertension, gestational hypertension, preeclampsia, and eclampsia) during pregnancy.

METHODS AND RESULTS: A cohort study was conducted using data derived from the Swedish National Birth Register, the National Patient Register, and the total Population Register. We used Cox regression analysis to compute hazard …

Pregnancy-Related Factors Responsible For Delivering Low Birth Weight Babies: An Institutional-Based Cross-Sectional Study, Jamnagar, Gujarat, Harsh K Patel, Jitesh P Mehta, Bela A Patel, Rohitkumar Ram, Dipesh V Parmar

Journal Articles

BACKGROUND: The WHO defines LBW as "Birth weight less than 2500 grams" regardless of gestational age. Being born with a low birth weight also incurs enormous economic costs, including higher medical expenditures and social service expenses, and decreased productivity in adulthood.

OBJECTIVE: To study distribution of newborns' according to pregnancy related factors and its association with newborns' birth weight.

METHODS: An institutional based cross-sectional study. New-borns delivered at study institute were considered as study participants. Estimated final sample size was 500. Guardians (mothers) were face-to-face interviewed and also recorded data were collected from the case file and Mother and Child …

Physical Activity, Anthropometric Measurements, Quality Of Life And Menopausal Symptoms Among South-Indian Women, Lavanya N, Sathyaprabha B

Journal Articles

INTRODUCTION: Menopause is the period when the reproductive capacity ceases in women's life. A wide range of symptoms occur as a consequence of estrogen decrease during menopause. Evidence suggests that physically active women have a better quality of life (QoL) and fewer menopausal symptoms. The aim of the study was to analyze the relationship between physical activity (PA), anthropometric measurements, QoL and menopausal symptoms.

MATERIAL AND METHOD: A cross-sectional study was conducted online through WhatsApp and Facebook and via email among menopausal women (April 2021 - June 2021). In total 168 responses were received; 153 responses were included in the …

Disparities In Fertility-Sparing Treatment And Use Of Assisted Reproductive Technology After A Diagnosis Of Cervical, Ovarian, Or Endometrial Cancer, Kirsten Jorgensen, Clare Meernik, Chi-Fang Wu, Caitlin C Murphy, Valerie L Baker, Peiton Jarmon, Paula C Brady, Roni Nitecki, Hazel B Nichols, Jose Alejandro Rauh-Hain

Journal Articles

OBJECTIVE: to assess the presence of sociodemographic and clinical disparities in fertility-sparing treatment and assisted reproductive technology (ART) use among patients with a history of cervical, endometrial, or ovarian cancer.

METHODS: We conducted a population-based cohort study of patients aged 18-45 years who were diagnosed with cervical cancer (stage IA, IB), endometrial cancer (grade 1, stage IA, IB), or ovarian cancer (stage IA, IC) between January 1, 2000, and December 31, 2015, using linked data from the CCR (California Cancer Registry), the California Office of Statewide Health Planning and Development, and the Society for Assisted Reproductive Technology. The primary outcome …

Disparities In The Use Of Assisted Reproductive Technologies After Breast Cancer: A Population-Based Study, Clare Meernik, Kirsten Jorgensen, Chi-Fang Wu, Caitlin C Murphy, Valerie L Baker, Paula C Brady, Roni Nitecki, Hazel B Nichols, J Alejandro Rauh-Hain

Journal Articles

PURPOSE: Equitable access to oncofertility services is a key component of cancer survivorship care, but factors affecting access and use remain understudied.

METHODS: to describe disparities in assisted reproductive technology (ART) use among women with breast cancer in California, we conducted a population-based cohort study using linked oncology, ART, and demographic data. We identified women age 18-45 years diagnosed with invasive breast cancer between 2000 and 2015. The primary outcome was ART use-including oocyte/embryo cryopreservation or embryo transfer-after cancer diagnosis. We used log-binomial regression to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) to identify factors associated with ART …

Using Implementation Mapping To Increase Uptake And Use Of Salud En Mis Manos: A Breast And Cervical Cancer Screening And Hpv Vaccination Intervention For Latinas, Lara S Savas, Preena Loomba, Ross Shegog, Angelita Alaniz, Crystal Costa, Emily Adlparvar, Marlyn A Allicock, Roshanda Chenier, Margaret Goetz, Christine M Markham, Maria E Fernandez

Journal Articles

BACKGROUND: Despite CDC recommendations for breast and cervical cancer screening and HPV vaccination, cancer control behaviors are underutilized among low-income Latinas.

