Paradigm Shift: A Meta-Narrative Review Of The Intricacies And Complications That Led To Changes In Standard Protocols For Primary Human Papillomavirus Screenings, Hillary L. Campbell, Sara N. Fernandez, Elysse S. Hodges, Jonathan J. Del Real, Mary Coolbaugh-Murphy Phd, Denise M. Juroske Short Phd

Research Methods Poster Session 2024

Objective:

To evaluate cervical cancer screening modalities and assess the reasoning that has led to primary HPV being the preferred target for screening.

Background:

History of HPV infection has been found to be correlated with cervical cancer precursor cells. Early detection of the infection is advantageous in decreasing the risk for women of reproductive age acquiring cervical cancer. The general consensus places an emphasis on implementing HPV testing in accordance with cervical cancer protocol.

Methods:

Six methodical reviews of cervical cancer screenings were done through PubMed and the M.D. Anderson Research library. Each article was evaluated to include recently published …

Pessary Use In Urology Clinics, Kathy Z. Lu Bs, Emily Brodowsky Md, Alex Stephens Ms, Samantha Raffee Md, Humphrey Atiemo Md

Medical Student Research Symposium

Introduction: Pessaries are a non-invasive treatment option for patients with pelvic organ prolapse (POP) or stress urinary incontinence (SUI). There is currently limited data regarding pessary usage among urology patients. The aim of this study is to determine the patient characteristics that predict long term pessary usage versus surgical intervention.

Methods: A 10-year retrospective review of pessary usage in women with either SUI or POP was performed. Patients were stratified into pessary longevity of less than or greater than one year. Quality of life measures before and after pessary use included pads per day, incontinence symptom index (ISI) scores, and …

Clinical Pathway Using Arabic Written Medical Information To Improve Incontinence Healthcare Utilization, John F. Knapp, Codrut Radoiu, Emma Ross, Jack Vercnocke Md, Aron Liaw Md, Nivedita Dhar

Medical Student Research Symposium

Introduction and Objective: Metro Detroit holds ~13% of all Arabic speakers in the U.S.A. and 91% of those in Michigan. Evidence supports that patients who do not speak the local language have poor access to healthcare. This study describes our preliminary experience of managing Arabic only speaking women with bothersome stress urinary incontinence (SUI) from May 2022 to October 2023. These women routinely request same-sex interpreters, which is not always possible, leading to a lack of detailed translation. A potential solution is to use Arabic written medical information (AWMI). The purpose of the study was to retrospectively look at the …

Impaired Neutrophil Extracellular Trap-Forming Capacity Contributes To Susceptibility To Chronic Vaginitis In A Mouse Model Of Vulvovaginal Candidiasis, Junko Yano, Paul L. Fidel

School of Dentistry Faculty Publications

Vulvovaginal candidiasis (VVC), caused by is characterized by aberrant inflammation by polymorphonuclear neutrophils (PMNs) in the vaginal lumen. Data from the established murine model shows that despite potent antifungal properties, PMNs fail to clear due to local heparan sulfate that inhibits the interaction between PMNs and , resulting in chronic vaginal immunopathology. To understand the role of neutrophil extracellular traps (NETs) in defense against at the vaginal mucosa, we investigated the NET-forming capacity of PMNs in chronic VVC-susceptible (CVVC-S/C3H) and -resistant (CVVC-R/CD-1) mouse strains. Immunofluorescence revealed the formation of NETs (release of DNA with PMN-derived antimicrobial proteins) in PMN cocultures …

Evaluating The Effect Of Maternal Non-Communicable Disease On Adverse Pregnancy Outcomes And Birthweight In Pakistan, A Facility Based Retrospective Cohort Study, Esther Wainwright, Sheikh Irfan Ahmed, Rahat Qureshi, Sana Yousuf, Raheela Khan, Matthew Elmes

