Medicine and Health Sciences Commons^™

Relationship Between Maternal Methadone Dose At Delivery And Neonatal Abstinence Syndrome., Neil S., Seligman, Christopher V. Almario, Edward J. Hayes, Kevin C. Dysart, Vincenzo Berghella, Jason K. Baxter

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: To estimate the relationship between maternal methadone dose and the incidence of neonatal abstinence syndrome (NAS).

STUDY DESIGN: We performed a retrospective cohort study of pregnant women treated with methadone for opiate addiction who delivered live-born neonates between 1996 and 2006. Four dose groups, on the basis of total daily methadone dose, were compared (160 mg/d). The primary outcome was treatment for NAS. Symptoms of NAS were objectively measured with the Finnegan scoring system, and treatment was initiated for a score>24 during the prior 24 hours.

RESULTS: A total of 330 women treated with methadone and their 388 …

Pregnancy Outcomes In Female Liver Recipients Transplanted Under The Age Of 21, Carlo B. Ramirez, Warren R. Maley, Cataldo Doria, Lisa A. Coscia, Michael J. Moritz, Vincent T. Armenti

Department of Surgery Faculty Papers

Conclusions: Liver recipients transplanted under the age of 21 are able to maintain pregnancy with 75% resulting in a livebirth. Pregnancy, potential risks for mother and newborn, and long-term maternal survival should be discussed with the recipient and the parents of the recipient. Transplant centers are encouraged to report pregnancy outcomes in these recipients to the NTPR.

Body Mass Index And Cerclage Success, A. Suhag, Md, N. S. Seligman, Md, V. Berghella, Md

Department of Obstetrics and Gynecology Faculty Papers

Conclusions:

Among women with a cerclage, pre-pregnancy BMI was not a significant predictor of SPTB <35 weeks.

There was a non-significant trend toward increased rates of SPTB at all gestational age cutoffs.

Morbidly obese women consistently had worse outcomes than obese and normal/overweight women.

Compared to normal/overweight, GA at delivery decreases by 1 week for obese and 2 weeks for morbidly obese women.

Recent Change In The Incidence Of Cervical Cerclage, Maria Bisulli, Md, Neil S. Seligman, Md, Komal Soin, Ms, Anju Suhag, Md, Vincenzo Berghella, Md

Department of Obstetrics and Gynecology Faculty Papers

Conclusions:

More selective indications for cervical cerclage based on recent randomized studies were associated with decreased cerclage placement.

The decrease in incidence of history-indicated cerclage may be due to the fact that more women with prior PTB are being followed by transvaginal cervical length measurements.

The decrease in incidence of ultrasound-indicated cerclage may be due to the use of 17-hydroxy progesterone caproate in women with PTB.

The Use Of The Use Of Negative Pressure Wound Therapy In Vulvar Wounds, E. K. Ricci, Md, J. Brace, Phd, Crn, Bc, Cwocn, Aprn, N. G. Rosenblum, Md, Phd

Department of Obstetrics and Gynecology Faculty Papers

Patients with severe HS or Necrotizing Fasciitis often require extensive surgical debridement.

Traditionally, these wounds have been closed using split-thickness skin grafts with or without the use of the VAC device.

Our case study demonstrates good outcomes using the VAC device alone to achieve complete closure when applied immediately following debridement with frequent VAC changes.

Duration Of Maternal Human Papilloma Virus Infection And Risk Of Spontaneous Preterm Birth, K. Soin, Ms, N. S. Seligman, Md, A. Nnoli, Md, K. Dysart, Md, J. K. Baxter, Md, Mscp

Department of Obstetrics and Gynecology Faculty Papers

Conclusions:

Duration of HPV infection was not a significant risk factor for spontaneous PTB <37 weeks.

Cervical HPV DNA and HPV serology may further delineate the relationship between HPV infection and SPTB <37 weeks.

A larger sample size may be necessary to show a difference.

The 3.5x higher rate of fetal death > 23 weeks in our study (compared to fetal death > 20 weeks in the U.S.) needs further investigation.

Biological Impact Of Geometric Uncertainties: What Margin Is Needed For Intra-Hepatic Tumors?, Hsiang-Chi Kuo, Wen-Shan Liu, Andrew Wu, Dennis Mah, Keh-Shih Chuang, Linda Hong, Ravi Yaparpalvi, Chandan Guha, Shalom Kalnicki

Department of Radiologic Sciences Faculty Papers

BACKGROUND: To evaluate and compare the biological impact on different proposed margin recipes for the same geometric uncertainties for intra-hepatic tumors with different tumor cell types or clinical stages. METHOD: Three different margin recipes based on tumor motion were applied to sixteen IMRT plans with a total of twenty two intra-hepatic tumors. One recipe used the full amplitude of motion measured from patients to generate margins. A second used 70% of the full amplitude of motion, while the third had no margin for motion. The biological effects of geometric uncertainty in these three situations were evaluated with Equivalent Uniform Doses …

The Development And Implementation Of A Curriculum Using Simulation To Teach Interns Basic Invasive Clinical Skills, C. Sultana, K. Berg, J. Kairys, J. Majdan, M. Vergare, D. Berg

Department of Obstetrics and Gynecology Faculty Papers

The ACGME requires that all residents are competent in performing basic invasive clinical procedures. Although simulation models have been used in other programs to teach these skills to interns with the intent to provide training and skills attainment before learning and performing on real patients, a large scale, mandatory simulation training, in which every incoming intern must satisfactorily complete training in a simulation center, prior to starting their intern year, has yet to be described. We describe such a curricular intervention produced in our Simulation Center.

A Novel Curriculum Using Simulation To Teach And Assess Indications And Technique Of Handwashing To Gme Learners, K. Berg, C. Sultana, R. Sorokin, J. Kairys, M. Vergare, D. Berg

Department of Obstetrics and Gynecology Faculty Papers

Proficiency in the clinical skill of effective hand washing is integral to high quality health care. Studies at our hospital revealed that in 2008, of 1215 direct, anonymous, observations of residents and attendings, only 53.3% washed their hands correctly during clinical activities. Medical students in fiscal year 2009 (July 1, 2008-June 30 2009) had a 52% compliance rate from 109 observations. This data prompted our hospital to work with the faculty of the University Clinical Skills and Simulation Center (UCSSC) to develop a module on the indications and technique of effective handwashing. This intervention, using multimedia simulation was introduced to …