METHODS: We used Implementation Mapping to create SEMM-Dissemination and Implementation Assistance (SEMM-DIA), a set of implementation strategies designed to support implementation and maintenance of SEMM in clinic settings. Specifically, we used Implementation Mapping's five iterative tasks to guide the use of theories and frameworks, evidence, new data, and stakeholder input to develop strategies to accelerate and improve implementation fidelity, reach, and maintenance of the SEMM intervention. The resulting implementation mapping logic model also guides the SEMM-DIA evaluation plan to …

Do Breast Cancer Survivors With A Recent History Of Clinical Depression Report Worse Experiences With Care? A Retrospective Cohort Study Using Seer-Cahps Data, Mariana Arevalo, Trevor A Pickering, Sally W Vernon, Kayo Fujimoto, Melissa F Peskin, Albert J Farias

Journal Articles

PURPOSE: We examined whether breast cancer survivors' experiences with care differed by a recent history of clinical depression, and whether associations differed by race/ethnicity.

METHODS: Using the Epidemiology and End Results-Consumer Assessment of Healthcare Providers and Systems (SEER-CAHPS) dataset, we analyzed records of breast cancer survivors who completed a survey at least 12 months after their cancer diagnosis. We assessed clinical depression 12 months prior to survey completion using Medicare claims. We used separate multivariable logistic regressions to examine the associations between depression and excellent (vs. less than excellent) ratings of experiences with care (i.e., doctor communication, getting needed care, …

Assessing Urinary Phenol And Paraben Mixtures In Pregnant Women With And Without Gestational Diabetes Mellitus: A Case-Control Study, Wei-Jen Chen, Candace Robledo, Erin M Davis, Jean R Goodman, Chao Xu, Jooyeon Hwang, Amanda E Janitz, Tabitha Garwe, Antonia M Calafat, Jennifer D Peck

Journal Articles

Prior studies have identified the associations between environmental phenol and paraben exposures and increased risk of gestational diabetes mellitus (GDM), but no study addressed these exposures as mixtures. As methods have emerged to better assess exposures to multiple chemicals, our study aimed to apply Bayesian kernel machine regression (BKMR) to evaluate the association between phenol and paraben mixtures and GDM. This study included 64 GDM cases and 237 obstetric patient controls from the University of Oklahoma Medical Center. Mid-pregnancy spot urine samples were collected to quantify concentrations of bisphenol A (BPA), benzophenone-3, triclosan, 2,4-dichlorophenol, 2,5-dichlorophenol, butylparaben, methylparaben, and propylparaben. Multivariable …

Potential Impact Of Revised Nci Eligibility Criteria Guidance: Prior Malignancy Exclusion In Breast Cancer Clinical Trials, Matthew Perez, Caitlin C Murphy, Sandi L Pruitt, Sawsan Rashdan, Asal Rahimi, David E Gerber

Journal Articles

BACKGROUND: Many individuals with cancer have survived a prior cancer and for this reason may have been excluded from clinical trials. Recent NCI guidance recommends including these individuals, especially when the risk of the prior malignancy interfering with either safety or efficacy endpoints is very low. Using breast cancer as an example, we determined the potential effect this policy change may have on clinical trial accrual.

PATIENTS AND METHODS: We reviewed protocols of NCI-sponsored breast cancer clinical trials activated in 1991 through 2016. We quantified prevalence of prior cancer-related exclusion criteria and assessed the association with trial characteristics using Fisher's …

Inclusion Of Pregnant Individuals Among Priority Populations For Coronavirus Disease 2019 Vaccination For All 50 States In The United States., A. Grünebaum, L. B. Mccullough, A. Litvak, F. A. Chervenak

Journal Articles

No abstract provided.