Department of Obstetrics & Gynaecology

Non-communicable diseases (NCDs) claim 74% of global lives, disproportionately affecting lower and middle-income countries like Pakistan. NCDs may increase the risk of preterm birth (PTB), caesarean section (CS), and low birthweight. This study aims to determine whether the high prevalence of NCDs in Pakistan play a role in the high rates of preterm births, and CS. This retrospective cohort study from Aga Khan University Hospital, Pakistan, investigated effects of pre-existing NCDs on pregnancy outcomes of 817 pregnant women. Medical records were used to generate odds ratios for the risk of PTB, labour outcome and birthweight in women with type 1 …

A Case Report And Evaluation Of Intrauterine Gas Of Unknown Origin, Chrystal Stallworth, Diane Gilbertson, Timothy Kremer

North Texas Research Forum 2024

Introduction: Most reports of intrauterine or endometrial gas have been reported in the setting of underlying gynecologic malignancy or infection. The significance of this case report is to give a presentation of a patient presenting with intrauterine gas who subsequently was found to have neither infectious nor malignant cause for such finding. Case Presentation: Patient is a 56 year old postmenopausal female who presenting with “hip pain” and was found to have incidental intrauterine gas on pelvic CT. She underwent in office and outpatient hysteroscopies with resection of a submucosal fibroid. Her final pathology was returned as benign and …

Sunitinib Induced Gomerular Thrombotic Microangiopathy, Aisha Khan

Gulf Coast Division Research Day 2024

No abstract provided.

Four Cesarean Scar Pregnancies Managed At Accreta Center Of Excellence At Medical City Dallas Hospital: A Case Series, Ana Adams, Nicole Tenzel, Monica Rodriguez, Robert Cohen

North Texas Research Forum 2024

Cesarean Scar Pregnancy results from pathologic implantation of a gestational sac into a hysterotomy scar. This rare disease continues to increase in incidence due to the rise of Cesarean delivery in the United States. Current management recommendations by the Society of Maternal Fetal Medicine (SMFM) include termination of pregnancy, or in rare instances, hysterectomy. This case series examines four patients diagnosed with Cesarean Scar Pregnancies that either declined termination or were unable to receive abortion services in the first trimester, and who were managed at the Accreta Center of Excellence at Medical City Dallas Hospital. This novel management strategy included …

Folate Deficiency Modifies The Risk Of Cin3+ Associated With Dna Methylation Levels: A Nested Case–Control Study From The Ascus-Col Trial, María C. Agudelo, Samuel Agudelo, Attila Lorincz, Arianis Tatiana Ramírez, Kelly Melisa Castañeda, Isabel Garcés-Palacio, Arnold H. Zea, Chandrika Piyathilake, Gloria Ines Sanchez

School of Medicine Faculty Publications

Purpose: To our knowledge, there are very few studies evaluating if the levels of folate modify the risk of cervical intraepithelial neoplasia grade 2 and higher (CIN2+ and CIN3+) associated with the levels of HPV genome methylation, two cofactors related to single carbon metabolism and independently associated with cervical cancer in previous studies. We conducted a case–control study nested in a three-arm randomized clinical pragmatic trial (ASCUS-COL trial) to evaluate the risk of CIN3+ associated with methylation levels according to serum folate concentrations. Methods: Cases (n = 155) were women with histologically confirmed CIN2+ (113 CIN2, 38 CIN3, and 4 …

The Effects Of Night Shift Work On Heart, Gut, And Reproductive Health, A Systematic Review, Courtney Grayson, Preeti Oza

Pacific Journal of Health

Night shift work, a commonplace in today’s society, creates a variety of health-related challenges for individuals who participate in it. Often, the only adverse health effects discussed in relation to night shift work are sleep dysfunction and mental health issues. This systematic review examined the cardiovascular, gastrointestinal, and fertility health effects that plague individuals working night shift. The goal of this work is to illuminate these lesser known, but equally important, health effects in an effort to bring awareness to the issues. By educating night shift workers and health care providers of the acute risks associated with this type of …

A Case Of A Retroperitoneal Leiomyoma During Total Laparoscopic Hysterectomy, Bruce Lee, Mohamad Mahmoud

Advances in Clinical Medical Research and Healthcare Delivery

Retroperitoneal leiomyomas are rare clinical entities and poses clinical and therapeutic challenges to the benign gynecologist. We present the case of a 51 year-old gravida 2 para 2 with symptomatic leiomyomas undergoing definitive surgical management with total laparoscopic hysterectomy. Intraoperatively, a retroperitoneal mass in the pelvic side was identified, excised, and removed from the abdominal cavity without complications. Final pathology confirmed a leiomyoma.