Professionally Responsible Coronavirus Disease 2019 Vaccination Counseling Of Obstetrical And Gynecologic Patients, F. A. Chervenak, L. B. Mccullough, E. Bornstein, L. Johnson, A. Katz, R. Mcleod-Sordjan, M. Nimaroff, B. L. Rochelson, A. Tekbali, A. Warman, K. Williams, A. Grünebaum

Journal Articles

© 2021 Elsevier Inc. The development of coronavirus disease 2019 vaccines in the current and planned clinical trials is essential for the success of a public health response. This paper focuses on how physicians should implement the results of these clinical trials when counseling patients who are pregnant, planning to become pregnant, breastfeeding or planning to breastfeed about vaccines with government authorization for clinical use. Determining the most effective approach to counsel patients about coronavirus disease 2019 vaccination is challenging. We address the professionally responsible counseling of 3 groups of patients—those who are pregnant, those planning to become pregnant, and …

Fetal Interventions In The Setting Of The Coronavirus Disease 2019 Pandemic: Statement From The North American Fetal Therapy Network, Mo Bahtiyar, A Baschat, J Deprest, S Emery, Wh Goodnight, A Johnson, L Mccullough, Js Moldenhauer, G Ryan, M Zaretsky, +3 Additional Authors

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No abstract provided.

Fetal Diagnosis And Therapy During The Covid-19 Pandemic: Guidance On Behalf Of The International Fetal Medicine And Surgery Society, J Deprest, M Choolani, F Chervenak, D Farmer, K Lagrou, E Lopriore, L Mccullough, O Olutoye, L Simpson, G Ryan, +1 Additional Author

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No abstract provided.

Pregnant Vs Nonpregnant Severe Acute Respiratory Syndrome Coronavirus 2 And Coronavirus Disease 2019 Hospital Admissions: The First 4 Weeks In New York, A Tekbali, A Grünebaum, A Saraya, L Mccullough, E Bornstein, Fa Chervenak

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No abstract provided.

Which Country Is Truly Developed? Covid-19 Has Answered The Question, Js Freed, Sy Kwon, Hj El, M Gottlieb, R Roth

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No abstract provided.

Maternal Mortality Among Women With Covid-19 Admitted To The Intensive Care Unit., Mj Blitz, B Rochelson, N Meirowitz, L Prasannan, Tj Rafael, S Chakravarthy, La Bracero, Sw Wasden, Sl Pachtmanshetty, O Santandreu, Fa Chervenak, Bm Schwartz, M Nimaroff, +2 Additional Authors

Journal Articles

No abstract provided.

Intensive Care Unit Admissions For Pregnant And Nonpregnant Women With Coronavirus Disease 2019, M J. Blitz, A Grünebaum, A Tekbali, E Bornstein, B Rochelson, M Nimaroff, Fa Chervenak

Journal Articles

No abstract provided.

Adherence And Acceptability Of Telehealth Appointments For High Risk Obstetrical Patients During The Covid-19 Pandemic., S. Jeganathan, L. Prasannan, M. J. Blitz, N. Vohra, B. Rochelson, N. Meirowitz

Journal Articles

Background:Telehealth has been successfully implemented for the delivery of obstetrical care. However, little is known regarding the attitudes and acceptability of patients and providers in high risk obstetrics and if implementation improves access to care in non-rural settings. Objective:The study aims to: 1) Describe patient and provider attitudes toward telehealth for delivery of high risk obstetrical care in a large health care system with both urban and suburban settings. 2) Determine if implementation of a telehealth model improves patient adherence to scheduled appointments in this patient population.Study DesignTwo self-administered surveys were designed. The first survey was sent to all high-risk …

Myocardial Injury Associated With Coronavirus Disease 2019 In Pregnancy., S. L. Pachtman Shetty, N. Meirowitz, M. J. Blitz, T. Gadomski, C. R. Weinberg

Journal Articles

OBJECTIVE:Coronavirus disease 2019 (COVID-19) is associated with cardiac injury1-3 and bradycardia4 in the non-pregnant population. The incidence of these complications in pregnancy is unknown. The objective of this study was to determine the rate of abnormal serum cardiac biomarkers or bradycardia among pregnant and immediately postpartum women admitted for treatment of severe or critical COVID-19 in a large integrated health system in New York. STUDY DESIGN:This is a retrospective review of all pregnant and immediately postpartum women hospitalized for COVID-19 at 7 hospitals within Northwell Health, the largest academic health system in New York state, from March 1 to April …

Pregnancy And Neonatal Outcomes In Sars-Cov-2 Infection: A Systematic Review., R. S. Chamseddine, F. Wahbeh, F. Chervenak, L. J. Salomon, B. Ahmed, A. Rafii