Vaginal Preparation In Cesarean Delivery To Decrease Surgical Site Infections: A Benchmark Study, Angelica Ware

MSN Capstone Projects

This benchmark project intends to decrease the rate of surgical site infections related to cesarean procedures with vaginal preparation through an evidence-based approach. Vaginal preparation is a simple technique that cleanses the vaginal walls by removing microorganisms. The goal of the benchmark project is to promote the implementation of a vaginal preparation policy across any healthcare facility that performs cesarean procedures. Vaginal preparation is intended for scheduled cases, add-on cases, and urgent cases. The benchmark study does not include emergent cesarean deliveries, as vaginal preparation is at the discretion of the physician in those cases.

The topic of surgical site …

The Silence Of Mitotic Figures, Hope K. Haefner Md

Patient Experience Journal

A career in medicine is guided by the patients you treat and those who have taught you to treat these individuals. Communication is of utmost importance in all aspects of healthcare. However, there are times when communication can be difficult. This story takes you through a physician’s experience that led to a career in women’s healthcare, reflecting on the silence that prevailed as her journey began.

Experience Framework

This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/).

• Access other PXJ articles related to this lens.
• Access other resources related …

Tumor-Resident Lactobacillus Iners Confer Chemoradiation Resistance Through Lactate-Induced Metabolic Rewiring, Lauren E. Colbert, Molly B. El Alam, Rui Wang, Tatiana Karpinets, David Lo, Erica J. Lynn, Timothy A. Harris, Jacob H. Elnaggar, Kyoko Yoshida-Court, Katarina Tomasic, Julianna K. Bronk, Julie Sammouri, Ananta V. Yanamandra, Adilene V. Olvera, Lily G. Carlin, Travis Sims, Andrea Y. Delgado Medrano, Tatiana Cisneros Napravnik, Madison O'Hara, Daniel Lin, Chike O. Abana, Hannah X. Li, Patricia J. Eifel, Anuja Jhingran, Melissa Joyner, Lilie Lin, Lois M. Ramondetta, Andrew M. Futreal

School of Medicine Faculty Publications

Tumor microbiota can produce active metabolites that affect cancer and immune cell signaling, metabolism, and proliferation. Here, we explore tumor and gut microbiome features that affect chemoradiation response in patients with cervical cancer using a combined approach of deep microbiome sequencing, targeted bacterial culture, and in vitro assays. We identify that an obligate L-lactate-producing lactic acid bacterium found in tumors, Lactobacillus iners, is associated with decreased survival in patients, induces chemotherapy and radiation resistance in cervical cancer cells, and leads to metabolic rewiring, or alterations in multiple metabolic pathways, in tumors. Genomically similar L-lactate-producing lactic acid bacteria commensal to other …

The Dual Delivery Of Y15 And Metformin In A Plga Scaffold For The Treatment Of Platinum Resistant Ovarian Cancer, Emily M. Jordan, Hannah Obregon, Arkene Levy, Sue Anne Chew

Research Symposium

Background: Ovarian cancer is the fifth leading cause of cancer mortality among women in the US. High mortality is linked to resistance to platinum compounds. Currently there is no treatment for platinum resistant ovarian cancer (OCpt). Platinum resistance shows increased activity of focal adhesion kinase (FAK). Y15 is a FAK inhibitor and increases OCpt sensitivity to chemotherapy. Metformin induces apoptosis, has no increased cytotoxicity, and works synergistically with Y15 in OCpt cells. Biomaterial scaffolds deliver drugs locally, maximizing drug concentration and bioavailability while minimizing systemic toxicity. PLGA copolymer has excellent biocompatibility, versatility, and a tailorable degradation rate. The objective of …

Educational Case: Endometrial Ectopia In Endometriosis And Adenomyosis, Carolyn G. Chen, Joanna S.Y. Chan

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

No abstract provided.

Outpatient Sexually Transmitted Infection Testing And Treatment Patterns In The United States: A Real-World Database Study, Rebecca Lillis, Louis Kuritzky, Zune Huynh, Rodney Arcenas, Avneet Hansra, Roma Shah, Baiyu Yang, Stephanie N. Taylor

School of Medicine Faculty Publications

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the most common notifiable sexually transmitted infections (STIs) in the United States. Because symptoms of these infections often overlap with other urogenital infections, misdiagnosis and incorrect treatment can occur unless appropriate STI diagnostic testing is performed in clinical settings. The objective of this study was to describe STI diagnostic testing and antimicrobial treatment patterns and trends among adolescent and adult men and women with lower genitourinary tract symptoms (LGUTS). Methods: We analyzed insurance claims data from the IBM® MarketScan® Research Databases. Patients included were between 14 and 64 years old with …

Encouraging Human Papillomavirus Vaccine Uptake: A Healthcare Improvement Project, Lauren E. Woll

Dissertations

Abstract

Problem: Human papillomaviruses are the causative agents of >95% of cervical cancers, most oropharyngeal and anogenital cancers, yet the vaccination status of the population remains critically low despite Gardasil9 offering robust protection against HPV-related disease.

Methods: This quality improvement project utilized a descriptive, observational design to assess the effect of the HPV Encouragement Bundle, a two-step intervention to improve HPV vaccine uptake. Quantitative data was collected via retrospective chart review to assess the effect of the intervention on first-dose administration of Gardasil9 (series initiation), as well as overall Gardasil9 vaccine uptake.

Results: Following implementation, Gardasil9 first dose uptake increased …

Time Is Ticking For Cervical Cancer, Vijay Kumar, Caitlin Bauer, John H. Stewart

School of Medicine Faculty Publications

Cervical cancer (CC) is a major health problem among reproductive-age females and comprises a leading cause of cancer-related deaths. Human papillomavirus (HPV) is the major risk factor associated with CC incidence. However, lifestyle is also a critical factor in CC pathogenesis. Despite HPV vaccination introduction, the incidence of CC is increasing worldwide. Therefore, it becomes critical to understand the CC tumor immune microenvironment (TIME) to develop immune cell-based vaccination and immunotherapeutic approaches. The current article discusses the immune environment in the normal cervix of adult females and its role in HPV infection. The subsequent sections discuss the alteration of different …

A Novel Gardnerella, Prevotella, And Lactobacillus Standard That Improves Accuracy In Quantifying Bacterial Burden In Vaginal Microbial Communities, Jacob H. Elnaggar, Caleb M. Ardizzone, Nuno Cerca, Evelyn Toh, Paweł Łaniewski, Rebecca A. Lillis, Melissa M. Herbst-Kralovetz, Alison J. Quayle, Christina A. Muzny, Christopher M. Taylor

School of Graduate Studies Faculty Publications

Bacterial vaginosis (BV) is the most common vaginal dysbiosis. In this condition, a polymicrobial biofilm develops on vaginal epithelial cells. Accurately quantifying the bacterial burden of the BV biofilm is necessary to further our understanding of BV pathogenesis. Historically, the standard for calculating total bacterial burden of the BV biofilm has been based on quantifying Escherichia coli 16S rRNA gene copy number. However, E. coli is improper for measuring the bacterial burden of this unique micro-environment. Here, we propose a novel qPCR standard to quantify bacterial burden in vaginal microbial communities, from an optimal state to a mature BV biofilm. …