Journal Articles

With the emergence of SARS-CoV-2 and its rapid spread, concerns regarding its effects on pregnancy outcomes have been growing. We reviewed 245 pregnancies complicated by maternal SARS-CoV-2 infection across 48 studies listed on PubMed and MedRxiv. The most common clinical presentations were fever (55.9%), cough (36.3%), fatigue (11.4%), and dyspnea (12.7%). Only 4.1% of patients developed respiratory distress. Of all patients, 89.0% delivered via cesarean section (n = 201), with a 33.3% rate of gestational complications, a 35.3% rate of preterm delivery, and a concerning 2.5% rate of stillbirth delivery or neonatal death. Among those tested, 6.45% of newborns were …

Race/Ethnicity And Spatiotemporal Trends In Sars-Cov-2 Prevalence On Obstetrical Units In New York., M. J. Blitz, B. Rochelson, L. Prasannan, W. Shan, F. A. Chervenak, M. Nimaroff, E. Bornstein

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No abstract provided.

Severe Acute Respiratory Syndrome Coronavirus 2 Antibodies In Pregnant Women Admitted To Labor And Delivery Units., L. Haizler-Cohen, A. Davidov, M. J. Blitz, G. Fruhman

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No abstract provided.

Teaching Professional Formation In Response To The Covid-19 Pandemic., L. B. Mccullough, J. Coverdale, F. A. Chervenak

Journal Articles

In response to the COVID-19 pandemic, the Association of American Medical Colleges has called for a temporary suspension of clinical teaching activities for medical students. Planning for the continued involvement of learners in patient care during this pandemic should include teaching learners professional formation. The authors provide an ethical framework to guide such teaching, based on the ethical principle of beneficence and the professional virtues of courage and self-sacrifice from professional ethics in medicine. The authors show that these concepts support the conclusion that learners are ethically obligated to accept reasonable, but not unreasonable, risk. Based on this ethical framework, …

Universal Testing For Coronavirus Disease 2019 In Pregnant Women Admitted For Delivery: Prevalence Of Peripartum Infection And Rate Of Asymptomatic Carriers At Four New York Hospitals Within An Integrated Healthcare System., M. J. Blitz, B. Rochelson, A. C. Rausch, R. Solmonovich, W. Shan, A. Combs, M. Nimaroff

Journal Articles

No abstract provided.

Racial And Ethnic Disparity And Spatiotemporal Trends In Severe Acute Respiratory Syndrome Coronavirus 2 Prevalence On Obstetrical Units In New York., M. J. Blitz, B. Rochelson, L. Prasannan, W. Shan, F. A. Chervenak, M. Nimaroff, E. Bornstein

Journal Articles

No abstract provided.

Gog 244-The Lymphedema And Gynecologic Cancer (Leg) Study: Incidence And Risk Factors In Newly Diagnosed Patients, J. W. Carlson, J. Kauderer, A. Hutson, J. Carter, J. Armer, S. Lockwood, S. Nolte, B. R. Stewart, L. Wenzel, R. R. Barakat, +9 Additional Authors

Journal Articles

© 2019 Elsevier Inc. Objectives: To evaluate the incidence and risk factors for lymphedema associated with surgery for gynecologic malignancies on GOG study 244. Methods: Women undergoing a lymph node dissection for endometrial, cervical, or vulvar cancer were eligible for enrollment. Leg volume was calculated from measurements at 10-cm intervals starting 10 cm above the bottom of the heel to the inguinal crease. Measurements were obtained preoperatively and postoperatively at 4–6 weeks, and at 3-, 6-, 9-, 12-, 18-, and 24- months. Lymphedema was defined as a limb volume change (LVC) ≥10% from baseline and categorized as mild: 10–19% LVC; …

Detection Of High-Risk Human Papillomavirus Rna In Urine For Cervical Cancer Screening With Hpv 16 & 18/45 Genotyping, R. R. Padhy, A. Davidov, L. Madrigal, G. Alcide, A. Spahiu

Journal Articles

© 2020 The Authors Objective: To detect high-risk human papillomavirus (hrHPV) messenger-RNA (mRNA) in urine samples, compare their concordance with cervical samples including HPV 16 & 18/45 genotyping, and to determine the utility in detecting ≥ CIN 2 lesions. Methods: A cohort of 189 non-pregnant patients (age ≥ 25) was recruited in three groups: Group 1 with abnormal pap-smears and hrHPV positivity, Group 2 with normal pap-smears and hrHPV positivity, and Group 3 with normal pap-smears and hrHPV negativity. Urine samples were tested for hrHPV-mRNA and subsequent hrHPV-mRNA genotype if positive. High-risk HPV detection and genotyping were performed using Aptima …